SI exam 4 practice exam questions with answers fully solved.

1. The surgeon prescribes cefazolin (Ancef) 1 g to be given IV at 0730 when the clients surgery is scheduled at 0800. What is the primary reason to start the antibiotic exactly at 0730? A. Legally the medication has to be given at the prescribed time B. The antibiotic is most effective in preventing infection if it is given 30-60 minutes before the operative incision is made C. The postoperative dose of Ancef needs to be started exactly 8 hours after the preoperative does ofAncef D. The peak and titer levels are needed for antibiotic therapy - correct answers the antibiotic is most effective in preventing infection if given 30-60 minutes before operative incision 2. During the pre admission testing for same-day surgery, a client states that shehas added two cloves of garlic each day to her diet to help control her bloodpressure. The nurse should further inquire about which of the following? A. The type of surgery the client is having B. What her blood pressure has been running C. The amount of garlic she is eating D. Her preference for the type of anesthesia - correct answers the amount of garlic she is eating can pose a problem with bleeding Unless contraindicated by the surgical procedure, which position is preferred for the unconscious patient immediately postoperative? A Supine B Lateral C Semi-Fowler's D High-Fowler's - correct answers lateral keeps airway open and reduces risk of aspiration. once conscious turn supine with HOB elevated Eight hours following bowel surgery, the nurse observes that the client's urine output has decreased from 50 to 20 ml/hr. The nurse should assess the client further for which of the following? A. Bowel obstruction B. Adverse effect of opioid analgesics C. Hemorrhage D. HTN - correct answers hemorrhage when urine is less then 30mL/hr could be hemorrhage or hypovolemia. nurse should assess VS, I'Os, dressing, labs, and notify PCP. Bowel obstruction is characterized by abd distention & absent bowel, nurse would expect client to have HYPOtension When the nurse is caring for a patient who has had a total laryngectomy and radical neck dissection during the first 24 hours after surgery, what is the priority nursing action? A. Monitor for bleeding. B. Assess breath sounds. C. Clean the inner cannula every 8 hours. D. Avoid changing the tracheostomy ties. - correct answers assess breath sounds maintenance of trash ties, cleaning inner cannula, and checking for bleeding are also appropriate just not of high priority A patient with an uncuffed tracheostomy tube coughs violently during suctioning and dislodges the tracheostomy tube. Which action should the nurse take first? A. Insert the obturator and attempt to reinsert the tracheostomy tube. B. Position the patient in an upright position with the neck extended. C. Assess the patients oxygen saturation and notify the health care provider. D. Ventilate the patient with a manual bag until the health care provider arrives. - correct answers insert the obturator and attempt to reinsert the tracheostomy's tube if nurse can reinsert cover with dressing and manually ventilate and place in semi fowler The health care provider inserts a chest tube in a patient with a hemopneumothorax. When monitoring the patient after the chest tube placement, the nurse will be most concerned about A. a large air leak in the water-seal chamber. B. 400 mL of blood in the collection chamber. C. complaint of pain with each deep inspiration. D. subcutaneous emphysema at the insertion site. - correct answers 400 ml of blood in collection chamber may indicate pt is in danger of developing hypovolemic shock, subcutaneous emphysema should be monitored but is not unusual A patient who has a right-sided chest tube following a thoracotomy has continuous bubbling in the suction-control chamber of the collection device. The most appropriate action by the nurse is to: A. document the presence of a large air leak. B. obtain and attach a new collection device. C. notify the surgeon of a possible pneumothorax. D. take no further action with the collection device. - correct answers take no further action with device continuous bubbling is expected indicated chamber is connected to suction, an air leak would be detected in the water seal chamber, a new collection device is needed when collection chamber is filled A patient who has had a total proctocolectomy and permanent ileostomy tells the nurse, "I cannot bear to even look at the stoma. I do not think I can manage all these changes." Which is the best action by the nurse? A. Develop a detailed written plan for ostomy care for the patient. B. Ask the patient more about the concerns with stoma management. C. Reassure the patient that care for the ileostomy will become easier. D. Postpone any patient teaching until the patient adjusts to the ileostomy. - correct answers ask pt more about the concerns with stoma A 51-year-old man is scheduled for an annual physical exam at the outpatient clinic. The nurse will plan to teach the patient about the purpose of: A. urinalysis collection. B. uroflowmetry studies. C. prostate specific antigen (PSA) testing. D. transrectal ultrasound scanning (TRUS). - correct answers prostate specific antigen (PSA) annual digital rectal exam 26. Following a radical retropubic prostatectomy for prostate cancer, the patient is incontinent of urine. The nurse will plan to teach the patient: A. to restrict oral fluid intake. B. pelvic floor muscle exercises. C. the use of belladonna and opium suppositories. D. how to perform intermittent self-catheterization. - correct answers pelvic floor exercises 29. The nurse is interviewing a surgical client in the holding area. Which information should the nurse report to the anesthesiologist? Select all that apply. A. The client has loose, decayed teeth. B. The client is experiencing anxiety. C. The client smokes two (2) packs of cigarettes a day. D. The client has had a chest x-ray which does not show infiltrates. E. The client reports using herbs - correct answers - the client has loose decayed teeth -client smokes 2 packs of cigarettes a day -client reports using herbs don't want to break teeth and possible cause aspiration, smokers are high risk for anesthesia, herbs (st. jo