Perioperative Nursing 001

1.) Which of the fol lowing is most dangerouscomplication during induction of spinalanesthesia?A.)TachycardiaB.)HypotensionC.)HyperthermiaD.)Bradypnea

Ans: B

2.) Which type of surgery is most l ikely topredispose a pat ient to postoperativeatelectasis , pneumonia or respiratoryfailure?A.)Upper abdominal surgery on an obesepatient with a long history of smokingB.)Upper abdominal surgery on a patientwith normal pulmonary funct ionC.)Lower abdominal surgery on a youngpatient with diabetes melli tusD.)Surgery on the extremities of anonsmoking football player

Ans: A

3.) Which of the fol lowing characterizesexci tement stage of anesthesiaA.) Occurs from the administration ofanesthesia to the loss of consciousnessB.) Extends from the loss of consciousnessto the loss of l id reflex, characterized bystruggling and talkingC.) From the loss of l id reflex to the loss ofmost reflexesD.) From the loss of most reflexes torespiratory and circulatory failure

Ans: B

4.) To prevent headache after spinalanesthesia the patient should be posit ioned:A.) Semi-fowler’sB.) Flat on bed for 6 to 8 hoursC.) Prone posi t ionD.) Modified trendelenburg

Ans: B

5.) Which of the fol lowing nursing act ions

should be given highest priority when

admitting the patient into the operatingroom?A.) Level of consciousnessB.) Vital signsC.) Patient identif ication and correctoperat ive consentD.) Posit ioning and skin preparat ion

Ans: C

6.) What is the primary reason for the gradualchange of posi t ion of the patient aftersurgery?A.) To prevent muscle injuryB.) To prevent sudden drop of BPC.) To prevent respiratory distressD.) To promote comfort

Ans: B

7.) Which of the fol lowing assessment data ismost important to determine when caring fora pat ient who has received spinalanesthesia?A.) The time of return of motion andsensation in the legs and toesB.) The character of respirat ionC.) Level of consciousnessD.) Amount of wound drainage

Ans: A

8.) Which of the fol lowing postop findingsshould the nurse report to the M.D.?A.) The pat ient pushes out the oral airway with his toungeB.) Urine output is 20ml/hr for the past twohoursC.) VS are as follows:BP=110/70;PR=95;RR=19,Temp=36.8CD.) Wound drainage is serosanguinous

Ans: B

9.) Which of the fol lowing is the earliest s ignof poor respiratory function?A.) CyanosisB.) Fast thready pulseC.) RestlessnessD.) Faintness

Ans: C

10.) If wound eviscerat ions occurs, theimmediate nursing action is:A.) Cover the wound with sterile gauze

moistened with sterile NSSB.) Cover the wound with water-soakedgauzeC.) Cover the wound with sterile dry gauzeD.) Leave the wound uncovered and pull theskin edges together

Ans: A

11.) Appendectomy is classified as

A.) Ablative

B.) ConstructiveC.) ReconstructiveD.) Pal lia tive

Ans: A

12.) The worst of al l fears among clientsundergoing surgery is:A.) Fear of f inancial burdenB.) Fear of deathC.) Fear of the unknownD.) Fear of loss of job

Ans: C

13.) The best t ime to provide preoperativeteaching on deep breathing, coughing andturning exercises is:A.) Before administrat ion of preoperativemedicat ionsB.) The afternoon or evening prior to surgeryC.) Several days prior to surgeryD.) Upon admission of the client in therecovery room

Ans: B

14.) The fol lowing are the appropriatenursing act ions before administration ofpreoperative 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 pacingalong the hal lway, goes to the bathroomfrequently and asks questions repeatedlyduring preoperative assessment. The mostlikely cause of the behavior is:A.) She is anxious about the surgicalprocedureB.) She is worried about separation from the

familyC.) She has urinary t ract infect ionD.) She has an underlying emotional problem

Ans: A

16.) Which of the fol lowing nursing act ionswould help the pat ient decrease anxietyduring the preoperat ive period?A.) Explaining al l procedures thoroughly inchronological orderB.) Spending time l istening to the patient andanswering questionsC.) Encouraging sleep and limitinginterruptionsD.) Reassuring the pat ient that the surgicalstaff are competent professional

Ans: B

17.) Which of the fol lowing is the primarypurpose of maintaining NPO for 6 to 8 hoursbefore surgery?A.) To prevent malnutri t ionB.) To prevent electrolyte imbalanceC.) To prevent aspirat ion pneumoniaD.) To prevent intest inal obstruction

Ans: C

18.) The fol lowing ensure val idity of informedwritten consent EXCEPT:A.) The pat ient is of legal age with propermental disposit ionB.) The consent has been secured within 24hours before the surgeryC.) If the patient is unable to write , secure theconsent from a relativeD.) The consent is secured beforeadministrat ion of any medication that al terthe level of consciousness

Ans: C

19.) Which of the fol lowing drugs isadministered to minimize respiratorysecret ions preop?

A.) Valium (Diazepam)B.) Nubain ( Nalbuphine HCL)C.) Phenergan (Promethazine)D.) Atropine Sulfate

Ans: D

20.) Which of the fol lowing is experienced by

the patient who is under spinal anesthesia?

A.) The pat ient is unconsciousB.) The patient is awakeC.) The patient experiences amnesiaD.) The pat ient experiences total loss ofsensation

Ans: B

21.) The patient who has undergone TAHBSOcomplains of pain. Which of the following isan ini t ia l nursing act ion?A.) Administer the PRN analgesicsB.) Instruct to do deep breathing exercisesC.) Assess the VSD.) Change the patient’s posi t ion

Ans: C

22.) How frequent should the nurse monitorthe 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 fol lowing drugs is given torelieve nausea and vomiting?A.) Mepivacaine

B.) Aquamephyton

C.) Nubain

D.) Plasi l

Ans: D

24.) The most important factor in theprevention of postop infection is:A.) Proper administration of antibioticsB.) Fluid intake of 2-3L/dayC.) Practice of str ict asept ic techniquesD.) Frequent change of wound dressings

Ans: C

25.) Which of the fol lowing primarilyprevents postop complications?A.) Adequate fluid intakeB.) Early ambulationC.) Well-balanced dietD.) Administrat ion of ant imicrobials

Ans: B

Situat ion: A female client, 23 y/o was

admitted for the fi rst t ime at the FatimaHospital with the chief complaint of RightIl iac Pain, accompanied by nausea andvomit ing, chi lls and fever. She wasdiagnosed to have acute appendici t is . Shewas scheduled to have emergencyappendectomy under spinal anesthesia

26.) Pre-op instruct ions to the client wouldinclude the following EXCEPT:A.) Deep breathing and coughing exerciseB.) Turning to sidesC.) Foot and leg exercisesD.) reassuring her that narcot ics will begiven every 4 hours round the clock unti l sheis discharged

Ans: D

27.) The client gave her consent for thesurgery. To ensure the legality of theconsent, the following conditions must bemet EXCEPT:A.) She gave her consent freelyB.) She must understand the nature of thesurgeryC.) The consent must be signed by a witnessD.) Signing should be done after theadministrat ion of pre-anesthesia meds

Ans: D

28.) The skin is shaved prior to surgery inorder to:A.) Facili tate skin incisionB.) Indicate the si te to be drapedC.) To prevent wound infect ionD.) Reduce post op scarring

Ans: C

29.) The important nursing intervention priorto administration of pre-anesthet icmedicat ion is:A.) Ask patient to empty the bladderB.) Do deep breathing and coughingexercisesC.) Regulate IVF accuratelyD.) Shave the skin

Ans: A

30.) Immediately fol lowing spinal anesthesia,the greatest r isk is:A.) Severe hemorrhageB.) Severe Hypotension

C.) Severe Hypoglycemia

D.) Hypertensive crisis

Ans: B

31.) Nursing measures to promote theclient’s respiratory function during recoveryfrom anesthesia are the fol lowing EXCEPT:A.) Encourages deep breathing andcoughing exercisesB.) Administer Humidified oxygenC.) Place in semi-fowlers posit ionD.) Place in supine posit ion with head turnedto the side without pil low support

Ans: C

32.) Which of the fol lowing criteria must bemet before the client is released from the RRto the unit .A.) Breathes with ease, coughs freelyB.) Has regained consciousnessC.) Vital signs fluctuates errat ical lyD.) Able to move four extremities

Ans: C

33.) Early signs of poor respiratory funct ioninclude which of the followingA.) CyanosisB.) HypotensionC.) Loss of consciousnessD.) Rest lessness

Ans: D

34.) Post operatively, the client must beencouraged 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 posit ionB.) Sim’s posit ion

C.) Modified t rendelenburgD.) Prone posit ion

Ans: C

36.) The most important factor in theprevention of post op wound infect ion is:A.) Adequate fluid intake

B.) Proper administrat ion of ant ibiot ics C.) Practice of str ict asept ic technique D.) Frequent cleaning of the wound

Ans: C

37.) When the patient vomits, the mostimportant nursing object ive is to prevent:A.) Dehydration

B.) Aspiration

C.) Rupture of suture l ine

D.) Met. Alkalosis

Ans: B

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

Ans: A

39.) Headache after spinal anesthesia is dueto:A.) Paralysis of vasomotor nervesB.) Traction placed on structures withinabdomenC.) Loss of CSF through dural holeD.) Administrat ion of large amounts andheavy concentration of anesthetic agents

Ans: C

40.) Nursing measures for post-opthrombophlebit is include the fol lowingEXCEPT:A.) Maintain bedrestB.) Elevate affected leg with pil low supportC.) Massage the painful extremitiesD.) Apply antiembolic stockings

Ans: C

41.) Nursing measures to rel ieve hiccupsinclude the following EXCEPT:A.) Exhale and inhale through a paper bagB.) Apply pressure over the eyebal l throughclosed eye l idsC.) Hold breath while taking a large pulp ofwaterD.) Administer high concentration of oxygen

Ans: D

42.) Modified radical mastectomy involves:A.) Removal of the ent ire breast , axil larylymph nodes, pectoral is muscleB.) Removal of the lump of the breastC.) Removal of the entire breast , axi l lary andneck lymph nodes, including pectoral ismusclesD.) Removal of the ent ire breast but nippleremains intact

Ans: A

43.) Which of the fol lowing is not appropriatenursing intervention after modified radicalmastectomy?A.) Place in semi fowler’s posit ion andelevate arm on the affected side with pil lowsupportB.) Check behind the client for bleedingC.) Monitor output from wound suctiondrainage

D.) Immobil ize the arm on affected side inadduction

Ans: D

44.) A fluid challenge is begun with a post-opgastric surgery client. Which assessment willgive the best indicat ion of cl ient response tothis 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 subtotalgastrectomy. In ant icipation of clarifyinginformation for client education, the nurseknows that vagotomy is done as part of thesurgical treatment for peptic ulcers in ordertoA.) Decrease secret ion of hydrochloric acidB.) Improve the tone of the GI musclesC.) Increase blood supply to the jejunumD.) Prevent the transmission of painimpulses

Ans: A

46.) Which of the fol lowing facts bestexplains why the duodenum is not removedduring a subtotal gastrectomy?A.) The head of the pancreas is adherent tothe duodenal wall

B.) The common bi le duct empties into theduodenal lumenC.) The wall of the jejunum contains nointest inal vil l iD.) The jejunum receives i ts blood supplythrough the duodenum

Ans: B

47.) During the immediate postoperat iveperiod fol lowing gastric surgery, why mustthe nurse be particularly conscient iousabout encouraging a client to cough anddeep-breathe at regular intervals?A.) Marked changes in intrathoracic pressurewill s t imulate gastric drainageB.) The high abdominal incision will lead toshallow breathing to avoid painC.) The phrenic nerve will have beenpermanently damaged during the surgicalprocedureD.) Deep-breathing will prevent post opvomit ing and intestinal distention

Ans: B

48.) Prior to having a subtotal gastrectomy, aclient is told about the dumping syndrome.The nurse explains that i t is :A.) The body’s absorption of toxins producedby liquefact ion of dead t issueB.) Formation of an ulcer at the margin of thegastrojejunal anastomosisC.) Obstruction of venous flow from thestomach into the portal systemD.) Rapid emptying of food and fluid from thestomach into the jejunum

Ans: D

49.) Which of the fol lowing statements by aclient recovering from a subtotalgastrectomy would indicate a need foraddit ional teaching about the diet protocolfor dumping syndrome?A.) “I plan to eat a diet low in carbohydratesand high in protein and fat”B.) “I plan to eat a diet high in CHO and lowin CHON and fat”

C.) “I will eat slowly and avoid drinking fluidsduring meals”D.) “I will t ry to assume a recumbent posit ionafter meals for 30 mins to 1 hour to enhancedigestion and rel ieve symptoms

Ans: B

50.) A 40 y/o female cl ient has arrived in thepost anesthesia room following acholecystectomy and a common bi le ductexploration. She is semi conscious. Her vitalsigns are within normal l imits . Which of thefollowing nursing actions would beinappropriate?A.) Apply a warm blanket to her bodyB.) Place her in a semi-fowler’s posit ionC.) Attached her T-tube to gravity drainageD.) Set up low, intermit tent suction for herNGT

Ans: B