NUR 305 Exam 1 Module Reviews/Case Study
Questions & Answers.
The Surgical Care Improvement Project (SCIP) goals focus on which of the
following ? (Select all that apply.
a.Stroke
b.Infection
c.Serious cardiac events
d.Thromboembolism
e.Hemorrhage
b.Infection
c.Serious cardiac events
d.Thromboembolism
Which of the following are correct examples for the different types of surgery?
a.Decompression craniotomy: palliative
b.Liver biopsy: diagnostic
c.Mastectomy: restorative
d.Hemicolectomy: diagnostic
e.Total shoulder replacement: restorative
a.Decompression craniotomy: palliative
b.Liver biopsy: diagnostic
e.Total shoulder replacement: restorative
Rationale: A diagnostic procedure is used to determine cell type of cancer and to
determine the cause of a problem. An example is a liver biopsy. A restorative procedure
aims to improve functional ability. An example would be a total shoulder replacement. A
curative procedure either removes or repairs the causative problem. An example would
be a mastectomy (not restorative) or a hemicolectomy (not diagnostic). A palliative
procedure relieves symptoms but will not cure the disease. An example is an ileostomy.
A cosmetic procedure is done to improve appearance. An example is rhinoplasty (a
"nose job").
Which of the following preoperative lab values must be reported immediately to
the surgeon?
a.Creatinine: 1.2 mg/dL(106.1 umol/l)
b.Hemoglobin: 14.8 mg/dL (148 mmol/L)
c.Sodium: 134 mEq/L (134 mmol/l)
d.Potassium: 2.9 mEq/L (2.9 mmol/l)
d. Potassium: 2.9 mEq/L (2.9 mmol/l)
The preoperative assessment revealed that the patient's HR is 115. The surgeon
ordered a beta-blocker. Which of the following is a correct rationale for this
prescription?
, a."A rapid heart rate requires more effort by the heart."
b."The patient may have an undiagnosed heart condition."
c."When the heart rate goes up, the blood pressure does too."
d."Anesthesia has bad effects if the patient is tachycardic."
a."A rapid heart rate requires more effort by the heart."
Rationale: Tachycardia increases the workload of the heart and requires more oxygen
delivery to the myocardial tissues. This added strain is not needed on top of the physical
and emotional stress of surgery. The beta-blocker will blunt the effect of sympathetic
nervous system stimulation and reduce the heart rate. The other statements are not
accurate.
The preoperative assessment revealed that the patient has brittle nails and hair,
dry skin turgor, and muscle wasting. What is the best nurse's action?
a.Refer the patient to Meals on Wheels after discharge.
b.Document the findings thoroughly in the patient's chart.
c.Encourage the patient to eat more after recovering from surgery.
d.Consult the surgeon about a postoperative dietitian referral
d.Consult the surgeon about a postoperative dietitian referral
Rationale: This patient has signs of malnutrition, which can impact recovery from
surgery. The nurse should consult the surgeon about prescribing a consultation with a
dietitian in the postoperative period. The nurse should document the findings but needs
to do more. Encouraging the patient to eat more may be helpful, but the patient needs a
professional nutritional assessment so that the appropriate diet and supplements can be
ordered. The patient may or may not need Meals on Wheels after discharge
Which of the following patients undergoing surgery are considered to be at high
risk for venous thromboembolism (VTE)? (Select all that apply.)
a.Wheelchair-bound patient
b.Patient who underwent a prolonged surgical procedure
c.Morbidly obese patient
d.Patient with a humerus fracture
e.Patient with severe heart failure
a.Wheelchair-bound patient
b.Patient who underwent a prolonged surgical procedure
c.Morbidly obese patient
e.Patient with severe heart failure
Rationale: All surgical patients should be assessed for VTE risk. Those considered to
be at higher risk include those who are obese; are over 40; have cancer; have
decreased mobility, immobility, or a spinal cord injury; have a history of any thrombotic
event, varicose veins, or edema; take oral contraceptives or smoke; have decreased
cardiac output; have a hip fracture; or are having total hip or knee surgery. Prolonged
surgical time increases risk due to mobility and positioning needs.
Questions & Answers.
The Surgical Care Improvement Project (SCIP) goals focus on which of the
following ? (Select all that apply.
a.Stroke
b.Infection
c.Serious cardiac events
d.Thromboembolism
e.Hemorrhage
b.Infection
c.Serious cardiac events
d.Thromboembolism
Which of the following are correct examples for the different types of surgery?
a.Decompression craniotomy: palliative
b.Liver biopsy: diagnostic
c.Mastectomy: restorative
d.Hemicolectomy: diagnostic
e.Total shoulder replacement: restorative
a.Decompression craniotomy: palliative
b.Liver biopsy: diagnostic
e.Total shoulder replacement: restorative
Rationale: A diagnostic procedure is used to determine cell type of cancer and to
determine the cause of a problem. An example is a liver biopsy. A restorative procedure
aims to improve functional ability. An example would be a total shoulder replacement. A
curative procedure either removes or repairs the causative problem. An example would
be a mastectomy (not restorative) or a hemicolectomy (not diagnostic). A palliative
procedure relieves symptoms but will not cure the disease. An example is an ileostomy.
A cosmetic procedure is done to improve appearance. An example is rhinoplasty (a
"nose job").
Which of the following preoperative lab values must be reported immediately to
the surgeon?
a.Creatinine: 1.2 mg/dL(106.1 umol/l)
b.Hemoglobin: 14.8 mg/dL (148 mmol/L)
c.Sodium: 134 mEq/L (134 mmol/l)
d.Potassium: 2.9 mEq/L (2.9 mmol/l)
d. Potassium: 2.9 mEq/L (2.9 mmol/l)
The preoperative assessment revealed that the patient's HR is 115. The surgeon
ordered a beta-blocker. Which of the following is a correct rationale for this
prescription?
, a."A rapid heart rate requires more effort by the heart."
b."The patient may have an undiagnosed heart condition."
c."When the heart rate goes up, the blood pressure does too."
d."Anesthesia has bad effects if the patient is tachycardic."
a."A rapid heart rate requires more effort by the heart."
Rationale: Tachycardia increases the workload of the heart and requires more oxygen
delivery to the myocardial tissues. This added strain is not needed on top of the physical
and emotional stress of surgery. The beta-blocker will blunt the effect of sympathetic
nervous system stimulation and reduce the heart rate. The other statements are not
accurate.
The preoperative assessment revealed that the patient has brittle nails and hair,
dry skin turgor, and muscle wasting. What is the best nurse's action?
a.Refer the patient to Meals on Wheels after discharge.
b.Document the findings thoroughly in the patient's chart.
c.Encourage the patient to eat more after recovering from surgery.
d.Consult the surgeon about a postoperative dietitian referral
d.Consult the surgeon about a postoperative dietitian referral
Rationale: This patient has signs of malnutrition, which can impact recovery from
surgery. The nurse should consult the surgeon about prescribing a consultation with a
dietitian in the postoperative period. The nurse should document the findings but needs
to do more. Encouraging the patient to eat more may be helpful, but the patient needs a
professional nutritional assessment so that the appropriate diet and supplements can be
ordered. The patient may or may not need Meals on Wheels after discharge
Which of the following patients undergoing surgery are considered to be at high
risk for venous thromboembolism (VTE)? (Select all that apply.)
a.Wheelchair-bound patient
b.Patient who underwent a prolonged surgical procedure
c.Morbidly obese patient
d.Patient with a humerus fracture
e.Patient with severe heart failure
a.Wheelchair-bound patient
b.Patient who underwent a prolonged surgical procedure
c.Morbidly obese patient
e.Patient with severe heart failure
Rationale: All surgical patients should be assessed for VTE risk. Those considered to
be at higher risk include those who are obese; are over 40; have cancer; have
decreased mobility, immobility, or a spinal cord injury; have a history of any thrombotic
event, varicose veins, or edema; take oral contraceptives or smoke; have decreased
cardiac output; have a hip fracture; or are having total hip or knee surgery. Prolonged
surgical time increases risk due to mobility and positioning needs.
