Exam 4 (Ch 37 Test Questions)

Question 1

1. The preoperative phase encompasses which period of time?
   1) Entry to the operating suite until admission to postanesthesia care
   2) Entry into the operating suite until discharge from the hospital
   3) The decision to have surgery until admission to postanesthesia care
   4) The decision to have surgery until entry to the operating suite

Answer 1

4

Question 2

2. A 2-year-old child is scheduled for a tonsillectomy. When determining the plan of care, the nurse should:
   1) Include the parents or caregivers in the plan of care.
   2) Explain to the child that she will have a sore throat after surgery.
   3) Tell the child that she can have her favorite foods for the first 24 hours after surgery.
   4) Prepare the child for discharge from the hospital as soon as she is alert.

Answer 2

1

Question 3

3. Which of the following is the most appropriate nursing goal for a 2-year-old who is to have a tonsillectomy?
   1) Separation anxiety will be minimal.
   2) The child will verbalize understanding of expected pain.
   3) The child will tolerate a normal diet 24 hours after surgery.
   4) The parent will indicate readiness to assume the child’s care.

Answer 3

1

Question 4

4. The focus of nursing activities in the preoperative phase is to:
   1) Admit the patient to the surgical suite.
   2) Prepare the patient mentally and physically for surgery.
   3) Set up the sterile field in the operating room.
   4) Perform the primary surgical scrub to the surgical site.

Answer 4

2

Question 5

5. A patient is scheduled for abdominal surgery tomorrow. While gathering preoperative data, the nurse learns that the patient takes the following medications daily: an anticoagulant, a multivitamin, and vitamin E 1,500 IU. The patient reports that he stopped taking the anticoagulant 4 days ago as instructed by the surgeon. He has continued to take the multivitamin and vitamin E. Based on the information given, the nurse telephones the surgeon because she:
   1) Needs an order to restart the anticoagulant.
   2) Iis concerned about continued use of the multivitamin.
   3) Is concerned about the vitamin E dosage.
   4) Thinks the surgery should be delayed until further notice.

Answer 5

3

Question 6

6. A patient is admitted for hip surgery. The patient usually takes the following medications daily: an anticoagulant, a multivitamin, and vitamin E 1,500 IU. He stopped taking his anticoagulant 4 days ago as instructed by his surgeon, but has continued to take the multivitamin and vitamin E. An important collaborative problem or nursing diagnosis for this patient is which of the following?
   1) Potential complication: anemia
   2) Risk for infection related to inadequate anticoagulant dosage
   3) Risk for noncompliance related to inability to follow instructions
   4) Potential complication: increased bleeding

Answer 6

4

Question 7

7. A patient is admitted from a local skilled nursing facility to the outpatient surgery center for surgical débridement of a stage IV sacral pressure ulcer. The perioperative nurse discovers that the patient does not have a signed consent form for the surgery on the chart or in the surgery center. The patient says that she has not talked to the surgeon and that she has many questions regarding her surgery. When informed of this, the surgeon tells the nurse to have the patient sign the informed consent form, and he will review it prior to the surgery. What should the nurse do?
   1) Follow the surgeon’s orders, and ask the patient to sign the surgical consent form.
   2) Inform the surgeon that she will have the patient sign after he discusses the surgery with the patient.
   3) Ensure that the signed surgical consent is witnessed by two nurses, because the surgeon is not available.
   4) Cancel the surgery and transfer the patient back to the long-term care facility.

Answer 7

2

Question 8

8. Identify the type of surgery a terminally ill patient will undergo if the purpose is removal of tissue to relieve pain.
   1) Procurement
   2) Ablative
   3) Palliative
   4) Diagnostic

Answer 8

3

Question 9

9. A patient had a hiatal hernia repair earlier today and is now in the postanesthesia care unit (PACU). The family asks the nurse why the patient is in the PACU rather than back in his room on the postsurgical unit. The nurse should inform the family that:
   1) Patients who have had surgical complications are observed in the PACU until they are stable enough to return to the floor.
   2) Patients recover from the effects of anesthesia in the PACU and then return to the postsurgical unit for further care.
   3) The PACU is a holding area for patients awaiting a surgical unit bed or awaiting adequate staff to provide care on the postsurgical unit.
   4) The nurse will ask the surgeon explain to them why the patient is not on the postsurgical unit, as is the usual procedure.

Answer 9

2

Question 10

10. The focus of nursing care in the intraoperative phase is to:
    1) Prepare the patient for surgery.
    2) Maintain the sterile field.
    3) Ensure patient safety during the surgery.
    4) Obtain a signed informed consent.

Answer 10

3

Question 11

11. The nurse has a prescription to give a series of medications on an “on call” basis. The nurse realizes that these medications will be given:
    1) In the postanesthesia recovery unit.
    2) At the time specified in the order.
    3) On the patient’s arrival in the surgery suite.
    4) When the OR staff notify the nurse to do so.

Answer 11

4

Question 12

12. A patient has chronic confusion secondary to dementia. As a result, he is unable to sign an informed consent for surgery. In this situation:
    1) An informed consent is not needed.
    2) Two nurses may sign the informed consent for the patient.
    3) The surgeon must sign the informed consent.
    4) A family member will be asked to sign the informed consent.

Answer 12

4

Question 13

13. The patient tells the nurse, “I’m so nervous. I want to be knocked out for the surgery so that I don’t know what is going on.” When the nurse communicates with the surgeon and anesthetist, she tells them that the patient desires which type of anesthesia?
    1) Conscious sedation
    2) General anesthesia
    3) Local anesthesia
    4) Regional anesthesia

Answer 13

2

Question 14

14. A patient is to have a sequential compression device (SCD) applied on the postoperative unit. The patient is wearing knee-high elastic (antiembolism) stockings. When applying the SCD, what should the nurse do?
    1) Remove the antiembolism stockings and not replace them.
    2) Replace the knee-high stockings with thigh-high stockings.
    3) Notify the surgeon that the patient is wearing antiembolism stockings.
    4) Apply the SCD over the knee-high antiembolism stockings.

Answer 14

4

Question 15

1. Surgeries are commonly classified by which of the following? Choose all that apply.
   1) Acuity
   2) Level of urgency
   3) Length of surgery
   4) Organ involved

Answer 15

1,2

Question 16

2. Which of the following describes the Perioperative Nursing Data Set? Choose all that apply.
   1) A standardized tool for assessing high-risk surgical patients
   2) A standardized vocabulary encompassing all surgical patient outcomes
   3) The first specialized nursing language recognized by the ANA
   4) A standardized language designed to describe the care of perioperative patients

Answer 16

3,4

Question 17

3. The nurse is caring for a patient who had abdominal surgery 3 days ago and will be discharged home later today. The nurse will know that teaching is effective if the patient does which of the following? Choose all that apply.
   1) Describes clinical findings associated with infection
   2) Performs the dressing change as prescribed
   3) Demonstrates freedom from surgical incision pain
   4) Completes the regimen of prescribed antibiotics

Answer 17

1,2,4

Question 18

4. Which of the following members of the operative team use sterile technique during the surgical procedure? Choose all that apply.
   1) Surgeon
   2) Anesthetist
   3) Scrub nurse
   4) Registered nurse first assistant

Answer 18

1,3,4

Question 19

5. Which of the following are potential complications of anesthesia? Choose all that apply.
   1) Hypothermia
   2) Respiratory depression
   3) Cardiovascular compromise
   4) Aspiration

Answer 19

2,3,4

Question 20

6. A young adult woman is scheduled for a bilateral breast reduction under general anesthesia. She is normally healthy and takes no daily medications. Identify the preoperative screening tests appropriate for this patient. Choose all that apply.
   1) Urinalysis
   2) EKG
   3) Creatinine clearance
   4) CBC

Answer 20

1,4

Question 21

7. Identify the desired effects of general anesthesia. Choose all that apply.
   1) Reduction of risk
   2) Analgesia
   3) Amnesia
   4) Muscle relaxation

Answer 21

2,3,4

Question 22

8. The preoperative nurse is preparing a patient for surgery. Identify the interventions the nurse will perform. Choose all that apply.
   1) Inform the family to wait in the surgical waiting room.
   2) Prepare the surgical suite for the operation.
   3) Remove the patient’s dentures and contact lenses.
   4) Assist the patient to complete a living will.

Answer 22

1,3

Question 23

9. A patient had a colon resection for removal of a cancerous tumor. Postoperatively, on the surgical floor which of the following activities would the nurse perform for the purpose of decreasing the risk of postoperative complications? Choose all that apply.
   1) Assist the patient to turn, breathe deeply, and cough every 2 hours.
   2) Teach the patient about the type of tumor removed.
   3) Assess the drainage from the surgical site.
   4) Monitor vital signs on a regular basis.

Answer 23

1, 3,4

Question 24

10. A patient returns from surgery with a nasogastric tube and intermittent gastric suction to provide abdominal decompression. Which of the following are correct nursing activities for managing the equipment and drainage? Choose all that apply.
    1) Wear nonsterile procedure gloves when emptying the drainage container.
    2) When irrigating the nasogastric tube, use sterile water.
    3) Wear sterile gloves when irrigating the nasogastric tube.
    4) Apply water-soluble lubricant if the patient’s lips are dry.

Answer 24

1,4