Question 1

The nurse is preparing to complete hand hygiene using an alcohol-based rub and knows that how much hand rub product will be required for adequate hand cleansing?

Accepted Answer

A)  0) 5-1.5 mL
B)  2-4 mL
C)  5-6 mL
D)  8-10 mL C

Question 2

The nurse enters a room in preparation for a sterile dressing change.Which must the nurse do before preparing the sterile field?

Accepted Answer

A)  Turn the room fan off.
B)  Open the blinds in the room.
C)  Request the client perform hand hygiene.
D)  Increase the temperature in the room 10 degrees to prevent chilling the client. A

Question 3

The nurse is caring for a client who is being prepared for surgery.Due to a motorcycle crash 10 years ago,the client has a prosthetic right arm,prosthetic left leg,prosthetic left eye,and wears hearing aids.The client also wears a wedding ring that cannot easily be removed from the client's finger.Which statement by the nurse indicates the proper way of preparing the client for surgery?

Accepted Answer

A)  "Please remove your hearing aids and your prosthetic leg,arm,and eye.I am going to securely tape your ring in place."
B)  "Please remove your hearing aids and prosthetic leg and arm.I will place tape over your left eye and tape on your ring to hold them both in place during the surgery."
C)  "I need for you to remove your hearing aids,and all of your prosthetics.I am going to get some oil to put on your finger because your ring must be removed prior to surgery."
D)  "I'm sure you know the drill because you have had many surgeries before.Please remove anything that is not your original equipment." A

Question 4

The nurse is preparing four older adult patients for surgery and knows that which client is at highest risk for postoperative pressure wound development?

Accepted Answer

A)  The client who regularly attends the local senior center for socialization and meals and takes diphenhydramine (Benadryl) at night for sleep
B)  The client who walks one mile every other day and takes ibuprofen twice a day for arthritis in his knees
C)  The client who babysits every day and takes prednisone daily for allergies
D)  The client who drives a bus every week and takes fluoxetine (Prozac) for anxiety

Question 5

The nurse is preparing a client for inguinal hernia surgery,which will require hair to be removed from the inguinal region.The nurse informs the client that this hair removal is completed at what time in relation to the surgery?

Accepted Answer

A)  The nurse will instruct the client on completing a preoperative shave with a safety razor on the night prior to the surgery.
B)  The nurse will instruct the client to complete the preoperative shave with a safety razor on the morning of the surgery prior to coming to the hospital.
C)  The nurse will explain that the preoperative shave will be completed using an electric clipper after the client arrives at the hospital the morning of surgery.
D)  The nurse will tell the client that the preoperative shave will be completed by the surgeon in the operating room immediately prior to the beginning of the surgery.

Question 6

The nurse is researching the literature to determine the best method to perform hand hygiene to prevent a postsurgical wound infection and has determined that which method has been determined to be the best?

Accepted Answer

A)  Hand hygiene using a surgical scrub brush and very hot water works best to prevent infection.
B)  Performing hand hygiene using an alcohol-based rub has been shown as the best method to prevent postoperative infection.
C)  Prior to surgery,washing the hands with soap and water and finishing with an alcohol-based hand wash is the best method to prevent infection.
D)  Research has not determined whether hand washing with soap or the use of alcohol-based hand hygiene is better at preventing infection.

Question 7

The nurse is caring for a client who had a knee replacement completed 2 days ago.When changing the knee dressing,the nurse notes that the incision appears red and feels warm to the touch.The client's temperature is now 100.6 degrees F and the client states that the knee hurts worse now than it did the day after surgery.After calling the surgeon,the nurse anticipates which to be ordered for this client?

Accepted Answer

A)  Keep the client NPO and prepare for the client to be returned to surgery.
B)  Restart the client's IV and give fluids and pain medication.
C)  Culture any drainage that is present and administer fluids and antibiotics.
D)  Provide anticoagulant therapy and place the client on oxygen.

Question 8

The nurse is caring for a client who had abdominal surgery three days ago.The client is able to drink fluids but is reluctant to eat anything for fear of nausea and vomiting.The nurse encourages the client to try and eat to prevent which postoperative complication?

Accepted Answer

A)  Dehydration
B)  Pneumonia
C)  Urinary retention
D)  Delayed wound healing

Question 9

The circulating nurse calls for a "time out" prior to the onset of a surgical procedure and knows that which client will not have a visible mark at the site of surgery?

Accepted Answer

A)  The client who is having a right bunionectomy
B)  The client who is having a left knee replacement
C)  The client who is having removal of a melanoma on the right arm
D)  The client who is having a splenectomy

Question 10

The nurse is preparing to change the dressing of a surgical client and will be alert for which signs or symptoms of a wound infection? Select all that apply.

Accepted Answer

A)  Cool to the touch
B)  Redness
C)  Serosanguinous drainage
D)  Client temperature of 101 degrees F
E)  Pain rating of 2 out of 10

Question 11

The nurse is conducting preoperative teaching for a 78-year-old client who will be having outpatient cataract surgery.Which statement by the nurse indicates the best approach to safely teaching this client?

Accepted Answer

A)  "Be at the eye surgery center at 6 AM,wear loose-fitting clothes,and make sure that you bring someone with you who can take you home."
B)  "Please do not eat or drink anything after 10 PM the night before surgery."
C)  "Please read this information about cataract surgery and I'll be back in a few minutes to answer any questions you may have."
D)  "I see that your spouse had a cataract removed with us last year.Everything will be about the same for your surgery."

Question 12

The nurse is preparing a client for surgery and asks the client to remove his dentures and place them in the specified cup at the bedside.The client states,"Why are you asking me to do this? The last time I had surgery I got to keep my dentures in my mouth." Which is the nurse's best response to this client statement?

Accepted Answer

A)  "You may have thought you kept them in.I'm guessing your dentures were removed after you went to sleep and were returned to your mouth before you were completely awake."
B)  "Some anesthesiologists allow a client to keep a full set of dentures in the mouth if a specific type of anesthesia is given."
C)  "I've never heard of anyone keeping their dentures in for surgery.You must remove them."
D)  "I'm sorry that you don't want to do this.You must take them out or your surgery will be canceled."

Question 13

Immediately prior to placing the client on a gurney for surgery,the nurse asks the client to remove the partial plate dentures.The client becomes upset and states,"No one can see me without my teeth.I am so embarrassed by the way I look without them." What is the nurse's best response to the client?

Accepted Answer

A)  "I realize this is hard for you to do.I will ask the nurse in surgery to remove them for you after you go to sleep."
B)  "Why don't you take them out and drape this washcloth over your face so no one can see you without your teeth?"
C)  "Leaving your teeth in during surgery may cause injury to you or your teeth.Here is the cup for your dentures.Take them out right before surgery and then you can place them back in your mouth as soon as you wake up."
D)  "This is just something you have to put up with when you have surgery.No one knows you here so it won't be that embarrassing."

Question 14

The nurse is preparing a sterile field prior to a wet to dry dressing change and notices that the corner of the sterile drape is damp.What is the nurse's best action at this time?

Accepted Answer

A)  Continue with the procedure because the dampness is in the area already considered to be contaminated.
B)  Put down a fresh drape but use the liquids that have already been poured.
C)  Begin the procedure from the beginning,including pouring fresh liquids.
D)  Wait 5 minutes to see if the damp area will move into the area considered sterile.If the sterile area becomes damp,begin again with fresh supplies.

Question 15

The nurse is caring for an older adult client who is being prepared for abdominal surgery.During the preoperative assessment,the nurse notes that the client has a nonproductive cough but all lung sounds appear normal.With regard to this finding,which preoperative teaching will take priority with this client?

Accepted Answer

A)  Postoperative nutrition
B)  Pursed-lip breathing
C)  Use of incentive spirometer
D)  Bed leg exercises

Question 16

The nurse is preparing the room for a client who is having surgery to repair a tibial fracture.In an effort to promote early ambulation,the nurse will have which safest assistive device available for the client?

Accepted Answer

A)  Cane
B)  Walker
C)  Crutches
D)  Wheelchair

Question 17

The nurse is preparing to do preoperative teaching for a client who will have abdominal surgery.Which preoperative teaching will the nurse emphasize for this client to assist the client with early ambulation? Select all that apply.

Accepted Answer

A)  How to get out of bed after surgery
B)  Requesting pain medication before the pain is severe
C)  Using an incentive spirometer
D)  How to turn in bed to prevent skin breakdown
E)  Splinting the incision before coughing

Question 18

The nurse is performing a surgical hand scrub prior to entering the operating room.The circulating nurse will stop the nurse and reinstruct on proper hand scrubbing if the nurse does which action?

Accepted Answer

A)  After wetting the hands and forearms,the nurse holds the hands above the level of the elbows.
B)  The nurse spends 25 to 30 seconds rubbing soap on the tops and palms of hands using an up-and-down motion.
C)  The nurse keeps the arms elevated and backs into the operating room.
D)  The nurse uses a sterile towel to dry one hand from fingers to the elbow and then picks up a second sterile towel for the other hand.

Question 19

The nurse has just completed teaching a client about postoperative leg exercises to prevent which postoperative complication?

Accepted Answer

A)  Pneumonia
B)  Pulmonary embolism
C)  Atelectasis
D)  Ileus

Question 20

The nurse has been asked to assist a healthcare provider with a sterile procedure at the client's bedside.The nurse enters the client's room to find a non-covered sterile field set out on the client's bedside table but the healthcare provider has left the room.What should the nurse do at this time?

Accepted Answer

A)  Nothing;it is not the nurse's responsibility.
B)  Leave the room and wait until the healthcare provider enters the room again before reentering.
C)  Ask the client how long the healthcare provider has been out of the room.
D)  Request that the healthcare provider set up a new sterile field.

Exam 13: Perioperative Care