Fundamentals Proctored Exam Questions Latest Update 2024

PERIOPERATIVE NURSING There are discharge criteria for clients in the postanesthesia care unit (PACU) regardless of the type of anesthesia used and additional criteria for specific types of anesthesia. Which is the criterion specific for the client who has received spinal anesthesia? a. oxygen saturation reaches the presurgical baseline b. motor and sensory function returns c. nausea and vomiting are minimal d. headache is reported as tolerable - b A client is admitted to the postanesthesia care unit. Which nursing action is most important during the client's stay in this unit? a. monitoring urinary output b. assessing level of consciousness c. ensuring patency of drainage tubes d. suctioning mucus from respiratory passages - d A postoperative client is transferred back to the surgical unit with an abdominal dressing and a Penrose drain. Which is the most important nursing action associated with caring for the client with a Penrose drain? a. removing the excess external portion until drainage stops b. changing the soiled dressing carefully c. maintaining the negative pressure d. pinning the drain to the dressing - b A client has abdominal surgery. Which should the nurse do to best assess for a sign of postoperative ileus in this client after surgery? a. identify the time of the first bowel movement b. monitor the tolerance of a clear liquid diet c. palpate for abdominal distention d. auscultate for bowel sounds - d Four days after abdominal surgery, while being transferred from a bed to a chair, a client says to a nurse, "my incision feels funny all of a sudden." Which should the nurse do first? a. take the vital signs b. apply an abdominal binder immediately c. place the client in the low-Fowler position d. encourage slow deep breathing by the client - c Which factor places a client at the highest risk for postoperative nausea and vomiting after receiving general anesthesia? a. obesity b. inactivity c. hypervolemia d. unconsciousness - a On the second postoperative day after an above-the-knee amputation, the client's elastic dressing accidentally comes off. Which should the nurse do first? a. wrap the residual limb with an elastic compression bandage b. apply a saline dressing to the residual limb c. notify the primary health-care provider d. place two pillows under the limb - a A nurse is caring for a postoperative client. Which action is effective in preventing postoperative urinary tract infections? a. eating foods with roughage b. taking sitz baths twice a day c. drinking an adequate amount of fluid d. increasing the intake of citrus fruit juices - c A client received conscious sedation during a colonoscopy. Which should the nurse expect regarding the client's experience with this procedure? a. client will be unresponsive and pain free b. client will be at risk for malignant hyperthermia c. client will be sleepy but able to follow verbal commands d. client will be positioned in the supine position to prevent headache - c Which client having emergency surgery should the nurse anticipate to be at the highest risk for postoperative mortality? a. individual who has alcoholism b. person who has epilepsy c. middle-age adult d. infant - a A nurse is caring for a client who had an abdominal hysterectomy. Which intervention best prevents postoperative thrombophelbitis? a. utilization of compression stockings at night b. deep breathing and coughing exercises daily c. leg exercises 10 times per hour when awake d. elevation of the legs on 2 pillows - c An obese client has abdominal surgery for removal of the gallbladder. Which should the nurse be most concerned about if exhibited by the client? a. constipation b. urinary retention c. shallow breathing d. inability to provide self-care - c A client arrives in the postanesthesia care unit. Which is the most important information that the nurse needs to know? a. anxiety level before surgery b. type and extent of the surgery c. type of intravenous fluids administered d. special requests that were expressed by the client - b Which client responses best support the decision to discharge the client from the postanesthesia care unit? a. SaO2 of 95%, vital signs stable for 30 minutes, active gag reflex b. tolerable pain, ability to move extremities, dry intact dressing c. urinary output of 30 mL/hr, awake, turning from side to side d. afebrile, adventitious breath sounds, ability to cough - a How many days after surgery should the nurse anticipate that a postoperative client will begin to exhibit signs and symptoms of a wound infection if it should occur? a. fifth day b. third day c. ninth day d. seventh day - b A nurse is assessing a client who had spinal anesthesia. For which common response should the nurse assess the client? a. headache b. neuropathy c. lower back discomfort d. increased blood pressure - a A hospitalized client who has been receiving medications via a variety of routes for several days is scheduled for surgery at 10 am. Which should the nurse plan to do on the day of surgery? a. use an alternative route for the oral medications b. withhold all the previously prescribed medications c. withhold the oral medications and administer the other drugs d. obtain directions from the primary health-care provider regarding the medications - d Which is the most common dietary prescription the nurse can anticipate after a client who had abdominal surgery exhibits a return of intestinal peristalsis? a. clear liquids b. full liquids c. low fiber d. regular - a A nurse compares the advantages and disadvantages of a central venous catheter inserted into a peripheral vein and a central venous catheter inserted into a subclavian vein. Which of the following does the nurse conclude is the reason why a peripheral catheter is more desirable? a. because it will not be in the superior vena cava b. because it will not cause a tension pneumothorax c. because it will not prevent the development of an infection - b A nurse is caring for a client who had abdominal surgery. Which type of incisional drainage should the nurse expect 4 hours after surgery? a. serous wound drainage b. purulent wound drainage c. sanguineous wound drainage d. serosanguineous wound drainage - d A nurse is assessing a postoperative client. Which client response identified by the nurse indicates altered renal perfusion? a. oliguria b. cachexia c. yellow sclera d. suprapubic distention - a A nurse is evaluating the effectiveness of nursing interventions for meeting the nutrient needs of clients during the first 2 days after abdominal surgery. Which outcome is most important? a. nausea and vomiting have not occurred b. fluid and electrolytes are balanced c. wound healing is progressing d. oral intake is reestablished - b Which is the next most important assessment made by the nurse after ensuring a postoperative client has a patent airway? a. condition of drains b. level of consciousness c. stability of the vital signs d. location of the surgical dressing - c A client's perineal area must be examined by the primary health-care provider prior to surgery. In which position should the nurse place the client for this physical assessment? a. sims b. supine c. lithotomy d. trendelenburg - c A nurse is caring for 2 clients. One of the clients has a Jackson-Pratt drain and the other client has a Hemovac drain. Which does the nurse understand is the difference between these two drains? a. the size of the collection container b. how the pressure within the collection container is reestablished c. the type of pressure that promotes drainage to the collection container d. where the collection container should be placed in relation to the insertion site - a A nurse is caring for several clients who received general anesthesia. A client with which concurrent health problem poses the highest risk for the development of a postoperative complication? a. gastroesophageal reflux disease b. reduced reflexes c. hypothyroidism d. emphysema - d A postoperative client experiences tachycardia, sudden chest pain, and low blood pressure. Which complication associated with the postoperative period should the nurse conclude that the client most likely experienced? a. pulmonary embolus b. hemorrhage c. heart attack d. pneumonia - a A client spikes a fever during the first postoperative day after major abdominal surgery. The nurse suspects that the fever indicates an infection. Which site does the nurse conclude most likely is the source of the infection? a. intestines b. bladder c. wound d. lungs - d