VERSIONS} 2024
2. The 6ynurse 6yis 6ycompleting 6ya 6ymedication 6yhistory 6yfor 6ythe 6ysurgical
6ypatient 6yin 6ypreadmission 6ytesting. 6yWhich 6ymedication 6yshould 6ythe
6ynurse 6yinstruct 6ythe
patient 6yto 6yhold 6y(discontinue) 6yin 6ypreparation 6yfor 6ysurgery 6yaccording 6yto
6yprotocol?
a. Warfarin
b. Vitamin 6yC
c. Prednisone
d. Acetaminophen
ANS: 6yA
Medications 6ysuch 6yas 6ywarfarin 6yor 6yaspirin 6yalter 6ynormal 6yclotting 6yfactors
6yand 6ythus 6yincrease 6ythe 6yrisk 6yof 6yhemorrhaging. 6yDiscontinue 6yat 6yleast 6y48
6yhours 6ybefore 6ysurgery. 6yAcetaminophen 6yis 6ya 6ypain 6yreliever 6ythat 6yhas 6yno
6yspecial 6yimplications 6yfor 6ysurgery. 6yVitamin 6yC 6yactually 6yassists 6yin 6ywound
6yhealing 6yand 6yhas 6yno 6yspecial 6yimplications 6yfor 6ysurgery. 6yPrednisone 6yis 6ya
6ycorticosteroid, 6yand 6ydosages 6yare 6yoften 6ytemporarily 6yincreased 6yrather
6ythan 6yheld.
3. The 6ynurse 6yis 6yprescreening 6ya 6ysurgical 6ypatient 6yin 6ythe 6ypreadmission
6ytesting 6yunit. 6yThe 6ymedication 6yhistory 6yindicates 6ythat 6ythe 6ypatient 6yis
currently 6ytaking 6yan 6yanticoagulant. 6yWhich 6yaction 6yshould 6ythe 6ynurse 6ytake
6ywhen 6yconsulting 6ywith 6ythe 6yhealth 6ycare 6yprovider?
a. Ask 6yfor 6ya 6yradiological 6yexamination 6yof 6ythe 6ychest.
b. Ask 6yfor 6yan 6yinternational 6ynormalized 6yratio 6y(INR).
c. Ask 6yfor 6ya 6yblood 6yurea 6ynitrogen 6y(BUN).
, d. Ask 6yfor 6ya 6yserum 6ysodium 6y(Na).
ANS: 6yB
INR, 6yPT 6y(prothrombin 6ytime), 6yAPTT 6y(activated 6ypartial 6ythromboplastin 6ytime),
6yand 6yplatelet 6ycounts 6yreveal 6ythe 6yclotting 6yability 6yof 6ythe 6yblood.
6yAnticoagulants 6ycan 6ybe 6yutilized 6yfor 6ydifferent 6yconditions, 6ybut 6yits 6yaction
6yis 6yto 6yincrease 6ythe 6ytime 6yit 6ytakes 6yfor 6ythe 6yblood 6yto 6yclot. 6yThis 6yaction 6ycan
6yput 6ythe 6ysurgical 6ypatient 6yat 6yrisk 6yfor 6ybleeding 6ytendencies.
Typically, 6yif 6yat 6yall 6ypossible, 6ythis 6ymedication 6yis 6yheld 6yseveral 6ydays
6ybefore 6ya 6ysurgical 6yprocedure 6yto 6ydecrease 6ythis 6yrisk. 6yChest 6yx-ray, 6yBUN,
6yand 6yNa 6yare 6ydiagnostic 6yscreening 6ytools 6yfor 6ysurgery 6ybut 6yare 6ynot 6yspecific
6yto 6yanticoagulants.
4. The 6ynurse 6yis 6ypreparing 6ya 6ypatient 6yfor 6ysurgery. 6yWhich 6ygoal 6yis 6ya
priority 6yfor 6yassessing 6ythe 6ypatient 6ybefore 6ysurgery?
a. Plan 6yfor 6ycare 6yafter 6ythe 6yprocedure.
b. Establish 6ya 6ypatient’s 6ybaseline 6yof 6ynormal 6yfunction.
c. Educate 6ythe 6ypatient 6yand 6yfamily 6yabout 6ythe 6yprocedure.
d. Gather 6yappropriate 6yequipment 6yfor 6ythe 6ypatient’s 6yneeds.
ANS: 6yB
The 6ygoal 6yof 6ythe 6ypreoperative 6yassessment 6yis 6yto 6yidentify 6ya 6ypatient’s
6ynormal 6ypreoperative 6yfunction 6yand 6ythe 6ypresence 6yof 6yany 6yrisks 6yto
6yrecognize, 6yprevent, 6yand 6yminimize 6ypossible 6ypostoperative 6ycomplications.
6yGathering 6yappropriate 6yequipment, 6yplanning 6ycare, 6yand 6yeducating 6ythe
6ypatient 6yand 6yfamily 6yare 6yall 6yimportant 6yinterventions 6ythat 6ymust 6ybe
6yprovided 6yfor 6ythe 6ysurgical 6ypatient; 6ythey 6yare 6ypart 6yof 6ythe 6ynursing 6yprocess
6ybut 6yare 6ynot 6ythe 6ypriority 6yreason/goal 6yfor 6ycompleting 6yan 6yassessment 6yof
6ythe 6ysurgical 6ypatient.
,5. The 6ynurse 6yis 6yencouraging 6ythe 6ypostoperative 6ypatient 6yto
6yutilize 6ydiaphragmatic
breathing. 6yWhich 6ypriority 6ygoal 6yis 6ythe 6ynurse 6ytrying 6yto 6yachieve?
a. Manage 6ypain
b. Prevent 6yatelectasis
c. Reduce 6yhealing 6ytime
d. Decrease 6ythrombus 6yformation
ANS: 6yB
After 6ysurgery, 6ypatients 6ymay 6yhave 6yreduced 6ylung 6yvolume 6yand 6ymay
6yrequire 6ygreater 6yeffort 6yto 6ycough 6yand 6ydeep 6ybreathe; 6yinadequate 6ylung
6yexpansion 6ycan 6ylead 6yto 6yatelectasis 6yand 6ypneumonia. 6yPurposely 6yutilizing
6ydiaphragmatic 6ybreathing 6ycan 6ydecrease 6ythis 6yrisk. 6yDuring 6ygeneral
6yanesthesia, 6ythe 6ylungs 6yare 6ynot 6yfully 6yinflated 6yduring 6ysurgery 6yand 6ythe
6ycough 6yreflex 6yis 6ysuppressed, 6yso 6ymucus 6ycollects 6ywithin 6yairway
6ypassages. 6yDiaphragmatic 6ybreathing 6ydoes 6ynot 6ymanage 6ypain; 6yin 6ysome
6ycases, 6yif 6ysplinting 6yand 6ypain 6ymedications 6yare 6ynot 6ygiven, 6yit 6ycan 6ycause
6ypain. 6yDiaphragmatic 6ybreathing 6ydoes 6ynot 6yreduce 6yhealing 6ytime 6yor
6ydecrease 6ythrombus 6yformation. 6yBetter, 6ymore 6yeffective 6yinterventions
6yare 6yavailable 6yfor 6ythese 6ysituations.
6. The 6ynurse 6yis 6ycaring 6yfor 6ya 6ypostoperative 6ypatient 6yon 6ythe 6ymedical-surgical
floor. 6yWhich 6yactivity 6ywill 6ythe 6ynurse 6yencourage 6yto 6yprevent 6yvenous 6ystasis
6yand 6ythe 6yformation 6yof 6ythrombus?
a. Diaphragmatic 6ybreathing
b. Incentive 6yspirometry
c. Leg 6yexercises
d. Coughing
, ANS: 6 y C
After 6 y general 6 y anesthesia, 6 y circulation 6 y slows, 6 y and 6 y when
6 y the 6 y rate 6 y of 6 y blo 6yod 6 y slows, 6 y a 6 y greater 6 y tendency 6 y for 6 y clot
6 y formation 6 y is 6 y noted. 6 y Immobilizati 6 y on 6 y results 6 y in 6 y decreased
6 y muscular 6 y contractions 6 y in 6 y the 6 y lower 6 y extremitie 6ys; 6 y these
promote 6 y venous 6 y stasis. 6 y Coughing, 6 y diaphragmatic 6 y breathing, 6 y and
6 y incenti 6yve 6 y spirometry 6 y are 6 y utilized 6 y to 6 y decrease
6 y atelectasis 6 y and 6 y pneumonia.
7. The 6 y nurse 6 y is 6 y caring 6 y for 6 y a 6 y preoperative 6 y patient.
6 y The 6 y nurse 6 y teac 6yhes 6 y the 6 y principles 6 y and 6 y demonstrates
6 y leg 6 y exercises 6 y for 6 y the 6 y patient.
The 6 y patient 6 y is
unable 6 y to 6 y perform 6 y leg 6 y exercises 6 y correctly. 6 y What 6 y is 6 y the
6 y nurse’s 6 y best 6 y next
step?
a. Encourage 6 y the 6 y patient 6 y to 6 y practice 6 y at 6 y a 6 y later 6 y date.
b. Assess 6 y for 6 y the 6 y presence 6 y of 6 y anxiety, 6 y pain, 6 y or 6 y fatigue.
c. Ask 6 y the 6 y patient 6 y why 6 y exercises 6 y are 6 y not 6 y being 6 y done.
d. Evaluate 6 y the 6 y educational 6 y methods 6 y used 6 y to 6 y educate
6 y the 6 y pa 6ytient. 6 y ANS: 6 y B
If 6 y the 6 y patient 6 y is 6 y unable 6 y to 6 y perform 6 y leg 6 y exercises, 6 y the
6 y nurse 6 y should 6 y look 6yfor 6 y circumstances 6 y that 6 y may 6 y be
6 y impacting 6 y the 6 y patient’s 6 y ability 6 y to 6 y learn. 6yIn 6 y this 6 y case,
6 y the 6 y patient 6 y can 6 y be 6 y anticipating 6 y the 6 y upcoming 6 y surgery
6 y and 6ymay 6 y be experiencing 6 y anxiety. 6 y The 6 y patient 6 y may 6 y also
6 y be 6 y in 6 y pain 6 y or 6 y may 6ybe 6 y fatigued; 6 y both 6 y of 6 y these 6 y can
6 y affect 6 y the 6 y ability 6 y to 6 y learn. 6 y Evaluation 6 y of 6yeducational
6 y methods 6 y may 6 y be 6 y needed, 6 y but 6 y in 6 y this 6 y case, 6 y principles
6 y and 6ydemonstrations 6 y are 6 y being 6 y utilized. 6 y Asking 6 y anyone 6 y “why”
6 y can 6 y cause 6 y defe 6 y nsiveness 6 y and 6 y may 6 y not 6 y help 6 y in
6 y attaining 6 y the 6 y answer. 6 y The 6 y nurse 6 y is 6 y awar 6ye 6 y that 6 y the
6 y patient 6 y is 6 y unable 6 y to 6 y do 6 y the 6 y exercises. 6 y Moving 6 y forward
6 y with 6yout 6 y ascertaining 6 y that 6 y learning 6 y has 6 y occurred 6 y will
6 y not 6 y help 6 y the 6 y patient 6 y in 6ymeeting 6 y goals.