Perioperative Nursing (Test Bank)
ANS: A
A life-threatening, rare hassle of anesthesia is malignant hyperthermia. Malignant hyperthermia
causes hypercarbia, tachycardia, tachypnea, premature ventricular contractions, volatile blood
stress, cyanosis, pores and skin mottling, and muscular tension. It frequently takes place at
some point of anesthesia induction. Hypoxia would occur with decreased oxygen saturation as
one in every of its symptoms and symptoms. Fluid imbalance might be assessed with
consumption and output and might manifest with tachycardia and blood strain fluctuations
however does no longer have muscle pressure. Hemorrhage can occur with tachycardia and
decreased blood stress, along with a thready pulse. Usually some signal or symptom of blood
loss is referred to (e.G., drains, incision, orifice, and stomach). - ANS-32. The nurse is being
concerned for a patient in the operating suite who's experiencing hypercarbia, tachypnea,
tachycardia, untimely ventricular contractions, and muscle rigidity. Which condition does the
nurse suspect the affected person is experiencing?
A. Malignant hyperthermia
b. Fluid imbalance
c. Hemorrhage
d. Hypoxia
ANS: A
A number one cognizance of intraoperative care is to save you harm and headaches related to
anesthesia, surgical operation, positioning, and device use, such as use of the electrical cautery
grounding pad for the prevention of burns. The perioperative nurse is an propose for the patient
at some stage in surgery and protects the patient's dignity and rights always. Signs and
symptoms of infection do now not have the time to give at some point of the intraoperative
section. During the intraoperative section, the affected person is anesthetized and subconscious
and usually has an endotracheal tube that stops conversation. Nausea, vomiting, and pain
commonly begin in the postoperative section of the enjoy. - ANS-29. The nurse is caring for a
patient within the working suite. Which outcome could be maximum appropriate for this patient
on the give up of the intraoperative section?
A. The patient may be freed from burns on the grounding pad.
B. The affected person can be freed from nausea and vomiting.
C. The patient may be freed from contamination.
D. The affected person can be freed from ache.
ANS: A
Depending at the surgical operation, a few sufferers do not regain voluntary control over urinary
function for six to 8 hours after anesthesia. Palpate the lower stomach just above the symphysis
,pubis for bladder distention. Another option is to apply a bladder test or ultrasound to assess
bladder volume. The nurse must determine earlier than finding out if the patient can strive again.
Not everybody feels as though they want to head however cannot after surgical operation.
Calling the fitness care issuer is not the preliminary excellent action. The nurse needs to have
information before calling the issuer. - ANS-35. The nurse is being concerned for a patient
inside the postanesthesia care unit. The affected person asks for a bedpan and states to the
nurse, "I feel like I need to go to the bathroom, but I cannot." Which nursing intervention can be
most suitable initially?
A. Assess the affected person for bladder distention.
B. Encourage the patient to wait a minute and strive once more.
C. Inform the affected person that everybody feels this manner after surgery.
D. Call the health care issuer to gain an order for catheterization.
ANS: A
For patients who've had eye, intracranial, or spinal surgical procedure, coughing can be
contraindicated because of the capacity growth in intraocular or intracranial strain. The nurse
will need to look this affected person first to manipulate the cough and intraocular strain. All the
rest are everyday postoperative patients. Leg exercise have to no longer be accomplished at
the operative leg with vascular surgical treatment. A patient after knee surgical operation must
receive heparin and be sporting intermittent pneumatic compression gadgets; whilst the nurse
will take a look at on the patient, it does no longer should be first. Monitoring important signs
and symptoms after surgical treatment is required and this is the standard time table. - ANS-38.
The nurse is caring for a group of patients. Which affected person will the nurse see first?
A. A affected person who had cataract surgery is coughing.
B. A patient who had vascular restore of the right leg isn't doing proper leg physical activities.
C. A patient after knee surgical treatment is carrying intermittent pneumatic compression
devices and receiving heparin.
D. A affected person after surgical treatment has crucial symptoms taken every 15 mins twice,
each 30 minutes twice, hourly for 2 hours then every 4 hours.
ANS: A
Induction of local anesthesia outcomes in loss of sensation in an area of the body—in this case,
the left leg. The peripheral nerve block affects the portions of sensory pathways that are
anesthetized in the targeted vicinity of the frame. Decreased pulse, ft cool to touch, and
cyanosis are warning signs of decreased blood go with the flow and are not expected findings.
Reports of pain in the left foot might also suggest that the block isn't working or is subsiding and
isn't an predicted finding within the immediately postoperative period. - ANS-6. The nurse is
being concerned for a patient inside the submit-anesthesia care unit who has gone through a
left general knee arthroplasty. The anesthesia company has indicated that the affected person
received a left femoral peripheral nerve block. Which evaluation will be an anticipated finding for
this affected person?
, A. Sensation reduced inside the left leg
b. Patient document of ache within the left foot
c. Pulse decreased at the left posterior tibia
d. Left toes cool to the touch and slightly cyanotic
ANS: A
Medications which includes warfarin or aspirin alter normal clotting elements and as a result
growth the chance of hemorrhaging. Discontinue as a minimum 48 hours earlier than surgical
operation. Acetaminophen is a pain reliever that has no special implications for surgery. Vitamin
C truely assists in wound recovery and has no unique implications for surgery. Prednisone is a
corticosteroid, and dosages are regularly temporarily increased as opposed to held. - ANS-8.
The nurse is finishing a remedy records for the surgical patient in preadmission trying out.
Which medication ought to the nurse train the patient to hold (stop) in education for surgical
operation consistent with protocol?
A. Warfarin
b. Vitamin C
c. Prednisone
d. Acetaminophen
ANS: A
One of the best worries after wellknown anesthesia is airway obstruction, particularly in sufferers
with obstructive sleep apnea. A drop in oxygen saturation by pulse oximetry is an indication of
airway obstruction in sufferers with obstructive sleep apnea. Weak pharyngeal/laryngeal muscle
tone from anesthetics; secretions within the pharynx, bronchial tree, or trachea; and laryngeal or
subglottic edema additionally make a contribution to airway obstruction. In the postanesthetic
affected person, the tongue is a chief cause of airway obstruction. Shallow respirations are
indicative of respiration melancholy. Moaning and reviews of pain are not unusual in all surgical
patients and are an predicted occasion. Disorientation is common whilst first awakening from
anesthesia however may be a signal of hypoxia. - ANS-31. The nurse is assessing a
postoperative patient with a history of obstructive sleep apnea for airway obstruction. Which
assessment locating will great alert the nurse to this hardship?
A. Drop in pulse oximetry readings
b. Moaning with reviews of ache
c. Shallow respirations
d. Disorientation
ANS: A
Patients normally obtain a regular weight loss program the primary nighttime after surgical
treatment except they have got undergone surgery on GI systems. Implement food regimen
consumption whilst judging the patient's response. For example, provide clean drinks including
water, apple juice, broth, or tea after nausea subsides. If the patient tolerates beverages with
out nausea, boost the weight loss program as ordered. There is no want to stay on ice chips for
ANS: A
A life-threatening, rare hassle of anesthesia is malignant hyperthermia. Malignant hyperthermia
causes hypercarbia, tachycardia, tachypnea, premature ventricular contractions, volatile blood
stress, cyanosis, pores and skin mottling, and muscular tension. It frequently takes place at
some point of anesthesia induction. Hypoxia would occur with decreased oxygen saturation as
one in every of its symptoms and symptoms. Fluid imbalance might be assessed with
consumption and output and might manifest with tachycardia and blood strain fluctuations
however does no longer have muscle pressure. Hemorrhage can occur with tachycardia and
decreased blood stress, along with a thready pulse. Usually some signal or symptom of blood
loss is referred to (e.G., drains, incision, orifice, and stomach). - ANS-32. The nurse is being
concerned for a patient in the operating suite who's experiencing hypercarbia, tachypnea,
tachycardia, untimely ventricular contractions, and muscle rigidity. Which condition does the
nurse suspect the affected person is experiencing?
A. Malignant hyperthermia
b. Fluid imbalance
c. Hemorrhage
d. Hypoxia
ANS: A
A number one cognizance of intraoperative care is to save you harm and headaches related to
anesthesia, surgical operation, positioning, and device use, such as use of the electrical cautery
grounding pad for the prevention of burns. The perioperative nurse is an propose for the patient
at some stage in surgery and protects the patient's dignity and rights always. Signs and
symptoms of infection do now not have the time to give at some point of the intraoperative
section. During the intraoperative section, the affected person is anesthetized and subconscious
and usually has an endotracheal tube that stops conversation. Nausea, vomiting, and pain
commonly begin in the postoperative section of the enjoy. - ANS-29. The nurse is caring for a
patient within the working suite. Which outcome could be maximum appropriate for this patient
on the give up of the intraoperative section?
A. The patient may be freed from burns on the grounding pad.
B. The affected person can be freed from nausea and vomiting.
C. The patient may be freed from contamination.
D. The affected person can be freed from ache.
ANS: A
Depending at the surgical operation, a few sufferers do not regain voluntary control over urinary
function for six to 8 hours after anesthesia. Palpate the lower stomach just above the symphysis
,pubis for bladder distention. Another option is to apply a bladder test or ultrasound to assess
bladder volume. The nurse must determine earlier than finding out if the patient can strive again.
Not everybody feels as though they want to head however cannot after surgical operation.
Calling the fitness care issuer is not the preliminary excellent action. The nurse needs to have
information before calling the issuer. - ANS-35. The nurse is being concerned for a patient
inside the postanesthesia care unit. The affected person asks for a bedpan and states to the
nurse, "I feel like I need to go to the bathroom, but I cannot." Which nursing intervention can be
most suitable initially?
A. Assess the affected person for bladder distention.
B. Encourage the patient to wait a minute and strive once more.
C. Inform the affected person that everybody feels this manner after surgery.
D. Call the health care issuer to gain an order for catheterization.
ANS: A
For patients who've had eye, intracranial, or spinal surgical procedure, coughing can be
contraindicated because of the capacity growth in intraocular or intracranial strain. The nurse
will need to look this affected person first to manipulate the cough and intraocular strain. All the
rest are everyday postoperative patients. Leg exercise have to no longer be accomplished at
the operative leg with vascular surgical treatment. A patient after knee surgical operation must
receive heparin and be sporting intermittent pneumatic compression gadgets; whilst the nurse
will take a look at on the patient, it does no longer should be first. Monitoring important signs
and symptoms after surgical treatment is required and this is the standard time table. - ANS-38.
The nurse is caring for a group of patients. Which affected person will the nurse see first?
A. A affected person who had cataract surgery is coughing.
B. A patient who had vascular restore of the right leg isn't doing proper leg physical activities.
C. A patient after knee surgical treatment is carrying intermittent pneumatic compression
devices and receiving heparin.
D. A affected person after surgical treatment has crucial symptoms taken every 15 mins twice,
each 30 minutes twice, hourly for 2 hours then every 4 hours.
ANS: A
Induction of local anesthesia outcomes in loss of sensation in an area of the body—in this case,
the left leg. The peripheral nerve block affects the portions of sensory pathways that are
anesthetized in the targeted vicinity of the frame. Decreased pulse, ft cool to touch, and
cyanosis are warning signs of decreased blood go with the flow and are not expected findings.
Reports of pain in the left foot might also suggest that the block isn't working or is subsiding and
isn't an predicted finding within the immediately postoperative period. - ANS-6. The nurse is
being concerned for a patient inside the submit-anesthesia care unit who has gone through a
left general knee arthroplasty. The anesthesia company has indicated that the affected person
received a left femoral peripheral nerve block. Which evaluation will be an anticipated finding for
this affected person?
, A. Sensation reduced inside the left leg
b. Patient document of ache within the left foot
c. Pulse decreased at the left posterior tibia
d. Left toes cool to the touch and slightly cyanotic
ANS: A
Medications which includes warfarin or aspirin alter normal clotting elements and as a result
growth the chance of hemorrhaging. Discontinue as a minimum 48 hours earlier than surgical
operation. Acetaminophen is a pain reliever that has no special implications for surgery. Vitamin
C truely assists in wound recovery and has no unique implications for surgery. Prednisone is a
corticosteroid, and dosages are regularly temporarily increased as opposed to held. - ANS-8.
The nurse is finishing a remedy records for the surgical patient in preadmission trying out.
Which medication ought to the nurse train the patient to hold (stop) in education for surgical
operation consistent with protocol?
A. Warfarin
b. Vitamin C
c. Prednisone
d. Acetaminophen
ANS: A
One of the best worries after wellknown anesthesia is airway obstruction, particularly in sufferers
with obstructive sleep apnea. A drop in oxygen saturation by pulse oximetry is an indication of
airway obstruction in sufferers with obstructive sleep apnea. Weak pharyngeal/laryngeal muscle
tone from anesthetics; secretions within the pharynx, bronchial tree, or trachea; and laryngeal or
subglottic edema additionally make a contribution to airway obstruction. In the postanesthetic
affected person, the tongue is a chief cause of airway obstruction. Shallow respirations are
indicative of respiration melancholy. Moaning and reviews of pain are not unusual in all surgical
patients and are an predicted occasion. Disorientation is common whilst first awakening from
anesthesia however may be a signal of hypoxia. - ANS-31. The nurse is assessing a
postoperative patient with a history of obstructive sleep apnea for airway obstruction. Which
assessment locating will great alert the nurse to this hardship?
A. Drop in pulse oximetry readings
b. Moaning with reviews of ache
c. Shallow respirations
d. Disorientation
ANS: A
Patients normally obtain a regular weight loss program the primary nighttime after surgical
treatment except they have got undergone surgery on GI systems. Implement food regimen
consumption whilst judging the patient's response. For example, provide clean drinks including
water, apple juice, broth, or tea after nausea subsides. If the patient tolerates beverages with
out nausea, boost the weight loss program as ordered. There is no want to stay on ice chips for
