Care Of The Surgical Patient Practice Test With Underlined Solutions 2024 Update, Exams of Nursing

Download Care Of The Surgical Patient Practice Test With Underlined Solutions 2024 Update and more Exams Nursing in PDF only on Docsity! Care Of The Surgical Patient Practice Test With Underlined Solutions 2024 Update 1. The nurse is providing care for a patient diagnosed with advanced colon cancer. The patient is scheduled for palliative surgery. Which purpose does the nurse identify for the type of surgery planned for this patient? a. Remove as much of the tumor as possible. b. Dissect the tumor and reconnect the bowel. c. Remove the colon and form an ileostomy. d. Implant a chemotherapy pump for a cure. The purpose of palliative cancer is to debulk the tumor as much as possible, alleviate symptoms, and bring comfort. Removing as much of the tumor as possible will reduce pressure and pain but will not cure the disease. 2. The nurse works in surgery at an acute care facility. Which patient would the nurse expect to come to surgery without preoperative medication? a. The female patient who needs uterine scraping to control excessive bleeding during menses b. The adolescent patient who needs an emergency appendectomy c. The toddler-aged patient who is brought to surgery for a tonsillectomy d. The older adult patient with Parkinson disease who is having joint replacement This patient is not likely to need preoperative medication for this type of surgery. The patient may or may not require general anesthesia. 3. The nurse is preparing a patient who is scheduled for carpal tunnel surgery. The health-care provider has decided on a Bier block for anesthesia. Which patient comment does the nurse validate? a. “Because they cut off circulation, the procedure is done quickly.” b. “I can expect some numbness and weakness in my arm for a day or two.” c. “I understand that I will be awake during the procedure.” d. “I know that I am getting this type of anesthetic because I am a high risk.” The patient with a Bier block is awake during the procedure; light sedation is available if the patient becomes anxious. 4. The nurse is providing care for a patient who returns from surgery wearing thigh-high antiembolism (AE) hose. Which action is most important for the nurse to perform? a. Monitor the presence of pedal pulses. b. Make sure the fabric stays smooth at the tops and behind the knees . c. Take the hose off twice daily to check for erythema, edema, or skin injury. d. Wash and dry the feet and legs before reapplying the AE hose at night. AE hose that fold down at the top or gather behind the knees act as tourniquets and will cause the blood in the extremities to pool. The nurse should check at least every 2 hours to avoid restriction of circulation. This is the most important action. 5. The nurse is checking the abdominal dressing on a patient who just returned from surgery. The nurse notes the dressing is saturated with bright red drainage. Which action does the nurse perform first? a. Reinforce the dressing and continue to monitor for bleeding. b. Outline the drainage in ink and add the time and the nurse’s initials. c. Palpate the abdomen for distention and rigidity. d. Change the dressing using strict sterile technique. Palpation is an assessment technique and should be performed first. The presence of distention and rigidity is indicative of internal bleeding, which is an emergency and needs to be reported to the health-care provider. 6. The nurse is providing care for a patient who returned to the unit after gastric surgery. The patient has a nasogastric (NG) tube in place and is ordered to be NPO (nothing by mouth). The patient reports severe nausea. Which action should the nurse take first? a. Make sure the NG tube is functioning. b. Offer the patient medication for pain control. c. Administer an oral antiemetic medication. d. Check if the health-care provider will order ice chips. The first action by the nurse is to make sure the NG tube is functioning. Fluid collecting in the stomach can cause nausea; the NG is placed to decompress the stomach after gastric surgery. 7. The scrub nurse is aware that needle, sponge, and instrument counts are performed periodically to prevent foreign objects from being left in surgical wounds. Which timing for the counts is correct? Select all that apply. a. As each sterile package is opened before surgery b. When additional supplies are added to the sterile field c. If a scrub nurse is replaced anytime during surgery d. When the patient is moved to the postanesthesia care unit (PACU) e. At the closure of each body cavity. 8. The licensed practical nurse/licensed vocational nurse (LPN/LVN) is working as a surgical scrub nurse. Which responsibility is assumed by someone other than the scrub nurse? a. Setting up the sterile field with all sterile instruments and supplies b. Passing sterile instruments, supplies, and equipment to the surgeon during surgery c. Assures that everything done in the operating room is in the best interest of the patient d. Ensures that the sterility of the sterile field is maintained while assisting the surgeon The circulating nurse, who is a registered nurse (RN), is the patient’s advocate during surgery when the patient can no longer speak for themselves. The responsibility of assuring that everything done during surgery is in the best interest of the patient belongs to the circulating nurse. The “cheat sheets” do not contain a list of the names and titles of the personnel who will be in the OR during surgery. 17. The nurse in a health-care provider’s office is interviewing a young adult patient with a knee injury that will likely require arthroscopic surgery. Which facility does the nurse expect the health-care provider to recommend for the procedure? a. A hospital outpatient surgery department b. An inpatient hospital-based surgery c. A stand-alone surgery center d. An in-office surgery The patient is young and there is no indication of medical conditions other than the injury, which may require hospitalization. This patient is a good candidate for a stand-alone surgery center. 18. When assessing a surgical wound the nurse looks for , which refers to when the edges of the wound meet and align with each other. a. approximation b. dehiscence c. Edema d. erythema Approximation is when the edges of the wound meet and align with each other. A wound that is not well approximated is at risk for infection. 19. The nurse is providing care to a patient diagnosed with a hemorrhagic cardiovascular accident. The nurse expects preparation for which type of surgery? a. Salvage surgery b. Emergency surgery c. Urgent surgery d. Elective surgery Emergency surgery is scheduled when surgical intervention is required within 2 hours or less to prevent serious complications or death. Active bleeding in the brain needs immediate attention. 20. The nurse is reviewing preoperative teaching with a patient who is scheduled to have surgery for a recurring medical condition. Which patient teaching will the nurse spend extra time on reviewing? a. The preparations during the preoperative period b. Any new postoperative care that is planned c. The environment of the operating room d. Expected pain levels and pain management 22. The nurse is interviewing a patient scheduled for emergency surgery for a kidney stone that is blocking a ureter. Which part of the patient’s medical history is least important? 23. The nurse works for a cosmetic surgeon who has a small surgery suite in the office. Which procedure would the nurse expect to be scheduled in a hospital setting? 24. The process of removing an endotracheal tube after surgery is referred to as . If postoperative care includes new interventions, the nurse should spend extra time in reviewing these changes. 21. The nurse works in an acute care surgical unit and is interviewing patients scheduled for surgery. Which patient does the nurse identify as being at greatest risk for surgery? a. The patient who had a reaction to anesthesia during a previous surgery and has a family history of kidney disease b. The patient who is underweight, smokes, and has a history of respiratory infections c. The patient who drinks wine at dinner every night and is borderline hypertensive d. The patient with a history of smoking and alcohol abuse, who is overweight, and has a family history of heart attacks The patient with a history of smoking and alcohol abuse is at risk for compromised respiratory and liver function. With the addition of being overweight and a family history of cardiac issues, the patient has four major surgical risks. a. Known medication allergies or intolerances b. Determine the date of the last menstrual period c. Ask about all medications currently taken d. Inquire if the reason for surgery is understood The date of the last menstrual period can help determine if the patient is pregnant; however, this is the least important question due to the emergency status of the surgery. a. Blepharoplasty b. Rhinoplasty c. Abdominoplasty d. Liposuction Abdominoplasty usually involves the removal of a large amount of body skin and tissue. Because the surgery is more invasive and the possibility of complications (bleeding) is higher, this procedure is performed in a higher-level surgery setting. a. Extubation b. Bier block c. Conscious sedation d. Regional anesthesia 25. The nurse is preparing to accompany the health-care provider to obtain an informed consent for surgery. Which factors does the nurse understand as being part of an informed consent? Select all that apply. At the end of surgery, anesthesia is lightened to a point where the endotracheal tube can be removed before moving the patient to the postanesthesia care unit (PACU). The procedure is called extubation. a. A clear definition of the procedure to be performed b. Available alternatives to the procedure c. A complete list of risks and possible complications d. Expected or desired outcomes to the procedure e. Credentials of the persons performing the procedure 26. The scrub nurse is participating in surgery with a patient who is under general anesthesia. The scrub nurse inquires if only one agent is used during the procedure. Which answers will the nurse receive from the anesthesia provider? Select all that apply. a. Benzodiazepines are used to reduce anxiety and provide amnesia and sedation . b. Inhalation agents are used to induce and maintain loss of consciousness. c. Narcotics are administered for pain relief. d. Oral anesthetics are used for sedation and to induce and maintain anesthesia. e. Muscle relaxants are given to promote skeletal muscle relaxation . 27. The nurse is in the process of releasing a patient to go to surgery. When checking the patient’s preoperative checklist, the nurse notes the patient was not given the opportunity to void before receiving preoperative medication. Which action should the nurse take? a. Call the circulating nurse and report the patient may need to void. b. Inform the patient they can ask to void while in the holding area. c. Ascertain if the patient can be assisted to the bathroom before leaving the unit. d. Provide a bedpan or urinal so the patient can void before leaving the unit. The nurse should provide a bedpan or urinal so the patient can void before leaving the unit. 28. The nurse in the operating room is aware that each person has a specific purpose. Which member of the surgical team is responsible for sustaining the patient’s life and ensuring that the patient remains comfortable? a. The anesthesia provider b. The surgeon c. The first surgical assistant d. The scrub nurse The anesthesia provider may be a medical doctor anesthesiologist (MDA), a RN who is a nurse anesthetist (CRNA), or an anesthesiologist assistant (AA). The responsibility is to sustain the patient’s life and ensure the patient’s comfort. 29. The nurse is checking the abdominal dressing on a patient who just returned from surgery. The nurse notes the dressing is saturated with bright red drainage. Which action does the nurse perform first? a. Reinforce the dressing and continue to monitor for bleeding.