MEDICAL SURGERY COMPREHENSIVE PRACTICE QUESTIONS

COMPREHENSIVE PRACTICE QUESTIONS Week One Perioperative – Preoperative 1. 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.” 2. A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in outpatient surgery. Which information is of most concern to the nurse? a. The patient is planning to drive home after surgery. b. The patient had a sip of water 4 hours before arriving. c. The patient’s insurance does not cover outpatient surgery. d. The patient has not had surgery using general anesthesia before. 3. A 38-year-old female is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to report to the anesthesiologist before surgery? a. The patient’s lack of knowledge about postoperative pain control measures b. The patient’s statement that her last menstrual period was 8 weeks previously c. The patient’s history of a postoperative infection following a prior cholecystectomy d. The patient’s concern that she will be unable to care for her children postoperatively 4. A patient who has never had any prior surgeries tells the nurse doing the preoperative assessment about an allergy to bananas and avocados. Which action is most important for the nurse to take? a. Notify the dietitian about the food allergies. b. Alert the surgery center about a possible latex allergy. c. Reassure the patient that all allergies are noted on the medical record. d. Ask whether the patient uses antihistamines to reduce allergic reactions. 5. The surgical unit nurse has just received a patient with a history of smoking from the postanesthesia care unit. Which action is most important at this time? a. Auscultate for adventitious breath sounds. b. Obtain the patient’s blood pressure and temperature. c. Remind the patient about harmful effects of smoking. d. Ask the health care provider about prescribing a nicotine patch. 6. The nurse obtains a health history from a patient who is scheduled for elective hip surgery in 1 week. The patient reports use of garlic and ginkgo biloba. Which action by the nurse is most appropriate? a. Ascertain that there will be no interactions with anesthetic agents. b. Teach the patient that these products may be continued preoperatively. c. Advise the patient to stop the use of all herbs and supplements at this time. MEDICAL SURGERY COMPREHENSIVE PRACTICE QUESTIONS COMPREHENSIVE PRACTICE QUESTIONS 2 d. Discuss the herb and supplement use with the patient’s health care provider. 7. The nurse is preparing to witness the patient signing the operative consent form when the patient says, “I do not really understand what the doctor said.” Which action is best for the nurse to take? a. Provide an explanation of the planned surgical procedure. b. Notify the surgeon that the informed consent process is not complete. c. Administer the prescribed preoperative antibiotics and withhold any ordered sedative medications. d. Notify the operating room staff that the surgeon needs to give a more complete explanation of the procedure. 8. Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for abdominal surgery for an open cholecystectomy? a. Care for the surgical incision b. Medications used during surgery c. Deep breathing and coughing techniques d. Oral antibiotic therapy after discharge home 9. A patient who has diabetes and uses insulin to control blood glucose has been NPO since midnight before having a knee replacement surgery. Which action should the nurse take? a. Withhold the usual scheduled insulin dose because the patient is NPO. b. Obtain a blood glucose measurement before any insulin administration. c. Give the patient the usual insulin dose because stress will increase the blood glucose. d. Administer a lower dose of insulin because there will be no oral intake before surgery. 10. 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. 11. When caring for a preoperative patient on the day of surgery, which actions included in the plan of care can the nurse delegate to unlicensed assistive personnel (UAP)? (Select all that apply.) a. Teach incentive spirometer use. b. Explain preoperative routine care. c. Obtain and document baseline vital signs. d. Remove nail polish and apply pulse oximeter. e. Transport the patient by stretcher to the operating room. Perioperative – Intraoperative 12. Which statement, if made by a new circulating nurse, is appropriate? a. “I will assist in preparing the operating room for the patient.” b. “I will remain gloved while performing activities in the sterile field.”