REQUIREMENT FOR CA2 MIDTERMS (10 Q & A

WITH RATIONALE (PPT & WORD DOCUMENT)

• GROUP 1- Anesthetic and preoperative drugs
• GROUP 2-Sutures and instruments
• GROUP 3- Principles of aseptic technique
• GROUP 4- Operative consent and preoperative checklist
• GROUP 5- Complications of surgery
• GROUP 6- Preoperative phase
• GROUP 7- intraoperative phase
• GROUP 8- Post operative phase
• SUBMIT THROUGH EMAIL & MOODLE SUBMISSION FOLDER: Group No., Topic
PERIOPERATIVE
NURSING:
QUESTIONS
CA2
1. The
nurse is preparing a client for surgery. What is the most effective
method for obtaining an accurate blood pressure reading from the client?
A. Obtain a cuff that covers the upper one-third of the client’s arm.
B. Position the cuff approximately 4 inches above the antecubital arm.
C. Use a cuff that is wide enough to cover the upper two-thirds of the
client’s arm.
D. Identify the Korotkoff sounds, and take a systolic reading at 10
mmHg after the first sound.
2. Which of the following items on a client’s presurgery laboratory results
would indicate a need to contact the surgeon?
A. Platelet count of 250,000/cu.mm.
B. Total cholesterol of 325 mg/dl.
C. Blood urea nitrogen (BUN)) 17 mg/dl.
D. Hemoglobin 9.5 mg/dl.
3. To prevent complications of immobility, which activities would
help the nurse plan for the first postoperative day after a colon
resection?
A. Turn, cough, and deep breathe every 30 minutes around the
clock.
B. Get the client out of bed and ambulate to a bedside chair.
C. Provide a passive range of motion three times a day.
D. It is not necessary to worry about complications of
immobility on the first postoperative day.
4. In the recovery room, the postoperative client suddenly becomes
cyanotic. What is the most appropriate nursing action?
A. Start administration of oxygen through a nasal cannula.
B. Call for assistance.
C. Reposition the head and determine patency of the airway.
D. Insert an oral airway and suction the nasopharynx.
5. How does palliative surgery differ from any other type of surgery?
A. The main purpose is cosmetic in nature rather than functional repair or comfort.
B. B. There are fewer risks associated with palliative surgery than with any other type of
surgery.
C. The outcomes of palliative surgery cannot be ensured to produce the desired effect or
restoration of functional ability.
D. Palliative surgery is performed to provide temporary relief of distressing symptoms
rather than to cure a problem or condition.
6. The nurse has just reassessed the condition of a postoperative
client who was admitted 1 hour ago to the surgical unit. The nurse
plans to monitor which parameter most carefully during the next
hour?
A. Urine output of 20ml/hour
B. Temperature of 37.6 C
C. Blood pressure of 114/70
D. Serous drainage on the surgical dressing
7. A postoperative client asks the nurse why it is so important to
deep-breathe and cough after surgery. When formulating a
response, the nurse incorporates the understanding that retained
pulmonary secretions in a postoperative client can lead to which
condition?
A. Pneumonia
B. Hypoxemia
C. Fluid imbalance
D. Pulmonary embolism
8. The nurse is developing a plan of care for a client scheduled for
surgery. The nurse should include which activity in the nursing care
plan for the client on the day of surgery?
A. Avoid oral hygiene and rinsing with mouthwash
B. Verify that the client has not eaten for the last 24 hours
C. Have the client void immediately before going into surgery
D. Report immediately any slight increase in BP or pulse
9. A client with a perforated gastric ulcer is scheduled for surgery.
The client cannot sign the operative consent form because of
sedation from opioid analgesics that have been administered. The
nurse should take which most appropriate action in the care of this
client?
A. Obtain a court order for the surgery.
B. Have the charge nurse sign the informed consent immediately
C. Send the client to surgery without the consent form being signed
D. Obtain a telephone consent from a family member, following
agency policy
10. A preoperative client expresses anxiety to the nurse about
upcoming surgery. Which response by the nurse is most likely to
stimulate further discussion between the client and the nurse?
A. "If it's any help, everyone is nervous before surgery."
B. "I will be happy to explain the entire surgical procedure with you."
C. "Can you share with me what you've been told about your surgery?"
D. "Let me tell you about the care you'll receive after surgery and the
amount of pain you can anticipate".
11. The nurse is conducting preoperative teaching with a client about
the use of an incentive spirometer. The nurse should include which
piece of information in discussions with the client?
A. Inhale as rapidly as possible
B. Keep a loose seal between the lips and the mouthpiece
C. After maximum inspiration, hold the breath for 15 seconds and
exhale. 
D. The best results are achieved when sitting up or with the head of the
bed elevated 45 to 90 degrees
12. The nurse has conducted preoperative teaching for a client
scheduled for surgery in 1 week. The client has a history of arthritis
and has been taking acetylsalicylic acid. The nurse determines that
the client needs additional teaching if the client makes which
statement?
A. "Aspirin can cause bleeding after surgery."
B. "Aspirin can cause my ability to clot blood to be abnormal."
C. "I need to continue to take the aspirin until the day of surgery."
D. "I need to check with my HCP about the need to stop the aspirin
before the scheduled surgery."
13. The nurse assess a client's surgical incision for signs of
infection. Which finding by the nurse would be interpreted as a
normal finding at the surgical site?
A. Red, hard skin
B. Serous drainage
C. Purulent drainage
D. Warm tender skin
14. A client who has had abdominal surgery complains of feeling as
though "something gave way" in the incisional site. The nurse
removes the dressing and notes the presence of a loop of bowel
protruding through the incision. Which nursing interventions should
the nurse take? Select all that apply
A. Contact the surgeon
B. Instruct the client to remain quiet
C. Prepare the client for wound closure
D. Document the findings and actions taken
E. Place a sterile saline dressing and icepacks over the wound
F. Place the client in a prone position without a pillow under the
head.
 

15. A client who has undergone preadmission testing, has had

blood drawn for serum lab studies, including a complete blood
count, coagulation studies and electrolytes and creatine levels.
Which lab result should be reported to the surgeon's office by the
nurse, knowing that it could cause surgery to be postponed?
A. Sodium, 141mEq/L
B. Hemoglobin, 8.0 g/dL
C. Platelets, 210,000/mm3
D. Serum creatine, 0.8 mg/dL
16. The nurse receives a telephone call from the post anesthesia
care unit stating that a client is being transferred to the surgical unit.
The nurse plans to take which action first on arrival of the client?
A. Assess the patency of the airway
B. Check tubes or drains for patency
C. Check the dressing to assess for bleeding
D. Assess the vital signs to compare with preoperative
measurements
17. The nurse is reviewing a prescription sheet for
preoperative client that states that the client must
be NPO after midnight. The nurse would
telephone the physician to clarify that which
medication should be given to the client and not
withheld?
A. Prednisone
B. Ferrous sulfate
C. Cyclobenzaprine (Flexeril)
D. Conjugated estrogen (Premarin)
18. A 26-year-old client comes into the clinic prior to a tonsillectomy.
Which action is priority during this phase of surgery?

A. Intraoperative consent signed

B. Intraoperative medication

C. Preoperative assessment

D. Postoperative assessment
19. A 76-year old client is to undergo a hernia repair. The nurse
knows that in order to aid in the healing process, the
perioperative nurse must assist the client with which concept
during what surgical phase?

A. Perfusion therapy during the intraoperative phase 

B. Wound healing during the postoperative phase 
C. Wound healing during the preoperative and intraoperative
phase
D. Infection during the postoperative phase
20. A 65-year old client is having neck surgery. Which nursing
diagnosis does the nurse include for this client?
A. Risk for burns
B. Risk for fluid volume: Deficient
C. Ineffective pain control
D. Risk for fluid volume: Excess
21. An 18-year-old client is admitted to the emergency room for an
emergency appendectomy. The nurse knows that which assessment
is priority with each perioperative phase

A. Medication assessment
B. Pain assessment
C. History and physical
D. Systems assessment
22. A 43-year-old client is undergoing a CABG. What priority
understanding does the nurse have about perioperative
documentation?

A. If it was not written, it was not done

B. It includes all steps of the nursing process
C. It's a legal document subject to internal review
D. It keeps the nurse and patient safe
23. A client diagnosed with gallbladder disease decides to
undergo a laparoscopic cholecystectomy as opposed to an open
procedure. The nurse realizes the client chose the laparoscopic
surgery due to what reason?

A. The laparoscopic surgery has a higher infection rate

B. The laparoscopic surgery requires a shorter hospital stay and
recovery
C. The open surgery is more expensive
D. The open surgery scars are less noticeable
24. A 55-year old woman with sleep apnea is having a double
mastectomy with reconstruction performed today. What priority
complication is important for this client?

A. Loss of blood and infection complications

B. Infection and airway complication
C. Injury and loss of blood complications
D. Airway and VTE complications
25. A client is rushed into surgery following an MVA. The client must
receive a blood transfusion to sustain life but is a Jehovah's Witness.
What priority intervention by the nurse is the most appropriate?

A. Obtain consent for an autologous blood transfusion

B. Do not ask for consent; give the blood anyway
C. Tell the family the client will die without the blood
D. Do nothing; the family will not change their minds
26.The nurse measures the client's blood pressure, pulse, and
capillary refill prior to sending the client to the operating room.
Which concept related to perioperative care is the nurse
implementing?

A. Quality control
B. Perfusion
C. Safety
D. Infection control
27. A preoperative client asks if blood products will be used
during the procedure. Which laboratory values should the
nurse explain are used to determine the client's need for
blood products?
(SELECT ALL THAT APPLY)

A. Hemoglobin
B. Hematocrit
C. Prothrombin time
D. Red blood cell count 
E. Platelets
28. The nurse is preparing a client for a surgical procedure to
remove a portion of the transverse colon. Which priority actions
should the nurse include to reduce the client's risk of developing
a postoperative complication?
(SELECT ALL THAT APPLY)

A. Observe for muscle twitching

B. Monitor body temperature
C. Monitor blood pressure and heart rate
D. Ensure aseptic technique is used for the procedure
E. Monitor urine concentration
29. What postoperative assessment would indicate to the nurse a
change in a client's cardiovascular status?
(SELECT ALL THAT APPLY)

A. Capillary refill time greater than 3 seconds 

B. Vomiting moderate amount of green emesis
C. Absent gag reflex
D. Pedal pulse non-palpable
E. Dropping blood pressure
30. The circulating nurse is ensuring that a client is adequately
positioned for surgery and determines that the procedure is going to
take longer than 30 minutes to complete. What did the nurse
assess to make this determination?
A. Client is in the lithotomy position
B. Client has a device on a finger to measure oxygen saturation
C. Client is wearing sequential compression devices
D. Client has pillows placed under the knees