Question 1

A patient asks a nurse to explain the differences between general anesthesia and regional anesthesia.What is the correct response relating to general anesthesia?

Accepted Answer

A)  "General anesthesia inhibits peripheral nerve conduction." 
B)  "Under general anesthesia all sensation and consciousness is lost." 
C)  "Under general anesthesia there is a loss of sensation in a specific area of the body." 
D)  "General anesthesia is routinely used for procedures that only require a decreased level of consciousness." 
A)  "General anesthesia inhibits peripheral nerve conduction." 
B)  "Under general anesthesia all sensation and consciousness is lost." 
C)  "Under general anesthesia there is a loss of sensation in a specific area of the body." 
D)  "General anesthesia is routinely used for procedures that only require a decreased level of consciousness." B

Question 2

The preoperative nurse who is providing patient teaching to a 49-year-old patient who is scheduled to undergo a right-side inguinal surgery repair.The nurse informs the patient that the American Society of Anesthesiologists recommend that patients undergoing surgery with a general anesthesia fast from meat and fried foods for how many hours before surgery?

Accepted Answer

A)  2 
B)  4 
C)  6 
D)  8 
A)  2 
B)  4 
C)  6 
D)  8 D

Question 3

A 57-year-old patient who is being admitted for an appendectomy.The patient is a 2-pack-a-day smoker,has a history of diabetes,and is 20 pounds overweight.Which of the following potential postoperative complications should be the nurse's highest concern for prevention?

Accepted Answer

A)  Atelectasis 
B)  Negative nitrogen balance 
C)  Delayed wound healing 
D)  Hyperthermia 
A)  Atelectasis 
B)  Negative nitrogen balance 
C)  Delayed wound healing 
D)  Hyperthermia A

Question 4

The nurse is providing preoperative teaching for a patient regarding pain control after surgery.Which of the following statements is/are true regarding the use of postoperative analgesia? (Select all that apply.)

Accepted Answer

A)  "Analgesics will not provide adequate relief if you wait until the pain becomes excruciating before using them." 
B)  "Pain control will help you recover from surgery quicker." 
C)  "You shouldn't be concerned about becoming addicted to your pain medications immediately after surgery." 
D)  "You will remain pain-free as long as you take your pain medications as prescribed." 
E)  "A PCA pump is commonly used to help patients control their pain."
F) "Take pain medication carefully as it will lengthen your recovery period." 
A)  "Analgesics will not provide adequate relief if you wait until the pain becomes excruciating before using them." 
B)  "Pain control will help you recover from surgery quicker." 
C)  "You shouldn't be concerned about becoming addicted to your pain medications immediately after surgery." 
D)  "You will remain pain-free as long as you take your pain medications as prescribed." 
E)  "A PCA pump is commonly used to help patients control their pain."
F) "Take pain medication carefully as it will lengthen your recovery period."

Question 5

When is it appropriate to ask a surgeon to clarify information for a patient who is undergoing surgery? (Select all that apply.)

Accepted Answer

A)  Before the informed consent has been signed 
B)  When a patient is confused about the reason for the procedure 
C)  When a patient understands the risks involved in a procedure 
D)  If there is confusion about the procedure after the informed consent is signed 
E)  After the surgery has been performed 
A)  Before the informed consent has been signed 
B)  When a patient is confused about the reason for the procedure 
C)  When a patient understands the risks involved in a procedure 
D)  If there is confusion about the procedure after the informed consent is signed 
E)  After the surgery has been performed

Question 6

The perioperative nurse is admitting a patient for an elective surgery.She questions the patient about issues with anesthesia,to assess the patient for malignant hyperthermia.Which of the following is a late sign of malignant hyperthermia?

Accepted Answer

A)  High CO2 levels 
B)  Tachycardia 
C)  Elevated temperature 
D)  Tachypnea 
A)  High CO2 levels 
B)  Tachycardia 
C)  Elevated temperature 
D)  Tachypnea

Question 7

Intraoperatively,the circulating nurse observes a member of the surgical team breach aseptic technique.As a result of this incident the postoperative patient can be at risk for which of the following?

Accepted Answer

A)  Paralytic ileus 
B)  Malignant hyperthermia 
C)  Development of infection 
D)  Alteration in pulmonary hygiene 
A)  Paralytic ileus 
B)  Malignant hyperthermia 
C)  Development of infection 
D)  Alteration in pulmonary hygiene

Question 8

A patient with a ruptured abdominal aortic aneurysm needs to have major surgery.The nurse explains to the family that major surgery:

Accepted Answer

A)  is an excision or removal of a diseased body part. 
B)  involves extensive surgery to reconstruct body parts. 
C)  is not necessary but may prevent additional problems. 
D)  is a surgical exploration that allows the physician or health care provider to confirm a diagnosis. 
A)  is an excision or removal of a diseased body part. 
B)  involves extensive surgery to reconstruct body parts. 
C)  is not necessary but may prevent additional problems. 
D)  is a surgical exploration that allows the physician or health care provider to confirm a diagnosis.

Question 9

A patient with a ruptured abdominal aortic aneurysm needs to have major surgery.The family asks the nurse what type of anesthesia the patient will receive.The best response is which of the following?

Accepted Answer

A)  Local anesthesia 
B)  Regional anesthesia 
C)  Moderate sedation 
D)  General anesthesia 
A)  Local anesthesia 
B)  Regional anesthesia 
C)  Moderate sedation 
D)  General anesthesia

Question 10

A 44-year-old patient with breast cancer who is scheduled to undergo a right-side mastectomy.Ideally when should preoperative teaching begin?

Accepted Answer

A)  As soon as she is diagnosed with breast cancer 
B)  One week before surgery 
C)  The day before surgery 
D)  The day of surgery 
A)  As soon as she is diagnosed with breast cancer 
B)  One week before surgery 
C)  The day before surgery 
D)  The day of surgery

Question 11

The nurse working on a medical/surgical floor knows that pulmonary embolisms can be a deadly complication after surgery.Which of the following patients is most likely to develop a pulmonary embolism?

Accepted Answer

A)  45-year-old patient after bariatric surgery 
B)  23-year-old patient with pneumonia 
C)  13-year-old patient after appendectomy 
D)  57-year-old patient after cholecystectomy 
A)  45-year-old patient after bariatric surgery 
B)  23-year-old patient with pneumonia 
C)  13-year-old patient after appendectomy 
D)  57-year-old patient after cholecystectomy

Question 12

The nurse is conducting preoperative teaching with the patient and family.The nurse teaches the patient the proper use of the incentive spirometer.The nurse knows that the patient understands the need for this intervention when the patient states,"I use this device to:

Accepted Answer

A)  help my cough reflex." 
B)  expand my lungs after surgery." 
C)  increase my lung circulation." 
D)  keep me from coughing." 
A)  help my cough reflex." 
B)  expand my lungs after surgery." 
C)  increase my lung circulation." 
D)  keep me from coughing."

Question 13

All patients undergoing surgery need to have preoperative preparation.When physically preparing the patient,the most appropriate action for the nurse to take is which of the following?

Accepted Answer

A)  Leaving all of the patient's jewelry in place 
B)  Removing the patient's makeup and nail polish 
C)  Providing the patient with sips of water for a dry mouth 
D)  Removing the patient's hearing aid before transport to the operating room 
A)  Leaving all of the patient's jewelry in place 
B)  Removing the patient's makeup and nail polish 
C)  Providing the patient with sips of water for a dry mouth 
D)  Removing the patient's hearing aid before transport to the operating room

Question 14

A nurse working in an ambulatory care surgery center is preparing to discharge a postoperative patient.The nurse knows that the convalescence period will occur:

Accepted Answer

A)  1 to 2 hours after surgery. 
B)  at home. 
C)  once the patient has been monitored overnight in the hospital. 
D)  2 to 4 hours after surgery. 
A)  1 to 2 hours after surgery. 
B)  at home. 
C)  once the patient has been monitored overnight in the hospital. 
D)  2 to 4 hours after surgery.

Question 15

The nurse instructs the postoperative patient to perform leg exercises every hour in order to do which of the following?

Accepted Answer

A)  Maintain muscle tone. 
B)  Increase venous return. 
C)  Exercise fatigued muscles. 
D)  Assess range of joint motion. 
A)  Maintain muscle tone. 
B)  Increase venous return. 
C)  Exercise fatigued muscles. 
D)  Assess range of joint motion.

Question 16

A student nurse has been assigned to a 67-year-old patient who is undergoing thoracic surgery to remove a tumor.As part of the preoperative teaching,the student nurse discusses the importance of coughing.Which of the following statements is true regarding why postoperative coughing is important? (Select all that apply.)

Accepted Answer

A)  "Coughing assists in removing retained mucus in the airways." 
B)  "It won't hurt to cough with adequate pain control." 
C)  "You can splint your incision when coughing to minimize pain." 
D)  "Deep breathing and coughing will remove anesthesia gases from your lungs." 
E) "Deep breathing involves fast, shallow, breaths and then one big breath."
F) "Coughing is not encouraged because of the potential or dehiscence at the surgical site." 
A)  "Coughing assists in removing retained mucus in the airways." 
B)  "It won't hurt to cough with adequate pain control." 
C)  "You can splint your incision when coughing to minimize pain." 
D)  "Deep breathing and coughing will remove anesthesia gases from your lungs." 
E) "Deep breathing involves fast, shallow, breaths and then one big breath."
F) "Coughing is not encouraged because of the potential or dehiscence at the surgical site."

Question 17

A 56-year-old nondiabetic patient is undergoing orthopedic surgery.The perioperative nurse is monitoring the blood glucose level.What is the main rationale for monitoring his blood glucose level during surgery?

Accepted Answer

A)  She does not want the patient to develop an embolism. 
B)  Research shows a strong relationship between wound infections and hyperglycemia. 
C)  She knows that normal glucose levels promote platelet production. 
D)  She is monitoring to prevent embolism. 
A)  She does not want the patient to develop an embolism. 
B)  Research shows a strong relationship between wound infections and hyperglycemia. 
C)  She knows that normal glucose levels promote platelet production. 
D)  She is monitoring to prevent embolism.

Question 18

A patient is awaiting surgery.The nurse's best rationale for assessing vital signs is to do which of the following?

Accepted Answer

A)  Assess the patient's anxiety level. 
B)  Determine the patient's basal temperature. 
C)  Establish a baseline for vital signs comparisons. 
D)  Assess for any changes that may indicate infection. 
A)  Assess the patient's anxiety level. 
B)  Determine the patient's basal temperature. 
C)  Establish a baseline for vital signs comparisons. 
D)  Assess for any changes that may indicate infection.

Question 19

A 45-year-old woman has been admitted for surgery to remove a cancerous abdominal tumor.She has been on chemotherapy and recently radiotherapy to shrink the tumor without success.To best facilitate wound healing,when is the best time for her to undergo surgery?

Accepted Answer

A)  During the radiotherapy treatments 
B)  Immediately after the radiotherapy treatments 
C)  2 to 3 weeks after radiotherapy treatments 
D)  4 to 6 weeks after radiotherapy treatments 
A)  During the radiotherapy treatments 
B)  Immediately after the radiotherapy treatments 
C)  2 to 3 weeks after radiotherapy treatments 
D)  4 to 6 weeks after radiotherapy treatments

Question 20

Which of the following patients is most at risk for hypovolemic shock after emergency surgery?

Accepted Answer

A)  14-year-old adolescent with gastroenteritis 
B)  59-year-old patient with pneumonia 
C)  12-year-old patient with H1N1 flu 
D)  28-year-old patient with a fractured ankle 
A)  14-year-old adolescent with gastroenteritis 
B)  59-year-old patient with pneumonia 
C)  12-year-old patient with H1N1 flu 
D)  28-year-old patient with a fractured ankle

Exam 39: Surgical Patient

A patient asks a nurse to explain the differences between general anesthesia and regional anesthesia.What is the correct response relating to general anesthesia?

A 57-year-old patient who is being admitted for an appendectomy.The patient is a 2-pack-a-day smoker,has a history of diabetes,and is 20 pounds overweight.Which of the following potential postoperative complications should be the nurse's highest concern for prevention?

The nurse is providing preoperative teaching for a patient regarding pain control after surgery.Which of the following statements is/are true regarding the use of postoperative analgesia? (Select all that apply.)

When is it appropriate to ask a surgeon to clarify information for a patient who is undergoing surgery? (Select all that apply.)

The perioperative nurse is admitting a patient for an elective surgery.She questions the patient about issues with anesthesia,to assess the patient for malignant hyperthermia.Which of the following is a late sign of malignant hyperthermia?

Intraoperatively,the circulating nurse observes a member of the surgical team breach aseptic technique.As a result of this incident the postoperative patient can be at risk for which of the following?

A patient with a ruptured abdominal aortic aneurysm needs to have major surgery.The nurse explains to the family that major surgery:

A patient with a ruptured abdominal aortic aneurysm needs to have major surgery.The family asks the nurse what type of anesthesia the patient will receive.The best response is which of the following?

A 44-year-old patient with breast cancer who is scheduled to undergo a right-side mastectomy.Ideally when should preoperative teaching begin?

The nurse working on a medical/surgical floor knows that pulmonary embolisms can be a deadly complication after surgery.Which of the following patients is most likely to develop a pulmonary embolism?

The nurse is conducting preoperative teaching with the patient and family.The nurse teaches the patient the proper use of the incentive spirometer.The nurse knows that the patient understands the need for this intervention when the patient states,"I use this device to:

All patients undergoing surgery need to have preoperative preparation.When physically preparing the patient,the most appropriate action for the nurse to take is which of the following?

A nurse working in an ambulatory care surgery center is preparing to discharge a postoperative patient.The nurse knows that the convalescence period will occur:

The nurse instructs the postoperative patient to perform leg exercises every hour in order to do which of the following?

A 56-year-old nondiabetic patient is undergoing orthopedic surgery.The perioperative nurse is monitoring the blood glucose level.What is the main rationale for monitoring his blood glucose level during surgery?

A patient is awaiting surgery.The nurse's best rationale for assessing vital signs is to do which of the following?

A 45-year-old woman has been admitted for surgery to remove a cancerous abdominal tumor.She has been on chemotherapy and recently radiotherapy to shrink the tumor without success.To best facilitate wound healing,when is the best time for her to undergo surgery?

Which of the following patients is most at risk for hypovolemic shock after emergency surgery?

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