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Quiz on Care of the Surgical Patient, created by asissons on 12/04/2015.

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Care of the Surgical Patient

Question 1 of 53

1

The goals of perioperative nursing are

Select one or more of the following:

  • assist the patient and family through the surgery

  • promote positive patient outcomes

  • assist the patient to achieve his/her optimal level of function after the surgery

Explanation

Question 2 of 53

1

what are the three phases of surgery?

Select one or more of the following:

  • preoperative care

  • intraoperative care

  • postoperative care (next week)

Explanation

Question 3 of 53

1

Role of the nurse in Pre-op admission clinic (PAC)

Select one or more of the following:

  • patient interview

  • nursing assessment

  • preoperative teaching

  • day of surgery prep

Explanation

Question 4 of 53

1

In the patient interview what information should you obtain?

Select one or more of the following:

  • determine pt expectations about surgery and anesthesia

  • provide and clarify information about the surgical experience

  • assess patient's emotional state and readiness for surgery

  • determine if pt has enough information to make an informed decision

  • may being some post op teaching

Explanation

Question 5 of 53

1

Informed consent involves

Select one or more of the following:

  • 1. adequate disclosure of diagnosis

  • understanding and comprehension of the information being provided

  • must be given voluntarily

Explanation

Question 6 of 53

1

Assess for ABCDE

Select one or more of the following:

  • Airway

  • breathing

  • Circulation

  • Diability

  • Exposure

Explanation

Question 7 of 53

1

What kind of allergies are you looking for?

Select one or more of the following:

  • Medication

  • foods

  • Chemicals

  • Tape

  • Pollen

  • perfumes

  • latex

Explanation

Question 8 of 53

1

For a pt about to undergo surgery ask about subjective health history

Select one or more of the following:

  • have you had surgeries in the past? which ones? did you have any complications?

  • Have you or any family members experienced any problems with anaesthesia

  • Do you have any past hospitalizations?

  • any chronic health conditions

Explanation

Question 9 of 53

1

Health history assessment

Select one or more of the following:

  • weight and height

  • limitations in neck mobility

  • history of drug or opiate abuse

  • hx of ETOH use

  • HX of smoking

Explanation

Question 10 of 53

1

Conduct lab and diagnostic tests

Select one or more of the following:

  • CBC

  • electrolyte panel

  • LFT

  • Renal Panel

  • Coagulation studies

  • Type and cross match

  • 12 lead ECG

  • Blood Glucose levels

  • CXR

Explanation

Question 11 of 53

1

What types of preoperative information is there?

Select one or more of the following:

  • Sensory - sights, smells sounds

  • Procedural - what to wear, what to eat, physical prep

  • Process - flow of surgery, family needs

Explanation

Question 12 of 53

1

An adult learner

Select one or more of the following:

  • likes to have choices

  • has a variety of learning styles and preferences

  • needs to have abilities and achievements recognized

  • does best in an environment where they feel safe, accepted and respected

Explanation

Question 13 of 53

1

What are the steps involved in client education

Select one or more of the following:

  • assessment of the need to learn

  • assessment of readiness

  • setting of objectives

  • teaching - learning

  • evaluation and re-teaching if necessary

Explanation

Question 14 of 53

1

Check all that are involved in a surgical team

Select one or more of the following:

  • 2 RNs

  • practical nurse

  • Surgeon and assistant

  • RN first assistant

  • Anaesthetist

Explanation

Question 15 of 53

1

What does SBAR-R stand for

Select one or more of the following:

  • S: Situation

  • B: background

  • A: Assessment

  • R: Recommendation

  • Repeat - repeat back so it is said properly

Explanation

Question 16 of 53

1

During the preoperative interview, a patient scheduled for an elective hysterectomy to treat benign tumours of the uterus tells the nurse that she does not know whether she can go through with the surgery because she knows she will die in surgery, as her mother did. What is the most appropriate response?

Select one of the following:

  • “Tell me more about what happened to your mother.”

  • “Think positively! Positive thoughts have been shown to influence a positive surgical outcome.

Explanation

Question 17 of 53

1

Why is it especially important for the nurse to determine the patient’s current use of medications during the preoperative assessment?

Select one of the following:

  • These medications may alter the patient’s perceptions about surgery.

  • Other medications may cause interactions with anaesthetics, altering the potency and effect of the drugs.

Explanation

Question 18 of 53

1

The nurse visits the patient to have him sign the operative permit as directed in the physician’s preoperative orders. The patient tells the nurse that the physician has not really told him what is involved in the surgical procedure. What should the nurse do?

Select one of the following:

  • Explain what the planned surgical procedure entails before having the patient sign the consent form.

  • Delay the patient’s signature on the consent form, and notify the physician that the informed-consent process is not complete.

Explanation

Question 19 of 53

1

What does appropriate preoperative teaching for a patient scheduled for abdominal surgery include?

Select one of the following:

  • How to breathe deeply and cough

  • How to care for the wound

Explanation

Question 20 of 53

1

An 82-year-old man is admitted to the hospital the evening before a prostatectomy for cancer of the prostate. He is alert and oriented but has difficulty seeing and hearing. His wife is at his bedside and answers most questions directed to the patient. What should the nurse do to accomplish preoperative teaching with the patient?

Select one of the following:

  • Provide additional time for the patient to understand preoperative instructions and carry out procedures

  • Ask the patient’s wife to wait in the hall in order to focus on preoperative teaching with the patient himself

Explanation

Question 21 of 53

1

What are the physical environment and traffic control measures of the OR primarily designed to do?

Select one of the following:

  • Protect the patient’s privacy.

  • Prevent transmission of infection

Explanation

Question 22 of 53

1

Which one of the following intraoperative patient positions would the nurse anticipate for the patient who is being prepared for abdominal surgery?

Select one of the following:

  • Prone

  • Supine

Explanation

Question 23 of 53

1

The nurse notes that a preoperative patient is drowsy, but oriented, in the receiving area. In addition to checking her hospital number and identification band, what should the nurse check?

Select one of the following:

  • Ask the patient to state her name, her doctor’s name, and the operative procedure planned.

  • Ask the surgeon to identify the patient and the planned surgical procedure.

Explanation

Question 24 of 53

1

The nurse from the general surgical unit brings the patient’s hearing aid to the surgical suite because the patient left the unit without it and it is needed to communicate with the patient. At the surgical suite, what areas can the general surgical unit nurse enter?

Select one of the following:

  • Clean core

  • Scrub sink areas

  • Information or nursing station

  • Corridors of the ORs

Explanation

Question 25 of 53

1

Which assessment finding would the nurse expect to observe in a patient with malignant hyperthermia

Select one of the following:

  • Decreased heart rate

  • Low, irregular respirations

  • Decreased temperature

  • Ventricular dysrhythmias

Explanation

Question 26 of 53

1

What is one of the most important goals of the registered nurse first assistant?

Select one of the following:

  • Safety of the patient

  • Documentation of the intraoperative care

Explanation

Question 27 of 53

1

You are the clinic nurse doing a preoperative assessment on a patient who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the patient's medical history, you note that this patient had a kidney transplant 8 years ago. The patient is taking immunosuppressive drugs. What is this patient at increased risk for when having surgery?

Select one of the following:

  • infection

  • death

Explanation

Question 28 of 53

1

An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?

Select one of the following:

  • Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.

  • older adults are more malnourished

Explanation

Question 29 of 53

1

How should a nurse teach a patient to perform deep breathing and coughing to use postoperatively?

Select one of the following:

  • The patient should take a deep breath in through the mouth and exhale all the air out through the mouth, take a short breath, and cough from deep in the lungs.

  • The patient should do box breathing

Explanation

Question 30 of 53

1

Which of the following clinical manifestations is often the earliest sign of malignant hyperthermia?

Select one of the following:

  • Tachycardia

  • bradycardia

Explanation

Question 31 of 53

1

A client who had abdominal surgery 4 days ago reports that "something gave way" when he sneezed. The nurse observes a wound evisceration. Which nursing action is the first priority?

Select one of the following:

  • Applying a sterile, moist dressing

  • suturing the wound

Explanation

Question 32 of 53

1

A postanesthesia care unit (PACU) nurse is caring for a patient with the following assessment data: pale, cool, moist skin; thready pulse of 122; blood pressure 78/60; urine output of 25 mL/h; temperature 99.2°F. What interventions by the nurse are appropriate? Select all that apply.

Select one or more of the following:

  • Maintain a patent airway.
    • Frequently monitor neurological status.

    .

  • • Apply oxygen per orders

  • • Administer blood products per orders.

  • apply warm blankets

Explanation

Question 33 of 53

1

Which of the following terms refers to a protrusion of abdominal organs through the surgical incision?

Select one or more of the following:

  • Eviseration

  • desiccation

Explanation

Question 34 of 53

1

Nursing assessment findings reveal a temperature of 96.2°F, pulse oximetry 90%, shivering, and client complains of chilling. The findings are indicative of which nursing diagnosis?

Select one or more of the following:

  • Ineffective thermoregulation

  • ineffective airway clearance

Explanation

Question 35 of 53

1

The nurse is caring for a client during the immediate postoperative period and is assessing for signs of shock. What signs and symptoms indicate that the client may be in shock?

Select one or more of the following:

  • weak and rapid pulse

  • bounding and rapid pulse

Explanation

Question 36 of 53

1

The client asks the nurse about ways to control pain other than taking pain medication. Which strategy should the nurse include when responding to the client? Select all that apply

Select one or more of the following:

  • Listening to music
    •

  • Watching television

  • • Changing position

  • yelling

Explanation

Question 37 of 53

1

The primary objective in the immediate postoperative period is

Select one of the following:

  • maintaining pulmonary ventilation.

  • preventing infection

Explanation

Question 38 of 53

1

In the transfer of accountability what is transferred?

Select one or more of the following:

  • rights

  • duties

  • obligations

  • charting

Explanation

Question 39 of 53

1

What is included in the post operative report/handover?

Select one or more of the following:

  • general patient information

  • patient history

  • intraoperative management

  • post anasesthesia care plan

Explanation

Question 40 of 53

1

Post operative orders (select all that apply)

Select one or more of the following:

  • iv fluids

  • resumption of diet and fluids

  • positioning

  • special wound care instructions

  • oxygen therapy

  • medications

  • emergency contact

  • number of nurse in PACU

Explanation

Question 41 of 53

1

what is part of your initial assessment of a post surgical patient?

Select one or more of the following:

  • ABCs

  • LOC

  • V/S

  • O2 therapy

  • Intake/output

  • IV lines/fluid

  • drains and tubes

  • Surgical site

  • pain

Explanation

Question 42 of 53

1

When assessing neurological systems what should you look for?

Select one or more of the following:

  • LOC

  • orientation

  • ability to follow commands

  • shine a pen light in their eye

Explanation

Question 43 of 53

1

what percent of patients have emergence delirium?

Select one of the following:

  • 10%

  • 5%

Explanation

Question 44 of 53

1

a neurological scale used to give reliable and objective way of recording the conscious state of a patient is a

Select one of the following:

  • glasgow coma scale

  • orientation scale

Explanation

Question 45 of 53

1

to prevent pulmonary complications what should you do?

Select one or more of the following:

  • keep head of bed at 25-45 degrees at all times

  • T and P q 2hs

  • leg exercises

  • teach splinting when coughing

Explanation

Question 46 of 53

1

list potential cardiovascular complications after surgery

Select one or more of the following:

  • hemorrhage

  • hypovolemia

  • hypotension

  • syncope/arrhythmias

  • deep vein thrombosis

Explanation

Question 47 of 53

1

what are some interventions to prevent cardiac complications?

Select one or more of the following:

  • IV management

  • early ambulation

  • t and p while in bed

  • leg exercises

  • anticoagulants

Explanation

Question 48 of 53

1

what are some GI function risks for post surgery

Select one or more of the following:

  • Nausea and vomitting

  • abdominal distention

  • paralytic ileus

  • constipation

  • acites

Explanation

Question 49 of 53

1

Potential dysfunction in GU function

Select one or more of the following:

  • Oliguria <30 ml/hr

  • anuria (no urine)

  • Urinary retention

  • UTI

Explanation

Question 50 of 53

1

when is the original dressing removed?

Select one of the following:

  • by the surgeon

  • by the nurse

Explanation

Question 51 of 53

1

when is a surgical dressing changed?

Select one of the following:

  • after 24 hours

  • after 48 hours

Explanation

Question 52 of 53

1

What are some of the benefits of discharge planning?

Select one or more of the following:

  • patient satisfaction

  • improved self care

  • decreased LOS

  • Decrease readmission rates

  • decreased cost

Explanation

Question 53 of 53

1

if a drug is equianlgesic it means

Select one of the following:

  • dose of one drug is equivalent in pain relieving effects compared with another drug

  • that the drugs work the same

Explanation

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