Perioperative Review

Question 1 of 20

1

An inpatient is scheduled to have surgery tomorrow. The nurse takes an incentive spirometer to the patient's room to provide education on its use in the postoperative period. Which of the following are instructions the nurse should include?

Select one of the following:

Standing position; deep breath; lips around mouthpiece; blow hard to make the ball rise
Prone position; lips around mouthpiece; exhale; slowly inhale to raise the marker and float the ball; hold breath for 3 seconds if possible
Upright position; lips around mouthpiece; exhale; slowly inhale to raise the marker and float the ball, hold breath for 3 seconds if possible
Upright position; lips on mouthpiece; deep breath; blow hard to move the marker and float the ball

Explanation

Question 2 of 20

1

A presurgical patient has signed the informed consent form, after which, the nurse signs the consent form. What is the purpose of the nurse's signature?

Select one of the following:

agreement that the patient understands the procedure
witness to the physician explaining the procedure to the patient
witness to the patient's signature
the patient is ready to be taken to the operating room

Explanation

Question 3 of 20

1

A patient is scheduled for surgery in one hour and has had NPO after midnight orders. Blood was drawn for labwork 30 minutes ago. Under which of the following circumstances should the nurse contact the surgeon to inform them prior to the patient going to surgery? Select all that apply.

Select one or more of the following:

the patient states they have not been told about the procedure and informed consent has not been signed
the patient experienced nausea and the nurse administered an IV antiemetic per prn orders
prothrombin time (PT) 22 seconds (range 10-13 seconds) and international normalized ratio (INR) 4 (range 2-3 for valvular heart disease prophlaxis)
blood glucose 102 mg/dL
the patient's temperature is 99.8 degrees
the surgical site was prepped with electric clippers 8 hours ago

Explanation

Question 4 of 20

1

The patient is scheduled for an upper endoscopy and a colonoscopy at 1200 today. At 1000 the patient returned from hemodialysis during which heparin was administered. What is the primary risk for this patient?

Select one of the following:

aspiration
sedation
bleeding
infection

Explanation

Question 5 of 20

1

Which of the following may be allowed by the surgeon for a patient who is to have nothing by mouth (NPO) for a procedure involving sedation?

Select one of the following:

smoking
clear gelatin up to 1 teaspoon
a prescribed PO medication with a sip of water
broth up to one teaspoon

Explanation

Question 6 of 20

1

Which of the following are considered to be advance directives? Select all that apply.

Select one or more of the following:

informed consent
living will
durable power of attorney
life insurance

Explanation

Question 7 of 20

1

Select from the dropdown lists to complete the text.

Prior to surgery and prior to the patient receiving any ( sedative medication, lunch ), the patient ( marks, points to ) the surgical site and the surgeon confirms it with ( marking, pointing ) as well. This is to ensure that the correct site is ( operated on, marked ).

Explanation

Question 8 of 20

1

The nurse knows that infection is a primary risk to a surgical patient. Which of the following interventions is most important to protect a surgical patient from infection?

Select one of the following:

adequate IV hydration
careful surgical site preparation
assessing WBCs prior to surgery
sterilization of the surgical incision after the procedure

Explanation

Question 9 of 20

1

Which of the following should the preoperative nurse replace prior to allowing the patient to be transported to surgery? Select all that apply.

Select one or more of the following:

an IV that has gone subcutaneous
the patient's earrings so they don't get lost
an identification band/bracelet that came off
1 mL : 1 mL IV fluid to replace urine output over the 8 hours prior to surgery

Explanation

Question 10 of 20

1

Which of the following is included in the group of three signs that, together, can be an early indication of malignant hyperthermia? Select all that apply.

Select one or more of the following:

decreased oxygen saturation (SpO2)
increased respiratory rate
restlessness
elevated end-tidal CO2 level
tachycardia
bradycardia

Explanation

Question 11 of 20

1

The surgical nurse is discussing the monitoring of end-tidal carbon dioxide (etCO2) during surgery with a student. Which of the following should the nurse include in the education?

Select one of the following:

etCO2 is also called capnography monitoring and can more accurately and more quickly measure a patient's oxygenation than SpO2 monitoring
etCO2 is measured by a sensor on the patient's finger
etCO2 monitoring is used only under special circumstances
etCO2 is first measured in the preoperative area

Explanation

Question 12 of 20

1

Malignant hyperthermia is an emergency situation that any person undergoing surgery can experience.

Select one of the following:

True
False

Explanation

Question 13 of 20

1

The nurse is discussing patient controlled analgesia with a patient and his family members prior to surgery. When the nurse stresses the requirement that only the patient push the button for a dose of pain medication, which concept is being discussed?

Select one of the following:

the use of a pain scale
trust vs. mistrust
PCA by proxy
informed consent

Explanation

Question 14 of 20

1

The longer the surgical procedure, the higher the risk for:
(select all that apply)

Select one or more of the following:

a longer recovery period
complications of anesthesia
hypothermia
venous thromboembolism
blood loss

Explanation

Question 15 of 20

1

The nurse is receiving hand-off report from another nurse about a patient who had abdominal surgery 12 hours ago, is stable, and is ambulating several times a day without difficulty. Which of the following should the receiving nurse question and ask for clarification about?

Select one of the following:

the patient has an order for anti-embolism stockings AND sequential compression boots
the patient should not be ambulating since surgery was only 12 hours ago
the patient is wearing sequential compression boots when in bed
the patient is doing coughing and deep breathing exercises q 2 hours

Explanation

Question 16 of 20

1

Which of the following would NOT be expected for a patient who had open abdominal surgery 24 hours ago?

Select one of the following:

serous drainage on the dressing
serosanguinous drainage on the dressing
dehiscence of the wound
the surgeon performs the first dressing change

Explanation

Question 17 of 20

1

Which of the following increase the risk of delayed surgical wound healing? Select all that apply.

Select one or more of the following:

malnutrition
obesity
smoking
infection
location of surgical wound being on the head
history of oral steroid use
hypertension
history of diabetes
history of renal disease

Explanation

Question 18 of 20

1

Which of the following are acceptable actions to delegate to unlicensed personnel such as a patient care assistant or medical assistant who has received the proper training?

Select one or more of the following:

measurement of vital signs
interpretation of vital signs
assessment of skin integrity
documentation of skin assessment
education of client on wound care
empty and record volume of surgical drains and foley catheter bags
check blood glucose using monitor

Explanation

Question 19 of 20

1

Fill the blank spaces to complete the text.

It important for a nurse to recall the anatomical of fingers and for confirmation of when one of these digits will be operated on.

Explanation

Question 20 of 20

1

Which of the following are true regarding malignant hyperthermia? Select all that apply.

Select one or more of the following:

it is an inherited disorder
diaphragmatic and intercostal muscle paralysis negatively affect respiratory status
the treatment includes IV dantrolene, a skeletal muscle relaxant
ongoing muscle contraction contributes to hypermetabolism
metabolic alkalosis occurs
hypotension, hypoxemia, hyperkalemia, renal injury or cardiac arrest can result

	Created by Angela Elenbaas about 4 years ago

Nursing (334 Materials) Quiz on Perioperative Review, created by Angela Elenbaas on 18/03/2020.

Perioperative Review

Question 1 of 20

An inpatient is scheduled to have surgery tomorrow. The nurse takes an incentive spirometer to the patient's room to provide education on its use in the postoperative period. Which of the following are instructions the nurse should include?

Select one of the following:

Explanation

Question 2 of 20

A presurgical patient has signed the informed consent form, after which, the nurse signs the consent form. What is the purpose of the nurse's signature?

Select one of the following:

Explanation

Question 3 of 20

A patient is scheduled for surgery in one hour and has had NPO after midnight orders. Blood was drawn for labwork 30 minutes ago. Under which of the following circumstances should the nurse contact the surgeon to inform them prior to the patient going to surgery? Select all that apply.

Select one or more of the following:

Explanation

Question 4 of 20

The patient is scheduled for an upper endoscopy and a colonoscopy at 1200 today. At 1000 the patient returned from hemodialysis during which heparin was administered. What is the primary risk for this patient?

Select one of the following:

Explanation

Question 5 of 20

Which of the following may be allowed by the surgeon for a patient who is to have nothing by mouth (NPO) for a procedure involving sedation?

Select one of the following:

Explanation

Question 6 of 20

Which of the following are considered to be advance directives? Select all that apply.

Select one or more of the following:

Explanation

Question 7 of 20

Select from the dropdown lists to complete the text.

Explanation

Question 8 of 20

The nurse knows that infection is a primary risk to a surgical patient. Which of the following interventions is most important to protect a surgical patient from infection?

Select one of the following:

Explanation

Question 9 of 20

Which of the following should the preoperative nurse replace prior to allowing the patient to be transported to surgery? Select all that apply.

Select one or more of the following:

Explanation

Question 10 of 20

Which of the following is included in the group of three signs that, together, can be an early indication of malignant hyperthermia? Select all that apply.

Select one or more of the following:

Explanation

Question 11 of 20

The surgical nurse is discussing the monitoring of end-tidal carbon dioxide (etCO2) during surgery with a student. Which of the following should the nurse include in the education?

Select one of the following:

Explanation

Question 12 of 20

Malignant hyperthermia is an emergency situation that any person undergoing surgery can experience.

Select one of the following:

Explanation

Question 13 of 20

The nurse is discussing patient controlled analgesia with a patient and his family members prior to surgery. When the nurse stresses the requirement that only the patient push the button for a dose of pain medication, which concept is being discussed?

Select one of the following:

Explanation

Question 14 of 20

The longer the surgical procedure, the higher the risk for: (select all that apply)

Select one or more of the following:

Explanation

Question 15 of 20

The nurse is receiving hand-off report from another nurse about a patient who had abdominal surgery 12 hours ago, is stable, and is ambulating several times a day without difficulty. Which of the following should the receiving nurse question and ask for clarification about?

Select one of the following:

Explanation

Question 16 of 20

Which of the following would NOT be expected for a patient who had open abdominal surgery 24 hours ago?

Select one of the following:

Explanation

Question 17 of 20

Which of the following increase the risk of delayed surgical wound healing? Select all that apply.

Select one or more of the following:

Explanation

Question 18 of 20

Which of the following are acceptable actions to delegate to unlicensed personnel such as a patient care assistant or medical assistant who has received the proper training?

Select one or more of the following:

Explanation

Question 19 of 20

Fill the blank spaces to complete the text.

It important for a nurse to recall the anatomical of fingers and for confirmation of when one of these digits will be operated on.

Explanation

Question 20 of 20

Which of the following are true regarding malignant hyperthermia? Select all that apply.

Select one or more of the following:

The longer the surgical procedure, the higher the risk for:
(select all that apply)