1
MEDSURG- 1
4. On the morning of Mrs. Sy’s planned
SAS #1 cholecystectomy, she awakens with a pain in
her right scapular area and thinks she slept in
poor position. While doing the pre-op check list
you note that on her routine CB report her WBC
is 15,000. Your responsibility at this point is:
1. As a nurse, what is the importance of a
thorough preoperative assessment? a. To notify the surgeon at once; this is an
elevated WBC indicating an inflammatory
a. To identify and correct problems before reaction
surgery and establish a baseline for
postoperative comparison b. To record this finding in a prominent place on
the pre-op checklist and in your pre-op notes
b. To save time doing an assessment after the
patient returns from surgery c. To call the laboratory for a STAT repeat WBC
c. To provide the doctor with information that d. None. This is not an unusual finding
may have been missed during the preadmission 5. Mrs. Sy is scheduled for surgery 2 days later
assessment and is to be given atropine 0.3 mg IM and
d. To ensure that postoperative complications Demerol 50 mg IM one hour preoperatively.
don’t occur Which nursing actions follow the giving of the
pre-op medication?
2. Before administering preoperative
medication to a client, nurse Jonalyn should a. Have her void soon after receiving the
plan to: medication
a. Verify the consent b. Allow her family to be with her before the
medication takes effect
b. Check the vital signs
c. Bring her valuables to the nursing station
c. Have the client void
d. Reinforce pre-op teaching
d. Remove the client’s dentures
6. A patient is admitted to the same day surgery
3. A client with Cataract is about to undergo unit for liver biopsy. Which of the following
surgery. Nurse Princess is preparing plan of laboratory tests assesses coagulation? SATA.
care. Which of the following nursing diagnosis is
most appropriate to address the long term need a. Partial thromboplastin time.
of this type of patient? b. Prothrombin time.
a. Anxiety related to the operation and its c. Platelet count.
outcome
d. Hemoglobin
b. Sensory perceptual alteration related to lens
extraction and replacement
c. Knowledge deficit related to the pre- 7. A client with a perforated gastric ulcer is
operative and post-operative self-care scheduled for emergency surgery. The client
d. Body Image disturbance related to the eye
packing after surgery
,2
cannot sign the operative consent form because 10. A nurse is reviewing the physician’s order
he has been sedated with opioid analgesics. The sheet for the preoperative client, which states
nurse should take which of the following that the client must be on nothing per mouth
actions in the care of this client? (NPO) status after midnight. The nurse would
clarify whether which of the following
a. Obtain a telephone consent from the family
medications should be given to the client and
member witnessed by two persons.
not withheld?
b. Obtain a court order for the surgery.
a. Conjugated estrogen (Premarin)
c. Send the client to surgery without the
b. Atenolol (Tenormin)
consent form being signed.
c. Cyclobenzaprine (Flexeril)
d. Have the hospital chaplain sign the informed
consent immediately d. Ferrous sulfate
8. A preoperative client expresses anxiety to the
nurse about the upcoming surgery. Which of
SAS #2
the following responses by
1. Nurse Jay is preparing to change a client’s
the nurse is most likely to stimulate further
dressing. The statement that best explains the
discussion between the client and the nurse?
basis of surgical asepsis that nurse will perform
a. “I will be happy to explain the entire surgical in this procedure is:
procedure to you.”
a. Keep the area free from microorganisms
b. “Let me tell you about the care you’ll receive
b. Protect self from microorganisms in the
after surgery and the amount of pain you can
wound
anticipate.”
c. Confine the microorganisms to the surgical
c. “If it’s any help, everyone is nervous before
site
surgery.”
d. Keep the number of opportunistic
d. “Can you share with me what you’ve been
microorganisms to a minimum
told about your surgery?”
2. Function of a circulating nurse is:
9. A nurse is preparing the client for transfer to
the operating room (OR). The nurse should take a. Assists the scrub nurse and surgeon
which of the following
b. Draping the client with sterile drapes
actions in the care of this client at this time?
c. Wear sterile gloves, gowns, caps
a. Administer all the daily medications.
d. Handling sterile instruments and supplies
b. Ensure that the client has voided.
3. Which among the following are not
c. Verify that the client has not eaten for the members of the sterile team in the operating
last 24 hours. room? Select that all apply:
d. Practice postoperative breathing exercises. 1. Surgeon
2. Anesthesiologist
,3
3. Radiation technician d. To prevent cardiac arrhythmias
4. Scrub nurse 7. What is the most important postoperative
instruction nurse Nikki must give to Mrs.
5. Circulating nurse
Serrano who has just returned from the
a. 1, 2, 3 operating room after receiving a subarachnoid
block?
b. 2, 3
a. "Avoid drinking liquids until the gag reflex
c. 2, 3, 5 returns."
d. 3, 4, 5 b. "Avoid eating milk products for 24 hours."
4. What is the responsibility of the nurse c. "Notify a nurse if you experience blood in
regarding informed consent? your urine."
a. To explain the surgical options d. "Remain supine for the time specified by the
b. To describe the operative procedure to be physician."
done 8. The common anesthesia used for
b. To explain the operative risks appendectomy is?
d. To witness a patient’s signature a. Spinal
5. Which of the following is the primary b. General
responsibility of the nurse before surgical c. Caudal
operation?
d. Hypnosis
a. Taking the vital signs
9. The client returns from surgery with a blood
b. Explaining the procedure pressure of 90/50, pulse 132, and respirations
c. Obtaining the permit 30. Which action by Nurse Jo should receive
priority?
d. Checking the lab works
a. Continue to monitor the vital signs
6. Mr. Alejandro is scheduled for a
prostatectomy and the anesthesiologist plans b. Contact the physician
to use a spinal (subarachnoid) block during c. Ask the client how he feels
surgery. In the operating room, the nurse
positions the client according to the d. Ask the nursing assistant to continue the
anesthesiologist's instructions. Why post-op care
does the client require special positioning for 10. An additive given to potentiate and
this type of anesthesia? prolong the effects of regional anesthesia is:
a. To prevent confusion a. Lidocaine
b. To prevent seizures b. Epinephrine
c. To prevent cerebrospinal fluid (CSF) leakage c. Digoxin
, 4
d. Lanoxin d. When the patient can be aroused and
recognizes where he or she is
5. What is included in the routine assessment
SAS #3
of the patient’s cardiovascular function on
1. What does progression of patients through admission to the PACU?
various phases of care in a post anesthesia
a. Monitoring arterial blood gases
care unit (PACU) primarily depend on?
b. Electrocardiographic (ECG) monitoring
a. Condition of patient
c. Determining fluid and electrolyte status
b. Type of anesthesia used
d. Direct arterial blood pressure monitoring
c. Preference of surgeon
6. With what are the postoperative respiratory
d. Type of surgical procedure
complications of atelectasis and aspiration of
2. Priority Decision: Upon admission of a gastric contents associated?
patient to the PACU, the nurse’s priority
a. Hypoxemia
assessment is
b. Hypercapnia
a. vital signs.
c. Hypoventilation
b. surgical site.
d. Airway obstruction
c. respiratory adequacy.
7. To prevent airway obstruction in the
d. level of consciousness
postoperative patient who is unconscious or
3. How is the initial information given to the semiconscious, what will the nurse do?
PACU nurses about the surgical patient?
a. Encourage deep breathing
a. A copy of the written operative report
b. Elevate the head of the bed
b. A verbal report from the circulating nurse
c. Administer oxygen per mask
c. A verbal report from the anesthesia care
d. Position the patient in a side-lying position
provider (ACP)
d. An explanation of the surgical procedure
from the surgeon
4. To prevent agitation during the patient’s 8. Priority Decision: To promote effective
recovery from anesthesia, when should the coughing, deep breathing, and ambulation in
nurse begin orientation explanations? the postoperative patient, what is most
important for the nurse to do?
a. When the patient is awake
a. Teach the patient-controlled breathing
b. When the patient first arrives in the PACU
b. Explain the rationale for these activities
c. When the patient becomes agitated or
frightened c. Provide adequate and regular pain
medication
MEDSURG- 1
4. On the morning of Mrs. Sy’s planned
SAS #1 cholecystectomy, she awakens with a pain in
her right scapular area and thinks she slept in
poor position. While doing the pre-op check list
you note that on her routine CB report her WBC
is 15,000. Your responsibility at this point is:
1. As a nurse, what is the importance of a
thorough preoperative assessment? a. To notify the surgeon at once; this is an
elevated WBC indicating an inflammatory
a. To identify and correct problems before reaction
surgery and establish a baseline for
postoperative comparison b. To record this finding in a prominent place on
the pre-op checklist and in your pre-op notes
b. To save time doing an assessment after the
patient returns from surgery c. To call the laboratory for a STAT repeat WBC
c. To provide the doctor with information that d. None. This is not an unusual finding
may have been missed during the preadmission 5. Mrs. Sy is scheduled for surgery 2 days later
assessment and is to be given atropine 0.3 mg IM and
d. To ensure that postoperative complications Demerol 50 mg IM one hour preoperatively.
don’t occur Which nursing actions follow the giving of the
pre-op medication?
2. Before administering preoperative
medication to a client, nurse Jonalyn should a. Have her void soon after receiving the
plan to: medication
a. Verify the consent b. Allow her family to be with her before the
medication takes effect
b. Check the vital signs
c. Bring her valuables to the nursing station
c. Have the client void
d. Reinforce pre-op teaching
d. Remove the client’s dentures
6. A patient is admitted to the same day surgery
3. A client with Cataract is about to undergo unit for liver biopsy. Which of the following
surgery. Nurse Princess is preparing plan of laboratory tests assesses coagulation? SATA.
care. Which of the following nursing diagnosis is
most appropriate to address the long term need a. Partial thromboplastin time.
of this type of patient? b. Prothrombin time.
a. Anxiety related to the operation and its c. Platelet count.
outcome
d. Hemoglobin
b. Sensory perceptual alteration related to lens
extraction and replacement
c. Knowledge deficit related to the pre- 7. A client with a perforated gastric ulcer is
operative and post-operative self-care scheduled for emergency surgery. The client
d. Body Image disturbance related to the eye
packing after surgery
,2
cannot sign the operative consent form because 10. A nurse is reviewing the physician’s order
he has been sedated with opioid analgesics. The sheet for the preoperative client, which states
nurse should take which of the following that the client must be on nothing per mouth
actions in the care of this client? (NPO) status after midnight. The nurse would
clarify whether which of the following
a. Obtain a telephone consent from the family
medications should be given to the client and
member witnessed by two persons.
not withheld?
b. Obtain a court order for the surgery.
a. Conjugated estrogen (Premarin)
c. Send the client to surgery without the
b. Atenolol (Tenormin)
consent form being signed.
c. Cyclobenzaprine (Flexeril)
d. Have the hospital chaplain sign the informed
consent immediately d. Ferrous sulfate
8. A preoperative client expresses anxiety to the
nurse about the upcoming surgery. Which of
SAS #2
the following responses by
1. Nurse Jay is preparing to change a client’s
the nurse is most likely to stimulate further
dressing. The statement that best explains the
discussion between the client and the nurse?
basis of surgical asepsis that nurse will perform
a. “I will be happy to explain the entire surgical in this procedure is:
procedure to you.”
a. Keep the area free from microorganisms
b. “Let me tell you about the care you’ll receive
b. Protect self from microorganisms in the
after surgery and the amount of pain you can
wound
anticipate.”
c. Confine the microorganisms to the surgical
c. “If it’s any help, everyone is nervous before
site
surgery.”
d. Keep the number of opportunistic
d. “Can you share with me what you’ve been
microorganisms to a minimum
told about your surgery?”
2. Function of a circulating nurse is:
9. A nurse is preparing the client for transfer to
the operating room (OR). The nurse should take a. Assists the scrub nurse and surgeon
which of the following
b. Draping the client with sterile drapes
actions in the care of this client at this time?
c. Wear sterile gloves, gowns, caps
a. Administer all the daily medications.
d. Handling sterile instruments and supplies
b. Ensure that the client has voided.
3. Which among the following are not
c. Verify that the client has not eaten for the members of the sterile team in the operating
last 24 hours. room? Select that all apply:
d. Practice postoperative breathing exercises. 1. Surgeon
2. Anesthesiologist
,3
3. Radiation technician d. To prevent cardiac arrhythmias
4. Scrub nurse 7. What is the most important postoperative
instruction nurse Nikki must give to Mrs.
5. Circulating nurse
Serrano who has just returned from the
a. 1, 2, 3 operating room after receiving a subarachnoid
block?
b. 2, 3
a. "Avoid drinking liquids until the gag reflex
c. 2, 3, 5 returns."
d. 3, 4, 5 b. "Avoid eating milk products for 24 hours."
4. What is the responsibility of the nurse c. "Notify a nurse if you experience blood in
regarding informed consent? your urine."
a. To explain the surgical options d. "Remain supine for the time specified by the
b. To describe the operative procedure to be physician."
done 8. The common anesthesia used for
b. To explain the operative risks appendectomy is?
d. To witness a patient’s signature a. Spinal
5. Which of the following is the primary b. General
responsibility of the nurse before surgical c. Caudal
operation?
d. Hypnosis
a. Taking the vital signs
9. The client returns from surgery with a blood
b. Explaining the procedure pressure of 90/50, pulse 132, and respirations
c. Obtaining the permit 30. Which action by Nurse Jo should receive
priority?
d. Checking the lab works
a. Continue to monitor the vital signs
6. Mr. Alejandro is scheduled for a
prostatectomy and the anesthesiologist plans b. Contact the physician
to use a spinal (subarachnoid) block during c. Ask the client how he feels
surgery. In the operating room, the nurse
positions the client according to the d. Ask the nursing assistant to continue the
anesthesiologist's instructions. Why post-op care
does the client require special positioning for 10. An additive given to potentiate and
this type of anesthesia? prolong the effects of regional anesthesia is:
a. To prevent confusion a. Lidocaine
b. To prevent seizures b. Epinephrine
c. To prevent cerebrospinal fluid (CSF) leakage c. Digoxin
, 4
d. Lanoxin d. When the patient can be aroused and
recognizes where he or she is
5. What is included in the routine assessment
SAS #3
of the patient’s cardiovascular function on
1. What does progression of patients through admission to the PACU?
various phases of care in a post anesthesia
a. Monitoring arterial blood gases
care unit (PACU) primarily depend on?
b. Electrocardiographic (ECG) monitoring
a. Condition of patient
c. Determining fluid and electrolyte status
b. Type of anesthesia used
d. Direct arterial blood pressure monitoring
c. Preference of surgeon
6. With what are the postoperative respiratory
d. Type of surgical procedure
complications of atelectasis and aspiration of
2. Priority Decision: Upon admission of a gastric contents associated?
patient to the PACU, the nurse’s priority
a. Hypoxemia
assessment is
b. Hypercapnia
a. vital signs.
c. Hypoventilation
b. surgical site.
d. Airway obstruction
c. respiratory adequacy.
7. To prevent airway obstruction in the
d. level of consciousness
postoperative patient who is unconscious or
3. How is the initial information given to the semiconscious, what will the nurse do?
PACU nurses about the surgical patient?
a. Encourage deep breathing
a. A copy of the written operative report
b. Elevate the head of the bed
b. A verbal report from the circulating nurse
c. Administer oxygen per mask
c. A verbal report from the anesthesia care
d. Position the patient in a side-lying position
provider (ACP)
d. An explanation of the surgical procedure
from the surgeon
4. To prevent agitation during the patient’s 8. Priority Decision: To promote effective
recovery from anesthesia, when should the coughing, deep breathing, and ambulation in
nurse begin orientation explanations? the postoperative patient, what is most
important for the nurse to do?
a. When the patient is awake
a. Teach the patient-controlled breathing
b. When the patient first arrives in the PACU
b. Explain the rationale for these activities
c. When the patient becomes agitated or
frightened c. Provide adequate and regular pain
medication
