what should the nurse do if a pt states that they do not fully understand a procedure?

ask what she already knows about the procedure from the surgeon

The nurse assesses a pt who had a total hysterectomy 2 days ago. Which info is most important to comm. to the provider?

The pt’s calf is swollen & warm to touch

what is the clinical significance for RBC, HGB, and HCT levels for surgery?

Could indicate blood loss or anemia

A pt is transferred to PACU after abd surgery. You notice they have to vomit. What is your first action?

Place pt in the lateral position

Nurse provides preop teaching to an alert older man w/ vision & hearing deficits. What should the nurse do?

Provide more time for pt to understand

During a pre-op assessment, why would the nurse ask the pt about his or her response to previous surgeries?

To predict pt’s response to anesthesia

why are lab values important prior to surgery?

may help prevent patient complications

Do nothing b/c this is the correct procedure

Which pt should the nurse see first?

Pt with dark red drainage from NG tube

Which statement made by the pt indicated a further need for preop teaching?

“I will wear my earrings on the day of surgery”

When performing a gross neurologic evaluation on a pt, what should the PACU nurse assess?

Responsiveness to stimulation and level of consciousness

Which instruction might a nurse give a pt in order to protect a surgical incision when turning in bed?

Use a pillow to splint the incision

On admission to PACU, the pt’s BP is 122/72, 30 mins later it’s 114/62. What should the nurse do?

Continue to monitor every 15 mins

which definition of autologous blood is accurate?

blood from the patient before surgery

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N1230 Surgery Part 1

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Questions 155

Answers

1
what type of surgery is a total hip replacement?
curative
preventative
reconstructive
diagnostic
2
what is the appropriate range for BUN?
10-20
15-30
0-7
25-35
3
what should the nurse do if a pt states that they do not fully understand a procedure?
ask what she already knows about the procedure from the surgeon
explain the procedure in detail
assess her neurological function
have her sign a consent form
4
The nurse assesses a pt who had a total hysterectomy 2 days ago. Which info is most important to comm. to the provider?
The pt has abd pain
The pt’s calf is swollen & warm to touch
The pt’s blood pressure is 132/78
The pt took the antibiotics as prescribed
5
what is the clinical significance for RBC, HGB, and HCT levels for surgery?
Could indicate blood loss or anemia
Could indicate infection
Could indicate need for antibiotics
6
which surgical procedure is categorized as curative?
ileostomy creation
rhinoplasty
appendectomy
joint arthroplasty
7
an excess or depletion of __ increases the chance of dysrhythmias during or after surgery.
potassium
bicarbonate
calcium
glucose
8
(medical or surgical) asepsis reduces the number of pathogens
surgical
medical
9
A pt is transferred to PACU after abd surgery. You notice they have to vomit. What is your first action?
Place pt in the lateral position
Place pt in high fowler’s
Place pt in semi-fowler’s
Give pt an emesis bag
10
What is the best indicator of a stage 1 pressure ulcer in a dark-pigmented patient?
Change in color
Change in temperature
Skin sensitivity
Pain status
11
Nurse provides preop teaching to an alert older man w/ vision & hearing deficits. What should the nurse do?
Give written instructions
Provide more time for pt to understand
Tell the patient’s wife instead
Come back another time
12
what happens to the body when stiffened lung tissue and enlarged air spaces occur?
increased heart rate
hypoglycemia
hypertension
blood oxygen reduced
13
what is the appropriate range in hemoglobin for MEN?
14-18 G/dL
12-16 G/dL
14
What should you do if a pt is confused and agitated after surgery?
Check o2 status
Assess pain status
Raise bed rails x4
Do a dressing change
15
What are priority assessments of skin integrity?
Pressure points and pulses
Pulses and skin color
Skin and pulses
Skin and heart rate
16
What would need to be reported to the surgeon and the ACP?
Pt taking scheduled antihypertensives with 2 sips of water this am
Potassium level 6.0
Pt lying in the assessment ab not smoking when she smokes
Pt taking 1300 mg aspirin
17
During a pre-op assessment, why would the nurse ask the pt about his or her response to previous surgeries?
To predict pt’s response to anesthesia
To help estimate amount of time pt will be hospitalized
To ID anatomic & physiologic alterations that may affect care
To determine the amount of pain med the pt will need
18
What is the most important factor in wound healing?
Drainage
Odor
Circulation
Pulses
19
which category of surgery is an ileostomy creation?
cosmetic
curative
diagnostic
palliative
20
what does a high hemoglobin value indicate?
dehydration
risk of clotting
polycythemia
risk of hemorrhage
21
who performs the following actions?
PACU nurse
circulating nurse
scrub nurse
RN first assistance
22
why are lab values important prior to surgery?
Provider will need to know
may help prevent patient complications
To know recovery time
23
what would low hematocrit levels indicate?
decreased clotting
malnutrition
fluid overload
anemia
24
A nurse is caring for a pt who had a leg amputated & is complaining of N/V. What is the nurse’s first action?
Give pt water
Give pt medications
Assess bowel sounds
Contact surgeon
25
what is an appropriate international normalized ratio (INR)?
1.27-3.2
0.6-1.27
0.2-2.1
1.54-2.0
26
which food is contraindicated in patients with povidone-iodine allergy?
soy products
egg
shellfish
peanuts
27
?
Tell the tech not to waste supplies
Take the sponge out of the room immediately
Do nothing b/c this is the correct procedure
Place the sponge back where it was
28
when is an NG tube placed?
during pt interview
upon admission
after anesthesia
after surgery
29
how long before surgery should the patient hold antiplatelets/NSAIDS?
1 week
2 weeks
24 hours
48 hours
30
Which pt should the nurse see first?
Pt ready to go home
Pt with dark red drainage from NG tube
Pt who was given morphine 20 mins ago
Pt who needs help ambulating
31
Which surgical team member is responsible for pt positioning during the intraoperative phase of surgery?
Surgeon
ACP
Circulating nurse
Scrub nurse
32
who's responsible for explaining procedure, risks, benefits, alternatives, & possible complications before consent?
the surgeon
the nurse
the family
the anesthesia provider
33
what is the appropriate range for chloride (Cl-)?
110-125 mEq/L
74-86 mEq/L
98-106 mEq/L
85-92 mEq-L
34
What lab data is important for a pt with a pressure ulcer?
Magnesium
Potassium
Calcium
Albumin
35
why is it important to watch white blood cell levels?
Could indicate bleeding
Could indicate infection
Could indicate problems with clotting
Could indicate hypertension
36
A nurse is caring for a pt w/ a pressure ulcer on L hip. The ulcer is black. What will the nurse do first?
Elevate the head of the bed
Turn the patient to L hip
Debride the wound
Dress the wound
37
surgical patients who smoke are at a higher risk for developing which of the following?
delayed wound healing
pneumonia
all of the above
atelectasis
38
if taken 2 weeks before surgery, what drug class may cause mild respiratory depression?
insulin
diuretics
antibiotics
anticoagulants
39
low hemoglobin often indicates what condition?
anemia
decreased clotting
malnutrition
fluid overload
40
Which statement made by the pt indicated a further need for preop teaching?
“I will wear my earrings on the day of surgery”
“I will ensure that I remove my toenail polish”
“I will not eat anything after midnight”
41
When performing a gross neurologic evaluation on a pt, what should the PACU nurse assess?
Ability to move upper extremities purposefully and equally
Responsiveness to stimulation and level of consciousness
The 12 cranial nerves
Orientation and fine motor skills
42
Which instruction might a nurse give a pt in order to protect a surgical incision when turning in bed?
Keep both legs straight when turning
Take paid medication 30 min before turning
Use a pillow to splint the incision
Hold your breath when turning
43
On admission to PACU, the pt’s BP is 122/72, 30 mins later it’s 114/62. What should the nurse do?
Notify the provider
Continue to monitor every 15 mins
Continue to monitor every hour
Notify the surgeon
44
When does the greatest need for analgesia after surgery occur?
12-24 hours
24-48 hours
36-48 hours
48-72 hours
45
Which intervention is most important when preventing postop complications?
Leg exercises
Early ambulation
Turn, cough, deep breathe
Incentive spirometry
46
A pt has experienced a laparoscopic appendectomy. Which type of healing will the pt experience?
Primary intention
Secondary intention
Tertiary intention
47
what is the appropriate range of hematocrit levels in WOMEN?
50-60%
30-40%
37-47%
25-35%
48
which definition of autologous blood is accurate?
blood from the patient before surgery
blood from a universal blood donor
blood donated by a patient's family member
a "bloodless" surgery
49
what is an appropriate range for creatinine in males?
1.2-1.8 mg/100 mL
0.3-0.9 mg/100mL
0.6-1.2 mg/100mL
0.5-1.1 mg/100mL
50
what is the appropriate range for red blood cell count in MEN?
3.4-4.2million/MM3
4.7-6.1million/MM3
2.2-3.7million/MM3
1.8-3.2million/MM3
51
Who is involved in a surgical time out?
Referring physician
ACP
Preoperative nurse
Circulating nurse setting up the other OR
52
what is the appropriate range for bicarbonate (HCO3-)?
15-22 mEq/L
33-45 mEq/L
23-30 mEq/L
35-41 mEq/L
53
What is the best action after observing a post-op abd dressing that has 5 cm of red drainage?
Notify surgeon
Apply abdominal binder
Apply a new dressing
Reassess in an hour
54
what type of surgery is a tummy tuck?
curative
cosmetic
diagnostic
palliative
55
what type of surgery is a prophylactic bilateral mastectomy?
preventative
reconstructive
diagnostic
curative
56
what risks are associated w/ clot formation in the older adults after surgery?
reduces respiratory muscle strength and cough reflex
decreased GFR and excretory times
increased calcium and cholesterol deposits in small arteries
increased skin fragility and decreased subcutaneous tissue
57
the patient should hold all herbal supplements how long before surgery?
2 weeks
48 hours
24 hours
1 week
58
which of the following medications is used to reduce secretions?
opioids
antiemetics
antibiotics
anticholinergics
59
What item will not be on a pre-op checklist?
Medical history/allergies
Patient identity/consent
Vital signs/lab results
Living will/insurance
60
If hypotension is confirmed by the PACU nurse, what causes should the PACU nurse begin to investigate?
Bladder distention
Snoring
Surgical bleeding
Hyperthermia
61
what is an appropriate range for potassium (K+)?
2.0-3.5 mEq/L
5.0-6.0 mEq/L
1.5-3.0 mEq/L
3.5-5.0 mEq/L
62
in regard to urgency, what type of surgery requires prompt intervention?
elective
urgent
emergent
63
BP of pre-op pt was 150/110mmHg. which condition would the nurse anticipate in the pt during surgery?
impaired wound healing
altered metabolism of medications
fluid and electrolyte imbalance
inadequate tissue oxygenation
64
general anesthetics cause vasoconstriction, resulting in heat retention
True
False
65
what do PT, PTT, and INR indicate?
potential for clotting or bleeding
dehydration
signs of infection
headaches
66
How should the nurse respond to a pt that is scared of getting bedsores?
They are one of many problems that can occur from prolonged bed rest.
Getting a bedsore is very serious. Sometime people die from infected ones.
Those are now called pressure injuries b/c they are caused by pressure.
The nurses will make sure you do not stay in bed long enough to get them.
67
which of the following medications prevents infection?
antibiotics
benzodiazepines
antiemetics
opioids
68
What phase of wound healing is the pt in if it has collagen?
Remodeling phase
Hemostasis phase
Inflammatory phase
Proliferation phase
69
During which perioperative phase does the nurse review the pt’s lab tests and allergies?
Post-operative
Intra-operative
Pre-operative
Never
70
which pt will the nurse carefully observe for a drop in o2 saturation during surgery?
chronic pain on nonsteroidal anti-inflammatory drugs
recent myocardial infarction on general anesthesia
obstructive sleep apnea on opioids
heart failure on beta blockers
71
after surgery, a pt requires _ kcal/day to maintain energy reserves.
1500
2000
1000
1100
72
A pt is diagnosed with a risk of infection. What should the nurse do?
Give pt a bath with disinfectant
Wear no gloves when caring for the patient
Wash hands with water
Teach family of pt about hand hygiene
73
What is an early sign of malignant hyperthermia?
HR 45 bpm
BP 115/71
Temp 102.1 F
HR 120 bpm
74
which of the following medications is used for their sedative and amnesic properties?
antiemetics
opioids
benzodiazepines
anticholinergics
75
An NG tube is removed 2 days post-op. Pt complains of cramping. What should the nurse do?
Notify the surgeon
Administer pain medication
Assist the pt to ambulate
Reassess in an hour
76
A post-op pt has not voided for 8 hours. What should the nurse do first?
Insert a Foley catheter
Assess the bladder
Check vital signs
Assess the patient’s pain status
77
any patient over the age of _ must have a chest x-ray
30
25
40
35
78
which item is provided by the blood election center to the patient after autologous blood donation?
matching tag
vitamin preparations
medicine
money
79
What stage is a pressure ulcer with necrotic tissue?
Stage II
Unstageable
Stage III
Stage IV
80
The pt receives a narcotic IM on call before being transferred. What should the nurse do?
Document vital signs
Raise both side rails
Check vital signs
Raise side rails x4
81
very young and old patients are at greater surgical risks bc of problems in temp control during surgery.
False
True
82
every patient is at risk for a fluid and electrolyte imbalance
True
False
83
RN is watching new nurse change dressing & perform care around Penrose drain. What action warrants intervention?
Performing hand hygiene before and after procedure
Using a sterile absorbent dressing
Securing the drain’s safety pin to the sheets
Shortening the drain per orders
84
ambulatory sx pts should be instructed to seek medical treatment if they are unable to void how long after sx?
2 hours
8 hours
4 hours
1 hour
85
Which actions can a surgical tech do?
Position patient & prepare sterile supplies
Pass sterile instruments & supplies to surgeon & participate in time-out
Monitor vital signs & pass sterile instruments
86
hydration status can be assessed by oral mucus membranes
True
False
87
when should antiembolism devices be places on the patient?
day before surgery
after surgery
morning of surgery
after anesthesia
88
Pt has surgery to bypass a tumor in the bowel. What type of surgery is this?
Curative
Palliative
Diagnostic
Reconstructive
89
What should the nurse do if a pt states that they are allergic to avocados and bananas?
Notify about an allergy to anesthesia
Notify about a possible latex allergy
Notify about a possible iodine allergy
90
which lab finding supports a nurse's conclusion that a pt is at increased risk of bleeding during surgery?
activated partial thromboplastin time 35 seconds
prothrombin time 11 seconds
international normalized ration 0.86
platelet count 100,000 cells/mm3
91
the circulating nurse is NOT scrubbed in and does NOT wear an OR gown
True
False
92
What action should you take if the anesthesiologist is not scrubbed?
Tell the surgeon
Make them leave
None, does not have to be scrubbed
Ask them to go scrub
93
Why might a nurse teach a pt scheduled for surgery how to do post-op exercises?
To ID cultural factors that reflect the pt’s perception of pain
To evaluate pt’s ability to participate in post-op activities
To minimize post-op complications
To maximize sense of well-being
94
what is the appropriate range for white blood cells?
2,000-3,000/MM3
1,000-5,000/MM3
5,000-10,000/MM3
7,000-15,000/MM3
95
What should the nurse do if a post of patient has absent bowel sounds?
Document findings
Notify surgeon
Reposition patient
Administer medications
96
What would require you to notify the surgeon?
A pt that quit taking herbal supplement 3 weeks ago
A pt who remained NPO for 12 hours before surgery
A pt states she had an infection 1 week prior to surgery
A pt who refuses to take off their necklace
97
A pt asks if they can keep a heating pad on longer than 30 mins. What is the nurse’s best response?
Applying heat longer than 30 mins is okay
Applying heat longer than 30 mins will reverse the effects
Applying heat longer than 30 mins will cause burns
98
what does a high platelet count indicate?
risk of hemorrhage
polycythemia
risk of clotting
dehydration
99
A post-op pt vomited. After cleaning & comforting pt, which action by the nurse is most important?
Assess vital signs
Check lab values
Offer a drink of water
Auscultate lung sounds
100
what vitamins are very important for wound healing?
Vitamins D, E, K
Vitamins A, C, E
Vitamins E and A
vitamins A, C, and B complex
101
which pt is at an increased risk for clot formation in the lower extremities after surgery?
pt has increase calcium levels
pt who has decreased cough reflex
pt who has elevated potassium levels
pt who has decreased reaction time
102
what type of surgery is the removal of a cancerous tumor or the removal of gallbladder?
diagnostic
reconstructive
curative
preventative
103
what is an appropriate range for sodium (Na+)?
180-200 mEq/L
150-165 mEq/L
120-125 mEq/L
136-145 mEq/L
104
what is a normal glucose reading?
137
68
85
119
105
A pt with diabetes has been NPO since midnight. What should the nurse do?
Administer insulin
Give the patient a glass of water
Feed the patient
Obtain a CBG before giving insulin
106
Which pre-op lab test would low levels indicate an increase of the potential for bleeding?
HCT
platelets
HGB
RBC
107
who is responsible to ensure cost-efficient use of supplies?
scrub nurse
circulating nurse
surgical team
surgeon
108
Which breakfast choice shows the pt has an understanding of wound healing?
Milk, waffle, strawberries
Apple juice, grits, banana
Orange juice, cinnamon roll, banana
Milk, scrambled eggs, and cantaloupe
109
pt is in PACU recovering from atrial ablation procedure. What assessments should nurse perform to monitor cardiac status
Hypotension, bradycardia, and SVT
Hypertension, hypotension, and tachycardia
Hypertension, hypothermia, and oliguria
Hypertension, bradycardia, and DVT
110
what is the appropriate range for red blood cell count in WOMEN?
4.7-6.1 million/MM3
4.2-5.4 million/MM3
111
What does the preop checklist include?
Vital signs, ID band, lab results
Lab results, necessary supplies, ID band
ID band, contact information, lab results
Vital signs, contact information, home address
112
what does a high hematocrit value indicate?
polycythemia
risk for clotting
dehydration
risk for hemorrhage
113
What type of dressing would be best for a partial-thickness wound?
Hydrocolloid dressing
Hydrogel dressing
Alginate dressing
Gauze dressing
114
for some pts, an enema is administered at least _ hours before surgery.
8 hours
1 hour
12 hours
24 hours
115
The nurse must obtain consent for surgery. Which client would not be able to consent legally to surgery?
16 year old who has a fractured ankle
80 year old who is not oriented to the day
30 year old who does not understand English
65 year old who cannot read or write
116
What is the best way for the nurse to assess a preop pt for possible latex allergy?
Ask the family
Ask the pt
Check the MAR
Check the chart
117
An older pt had knee replacement surgery 2 days ago and is relatively immobile. What is he most at risk for?
Pressure ulcers
Venous thromboembolism
Hemorrhage
Pneumonia
118
If hypertension is confirmed by PACU nurse, what causes should the PACU nurse begin to investigate?
Pain, bladder distention, and hypoxemia
Hypercarbia, bladder distention, and snoring
Pain, dehydration, and hypoxemia
Hypercarbia, internal bleeding, and pain
119
which of the following medications is used to decrease pain and intraoperative anesthetic requirements?
antiemetics
benzodiazepines
opioids
antibiotics
120
sometimes, an allergy to eggs, peanuts, and soy can react with what medication?
propofol
ibuprofen
benedryl
acetaminophen
121
what is an appropriate range for prothrombin time?
11-12.5 seconds
1-3 seconds
5-7 seconds
13-15 seconds
122
all of the following chemistries deal with renal function except:
glucose
bicarbonate
BUN
creatinine
123
Which observation indicates that the pt is at risk for pressure ulcer formation?
The pt has fecal incontinence
The pt rates pain 3 on a scale of 0-10
The pt gets out of bed often
The pt is AAOx3
124
ppl ages _ & over, have chronic health conditions (hypertension, heart dz, cancer, & diabetes) surgical risk factors
50
45
60
65
125
what is a good range for partial thromboplastin time?
5-15 seconds
45-75 seconds
20-45 seconds
10-20 seconds
126
what is the appropriate range for hematocrit levels in MEN?
42%-52%
50%-57%
25%-35%
37%-45%
127
Pt returned from surgery at 10 am. It’s now 6pm & pt has no complications. How often should you reassess?
Every 30 mins
Every 15 mins
Every hour
Every 4 hours
128
A T-Tube is draining dark green fluid after gallbladder surgery. What should the nurse do?
Assess the pt for pain
Report it to the surgeon
Report it to the provider
Document the color and the amount of drainage
129
what type of surgery is an ileostomy creation?
diagnostic
curative
reconstructive
palliative
130
a pre-op nursing history includes info about what body systems?
cardiovascular system
all of them
nervous system
respiratory system
131
A pt is admitted for spinal surgery. How should they be positioned?
With the head and neck in alignment
In high fowler’s position
With the head elevated with pillows
With the feet elevated with pillows
132
Which patient’s are most at risk for surgery?
79 year old, pt with BMI of 38
32 year old, pt with no allergies
37 year old, pt with allergy to cats
25 year old, pt with BMI 22
133
Pt is upset about surgery during pre-op teaching and starts crying. What action should the nurse take?
Offer reassurance about the surgery
Leave the room until client has composed herself
Calmly continue the pre-op instructions
Quietly sit with client
134
some patients are allowed to take specific meds with a sip of water before surgery
True
False
135
why is surgery risky for someone with renal disease?
Alters digestive system
alters excretion of anesthetic drugs
136
a pt with addison's disease should immediately stop replacement corticosteroids as they may interfere w/ anesthesia
True
False
137
in regard to urgency, what surgery requires immediate intervention bc of life-threatening consequences?
elective
no idea
emergent
urgent
138
(medical or surgical) asepsis eliminates all pathogens.
surgical
medical
139
how long would a surgeon wait to perform a surgery after the completion of radiation treatments?
5-7 days
3-5 weeks
4-6 weeks
1-2 weeks
140
scrub nurses must have thorough knowledge of surgical procedure & must anticipate the needs of the surgeons
False
True
141
Nurse is encouraging post-op pt to use diaphragmatic breathing. Which priority goal is the nurse trying to achieve?
Manage pain
Reduce healing time
Decrease thrombus formation
Prevent atelectasis
142
in regard to urgency, what is a cataract removal, hernia repair, and total joint replacement?
no idea
emergent
elective
urgent
143
what is an appropriate creatinine range in females?
0.5-1.1 mg/100mL
0.3-0.9 mg/100mL
1.2-1.8 mg/100mL
0.6-1.2 mg/100mL
144
What preop assessments would alert the nurse that special protection techniques should be implemented?
Malignant hyperthermia
Hx of spinal and hip arthritis
B and D are both correct
Malignant hypothermia
145
A pt has a fever of 100.6, purulent sputum, and crackles in the lungs. What post op complication are they experiencing?
Infection
Pneumonia
Bronchitis
Pulmonary embolism
146
sedatives, __, & general anesthesia causes relaxation of upper airway & may worsen OSA.
NSAIDs
anti-histamines
anti-hypertensives
opioid analgesics
147
what is the appropriate range for a platelet count?
150,000-400,000/MM3
100,000-300,000/MM3
250,000-500,000/MM3
500,000-750,000/MM3
148
How should the nurse respond to a nurse that is scared to overdose on a PCA pump?
I’ll tell the surgeon that you prefer the nurses to administer your meds
The pump has a control device that prevents you from overdosing on the med
You will use the pump for the first 24 hours after surgery
The surgeon will prescribe the dose of medication that is correct for you
149
what should you do w/ a pt that has a reduce ROM in the diaphragm?
Have pt do sit-ups
Have pt exercise
Have pt ambulate to the bathroom every hour
Have pt ambulate and sit in chair frequently
150
what does the acronym TBACK (for food related latex allergy) stand for?
turnips, berries, avacados, chestnuts, kale
turnips, bananas, avacados, chestnuts, kiwis
tomatoes, berries, avacados, chestnuts, kale
tomatoes, bananas, avacados, chestnuts, kiwis
151
why is wound healing slow for obese patients?
Poor diets
Position changing is hard
They are lazy
Fatty tissue contains a poor blood supply
152
what type of surgery is a stent replacement to relieve blockage?
curative
preventative
palliative
reconstructive
153
what type of surgery is a breast biopsy and joint arthroscopy?
preventative
palliative
curative
diagnostic
154
A pt is having surgery & informs nurse that she takes 20mg steroids/day for antithyroid issues. What should nurse do?
Request lab work
Assess vital signs
Nothing
Notify surgeon and ACP
155
which of the following chemistries can increase the risk for cardiac problems?
Creatinine
Sodium (Na+)
Glucose
Potassium (K)

N1230 Surgery Part 1 Flashcards | StudBud