Perioperative Practice Questions

Question 1

1) When a pt cannot read or write but is of sound mind, the nurse should read the informed consent to the pt in the presence of two witnesses and do what next?
a. Have the pt’s next of kin sign the informed consent
b. Have the pt put an “X” on the signature line
c. Have a court appoint a guardian for the pt
d. Have a hospital quality management coordinator sign for the pt

Answer 1

b. Have the pt put an “X” on the signature line

Question 2

2) A 12 year old pt needs lifesaving emergency surgery, but the relatives live an hour away from the hospital and cannot sign the consent form. What is the nurse’s best response?
a. Send the pt to surgery without the consent
b. Call the family for a consent over the phone, and have another nurse listen as a witness
c. No action is necessary in this case because consent is not needed
d. Have the family sign the consent form as soon as they arrive

Answer 2

b. Call the family for a consent over the phone, and have another nurse listen as a witness

Question 3

3) Which member of the operating room team is responsible for setting up the sterile field?
a. Nurse anesthetist
b. Surgical assistant
c. Circulating nurse
d. Scrub nurse

Answer 3

d. Scrub nurse

Question 4

4) Which characteristics are appropriate to moderate sedation drugs? Select all that apply.
a. Reduce sensory perception
b. Require placement of an artificial airway
c. Amnesia action is short
d. Return to normal function is rapid
e. Increase level of consciousness
f. May be administered only by a physician

Answer 4

A, C, D

Question 5

5) Prior to surgery, the client is to take nothing by mouth after 0400. Which statement indicates the client did not follow the preoperative directions? The client:
a. Ate a gelatin dessert at 0330
b. Brushed teeth at 0400 but did not swallow
c. Held a cold washcloth against the lips
d. Smoked a cigarette at 0600

Answer 5

D

Question 6

6) During the preoperative interview, the nurse obtains information about the client’s medication history. Which information is not necessary to record about the client?
a. Current use of medications, herbs, and vitamins
b. Over-the-counter medication sue in the last 6 weeks
c. Steroid use in the last year
d. All drugs taken in the last 18 months

Answer 6

D

Question 7

7) Which client is most at risk for potential hazards from the surgical experience?
a. An 80 year old client
b. A 50 year old client
c. A 30 year old client
d. A 15 year old client

Answer 7

A

Question 8

8) Which nursing intervention is most important in preventing postoperative complications?
a. Progressive diet planning
b. Pain management
c. Bowel and elimination monitoring
d. Early ambulation

Answer 8

D

Question 9

9) A client arrives from surgery to the postanesthesia care unit. Which respiratory assessment should the nurse complete first?
a. Oxygen saturation
b. Respiratory rate
c. Breath sounds
d. Airway flow

Answer 9

D

Question 10

10) The nurse is assessing a client recovering from anesthesia. Which findings is an early indicator of hypoxemia?
a. Somnolence
b. Restlessness
c. Chills
d. urgency

Answer 10

B

Question 11

11) The nurse assesses that a client is restless and becoming agitated in the immediate postoperative period. The client’s oxygen saturation is 91%. What should the nurse do next?
a. Administer a sedative
b. Offer ice chips
c. Administer oxygen
d. Apply wrist restraints

Answer 11

C

Question 12

12) The nurse is helping to prepare a client for nonemergency surgery. What should the nurse do?
a. Obtain informed consent from the client.
b. Explain the surgical procedure in detail.
c. Verify that the client understands the informed consent form.
d. Inform the client about the risks of the surgery to be performed.

Answer 12

C

Question 13

13) 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?
a. perioperative
b. preoperative
c. intraoperative
d. postoperative

Answer 13

B

Question 14

14) 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?
a. major
b. urgent
c. elective
d. emergency

Answer 14

D

Question 15

15) 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?
a. normal, healthy patient
b. denial of any major illnesses or conditions
c. poorly controlled hypertension with implanted pacemaker
d. moribund patient not expected to survive without the operation

Answer 15

C

Question 16

16) The patient has presented to the ambulatory surgery center to have a colonoscopy. The patient is scheduled to receive moderate sedation (conscious sedation) during the procedure. How will the nurse interpret this information?
a. The procedure results in loss of sensation in an area of the body.
b. The procedure requires a depressed level of consciousness.
c. The procedure will be performed on an outpatient basis.
d. The procedure necessitates the patient to be immobile.

Answer 16

B

Question 17

17) 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?
a. warfarin
b. vitamin C
c. prednisone
d. acetaminophen

Answer 17

A

Question 18

18) The nurse is reviewing the surgical consent with the patient during preoperative education and finds the patient does not understand what procedure will be completed. What is the nurse’s best next step?
a. Notify the health care provider about the patient’s question.
b. Explain the procedure that will be completed.
c. Continue with preoperative education.
d. Ask the patient to sign the form.

Answer 18

A

Question 19

19) 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?
a. A delay in or cancellation of surgery
b. Questions regarding components of the coffee
c. Additional questions about why the patient had coffee
d. Instructions to determine what education was provided in the preoperative visit

Answer 19

A

Question 20

20) The nurse has administered a preoperative medication to the patient going to surgery. Which action will the nurse take next?
a. Notify the operating suite that the medication has been given.
b. Instruct the patient to call for help to go to the restroom.
c. Waste any unused medication according to policy.
d. Ask the patient to sign the consent for surgery.

Answer 20

B

Question 21

21) The circulating nurse is caring for a patient intraoperatively. Which primary role of the circulating nurse will be implemented?
a. Suturing the surgical incision in the OR suite
b. Managing patient care activities in the OR suite
c. Assisting with applying sterile drapes in the OR suite
d. Handing sterile instruments and supplies to the surgeon in the OR suite

Answer 21

B

Question 22

22) 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?
a. The patient will be free of burns at the grounding pad.
b. The patient will be free of nausea and vomiting.
c. The patient will be free of infection.
d. The patient will be free of pain.

Answer 22

A

Question 23

23) 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?
a. Encouraging the patient to bathe before surgery
b. Securing attachments to the operating table with foam padding
c. Periodically adjusting the patient during the surgical procedure
d. Measuring the time a patient is in one position during surgery

Answer 23

B

Question 24

24) The nurse is caring for a patient in the operating suite who is experiencing hypercarbia, tachypnea, tachycardia, premature ventricular contractions, and muscle rigidity. What nursing action is priority?
a. Administer dantrolene.
b. Apply oxygen via nasal cannula.
c. Apply telemetry.
d. Stop anesthesia.

Answer 24

D

Question 25

25) The nurse is caring for a group of patients. Which patient will the nurse see first?
a. A patient who had cataract surgery is coughing.
b. A patient who had vascular repair of the right leg is not doing right leg exercises.
c. A patient after knee surgery is wearing intermittent pneumatic compression devices and receiving heparin.
d. A patient after surgery has vital signs taken every 15 minutes twice, every 30 minutes twice, hourly for 2 hours then every 4 hours.

Answer 25

A

Question 26

26) The nurse monitoring a patient after surgery keeps in mind that the primary concern with use of a neuromuscular blocking drug is which adverse effect?
a. Respiratory arrest
b. Headache
c. Bradycardia
d. Hypertension

Answer 26

A

Question 27

27) To decrease the possibility of a headache after spinal anesthesia, the nurse will provide which instruction to the patient?
a. Sit in high Fowler’s position
b. Maintain strict bedrest
c. Limit fluids
d. Ambulate in the hall several times a day

Answer 27

B

Question 28

28) When the effects of local anesthetics begin to wear off, which physiologic response is the first to occur?
a. Memory returns
b. Motor activity returns
c. Sensory activity returns
d. Autonomic activity returns

Answer 28

B

Question 29

29) The nurse is preparing for an older adult patient who will be going to surgery. The nurse screens for risk factors that can increase an older adult’s risk in surgery. What risk factors are included in the nurse’s screening? (Select all that apply.)
a. Dry skin with more subcutaneous fat
b. Cognitive changes
c. Decreased alveolar elasticity
d. Decreased BP
e. Increased ability to adjust to changes in the environment

Answer 29

B, C

Question 30

30) A preoperative nurse is reviewing morning laboratory values on four clients waiting for surgery. Which result warrants immediate communication with the surgical team?
a. Creatinine: 1.2 mg/dL (106.1 umol/L)
b. Hemoglobin: 14.8 mg/dL (148 mmol/L)
c. Potassium: 2.9 mEq/L (2.9 mmol/L)
d. Sodium: 134 mEq/L (134 mmol/L)

Answer 30

C

Question 31

31) The postanesthesia care unit (PACU) nurse is caring for an older client following a lengthy surgery. The client’s pulse is 48 beats/min which is 20 beats/min lower than the preoperative baseline. What assessment does the nurse make next?
a. Temperature
b. Level of consciousness
c. Blood pressure
d. Rate of IV infusion

Answer 31

A

Question 32

32) A nurse is learning about different surgical procedures and their classifications. Which examples below does this include? (Selectall that apply.)
a. Rhinoplasty: curative
b. Liver biopsy: diagnostic
c. Arthroscopy: diagnostic. Ileostomy: palliative. Total shoulder replacement: reconstructive
d. Body contouring: cosmetics

Answer 32

B, C, D

Question 33

33) A client has received several doses of midazolam. The nurse assesses the client to be difficult to arouse with respirations of 6 breaths/min. What actions by the nurse are most important? (Select all that apply.)
a. Administer oxygen per protocol.
b. Obtain one dose of flumazenil.
c. Obtain naloxone, 0.04 mg for IV push.
d. Ensure suction is working
e. Transfer the client to intensive care.
f. Monitor client every 10 to 15 minutes for the next 2 hours.

Answer 33

A, D, E

Question 34

34) A nurse orienting to the postoperative area learns which principles about the postoperative period? (Select all that apply.)
a. All phases require the client to be in the hospital.
b. Phase I care may last for several days in some clients.
c. Phase I requires intensive care unit monitoring.
d. Phase II ends when the client is stable and awake.
e. Vital signs may be taken only once a day in phase III.
f. Some clients may be discharged directly after phase I.

Answer 34

C, D, E