NRS 112 EXAM 1 & EXAM 2 QUESTIONS AND CORRECT
ANSWERS
8 stages of trajectory model - ANSWER: 1. initial or pre-trajectory phase
2. trajectory onset phase
3. crisis phase
4. acute phase
5. stable phase
6. unstable phase
7. downward phase
8. dying phase
purpose of patient interview - ANSWER: -obtain health info
-determine expectations
-provide and clarify info about surgery and anesthesia
-assess emotional state and readiness
-ask about allergies, health conditions
-psychosocial assessment
preoperative nursing assessment goals - ANSWER: -establish baseline data
-determine psychological status to reinforce coping strategies
-determine physiologic factors of the procedure contributing to risks
role of the nurse for preoperative - ANSWER: -identify and document surgical site
-identify meds and herbs that may affect surgery outcome
-identify, document, and communicate results of lab/diagnostic tests
-identify cultural and ethnic factors
-determine info from surgeon to sign informed consent
-determine if informed consent was obtained
-confirm informed consent was signed and witnessed
What herbs need to be avoided 2-3 weeks before surgery? - ANSWER: -astragalus
and ginseng (raise BP)
-garlic, vitamin E, ginkgo, fish oil, (increase risk of bleeding)
-cava and valerian (increase sedation)
-multivitamin stop taking day before
what 3 things can happen for a patient taking antiplatelet and NSAIDs before
surgery? - ANSWER: 1. continue therapy if it's better for patient
2. pause drug therapy
3. alter drug or route of delivery
what kind of medications can increase opioid effects if taken prior to surgery? -
ANSWER: antidepressents
,what kind of medication would a patient keep taking before surgery? - ANSWER:
beta blockers
what is informed consent? - ANSWER: a shared decision-making process between
the patient and healthcare provider
what is the purpose of informed consent? - ANSWER: to provide complete info prior
to obtaining agreement to accept a course of tx
what are the 3 essential elements of a valid informed consent? - ANSWER: 1.
adequate disclosure of the diagnoses, purpose of tx, risks and consequences,
expected outcome, and prognoses
2. patient must demonstrate clear understanding of info before sedation
3. consent must be voluntary
potential barriers to informed consent - ANSWER: -language
-level of health care literacy
-cultural beliefs
-anxiety
-fear
what 3 things does the patients signature represent on a written consent? -
ANSWER: 1. voluntary consent of patient or rep
2. authentic signature
3. apparent competency of patient or rep to sign consent
psychosocial assessment outcomes for a pre-op patient? - ANSWER: -excessive stress
can affect recovery
-anxiety and fear can impair cognition, decision making, and coping abilities
-.anxiety can arise from lack of knowledge, unrealistic expectations, conflict with
interventions (blood transfusion)
what are some influencing factors that could contribute to anxiety and fear for a pre-
op patient? - ANSWER: -age/ developmental level
-past experience
-current health
-socioeconomic status (access to support services)
what is the role of the nurse for communicating to a pre-op patient? - ANSWER: -use
common language and avoid medical jargon
-use translators if needed
-communicate concerns to surgical team
what needs to be asked when obtaining a health history from a pre-op pt? -
ANSWER: 1. previous and current diagnosed medical conditions
2. previous surgeries and problems
3. menstrual/ob history
, 4. familial diseases
5. inherited traits
6. conditions
7. reactions/problems to anesthesia
why do we need to ask about substance use to a pre-op pt? - ANSWER: -they can
withdraw
-the anesthetic may not work as intended
what foods can someone be allergic to that could suggest a latex allergy? - ANSWER:
-avocados
-bananas
-chestnuts
-eggs
-potatoes
what is the purpose of review of systems? - ANSWER: -confirms presence or absence
of disease
-alerts areas to examine closely
-provides essential data to determine pre-op tests
commonly prescribed collaborative care orders: cardiovascular - ANSWER: -12-lead
ECG
-coagulation studies
-prophylactic abx (prosthetic heart valve)
-venous thromboembolism prophylaxis (reduced mobility can increase clot
formation)
nursing assessment: cardio - ANSWER: -cardiac problems so they can be monitored
intraoperative
-use of cardiac drugs
-presence of pacemaker or implanted cardioverter-defibrillator
nursing assessment: respiratory - ANSWER: -recent upper respiratory infection (can
increase risk of laryngospasm, bronchospasm, or decreased SaO2; surgery may need
to be cancelled)
-history of dyspnea, coughing or hemoptysis (bloody sputum)
-chronic obstructive pulmonary disease or asthma (increased risk of atelectasis or
hypoxemia)
-sleep apnea, obesity, airway deformities (bring machine)
-smokers stop smoking 6 weeks prior to surgery
nursing assessment: nervous system - ANSWER: -hearing loss can influence results
(how they respond and follow instructions
-cognitive deficits can affect informed consent and cause adverse outcomes
-fluid imbalance; dehydration can alter mental status
ANSWERS
8 stages of trajectory model - ANSWER: 1. initial or pre-trajectory phase
2. trajectory onset phase
3. crisis phase
4. acute phase
5. stable phase
6. unstable phase
7. downward phase
8. dying phase
purpose of patient interview - ANSWER: -obtain health info
-determine expectations
-provide and clarify info about surgery and anesthesia
-assess emotional state and readiness
-ask about allergies, health conditions
-psychosocial assessment
preoperative nursing assessment goals - ANSWER: -establish baseline data
-determine psychological status to reinforce coping strategies
-determine physiologic factors of the procedure contributing to risks
role of the nurse for preoperative - ANSWER: -identify and document surgical site
-identify meds and herbs that may affect surgery outcome
-identify, document, and communicate results of lab/diagnostic tests
-identify cultural and ethnic factors
-determine info from surgeon to sign informed consent
-determine if informed consent was obtained
-confirm informed consent was signed and witnessed
What herbs need to be avoided 2-3 weeks before surgery? - ANSWER: -astragalus
and ginseng (raise BP)
-garlic, vitamin E, ginkgo, fish oil, (increase risk of bleeding)
-cava and valerian (increase sedation)
-multivitamin stop taking day before
what 3 things can happen for a patient taking antiplatelet and NSAIDs before
surgery? - ANSWER: 1. continue therapy if it's better for patient
2. pause drug therapy
3. alter drug or route of delivery
what kind of medications can increase opioid effects if taken prior to surgery? -
ANSWER: antidepressents
,what kind of medication would a patient keep taking before surgery? - ANSWER:
beta blockers
what is informed consent? - ANSWER: a shared decision-making process between
the patient and healthcare provider
what is the purpose of informed consent? - ANSWER: to provide complete info prior
to obtaining agreement to accept a course of tx
what are the 3 essential elements of a valid informed consent? - ANSWER: 1.
adequate disclosure of the diagnoses, purpose of tx, risks and consequences,
expected outcome, and prognoses
2. patient must demonstrate clear understanding of info before sedation
3. consent must be voluntary
potential barriers to informed consent - ANSWER: -language
-level of health care literacy
-cultural beliefs
-anxiety
-fear
what 3 things does the patients signature represent on a written consent? -
ANSWER: 1. voluntary consent of patient or rep
2. authentic signature
3. apparent competency of patient or rep to sign consent
psychosocial assessment outcomes for a pre-op patient? - ANSWER: -excessive stress
can affect recovery
-anxiety and fear can impair cognition, decision making, and coping abilities
-.anxiety can arise from lack of knowledge, unrealistic expectations, conflict with
interventions (blood transfusion)
what are some influencing factors that could contribute to anxiety and fear for a pre-
op patient? - ANSWER: -age/ developmental level
-past experience
-current health
-socioeconomic status (access to support services)
what is the role of the nurse for communicating to a pre-op patient? - ANSWER: -use
common language and avoid medical jargon
-use translators if needed
-communicate concerns to surgical team
what needs to be asked when obtaining a health history from a pre-op pt? -
ANSWER: 1. previous and current diagnosed medical conditions
2. previous surgeries and problems
3. menstrual/ob history
, 4. familial diseases
5. inherited traits
6. conditions
7. reactions/problems to anesthesia
why do we need to ask about substance use to a pre-op pt? - ANSWER: -they can
withdraw
-the anesthetic may not work as intended
what foods can someone be allergic to that could suggest a latex allergy? - ANSWER:
-avocados
-bananas
-chestnuts
-eggs
-potatoes
what is the purpose of review of systems? - ANSWER: -confirms presence or absence
of disease
-alerts areas to examine closely
-provides essential data to determine pre-op tests
commonly prescribed collaborative care orders: cardiovascular - ANSWER: -12-lead
ECG
-coagulation studies
-prophylactic abx (prosthetic heart valve)
-venous thromboembolism prophylaxis (reduced mobility can increase clot
formation)
nursing assessment: cardio - ANSWER: -cardiac problems so they can be monitored
intraoperative
-use of cardiac drugs
-presence of pacemaker or implanted cardioverter-defibrillator
nursing assessment: respiratory - ANSWER: -recent upper respiratory infection (can
increase risk of laryngospasm, bronchospasm, or decreased SaO2; surgery may need
to be cancelled)
-history of dyspnea, coughing or hemoptysis (bloody sputum)
-chronic obstructive pulmonary disease or asthma (increased risk of atelectasis or
hypoxemia)
-sleep apnea, obesity, airway deformities (bring machine)
-smokers stop smoking 6 weeks prior to surgery
nursing assessment: nervous system - ANSWER: -hearing loss can influence results
(how they respond and follow instructions
-cognitive deficits can affect informed consent and cause adverse outcomes
-fluid imbalance; dehydration can alter mental status
