Foundations Week 9 Exam Study

Question 1

When is a patient permitted to eat following surgery

Answer 1

When the gag reflex returns
When bowel sounds return
When the Pt passes gas.
After the patient’s first bowel movement

Answer- When bowel sounds return

Question 2

Which of the following tests are routinely ordered prior to surgery?
Check all that apply

Answer 2

CBC
Type and Cross
Blood Cultures
EKG

Answer- CBC, Type and Cross, and EKG

Question 3

A heavy smoker who undergoes a surgical procedure has an increased risk of what?
Check all that apply.

Answer 3

Thrombophlebitis (swelling and inflammation in a vein, often due to a blood clot)
Atelectasis ( partial or complete collapse of a lung, or a section of the lung called a lobe)
Pneumonia (Serious lung infection that causes air sacs in the lungs to fill with fluid or pus and become inflamed)
Constipation (unable to have a bowel movement)

Answer is Pneumonia

Question 4

A patient with diabetes who undergoes a surgical procedure has an increased risk for what?
Check all that apply.

Answer 4

Infection
Fluid volume excess
constipation
delayed wound healing

Answer is infection and delayed wound healing

Question 5

Stages of wound healing in order from first to last

Answer 5

-Inflammation-platelet aggregation, fibrin clot formation, homeostasis.
-Proliferation-new connective tissue forms and epithelium covers the wound.
-Maturation-collagen lysis and synthesis, scare formation
-Wound is healed.

Question 6

Which of the following are the duties of the scrub nurse?
Select all that apply.

Answer 6

Answer is
-Monitors for breaks in sterility and points them out
-Labels and handles surgical specimens correctly, hands instruments and supplies to the team during surgery
-Maintains an accurate count of sponges, sharps, and instruments

Question 7

Which of the following are ways to prevent wrong site surgical errors?
Select all that apply.

Answer 7

Correct Answer
-Completing a pre-op checklist
-Having a “time out” prior to surgery to ensure correct Pt, procedure, and site
-Having medical records and imaging studies available during the procedure
-involve the Pt in the site marking process.

Question 8

What does the LPN need to do immediately prior to surgery to prepare their patient?
Select all that apply.

Answer 8

Correct Answer
-Remove any jewelry, glasses, contacts, etc, and ensure they are secure
-Have the Pt void
-Dress the Pt in a clean gown without underwear
-Secure the Pt’s hair in a surgical cap

Question 9

All women of childbearing age should have a pregnancy test prior to surgery?
True or false.

Answer 9

True

Question 10

What information should your discharge instructions include for the surgical patient?

Answer 10

-Info about all meds, including when to take and why
-Discuss any limitations in activity and instructions for use of equipment
-Alcohol should be avoided in the first 24 hours after surgery
- Discuss diet, any restrictions and guidelines on fluid intake.

Question 11

Stages of anesthesia in order from first to last

Answer 11

-Anesthesia-administration of anesthesia agent and Pt becomes unconscious
-Excitement-muscles tense, but swallowing and vomiting reflexes are present
-Surgical anesthesia -pupils are fixed and reflexes absent
-Complete respiratory depression-spontaneous respirations are absent.

Question 11

Your confused Pt needs surgery, but their POA is out of the country. Surgical consent can be obtained over the phone.
True or false

Answer 11

True

Question 12

Which of the following factors are considered surgical risk factors?
Select all that apply.

Answer 12

-Obesity
-Malnutrition
-Very young or very old age
-Peripheral vascular disease

Question 13

Which of the following are risk factors for delayed wound healing?
Select all that apply

Answer 13

-Diabetes
-Obesity
-Protein deficiency
-PVD

Question 14

Which of the following are recommended measures to prevent surgical site infections?
Select all that apply

Answer 14

-Administer prophylactic antibiotics as ordered
-Maintain glycemic control for the first 48 hours post-op
-Maintain body temp b/t 96.8 - 100.4 during and after surgery.

Question 15

The suffix -otomy means to cut out or off
True or false

Answer 15

False. It means to cut or make an incision into a body part.

Question 16

Your Pt in the ER was cutting up food and sliced the tip of their finger off. How would you chart this?

Answer 16

Avulsion - The action of pulling or tearing away.

Question 17

Which medications can impair wound healing?

Answer 17

-Immunosuppressants/ steroids
-Anticoagulants
-Antineoplastic agents
-Anti-inflammatory drugs

Question 18

High sensory input seems to close the pain gate, while a lack of this input allows the gate to open
True or false

Answer 18

True

Question 19

Which of the following are critical to monitor when your post-op Pt has a negative pressure drain in place?

Answer 19

-Ensure the drainage device is compressed to drain fluid
-Monitor the site surrounding the drain for infection
-Ensure there are no kinks in the drain tubing

Question 20

It is appropriate to use the spreader bar of a hip spica cast to help turn and move the patient
True or false

Answer 20

False

Question 21

Demonstrate proper cast care

Answer 21

-Elevate the cast above the heart to decrease edema
-Cover the cast during showering to prevent it getting wet
-Use a hair dryer on the cool setting to decrease itching
-Not bearing weight on the cast to prevent damage to it

Question 22

Which type of bandaging technique is commonly used on elbows, knees, and ankles?

Answer 22

Figure-of-eight

Question 23

Which of the following interventions help prevent pressure injuries in immobilized Pts

Answer 23

-AROM or PROM exercises
-Keeping skin clean and dry
-Adequate nutritional and fluid intake
-Utilizing a specialty mattress to prevent the occlusion of blood vessels

Question 24

What should the nurse be sure to include in the assessment of a client’s pain?

Answer 24

-Precipitating events, Quality of pain
-Timing of Pain
-Radiation of pain, Severity of Pain
-Treatments used to help alleviate pain

Question 25

What complimentary therapies utilizes sterile needles to help redistribute energy along meridians

Answer 25

Acupuncture

Question 26

Your Pt is taking kava to manage their anxiety pre-operatively. What lab value is important to monitor?

Answer 26

AST and ALP

Question 27

Referred pain felt between the shoulder blades originates from what site?

Answer 27

Abdomen

Question 28

Which supplement can affect a patient’s blood glucose levels?

Answer 28

Ginko biloba

Question 29

Which supplement should a patient with pre-existing cardiac arrhythmias avoid?

Answer 29

Ephedra

Question 30

Referred pain from the bladder can be felt in the rectum and buttocks.
True or false

Answer 30

True

Question 31

What is important to monitor when a Pt is taking opiates?

Answer 31

-Respiratory depression
-Pruritus
-Constipation and/or urinary retention
-Hypotension/ bradycardia

Question 32

It is acceptable for a Pt’s family member to push the PCA button if the Pt is asleep so they don’t wake up in pain
True or false

Answer 32

False

Question 33

Which type of analgesic works by blocking pain at the central nervous system level?

Answer 33

Opioids

Question 34

What is considered adjuvant analgesics?

Answer 34

-Anticonvulsants
-Muscle relaxants
-Antidepressants
-Stimulants

Question 35

Opioids are the best treatment for neuropathic pain
True or false.

Answer 35

False

Question 36

Steps the LPN would follow immediately after discovering a Pt has an evisceration from first to last

Answer 36

-Place the Pt in a supine position
-Place sterile dressings soaked in normal saline over the wound
-Notify the provider
-Prepare the Pt to return to the operating room

Question 37

Natural herbal supplements can interact with prescription medications
True or false

Answer 37

True

Question 38

Place the phases of nociceptive pain in order from first to last

Answer 38

-Transduction: Tissue damage releases substances that stimulate nociceptors
-Transmission: Movement of pain along the spinal cord
-Perception: Pain impulses reach the brain and pain is recognized
-Modulation: Neurons in the brain send signals back down the spinal cord

Question 39

What patient is most likely to suffer from nociceptor pain?

Answer 39

Pt in a motor vehicle accident

Question 40

What patient(s) is/are most likely to suffer from neuropathic pain?

Answer 40

-Diabetic
-HIV positive
-Cancer

Question 41

Acute pain can cause a decrease in HR, BP, and RR
True or false

Answer 41

False

Question 42

What factors can cause acute pain to worsen?

Answer 42

Fear and anxiety

Question 43

Complimentary therapies are used in replacement for traditional medical treatments
True or false

Answer 43

False

Question 44

What are considered sleep disorders that can interfere w/ a Pt’s quality of life

Answer 44

-Insomnia
-Sleep apnea
-Narcolepsy

Question 45

What are factors that can adversely affect sleep

Answer 45

-Alcohol consumption near bedtime
-Consuming caffeine prior to bedtime
-A rotating shift schedule
-Watching TV or playing video games in bed

Question 46

High-frequency TENS therapy is most effective for chronic pain.
True or false

Answer 46

False

Question 47

What interventions can help prevent thrombophlebitis in the post op patient

Answer 47

-Encourage leg exercises and ambulation when Pt is able
-Apply anti-embolism stockings
-Keep Pt well hydrated

Question 48

What interventions can help prevent pneumonia in the post-op patient?

Answer 48

-Deep breathing and coughing
-Use of incentive spirometer
-Encouraging your Pt to ambulate as soon as they are able