Med Surg: Perioperative Care - TestBank
1. A patient scheduled for an elective hysterectomy tells the nurse, "I am afraid that I will die in surgery
like my mother did!" Which initial response by the nurse is appropriate?
a. "Surgical techniques have improved in recent years."
b. "Tell me more about what happened to your mother."
c. "You will receive medication to reduce your anxiety."
d. "You should talk to the doctor again about the surgery." - ANSWER-b. "Tell me more about what
happened to your mother."
1. On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72
mm Hg. Thirty minutes after admission, the BP is 114/62, with a pulse of 74 and warm, dry skin. Which
action by the nurse is most appropriate?
a. Increase the IV fluid rate.
b. Notify the anesthesia care provider (ACP).
c. Continue to take vital signs every 15 minutes.
d. Administer oxygen therapy at 100% per mask. - ANSWER-c. Continue to take vital signs every 15
minutes.
- A slight drop in postoperative BP with a normal pulse and warm, dry skin indicates normal response to
the residual effects of anesthesia and requires only ongoing monitoring. Hypotension with tachycardia
or cool, clammy skin would suggest hypovolemic or hemorrhagic shock and the need for notification of
the ACP, increased fluids, and high-concentration oxygen administration.
1. The nurse facilitates student clinical experiences in the surgical suite. Which action, if performed by a
student, would require the nurse to intervene?
a. The student wears a mask in the semirestricted area.
b. The student wears street clothes in the semirestricted area.
c. The student wears surgical scrubs in the semirestricted area.
d. The student covers head and facial hair in the semirestricted area. - ANSWER-b. The student wears
street clothes in the semirestricted area.
1. When caring for a preoperative patient on the day of surgery, which actions included in the plan of
care can the nurse delegate to unlicensed assistive personnel (UAP) (select all that apply)?
a. Teach incentive spirometer use.
b. Explain routine preoperative care.
c. Obtain and document baseline vital signs.
d. Remove nail polish and apply pulse oximeter.
,Med Surg: Perioperative Care - TestBank
e. Transport the patient by stretcher to the operating room. - ANSWER-C, D, E
1. Which actions will the nurse include in the surgical time-out procedure before surgery (select all that
apply)?
a. Check for patency of IV lines.
b. Have the surgeon identify the patient.
c. Have the patient state name and date of birth.
d. Verify the patient identification band number.
e. Ask the patient to state the surgical procedure. - ANSWER-C, D, E
1. While ambulating in the room, a patient complains of feeling dizzy. In what order will the nurse
accomplish the following activities? (Put a comma and a space between each answer choice [A, B, C, D].)
a. Have the patient sit down in a chair.
b. Give the patient something to drink.
c. Take the patient's blood pressure (BP).
d. Inform the patient's health care provider. - ANSWER-A,C,B,D
10. Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated
shoulder. What action does the nurse anticipate?
a. Starting an IV in the patient's unaffected arm
b. Securing an airtight fit for the inhalation mask
c. Preparing for placement of an epidural catheter
d. Giving deep sedation under physician supervision. - ANSWER-a. Starting an IV in the patient's
unaffected arm
10. Which action could the postanesthesia care unit (PACU) nurse delegate to unlicensed assistive
personnel (UAP) who help to transport a patient to the clinical unit?
a. Clarify the postoperative orders with the surgeon.
b. Help with the transfer of the patient onto a stretcher.
c. Document the appearance of the patient's incision in the chart.
d. Provide hand off communication to the surgical unit charge nurse - ANSWER-b. Help with the transfer
of the patient onto a stretcher.
10. Which topic is most important for the nurse to discuss preoperatively with a patient who is
scheduled for an open cholecystectomy?
a. Care for the surgical incision
, Med Surg: Perioperative Care - TestBank
b. Deep breathing and coughing
c. Oral antibiotic therapy after discharge
d. Medications to be used during surgery - ANSWER-b. Deep breathing and coughing
11. A patient is transferred from the postanesthesia care unit (PACU) to the clinical unit. Which action by
the nurse on the clinical unit should be performed first?
a. Assess the patient's pain.
b. Orient the patient to the unit.
c. Take the patient's vital signs.
d. Read the postoperative orders. - ANSWER-c. Take the patient's vital signs.
11. Five minutes after receiving the ordered preoperative midazolam by IV injection, the patient asks to
get up to go to the bathroom to urinate. Which action by the nurse is most appropriate?
a. Assist the patient to the bathroom.
b. Offer the patient a urinal or bedpan.
c. Ask the patient to wait until the drug has been fully metabolized.
d. Tell the patient that a bladder catheter will be placed in the operating room. - ANSWER-b. Offer the
patient a urinal or bedpan.
11. Which action will the perioperative nurse take after surgery is completed for a patient who received
ketamine as an anesthetic agent?
a. Question the order for giving a benzodiazepine.
b. Ensure that atropine is available in case of bradycardia.
c. Provide a quiet environment in the postanesthesia care unit.
d. Anticipate the need for higher than usual doses of analgesic agents. - ANSWER-c. Provide a quiet
environment in the postanesthesia care unit.
- Hallucinations are an adverse effect associated with the dissociative anesthetics such as ketamine.
Therefore the postoperative environment should be kept quiet to decrease the risk of hallucinations.
Because ketamine causes profound analgesia lasting into the postoperative period, higher doses of
analgesics are not needed. Ketamine causes an increase in heart rate. Benzodiazepine may be used with
ketamine to decrease the incidence of hallucinations and nightmares
12. An older patient who had knee replacement surgery 2 days ago can only tolerate being out of bed
with physical therapy twice a day. Which collaborative problem should the nurse identify as a priority
for this patient?
a. Potential complication: hypovolemic shock
1. A patient scheduled for an elective hysterectomy tells the nurse, "I am afraid that I will die in surgery
like my mother did!" Which initial response by the nurse is appropriate?
a. "Surgical techniques have improved in recent years."
b. "Tell me more about what happened to your mother."
c. "You will receive medication to reduce your anxiety."
d. "You should talk to the doctor again about the surgery." - ANSWER-b. "Tell me more about what
happened to your mother."
1. On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72
mm Hg. Thirty minutes after admission, the BP is 114/62, with a pulse of 74 and warm, dry skin. Which
action by the nurse is most appropriate?
a. Increase the IV fluid rate.
b. Notify the anesthesia care provider (ACP).
c. Continue to take vital signs every 15 minutes.
d. Administer oxygen therapy at 100% per mask. - ANSWER-c. Continue to take vital signs every 15
minutes.
- A slight drop in postoperative BP with a normal pulse and warm, dry skin indicates normal response to
the residual effects of anesthesia and requires only ongoing monitoring. Hypotension with tachycardia
or cool, clammy skin would suggest hypovolemic or hemorrhagic shock and the need for notification of
the ACP, increased fluids, and high-concentration oxygen administration.
1. The nurse facilitates student clinical experiences in the surgical suite. Which action, if performed by a
student, would require the nurse to intervene?
a. The student wears a mask in the semirestricted area.
b. The student wears street clothes in the semirestricted area.
c. The student wears surgical scrubs in the semirestricted area.
d. The student covers head and facial hair in the semirestricted area. - ANSWER-b. The student wears
street clothes in the semirestricted area.
1. When caring for a preoperative patient on the day of surgery, which actions included in the plan of
care can the nurse delegate to unlicensed assistive personnel (UAP) (select all that apply)?
a. Teach incentive spirometer use.
b. Explain routine preoperative care.
c. Obtain and document baseline vital signs.
d. Remove nail polish and apply pulse oximeter.
,Med Surg: Perioperative Care - TestBank
e. Transport the patient by stretcher to the operating room. - ANSWER-C, D, E
1. Which actions will the nurse include in the surgical time-out procedure before surgery (select all that
apply)?
a. Check for patency of IV lines.
b. Have the surgeon identify the patient.
c. Have the patient state name and date of birth.
d. Verify the patient identification band number.
e. Ask the patient to state the surgical procedure. - ANSWER-C, D, E
1. While ambulating in the room, a patient complains of feeling dizzy. In what order will the nurse
accomplish the following activities? (Put a comma and a space between each answer choice [A, B, C, D].)
a. Have the patient sit down in a chair.
b. Give the patient something to drink.
c. Take the patient's blood pressure (BP).
d. Inform the patient's health care provider. - ANSWER-A,C,B,D
10. Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated
shoulder. What action does the nurse anticipate?
a. Starting an IV in the patient's unaffected arm
b. Securing an airtight fit for the inhalation mask
c. Preparing for placement of an epidural catheter
d. Giving deep sedation under physician supervision. - ANSWER-a. Starting an IV in the patient's
unaffected arm
10. Which action could the postanesthesia care unit (PACU) nurse delegate to unlicensed assistive
personnel (UAP) who help to transport a patient to the clinical unit?
a. Clarify the postoperative orders with the surgeon.
b. Help with the transfer of the patient onto a stretcher.
c. Document the appearance of the patient's incision in the chart.
d. Provide hand off communication to the surgical unit charge nurse - ANSWER-b. Help with the transfer
of the patient onto a stretcher.
10. Which topic is most important for the nurse to discuss preoperatively with a patient who is
scheduled for an open cholecystectomy?
a. Care for the surgical incision
, Med Surg: Perioperative Care - TestBank
b. Deep breathing and coughing
c. Oral antibiotic therapy after discharge
d. Medications to be used during surgery - ANSWER-b. Deep breathing and coughing
11. A patient is transferred from the postanesthesia care unit (PACU) to the clinical unit. Which action by
the nurse on the clinical unit should be performed first?
a. Assess the patient's pain.
b. Orient the patient to the unit.
c. Take the patient's vital signs.
d. Read the postoperative orders. - ANSWER-c. Take the patient's vital signs.
11. Five minutes after receiving the ordered preoperative midazolam by IV injection, the patient asks to
get up to go to the bathroom to urinate. Which action by the nurse is most appropriate?
a. Assist the patient to the bathroom.
b. Offer the patient a urinal or bedpan.
c. Ask the patient to wait until the drug has been fully metabolized.
d. Tell the patient that a bladder catheter will be placed in the operating room. - ANSWER-b. Offer the
patient a urinal or bedpan.
11. Which action will the perioperative nurse take after surgery is completed for a patient who received
ketamine as an anesthetic agent?
a. Question the order for giving a benzodiazepine.
b. Ensure that atropine is available in case of bradycardia.
c. Provide a quiet environment in the postanesthesia care unit.
d. Anticipate the need for higher than usual doses of analgesic agents. - ANSWER-c. Provide a quiet
environment in the postanesthesia care unit.
- Hallucinations are an adverse effect associated with the dissociative anesthetics such as ketamine.
Therefore the postoperative environment should be kept quiet to decrease the risk of hallucinations.
Because ketamine causes profound analgesia lasting into the postoperative period, higher doses of
analgesics are not needed. Ketamine causes an increase in heart rate. Benzodiazepine may be used with
ketamine to decrease the incidence of hallucinations and nightmares
12. An older patient who had knee replacement surgery 2 days ago can only tolerate being out of bed
with physical therapy twice a day. Which collaborative problem should the nurse identify as a priority
for this patient?
a. Potential complication: hypovolemic shock
