Perioperative Quiz (Test 3)

Question 1

The patient is 38 years old and is in her second postoperative day after a fracture of her left femur. She is receiving analgesia via a patient-controlled analgesia (PCA) device. All of the interventions related to caring for a patient with a PCA are appropriate except:

a) maintaining the system
b) recording activations of the system
c) administering the analgesia to the patient
d) monitoring the patient’s pain level

Answer 1

c) administering the analgesia to the patient

Question 2

The patient’s Bill of Rights states that a patient must give his/her permission for any specific test or procedure to be performed. What is the legal term for this permission?

a) verbal consent
b) medical documentation
c) informed consent
d) informed decision

Answer 2

c) informed consent

Question 3

An informed consent was to be obtained from the patient for his scheduled open cholecystectomy. Which circumstance could prevent the patient from signing his informed consent?

a) pain radiating to the scapula
b) an injection of Demerol, 75 mg IM, 1 hour ago
c) the presence of jaundice and scleria icterus
d) his concern over his insurance company not covering the procedure

Answer 3

b) an injection of Demerol, 75 mg IM, 1 hour ago

Question 4

The anesthesiologist provides this type of anesthesia by inhalation and IV administration routes:

a) general
b) regional
c) specific
d) preoperative

Answer 4

a) general

Question 5

A type of anesthesia that requires a depressed level of consciousness is:

a) regional anesthesia
b) specific anesthesia
c) optional anesthesia
d) conscious sedation

Answer 5

d) conscious sedation

Question 6

The older adult patient may not respond to surgical treatment as well as a younger adult because of:

a) poor skin turgor resulting in dehydration
b) disturbed body image related to surgical incision
c) his or her body’s responses slowed by physiological changes
d) none of the above

Answer 6

c) his or her body’s responses slowed by physiological changes

Question 7

A male patient, age 45, is being induced and the anesthesiologist has asked for quiet in the room. Stimulation during this time can cause:

a) increased oxygen saturation
b) increased heart rate and blood pressure
c) hypothermia
d) respiratory depression

Answer 7

b) increased heart rate and blood pressure

Question 8

A male patient, age 80, has had a total hip replacement and is in the recovery room (PACU). Hypoventilation and immobility post-op can cause which complication:

a) hypotension
b) malignany hyperthermia
c) paralytic ileus
d) atelectasis

Answer 8

d) atelectasis

Question 9

A female patient, age 65, underwent a right hemicolectomy. On postoperative day 4, her surgical wound dehisced. this means that:

a) there is a partial or complete wound separation
b) there has been inadequate wound closure
c) abdominal viscera protrude through the walls
d) the wound will not heal well when it is resutured

Answer 9

a) there is a partial or complete wound separation

Question 10

A patient is on postoperative day 2 after a nephrectomy. The nurse is aware that the most effective way to increase her peristalsis is:

a) ambulation
b) an enema
c) encouraging hot liquids
d) administering a laxative

Answer 10

a) ambulation

Question 11

A patient is transferred from the operating room to the recovery room after undergoing an open reduction and internal fixation (ORIF) of his left ankle. Which is the first assessment to make?

a) check ankle dressings
b) check airway for patency
c) check intravenous site
d) check vital signs

Answer 11

b) check airway for patency

Question 12

Which patient would be at greatest risk during surgery?

a) 78 year old taking an analgesic
b) 43 year old taking an anti-hypertensive
c) 27 year old taking an anticoagulant
d) 10 year old taking an antibiotic

Answer 12

c) 27 year old taking an anticoagulant

Question 13

Frequent monitoring of the postoperative patient’s vital signs assesses which body system:

a) gastrointestinal
b) endocrine
c) neurological
d) cardiovascular

Answer 13

d) cardiovascular

Question 14

The nurse acknowledges that all preoperative nursing interventions have been performed by signing which document?

a) nurse’s notes
b) anesthesia record
c) surgical checklist
d) physician’s order sheet

Answer 14

c) surgical checklist

Question 15

Which nursing intervention would be appropriate after a wound evisceration?

a) place the patient in high Fowler’s position
b) give the patient fluids to prevent shock
c) replace the dressing with sterile fluffy pads
d) apply a warm, moist normal saline sterile dressing and call the physician

Answer 15

d) apply a warm, moist normal saline sterile dressing and call the physician

Question 16

When should the nurse offer prescribed analgesics to a patient who is 24 hours postoperative?

a) only when a patient asks
b) regularly every three to four hours before pain gets severe
c) only when the physician orders it
d) only when the patient is in severe pain

Answer 16

b) regularly every three to four hours before pain gets severe

Question 17

What nursing interventions will minimize the effect of venous stasis?

a) pillows under the knees in a position of comfort
b) sitting with the feet flat on the floor
c) early ambulation
d) gentle leg massages

Answer 17

c) early ambulation

Question 18

The nurse is assisting with the sponge and instrument count in the operating room. The operative phase in which the nurse is assisting is called the:

a) perioperative phase
b) preoperative phase
c) intraoperative phase
d) postoperative phase

Answer 18

c) intraoperative phase

Question 19

A patient will have an incision in the lower left abdomen. Which intervention by the nurse will help decrease comfort in the incisional area when she coughs?

a) apply a splint directly over the lower abdomen
b) keep the patient flat with feet flexed
c) turn her on her right side
d) apply a splint above and below the incision

Answer 19

a) apply a splint directly over the lower abdomen

Question 20

Sudden chest pain combined with dyspnea, cyanosis and tachycardia is an indication of:

a) hypovolemic shock
b) dehiscence
c) atelectasis
d) pulmonary embolus

Answer 20

d) pulmonary embolus

Question 21

What is the responsibility of the nurse regarding informed consent:

a) explain the surgical options
b) explain the operative risks
c) obtain the patient’s signature
d) check form for appropriate signatures

Answer 21

c) obtain the patient’s signature (IF you know the DR has already talked with PT which answered any questions)
d) check form for appropriate signatures

Question 22

Which preoperative fear is linked to postoperative behavior?

a) fear of anesthesia and death
b) fear of death and malnutrition
c) fear of unknown and lack of respect
d) check form for appropriate signatures

Answer 22

a) fear of anesthesia and death

Question 23

Ideally, preoperative teaching should be done:

a) immediately before surgery to eliminate fear
b) 2 months in advance so the patient can prepare
c) 1 to 2 days before the surgery when anxiety is not as high
d) in the surgical holding area

Answer 23

c) 1 to 2 days before the surgery when anxiety is not as high

Question 24

Southeast Asian and Native American patients often do not make eye contact when preoperative teaching is being performed because:

a) they aren’t educated
b) they aren’t paying attention
c) they believe eye contact is disrespectful
d) they believe they are superior to the nurse

Answer 24

c) they believe eye contact is disrespectful

Question 25

When the nurse performs hand hygiene and uses sterile supplies, the patient's: a) hospital stay is shortened b) sense of self-worth is improved c) risk of infection is reduced d) nursing care need is reduced

Answer 25

c) risk of infection is reduced

Question 26

The nurse carefully measures drainage during the first 24 hours after surgery on a patient with a Jackson-Pratt drain. It is considered abnormal if the drainage exceeds: a) 50 mLs b) 100 mLs c) 200 mLs d) 300 mLs

Answer 26

d) 300 mLs

Question 27

The nurse recognizes that the Jackson-Pratt drainage removal system is classified as a(n): a) sterile drainage system b) closed drainage system c) open drainage system d) self-measuring drainage system

Answer 27

b) closed drainage system

Question 28

The nurse assessing a patient's wound notes a clear watery drainage. The nurse documents this finding as: a) serous drainage b) purulent drainage c) sanguineous drainage d) serosanguineous drainage

Answer 28

a) serous drainage

Question 29

The nurse assessing a patient's wound notes thick, yellow drainage. The nurse documents this finding as: a) serous drainage b) purulent drainage c) sanguineous drainage d) serosanguineous drainage

Answer 29

b) purulent drainage

Question 30

The nurse assessing a patient's wound notes pale red watery drainage. The nurse documents this finding as: a) serous drainage b) purulent drainage c) sanguineous drainage d) serosanguineous drainage

Answer 30

d) serosanguineous drainage

Question 31

A patient is scheduled for a right total knee replacement. Which of the following would ensure proper site identification? a) an ACE bandage applied to the left knee b) a smiley face drawn on the right knee c) an ACE bandage applied to the right knee d) initials marked over the right knee

Answer 31

d) initials marked over the right knee

Question 32

What are the high-risk procedures that may affect perioperative procedures? Select the MOST applicable answer: a) age, health, occupation and mental status b) financial income, health, nutritional status c) age, mental state, nutritional status, health d) occupation, age, nutritional status, health e) , financial income, occupation, age, health

Answer 32

c) age, mental state, nutritional status, health

Question 33

Surgical asepsis is: a) the same as medical asepsis b) is known as a cleaning technique c) is known as hand hygiene d) in known as sterile technique

Answer 33

d) is known as sterile technique

Question 34

The nurse instructs the patient that the most important preventative technique for breaking the chain of infection is: a) sterilization b) standard precautions c) hand hygiene d) medical asepsis

Answer 34

c) hand hygiene

Question 35

The infection control officer recognizes the need for more instruction on surgical asepsis after observing a nurse: a) facing the sterile field b) placing a sterile dressing on a sterile field c) touching the edges of the sterile field with sterile gloves d) keeping sterile gloved hands above the waist

Answer 35

c) touching the edges of the sterile field with sterile gloves

Question 36

A method used to kill all microorganisms, including spores, is: a) disinfecting b) using an antiseptic c) using chlorine bleach d) sterilizing

Answer 36

d) sterilizing

Question 37

A 73 year old patient with diabetes was admitted for a below-the-knee amputation of his right leg. Removal of his right leg is what type of surgery? a) palliative b) diagnostic c) reconstructive d) ablative

Answer 37

d) ablative

Question 38

When the nurse discovers that the gauze dressing has adhered to the wound, the nurse should: a) call the physician b) gently remove the gauze with sterile forceps c) cover with an occlusive dressing d) moisten the dressing with sterile water and remove

Answer 38

d) moisten the dressing with sterile water and remove

Question 39

The nurse follows the basic concept of wound irrigation when directing the flow of the irrigant: a) from the area of least contamination to the area of most contamination b) forcefully into the wound c) gently over the skin into the wound d) from a distance of 12 inches

Answer 39

a) from the area of least contamination to the area of most contamination

Question 40

The nurse informs a patient that a wet-to-dry dressing is applied wet and allowed to dry. This drying process causes it to adhere to the wound, which when removed results in: a) destruction of tissue b) bleeding c) mechanical debridement d) prevention of infection

Answer 40

c) mechanical debridement