NRS 3015 Final Review Exam With
Complete Solutions
The nurse is preparing a client for surgery scheduled in two hours. Which interventions
are appropriate in the preoperative period? Select all that apply. - ANSWER assist the
client to void before transfer to the operating room, review the client's record for a
history and physical report and lab reports, check all surgeon's prescriptions to ensure
they have been carried out
The nurse is creating 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? -
ANSWER have the client void immediately before going into surgery
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? - ANSWER the best results are achieved when sitting up or
with the head of the bed elevated 45 to 90 degrees
In preparation for ambulation, the nurse is planning to assist a postoperative client to
progress from a lying position to a sitting position. Which nursing action is appropriate
to maintain the safety of the client? - ANSWER assess the client for signs of dizziness
and hypotension
The PACU nurse caring for a client with a nasogastric (NG) tube notes 300 mL of bright
red blood has collected. What is the appropriate nursing action? - ANSWER call the
client's surgeon to report the drainage
The nurse is preparing a preoperative client for transfer to the operating room. The
nurse should take which action in the care of this client at this time? - ANSWER ensure
that the client has not eaten for the past 24 hours
A client is admitted to the ambulatory surgery center for elective surgery. The nurse
asks the client whether any food, fluid, or medication was taken today. Which
, medication, if taken by the client, should indicate to the nurse the need to contact the
health care provider? - ANSWER an anticoagulatn
The nurse is caring for a client who recently returned from the operating room. On data
collection, the nurse notes that the client's vital signs are blood pressure (BP), 118/70
mm Hg; pulse, 91 beats/minute; and respirations, 16 breaths/minute. Preoperative vital
signs were BP, 132/88 mm Hg; pulse, 74 beats/minute; and respirations, 20
breaths/minute. Which action should the nurse plan to take first? - ANSWER recheck the
vital signs in 15 mins
A client is scheduled for surgery at noon. The surgeon is delayed and the surgery is now
scheduled for 3:00 PM. How will the nurse plan to administer the preoperative
prophylactic antibiotic? - ANSWER adjust the administration time to be given within one
hour prior to surgery
Which assessment data finding for a client scheduled for total knee replacement
surgery is most important for the nurse to communicate to the surgeon and the
anesthesia provider before the procedure? Select all that apply. - ANSWER the client
took a total of 1300 mg of aspirin yesterday, after receiving the preoperative
medications the client tells the nurse that he lied on the assessment form and that he
really is a current smoker, serum potassium level is 3.0
Which finding in a postoperative client would be of concern to the nurse? - ANSWER BP
of 88/52 mmHg
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? - ANSWER urinary output of 20ml/hr
When a client is transferred from the postanesthesia care unit and arrives on the
surgical unit, which should be the first action taken by the nurse? - ANSWER obtain the
client's vital signs
The nurse has instructed a preoperative client using an incentive spirometer to sustain
the inhaled breath for 3 seconds. When the client asks about the rationale for this
Complete Solutions
The nurse is preparing a client for surgery scheduled in two hours. Which interventions
are appropriate in the preoperative period? Select all that apply. - ANSWER assist the
client to void before transfer to the operating room, review the client's record for a
history and physical report and lab reports, check all surgeon's prescriptions to ensure
they have been carried out
The nurse is creating 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? -
ANSWER have the client void immediately before going into surgery
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? - ANSWER the best results are achieved when sitting up or
with the head of the bed elevated 45 to 90 degrees
In preparation for ambulation, the nurse is planning to assist a postoperative client to
progress from a lying position to a sitting position. Which nursing action is appropriate
to maintain the safety of the client? - ANSWER assess the client for signs of dizziness
and hypotension
The PACU nurse caring for a client with a nasogastric (NG) tube notes 300 mL of bright
red blood has collected. What is the appropriate nursing action? - ANSWER call the
client's surgeon to report the drainage
The nurse is preparing a preoperative client for transfer to the operating room. The
nurse should take which action in the care of this client at this time? - ANSWER ensure
that the client has not eaten for the past 24 hours
A client is admitted to the ambulatory surgery center for elective surgery. The nurse
asks the client whether any food, fluid, or medication was taken today. Which
, medication, if taken by the client, should indicate to the nurse the need to contact the
health care provider? - ANSWER an anticoagulatn
The nurse is caring for a client who recently returned from the operating room. On data
collection, the nurse notes that the client's vital signs are blood pressure (BP), 118/70
mm Hg; pulse, 91 beats/minute; and respirations, 16 breaths/minute. Preoperative vital
signs were BP, 132/88 mm Hg; pulse, 74 beats/minute; and respirations, 20
breaths/minute. Which action should the nurse plan to take first? - ANSWER recheck the
vital signs in 15 mins
A client is scheduled for surgery at noon. The surgeon is delayed and the surgery is now
scheduled for 3:00 PM. How will the nurse plan to administer the preoperative
prophylactic antibiotic? - ANSWER adjust the administration time to be given within one
hour prior to surgery
Which assessment data finding for a client scheduled for total knee replacement
surgery is most important for the nurse to communicate to the surgeon and the
anesthesia provider before the procedure? Select all that apply. - ANSWER the client
took a total of 1300 mg of aspirin yesterday, after receiving the preoperative
medications the client tells the nurse that he lied on the assessment form and that he
really is a current smoker, serum potassium level is 3.0
Which finding in a postoperative client would be of concern to the nurse? - ANSWER BP
of 88/52 mmHg
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? - ANSWER urinary output of 20ml/hr
When a client is transferred from the postanesthesia care unit and arrives on the
surgical unit, which should be the first action taken by the nurse? - ANSWER obtain the
client's vital signs
The nurse has instructed a preoperative client using an incentive spirometer to sustain
the inhaled breath for 3 seconds. When the client asks about the rationale for this
