Question 1

Which of the following is classified as an urgent surgery?

Accepted Answer

A)   Hernia repair due to a work-related injury
B)   Cholecystectomy related to presence of stones
C)   Appendectomy for a perforated appendix
D)   Breast reconstruction after a previous motor vehicle accident injury one year before B

Question 2

An appendectomy is appropriately documented by the nurse as which following type of surgery?

Accepted Answer

A)   Diagnostic surgery
B)   Palliative surgery
C)   Ablative surgery
D)   Reconstructive surgery C

Question 3

Which drug class may interact with anaesthetic agents to cause bradycardia,hypotension,and impaired circulation?

Accepted Answer

A)   Diuretics
B)   Antibiotics
C)   Anticoagulants
D)   Antihypertensives D

Question 4

Coughing postoperatively is contraindicated following which type of surgery?

Accepted Answer

A)   Eye surgery
B)   Chest surgery
C)   Thoracic surgery
D)   Perineal surgery

Question 5

An obese patient is admitted for abdominal surgery.The nurse recognizes that this patient is more susceptible to which of the following postoperative complications?

Accepted Answer

A)   Anemia
B)   Seizures
C)   Protein loss
D)   Dehiscence

Question 6

Which of the following is one of the greatest risks of general anaesthesia?

Accepted Answer

A)   Hypertension
B)   Cardiovascular depression
C)   Oral mucosa damage
D)   Tachypnea

Question 7

On admission to the PACU,in which manner does the nurse position the patient who has no orthopaedic or neurological restrictions?

Accepted Answer

A)   With the bed flat and the patient's arms to the sides
B)   With the patient's neck flexed and body in prone position
C)   With the patient in side-lying position
D)   With the patient's arms crossed over the chest and the bed in high Fowler's position

Question 8

The nurse is completing the preoperative checklist for an adult patient who is scheduled for an operative procedure later in the morning.Which preoperative assessment finding for this patient indicates a need to contact the anaesthesiologist?

Accepted Answer

A)   Temperature 39ºC
B)   Pulse 90 beats per minute
C)   Respirations 20 breaths per minute
D)   Blood pressure 130/74 mm Hg

Question 9

The patient tells the nurse,"Blowing into this tube thing (incentive spirometer)is a ridiculous waste of time." Which one of the following does the nurse tell the patient is the specific purpose of using an incentive spirometer?

Accepted Answer

A)   It directly removes excess secretions from the lungs.
B)   It increases pulmonary circulation.
C)   It promotes optimal lung expansion.
D)   It stimulates the cough reflex.

Question 10

The nurse is completing the preoperative checklist for an adult female patient who is scheduled for an operative procedure later in the morning.Which preoperative assessment finding would the nurse report to the surgeon?

Accepted Answer

A)   Hemoglobin 90 g/L
B)   Creatinine 50 mcmol/L
C)   Blood urea nitrogen (BUN)  3.0 mmol/L
D)   Platelets 200 ´ 109 cells/L

Question 11

The patient is in the PACU recovering from a hysterectomy.Which one of the following is a normal expectation for the patient in this stage of recovery?

Accepted Answer

A)   Returned normal bowel sounds on auscultation
B)   Pain that is relieved with noninvasive comfort measures
C)   Voluntary bladder control and function
D)   A subdued level of consciousness and neurological function

Question 12

A 43-year-old patient is scheduled to have a gastrectomy.Which one of the following is a major preoperative concern?

Accepted Answer

A)   The patient's brother had a tonsillectomy at 11 years of age.
B)   The patient smokes a pack of cigarettes a day.
C)   An intravenous (IV)  infusion is present.
D)   The patient has a history of employment as a computer programmer.

Question 13

In the morning,the patient had surgery that involved the right femoral artery.To assess the patient's circulation status to the right leg,at which site will the nurse make sure to check the pulse?

Accepted Answer

A)   Radial artery
B)   Ulnar artery
C)   Brachial artery
D)   Dorsalis pedis artery

Question 14

The patient is scheduled for abdominal surgery and has just received the preoperative medications.Which of the following actions should the nurse take to assure the patient's safety?

Accepted Answer

A)   Keep the patient quiet.
B)   Obtain the consent.
C)   Prepare the skin at the surgical site.
D)   Raise the side rails on the bed or stretcher.

Question 15

Which of the following lab results would cause the nurse to prepare to administer preoperative IV fluid replacement?

Accepted Answer

A)   Fasting glucose 3.3 mmol/L
B)   Serum creatinine 62 mcmol/L
C)   BUN 8.9 mmol/L
D)   International normalized ratio 1.01

Question 16

In the postoperative period,the nurse recognizes that which one of the following is an early sign of malignant hyperthermia?

Accepted Answer

A)   Fever
B)   Tachycardia
C)   Muscle relaxation
D)   Skin pallor

Question 17

A 92-year-old patient is scheduled for a colectomy.Which of the following physiological changes accompanies the aging process and increases this patient's risk for surgery?

Accepted Answer

A)   An increased tactile sensation
B)   An increased metabolic rate
C)   A relaxation of arterial walls
D)   Reduced glomerular filtration

Question 18

The patient will have an incision in the lower left abdomen.Which of the following measures by the nurse will help decrease discomfort in the incisional area when the patient coughs postoperatively?

Accepted Answer

A)   Applying a splint directly over the lower abdomen
B)   Keeping the patient flat with feet flexed
C)   Turning the patient onto the right side
D)   Applying pressure above and below the incision

Question 19

The nurse is working in a postoperative care unit in an ambulatory surgery centre.Of the following patients that have come to have surgery,which one is at the greatest risk during surgery?

Accepted Answer

A)   A 78-year-old taking an analgesic agent
B)   A 43-year-old taking corticosteroids
C)   A 27-year-old taking an anticoagulant agent
D)   A 10-year-old taking an antibiotic agent

Question 20

When speaking with the patient,the nurse discovers that the patient does not have a complete understanding of the surgical procedure.Which of the following courses of action should the nurse take?

Accepted Answer

A)   Obtain the consent, as this is expected with preoperative anxiety.
B)   Teach the patient all about the procedure.
C)   Ask the unit manager to assist with a teaching plan.
D)   Inform the surgeon, so that necessary information can be provided to the patient.

Exam 48: Care of Surgical Patients