Complete Test Bank With Answers
Sample Questions Posted Below
| 1. |
You are doing a preoperative assessment on a patient going to surgery. The patient informs you that he drinks six to eight beers each day and has for the last 15 years. What postoperative difficulties can the nurse anticipate for this patient? |
| A) |
Delirium tremens immediately following surgery |
| B) |
Delirium tremens within 72 hours after his last alcohol drink |
| C) |
Delirium tremens upon administration of general anesthesia |
| D) |
Delirium tremens 1 week after his last alcohol drink |
| 2. |
The nurse is preparing a patient for surgery. The patient is to undergo a hysterectomy without oophorectomy, and the nurse is witnessing the patient’s signature on a consent form. Which comment by the patient would best indicate informed consent? |
| A) |
“I know I’ll be fine because the health care provider said he has done this procedure hundreds of times.” |
| B) |
“I know I’ll have pain after the surgery.” |
| C) |
“The health care provider is going to remove my uterus and told me about the risk of hemorrhage.” |
| D) |
“Because the health care provider isn’t taking my ovaries, I’ll still be able to have children.” |
| 3. |
You are admitting an insulin-dependent patient to the same-day surgical suite for carpal tunnel surgery. You know that this patient may be at risk for which metabolic disorder? |
| A) |
Adrenal insufficiency |
| B) |
Thyrotoxicosis |
| C) |
Impaired acid base balance |
| D) |
Hyperglycemia |
| 4. |
How should a nurse teach a patient to perform deep breathing and coughing to use postoperatively? |
| A) |
The patient should take three deep breaths and cough hard three times. |
| B) |
The patient should take three deep breaths and exhale forcefully, take a quick short breath and cough from deep in the lungs. |
| C) |
The patient should take a deep breath in through the mouth and exhale all the air out through the mouth, take a short breath, and cough from deep in the lungs. |
| D) |
The patient should rapidly inhale, hold for 30 seconds, and exhale slowly. |
| 5. |
As an OR nurse, you have an increased awareness regarding asepsis. You know that a basic guideline for maintaining surgical asepsis is that: |
| A) |
Sterile surfaces or articles may touch other sterile surfaces |
| B) |
Sterile supplies can be used on another patient if the packages are intact |
| C) |
The outer lip of a sterile solution is considered sterile |
| D) |
The scrub nurse may pour a sterile solution from a nonsterile bottle |
| 6. |
You are the circulating nurse in an outpatient surgery center. Your patient is scheduled to receive moderate sedation. You know that a patient receiving this form of anesthesia should: |
| A) |
Never be left unattended by the nurse |
| B) |
Receive an antiemetic |
| C) |
Remember most of the procedure |
| D) |
Be able to maintain his or her own airway |
| 7. |
A nurse is caring for a patient following surgery under a spinal anesthetic. What interventions can the nurse implement to prevent a spinal headache? |
| A) |
Have the patient sit in a chair. |
| B) |
Ambulate the patient. |
| C) |
Limit fluids. |
| D) |
Keep the patient lying flat. |
| 8. |
You are the recovery room nurse who is admitting a patient from the OR. What is the first assessment you would make on a newly admitted patient? |
| A) |
Heart rate |
| B) |
Capillary refill |
| C) |
Core temperature |
| D) |
Patency of the airway |
| 9. |
Your patient is a 78-year-old man who has had outpatient surgery. You are getting him up for his first walk postoperatively. To decrease the potential for orthostatic hypotension, what should you plan to have the patient do? |
| A) |
Sit in a chair for 10 minutes prior to ambulating. |
| B) |
Encourage the patient to drink plenty of fluids to increase circulating blood volume. |
| C) |
Stand upright for 2 to 3 minutes prior to ambulating. |
| D) |
Sit upright on the side of the bed for 15 minutes prior to ambulating. |
| 10. |
You are caring for a 79-year-old man who has returned to the Medical-Surgical unit following abdominal surgery. Your patient is unable to ambulate and is now refusing to wear an external pneumatic compression stocking. You explain that refusing to wear external pneumatic compression stockings places him at significant risk for what? |
| A) |
Sepsis |
| B) |
Infection |
| C) |
Pulmonary embolism |
| D) |
Hematoma |
| 11. |
A nurse who has provided care in perioperative settings for many years has seen first-hand the trend toward increasing numbers of surgical procedures being performed in ambulatory surgical centers and on an outpatient basis. What factors have contributed most significantly to this trend? |
| A) |
The emergence of managed care and the large number of Americans who lack health insurance |
| B) |
The nursing shortage and decreasing numbers of health care providers who are choosing surgical specialties |
| C) |
Advances in anesthesia and in the technology surrounding surgical techniques |
| D) |
Pressure from health care consumers to avoid hospital stays and the decreasing incidence of acute illnesses |
| 12. |
A 79-year-old man is scheduled for surgical repair of an inguinal hernia. In light of this patient’s age, the nurse will prioritize nursing interventions aimed at preventing: |
| A) |
Overstimulation |
| B) |
Skin breakdown |
| C) |
Hyperglycemia or hypoglycemia |
| D) |
Early ambulation |
| 13. |
A patient has reported to the preadmission clinic in anticipation of her scheduled hysterectomy and oophorectomy. The patient states that her health care provider has explained the parameters for fasting prior to her surgery but tells the nurse that she does not entirely understand why she cannot eat or drink before surgery. What explanation should the nurse provide to this patient? |
| A) |
“It’s important to rest your stomach and bowels during and after surgery so that blood flow is concentrated to your vital organs.” |
| B) |
“Your surgeon and anesthetist need your stomach empty during surgery in case there is a need to insert a tube into your throat or stomach.” |
| C) |
“You need to fast before surgery so that the surgical team has a ‘clean slate’ for managing your fluid balance and nutritional status.” |
| D) |
“You’re asked to refrain from eating and drinking so there’s less of a chance that you’ll inhale food or fluids into your lungs.” |
| 14. |
A 72-year-old woman will be having total hip arthroplasty this morning to repair a fracture that she suffered in a recent fall. What patient teaching should the nurse prioritize during the preoperative phase of this patient’s care? |
| A) |
The positioning that the patient will be asked to adopt postoperatively |
| B) |
Strategies to maintain her nutritional status in the postoperative period |
| C) |
Signs and symptoms of infiltration at the patient’s intravenous site |
| D) |
The effects of age-related changes on the healing process |
| 15. |
A 30-year-old man is currently in the preoperative holding area on call for his tympanoplasty (eardrum reconstruction) that will be performed this morning. The nurse has administered the preanesthetic as ordered. What action should the nurse prioritize at this point in the patient’s care? |
| A) |
Teaching the patient about pain management and the appropriate use of oral analgesics postoperatively |
| B) |
Teaching the patient the correct technique for performing deep-breathing and coughing exercises |
| C) |
Ensuring the patient’s safety by keeping him in bed and discouraging him from ambulating |
| D) |
Performing a thorough respiratory assessment including breath sounds, respiratory rate, and oxygen saturation levels |
| 16. |
To maintain their skill sets, the nurses who provide care in the OR of a large university hospital take turns acting in the circulating role and the scrub role. Which of the following tasks is the sole domain of the scrub nurse? |
| A) |
Performing a count of instruments and supplies after surgery |
| B) |
Monitoring the aseptic technique of the surgical team |
| C) |
Coordinating the activities of the surgical team |
| D) |
Setting up a sterile field |
| 17. |
Based on a patient’s history and the preoperative assessment, the surgical team has opted to use a peripheral nerve block (PNB) with a patient who will undergo a bunionectomy. What advantages are conferred by the use of PNB? |
| A) |
The patient will have no recollection of the surgical procedure. |
| B) |
The patient will not have to be intubated. |
| C) |
The patient will experience better pain control than if general anesthesia were used. |
| D) |
PNB can be reversed immediately if the need arises. |
| 18. |
Despite advances in surgical techniques, surgery remains an activity that carries a significant risk of injury. What measure should the OR nurse take to minimize a patient’s risk of intraoperative positioning injury? |
| A) |
Assess the patient’s IV access site at regular intervals during surgery. |
| B) |
Ensure that no body part experiences undue pressure or restriction of blood supply. |
| C) |
Reposition the patient every 20 to 30 minutes while the patient is under anesthetic. |
| D) |
Perform light massage to pressure points during surgery if the procedure allows for this. |
| 19. |
A patient who is currently undergoing surgery has vomited a small amount of emesis. How should the OR nurses best respond to this intraoperative event? |
| A) |
Turn the patient on his or her side and perform oral suctioning. |
| B) |
Maintain the patient’s current position and perform deep suctioning. |
| C) |
Administer an antiemetic as ordered and closely monitor the patient for further vomiting. |
| D) |
Assist the anesthesiologist with extubating the patient. |
| 20. |
A middle-aged patient with a history of type 1 diabetes is having a transmetatarsal amputation performed because a diabetic ulcer on his foot has failed to heal and threatens to develop into osteomyelitis. The OR nurse who is participating in the procedure recognizes the fact that the patient is at risk of hypothermia in the intraoperative period. How can the nurse best minimize this risk? |
| A) |
Ensure that the surgical team maintains the room at a constant 28°C (82°F). |
| B) |
Minimize the amount of IV fluids that are administered to the patient. |
| C) |
Remove wet gowns and drapes from the patient as soon as possible. |
| D) |
Encouraging physical activity before the administration of preanesthetics. |
| 21. |
A patient was admitted 2 hours ago to the postsurgical unit from PACU following a Hartmann’s resection (bowel surgery). During the nurse’s most recent assessment of the patient, significant bleeding was noted on the patient’s abdominal dressing, which was previously dry and intact. What action should the nurse perform first? |
| A) |
Apply a transparent dressing over the existing bandage and position the patient side-lying. |
| B) |
Remove the patient’s dressing and insert gauze packing if dehiscence is apparent. |
| C) |
Check the results of the patient’s preoperative blood group and screen, |
| D) |
Apply a sterile gauze and hold it in place while applying moderate pressure. |
| 22. |
Many medications are available to control nausea and vomiting without oversedating the patient. At what point should a nurse normally administer antiemetics to a surgical patient? |
| A) |
Upon admission from PACU |
| B) |
When the patient reports that he or she will soon vomit |
| C) |
At the patient’s first report of nausea |
| D) |
When nonpharmacologic interventions are unsuccessful |
| 23. |
Mr. McLeod has been admitted to the postsurgical unit from PACU after a transurethral prostatic resection (TUPR). Mr. McLeod has continuous bladder irrigation running to prevent clotting and his Foley catheter is draining appropriately. His vital signs on admission reveal a blood pressure of 171/ 98 despite the fact that he has no documented history of hypertension. What factor most likely accounts for Mr. McLeod’s present increase in blood pressure? |
| A) |
Mr. McLeod is experiencing a postoperative hemorrhage. |
| B) |
Mr. McLeod is showing signs and symptoms of malignant hyperthermia. |
| C) |
Mr. McLeod’s sympathetic nervous system is stimulated, possibly by pain. |
| D) |
Mr. McLeod is fluid overloaded from the intraoperative administration of IV fluids. |
| 24. |
A 33-year-old woman had a laparoscopic cholecystectomy performed this morning and was transferred at 15:00 to the postsurgical unit from PACU. It is now 16:30. At this point in the patient’s recovery, what are the nursing priorities? |
| A) |
Health education about the dietary and lifestyle changes necessitated by her gall bladder surgery |
| B) |
Monitoring and treating the patient’s pain, nausea, and vomiting |
| C) |
Encouraging the patient to ambulate, and teaching the patient about the benefits of early ambulation |
| D) |
Performing a sterile dressing change and assessing the integrity of the patient’s surgical incision |
| 25. |
A nurse on a postsurgical unit is providing care for 20-year-old man who had an open appendectomy performed earlier this morning. Which of the following assessment findings should prompt the nurse to contact the patient’s surgeon? |
| A) |
The patient has put out 35 mL of urine in the 7 hours since admission. |
| B) |
The patient is complaining of nausea and has received a dose of metoclopramide (Reglan). |
| C) |
The patient’s peripheral IV has gone interstitial. |
| D) |
The patient has stated that he has no place to go after he is discharged and lacks a social support system. |
Answer Key
| 1. |
B |
| 2. |
C |
| 3. |
D |
| 4. |
C |
| 5. |
A |
| 6. |
A |
| 7. |
D |
| 8. |
D |
| 9. |
C |
| 10. |
C |
| 11. |
C |
| 12. |
B |
| 13. |
D |
| 14. |
A |
| 15. |
C |
| 16. |
D |
| 17. |
B |
| 18. |
B |
| 19. |
A |
| 20. |
C |
| 21. |
D |
| 22. |
C |
| 23. |
C |
| 24. |
B |
| 25. |
A |
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