Professional Documents
Culture Documents
Periop 8
Periop 8
1. Minimally invasive surgery is very much into technology. Aside from the usual surgical team
who else to be present when a client undergoes laparoscopic surgery?
Electrician
Information technician
Laboratory technician
Biomedical technician
2. Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain
in varying degrees upon movement of body parts. Troy is a one day post open reduction and
internal fixation (ORIF) of the left hip and is in pain. Which of the following observation
would prompt you to call the doctor?
3. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is
your nursing priority care in such a case?
4. Situation 1 – Concerted work efforts among members of the surgical team is essential to the
success of the surgical procedure. The sterile nurse or sterile personnel touch only sterile
supplies and instruments. When there is a need for sterile supply which is not in the sterile
field, who hands out these items by opening its outer cover?
Anesthesiologist
Surgeon
Circulating nurse
Nursing aide
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department
needs to be alerted to coordinate closely with the patient’s family for immediate blood
component therapy?
Security Division
Chaplaincy
Social Service Section
Pathology department
6. Disposal of medical records in government hospitals/institutions must be done in close
coordination with what agency?
7. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing
care during the intraoperative phase. As the circulating nurse, you make certain that
throughout the procedure…
8. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such
as cultural or psychological that influence pain. How can you alter these factors as the nurse?
9. The OR team performs distinct roles for one surgical procedure to be accomplished within a
prescribed time frame and deliver a standard patient outcome. White the surgeon performs
the surgical procedure, who monitors the status of the client like urine output, blood loss? ✖
Surgeon
Scrub nurse
Anesthesiologist
Circulating nurse
10. You readmitted a client who was in another department a month ago. Since you will need the
previous chart, from whom do you request the old chart?
12. Situation 4 – In the OR, there are safety protocols that should be followed. The OR nurse
should be well versed with all these to safeguard the safety and quality to patient delivery
outcome. Which of the following should be given highest priority when receiving patient in
the OR?
13. Records Management and Archives Offices of the DOH is responsible for implementing its
policies on record, disposal. You know that your institution is covered by this policy it;
14. Another nursing check that should not be missed before the induction of general anesthesia
is:
15. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol
at 5 pm. The next dose of Demerol 50 mg I.M. is given:
16. Surgery schedules are communicated to the OR usually a day prior to the procedure by the
nurse of the floor or ward where the patient is confined. For orthopedic cases, what
department is usually informed to be present in the OR?
Maintenance department
Laboratory department
Radiology department
Rehabilitation department
17. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors-
indicate appropriate adaptation?
18. In the hospital, when you need-the medical record of a discharged patient for research, you
will request permission through:
19. Some different habits and hobbies affect postoperative respiratory function. If your client
smokes 3 packs of cigarettes a day for the part 10 years, you will anticipate increased risk
for:
20. Surgeries like I and D (incision and drainage) and debridement are relatively short
procedures but considered ‘dirty cases’. When are these; procedures best scheduled?
22. As a nurse you know you can improve on accuracy of patient’s identification by 2 patient
identifiers, EXCEPT:
23. While team effort is needed in the OR for efficient and quality patient care delivery, we
should limit the number of people in the room for infection control. Who comprise this team?
24. As a perioperative nurse, how can you best meet the safety need of the client after
administering preoperative narcotic?
25. In the OR, the nursing tandem for every surgery is:
26. Which of the following nursing intervention is done when examining the incision wound and
changing the dressing?
27. It is also the nurse’s function to determine when infection is developing in the surgical
incision. The perioperative nurse should observe for what signs of impending infection?
28. Situation 8 – Team efforts is best demonstrated in the OR If you are the nurse in charge for
scheduling surgical cases, what important information do you need to ask the surgeon?
29. You identified a potential risk of pre and postoperative clients. To reduce the risk of patient
harm resulting from fall, you can implement the following EXCEPT:
Take action to address any identified risks through Incident Report (IR)
Allow client to walk with relative to the OF?
Assess and periodically reassess individual client’s risk for falling - Given
Assess potential risk of fail associated with the patient’s the following EXCEPT: medication
regimen
30. Situation 6 – Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min
and he appears to be in acute respiratory distress. Which of the following nursing actions
should be initiated first?
31. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing surgery. If
hair at the operative site is not shaved, what should be done to make suturing easy and lessen
chance of incision infection?
Shampooed
Draped
Pulled
Clipped
Leg work
Communication
Electricity
Inadequate supply
33. The asthmatic client asked you what breathing technique he can best practice when asthmatic
attack starts. What will be the best position?
34. As a nurse you are always alerted to monitor status asthmaticus who will likely and initially
manifest symptoms of:
metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis
35. Over dosage of medication or anesthetic can happen even with the aid of technology like
infusion pump, sphygmomanometer, and similar devices/machines. As a staff, how can you
improve the safety of using infusion pumps?
36. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction
will include the following EXCEPT:
37. Situation 5 – Nurses hold a variety of roles when providing care to a perioperative patient.
Which of the following role would be the responsibility of the scrub nurse?
38. JCAHO’s universal protocol for surgical and invasive procedures to prevent wrong site,
wrong person, and wrong procedures/surgery includes the following EXCEPT:
39. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what its
indication the nurse will say is:
40. When surgery is on-going, who coordinates the activities outside, including the family?
Nurse supervisor
Anaesthesiologist
Circulating nurse
Orderly/clerk
41. Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical
responsibility about sponge and Instrument count. When is the first sponge/instrument count
reported?
42. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:
43. What sensation is used as a gauge so that patients with ileostomy can determine how often
their pouch should be drained?
Sensation of smell
Sensation of taste
Sensation of pressure
Urge to defecate
44. Another alternative “suture” for skin closure is the use of:
Absorbent dressing
Staple
Therapeutic glue
invisible suture
46. What health instruction will enhance regulation of a colostomy (defecation) of clients?
47. Situation 10 – As a beginner in research, you are aware that sampling is an essential element
of the research process. What does a sample group represent?
Control group
Universe
Study subjects
General population
Clean the area daily with soap and water before applying bag
Use karaya paste and rings around the stoma
Apply talcum powder twice a day
Apply liberal amount of mineral oil to the area
49. You decided to include 5 barangays in your municipality and chose a sampling method that
would get representative samples from each barangay. What should be the appropriate
method for you to use in this care?
Cluster sampling
Random sampling
Stratified sampling
Systematic sampling
50. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient who
is prone to keloid formation and has a low threshold of pain, what needle would you prepare?
Tapered needle
Atraumatic needle
Round needle
Reverse cutting needle
51. As a nurse, your primary focus in the workplace is the client’s safety. However, personal
safety is also a concern. You can communicate hazards to your co-workers through the use of
the following EXCEPT:
52. As a nurse, what is one of the best way to reconcile medications across the continuum of
care?
Endorse in writing
Communication a complete list of the patient’s medication to the next provider of service
Endorse the routine and ‘stat’ medications every shift
Endorse on a case-to-case basis
53. As a nurse, you can help improve the effectiveness of communication among health care
givers
54. Situation 12 – As a nurse, you should be aware and prepared of the different roles you play.
What role do you play, when you hold all clients’ information entrusted to you in the strictest
confidence?
Patient’s arbiter
Patient’s Liaison
Educator
Patient’s advocate
Appropriate location
Randomization
Representativeness
Appropriate number
Which of the following sampling methods allows the use of any group of research subject?
Purposive
Snow-bail
Quota - Given
Convenience
56. What major supportive layer of the abdominal wall must be sutured with long tensile strength
such as cotton or nylon or silk suture?
Skin
Muscle
Peritoneum
Fascia
58. Like any nursing interventions, counts should be documented. To whom does the scrub nurse
report any discrepancy of country so that immediate ‘and appropriate action is instituted?
Anesthesiologist
Circulating nurse
Or nurse supervisor
Surgeon
59. As a nurse, you protect yourself and co-workers from misinformation and misrepresentations
through the following EXCEPT:
Advising the client, by virtue of your expertise, that which can contribute to the client’s well-
being
Health education among clients and significant others regarding the use of chemical disinfectant
Provide information to clients about a variety of services that can help alleviate the client’s pain
and other conditions
Endorsement thru trimedia to advertise your favorite disinfectant solution
60. Situation 14 – You were on duty at the medical ward when Zeny came in for admission for
tiredness, cold intolerance, constipation, and weight gain. Upon examination, the doctor’s
diagnosis was hypothyroidism. Your independent nursing care for hypothyroidism includes:
61. Before bedtime, you want to ensure Kyle’s safety in ‘bed. You will do which of the
following:
62. Pentoxicodone 5 mg IV every 8 hours was prescribed for post abdominal pain. Which will be
your priority nursing action?
63. To prevent leakage of fluid in the thoracic cavity, how wilt you position the client after
thoracentesis?
64. During thoracentesis, which of the following nursing intervention will be most crucial?
65. Myxedema coma is a life threatening complication of long standing and untreated
hypothyroidism with one of the following characteristics.
Hyperglycemia
hypoglycemia
hyperthermia
hypothermia
66. Mrs. Pichay, who is for thoracentesis, is assisted by the nurse to any of the following
positions, EXCEPT:
sitting on the edge of the bed with her feet supported and arms and head on a padded overhead
table
straddling a chair with arms and head resting on the back of the chair
lying prone with the head of the bed lowered 15-30 degrees
lying on the unaffected side with the bed elevated 30-40 degrees
67. A one-day postoperative abdominal surgery client has been complaining of severe throbbing
abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds
on all quadrants and the dressing is dry and intact. What nursing intervention would you
take? ✖
68. Chest x-ray was ordered after thoracentesis. When you client asks what is the reason for
another chest x-ray, you will explain:
69. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism would
probably include which of the following?
70. Kyle is diagnosed to have measles. What will your protective personal attire include?
Face mask
Eyewear
Gloves
Gown
71. Situation 16 – In the hospital, you are aware that we are helped by the .use of a variety of
equipment/devices to enhance quality patient care delivery; You are initiate an IV line to
your patient, Kyle, 5, who is febrile. What IV administration set will you prepare?
Microset
Volumetric chamber
Macroset
Blood transfusion set
72. Surgical pain might be minimized by which nursing action in the OR:
73. As the nurse, you should anticipate to administer which of the following medications to Zeny
who is diagnosed to be suffering from hypothyroidism?
Lipitor
Lidocaine
Levophed
Levothyroxine
75. Situation 15 – Mrs. Pichay is admitted to your ward. The MD ordered “Prepared for
thoracentesis this pm to remove excess air from the pleural cavity.” Which of the following
nursing responsibility is essential in Mrs. Pichay who will undergo thoracentesis?
Ascertain if chest x-rays and other tests have been prescribed and completed
Determine if client has allergic reaction to local anesthesia
Support, and reassure client during the procedure
Ensure that informed consent has been signed
76. Kyle’s room is fully mechanized. What do you teach the watcher and Kyle to alert the nurse
for help?
Call system
How to lock side rails
Number of the telephone operator
Remote control
77. The client complained of abdominal and pain. Your nursing intervention that can alleviate
pain is:
78. As a nurse, you know that the most common type of goiter is related to a deficiency
iodine
thyroxine
iron
thyrotropin
79. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid intake?
Provide a calibrated pitcher of drinking water and juice at the bedside and monitor intake and
output
Provide a writing pad to record his intake
Provide a glass of fruit every meal
Regulate his IV to 30 drops per minute
80. Situation 20 – At the medical-surgical ward, the nurse must also be concerned about drug
interactions. You have a client with TPN. You know that in TPN, like blood transfusion,
there should be no drug incorporation. However, the MD’s order read; incorporate insulin to
present TPN. Will you follow the order?
81. Situation 17 – Tony, 11 years old, has ‘kissing tonsils’ and is scheduled for tonsillectomy and
adenoidectomy or T and A. You are the nurse of Tony who will undergo T and A in the
morning. His mother asked you if Tony will be put to sleep. Your teaching will focus on:
anesthesiologist’s preference
general anesthesia
spinal anesthesia
local anesthesia
82. Situation 19 – Fe is experiencing left sharp pain and occasional hematuria. She was advised
to undergo IVP by her physician. Fe was so anxious about the procedure and particularly
expressed her low pain threshold. Nursing health instruction will include:
After an exercise
After ingestion of food
After excitement
After a good night’s rest
84. Tony is to be discharged in the afternoon of the same day after tonsillectomy and
adenoidectomy. You as the RN will make sure that the family knows to:
85. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously. To
increase the chance of passing the stones, you instructed her to force fluids and do which of
the following?
Ambulance more
Strain all urine
Balanced diet
Bed rest
86. What will the nurse monitor and instruct the client and significant others, post IVP?
87. A renal failure patient was ordered for creatinine clearance. As the nurse you will collect
88. Post IVP, Fe should excrete the contrast medium. You instructed the family to include more
vegetables in the diet and
89. Situation 18 – Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered
that an A-V shunt was surgically created. Which of the following action would be of highest
priority with regards to the external shunt?
Urolithiasis
Ureterolithiasis
Nephrolithiasis
Colelithiasis
91. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium syndrome.
He asked you how this can be prevented. Your response is:
92. The RR nurse should monitor for the most common postoperative complication of:
93. One patient has a ‘runaway’ IV of 50% dextrose. To prevent temporary excess of insulin
transient hyperinsulin reaction, what solution should you prepare in anticipation of the
doctors order?
Isotonic solution
Hypertonic solution
Hypotonic solution
Any IV solution available to KVO
95. You are assisted by a nursing aide with the care of the client with renal failure. Which
delegated function to the aide would you particularly check?
96. The PACU nurse will maintain postoperative T and A client in what position?
97. The RN should also know that some drugs have increased absorption when infused in PVC
container. How will you administer drugs such as insulin, nitroglycerine hydralazine to
promote better therapeutic drug effects?
98. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food
prepared and give their children after surgery. You as the nurse will say:
99. Diet therapy for Rudy, who has acute renal failure, is two-protein, low potassium and
sodium. The nutrition instruction should include:
Bananas, cantaloupe, orange and other fresh fruits can be included in the diet
Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
Recommend protein of high biologic value like eggs, poultry and lean meat