SThiVERSIONS}hi2024
1. Thehinursehiishicompletinghiahimedicationhihistoryhiforhithehisurgicalhipa
tienthiinhipreadmissionhitesting.hiWhichhimedicationhishouldhithehinursehiins
tructhithe
patienthitohiholdhi(discontinue)hiinhipreparationhiforhisurgeryhiaccordinghitohipro
tocol?
a. Warfarin
b. VitaminhiC
c. Prednisone
d. Acetaminophen
ANS:hiA
Medicationshisuchhiashiwarfarinhiorhiaspirinhialterhinormalhiclottinghifactorshian
dhithushiincreasehithehiriskhiofhihemorrhaging.hiDiscontinuehiathileasthi48hihours
hibeforehisurgery.hiAcetaminophenhiishiahipainhirelieverhithathihashinohispecialhii
mplicationshiforhisurgery.hiVitaminhiChiactuallyhiassistshiinhiwoundhihealinghian
dhihashinohispecialhiimplicationshiforhisurgery.hiPrednisonehiishiahicorticosteroid
,hiandhidosageshiarehioftenhitemporarilyhiincreasedhiratherhithanhiheld.
2. Thehinursehiishiprescreeninghiahisurgicalhipatienthiinhithehipreadmissionhite
stinghiunit.hiThehimedicationhihistoryhiindicateshithathithehipatienthiis
currentlyhitakinghianhianticoagulant.hiWhichhiactionhishouldhithehinursehitakehiw
henhiconsultinghiwithhithehihealthhicarehiprovider?
a. Askhiforhiahiradiologicalhiexaminationhiofhithehichest.
b. Askhiforhianhiinternationalhinormalizedhiratiohi(INR).
c. Askhiforhiahibloodhiureahinitrogenhi(BUN).
, d. Askhiforhiahiserumhisodiumhi(Na).
ANS:hiB
INR,hiPThi(prothrombinhitime),hiAPTThi(activatedhipartialhithromboplastinhitime),hi
andhiplatelethicountshirevealhithehiclottinghiabilityhiofhithehiblood.hiAnticoagulant
shicanhibehiutilizedhiforhidifferenthiconditions,hibuthiitshiactionhiishitohiincreasehithe
hitimehiithitakeshiforhithehibloodhitohiclot.hiThishiactionhicanhiputhithehisurgicalhipati
enthiathiriskhiforhibleedinghitendencies.
Typically,hiifhiathiallhipossible,hithishimedicationhiishiheldhiseveralhidayshibeforehi
ahisurgicalhiprocedurehitohidecreasehithishirisk.hiChesthix-
ray,hiBUN,hiandhiNahiarehidiagnostichiscreeninghitoolshiforhisurgeryhibuthiarehinot
hispecifichitohianticoagulants.
3. Thehinursehiishipreparinghiahipatienthiforhisurgery.hiWhichhigoalhiishia
priorityhiforhiassessinghithehipatienthibeforehisurgery?
a. Planhiforhicarehiafterhithehiprocedure.
b. Establishhiahipatient’shibaselinehiofhinormalhifunction.
c. Educatehithehipatienthiandhifamilyhiabouthithehiprocedure.
d. Gatherhiappropriatehiequipmenthiforhithehipatient’shineeds.
ANS:hiB
Thehigoalhiofhithehipreoperativehiassessmenthiishitohiidentifyhiahipatient’shinormalh
ipreoperativehifunctionhiandhithehipresencehiofhianyhiriskshitohirecognize,hiprevent
,hiandhiminimizehipossiblehipostoperativehicomplications.hiGatheringhiappropriat
ehiequipment,hiplanninghicare,hiandhieducatinghithehipatienthiandhifamilyhiarehiallh
iimportanthiinterventionshithathimusthibehiprovidedhiforhithehisurgicalhipatient;hit
heyhiarehiparthiofhithehinursinghiprocesshibuthiarehinothithehipriorityhireason/goalhi
forhicompletinghianhiassessmenthiofhithehisurgicalhipatient.
, 4. Thehinursehiishiencouraginghithehipostoperativehipatienthitohiuti
lizehidiaphragmatic
breathing.hiWhichhipriorityhigoalhiishithehinursehitryinghitohiachieve?
a. Managehipain
b. Preventhiatelectasis
c. Reducehihealinghitime
d. Decreasehithrombushiformation
ANS:hiB
Afterhisurgery,hipatientshimayhihavehireducedhilunghivolumehiandhimayhirequir
ehigreaterhiefforthitohicoughhiandhideephibreathe;hiinadequatehilunghiexpansio
nhicanhileadhitohiatelectasishiandhipneumonia.hiPurposelyhiutilizinghidiaphragm
atichibreathinghicanhidecreasehithishirisk.hiDuringhigeneralhianesthesia,hithehilu
ngshiarehinothifullyhiinflatedhiduringhisurgeryhiandhithehicoughhireflexhiishisuppre
ssed,hisohimucushicollectshiwithinhiairwayhipassages.hiDiaphragmatichibreathin
ghidoeshinothimanagehipain;hiinhisomehicases,hiifhisplintinghiandhipainhimedicatio
nshiarehinothigiven,hiithicanhicausehipain.hiDiaphragmatichibreathinghidoeshinothi
reducehihealinghitimehiorhidecreasehithrombushiformation.hiBetter,himorehieffe
ctivehiinterventionshiarehiavailablehiforhithesehisituations.
5. Thehinursehiishicaringhiforhiahipostoperativehipatienthionhithehimedical-surgical
floor.hiWhichhiactivityhiwillhithehinursehiencouragehitohipreventhivenoushistasishi
andhithehiformationhiofhithrombus?
a. Diaphragmatichibreathing
b. Incentivehispirometry
c. Leghiexercises
d. Coughing