Fundamentals--Mock--Ch. 50
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The nurse is caring for a surgical patient, when the family member asks what perioperative nursing means. How should the nurse respond?

  • Perioperative nursing occurs in preadmission testing.
  • Perioperative nursing occurs primarily in the postanesthesia care unit.
  • Perioperative nursing includes activities before, during, and after surgery. (correct)
  • Perioperative nursing includes activities only during the surgical procedure.
  • The nurse is caring for a patient who is scheduled to undergo a surgical procedure. The nurse is completing an assessment and reviews the patient’s laboratory tests and allergies and prepares the patient for surgery. In which perioperative nursing phase is the nurse working?

  • Perioperative
  • Preoperative (correct)
  • Intraoperative
  • Postoperative
  • The nurse is caring for a patient in the postanesthesia care unit. The patient has developed profuse bleeding from the surgical site, and the surgeon has determined the need to return to the operative area. How will the nurse classify this procedure?

  • Major
  • Urgent
  • Elective
  • Emergency (correct)
  • The nurse is caring for a patient in preadmission testing. The patient has been assigned a physical status classification by the American Society of Anesthesiologists of ASA III. Which assessment will support this classification?

    <p>Poorly controlled hypertension with implanted pacemaker (C)</p> Signup and view all the answers

    The patient presented to the ambulatory surgery center to have a colonoscopy is scheduled to receive moderate sedation (conscious sedation) during the procedure. How will the nurse interpret this information?

    <p>The procedure requires a depressed level of consciousness. (B)</p> Signup and view all the answers

    The nurse is caring for a patient in the postanesthesia care unit who has undergone a left total knee arthroplasty. The anesthesia provider has indicated that the patient received regional anesthesia in the form of a left femoral peripheral nerve block. Which assessment will be an expected finding for this patient?

    <p>Sensation decreased in the left leg (A)</p> Signup and view all the answers

    Which nursing goal is a priority for assessing the patient before surgery?

    <p>Establish a patient’s baseline of normal function. (B)</p> Signup and view all the answers

    The nurse is completing a medication history for the surgical patient in preadmission testing. Which medication should the nurse instruct the patient to hold (discontinue) in preparation for surgery according to protocol?

    <p>Warfarin (A)</p> Signup and view all the answers

    The nurse is prescreening a surgical patient in the preadmission testing unit. The medication history indicates that the patient is currently taking an anticoagulant. Which action should the nurse request when consulting with the health care provider?

    <p>An international normalized ratio (INR) (B)</p> Signup and view all the answers

    The nurse is encouraging the postoperative patient to utilize diaphragmatic breathing. Which priority goal is the nurse trying to achieve?

    <p>Prevent atelectasis. (B)</p> Signup and view all the answers

    The nurse caring for a postoperative patient will encourage what activity to prevent venous stasis and the formation of thrombus?

    <p>Leg exercises (C)</p> Signup and view all the answers

    The nurse caring for a preoperative patient teaches the principles and demonstrates leg exercises for the patient. The patient is unable to perform leg exercises correctly. What is the nurse’s best next step?

    <p>Assess for the presence of anxiety, pain, or fatigue. (B)</p> Signup and view all the answers

    Which nursing assessment will indicate the patient is performing diaphragmatic breathing correctly?

    <p>Hands placed on the border of the rib cage with fingers extended will touch as the chest wall contracts. (A)</p> Signup and view all the answers

    The nurse is caring for a postoperative patient with an abdominal incision. When the nurse provides a pillow to use during coughing, which activity is the nurse promoting?

    <p>Splinting (B)</p> Signup and view all the answers

    The nurse is encouraging a reluctant postoperative patient to deep breathe and cough. Which explanation can the nurse provide that may encourage the patient to comply?

    <p>&quot;Deep breathing and coughing will clear your lungs of the anesthesia.&quot; (D)</p> Signup and view all the answers

    The nurse and the nursing assistive personnel are assisting a postoperative patient to turn in bed. To assist in minimizing discomfort, which instruction should the nurse provide to the patient?

    <p>&quot;Use your hand to support your incision.&quot; (D)</p> Signup and view all the answers

    The nurse is preparing to assist the patient in using the incentive spirometer. Which nursing intervention should the nurse provide first?

    <p>Perform hand hygiene. (A)</p> Signup and view all the answers

    The nurse and the nursing assistive personnel (NAP) are caring for a group of postoperative patients who need turning, coughing, deep breathing, incentive spirometer, and leg exercises. Which task will the nurse assign to the NAP?

    <p>Informing the nurse if the patient is unwilling to perform exercises (D)</p> Signup and view all the answers

    The nurse is providing preoperative teaching for the ambulatory surgery patient who will be having a cyst removed from the right arm. Which will be the best explanation for diet progression after surgery?

    <p>&quot;Start with clear liquids, soup, and crackers. Advance to a normal diet as tolerated.&quot; (A)</p> Signup and view all the answers

    The nurse explains the pain-relief measures available after surgery during preoperative teaching for a surgical patient. Which comment from the patient indicates the need for additional education on this topic?

    <p>&quot;I will have minimal pain because of the anesthesia.&quot; (B)</p> Signup and view all the answers

    The nurse is making a preoperative education appointment with a patient. The patient asks if a family member should come to the appointment. Which is the best response by the nurse?

    <p>&quot;We recommend including family members at this appointment.&quot; (C)</p> Signup and view all the answers

    The nurse is reviewing the surgical consent with the patient during preoperative education and finds the patient does not understand what procedure will be performed. What is the nurse’s best next step?

    <p>Notify the health care provider about the patient’s question. (A)</p> Signup and view all the answers

    During preoperative assessment for a 7:30 AM (0730) surgery, the nurse finds the patient drank a cup of coffee this morning. The nurse reports this information to the anesthesia provider. Which action does the nurse anticipate next?

    <p>A delay in or cancellation of surgery (A)</p> Signup and view all the answers

    The nurse has administered a preoperative medication to the patient going to surgery. Which action will the nurse take next?

    <p>Instruct the patient to call for help to go to the restroom. (B)</p> Signup and view all the answers

    The nurse has completed a preoperative assessment for a patient going to surgery and gathers assessment data. Which will be the most important next step for the nurse to take?

    <p>Notify the operating suite that the patient has a latex allergy. (A)</p> Signup and view all the answers

    The nurse is preparing a patient for a surgical procedure on the right great toe. Which action will be most important to include in this patient’s preparation?

    <p>Ascertain that the surgical site has been correctly marked. (C)</p> Signup and view all the answers

    The circulating nurse is caring for a patient intraoperatively. Which primary role of the circulating nurse will be implemented?

    <p>Managing patient care activities in the OR suite (B)</p> Signup and view all the answers

    The nurse is caring for a patient in the preoperative holding area of an ambulatory surgery center. Which nursing action will be most appropriate for this area?

    <p>Applying a warm blanket (D)</p> Signup and view all the answers

    The nurse is caring for a patient in the operating suite. Which outcome will be most appropriate for this patient at the end of the intraoperative phase?

    <p>The patient will be free of burns at the grounding pad. (A)</p> Signup and view all the answers

    The nurse is concerned about the skin integrity of the patient in the intraoperative phase of surgery. Which action will the nurse take to minimize skin breakdown?

    <p>Securing attachments to the operating table with foam padding (B)</p> Signup and view all the answers

    The nurse is assessing a postoperative patient with a history of obstructive sleep apnea for airway obstruction. Which assessment finding will best alert the nurse to this complication?

    <p>Drop in pulse oximetry readings (A)</p> Signup and view all the answers

    The nurse is caring for a patient in the operating suite who is experiencing hypercarbia, tachypnea, tachycardia, premature ventricular contractions, and muscle rigidity. Which condition does the nurse suspect the patient is experiencing?

    <p>Malignant hyperthermia (A)</p> Signup and view all the answers

    The nurse is caring for a postoperative patient who has had a minimally invasive carpel tunnel repair. The patient has a temperature of 97 F and is shivering. Which reason will the nurse most likely consider as the primary cause when planning care?

    <p>Anesthesia lowers metabolism. (A)</p> Signup and view all the answers

    The nurse is monitoring a patient in the post-anesthesia care unit (PACU) for postoperative fluid and electrolyte imbalance. Which action will be most appropriate for the nurse to take?

    <p>Measure and record all intake and output. (C)</p> Signup and view all the answers

    The nurse is caring for a patient in the post-anesthesia care unit. The patient asks for a bedpan and states to the nurse, "I feel like I need to go to the bathroom, but I can’t." Which nursing intervention will be most appropriate initially?

    <p>Assess the patient for bladder distention. (A)</p> Signup and view all the answers

    The post-anesthesia care unit (PACU) nurse transports the inpatient surgical patient to the medical-surgical floor. Before leaving the floor, the medical-surgical nurse obtains a complete set of vital signs. What is the rationale for this nursing action?

    <p>This is done to compare and monitor for vital sign variation during transport. (B)</p> Signup and view all the answers

    The nurse is caring for a patient who will undergo a removal of a lung lobe. Which level of care will the patient require immediately post procedure?

    <p>Acute care—intensive care unit (B)</p> Signup and view all the answers

    The nurse is caring for a group of patients. Which patient will the nurse see first?

    <p>A patient who had cataract surgery is coughing. (A)</p> Signup and view all the answers

    The nurse demonstrates postoperative exercises for a patient. In which order will the nurse instruct the patient to perform the exercises?

    1. Turning
    2. Breathing
    3. Coughing
    4. Leg exercises

    <p>4, 1, 2, 3 (A)</p> Signup and view all the answers

    The nurse is participating in a "time-out". In which activities will the nurse be involved? (Select all that apply.)

    <p>Verify the correct site. (A), Verify the correct patient. (B), Verify the correct procedure. (C)</p> Signup and view all the answers

    The nurse is using a forced air warmer for a surgical patient preoperatively. Which goals is the nurse trying to achieve? (Select all that apply.)

    <p>Reduce blood loss. (B), Reduce cardiac arrests. (C), Reduce surgical site infection. (D)</p> Signup and view all the answers

    The nurse is caring for a postoperative patient with an incision. Which actions will the nurse take to decrease wound infections? (Select all that apply.)

    <p>Maintain normoglycemia. (A), Perform hand hygiene before and after contact with the patient. (D)</p> Signup and view all the answers

    The nurse is preparing for a patient who will be going to surgery. The nurse screens for risk factors that can increase a person’s risks in surgery. What risk factors are included in the nurse’s screening? (Select all that apply.)

    <p>Age (A), Obesity (B), Nutrition (C), Pregnancy (D)</p> Signup and view all the answers

    The nurse is providing preoperative education and reviews with the patient what it will be like to be in the surgical environment. Which points should the nurse include in the teaching session? (Select all that apply.)

    <p>The family is not allowed in the operating suite. (A), The nurses will be there to assist you through this process. (B), The surgical staff will be dressed in special clothing with hats and masks. (C)</p> Signup and view all the answers

    The operating room nurse is providing a hand-off report to the post-anesthesia care unit (PACU) nurse. Which components will the operating room nurse include? (Select all that apply.)

    <p>IV fluids (A), Vital signs (B), Anesthesia provided (C), Estimated blood loss (D)</p> Signup and view all the answers

    The nurse is caring for a group of postoperative patients on the surgical unit. Which patient assessments indicate the nurse needs to follow up? (Select all that apply.)

    <p>Patient with lung surgery has 20 mL/hr of urine output via catheter. (C), Patient with appendix surgery has thready pulse and blood pressure is 90/60. (D)</p> Signup and view all the answers

    Flashcards

    What is perioperative nursing?

    Perioperative nursing is a specialized area of nursing that involves providing care to patients before, during, and after surgery.

    What is the preoperative phase of perioperative nursing?

    The preoperative phase is the period of time before a surgical procedure, where the nurse prepares the patient for surgery.

    What is the intraoperative phase of perioperative nursing?

    The intraoperative phase is the period of time during the surgical procedure, where the nurse assists the surgical team and monitors the patient.

    What is the postoperative phase of perioperative nursing?

    The postoperative phase is the period of time after the surgical procedure, where the nurse monitors the patient's recovery.

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    What is an Emergency procedure?

    An emergency procedure is surgery that is performed immediately to address a life-threatening condition.

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    What is an Elective procedure?

    An elective procedure is surgery that is planned in advance and is not immediately necessary for the patient's survival.

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    What is a Urgent procedure?

    A urgent procedure is surgery that is performed within a few hours to prevent serious consequences.

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    What is the American Society of Anesthesiologists (ASA) Physical Status Classification System?

    The ASA Physical Status Classification System is a standardized way to assess a patient's overall health before surgery.

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    What does ASA I mean?

    ASA I indicates a healthy patient with no underlying health conditions.

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    What does ASA II mean?

    ASA II indicates a patient with mild systemic disease.

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    What does ASA III mean?

    ASA III indicates a patient with severe systemic disease that limits their daily activity.

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    What does ASA IV mean?

    ASA IV indicates a patient with severe systemic disease that is a constant threat to life.

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    What does ASA V mean?

    ASA V indicates a moribund patient who is not expected to survive without surgery.

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    What does ASA VI mean?

    ASA VI indicates a patient who is declared brain-dead, whose organs may be used for donation.

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    What is Moderate Sedation (Conscious Sedation)?

    Moderate sedation, also known as conscious sedation, is a level of sedation that allows the patient to remain conscious but relaxed and comfortable during a procedure.

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    What is Regional Anesthesia?

    Regional anesthesia is a type of anesthesia that numbs a specific area of the body, such as a leg or arm.

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    What is General Anesthesia?

    General anesthesia is a type of anesthesia that puts the patient completely to sleep, blocking pain and consciousness.

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    Why is it important to establish a patient's baseline before surgery?

    Establishing a baseline helps the nurse identify any changes that may occur during or after surgery, which can guide interventions.

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    Why is it important to get a complete medication history before surgery?

    Medications can interact with anesthesia and increase the risk of complications during surgery.

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    What is Warfarin?

    Warfarin is a blood-thinning medication that is often held before surgery.

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    What is an International Normalized Ratio (INR)?

    An International Normalized Ratio (INR) is a blood test that measures how long it takes for blood to clot.

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    Why is it important to encourage deep breathing and coughing after surgery?

    Deep breathing and coughing help prevent atelectasis (collapsed lung) and pneumonia.

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    What is Atelectasis?

    Atelectasis is a condition where a lung collapses or does not expand completely.

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    Why is it necessary to encourage leg exercises after surgery?

    Leg exercises prevent venous stasis (blood pooling) and the formation of a thrombus (blood clot).

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    Why is it important for a nurse to assess for anxiety, pain, or fatigue when the patient is unable to perform leg exercises correctly?

    Anxiety, pain, or fatigue can make it difficult for a patient to perform leg exercises.

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    What does it mean when the patient's hands touch as the chest wall contracts during diaphragmatic breathing?

    This indicates the patient is using their diaphragm correctly to breathe.

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    What is splinting?

    Splinting is the use of a pillow or other support to reduce pressure on a surgical incision during coughing or deep breathing.

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    Why is it important to perform hand hygiene before using an incentive spirometer?

    Hand hygiene is important to prevent the spread of germs and infection.

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    What are time-outs?

    Time-outs are a safety measure used in the operating room to ensure the correct patient, procedure, and site.

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    What is a forced air warmer used for?

    A forced air warmer is used to help maintain a patient's body temperature during surgery.

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    Why is it important to maintain normoglycemia in a postoperative patient with an incision?

    Maintaining normoglycemia (normal blood sugar levels) helps reduce wound infection risk.

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    What are some risk factors that can increase a person’s risks in surgery?

    Age, smoking, obesity, diabetes, and heart disease are some risk factors that can increase a person’s risk of complications during surgery.

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    What should the nurse teach the patient about the surgical environment?

    The nurse should teach the patient about the operating room environment, including what to expect during the procedure, their role in the process, and the importance of communication.

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    What information should the operating room nurse include in the hand-off report to the PACU nurse?

    The operating room nurse should include information about the patient's vital signs, medications given, procedures performed, and any complications that occurred.

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    What are signs of a postoperative complication?

    Signs of a postoperative complication include high fever, increased pain, bleeding, shortness of breath, swelling, and changes in mental status.

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