Perioperative Nursing 001 1.) Which of the following is most dangerouscomplication during induction of spinalanesthesia? A.)Tachycardia B.)Hypotension C.

)Hyperthermia D.)Bradypnea Ans: B

2.) Which type of surgery is most likely topredispose a patient to postoperativeatelectasis, pneumonia or respiratoryfailure? A.)Upper abdominal surgery on an obesepatient with a long history of smoking B.)Upper abdominal surgery on a patientwith normal pulmonary function C.)Lower abdominal surgery on a youngpatient with diabetes mellitus D.)Surgery on the extremities of anonsmoking football player Ans: A 3.) Which of the following characterizesexcitement stage of anesthesia A.) Occurs from the administration of anesthesia to the loss of consciousness B.) Extends from the loss of consciousnessto the loss of lid reflex, characterized bystruggling and talking C.) From the loss of lid reflex to the loss of most reflexes D.) From the loss of most reflexes torespiratory and circulatory failure Ans: B 4.) To prevent headache after spinalanesthesia the patient should be positioned: A.) Semi-fowlers B.) Flat on bed for 6 to 8 hours C.) Prone position D.) Modified trendelenburg Ans: B 5.) Which of the following nursing actionsshould be given highest priority whenadmitting the patient into the operatingroom? A.) Level of consciousness

B.) Vital signs C.) Patient identification and correctoperative consent D.) Positioning and skin preparation Ans: C 6.) What is the primary reason for the gradualchange of position of the patient after surgery?A.) To prevent muscle injury B.) To prevent sudden drop of BP C.) To prevent respiratory distress D.) To promote comfort Ans: B 7.) Which of the following assessment data ismost important to determine when caring for a patient who has received spinalanesthesia? A.) The time of return of motion andsensation in the legs and toes B.) The character of respiration C.) Level of consciousness D.) Amount of wound drainage Ans: A 8.) Which of the following postop findingsshould the nurse report to the M.D.? A.) The patient pushes out the oral airway with his tounge B.) Urine output is 20ml/hr for the past twohours C.) VS are as follows:BP=110/70;PR=95;RR=19,Temp=36.8C D.) Wound drainage is serosanguinous Ans: B 9.) Which of the following is the earliest signof poor respiratory function? A.) Cyanosis B.) Fast thready pulse

C.) Restlessness D.) Faintness Ans: C 10.) If wound eviscerations occurs, theimmediate nursing action is: A.) Cover the wound with sterile gauze moistened with sterile NSS B.) Cover the wound with water-soakedgauze C.) Cover the wound with sterile dry gauze D.) Leave the wound uncovered and pull theskin edges together Ans: A 11.) Appendectomy is classified as A.) Ablative B.) Constructive C.) Reconstructive D.) Palliative Ans: A 12.) The worst of all fears among clientsundergoing surgery is: A.) Fear of financial burden B.) Fear of death C.) Fear of the unknown D.) Fear of loss of job Ans: C 13.) The best time to provide preoperativeteaching on deep breathing, coughing andturning exercises is: A.) Before administration of preoperativemedications B.) The afternoon or evening prior to surgery C.) Several days prior to surgery

D.) Upon admission of the client in therecovery room Ans: B 14.) The following are the appropriatenursing actions before administration of preoperative medications EXCEPT: A.) Ascertain the consent has been signed B.) Ensure that NPO has been maintained C.) Instruct patient to empty his bladder D.) Shave the skin at the site of surgery Ans: D 15.) The patient has been observed pacingalong the hallway, goes to the bathroomfrequently and asks questions repeatedlyduring preoperative assessment. The mostlikely cause of the behavior is: A.) She is anxious about the surgicalprocedure B.) She is worried about separation from thefamily C.) She has urinary tract infection D.) She has an underlying emotional problem Ans: A 16.) Which of the following nursing actionswould help the patient decrease anxietyduring the preoperative period? A.) Explaining all procedures thoroughly inchronological order B.) Spending time listening to the patient andanswering questions C.) Encouraging sleep and limitinginterruptions D.) Reassuring the patient that the surgicalstaff are competent professional Ans: B 17.) Which of the following is the primarypurpose of maintaining NPO for 6 to 8 hoursbefore surgery?A.) To prevent malnutritionB.) To prevent electrolyte imbalanceC.) To prevent aspiration pneumoniaD.) To prevent intestinal obstructionAns: C 18.) The following ensure validity of informedwritten consent EXCEPT:A.) The patient is of legal age with proper mental dispositionB.) The consent has been secured within 24hours before the surgeryC.) If the

patient is unable to write, secure theconsent from a relativeD.) The consent is secured beforeadministration of any medication that alter the level of consciousnessAns: C 19.) Which of the following drugs isadministered to minimize respiratorysecretions preop?A.) Valium (Diazepam) B.) Nubain ( Nalbuphine HCL) C.) Phenergan (Promethazine) D.) Atropine Sulfate Ans: D 20.) Which of the following is experienced bythe patient who is under spinal anesthesia? A.) The patient is unconscious B.) The patient is awake C.) The patient experiences amnesia D.) The patient experiences total loss of sensation Ans: B 21.) The patient who has undergone TAHBSOcomplains of pain. Which of the following isan initial nursing action? A.) Administer the PRN analgesics B.) Instruct to do deep breathing exercises C.) Assess the VS D.) Change the patients position Ans: C 22.) How frequent should the nurse monitor the VS of the patient in the recovery room? A.) Every 15 minutes B.) Every 30 mins C.) Every 45 mins D.) Every 60 mins Ans: A

23.) Which of the following drugs is given torelieve nausea and vomiting? A.) Mepivacaine B.) Aquamephyton C.) Nubain D.) Plasil Ans: D 24.) The most important factor in theprevention of postop infection is: A.) Proper administration of antibiotics B.) Fluid intake of 2-3L/day C.) Practice of strict aseptic techniques D.) Frequent change of wound dressings Ans: C 25.) Which of the following primarilyprevents postop complications? A.) Adequate fluid intake B.) Early ambulation C.) Well-balanced diet D.) Administration of antimicrobials Ans: B Situation: A female client, 23 y/o wasadmitted for the first time at the FatimaHospital with the chief complaint of RightIliac Pain, accompanied by nausea andvomiting, chills and fever. She wasdiagnosed to have acute appendicitis. Shewas scheduled to have emergencyappendectomy under spinal anesthesia 26.) Pre-op instructions to the client wouldinclude the following EXCEPT: A.) Deep breathing and coughing exercise B.) Turning to sides C.) Foot and leg exercises D.) reassuring her that narcotics will begiven every 4 hours round the clock until sheis discharged

Ans: D 27.) The client gave her consent for thesurgery. To ensure the legality of theconsent, the following conditions must bemet EXCEPT: A.) She gave her consent freely B.) She must understand the nature of thesurgery C.) The consent must be signed by a witness D.) Signing should be done after theadministration of pre-anesthesia meds Ans: D 28.) The skin is shaved prior to surgery inorder to: A.) Facilitate skin incision B.) Indicate the site to be draped C.) To prevent wound infection D.) Reduce post op scarring Ans: C 29.) The important nursing intervention prior to administration of pre-anestheticmedication is: A.) Ask patient to empty the bladder B.) Do deep breathing and coughingexercises C.) Regulate IVF accurately D.) Shave the skin Ans: A 30.) Immediately following spinal anesthesia,the greatest risk is: A.) Severe hemorrhage B.) Severe Hypotension C.) Severe Hypoglycemia D.) Hypertensive crisis Ans: B

31.) Nursing measures to promote theclients respiratory function during recoveryfrom anesthesia are the following EXCEPT: A.) Encourages deep breathing andcoughing exercises B.) Administer Humidified oxygen C.) Place in semi-fowlers position D.) Place in supine position with head turnedto the side without pillow support Ans: C 32.) Which of the following criteria must bemet before the client is released from the RRto the unit. A.) Breathes with ease, coughs freely B.) Has regained consciousness C.) Vital signs fluctuates erratically D.) Able to move four extremities Ans: C 33.) Early signs of poor respiratory functioninclude which of the following A.) Cyanosis B.) Hypotension C.) Loss of consciousness D.) Restlessness Ans: D 34.) Post operatively, the client must beencouraged to turn, cough and deep breathe: A.) Every 1-2 hours B.) Every 4 hours C.) Every 30 Mins D.) Every 8 hours Ans: A 35.) A client in shock must be placed in:

A.) High-fowlers position B.) Sims position C.) Modified trendelenburg D.) Prone position Ans: C 36.) The most important factor in theprevention of post op wound infection is: A.) Adequate fluid intake B.) Proper administration of antibiotics C.) Practice of strict aseptic technique D.) Frequent cleaning of the wound Ans: C 37.) When the patient vomits, the mostimportant nursing objective is to prevent: A.) Dehydration B.) Aspiration C.) Rupture of suture line D.) Met. Alkalosis Ans: B 38.) Post operatively, a patient is expected tovoid after: A.) 6-8 hours B.) 2-4 hours C.) 12-24 hours D.) 10-12 hours Ans: A 39.) Headache after spinal anesthesia is dueto: A.) Paralysis of vasomotor nerves

B.) Traction placed on structures withinabdomen C.) Loss of CSF through dural hole D.) Administration of large amounts andheavy concentration of anesthetic agents Ans: C 40.) Nursing measures for post-opthrombophlebitis include the followingEXCEPT: A.) Maintain bedrest B.) Elevate affected leg with pillow support C.) Massage the painful extremities D.) Apply antiembolic stockings Ans: C 41.) Nursing measures to relieve hiccupsinclude the following EXCEPT: A.) Exhale and inhale through a paper bag B.) Apply pressure over the eyeball throughclosed eye lids C.) Hold breath while taking a large pulp of water D.) Administer high concentration of oxygen Ans: D