Angela DeVarso

Angela DeVarso

Perioperative Nursing 001

1.) Which of the following 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 patient 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 functionC.)Lower abdominal surgery on a youngpatient with diabetes melli tusD.)Surgery on the extremities of anonsmoking football player

Ans: A

3.) Which of the following characterizesexcitement 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

Angela DeVarso

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 posit ionD.) Modified trendelenburg

Ans: B

5.) Which of the following nursing actions

should be given highest priori ty when

admitt ing the patient into the operatingroom?A.) Level of consciousnessB.) Vital signsC.) Patient identif ication and correctoperative consentD.) Posit ioning and skin preparation

Ans: C

6.) What is the primary reason for the gradualchange of posit 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 following assessment data ismost important to determine when caring fora patient who has received spinalanesthesia?A.) The t ime of return of motion andsensation in the legs and toesB.) The character of respirationC.) Level of consciousnessD.) Amount of wound drainage

Angela DeVarso

Ans: A

8.) Which of the following postop findingsshould the nurse report to the M.D.?A.) The patient 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 following is the earl iest signof poor respiratory function?A.) CyanosisB.) Fast thready pulseC.) RestlessnessD.) Faintness

Ans: C

10.) If wound eviscerations occurs, theimmediate nursing action is:A.) Cover the wound with steri le gauze

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

Ans: A

11.) Appendectomy is classified as

A.) Ablative

B.) ConstructiveC.) ReconstructiveD.) Pall iat ive

Ans: A

Angela DeVarso

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 administration of preoperativemedicationsB.) The afternoon or evening prior to surgeryC.) Several days prior to surgeryD.) Upon admission of the client in therecovery room

Ans: B

14.) The following are the appropriatenursing actions 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 si te of surgery

Ans: D

15.) The patient has been observed pacingalong the hallway, goes to the bathroomfrequently and asks questions repeatedlyduring preoperative assessment. The mostl ikely cause of the behavior is:A.) She is anxious about the surgicalprocedureB.) She is worried about separation from the

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

Angela DeVarso

Ans: A

16.) Which of the following nursing actionswould help the patient decrease anxietyduring the preoperative period?A.) Explaining all procedures thoroughly inchronological orderB.) Spending t ime l istening to the patient andanswering questionsC.) Encouraging sleep and l imitinginterruptionsD.) Reassuring the patient that the surgicalstaff are competent professional

Ans: B

17.) Which of the following is the primarypurpose of maintaining NPO for 6 to 8 hoursbefore surgery?A.) To prevent malnutri t ionB.) To prevent electrolyte imbalanceC.) To prevent aspiration pneumoniaD.) To prevent intestinal obstruction

Ans: C

18.) The following ensure validity of informedwrit ten consent EXCEPT:A.) The patient 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 beforeadministration of any medication that al terthe level of consciousness

Ans: C

19.) Which of the following drugs isadministered to minimize respiratorysecretions preop?

Angela DeVarso

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 ofsensation

Ans: B

21.) The patient who has undergone TAHBSOcomplains of pain. Which of the following isan init ial nursing action?A.) Administer the PRN analgesicsB.) Instruct to do deep breathing exercisesC.) Assess the VSD.) Change the patient’s posit 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 following drugs is given torelieve nausea and vomiting?A.) Mepivacaine

B.) Aquamephyton

C.) Nubain

Angela DeVarso

D.) Plasil

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 aseptic techniquesD.) Frequent change of wound dressings

Ans: C

25.) Which of the following primarilyprevents 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 t ime at the FatimaHospital with the chief complaint of RightIl iac Pain, accompanied by nausea andvomiting, chil ls and fever. She wasdiagnosed to have acute appendicit is . Shewas scheduled to have emergencyappendectomy under spinal anesthesia

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

Ans: D

Angela DeVarso

27.) The client gave her consent for thesurgery. To ensure the legali ty 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 theadministration of pre-anesthesia meds

Ans: D

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

Ans: C

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

Ans: A

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

C.) Severe Hypoglycemia

D.) Hypertensive crisis

Ans: B

Angela DeVarso

31.) Nursing measures to promote theclient’s respiratory function during recoveryfrom anesthesia are the following 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 following cri teria must bemet before the client is released from the RRto 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 functioninclude which of the followingA.) CyanosisB.) HypotensionC.) Loss of consciousnessD.) Restlessness

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

Angela DeVarso

C.) Modified trendelenburgD.) Prone posit ion

Ans: C

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

B.) Proper administration of antibiotics C.) Practice of str ict aseptic technique D.) Frequent cleaning of the wound

Ans: C

37.) When the patient vomits, the mostimportant nursing objective 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.) Administration of large amounts andheavy concentration of anesthetic agents

Ans: C

Angela DeVarso

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

Ans: C

41.) Nursing measures to relieve hiccupsinclude the following EXCEPT:A.) Exhale and inhale through a paper bagB.) Apply pressure over the eyeball 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 entire breast , axil larylymph nodes, pectoralis muscleB.) Removal of the lump of the breastC.) Removal of the entire breast , axil lary andneck lymph nodes, including pectoralismusclesD.) Removal of the entire breast but nippleremains intact

Ans: A

43.) Which of the following 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

Angela DeVarso

D.) Immobilize 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 indication 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 anticipation of clarifyinginformation for cl ient education, the nurseknows that vagotomy is done as part of thesurgical treatment for peptic ulcers in ordertoA.) Decrease secretion 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 following 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 bile duct empties into theduodenal lumenC.) The wall of the jejunum contains nointestinal vil l iD.) The jejunum receives i ts blood supplythrough the duodenum

Angela DeVarso

Ans: B

47.) During the immediate postoperativeperiod following gastric surgery, why mustthe nurse be part icularly conscientiousabout encouraging a client to cough anddeep-breathe at regular intervals?A.) Marked changes in intrathoracic pressurewill st 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 opvomiting 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 l iquefaction 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 following 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”

Angela DeVarso

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

Ans: B

50.) A 40 y/o female client has arrived in thepost anesthesia room following acholecystectomy and a common bile 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, intermittent suction for herNGT

Ans: B