Question 1

Which of the following interventions can the nurse perform to reduce the risk of infection after the patient has been transferred to the surgical unit?

Accepted Answer

To reduce the risk of infection in the postoperative period, the nurse should remove the indwelling catheter as soon as possible. Keeping a catheter in place longer than necessary provides a medium for bacterial growth in the urinary tract and bladder. The nurse should not remove the catheter before it is warranted, but once the patient is able to ambulate and get to the bathroom, the catheter may need to be removed to reduce infection.

Question 2

The patient is transferred from the operating room to the PACU and upon initial assessment, tells the nurse, "I feel like I'm going to throw up." Which of the following is the most appropriate response from the nurse?

Accepted Answer

The nurse should respond by saying, "I'm going to turn you on your side now." This action is appropriate for a patient who can turn: if they vomit, they will avoid aspirating stomach contents. The nurse should respond quickly to patient statements of nausea or vomiting. Vomiting stomach contents could lead to aspiration into the lungs and breathing difficulties.

Question 3

Which of the following is important for the nurse to teach the patient prior to having a fiberoptic colonoscopy?

Accepted Answer

It is important for the nurse to teach the patient having a fiberoptic colonoscopy that the lavage solution may be ingested orally or through a nasogastric tube. This solution cleans and prepares the bowel so the physician can visualize the internal structures during the procedure. The patient typically needs to refrain from all medications after the cleansing solution and may need to limit fluids for one to two days before the procedure.

Question 4

When starting an intravenous line, the nurse holds the needle with the bevel up before penetrating the skin. What is the rationale for this practice?

Accepted Answer

The rationale for holding the needle with the bevel up is that it is less traumatic to the skin. The needle inserted in this position may penetrate the skin more easily and is less likely to cause damage to the skin or the vein. This practice may also make starting an intravenous line easier for the nurse without marking the skin or causing bleeding at the site.

Question 5

Which of the following is not a nursing intervention for a patient with a diagnosis of anxiety related to the surgical procedure?

Accepted Answer

The nurse who is caring for a patient with a diagnosis of anxiety related to the surgical procedure should not simply call a social worker to come and stay with the patient. The nurse should try to remain with the patient as much as possible in order to help them verbalize anxious feelings and to prepare them for the surgery. Teaching the patient relaxation techniques and minimizing outside distractions can also help to relieve anxiety.

Question 6

What type of appearance should the nurse expect to see in a patient with polycythemia who presents for surgery?

Accepted Answer

A patient who presents with polycythemia will have a ruddy-blue appearance in the face, hands and feet. Polycythemia results in increased numbers of red blood cells and pooling of the blood in some of the capillaries. The condition may also lead to increased white blood cell counts and platelet counts. A patient with polycythemia may complain of itchy skin or have symptoms of phlebitis as well.

Question 7

What is the purpose of administering an enema to a patient prior to some types of surgical procedures?

Accepted Answer

The purpose of administering an enema to a patient prior to some types of surgery is that it prevents the patient from defecating during the surgical procedure. Because of anesthesia, the patient may not have control of their bowels during surgery and may be more likely to pass stool. Administering an enema clears the bowel and reduces the likelihood that this may occur.

Question 8

Which of the following tests measures coagulation by assessing fibrinogen and clotting factors V, VII, and X?

Accepted Answer

The prothrombin time is a test that measures coagulation by assessing fibrinogen and clotting factors V, VII, and X. This type of test may be performed in at-risk patients to determine clotting abilities, outcomes of certain types of medication, and risk factors for surgery. The patient with decreased coagulation may need to have surgery postponed, depending on the procedure.

Question 9

The nurse is performing a preoperative assessment on a patient and notes that they have a heart murmur. When assessing intensity of a cardiac murmur, what question should the nurse ask themself?

Accepted Answer

When assessing intensity of a cardiac murmur, the nurse should ask themself how loud is the murmur? Intensity measures the volume of the murmur and is typically graded from a very soft, grade I murmur to a loud grade VI. The nurse can identify the intensity of the murmur by auscultating with a stethoscope and then notifying the physician of their findings.

Question 10

Which of the following is a benefit of using depilatory cream as part of skin preparation before a surgical procedure?

Accepted Answer

The benefits of using depilatory cream as part of skin preparation before a surgical procedure are that the skin at the surgical site remains intact and that in some situations, the patient may apply the cream to themself. Depilatory cream avoids cutting or shaving for hair removal, which keeps the skin intact and less prone to infection. It is easy to apply and in some personal situations, the patient may feel more comfortable applying the cream themself.

Question 11

The term used to describe anesthesia that includes a mixture of a hypnotic-sedative, a narcotic, a muscle relaxant and inhalation medication is called:

Accepted Answer

The term used to describe anesthesia that includes a mixture of a hypnotic-sedative, a narcotic, a muscle relaxant and inhalation medication is called balanced anesthesia. This type of anesthesia produces effects similar to that of general anesthesia. It is most commonly used in surgical situations where the patient needs universal anesthesia for sleep.

Question 12

Which of the following actions should be performed with instruments that are difficult to clean and have been used on a patient with Creutzfeldt-Jakob disease?

Accepted Answer

When handling instruments that are difficult to clean after being used on a patient with Creutzfeldt-Jakob disease, the nurse should begin decontamination by using a steam autoclave. This disease is fatal and may be transmitted between patients through surgical instruments. The prion that is associated with this disease is extremely difficult to eradicate with conventional methods of sterilization and without following proper protocol, could actually be fixated further to infected instruments.

Question 13

Which of the following practices disrupts the integrity of the sterile field?

Accepted Answer

Setting up supplies ahead of time and covering them with sterile towels for protection may disrupt the integrity of the sterile field. If sterile instruments are set up in advance, the nurse may be unaware if something in the environment occurs that compromises the sterile field. Covering with towels and then later uncovering them may also inadvertently usher in more microorganisms through air currents or increase the risk of the items becoming wet.

Question 14

Which type of complication occurs most commonly with a vertical midline incision of the abdomen?

Accepted Answer

The most common type of complication that occurs with a vertical midline incision of the abdomen is wound dehiscence and evisceration. This can occur due to increased pressure on the suture line, causing the wound to open and abdominal organs to protrude. It is more commonly associated with patients who are obese or who have diabetes.

Question 15

What conditions are considered indications for a surgical vitrectomy?

Accepted Answer

Two examples that are indications for a surgical vitrectomy are severe diabetic retinopathy and a foreign object in the eye. A vitrectomy is performed by removing part or all of the vitreous humor. It is indicated in situations where the procedure will preserve the patient's sight. Retinopathy and a retained foreign body in the eye both put the patient at risk of vision loss due to potential membrane formation in the eye.

Question 16

Which of the following are potential outcomes of hypothermia in a patient during a surgical procedure? Choose all that apply.

Accepted Answer

Potential outcomes of hypothermia in a patient during a surgical procedure include increased bleeding during surgery and slow wound healing. Maintenance of normal body temperature is an essential nursing intervention during the surgical process. The nurse must remain aware of potential factors that can contribute to hypothermia during surgery.

Question 17

Halothane and enflurane are examples of what types of anesthetic agents?

Accepted Answer

Halothane and enflurane are examples of inhalation anesthetic agents. These substances are volatile liquid anesthetics that work when the patient inhales them in their gaseous form. They typically work very rapidly but require close monitoring of heart rate and respiratory status.

Question 18

Which of the following practices can the nurse perform to reduce air contamination during the perioperative setting?

Accepted Answer

In order to reduce air contamination during the perioperative setting, the nurse can keep doors closed while in the operating suite and avoid excessive movement between rooms. Some types of microorganisms can travel through air currents and ventilation systems, and frequently opening and closing doors could potentially move pathogens into the room. This can be particularly dangerous for the patient having a surgical procedure if their body cavity is exposed.

Question 19

When performing a sponge count during a surgical procedure, which aspects should be included in the documentation?

Accepted Answer

When documenting a sponge count during a surgical procedure, the nurse should record who performed the count and the results of the count. The number of times a count must be performed during a procedure is up to the policy of the hospital. Counting sponges and recording the correct counts, or action taken if counts are incorrect, documents that the surgical staff took every measure to reduce the chances of a sponge being left in a patient's body.

Question 20

At what points should medications be checked before being administered to a patient?

Accepted Answer

Medication should be checked three different times before administration: when the drug is brought out for use, when the drug is drawn up, and when the drug is administered. Surgical nurses have several opportunities to routinely check medications as part of the administration process. Because drug errors can be detrimental to the patient's health and safety, the nurse should routinely check drugs before giving them to the patient.

Quiz 1: Essential Nursing Considerations During the Perioperative Period