Question 1

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

The 27-year-old taking an anticoagulant agent is at the greatest risk during surgery because anticoagulants increase the risk of bleeding during the surgical procedure. Special precautions need to be taken to prevent excessive bleeding during and after surgery. The other patients are taking medications that do not pose as great of a risk during surgery.

Question 2

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

Accepted Answer

An appendectomy is an example of ablative surgery, which involves the removal of diseased tissue or organs. In this case, the appendix is removed because of inflammation or infection. Diagnostic surgery is performed to determine the cause of symptoms, palliative surgery is done to relieve symptoms rather than cure the underlying condition, and reconstructive surgery is done to repair or restore function and appearance after injury or illness.

Question 3

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

Accepted Answer

C

Question 4

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

In the immediate postoperative period, it is normal for a patient to have a subdued level of consciousness due to the effects of anesthesia.

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

Obese patients have an increased risk of wound dehiscence due to the increased tension on the incision site from excess body fat. Anemia, seizures, and protein loss are not necessarily more common complications in this population.

Question 6

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 of 39ºC indicates fever and may indicate an underlying infection. The anaesthesiologist should be notified as fever may affect the patient's response to anaesthesia and the risk of postoperative complications. The other vital signs within normal limits.

Question 7

The nurse is evaluating the patient in the hospital's postanaesthesia care unit (PACU)and determines that the Aldrete score is 8.Based on this assessment,which of the following does the nurse anticipate will happen?

Accepted Answer

An Aldrete score of 8 indicates that the patient is ready for discharge to the nursing unit. An Aldrete score of 9 or 10 is optimal for discharge, but a score of 8 is generally acceptable. The patient does not need to go to the intensive care unit or back to the operating room, and there is no need to remain in the PACU if the patient has a score of 8 or higher.

Question 8

Which of the following is classified as an urgent surgery?

Accepted Answer

The answer of Which of the following is classified as...

Question 9

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

Accepted Answer

Smoking increases the risk of postoperative complications, including infections and delayed wound healing. It can also lead to bronchospasm and other respiratory problems during and after surgery. Therefore, smoking cessation should be encouraged before surgery. The patient's brother's tonsillectomy history, IV infusion, and employment history as a computer programmer are not major preoperative concerns for a gastrectomy.

Question 10

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

The dorsalis pedis artery is the pulse site that supplies blood to the top of the foot and is used to assess circulation to the lower extremities, including the right leg in this case. The radial, ulnar, and brachial arteries supply blood to the arms and are not relevant for assessing circulation to the right leg.

Question 11

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 level of 90 g/L is significantly low and may indicate anemia, which can affect the patient's ability to tolerate anesthesia and increase the risk of bleeding during surgery. The surgeon should be notified so that appropriate interventions can be implemented. Choice B and C are within normal range and D is a normal platelet count.

Question 12

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

Raising the side rails on the bed or stretcher ensures the patient's safety by preventing falls or accidental injury. Keeping the patient quiet may be helpful in promoting relaxation, but it is not a safety measure. Obtaining the consent and preparing the skin at the surgical site are important preoperative tasks, but they do not directly address the patient's safety at this particular moment.

Question 13

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

The specific purpose of using an incentive spirometer is to promote optimal lung expansion by encouraging the patient to take deep breaths and expand their lung capacity. This helps prevent complications such as atelectasis and pneumonia.

Question 14

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

Applying a splint directly over the lower abdomen will help decrease discomfort in the incisional area when the patient coughs postoperatively. This provides support and stability to the area and reduces tension on the incision. Keeping the patient flat with feet flexed may help decrease strain on the incision, but may also increase discomfort due to pressure on the incisional area. Turning the patient onto the right side or applying pressure above and below the incision will not directly address the discomfort associated with coughing.

Question 15

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

Reduced glomerular filtration is a common physiological change that occurs with aging and can increase the risk of surgery. This is because the kidneys may not be able to excrete drugs and metabolites as efficiently, leading to potential drug toxicity and longer recovery times. As a result, the dose and administration of medications must be carefully monitored in older adult patients undergoing surgery. Choices A and B are not correct as the aging process typically leads to a decreased tactile sensation and metabolic rate. Choice C is also incorrect as arterial walls tend to stiffen rather than relax with age.

Question 16

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

The nurse should inform the surgeon so that necessary information can be provided to the patient. It is the surgeon's responsibility to ensure that the patient fully understands the surgical procedure, risks, benefits, and alternatives, and the nurse should collaborate with the surgeon to facilitate this understanding. Obtaining consent without first ensuring the patient's understanding would be inappropriate. Teaching the patient all about the procedure without consulting the surgeon could be inaccurate and potentially harmful. Asking the unit manager to assist with a teaching plan may delay the process of ensuring the patient's understanding.

Question 17

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

Accepted Answer

Cardiovascular depression is one of the greatest risks of general anaesthesia. It can lead to hypotension, decreased cardiac output, and other serious complications. Hypertension, oral mucosa damage, and tachypnea may occur but are generally not considered as significant risks of general anaesthesia.

Question 18

Coughing postoperatively is contraindicated following which type of surgery?

Accepted Answer

Coughing postoperatively is contraindicated following eye surgery because it can increase intraocular pressure, which may lead to complications or damage to the surgical site.

Question 19

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

Accepted Answer

Antihypertensives, such as beta-blockers and calcium channel blockers, can interact with anaesthetic agents to cause bradycardia (slow heart rate), hypotension (low blood pressure), and impaired circulation. It is important to monitor blood pressure and heart rate closely when administering these drugs together.

Question 20

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

Accepted Answer

Tachycardia is an early sign of malignant hyperthermia, which is a rare but potentially life-threatening reaction to certain medications used during anesthesia. Other signs and symptoms may include muscle rigidity, rapid breathing, high fever, and changes in blood pressure. Prompt recognition and treatment of this condition is essential to prevent complications and death.

Quiz 48: Care of Surgical Patients