Perioperative Nursing 001

1.) Which of the following is most dangerous complication during induction of spinal anesthesia?A.)TachycardiaB.)HypotensionC.)HyperthermiaD.)Bradypnea

Ans: B

2.) Which type of surgery is most likely to predispose a patient to postoperative atelectasis, pneumonia or respiratory failure?A.)Upper abdominal surgery on an obese patient with a long history of smokingB.)Upper abdominal surgery on a patient with normal pulmonary functionC.)Lower abdominal surgery on a young patient with diabetes mellitusD.)Surgery on the extremities of a nonsmoking football player

Ans: A

3.) Which of the following characterizes excitement stage of anesthesiaA.) Occurs from the administration of anesthesia to the loss of consciousnessB.) Extends from the loss of consciousness to the loss of lid reflex, characterized by struggling and talkingC.) From the loss of lid reflex to the loss of most reflexesD.) From the loss of most reflexes to respiratory and circulatory failure

Ans: B

4.) To prevent headache after spinal anesthesia the patient should be positioned:A.) Semi-fowler’sB.) Flat on bed for 6 to 8 hoursC.) Prone positionD.) Modified trendelenburg

Ans: B

5.) Which of the following nursing actions should be given highest priority when

admitting the patient into the operating room?A.) Level of consciousnessB.) Vital signsC.) Patient identification and correct operative consentD.) Positioning and skin preparation

Ans: C

6.) What is the primary reason for the gradual change of position of the patient after surgery?A.) To prevent muscle injuryB.) To prevent sudden drop of BPC.) To prevent respiratory distressD.) To promote comfort

Ans: B

7.) Which of the following assessment data is most important to determine when caring for a patient who has received spinal anesthesia?A.) The time of return of motion and sensation in the legs and toesB.) The character of respirationC.) Level of consciousnessD.) Amount of wound drainage

Ans: A

8.) Which of the following postop findings should the nurse report to the M.D.?A.) The patient pushes out the oral airway wit h his toungeB.) Urine output is 20ml/hr for the past two hoursC.) VS are as follows: BP=110/70;PR=95;RR=19,Temp=36.8CD.) Wound drainage is serosanguinous

Ans: B

9.) Which of the following is the earliest sign of poor respiratory function?A.) CyanosisB.) Fast thready pulseC.) RestlessnessD.) Faintness

Ans: C

10.) If wound eviscerations occurs, the immediate nursing action is:A.) Cover the wound with sterile gauze

moistened with sterile NSSB.) Cover the wound with water-soaked gauzeC.) Cover the wound with sterile dry gauzeD.) Leave the wound uncovered and pull the skin edges together

Ans: A

11.) Appendectomy is classified asA.) AblativeB.) ConstructiveC.) ReconstructiveD.) Palliative

Ans: A

12.) The worst of all fears among clients undergoing surgery is:A.) Fear of financial burdenB.) Fear of deathC.) Fear of the unknownD.) Fear of loss of job

Ans: C

13.) The best time to provide preoperative teaching on deep breathing, coughing and turning exercises is:A.) Before administration of preoperative medicationsB.) The afternoon or evening prior to surgeryC.) Several days prior to surgeryD.) Upon admission of the client in the recovery room

Ans: B

14.) The following are the appropriate nursing actions before administration of preoperative medications EXCEPT:A.) Ascertain the consent has been signedB.) Ensure that NPO has been maintainedC.) Instruct patient to empty his bladderD.) Shave the skin at the site of surgery

Ans: D

15.) The patient has been observed pacing along the hallway, goes to the bathroom frequently and asks questions repeatedly during preoperative assessment. The most likely cause of the behavior is:A.) She is anxious about the surgical procedureB.) She is worried about separation from the

familyC.) She has urinary tract infectionD.) She has an underlying emotional problem

Ans: A

16.) Which of the following nursing actions would help the patient decrease anxiety during the preoperative period?A.) Explaining all procedures thoroughly in chronological orderB.) Spending time listening to the patient and answering questionsC.) Encouraging sleep and limiting interruptionsD.) Reassuring the patient that the surgical staff are competent professional

Ans: B

17.) Which of the following is the primary purpose of maintaining NPO for 6 to 8 hours before surgery?A.) To prevent malnutritionB.) To prevent electrolyte imbalanceC.) To prevent aspiration pneumoniaD.) To prevent intestinal obstruction

Ans: C

18.) The following ensure validity of informed written consent EXCEPT:A.) The patient is of legal age with proper mental dispositionB.) The consent has been secured within 24 hours before the surgeryC.) If the patient is unable to write, secure the consent from a relativeD.) The consent is secured before administration of any medication that alter the level of consciousness

Ans: C

19.) Which of the following drugs is administered to minimize respiratory secretions preop?A.) Valium (Diazepam)B.) Nubain ( Nalbuphine HCL)C.) Phenergan (Promethazine)D.) Atropine Sulfate

Ans: D

20.) Which of the following is experienced by the patient who is under spinal anesthesia?

A.) The patient is unconsciousB.) The patient is awakeC.) The patient experiences amnesiaD.) The patient experiences total loss of sensation

Ans: B

21.) The patient who has undergone TAHBSO complains of pain. Which of the following is an initial nursing action?A.) Administer the PRN analgesicsB.) Instruct to do deep breathing exercisesC.) Assess the VSD.) Change the patient’s position

Ans: C

22.) How frequent should the nurse monitor the VS of the patient in the recovery room?A.) Every 15 minutesB.) Every 30 minsC.) Every 45 minsD.) Every 60 mins

Ans: A

23.) Which of the following drugs is given to relieve nausea and vomiting?A.) MepivacaineB.) AquamephytonC.) NubainD.) Plasil

Ans: D

24.) The most important factor in the prevention of postop infection is:A.) Proper administration of antibioticsB.) Fluid intake of 2-3L/dayC.) Practice of strict aseptic techniquesD.) Frequent change of wound dressings

Ans: C

25.) Which of the following primarily prevents postop complications?A.) Adequate fluid intakeB.) Early ambulationC.) Well-balanced dietD.) Administration of antimicrobials

Ans: B

Situation: A female client, 23 y/o was

admitted for the first time at the Fatima Hospital with the chief complaint of Right Iliac Pain, accompanied by nausea and vomiting, chills and fever. She was diagnosed to have acute appendicitis. She was scheduled to have emergency appendectomy under spinal anesthesia

26.) Pre-op instructions to the client would include the following EXCEPT:A.) Deep breathing and coughing exerciseB.) Turning to sidesC.) Foot and leg exercisesD.) reassuring her that narcotics will be given every 4 hours round the clock until she is discharged

Ans: D

27.) The client gave her consent for the surgery. To ensure the legality of the consent, the following conditions must be met EXCEPT:A.) She gave her consent freelyB.) She must understand the nature of the surgeryC.) The consent must be signed by a witnessD.) Signing should be done after the administration of pre-anesthesia meds

Ans: D

28.) The skin is shaved prior to surgery in order to:A.) Facilitate skin incisionB.) Indicate the site to be drapedC.) To prevent wound infectionD.) Reduce post op scarring

Ans: C

29.) The important nursing intervention prior to administration of pre-anesthetic medication is:A.) Ask patient to empty the bladderB.) Do deep breathing and coughing exercisesC.) Regulate IVF accuratelyD.) Shave the skin

Ans: A

30.) Immediately following spinal anesthesia, the greatest risk is:A.) Severe hemorrhageB.) Severe Hypotension

C.) Severe HypoglycemiaD.) Hypertensive crisis

Ans: B

31.) Nursing measures to promote the client’s respiratory function during recovery from anesthesia are the following EXCEPT:A.) Encourages deep breathing and coughing exercisesB.) Administer Humidified oxygenC.) Place in semi-fowlers positionD.) Place in supine position with head turned to the side without pillow support

Ans: C

32.) Which of the following criteria must be met before the client is released from the RR to the unit.A.) Breathes with ease, coughs freelyB.) Has regained consciousnessC.) Vital signs fluctuates erraticallyD.) Able to move four extremities

Ans: C

33.) Early signs of poor respiratory function include which of the following A.) CyanosisB.) HypotensionC.) Loss of consciousnessD.) Restlessness

Ans: D

34.) Post operatively, the client must be encouraged to turn, cough and deep breathe:A.) Every 1-2 hoursB.) Every 4 hoursC.) Every 30 MinsD.) Every 8 hours

Ans: A

35.) A client in shock must be placed in:A.) High-fowlers positionB.) Sim’s positionC.) Modified trendelenburgD.) Prone position

Ans: C

36.) The most important factor in the prevention of post op wound infection is:A.) Adequate fluid intake

B.) Proper administration of antibioticsC.) Practice of strict aseptic techniqueD.) Frequent cleaning of the wound

Ans: C

37.) When the patient vomits, the most important nursing objective is to prevent:A.) DehydrationB.) AspirationC.) Rupture of suture lineD.) Met. Alkalosis

Ans: B

38.) Post operatively, a patient is expected to void after:A.) 6-8 hoursB.) 2-4 hoursC.) 12-24 hoursD.) 10-12 hours

Ans: A

39.) Headache after spinal anesthesia is due to:A.) Paralysis of vasomotor nervesB.) Traction placed on structures within abdomenC.) Loss of CSF through dural holeD.) Administration of large amounts and heavy concentration of anesthetic agents

Ans: C

40.) Nursing measures for post-op thrombophlebitis include the following EXCEPT:A.) Maintain bedrestB.) Elevate affected leg with pillow supportC.) Massage the painful extremitiesD.) Apply antiembolic stockings

Ans: C

41.) Nursing measures to relieve hiccups include the following EXCEPT:A.) Exhale and inhale through a paper bagB.) Apply pressure over the eyeball through closed eye lidsC.) Hold breath while taking a large pulp of waterD.) Administer high concentration of oxygen

Ans: D

42.) Modified radical mastectomy involves:A.) Removal of the entire breast, axillary lymph nodes, pectoralis muscleB.) Removal of the lump of the breastC.) Removal of the entire breast, axillary and neck lymph nodes, including pectoralis musclesD.) Removal of the entire breast but nipple remains intact

Ans: A

43.) Which of the following is not appropriate nursing intervention after modified radical mastectomy?A.) Place in semi fowler’s position and elevate arm on the affected side with pillow supportB.) Check behind the client for bleedingC.) Monitor output from wound suction drainageD.) Immobilize the arm on affected side in adduction

Ans: D

44.) A fluid challenge is begun with a post-op gastric surgery client. Which assessment will give the best indication of client response to this treatment?A.) CVP readings and hourly urine outputB.) Blood pressure and apical rate checksC.) Lung sounds and arterial blood gasesD.) Electrolytes, BUN, creatinine results

Ans: A

45.) A client is scheduled for a subtotal gastrectomy. In anticipation of clarifying information for client education, the nurse knows that vagotomy is done as part of the surgical treatment for peptic ulcers in order toA.) Decrease secretion of hydrochloric acidB.) Improve the tone of the GI musclesC.) Increase blood supply to the jejunumD.) Prevent the transmission of pain impulses

Ans: A

46.) Which of the following facts best explains why the duodenum is not removed during a subtotal gastrectomy?A.) The head of the pancreas is adherent to the duodenal wall

B.) The common bile duct empties into the duodenal lumenC.) The wall of the jejunum contains no intestinal villiD.) The jejunum receives its blood supply through the duodenum

Ans: B

47.) During the immediate postoperative period following gastric surgery, why must the nurse be particularly conscientious about encouraging a client to cough and deep-breathe at regular intervals?A.) Marked changes in intrathoracic pressure will stimulate gastric drainageB.) The high abdominal incision will lead to shallow breathing to avoid painC.) The phrenic nerve will have been permanently damaged during the surgical procedureD.) Deep-breathing will prevent post op vomiting and intestinal distention

Ans: B

48.) Prior to having a subtotal gastrectomy, a client is told about the dumping syndrome. The nurse explains that it is:A.) The body’s absorption of toxins produced by liquefaction of dead tissueB.) Formation of an ulcer at the margin of the gastrojejunal anastomosisC.) Obstruction of venous flow from the stomach into the portal systemD.) Rapid emptying of food and fluid from the stomach into the jejunum

Ans: D

49.) Which of the following statements by a client recovering from a subtotal gastrectomy would indicate a need for additional teaching about the diet protocol for dumping syndrome?A.) “I plan to eat a diet low in carbohydrates and high in protein and fat”B.) “I plan to eat a diet high in CHO and low in CHON and fat”C.) “I will eat slowly and avoid drinking fluids during meals”D.) “I will try to assume a recumbent position after meals for 30 mins to 1 hour to enhance digestion and relieve symptoms

Ans: B

50.) A 40 y/o female client has arrived in the post anesthesia room following a cholecystectomy and a common bile duct exploration. She is semi conscious. Her vital signs are within normal limits. Which of the following nursing actions would be inappropriate?A.) Apply a warm blanket to her bodyB.) Place her in a semi-fowler’s positionC.) Attached her T-tube to gravity drainageD.) Set up low, intermittent suction for her NGT

Ans: B