NCM112j - Perioperative

Quiz 1
1. A surgery that is performed when the a. Planning for discharge and any projected
condition is not imminently life changes in lifestyle due to surgery
threatening. Nurse Shey is correct is when b. Giving the person and significant others
she answers: complete learning/ teaching guidelines
a. Elective surgery regarding surgery
b. Emergency surgery c. Reestablishing the patient's physiologic
c. Direct equilibrium, alleviating pain, preventing
d. None of the above complications, and teaching the patient
self-care.
2. Classification of surgery that involves high d. Assessing and correcting physiologic and
degree of risk. psychologic problems that might increase
a. Ambulatory Surgery surgical risk
b. Major Surgery
c. Minor Surgery 8. Who among the following should secure
d. Exploratory informed consent for surgery?
a. Ward nurse b. OR nurse
3. Perioperative phase that begins at the c. Surgeon d. Anesthesiologist
time of decision for surgery and ends
when the client is transferred to the 9. Consent for surgical procedure and
Operating Room. anesthesia must be signed prior to
a. Decision Phase transport of patient is to OR. Which of the
b. Preoperative Phase following is the most eligible person to
c. Intraoperative Phase sign the consent if patient is 38 years old,
d. Postoperative Phase married for 15 years with 2 children and is
unconscious?
4. In surgical suffixes, what do you mean by a. Mother b. Father
ostomy? c. Husband d. Sister
a. Making an opening
b. Making an opening and insertion of tube 10.Nurse Shey is assigned to a 17-year-old
c. Removal of organ or part of an organ client with history of falls and sustains an
d. To visualize of or to look into injury to the lower leg while having their
trail to campsite. After assessment made
5. Colposcopy or examining the cervix, by the attending physician, Nurse Shey
vagina and vulva for signs of disease is learns that the teenager will require
classified as: surgery to realign the bones in the
a. Ablative b. Diagnostic fractured tibia. In this case, from whom is
c. Constructive d. Palliative it most appropriate for the physician, with
the nurse as a witness, to obtain consent
6. Classification of surgery that is performed to perform the surgical procedure?
to remove or repair damaged, diseased, a. The client
or congenitally malformed organs or b. The client's physician
tissues. c. The client's scout leader
a. Ablative b. Diagnostic d. The client's parent
c. Curative d. Palliative
11. Nurse Shey understands that the
 In the surgical unit, Nurse Shey is following ensures validity of informed written
assigned to provide care to clients for consent except:
surgery. a. Patient is above 18 years of age with
7. Nurse Shey is aware that the following are proper mental disposition.
goals of preoperative phase, except: b. The consent has been secured within 24
hours before surgery.
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Quiz 1
c. For "no read, no write" client, secure the
consent from a relative of legal age. 16. Nurse Shey is planning to provide
d. Consent must be signed before giving pre- preoperative teaching on deep breathing,
op medications coughing, and turning exercises, to her client
for surgery, when is the best time for her to
12. Nurse Shey is aware that consent is not conduct teachings?
needed for emergency care only if the a. Before administration of Hydroxyzine
following criteria meet: (Sedazine)
I. There is an immediate threat to life b. The afternoon or evening prior to
II. Experts agree that it is an emergency scheduled surgery.
III. Client is of legal age and conscious c. A Day prior to hospital admission.
IV. Client is unable to consent d. Upon admission to the recovery room
V. A legally authorized person cannot be
reached. 17. To help client alleviate or minimize
a. I, II, III, IV anxiety, Nurse Shey needs to implement the
b. I, III, IV, V following interventions, except:
c. I, II, IV, V a. Explore client's fears and anxieties
d. I, III, IV, V b. Reassure client of positive outcomes
c. Establish trusting relationship with client
13. Nurse Shey is assessing the laboratory and significant others
test results of a client who is for surgery, d. Demonstrate confidence in surgeon and
which of the following would indicate a need staff
to contact the surgeon?
a. Creatinine level of 54umol/L 18. Which of the following procedures for
b. Hemoglobin 135mg/dI using an incentive spirometer is appropriate
c. Prothrombin time 17secs. for Nurse Shey to provide the client during
d. Platelet count 170,000/cu.mm. preoperative instructions?
a. Inhale completely and exhale rapidly
14. Nurse Shey noticed that the client for through the spirometer lip
surgery is taking Adrenal Corticosteroids, it is b. exhale completely, take slow deep breath
best for her to: through the spirometer, hold breath then
a. Discontinue abruptly before surgery exhale through purse lips
b. Administer a bolus of steroids IV before c. Inhale completely through the spirometer,
and after surgery exhale and hold breath
c. Notify Surgeon and/or anesthesiologist d. Exhale through the spirometer, hold
d. Monitor Capillary Blood Glucose since breath then inhale
Steroids will cause an increased in blood
glucose. 19. Twenty minutes after an infant has
received a preoperative injection of Atropine
15. To decrease the anxiety of the client and Sulfate, the mother Informs the nurse that
his/her family about an impending surgery, her baby must be allergic to the medication
the nurse should: because the skin of the baby becomes
a. Describe the details of the surgery to the reddish. What is the Nurse Shev best
client and family response?
b. Provide general information and answer a. Document the findings as the only action
appropriate questions of the client and b. Check the patient's pulse and blood
family. pressure
c. Empower the client to make decision by c. Prepare to administer epinephrine and
obtaining the client's consent diphenhydramine
d. Give full reassurance that the surgical d. Explain to the patient that this is normal
team is experienced to handle the surgery responses to the medication
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Quiz 1
c. Clipping the hair around the intended
20. The purpose of giving vagolytic agent, incisional area
such as, Atropine sulfate to a patient for d. Shaving in the direction of hair growth
surgery is to:
a. Increase the heart rate of the patient 25. Nurse Shey prepares the patient for
b. Increase body temperature to prevent surgery. The overall goals by the surgical
hypothermia intraoperatively team for the client going for operation
c. Reduce GI and respiratory secretions include which of the following?
d. Reduce anxiety of the patient I. Relief of pain
II. Preventing fluid volume
21. After giving client preoperative deficit
medications, including Meperidine III. Eliminating infection
Hydrochloride (Demerol), Hydroxyzine IV. Reducing anxiety
(Sedazine), and Atropine Sulfate, what is the reaction
most important action for Nurse Shey to a. I, II, III & IV
perform? b. I, II, & III
a. Raising the bed side rails c. III & IV
b. Helping the client to the toilet d. I & II
c. Observing for a dry mouth
d. Placing an emesis basis by the bedside 26. When assisting the anesthesiologist in the
induction of general anesthesia, Nurse Shey
22. When preparing a client for should perform the following, except:
bronchoscopy, Nurse Shey should instruct a a. Check the laryngoscope if functioning and
client not to: prepares endotracheal tube
a. Talk b. Walk b. Prepare and check portable suction
c. Cough d. Eat machine with appropriate sizes of suction
tubes
23. A total hip replacement (hip arthroplasty) c. Prepare and ensure that the emergency
is planned for A 70-year-old client with cart is complete
osteoarthritis. The physician instructs the d. Prepare the sedative and muscle relaxant
client to stop taking enteric-coated aspirin 1 in a syringe
week before surgery. Which statement by
Nurse Shey best explains the rationale for the 27. Which of the following anesthetics causes
physician's instructions? emergence of hallucinations:
a. "Aspirin can increase your risk of wound a. Sodium Pentothal
infection." b. Propofol
b. "Aspirin impairs your ability to control c. Ketamine
bleeding." d. Nitrous Oxide
c. "Aspirin can make it difficult to assess
your pain." 28. Surgical asepsis is based on the principle
d. "Aspirin interferes with your ability to heal of.
Just before the total hip replacement." a. Destroying organisms before they enter
the body
24. Nurse Shey prepares a large area of the b. Isolating all patients who have infectious
client's skin for surgery. Which technique is disease
most appropriate for the nurse to use when c. Basic cleanliness and sanitation
preparing the operative site? d. Destroying bacteria as they leave the
a. Washing the area with soap and water body
b. Pressing the razor deeply into the skin
while shaving 29. If an object has been rendered absolutely
sterile, this means that:
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Quiz 1
a. It is free from most pathogenic d. Sterilized by any means other than
organisms. submersion in disinfectant.
b. It has been thoroughly washed.
c. There is no living organism in or on the 35. While working around a sterile field, it is
object. best to stand:
d. Disinfectant has been applied to the a. At the side of a sterile field.
object. b. At least 3 feet away from the sterile field.
c. Directly over the sterile field to avoid
30. The most reliable method for sterilizing dropping equipment on the floor.
hospital equipment so that it is free of spores d. With your back to the sterile field.
and active bacteria is:
a. Soaking it in strong chemicals 36. A manager of an accounting firm is
b. Washing and drying it thoroughly after admitted to the hospital due to an acute
each used. abdominal pain and passing out of bloody
c. Applying steam under pressure in an stools. After several diagnostic and laboratory
autoclave. examinations the physician ordered him to
d. Boiling instruments undergo an exploratory laparotomy. Patient
was visited by the anesthesiologist and
31. To properly place the cover of a sterile explained the anesthesia for his surgery.
container on the table so that the contents Which of the following types of anesthesia
will not be contaminated, you must: would Nurse Shey expect to be ordered?
a. Place sterile side up a. Spinal
b. Sterile side down b. Caudal
c. On a clean paper towel c. Local
d. On the side of the container d. General

32. The first line of defense of the body 37 Which of the following universal protocols
against disease is: are adopted and validated prior to surgery?
a. An intact skin I. Patient's identity
b. Personal hygiene II. Surgical procedure
c. Complete immunization III. Surgical site
d. Physical stamina IV. Surgical equipment
a. II & III
33. One very simple nursing procedure is b. I & Il
considered the most important in preventing c. I, II & IV
the spread of infection. d. I, II, & III
a. Isolation of all patients suspected of
having an infection. 38. According to the basic rules of creating
b. Wearing gloves when performing nursing and maintaining a sterile field, which of the
procedures for surgical patients following is incorrect?
c. Washing each hand thoroughly before and a. The sterile field must be at the waist level
after each contact with the patient or lower.
d. Sterilizing the hands with strong b. The sterile field must always be within
germicides at least once a day to your view.
c. The sterile field can be set up several
34. An object must be considered hours before the procedure.
contaminated if it is: d. Sterile and nonsterile items can be placed
a. Handled with sterile pick-up forceps. on the sterile field for use
b. Handled with sterile gloves.
c. Left uncovered for a period of time. 39. The scrub nurse in the operating room
has which responsibility?
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Quiz 1
a. Positioning the patient a. Prone b. Supine
b. Assisting with gowning and gloving c. Jackknife d. Lithotomy
c. Handling surgical instruments to the
surgeon 46. Name of stone holding clamp used during
d. Applying surgical drapes removal of stone in the kidney and ureters.
a. Randalls b. Debakey
40. When receiving patient for surgery is vital c. Allis d. Babcock
role of the OR nurse to verify the identity of
the patient. Verifying patient is emphasized in 47. The stages of surgical anesthesia
the WHO safety checklist during, except: proceeds in which of the following order?
a. Sign in b. Time Out a. Excitement, surgical anesthesia, loss of
c. Sign Out d. Before Incision consciousness, danger stage
b. Loss of consciousness, excitement,
41. After the patient is anesthetized, who surgical anesthesia, danger stage
should confirm that the patient is ready for c. Surgical anesthesia, excitement, loss of
surgical positioning? consciousness, danger stage
a. Surgeon d. Loss of consciousness, surgical
b. Anesthesiologist anesthesia, excitement, danger stage
c. Circulating Nurse
d. Scrub Nurse 48. Which of the following complications can
result from the use of general anesthesia
42. Checking of the equipment if functioning during surgery?
well is also the responsibility of the OR nurse. a. Fluid loss
Which of the following is the appropriate time b. Peripheral fluid retention
for Nurse Shay to check the equipment? c. Atelectasis
a. During preparation of the theater for d. Muscle rigidity
surgery
b. Immediately after induction of anesthesia 49. The surgeon closes the client's abdominal
to maintain sterility of the tissue layer. Nurse Shey knows that closure
c. Before the skin incision of the abdominal tissue layers begins with
d. During sign out of the WHO safety the peritoneum, extra peritoneal fat,
checklist transversals fascia, followed by:
a. Deep fascia, muscle, subcutaneous tissue,
43. The official initial counting of instruments, skin
sponges and needles is during: b. Muscle, deep fascia, subcutaneous tissue,
a. Preparation of sterile packs and skin
instruments c. Subcutaneous tissue, deep fascia, muscle,
b. Prior to skin incision skin
c. Sign in d. Skin, muscle, subcutaneous tissue, deep
d. When the scrub nurse is ready for the fascia
count
50. To facilitate drainage of secretions from
44. The following are commonly used the operative site, Nurse Shey should:
absorbable sutures in the OR, except: a. Turn the client to the unoperative side
a. Vicry! b. Chromic every 2-3hours
c. plain d. Prolene b. Turn the client to the operative side every
2-hours
45. The Nurse Shey is positioning a patient c. Keep the patient supine until wound
who is for hemorrhoidectomy. Nurse Shey is healing
correct when she placed patient on what d. Place the patient on semi-fowler's position
appropriate position? at least once every shift
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NCM112j - Perioperative
Quiz 1
b. Prone Position
51. The most important factor in the c. Flat on bed for 5 to 8 hours
prevention of post operative infection is: d. Modified Trendelenburg
a. Proper administration of antibiotics
b. Fluid intake 2-3 liters/ day. 56. Which of the following assessment data is
c. Practice of strict aseptic technique most important to determine when caring for
d. Frequent change of wound dressing a patient who has received spinal anesthesia?
a. The time of return of motion and
52. You are preparing a plan of care for a sensation in the legs and toes
client who is experiencing pain related to b. The character of respiration
incisional swelling following laminectomy. c. Level of consciousness
Which of the following should be included in d. Amount of wound drainage
the nursing care plan?
a. Encourage the client to log roll when 57. The Post Anesthesia Care Unit Nurse On-
turning Duty may release postoperative patient after
b. Encourage the client to do self-care meeting the following criteria, except:
c. Instruct the client to do deep breathing a. Patient breathe with ease, coughs freely
exercises b. Patient regained consciousness
d. Ambulate the client in ward premises c. Patient's vital signs fluctuates erratically
every twenty minutes d. Able to move four extremities
53. After surgery, the client is instructed to
wear thigh-high Antiembolism stockings. 58. Postoperative patient is in acute pain with
Which statement by Nurse Shey provides the vital signs are as follows: blood pressure of
best explanation about the purpose of 80/50mmg, pulse rate of 140bpm, and
antiembolism stockings? respiratory rate of 32b/min. Nurse On-Duty is
a. Antiembolism stockings prevent blood suspecting of shock, which of the following
from pooling in the legs orders would the nurse question?
b. Antiembolism reduce blood flow to the a. Position patient on modified
extremities Trendelenburg's position
c. Antiembolism stockings keep the blood b. Administer oxygen at 100%
pressure lower in the legs c. Monitor urine output every hour
d. Antiembolism stockings keep the blood d. Administer Nalbuphine 10mg IV every 6
vessels restricted hours

54. Who is responsible for accompanying the 59. During the initial assessment of the
surgical patient to the post anesthesia care patient admitted in the PACU, the nurse first
unit following surgery and for giving a report checks the patient's:
of the patient's intraoperative experience to a. Level of consciousness
the PACU nurse? b. Level of pain and status of protective
I. Surgeon reflexes
II. Anesthesiologist c. Respiratory and cardiac status and skin
III. Circulating Nurse color
IV. Scrub Nurse d. Drainage tubes and catheter for type and
a. I, III, and IV patency
b. I and II
c. II and III 60. A patient was admitted in the Post
d. I and III Anesthesia Care Unit following chest surgery.
The patient has an indwelling catheter in
55. To prevent headache after spinal place. After an hour, the nurse noted the
anesthesia the patient should be positioned: urine output is 50ml. The nurse should:
a. Semi-fowler's a. Notify the surgeon
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NCM112j - Perioperative
Quiz 1
b. Notify the anesthesiologist
c. Check the patency of the catheter
d. Continue to monitor urine output