Med Surg, Pre-Op, Intra-Op, Post-Op Review Questions
With Complete Solutions
1. A patient complains of dizziness when ambulating in the
room on the first postoperative day. In what order will the nurse
accomplish the following activities? (All the activities are
appropriate.) Put a comma and space between each answer
choice (a, b, c, d, etc.) ____________________
a. Take the patients blood pressure (BP).
b. Have the patient sit down in a chair.
c. Give the patient something to drink.
d. Notify the patients health care provider. Correct Answers
ANS:
B, A, C, D
The first priority for the patient with syncope is to prevent a fall,
so the patient should be assisted to a chair. Assessment of the
BP will determine whether the dizziness is due to orthostatic
hypotension, which occurs because of hypovolemia. Increasing
the fluid intake will help prevent orthostatic dizziness. Because
this is a common postoperative problem that is usually resolved
through nursing measures such as increasing fluid intake and
making position changes more slowly, there is no urgent need to
notify the health care provider.
1. During the preoperative interview, a patient scheduled for an
elective hysterectomy tells the nurse, I am afraid that I will die
in surgery like my mother did! Which response by the nurse is
most appropriate?
a.
Tell me more about what happened to your mother.
b.
,You will receive medications to reduce your anxiety.
c.
You should talk to the doctor again about the surgery.
d.
Surgical techniques have improved a lot in recent years. Correct
Answers ANS: A
The patients statement may indicate an unusually high anxiety
level or a family history of problems such as malignant
hyperthermia, which will require precautions during surgery.
The other statements also may address the patients concerns, but
further assessment is needed first.
1. The perioperative nurse encourages a family member or a
friend to remain with a patient in the preoperative holding area
until the patient is taken into the operating room primarily to
a.
ensure the proper identification of the patient before surgery.
b.
protect the patient from cross-contamination with other patients.
c.
assist the perioperative nurse to obtain a complete patient
history.
d.
help relieve the stress of separation for the patient and
significant others. Correct Answers ANS: D
The presence of a family member or friend reduces the stress
associated with the preoperative period. Although the family
may give information about the patients name and history, this
information is obtained and confirmed by the nurse in other
ways. Nursing staff, rather than family members, are responsible
for prevention of cross-contamination.
,10. Ten minutes after receiving the ordered preoperative opioid
by intravenous (IV) injection, the patient asks to get up to go to
the bathroom to urinate. The most appropriate action by the
nurse is to
a.
assist the patient to the bathroom and stay with the patient to
prevent falls.
b.
offer a urinal or bedpan and position the patient in bed to
promote voiding.
c.
allow the patient up to the bathroom because the onset of the
medication takes more than 10 minutes.
d.
ask the patient to wait because catheterization is performed at
the beginning of the surgical procedure. Correct Answers ANS:
B
The patient will be at risk for a fall after receiving the opioid, so
the best nursing action is to have the patient use a bedpan or
urinal. Having the patient get up either with assistance or
independently increases the risk for a fall. The patient will be
uncomfortable and risk involuntary incontinence if the bladder is
full during transport to the operating room.
10. When the nurse caring for a patient before surgery has a
question about a sedative medication to be given before sending
the patient to the surgical suite, the nurse will communicate with
the
a.
surgeon.
, b.
anesthesiologist.
c.
circulating nurse.
d.
registered nurse first assistant (RNFA). Correct Answers ANS:
B
The anesthesiologist is responsible for prescribing preoperative
medications. The RNFA and surgeon are responsible for the
surgery, but not for the preoperative sedation. The circulating
nurse does not have authority to make a change in any
medication.
10. Which action should the postanesthesia care unit (PACU)
nurse delegate to nursing assistive personnel (NAP) who help
with the transfer of a patient to the surgical unit?
a.
Help with the transfer of the patient onto a stretcher.
b.
Give a verbal report to the surgical unit charge nurse.
c.
Document the appearance of the patients incision in the chart.
d.
Ensure that the receiving nurse understands the postoperative
orders. Correct Answers ANS: A
The scope of practice for nursing assistants includes
repositioning and moving patients under the supervision of an
RN. Providing report to another RN, assessing and documenting
the wound appearance, and clarifying physician orders with
another RN require RN level education and scope of practice.
With Complete Solutions
1. A patient complains of dizziness when ambulating in the
room on the first postoperative day. In what order will the nurse
accomplish the following activities? (All the activities are
appropriate.) Put a comma and space between each answer
choice (a, b, c, d, etc.) ____________________
a. Take the patients blood pressure (BP).
b. Have the patient sit down in a chair.
c. Give the patient something to drink.
d. Notify the patients health care provider. Correct Answers
ANS:
B, A, C, D
The first priority for the patient with syncope is to prevent a fall,
so the patient should be assisted to a chair. Assessment of the
BP will determine whether the dizziness is due to orthostatic
hypotension, which occurs because of hypovolemia. Increasing
the fluid intake will help prevent orthostatic dizziness. Because
this is a common postoperative problem that is usually resolved
through nursing measures such as increasing fluid intake and
making position changes more slowly, there is no urgent need to
notify the health care provider.
1. During the preoperative interview, a patient scheduled for an
elective hysterectomy tells the nurse, I am afraid that I will die
in surgery like my mother did! Which response by the nurse is
most appropriate?
a.
Tell me more about what happened to your mother.
b.
,You will receive medications to reduce your anxiety.
c.
You should talk to the doctor again about the surgery.
d.
Surgical techniques have improved a lot in recent years. Correct
Answers ANS: A
The patients statement may indicate an unusually high anxiety
level or a family history of problems such as malignant
hyperthermia, which will require precautions during surgery.
The other statements also may address the patients concerns, but
further assessment is needed first.
1. The perioperative nurse encourages a family member or a
friend to remain with a patient in the preoperative holding area
until the patient is taken into the operating room primarily to
a.
ensure the proper identification of the patient before surgery.
b.
protect the patient from cross-contamination with other patients.
c.
assist the perioperative nurse to obtain a complete patient
history.
d.
help relieve the stress of separation for the patient and
significant others. Correct Answers ANS: D
The presence of a family member or friend reduces the stress
associated with the preoperative period. Although the family
may give information about the patients name and history, this
information is obtained and confirmed by the nurse in other
ways. Nursing staff, rather than family members, are responsible
for prevention of cross-contamination.
,10. Ten minutes after receiving the ordered preoperative opioid
by intravenous (IV) injection, the patient asks to get up to go to
the bathroom to urinate. The most appropriate action by the
nurse is to
a.
assist the patient to the bathroom and stay with the patient to
prevent falls.
b.
offer a urinal or bedpan and position the patient in bed to
promote voiding.
c.
allow the patient up to the bathroom because the onset of the
medication takes more than 10 minutes.
d.
ask the patient to wait because catheterization is performed at
the beginning of the surgical procedure. Correct Answers ANS:
B
The patient will be at risk for a fall after receiving the opioid, so
the best nursing action is to have the patient use a bedpan or
urinal. Having the patient get up either with assistance or
independently increases the risk for a fall. The patient will be
uncomfortable and risk involuntary incontinence if the bladder is
full during transport to the operating room.
10. When the nurse caring for a patient before surgery has a
question about a sedative medication to be given before sending
the patient to the surgical suite, the nurse will communicate with
the
a.
surgeon.
, b.
anesthesiologist.
c.
circulating nurse.
d.
registered nurse first assistant (RNFA). Correct Answers ANS:
B
The anesthesiologist is responsible for prescribing preoperative
medications. The RNFA and surgeon are responsible for the
surgery, but not for the preoperative sedation. The circulating
nurse does not have authority to make a change in any
medication.
10. Which action should the postanesthesia care unit (PACU)
nurse delegate to nursing assistive personnel (NAP) who help
with the transfer of a patient to the surgical unit?
a.
Help with the transfer of the patient onto a stretcher.
b.
Give a verbal report to the surgical unit charge nurse.
c.
Document the appearance of the patients incision in the chart.
d.
Ensure that the receiving nurse understands the postoperative
orders. Correct Answers ANS: A
The scope of practice for nursing assistants includes
repositioning and moving patients under the supervision of an
RN. Providing report to another RN, assessing and documenting
the wound appearance, and clarifying physician orders with
another RN require RN level education and scope of practice.
