HESI Patient Review: Perioperative Care - John Hale 2
with complete solution
Of the following, which are also appropriate at this time?
a. Contact lenses should be removed
b. Mr. Hale should be asked to void
c. Vital signs should be taken and recorded
d. Mrs. Hale should be asked to leave
a. Contact lenses should be removed
Contact lenses should be removed before surgery. Any dentures should also be
removed, to avoid the possibility of airway obstruction or interference with intubation.
Preferably, a family member can hold or secure personal items, including any jewelry or
eyeglasses, until they are needed.
b. Mr. Hale should be asked to void
Mr. Hale should urinate before surgery, before any preanesthesia medications are
given. The bladder should be emptied to prevent urinary incontinence during surgery
and avoid urinary retention after surgery. Also, a full bladder could obstruct surgical
view and possibly be injured during surgery.
c. Vital signs should be taken and recorded
Vital signs should be taken before surgery, and recorded. Preoperative vital signs
establish a baseline for postoperative comparison. Baseline vital signs should be
determined before the depressant effects of any preanesthesia medications have taken
effect. Mr. Hale's baseline vital signs are BP 124/80, apical pulse rate 86, respiratory
rate 20. His temperature, taken with a tympanic thermometer, is 36.6 degrees C (97.9
degrees F). Preoperative blood pressure and pulse rate may be higher than usual,
because of the emotional stress associated with surgery.
Upon arrival in the Preoperative Holding Area, Mr. Hale's identity is confirmed.
This is best done by:
a. Asking his name
b. Asking him what surgery he is scheduled for
c. Checking his identification bracelet and asking his name and birth date
c. Checking his identification bracelet and asking his name and birth date
To insure accuracy of patient identification, at least two patient identifiers should be
used. Checking a patient's identification bracelet and asking his name and birth date are
acceptable safe ways to confirm identity. The patient's identification bracelet should
contain his full name (correctly spelled), birth date, and an assigned identification
number. The name, birth date, and identification number on the patient's identification
, bracelet should match the patient identity information contained in the patient's medical
record and on the surgery schedule.
Surgical site marking is required for some procedures. For which of the following
procedures would site marking be required?
a. Left leg above the knee amputation
b. Right inguinal hernia repair
c. Cesarean section
d. Cataract removal left eye
e. Exploratory laparotomy
a. Left leg above the knee amputation
Surgical site marking is designed to prevent wrong procedure and wrong site surgery.
Site marking directs the surgical team to the correct location for the surgical procedure.
Surgical site marking is required for all procedures that involve right/left distinction,
multiple structures (e.g., finger, toes etc.), or levels (e.g., spinal surgery). For a left leg
above the knee amputation, the left leg would be marked at the level of the amputation.
b. Right inguinal hernia repair
Surgical site marking is designed to prevent wrong procedure and wrong site surgery.
Site marking directs the surgical team to the correct location for the surgical procedure.
Surgical site marking is required for all procedures that involve right/left distinction,
multiple structures (e.g., finger, toes etc.), or levels (e.g., spinal surgery). For a right
inguinal hernia repair, the right side of the lower abdomen would be marked.
d. Cataract removal left eye
Surgical site marking is designed to prevent wrong procedure and wrong site surgery.
Site marking directs the surgical team to the correct location for the surgical procedure.
Surgical site marking is required for all procedures that involve right/left distinction,
multiple structures (e.g., finger, toes etc.), or levels (e.g., spinal surgery). For left eye
cataract removal, the skin area adjacent to the left eye would be marked.
Versed (midazolam hydrochloride) is often used as preanesthesia medication
prior to general anesthesia. You expect that the Versed (midazolam
hydrochloride) will:
a. Promote systemic muscle relaxation
b. Induce local analgesia
c. Induce systemic analgesia
d. Decrease Mr. Hale's anxiety
e. Provide for amnesia of perioperative events
a. Promote systemic muscle relaxation
Versed (midazolam hydrochloride) causes central nervous system depression that
should promote muscle relaxation in Mr. Hale.
with complete solution
Of the following, which are also appropriate at this time?
a. Contact lenses should be removed
b. Mr. Hale should be asked to void
c. Vital signs should be taken and recorded
d. Mrs. Hale should be asked to leave
a. Contact lenses should be removed
Contact lenses should be removed before surgery. Any dentures should also be
removed, to avoid the possibility of airway obstruction or interference with intubation.
Preferably, a family member can hold or secure personal items, including any jewelry or
eyeglasses, until they are needed.
b. Mr. Hale should be asked to void
Mr. Hale should urinate before surgery, before any preanesthesia medications are
given. The bladder should be emptied to prevent urinary incontinence during surgery
and avoid urinary retention after surgery. Also, a full bladder could obstruct surgical
view and possibly be injured during surgery.
c. Vital signs should be taken and recorded
Vital signs should be taken before surgery, and recorded. Preoperative vital signs
establish a baseline for postoperative comparison. Baseline vital signs should be
determined before the depressant effects of any preanesthesia medications have taken
effect. Mr. Hale's baseline vital signs are BP 124/80, apical pulse rate 86, respiratory
rate 20. His temperature, taken with a tympanic thermometer, is 36.6 degrees C (97.9
degrees F). Preoperative blood pressure and pulse rate may be higher than usual,
because of the emotional stress associated with surgery.
Upon arrival in the Preoperative Holding Area, Mr. Hale's identity is confirmed.
This is best done by:
a. Asking his name
b. Asking him what surgery he is scheduled for
c. Checking his identification bracelet and asking his name and birth date
c. Checking his identification bracelet and asking his name and birth date
To insure accuracy of patient identification, at least two patient identifiers should be
used. Checking a patient's identification bracelet and asking his name and birth date are
acceptable safe ways to confirm identity. The patient's identification bracelet should
contain his full name (correctly spelled), birth date, and an assigned identification
number. The name, birth date, and identification number on the patient's identification
, bracelet should match the patient identity information contained in the patient's medical
record and on the surgery schedule.
Surgical site marking is required for some procedures. For which of the following
procedures would site marking be required?
a. Left leg above the knee amputation
b. Right inguinal hernia repair
c. Cesarean section
d. Cataract removal left eye
e. Exploratory laparotomy
a. Left leg above the knee amputation
Surgical site marking is designed to prevent wrong procedure and wrong site surgery.
Site marking directs the surgical team to the correct location for the surgical procedure.
Surgical site marking is required for all procedures that involve right/left distinction,
multiple structures (e.g., finger, toes etc.), or levels (e.g., spinal surgery). For a left leg
above the knee amputation, the left leg would be marked at the level of the amputation.
b. Right inguinal hernia repair
Surgical site marking is designed to prevent wrong procedure and wrong site surgery.
Site marking directs the surgical team to the correct location for the surgical procedure.
Surgical site marking is required for all procedures that involve right/left distinction,
multiple structures (e.g., finger, toes etc.), or levels (e.g., spinal surgery). For a right
inguinal hernia repair, the right side of the lower abdomen would be marked.
d. Cataract removal left eye
Surgical site marking is designed to prevent wrong procedure and wrong site surgery.
Site marking directs the surgical team to the correct location for the surgical procedure.
Surgical site marking is required for all procedures that involve right/left distinction,
multiple structures (e.g., finger, toes etc.), or levels (e.g., spinal surgery). For left eye
cataract removal, the skin area adjacent to the left eye would be marked.
Versed (midazolam hydrochloride) is often used as preanesthesia medication
prior to general anesthesia. You expect that the Versed (midazolam
hydrochloride) will:
a. Promote systemic muscle relaxation
b. Induce local analgesia
c. Induce systemic analgesia
d. Decrease Mr. Hale's anxiety
e. Provide for amnesia of perioperative events
a. Promote systemic muscle relaxation
Versed (midazolam hydrochloride) causes central nervous system depression that
should promote muscle relaxation in Mr. Hale.
