Question 1

Hypothermia may occur as a result of

Accepted Answer

open body wounds

Question 2

When a person with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period?

Accepted Answer

up to 72 hours after alcohol withdrawal

Question 3

In which position would a patient undergoing a lumbar puncture be placed?

Accepted Answer

side-lying, knee to chest

Question 4

The PACU nurse is caring for an older adult who presents with clinical manifestations of delirium. Which short-term outcome would be most important for this client? The client:

Accepted Answer

maintains adequate oxygenation status

Question 5

Which of the following characteristics should the nurse include when teaching the client about moderate sedation?

Accepted Answer

ability to respond to verbal commands

Question 6

The anesthesiologist will use moderate (conscious) sedation during the client\'s surgical procedure. The circulating nurse will expect the client to:

Accepted Answer

respond verbally during the procedure

Question 7

When is the ideal time to discuss preoperative teaching

Accepted Answer

preadmission visit

Question 8

Adequate hourly urine output for a patient with an indwelling urinary catheter is

Accepted Answer

30mL/hr

Question 9

A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. This wound is healing by:

Accepted Answer

first intention

Question 10

A client is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist\'s instructions. Why does the client require special positioning for this type of anesthesia?

Accepted Answer

to prevent CSF leakage

Question 11

Which question is most important for the nurse to ask the client when obtaining the preoperative admission history?

Accepted Answer

\"When is the last time you ate or drank?\"

Question 12

Which of the following terms refers to a protrusion of abdominal organs through the surgical incision?

Accepted Answer

Evisceration

Question 13

At what point does the preoperative period end?

Accepted Answer

When the client is transferred onto the operating table

Question 14

The primary objective in the immediate postoperative period is

Accepted Answer

maintaining pulmonary ventilation

Question 15

The nurse discovers that the client did not sign the operative consent before receiving the preoperative medication. The appropriate nursing action is:

Accepted Answer

to notify the surgeon

Question 16

A 57-year-old client is undergoing preoperative assessment before surgical repair of a fractured ulna. During admission paperwork, the client divulges that she enjoyed a hearty breakfast this morning to be ready for her procedure. What is the nurse\'s next action?

Accepted Answer

notify the surgeon

Question 17

A term used to describe a partial or complete separation of the wound edges is

Accepted Answer

dehiscence

Question 18

What is the primary objective of the health care team during the immediate postoperative period?

Accepted Answer

maintaining ventilation

Question 19

A gunshot wound would be classified under which category of surgery based on urgency?

Accepted Answer

emergent

Question 20

You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply?

Accepted Answer

\"Many people have diagnostic or short therapeutic surgical procedures.\"

Question 21

You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility?

Accepted Answer

Place gauze under and over the ring and apply adhesive tape over it.

Question 22

The circulating nurse must be vigilant in monitoring the surgical environment. Which of the following actions by the nurse is inappropriate?

Accepted Answer

Allow unnecessary personnel to enter the OR environment.

Question 23

A fractured skull would be classified under which category of surgery based on urgency?

Accepted Answer

Emergent

Question 24

As a circulating nurse, what task are you solely responsible for?

Accepted Answer

keeping records

Question 25

Surgical asepsis is a requirement in the restricted zone of the operating suite. What personal protective equipment should the nurse wear at all times in the restricted zone of the operating room?

Accepted Answer

masks covering the nose and mouth

Question 26

The nurse is changing the dressing of a client who is 4 days postoperative with an abdominal wound. The nurse has changed this dressing daily since surgery. Today, the nurse notes increased serosanguinous drainage, wound edges not approximated, and a Â¼-inch gap at the lower end of the incision. The nurse concludes which of the following conditions exists?

Accepted Answer

dehiscence

Question 27

A nurse asks a client who had abdominal surgery 3 days ago if he has moved his bowels since surgery. The client states, \"I haven\'t moved my bowels, but I am passing gas.\" How should the nurse intervene?

Accepted Answer

Encourage the client to ambulate at least three times a day

Question 28

The OR personnel responsible for maintaining the safety of the client and the surgical environment is the:

Accepted Answer

circulating nurse

Question 29

A client just entered the post-anesthesia care unit following abdominal surgery. The client is showing frank, increased bleeding; his blood pressure is plummeting. Which of the following interventions will the nurse perform to manage and minimize hemorrhage and shock?

Accepted Answer

reinforcing dressing and applying pressure

Question 30

The nurse understands that the purpose of the \"time out\" is to:

Accepted Answer

maintain the safety of the client

Question 31

When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as

Accepted Answer

emergency

Question 32

Which of the following actions should the nurse perform to prevent deep vein thrombosis in a client recovering from abdominal surgery?

Accepted Answer

reinforce the need for the client to perform leg exercises every hour while awake

Question 33

Terry Richards, a 60-year-old male, is readying for surgery to remove his gallbladder. His assessment is complete, all consents have been signed, and family is at his bedside. Before administering his preoperative medications, what is your first step?

Accepted Answer

check his ID bracelet

Question 34

Which of the following techniques least exhibits surgical asepsis?

Accepted Answer

suctioning the nasopharyngeal airway of the client

Question 35

During an intraoperative procedure, a client starts gagging and retching. The nurse immediately sits the client up and turns the client\'s head to one side? Why?

Accepted Answer

to avoid aspiration

Question 36

The nurse concludes that further teaching about diaphragmatic breathing is needed when the client:

Accepted Answer

exhales forcefully with a short expiration

Question 37

Which statement by the client indicates further teaching about epidural anesthesia is necessary?

Accepted Answer

\"I will become unconscious\"

Question 38

Which of the following is often the earliest sign of malignant hyperthermia?

Accepted Answer

tachycardia

Question 39

You are caring for a client postoperatively. What nursing interventions help prevent venous stasis and other circulatory complications in a client who has undergone surgery?

Accepted Answer

Encourage the client to move legs frequently and do leg exercises.

Question 40

Fentanyl (Sublimaze) is categorized as which type of intravenous anesthetic agent?

Accepted Answer

opioid

Question 41

Patients who have received corticosteroids preoperatively are at risk for which type of insufficiency?

Accepted Answer

adrenal

Question 42

During the first 24 hours after surgery, how often will the nurse evaluate the client\'s temperature?

Accepted Answer

every 4 hours

Question 43

The nursing assessment of the postoperative client reveals an incision that is well-approximated with sutures intact, minimal redness and edema, and absence of drainage. The nurse recognizes the wound is healing by:

Accepted Answer

first intention

Question 44

For the patient who is taking aspirin, it is important to stop taking this medication at least how many day(s) prior to surgery?

Accepted Answer

7

Question 45

As an OR nurse, you are required to assess the client continuously and protect them from developing potential complications, as much as humanly possible. To protect a client from malignant hyperthermia, you need to know the symptomsâwhat are the symptoms of malignant hyperthermia?

Accepted Answer

all options are correct: cyanosis, hypotension and decreased urine output

Question 46

The nurse is caring for a client who develops an evisceration. What nursing intervention is most appropriate when an evisceration occurs in the surgical wound of a client who has undergone surgery?

Accepted Answer

Place sterile dressings moistened with normal saline over the protruding organs and tissues.

Question 47

The nurse expects informed consent to be obtained for insertion of:

Accepted Answer

a gastrostomy tube

Question 48

The scrub nurse is responsible for:

Accepted Answer

preparing the sterile instruments

Question 49

Which stage of general anesthesia is reached when too much anesthesia has been administered?

Accepted Answer

stage IV

Question 50

In developing the plan of care for the intraoperative client, the nurse recognizes that it is essential to consider:

Accepted Answer

the client\'s cultural beliefs

Question 51

The nurse positions the client in the lithotomy position in preparation for

Accepted Answer

perineal surgery

Question 52

Which stage of surgical anesthesia is also known as excitement?

Accepted Answer

II

Question 53

Following diagnostic testing, a patient requires a cholecystectomy. This surgical procedure would be categorized as which of the following?

Accepted Answer

urgent

Question 54

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?

Accepted Answer

use diaphragmatic breathing

Question 55

Which type of healing occurs when granulation tissue is not visible and scar formation is minimal?

Accepted Answer

first intention

Question 56

A client is being prepared for a same-day surgical procedure and is discussing with the nurse what potential ramifications this type of surgery has. Which of the following would the nurse correctly identify? Select all that apply.

Accepted Answer

â¢ The client must be prepared to take on more self-care than he or she may have done in the past. â¢ The client will leave the hospital sooner than in the past. â¢ Need for teaching is increased.

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