NP3 Exam with accurate !| !| !| !|
solutions
1. When Nurse Jane is admitting a client for surgery, which question is most
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
useful in determining the client's current nutritional status?
!| !| !| !| !| !| !|
A. "How is your appetite usually?"
!| !| !| !| !|
B. "What did you eat and drink yesterday?"
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C. "Have you noticed any weight loss recently?"
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D. "Who does most of your shopping and cooking?" - Correct answer ✔B.
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"What did you eat and drink yesterday?"
!| !| !| !| !| !|
2. A client complains of severe pain 2 days after surgery. Which initial action
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
should Nurse Jane take after assessing the character of the pain?
!| !| !| !| !| !| !| !| !| !|
A. have the client rest
!| !| !| !|
B. take the client's vital signs
!| !| !| !| !|
C. administer the prn analgesic
!| !| !| !|
D. document the client's complaint - Correct answer ✔B. take the client's
!| !| !| !| !| !| !| !| !| !| !| !|
vital signs !|
,3. A client who is scheduled for a Billroth II procedure asks the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
explain what will be done during the surgery. Which response should the
!| !| !| !| !| !| !| !| !| !| !| !|
nurse make? !|
A. "The surgeon will explain the procedure to you since the doctor is
!| !| !| !| !| !| !| !| !| !| !| !| !|
responsible for obtaining consent." !| !| !|
B. "Your stomach is completely removed and the esophagus is connected to
!| !| !| !| !| !| !| !| !| !| !| !|
the small intestine."
!| !|
C. "The bottom part of the stomach is removed and the remainder is
!| !| !| !| !| !| !| !| !| !| !| !| !|
attached to the small intestine." !| !| !| !|
D. "The nerves that go to your stomach are cut and a larger opening is made
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
for stomach emptying." - Correct answer ✔C. "The bottom part of the
!| !| !| !| !| !| !| !| !| !| !| !|
stomach is removed and the remainder is attached to the small intestine."
!| !| !| !| !| !| !| !| !| !| !|
4. On the first postoperative day after an open Billroth II procedure a client
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
develops hiccups, 6 on a scale of 10 epigastric pain, and a drop in blood
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
pressure. The nurse's initial actions should be to: !| !| !| !| !| !| !|
A. assess the amount of drainage from the nasogastric (NG) tube.
!| !| !| !| !| !| !| !| !| !|
B. notify the client's physician.
!| !| !| !|
C. assess the abdominal dressing.
!| !| !| !|
D. administer the ordered Morphine Sulfate 4 mg IV. - Correct answer ✔A.
!| !| !| !| !| !| !| !| !| !| !| !| !|
assess the amount of drainage from the nasogastric (NG) tube.
!| !| !| !| !| !| !| !| !|
5. As a Surgical Nurse management of Peri-operative clients demand the use
!| !| !| !| !| !| !| !| !| !| !| !|
of knowledge, judgement and skills based on the principles of surgical
!| !| !| !| !| !| !| !| !| !| !|
,nursing practice. Which information obtained in the postoperative assessment
!| !| !| !| !| !| !| !|
of a 32-year-old client with Peritonitis will be of most concern to the nurse?
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
A. Bowel sounds are decreased in all four quadrants.
!| !| !| !| !| !| !| !|
B. Drainage from wound drains is purulent.
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C. Oxygen saturation is 90%.
!| !| !| !|
D. Pain level is 6 on a scale of 10. - Correct answer ✔C. Oxygen saturation is
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
90%.
Situation: The postoperative care continues after the patient's condition
!| !| !| !| !| !| !| !| !|
stabilized as well as after the patient is discharged from surgery facility. It is
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
necessary for recovery room nurses to continue evaluating the patient's
!| !| !| !| !| !| !| !| !| !|
condition to anticipate and treat complications. !| !| !| !| !|
6. On the first postoperative day after an abdomino-perineal resection, the
!| !| !| !| !| !| !| !| !| !| !|
surgical nurse notes that there is a large quantity of serous drainage on the
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
client's perineal dressing. The nurse will:
!| !| !| !| !|
A. reinforce or change the dressing.
!| !| !| !| !|
B. notify the physician immediately.
!| !| !| !|
C. irrigate the wound drain.
!| !| !| !|
D. culture the drainage. - Correct answer ✔A. reinforce or change the
!| !| !| !| !| !| !| !| !| !| !| !|
dressing.
, 7. When developing the postoperative plan of care for a client who has had a
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
Cystectomy and creation of a neobladder, which action is appropriate to
!| !| !| !| !| !| !| !| !| !| !|
include?
A. Assess the stoma every hour for the first 24 hours after surgery.
!| !| !| !| !| !| !| !| !| !| !| !|
B. Call the surgeon if the urine appears cloudy or has clots.
!| !| !| !| !| !| !| !| !| !| !|
C. Irrigate the urethral catheter with saline every 2 to 4 hours.
!| !| !| !| !| !| !| !| !| !| !|
D. Change the ostomy bag when it is one-half full of urine. - Correct answer
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
✔C. Irrigate the urethral catheter with saline every 2 to 4 hours.
!| !| !| !| !| !| !| !| !| !| !|
8. Which information about a client on the first postoperative day after a
!| !| !| !| !| !| !| !| !| !| !| !| !|
total vaginal hysterectomy is most important to communicate to the
!| !| !| !| !| !| !| !| !| !|
physician?
A. The client has hypotonic bowel sounds.
!| !| !| !| !| !|
B. The client complains of incisional pain with coughing rated at 8 on a scale
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
of 10.
!|
C. The client's sanitary pad needs to be changed every hour.
!| !| !| !| !| !| !| !| !| !|
D. The client's temperature is 100.3 degrees F. - Correct answer ✔C. The
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client's sanitary pad needs to be changed every hour.
!| !| !| !| !| !| !| !|
9. Mrs. Cambay 47 year old is being admitted for elective surgery. The client
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
has a history of diabetes and hypertension. She uses alternative therapies to
!| !| !| !| !| !| !| !| !| !| !| !|
assist in keeping her diabetes and hypertension under control like taking
!| !| !| !| !| !| !| !| !| !| !|
black tea as an adjunct therapy. The Physician is requesting her to stop
!| !| !| !| !| !| !| !| !| !| !| !| !|
solutions
1. When Nurse Jane is admitting a client for surgery, which question is most
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
useful in determining the client's current nutritional status?
!| !| !| !| !| !| !|
A. "How is your appetite usually?"
!| !| !| !| !|
B. "What did you eat and drink yesterday?"
!| !| !| !| !| !| !|
C. "Have you noticed any weight loss recently?"
!| !| !| !| !| !| !|
D. "Who does most of your shopping and cooking?" - Correct answer ✔B.
!| !| !| !| !| !| !| !| !| !| !| !| !|
"What did you eat and drink yesterday?"
!| !| !| !| !| !|
2. A client complains of severe pain 2 days after surgery. Which initial action
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
should Nurse Jane take after assessing the character of the pain?
!| !| !| !| !| !| !| !| !| !|
A. have the client rest
!| !| !| !|
B. take the client's vital signs
!| !| !| !| !|
C. administer the prn analgesic
!| !| !| !|
D. document the client's complaint - Correct answer ✔B. take the client's
!| !| !| !| !| !| !| !| !| !| !| !|
vital signs !|
,3. A client who is scheduled for a Billroth II procedure asks the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
explain what will be done during the surgery. Which response should the
!| !| !| !| !| !| !| !| !| !| !| !|
nurse make? !|
A. "The surgeon will explain the procedure to you since the doctor is
!| !| !| !| !| !| !| !| !| !| !| !| !|
responsible for obtaining consent." !| !| !|
B. "Your stomach is completely removed and the esophagus is connected to
!| !| !| !| !| !| !| !| !| !| !| !|
the small intestine."
!| !|
C. "The bottom part of the stomach is removed and the remainder is
!| !| !| !| !| !| !| !| !| !| !| !| !|
attached to the small intestine." !| !| !| !|
D. "The nerves that go to your stomach are cut and a larger opening is made
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
for stomach emptying." - Correct answer ✔C. "The bottom part of the
!| !| !| !| !| !| !| !| !| !| !| !|
stomach is removed and the remainder is attached to the small intestine."
!| !| !| !| !| !| !| !| !| !| !|
4. On the first postoperative day after an open Billroth II procedure a client
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
develops hiccups, 6 on a scale of 10 epigastric pain, and a drop in blood
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
pressure. The nurse's initial actions should be to: !| !| !| !| !| !| !|
A. assess the amount of drainage from the nasogastric (NG) tube.
!| !| !| !| !| !| !| !| !| !|
B. notify the client's physician.
!| !| !| !|
C. assess the abdominal dressing.
!| !| !| !|
D. administer the ordered Morphine Sulfate 4 mg IV. - Correct answer ✔A.
!| !| !| !| !| !| !| !| !| !| !| !| !|
assess the amount of drainage from the nasogastric (NG) tube.
!| !| !| !| !| !| !| !| !|
5. As a Surgical Nurse management of Peri-operative clients demand the use
!| !| !| !| !| !| !| !| !| !| !| !|
of knowledge, judgement and skills based on the principles of surgical
!| !| !| !| !| !| !| !| !| !| !|
,nursing practice. Which information obtained in the postoperative assessment
!| !| !| !| !| !| !| !|
of a 32-year-old client with Peritonitis will be of most concern to the nurse?
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
A. Bowel sounds are decreased in all four quadrants.
!| !| !| !| !| !| !| !|
B. Drainage from wound drains is purulent.
!| !| !| !| !| !|
C. Oxygen saturation is 90%.
!| !| !| !|
D. Pain level is 6 on a scale of 10. - Correct answer ✔C. Oxygen saturation is
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
90%.
Situation: The postoperative care continues after the patient's condition
!| !| !| !| !| !| !| !| !|
stabilized as well as after the patient is discharged from surgery facility. It is
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
necessary for recovery room nurses to continue evaluating the patient's
!| !| !| !| !| !| !| !| !| !|
condition to anticipate and treat complications. !| !| !| !| !|
6. On the first postoperative day after an abdomino-perineal resection, the
!| !| !| !| !| !| !| !| !| !| !|
surgical nurse notes that there is a large quantity of serous drainage on the
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
client's perineal dressing. The nurse will:
!| !| !| !| !|
A. reinforce or change the dressing.
!| !| !| !| !|
B. notify the physician immediately.
!| !| !| !|
C. irrigate the wound drain.
!| !| !| !|
D. culture the drainage. - Correct answer ✔A. reinforce or change the
!| !| !| !| !| !| !| !| !| !| !| !|
dressing.
, 7. When developing the postoperative plan of care for a client who has had a
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
Cystectomy and creation of a neobladder, which action is appropriate to
!| !| !| !| !| !| !| !| !| !| !|
include?
A. Assess the stoma every hour for the first 24 hours after surgery.
!| !| !| !| !| !| !| !| !| !| !| !|
B. Call the surgeon if the urine appears cloudy or has clots.
!| !| !| !| !| !| !| !| !| !| !|
C. Irrigate the urethral catheter with saline every 2 to 4 hours.
!| !| !| !| !| !| !| !| !| !| !|
D. Change the ostomy bag when it is one-half full of urine. - Correct answer
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
✔C. Irrigate the urethral catheter with saline every 2 to 4 hours.
!| !| !| !| !| !| !| !| !| !| !|
8. Which information about a client on the first postoperative day after a
!| !| !| !| !| !| !| !| !| !| !| !| !|
total vaginal hysterectomy is most important to communicate to the
!| !| !| !| !| !| !| !| !| !|
physician?
A. The client has hypotonic bowel sounds.
!| !| !| !| !| !|
B. The client complains of incisional pain with coughing rated at 8 on a scale
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
of 10.
!|
C. The client's sanitary pad needs to be changed every hour.
!| !| !| !| !| !| !| !| !| !|
D. The client's temperature is 100.3 degrees F. - Correct answer ✔C. The
!| !| !| !| !| !| !| !| !| !| !| !| !|
client's sanitary pad needs to be changed every hour.
!| !| !| !| !| !| !| !|
9. Mrs. Cambay 47 year old is being admitted for elective surgery. The client
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
has a history of diabetes and hypertension. She uses alternative therapies to
!| !| !| !| !| !| !| !| !| !| !| !|
assist in keeping her diabetes and hypertension under control like taking
!| !| !| !| !| !| !| !| !| !| !|
black tea as an adjunct therapy. The Physician is requesting her to stop
!| !| !| !| !| !| !| !| !| !| !| !| !|
