Perioperative NCLEX style
questions & Answers 2021/2022.
Which teaching by the nurse during the preoperative period best informs the patient
regarding the primary purpose of an incentive spirometer?
- The PURPOSE (key word!) of the incentive spirometer is that it will encourage lung
expansion, thus decreasing atelectasis.
Proper use entails holding the breath 3 to 5 seconds at a time, setting daily goals, and
sealing the lips tightly around the mouth piece are all directions on how to use the
device, but do not describe its function. (be careful of key words in question!)
The nurse interviews a patient scheduled to undergo general anesthesia for a hernia
repair. Which information is most important to communicate to the surgeon and
anesthesiologist before surgery?
a. The patient drinks 3 or 4 cups of coffee every morning before going to work.
b. The patient takes a baby aspirin daily but stopped taking aspirin 10 days ago.
c. The patient drank 4 ounces of apple juice 3 hours before coming to the hospital.
d. The patient's father died after receiving general anesthesia for abdominal surgery. -
D. The patient's father died after receiving general anesthesia for abdominal surgery.
The information about the patient's father suggests that there may be a family history of
malignant hyperthermia and that precautions may need to be taken to prevent this
complication. Current research indicates that having clear liquids 3 hours before surgery
does not increase the risk for aspiration in most patients. Patients are instructed to
discontinue aspirin 1 to 2 weeks before surgery. The patient should be offered
caffeinated beverages postoperatively to prevent a caffeine-withdrawal headache, but
this does not have preoperative implications.
A patient who takes a diuretic and a beta-blocker to control blood pressure is scheduled
for breast reconstruction surgery. Which patient information is most important to
communicate to the health care provider before surgery?
a. Hematocrit 36%
b. Blood pressure 144/82
c. Pulse rate 58 beats/minute
d. Serum potassium 3.2 mEq/L - d. Serum potassium 3.2 mEq/L
ANS: D
The low potassium level may increase the risk for intraoperative complications such as
dysrhythmias. Slightly elevated blood pressure is common before surgery because of
anxiety. The lower heart rate would be expected in a patient taking a -blocker. The
hematocrit is in the low normal range but does not require any intervention before
surgery.
,A preoperative nurse is assessing a client prior to surgery. Which information would be
most important for the nurse to relay to the surgical team?
a. Allergy to bee and wasp stings
b. History of lactose intolerance
c. No previous experience with surgery
d. Use of multiple herbs and supplements - d. Use of multiple herbs and supplements
Some herbs and supplements can interact with medications, so this information needs
to be reported as the priority. An allergy to bee and wasp stings should not affect the
client during surgery. Lactose intolerance should also not affect the client during surgery
but will need to be noted before a postoperative diet is ordered. Lack of experience with
surgery may increase anxiety and may require higher teaching needs, but is not the
priority over client safety.
***side note:pt taking St. John's wort may prolong the effects of anesthetic agents and
increase the time to waken completely after surgery.**
Ten hours after surgery, a postoperative client reports that the antiembolism stockings
and sequential compression devices itch and are too hot. The client asks the nurse to
remove them. What response by the nurse is best?
a. "Let me call the surgeon to see if you really need them."
b. "No, you have to use those for 24 hours after surgery."
c. "OK, we can remove them since you are stable now."
d. "To prevent blood clots you need them a few more hours." - d. "To prevent blood
clots you need them a few more hours."
According to the Surgical Care Improvement Project (SCIP), any prophylactic measures
to prevent thromboembolic events during surgery are continued for 24 hours afterward.
The nurse should explain this to the client. Calling the surgeon is not warranted. Simply
telling the client he or she has to wear the hose and compression devices does not
educate the client. The nurse should not remove the devices.
An inpatient nurse brings an informed consent form to a client for an operation
scheduled for tomorrow. The client asks about possible complications from the
operation. What response by the nurse is best?
a. Answer the questions and document that teaching was done.
b. Do not have the client sign the consent and call the surgeon.
c. Have the client sign the consent, then call the surgeon.
d. Remind the client of what teaching the surgeon has done. - ANS: B Do not have the
client sign the consent and call the surgeon.
In order to give informed consent, the client needs sufficient information. Questions
about potential complications should be answered by the surgeon. The nurse should
notify the surgeon to come back and answer the client's questions before the client
signs the consent form. The other actions are not appropriate.
, The most dangerous metabolic side effect of general anesthesia that can occur during
surgery is:
Hyperglycemia
Hyperthermia
Hypoglycemia
Hypothermia
Explanation:
Malignant hyperthermia is the most dangerous metabolic side effect of general
anesthesia. - Hyperthermia
Explanation:
Malignant hyperthermia is the most dangerous metabolic side effect of general
anesthesia.
Mr. Baltazar will be undergoing surgery with general anesthesia. The client should be
given which of the following instructions preoperatively?
Eat big breakfast
Expect to be incontinent of urine postoperatively
Double your medication doses
Eat big breakfast
Expect to be incontinent of urine postoperatively
Expect nausea, vomiting, shivering, and pain postoperatively. - Expect nausea,
vomiting, shivering, and pain postoperatively.
Explanation:
These responses should be expected, and the client should be prepared for them. Food
is contraindicated before surgery. Urinary retention, not incontinence is likely.
Medication is more likely to be held on the day of surgery.
Which of the following statements about shivering is correct?
Shivering is a response controlled by the brainstem.
Shivering can occur in the absence of hypothermia.
Shivering is effectively treated with small doses of naloxone.
Shivering is an uncomfortable, though harmless, effect of anesthesia. - Shivering can
occur in the absence of hypothermia
Explanation:
Shivering can also appear after surgery. This is known as postanesthetic shivering.
The nurse receives the client in the postanesthesia care unit (PACU) following a
procedure requiring general anesthesia. The most important assessment made by the
nurse relates to the client's:
Level of consciousness.
Pain.
Vital signs.
questions & Answers 2021/2022.
Which teaching by the nurse during the preoperative period best informs the patient
regarding the primary purpose of an incentive spirometer?
- The PURPOSE (key word!) of the incentive spirometer is that it will encourage lung
expansion, thus decreasing atelectasis.
Proper use entails holding the breath 3 to 5 seconds at a time, setting daily goals, and
sealing the lips tightly around the mouth piece are all directions on how to use the
device, but do not describe its function. (be careful of key words in question!)
The nurse interviews a patient scheduled to undergo general anesthesia for a hernia
repair. Which information is most important to communicate to the surgeon and
anesthesiologist before surgery?
a. The patient drinks 3 or 4 cups of coffee every morning before going to work.
b. The patient takes a baby aspirin daily but stopped taking aspirin 10 days ago.
c. The patient drank 4 ounces of apple juice 3 hours before coming to the hospital.
d. The patient's father died after receiving general anesthesia for abdominal surgery. -
D. The patient's father died after receiving general anesthesia for abdominal surgery.
The information about the patient's father suggests that there may be a family history of
malignant hyperthermia and that precautions may need to be taken to prevent this
complication. Current research indicates that having clear liquids 3 hours before surgery
does not increase the risk for aspiration in most patients. Patients are instructed to
discontinue aspirin 1 to 2 weeks before surgery. The patient should be offered
caffeinated beverages postoperatively to prevent a caffeine-withdrawal headache, but
this does not have preoperative implications.
A patient who takes a diuretic and a beta-blocker to control blood pressure is scheduled
for breast reconstruction surgery. Which patient information is most important to
communicate to the health care provider before surgery?
a. Hematocrit 36%
b. Blood pressure 144/82
c. Pulse rate 58 beats/minute
d. Serum potassium 3.2 mEq/L - d. Serum potassium 3.2 mEq/L
ANS: D
The low potassium level may increase the risk for intraoperative complications such as
dysrhythmias. Slightly elevated blood pressure is common before surgery because of
anxiety. The lower heart rate would be expected in a patient taking a -blocker. The
hematocrit is in the low normal range but does not require any intervention before
surgery.
,A preoperative nurse is assessing a client prior to surgery. Which information would be
most important for the nurse to relay to the surgical team?
a. Allergy to bee and wasp stings
b. History of lactose intolerance
c. No previous experience with surgery
d. Use of multiple herbs and supplements - d. Use of multiple herbs and supplements
Some herbs and supplements can interact with medications, so this information needs
to be reported as the priority. An allergy to bee and wasp stings should not affect the
client during surgery. Lactose intolerance should also not affect the client during surgery
but will need to be noted before a postoperative diet is ordered. Lack of experience with
surgery may increase anxiety and may require higher teaching needs, but is not the
priority over client safety.
***side note:pt taking St. John's wort may prolong the effects of anesthetic agents and
increase the time to waken completely after surgery.**
Ten hours after surgery, a postoperative client reports that the antiembolism stockings
and sequential compression devices itch and are too hot. The client asks the nurse to
remove them. What response by the nurse is best?
a. "Let me call the surgeon to see if you really need them."
b. "No, you have to use those for 24 hours after surgery."
c. "OK, we can remove them since you are stable now."
d. "To prevent blood clots you need them a few more hours." - d. "To prevent blood
clots you need them a few more hours."
According to the Surgical Care Improvement Project (SCIP), any prophylactic measures
to prevent thromboembolic events during surgery are continued for 24 hours afterward.
The nurse should explain this to the client. Calling the surgeon is not warranted. Simply
telling the client he or she has to wear the hose and compression devices does not
educate the client. The nurse should not remove the devices.
An inpatient nurse brings an informed consent form to a client for an operation
scheduled for tomorrow. The client asks about possible complications from the
operation. What response by the nurse is best?
a. Answer the questions and document that teaching was done.
b. Do not have the client sign the consent and call the surgeon.
c. Have the client sign the consent, then call the surgeon.
d. Remind the client of what teaching the surgeon has done. - ANS: B Do not have the
client sign the consent and call the surgeon.
In order to give informed consent, the client needs sufficient information. Questions
about potential complications should be answered by the surgeon. The nurse should
notify the surgeon to come back and answer the client's questions before the client
signs the consent form. The other actions are not appropriate.
, The most dangerous metabolic side effect of general anesthesia that can occur during
surgery is:
Hyperglycemia
Hyperthermia
Hypoglycemia
Hypothermia
Explanation:
Malignant hyperthermia is the most dangerous metabolic side effect of general
anesthesia. - Hyperthermia
Explanation:
Malignant hyperthermia is the most dangerous metabolic side effect of general
anesthesia.
Mr. Baltazar will be undergoing surgery with general anesthesia. The client should be
given which of the following instructions preoperatively?
Eat big breakfast
Expect to be incontinent of urine postoperatively
Double your medication doses
Eat big breakfast
Expect to be incontinent of urine postoperatively
Expect nausea, vomiting, shivering, and pain postoperatively. - Expect nausea,
vomiting, shivering, and pain postoperatively.
Explanation:
These responses should be expected, and the client should be prepared for them. Food
is contraindicated before surgery. Urinary retention, not incontinence is likely.
Medication is more likely to be held on the day of surgery.
Which of the following statements about shivering is correct?
Shivering is a response controlled by the brainstem.
Shivering can occur in the absence of hypothermia.
Shivering is effectively treated with small doses of naloxone.
Shivering is an uncomfortable, though harmless, effect of anesthesia. - Shivering can
occur in the absence of hypothermia
Explanation:
Shivering can also appear after surgery. This is known as postanesthetic shivering.
The nurse receives the client in the postanesthesia care unit (PACU) following a
procedure requiring general anesthesia. The most important assessment made by the
nurse relates to the client's:
Level of consciousness.
Pain.
Vital signs.
