Perioperative Nursing 001

1.) Which of the following is most dangerous

complication during induction of spinal
anesthesia?
A.)Tachycardia
.)!ypotension
".)!yperthermia
#.)radypnea
Ans$
%.) Which type of surgery is most li&ely to
predispose a patient to postoperative
atelectasis' pneumonia or respiratory
failure?
A.)(pper a)dominal surgery on an o)ese
patient with a long history of smo&ing
.)(pper a)dominal surgery on a patient
with normal pulmonary function
".)*ower a)dominal surgery on a young
patient with dia)etes mellitus
#.)+urgery on the e,tremities of a
nonsmo&ing foot)all player
Ans$ A
-.) Which of the following characteri.es
e,citement stage of anesthesia
A.) /ccurs from the administration of
anesthesia to the loss of consciousness
.) 0,tends from the loss of consciousness
to the loss of lid refle,' characteri.ed )y
struggling and tal&ing
".) 1rom the loss of lid refle, to the loss of
most refle,es
#.) 1rom the loss of most refle,es to
respiratory and circulatory failure
Ans$
2.) To prevent headache after spinal
anesthesia the patient should )e positioned$
A.) +emi3fowler4s
.) 1lat on )ed for 5 to 6 hours
".) Prone position
#.) 7odified trendelen)urg
Ans$
8.) Which of the following nursing actions
should )e given highest priority when
admitting the patient into the operating
room?
A.) *evel of consciousness
.) 9ital signs
".) Patient identification and correct
operative consent
#.) Positioning and s&in preparation
Ans$ "
5.) What is the primary reason for the gradual
change of position of the patient after
surgery?
A.) To prevent muscle in:ury
.) To prevent sudden drop of P
".) To prevent respiratory distress
#.) To promote comfort
Ans$
;.) 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 toes
.) The character of respiration
".) *evel of consciousness
#.) Amount of wound drainage
Ans$ A
6.) Which of the following postop findings
should the nurse report to the 7.#.?
A.) The patient pushes out the oral airway wit
h his tounge
.) (rine output is %0ml<hr for the past two
hours
".) 9+ are as follows$
P=110<;0>P?=@8>??=1@'Temp=-5.6"
#.) Wound drainage is serosanguinous
Ans$
@.) Which of the following is the earliest sign
of poor respiratory function?
A.) "yanosis
.) 1ast thready pulse
".) ?estlessness
#.) 1aintness
Ans$ "
10.) Af wound eviscerations occurs' the
immediate nursing action is$
A.) "over the wound with sterile gau.e
moistened with sterile N++
.) "over the wound with water3soa&ed
gau.e
".) "over the wound with sterile dry gau.e
#.) *eave the wound uncovered and pull the
s&in edges together
Ans$ A
11.) Appendectomy is classified as
A.) A)lative
.) "onstructive
".) ?econstructive
#.) Palliative
Ans$ A
1%.) The worst of all fears among clients
undergoing surgery is$
A.) 1ear of financial )urden
.) 1ear of death
".) 1ear of the un&nown
#.) 1ear of loss of :o)
Ans$ "
1-.) The )est time to provide preoperative
teaching on deep )reathing' coughing and
turning e,ercises is$
A.) efore administration of preoperative
medications
.) The afternoon or evening prior to surgery
".) +everal days prior to surgery
#.) (pon admission of the client in the
recovery room
Ans$
12.) The following are the appropriate
nursing actions )efore administration of
preoperative medications 0B"0PT$
A.) Ascertain the consent has )een signed
.) 0nsure that NP/ has )een maintained
".) Anstruct patient to empty his )ladder
#.) +have the s&in at the site of surgery
Ans$ #
18.) The patient has )een o)served pacing
along the hallway' goes to the )athroom
freCuently and as&s Cuestions repeatedly
during preoperative assessment. The most
li&ely cause of the )ehavior is$
A.) +he is an,ious a)out the surgical
procedure
.) +he is worried a)out separation from the
family
".) +he has urinary tract infection
#.) +he has an underlying emotional pro)lem
Ans$ A
15.) Which of the following nursing actions
would help the patient decrease an,iety
during the preoperative period?
A.) 0,plaining all procedures thoroughly in
chronological order
.) +pending time listening to the patient and
answering Cuestions
".) 0ncouraging sleep and limiting
interruptions
#.) ?eassuring the patient that the surgical
staff are competent professional
Ans$
1;.) Which of the following is the primary
purpose of maintaining NP/ for 5 to 6 hours
)efore surgery?
A.) To prevent malnutrition
.) To prevent electrolyte im)alance
".) To prevent aspiration pneumonia
#.) To prevent intestinal o)struction
Ans$ "
16.) The following ensure validity of informed
written consent 0B"0PT$
A.) The patient is of legal age with proper
mental disposition
.) The consent has )een secured within %2
hours )efore the surgery
".) Af the patient is una)le to write' secure the
consent from a relative
#.) The consent is secured )efore
administration of any medication that alter
the level of consciousness
Ans$ "
1@.) Which of the following drugs is
administered to minimi.e respiratory
secretions preop?
A.) 9alium D#ia.epam)
.) Nu)ain D Nal)uphine !"*)
".) Phenergan DPrometha.ine)
#.) Atropine +ulfate
Ans$ #
%0.) Which of the following is e,perienced )y
the patient who is under spinal anesthesia?
A.) The patient is unconscious
.) The patient is awa&e
".) The patient e,periences amnesia
#.) The patient e,periences total loss of
sensation
Ans$
%1.) The patient who has undergone TA!+/
complains of pain. Which of the following is
an initial nursing action?
A.) Administer the P?N analgesics
.) Anstruct to do deep )reathing e,ercises
".) Assess the 9+
#.) "hange the patient4s position
Ans$ "
%%.) !ow freCuent should the nurse monitor
the 9+ of the patient in the recovery room?
A.) 0very 18 minutes
.) 0very -0 mins
".) 0very 28 mins
#.) 0very 50 mins
Ans$ A
%-.) Which of the following drugs is given to
relieve nausea and vomiting?
A.) 7epivacaine
.) ACuamephyton
".) Nu)ain
#.) Plasil
Ans$ #
%2.) The most important factor in the
prevention of postop infection is$
A.) Proper administration of anti)iotics
.) 1luid inta&e of %3-*<day
".) Practice of strict aseptic techniCues
#.) 1reCuent change of wound dressings
Ans$ "
%8.) Which of the following primarily
prevents postop complications?
A.) AdeCuate fluid inta&e
.) 0arly am)ulation
".) Well3)alanced diet
#.) Administration of antimicro)ials
Ans$
+ituation$ A female client' %- y<o was
admitted for the first time at the 1atima
!ospital with the chief complaint of ?ight
Aliac Pain' accompanied )y nausea and
vomiting' chills and fever. +he was
diagnosed to have acute appendicitis. +he
was scheduled to have emergency
appendectomy under spinal anesthesia
%5.) Pre3op instructions to the client would
include the following 0B"0PT$
A.) #eep )reathing and coughing e,ercise
.) Turning to sides
".) 1oot and leg e,ercises
#.) reassuring her that narcotics will )e
given every 2 hours round the cloc& until she
is discharged
Ans$ #
%;.) The client gave her consent for the
surgery. To ensure the legality of the
consent' the following conditions must )e
met 0B"0PT$
A.) +he gave her consent freely
.) +he must understand the nature of the
surgery
".) The consent must )e signed )y a witness
#.) +igning should )e done after the
administration of pre3anesthesia meds
Ans$ #
%6.) The s&in is shaved prior to surgery in
order to$
A.) 1acilitate s&in incision
.) Andicate the site to )e draped
".) To prevent wound infection
#.) ?educe post op scarring
Ans$ "
%@.) The important nursing intervention prior
to administration of pre3anesthetic
medication is$
A.) As& patient to empty the )ladder
.) #o deep )reathing and coughing
e,ercises
".) ?egulate A91 accurately
#.) +have the s&in
Ans$ A
-0.) Ammediately following spinal anesthesia'
the greatest ris& is$
A.) +evere hemorrhage
.) +evere !ypotension
".) +evere !ypoglycemia
#.) !ypertensive crisis
Ans$
-1.) Nursing measures to promote the
client4s respiratory function during recovery
from anesthesia are the following 0B"0PT$
A.) 0ncourages deep )reathing and
coughing e,ercises
.) Administer !umidified o,ygen
".) Place in semi3fowlers position
#.) Place in supine position with head turned
to the side without pillow support
Ans$ "
-%.) Which of the following criteria must )e
met )efore the client is released from the ??
to the unit.
A.) reathes with ease' coughs freely
.) !as regained consciousness
".) 9ital signs fluctuates erratically
#.) A)le to move four e,tremities
Ans$ "
--.) 0arly signs of poor respiratory function
include which of the following
A.) "yanosis
.) !ypotension
".) *oss of consciousness
#.) ?estlessness
Ans$ #
-2.) Post operatively' the client must )e
encouraged to turn' cough and deep )reathe$
A.) 0very 13% hours
.) 0very 2 hours
".) 0very -0 7ins
#.) 0very 6 hours
Ans$ A
-8.) A client in shoc& must )e placed in$
A.) !igh3fowlers position
.) +im4s position
".) 7odified trendelen)urg
#.) Prone position
Ans$ "
-5.) The most important factor in the
prevention of post op wound infection is$
A.) AdeCuate fluid inta&e
.) Proper administration of anti)iotics
".) Practice of strict aseptic techniCue
#.) 1reCuent cleaning of the wound
Ans$ "
-;.) When the patient vomits' the most
important nursing o):ective is to prevent$
A.) #ehydration
.) Aspiration
".) ?upture of suture line
#.) 7et. Al&alosis
Ans$
-6.) Post operatively' a patient is e,pected to
void after$
A.) 536 hours
.) %32 hours
".) 1%3%2 hours
#.) 1031% hours
Ans$ A
-@.) !eadache after spinal anesthesia is due
to$
A.) Paralysis of vasomotor nerves
.) Traction placed on structures within
a)domen
".) *oss of "+1 through dural hole
#.) Administration of large amounts and
heavy concentration of anesthetic agents
Ans$ "
20.) Nursing measures for post3op
throm)ophle)itis include the following
0B"0PT$
A.) 7aintain )edrest
.) 0levate affected leg with pillow support
".) 7assage the painful e,tremities
#.) Apply antiem)olic stoc&ings
Ans$ "
21.) Nursing measures to relieve hiccups
include the following 0B"0PT$
A.) 0,hale and inhale through a paper )ag
.) Apply pressure over the eye)all through
closed eye lids
".) !old )reath while ta&ing a large pulp of
water
#.) Administer high concentration of o,ygen
Ans$ #
2%.) 7odified radical mastectomy involves$
A.) ?emoval of the entire )reast' a,illary
lymph nodes' pectoralis muscle
.) ?emoval of the lump of the )reast
".) ?emoval of the entire )reast' a,illary and
nec& lymph nodes' including pectoralis
muscles
#.) ?emoval of the entire )reast )ut nipple
remains intact
Ans$ A
2-.) Which of the following is not appropriate
nursing intervention after modified radical
mastectomy?
A.) Place in semi fowler4s position and
elevate arm on the affected side with pillow
support
.) "hec& )ehind the client for )leeding
".) 7onitor output from wound suction
drainage
#.) Ammo)ili.e the arm on affected side in
adduction
Ans$ #
22.) A fluid challenge is )egun with a post3op
gastric surgery client. Which assessment will
give the )est indication of client response to
this treatment?
A.) "9P readings and hourly urine output
.) lood pressure and apical rate chec&s
".) *ung sounds and arterial )lood gases
#.) 0lectrolytes' (N' creatinine results
Ans$ A
28.) A client is scheduled for a su)total
gastrectomy. An anticipation of clarifying
information for client education' the nurse
&nows that vagotomy is done as part of the
surgical treatment for peptic ulcers in order
to
A.) #ecrease secretion of hydrochloric acid
.) Amprove the tone of the EA muscles
".) Ancrease )lood supply to the :e:unum
#.) Prevent the transmission of pain
impulses
Ans$ A
25.) Which of the following facts )est
e,plains why the duodenum is not removed
during a su)total gastrectomy?
A.) The head of the pancreas is adherent to
the duodenal wall
.) The common )ile duct empties into the
duodenal lumen
".) The wall of the :e:unum contains no
intestinal villi
#.) The :e:unum receives its )lood supply
through the duodenum
Ans$
2;.) #uring the immediate postoperative
period following gastric surgery' why must
the nurse )e particularly conscientious
a)out encouraging a client to cough and
deep3)reathe at regular intervals?
A.) 7ar&ed changes in intrathoracic pressure
will stimulate gastric drainage
.) The high a)dominal incision will lead to
shallow )reathing to avoid pain
".) The phrenic nerve will have )een
permanently damaged during the surgical
procedure
#.) #eep3)reathing will prevent post op
vomiting and intestinal distention
Ans$
26.) Prior to having a su)total gastrectomy' a
client is told a)out the dumping syndrome.
The nurse e,plains that it is$
A.) The )ody4s a)sorption of to,ins
produced )y liCuefaction of dead tissue
.) 1ormation of an ulcer at the margin of the
gastro:e:unal anastomosis
".) /)struction of venous flow from the
stomach into the portal system
#.) ?apid emptying of food and fluid from the
stomach into the :e:unum
Ans$ #
2@.) Which of the following statements )y a
client recovering from a su)total
gastrectomy would indicate a need for
additional teaching a)out the diet protocol
for dumping syndrome?
A.) FA plan to eat a diet low in car)ohydrates
and high in protein and fatG
.) FA plan to eat a diet high in "!/ and low
in "!/N and fatG
".) FA will eat slowly and avoid drin&ing fluids
during mealsG
#.) FA will try to assume a recum)ent position
after meals for -0 mins to 1 hour to enhance
digestion and relieve symptoms
Ans$
80.) A 20 y<o female client has arrived in the
post anesthesia room following a
cholecystectomy and a common )ile duct
e,ploration. +he is semi conscious. !er vital
signs are within normal limits. Which of the
following nursing actions would )e
inappropriate?
A.) Apply a warm )lan&et to her )ody
.) Place her in a semi3fowler4s position
".) Attached her T3tu)e to gravity drainage
#.) +et up low' intermittent suction for her
NET
Ans$