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2024 PRE-OP INTRA-OP POST-OP CARE EXAM 1-9 WITH CORRECT ANSWERS
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2024 PRE-OP INTRA-OP POST-OP CARE EXAM 1-9 WITH CORRECT ANSWERS
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2024 PRE-OP INTRA-OP POST-OPCARE EXAM 1-9 WITH CORRECT
ANSWERS
A patient who is just waking up after having hip replacement surgery is
agitated and confused. Which action should the nurse take first?
a. Administer the prescribed opioid.
b. Check the oxygen (O2) saturation.
c. Take the blood pressure and pulse.
d. Apply wrist restraints to secure IV lines. - CORRECT-ANSWERSANS: B
Emergence delirium may be caused by a variety of factors. However, the
nurse should first assess for hypoxemia. The other actions also may be
appropriate, but are not the best initial action.
Monitored anesthesia care (MAC) is going to be used for a closed, manual
reduction of a dislocated shoulder. What action does the nurse anticipate?
a. Starting an IV in the patient's unaffected arm
b. Securing an airtight fit for the inhalation mask
c. Preparing for placement of an epidural catheter
d. Giving deep sedation under physician supervision. - CORRECT-
ANSWERSANS: AFor MAC, IV sedatives, such as the benzodiazepines, are
given. Therefore the patient needs IV access. Inhaled and epidural agents
are not included in MAC. RNs who are trained and are allowed by agency
protocols and state nurse practice acts can provide moderate to deep
sedation. However, the provider of MAC must be an anesthesia care
provider, since it may be necessary to change to general anesthesia during
the procedure.
Which action will the perioperative nurse take after surgery is completed for
a patient who received ketamine as an anesthetic agent?
a. Question the order for giving a benzodiazepine.
b. Ensure that atropine is available in case of bradycardia
.c. Provide a quiet environment in the postanesthesia care unit.
d. Anticipate the need for higher than usual doses of analgesic agents. -
CORRECT-ANSWERSANS: CHallucinations are an adverse effect associated
with the dissociative anesthetics such as ketamine. Therefore the
postoperative environment should be kept quiet to decrease the risk of
hallucinations. Because ketamine causes profound analgesia lasting into the
,postoperative period, higher doses of analgesics are not needed. Ketamine
causes an increase in heart rate. Benzodiazepine may be used with ketamine
to decrease the incidence of hallucinations and nightmares.
Which intraoperative nursing responsibilities should be performed by the
scrub nurse (select all that apply)?
a. Documenting intraoperative care
b. Keeping track of irrigation solutions for monitoring of blood loss
c. Passing instruments and supplies to the surgeon by anticipating his or her
needs
d. Coordinating the flow and activities of members of the surgical team in the
surgical suite
e. Performing the count of sponges, needles, and instruments used during
the surgical procedure - CORRECT-ANSWERSB,C,E
Both the scrub nurse and circulating nurse will participate in the counting of
surgical sponges, needles, and instruments, whereas passing instruments to
the surgeon and other sterile activities are the exclusive responsibility of the
scrub nurse. The circulating nurse takes primary responsibility for the
coordination of the surgical suite and documentation.
A patient with a dislocated shoulder is prepared for a closed, manual
reduction of the dislocation with monitored anesthesia care (MAC). The nurse
anticipates the administration of
a.IV midazolam (Versed).
b.inhaled desflurane (Suprane)
c.epidural lidocaine (Xylocaine)
.d.eutectic mixture of local anesthetics (EMLA). - CORRECT-ANSWERSANS:
AIV sedatives such as the benzodiazipines are administered for MAC. Inhaled,
epidural, and topical agents are not included in MAC.
An intraoperative nurse is applying interventions that will address surgical
patients risks for perioperative positioning injury. Which of the following
factors contribute to this increased risk for injury in the intraoperative phase
of the surgical experience? Select all that apply.
A) Absence of reflexes
B) Diminished ability to communicate
C) Loss of pain sensation
D) Nausea resulting from anesthetic
E) Reduced blood pressure - CORRECT-ANSWERSA, B, C
Feedback:
Loss of pain sense, reflexes, and ability to communicate subjects the
intraoperative patient to possible injury. Nausea and low blood pressure are
not central factors that contribute to this risk, though they are adverse
outcomes.
,A nurse is reviewing the medical record of a patient who is to receive general
anesthesia and notes a nursing diagnosis of anxiety related to surgical
concerns. The nurse implements measures to reduce the patient's anxiety
based on the understanding of which of the following?
a) The patient is at risk for additional complications.
b) The anesthetic will result in a more potent effect on the patient.
c) Increased anxiety can increase the patient's postoperative pain level.
d) Anxiety interferes with progression through the stages of general
anesthesia. - CORRECT-ANSWERSc) Increased anxiety can increase the
patient's postoperative pain level.
Explanation:
Anxiety increases the amount of anesthetic medication needed, the level of
postoperative pain, and overall recovery time. Anxiety may place the patient
at risk for complications, but other factors are usually also involved. When a
patient is anxious, induction is slower and greater quantities of anesthetic
agents are required because the brain receives a smaller quantity of
anesthetic agent. Anxiety is unrelated to the patient's progression through
the stages of general anesthesia. Additionally, when opioid agents and
neuromuscular blockers are administered as part of general anesthesia,
several of the stages are absent.
Which of the following should be the PACU Nurse's immediate priorities
postoperatively? (Select all that apply.)
A. ABCs
B. Monitor for bleeding
C. Maslow's Hierarchy of Needs
D. Pain
E. VS/Temp - CORRECT-ANSWERSA, B, D, E
The anesthesiologist administered a transsacral conduction block. Which of
the following documentation by the nurse is consistent with the anesthesia
being administered?
a) Unresponsive to verbal or tactile stimuli
b) Yelling and pulling at equipment
c) No movement in right lower leg
d) Denies sensation to perineum and lower abdomen - CORRECT-ANSWERSd)
Denies sensation to perineum and lower abdomen
Explanation:
A transsacral block produces anesthesia of the perineum, and occasionally,
the lower abdomen. Yelling and pulling at equipment can be related to the
excitement phase of general anesthesia. Unresponsive to verbal or tactile
stimuli and no movement in the right lower leg are not consistent with a
transsacral conduction block.
, A patient is undergoing a perineal surgical procedure. Which of the following
actions by the nurse is appropriate?
a) Place the patient in lithotomy position.
b) Place the patient in the Trendelenburg position.
c) Place the patient in a dorsal recumbent position.
d) Place the patient in Sims' position. - CORRECT-ANSWERSa
A nurse is working as a registered nurse first assistant as defined by the
state's nurse practice act. This nurse practices under the direct supervision
of which surgical team member?
a) Surgeon
b) Scrub nurse
c) Circulating nurse
d) Anesthetist - CORRECT-ANSWERSa
A patient is to receive general anesthesia with sevoflurane. The nurse
anticipates the need for which of the following?
a) Alfentanil
b) Lidocaine
c) Oxygen
d) Rocuronium - CORRECT-ANSWERSc) Oxygen
Explanation:
Sevoflurane is an inhalation anesthetic always combined with oxygen. It
would not be combined with alfentanil, rocuronium, or lidocaine. Alfentanil
and rocuronium are intravenous anesthetics. Lidocaine is a local anesthetic.
Which of the following is the most common cause of anaphylaxis?
a) Latex
b) Medications
c) Plastic
d) Fibrin sealants - CORRECT-ANSWERSb) Medications
Explanation:
Because medications are the most common cause of anaphylaxis,
intraoperative nurses must be aware of the type and method of anesthesia
used as well as the specific agents. Latex, fibrin sealants, and plastic are not
the most common cause of anaphylaxis.
A patient has been administered ketamine (Ketalar) for moderate sedation.
What is the priority nursing intervention?
a) Administering oxygen
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