Mod 8 practice Q's

Question 1

healing requires increased vitamin ? and ? for collagen formation, vitamin ? for blood clotting, and ? for tissue growth, skin integrity, and cell mediated immunity.

Answer 1

A and D;
K;
zinc;

Question 2

? are essential for controlling fluid balance and manufacturing antibodies and white blood cells. Hypoalbuminemia, a low ? albumin, impedes the return of interstitial fluid to the venous return system, ? the risk of shock. A serum ? level is a useful measure of protein status

Answer 2

Proteins;
serum;
increasing;
albumin;

Question 3

most ? need to be stopped before surgery

Answer 3

anticoagulants such as warfarin (coumadin) - the surgeon determines if they are needed to be stopped or not (mostly are)

Question 4

what is ordered to be monitored for diabetic pts on admission

Answer 4

blood glucose monitoring

Question 5

what therapy can NOT be abruptly stopped when NOP is ordered.
And by what route would you give this is pt is NPO

Answer 5

chronic oral steroid therapy;

via the parenteral route

Question 6

what can develop if steroids are stopped abruptly

Answer 6

circulatory collapse

Question 7

time frame, wound healing, and pt effect for phase I

Answer 7

incision to 2nd post op day, inflammatory response, fever and malaise

Question 8

time frame, wound healing, and pt effect for phase II

Answer 8

3rd - 14th post op day, granulation tissue forms, feeling better

Question 9

time frame, wound healing, and pt effect for phase III

Answer 9

3rd - 6th post op week, collagen deposited, raised scar formed,

Question 10

time frame, wound healing, and pt effect for phase IV

Answer 10

months to 1 year, collagen deposited, flat and thin scar

Question 11

why would a pt go in for a pre admission testing

Answer 11

nursing interview, diagnostic testing, anesthesia interview, preoperative teaching to ensure pt is in the best possible condition for surgery

Question 12

what pre admission testing may be done for someone scheduled for a total hip replacement that has osteoarthritis

Answer 12

blood glucose, creatinine, blood urea nitrogen (BUN), electrolytes, complete bloom count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), bleeding time, type and screen, and urinalysis are some common tests; oxygen saturation, electrocardiogram(ECG), chest x ray

Question 13

what teaching should the nurse do in pre admission testing?

Answer 13

explain what is to be done in pre admission testing; explain pre admission prep: bathing, scrubs, preps, medications, nil per os (NPO) time, no nail polish or makeup;
admission procedures the day of surgery: registration, nursing unit, emotional support, consent signed, prep checklist completion
Intravenous(IV) line insertion, medications, surgery, post anesthesia care unit and family waiting locations, surgery time frames
post op care: pain control, deep breathing and coughing, leg exercises, activity, leg abduction, drains

Question 14

what are the responsibilities of the admitting nurse to prepare pt for surgery

Answer 14

explain admission procedures; get consent signed, preoperative checklist completion; iv insertion; give medications

Question 15

what is the role of the holding area nurse

Answer 15

greeting the pt; verifying pts name, age and allergies;
surgeon performing the surgery, consent, surgical procedure and if left or right, med history, answering q’s, and alleviating anxiety.
Explain what to expect in surgery.

Question 16

what is the role of the LPN in the operating room?

Answer 16

may scrub in surgery to hand instruments, must know sterile technique, surgical instruments, and medications placed in the sterile field for use during surgery

Question 17

what are the two prioritized primary responsibilities of the perianesthesia care nurse

Answer 17

maintaing the pt’s airway and safety

Question 18

which of the following is an LPN pt care role in the preoperative phase?

Answer 18

offering emotional support

Question 19

when the pts signature is witnessed by the nurse on the surgical consent, what does the nurses signature indicate?

Answer 19

the nurse verified that the pt signed the consent

Question 20

what is an introperative outcome for a pt underling an inguinal hernia repair

Answer 20

maintains skin integrity

Question 21

what is a discharge criterion from the PACU for a pt following surgery?

Answer 21

oxygen saturation above 90%

Question 22

what is one of the discharge criteria from ambulatory surgery for pts following surgery

Answer 22

understands discharge instructions

Question 23

the LPN is caring for a pt in the preoperative period who even after verbalizing concerns and having questions answered, states “i know i am not going to wake up after surgery” what action should the LPN take

Answer 23

inform the registered nurse so the surgeon can be notified

Question 24

what is the reason that long term steroid therapy cannot be used?

Answer 24

higher steroid levels are needed during stress to the body, which surgery produces

Question 25

what complications would the nurse correctly explain to a pt can be prevented with early post op ambulation

Answer 25

pneumonia can be prevented with lung expansion promoted by ambulation

Question 26

after surgery the nurse notes that the pts urine is dark amber and concentrated. what does the nurse understand may be the reason for this

Answer 26

the sympathetic nervous system saves fluid in response to stress of surgery, which reduces urine output initially

Question 27

the pt develops a low grade fever 18 hours post operatively and has diminished breath sounds. what actions are most appropriate for the nurse to take to prevent complications?

Answer 27

a fever occurring shortly after surgery is often due to atelectasis because infection takes longer to develop, so encouraging coughing and deep breathing and ambulating to expand lungs can help recent pneumonia `

Question 28

what nursing actions would reduce surgical risk factors for preoperative pts?

Answer 28

playing music of pts choice, reinforcing pain control methods, showing use of incentive pyrometer, monitoring blood glucose for a pt with diabetes, and teaching to perform leg exercises hourly while awake. All of these will calm the pt, place the pt in a healthier state, or teach the pt ways to promote recovery

Question 29

what is the pt care role in the pre-op phase

Answer 29

assisting in data collection

Question 30

what is within the LPN’s scope of practice related to the pt providing consent for surgery?

Answer 30

requesting pt questions be referred to physician, witnessing the pts signature on the consent, and reading the consent to a pt prior to signing

Question 31

what interventions would help prevent atelectasis in a post-op pt?

Answer 31

coughing and deep breathing, pain control, and ambulation. controlling pain allows the pt to cough and deep breath more comfortably, which expands the lungs, as does ambulation.

Question 32

what findings would the nurse recognize as being the earliest indicator of hemorrhage or shock that should be reported to the physician?

Answer 32

tachycardia - is a compensatory sign to maintain cardiac output for fluid volume loss, as in hemorrhage

Question 33

what criterion would a nurse use to determine pt readiness for discharge from ambulatory surgery?

Answer 33

nausea and vomiting must be controlled before discharge.

Question 34

what is the role of the home health nurse in caring for post-op pts?

Answer 34

to assist the pts recovery

Question 35

A patient is having surgery to remove a metastatic tumor causing severe pain in the abdomen. The purpose of the surgery is to relieve pain. What is the type of surgery called?

Answer 35

curative

Question 36

An epidural block used in an obstetric patient is a type of:

Answer 36

regional anesthesia

Question 37

Diagnostic test data usually required before surgery include:

Answer 37

chest radiograph

Question 38

Which pain medication is most likely to cause confusion in the elderly if used continuously?

Answer 38

Meperidine (Demerol)

Question 39

In the post-anesthesia care unit (PACU), the nurse should:

Answer 39

position the patient to prevent aspiration and promote lung expansion.

Question 40

The most appropriate outcome for the nursing diagnosis Risk for infection related to surgical wound is which of the following?

Answer 40

Promote wound healing

Question 41

To promote respiratory function in a postoperative patient, a nurse should:

Answer 41

notify the physician if the patient reports shortness of breath (SOB) and pain on inspiration.

Question 42

A nurse caring for a postoperative patient reports separation of the layers of the surgical abdominal wound. This finding is called:

Answer 42

dehiscence.

Question 43

The goals of anesthesia administration include: (Select all that apply.)

Answer 43

prevent pain.
calm fear.
achieve adequate muscle relaxation.

Question 44

? is a blood clot causing inflammation of a vessel.

Answer 44

Thrombophlebitis

Question 45

what surgery is performed to make a patient more comfortable. what surgery alleviates a problem. what surgery is voluntary. what surgery is done as soon as possible to avoid serious medical problems.

Answer 45

Palliative
Curative
Elective
Emergency

Question 46

a client who had a hysterectomy resumed a regular diet earlier in the day. now the client is reporting nausea and has vomited once. which of the following actions should the nurse take First?!

Answer 46

monitor for bowel sounds

Question 47

a nurse is caring for a client who had abdominal surgery 7 days ago. the nurse observes serosanguineous drainage from the incision site. what are the appropriate nursing actions at this time

Answer 47

report finding to charge nurse, reinforce coughing, but avoid forceful coughing, splint the incision upon movement

Question 48

a nurse is caring for a client who is postoperative gastric resection. what actions should the nurse take

Answer 48

apply pneumatic compression stocking bilaterally, administer pain meds 30 mins prior to ambulation, encourage the client to perform leg exercises every 1 - 2 hours

Question 49

68 yr old client is undergoing an endoscoy, which will require moderate sedation what findings in the clients history indicates the need for further data colleciton

Answer 49

chronic obsturctive pulmonary disease poses a risk for possible airway compromise indicating a need to collect more data.