PERIOPERATIVE NURSING

B) Flat on bed for 6 to 8 hours

1.) Which of the following is most
C) Prone position
dangerous complication during
D) Modified trendelenburg
induction of spinal anesthesia?
A) Tachycardia
5.) Which of the following nursing
B) Hypotension
actions should be given highest priority
C) Hyperthermia
when admitting the patient into the
D) Bradypnea
operating room?
A) Level of consciousness
2.) Which type of surgery is most likely
B) Vital signs
to predispose a patient to postoperative
C) Patient identification and correct
atelectasis, pneumonia or respiratory
operative consent
failure?
D. Positioning and skin preparation
A) Upper abdominal surgery on an obese
patient with a long history of smoking
6.) What is the primary reason for the
B) Upper abdominal surgery on a patient
gradual change of position of the patient
with normal pulmonary function
after surgery?
C) Lower abdominal surgery on a young
A) To prevent muscle injury
patient with diabetes mellitus
B) To prevent sudden drop of BP
D)Surgery on the extremities of a
C) To prevent respiratory distress
nonsmoking football player
D) To promote comfort
3.) Which of the following characterizes
excitement stage of anesthesia
7.) Which of the following assessment
A) Occurs from the administration of
data is most important to determine
anesthesia to the loss of consciousness
when caring for a patient who has
B) Extends from the loss of
received spinal anesthesia?
consciousness to the loss of lid reflex,
A) The time of return of motion and
characterized by struggling and talking
sensation in the legs and toes
C) From the loss of lid reflex to the loss
B) The character of respiration
of most reflexes
C) Level of consciousness
D) From the loss of most reflexes to
D) Amount of wound drainage
respiratory and circulatory failure

8.) Which of the following postop

4.) To prevent headache after spinal
findings should the nurse report to the
anesthesia the patient should be
M.D.?
positioned:
A) The patient pushes out the oral
A) Semi-fowler’s
airway with his tongue
B) Urine output is 20ml/hr for the past
two hours coughing and turning exercises is:
C) VS are as follows: A) Before administration of preoperative
BP=110/70;PR=95;RR=19,Temp=36.8C medications
16
B) The afternoon or evening prior to
D) Wound drainage is serosanguinous surgery
C) Several days prior to surgery
9.) Which of the following is the earliest
D) Upon admission of the client in the
sign of poor respiratory function?
recovery room
A) Cyanosis
B) Fast thready pulse
14.) The following are the appropriate
C) Restlessness
nursing actions before administration of
D) Faintness
preoperative medications EXCEPT:
A) Ascertain the consent has been
10.) If wound eviscerations occurs, the
signed
immediate nursing action is:
B) Ensure that NPO has been
A) Cover the wound with sterile gauze
maintained
moistened with sterile NSS
C) Instruct patient to empty his bladder
B) Cover the wound with water-soaked
D) Shave the skin at the site of surgery
gauze
C) Cover the wound with sterile dry
15.) The patient has been observed
gauze
pacing along the hallway goes to the
D) Leave the wound uncovered and pull
bathroom frequently and asks questions
the skin edges together
repeatedly during preoperative
assessment. The most likely cause of the
11.) Appendectomy is classified as
behavior is:
A) Ablative
A) She is anxious about the surgical
B) Constructive
procedure
C) Reconstructive
B) She is worried about separation from
D) Palliative
the family
C) She has urinary tract infection
12.) The worst of all fears among clients
D) She has an underlying emotional
undergoing surgery is:
problem
A) Fear of financial burden
B) Fear of death
16.) Which of the following nursing
C) Fear of the unknown
actions would help the patient decrease
D) Fear of loss of job
anxiety during the preoperative period?
A) Explaining all procedures thoroughly
13.) The best time to provide
in chronological order
preoperative teaching on deep breathing,
B) Spending time listening to the patient
and answering questions
C) Encouraging sleep and limiting
interruptions
D) Reassuring the patient that the surgical staff
are competent professional
17.) Which of the following is the primary
purpose of maintaining NPO for 6 to 8
hours before surgery?
A) To prevent malnutrition
B) To prevent electrolyte imbalance
C) To prevent aspiration pneumonia
D) To prevent intestinal obstruction
18.) The following ensure validity of
informed written consent EXCEPT:
A) The patient is of legal age with proper
mental disposition
B) The consent has been secured within
24 hours before the surgery
C) If the patient is unable to write,
secure the consent from a relative
D) The consent is secured before
administration of any medication that
alter the level of consciousness
19.) Which of the following drugs is
administered to minimize respiratory
secretions preop?
A) Valium (Diazepam)
B) Nubain ( Nalbuphine HCL)
C) Phenergan (Promethazine)
D) Atropine Sulfate
20.) Which of the following is
experienced by the patient who is under
spinal anesthesia?
A) The patient is unconscious
B) The patient is awake
C) The patient experiences amnesia
D) The patient experiences total loss of
Sensation
21.) The patient who has undergone
TAHBSO complains of pain. Which of the
following is an initial nursing action?
A) Administer the PRN analgesics
B) Instruct to do deep breathing
exercises
C) Assess the VS
D) Change the patient’s position
22.) How frequent should the nurse
monitor the VS of the patient in the
recovery room?
A) Every 15 minutes
B) Every 30 mins
C) Every 45 mins
D) Every 60 mins
23.) Which of the following drugs is
given to relieve nausea and vomiting?
A) Mepivacaine
B) Aquamephyton
C) Nubain
D) Plasil
24.) The most important factor in the
prevention of postop infection is:
A) Proper administration of antibiotics
B) Fluid intake of 2-3L/day
C) Practice of strict aseptic techniques
D) Frequent change of wound dressings
25.) Which of the following primarily
prevents postop complications?
A) Adequate fluid intake
B) Early ambulation
C) Well-balanced diet
D) Administration of antimicrobials
Situation: A female client, 23 y/o was
admitted for the first time at the Fatima
Hospital with the chief complaint of
Right Iliac Pain, accompanied by nausea
and vomiting, chills and fever. She was
diagnosed to have acute appendicitis.
She was scheduled to have emergency
appendectomy under spinal anesthesia
26.) Pre-op instructions to the client
would include the following EXCEPT:
A) Deep breathing and coughing
exercise
B) Turning to sides
C) Foot and leg exercises
D) reassuring her that narcotics will be
given every 4 hours round the clock until
she is discharged
27.) The client gave her consent for the
surgery. To ensure the legality of the
consent, the following conditions must
be met EXCEPT:
A) She gave her consent freely
B) She must understand the nature of
the surgery
C) The consent must be signed by a
witness
D) Signing should be done after the
administration of pre-anesthesia meds
28.) The skin is shaved prior to surgery
in order to:
A) Facilitate skin incision
B) Indicate the site to be draped
C) To prevent wound infection
D) Reduce post op scarring
29) The important nursing intervention
prior to administration of pre-anesthetic
medication is:
A) Ask patient to empty the bladder
B) Do deep breathing and coughing
exercises
C) Regulate IVF accurately
D) Shave the skin
30.) Immediately following spinal
anesthesia, the greatest risk is:
A) Severe hemorrhage
B) Severe Hypotension
C) Severe Hypoglycemia
D) Hypertensive crisis
31.) Nursing measures to promote the
client’s respiratory function during
recovery from anesthesia are the
following EXCEPT:
A) Encourages deep breathing and
coughing exercises
B) Administer Humidified oxygen
C) Place in semi-fowlers position
D) Place in supine position with head
turned to the side without pillow support
32.) Which of the following criteria must
be met before the client is released from
the RR to the unit.
A) Breathes with ease, coughs freely
B) Has regained consciousness
C) Vital signs fluctuates erratically
D) Able to move four extremities
33.) Early signs of poor respiratory
function include which of the following
A) Cyanosis
B) Hypotension
C) Loss of consciousness
D) Restlessness
34.) Post operatively, the client must be
encouraged to turn, cough and deep
breathe:
A) Every 1-2 hours
B) Every 4 hours
C) Every 30 Mins
D.) Every 8 hours
35.) A client in shock must be placed in:
A) High-fowlers position
B) Sim’s position
C) Modified trendelenburg
D) Prone position
36.) The most important factor in the
prevention of post op wound infection is:
A) Adequate fluid intake
B) Proper administration of antibiotics
C) Practice of strict aseptic technique
D) Frequent cleaning of the wound
37.) When the patient vomits, the most
important nursing objective is to
prevent:
A) Dehydration
B) Aspiration
C) Rupture of suture line
D) Met. Alkalosis
38.) Post operatively, a patient is
expected to void after:
A) 6-8 hours
B) 2-4 hours
C) 12-24 hours
D) 10-12 hours
39.) Headache after spinal anesthesia is
due to:
A) Paralysis of vasomotor nerves
B) Traction placed on structures within
abdomen
C) Loss of CSF through dural hole
D. Administration of large amounts and
heavy concentration of anesthetic
agents
40.) Nursing measures for post-op
thrombophlebitis include the following EXCEPT:
A) Maintain bedrest
B) Elevate affected leg with pillow
support
C) Massage the painful extremities
D) Apply antiembolic stockings
41.) Nursing measures to relieve hiccups
include the following EXCEPT:
A) Exhale and inhale through a paper bag
B.) Apply pressure over the eyeball through closed
eye lids
C) Hold breathe while taking a large pulp of water
D.) Administer high concentration of
oxygen
42.) Modified radical mastectomy involves:
A) Removal of the entire breast, axillary
lymph nodes, pectoralis muscle
B) Removal of the lump of the breast
C) Removal of the entire breast, axillary
and neck lymph nodes, including
pectoralis muscles
D) Removal of the entire breast but
nipple remains intact
43.) Which of the following is not
appropriate nursing intervention after
modified radical mastectomy?
A) Place in semi fowler’s position and
elevate arm on the affected side with
pillow support
B) Check behind the client for bleeding
C) Monitor output from wound suction
drainage
D. Immobilize the arm on affected side
in adduction
44.) A fluid challenge is begun with a
post-op gastric surgery client. Which
assessment will give the best indication
of client response to this treatment?
A) CVP readings and hourly urine output
B) Blood pressure and apical rate
checks
C) Lung sounds and arterial blood
gases
D) Electrolytes, BUN, creatinine results
45.) A client is scheduled for a subtotal
gastrectomy. In anticipation of clarifying
information for client education, the
nurse knows that vagotomy is done as
part of the surgical treatment for peptic
ulcers in order to
A) Decrease secretion of hydrochloric
acid
B) Improve the tone of the GI muscles
C) Increase blood supply to the jejunum
D) Prevent the transmission of pain
impulses
46.) Which of the following facts best
explains why the duodenum is not
removed during a subtotal gastrectomy?
A) The head of the pancreas is adherent
to the duodenal wall
B) The common bile duct empties into
the duodenal lumen
C) The wall of the jejunum contains no
intestinal villi
D) The jejunum receives its blood
supply through the duodenum
47.) During the immediate postoperative
period following gastric surgery, why
must the nurse be particularly
conscientious about encouraging a
client to cough and deep-breathe at
regular intervals?
A) Marked changes in intrathoracic
pressure will stimulate gastric drainage
B) The high abdominal incision will lead
to shallow breathing to avoid pain
C) The phrenic nerve will have been
permanently damaged during the
surgical procedure
D) Deep-breathing will prevent post op
vomiting and intestinal distention
48.) Prior to having a subtotal
gastrectomy, a client is told about the
dumping syndrome. The nurse explains
that it is:
A) The body’s absorption of toxins
produced by liquefaction of dead tissue
B) Formation of an ulcer at the margin of
the gastrojejunal anastomosis
C) Obstruction of venous flow from the
 5. c 45. a
stomach into the portal system
6. b 46. b
D) Rapid emptying of food and fluid 7. a 47. b
from the stomach into the jejunum 8. b 48. d
9. c 49. b
10. a 50. b
49.) Which of the following statements 11. a
by a client recovering from a subtotal 12. c
gastrectomy would indicate a need for 13. b
additional teaching about the diet 14. d
15. a
protocol for dumping syndrome?
16. b
A) “I plan to eat a diet low in
17. c
carbohydrates and high in protein and
18. c
fat” 19. d
B) “I plan to eat a diet high in CHO and 20. b
low in CHON and fat” 21. c
C) “I will eat slowly and avoid drinking 22. a
23. d
fluids during meals”
24. c
D) “I will try to assume a recumbent
25. b
position after meals for 30 mins to 1 hour 26. d
to enhance digestion and relieve 27. d
symptoms 28. c
29. a
50.) A 40 y/o female client has arrived in 30. b
31. c
the post anesthesia room following a
32. c
cholecystectomy and a common bile
33. d
duct exploration. She is semi conscious. 34. a
Her vital signs are within normal limits. 35. c
Which of the following nursing actions 36. c
would be inappropriate? 37. b
A) Apply a warm blanket to her body 38. a
39. c
B) Place her in a semi-fowler’s position
40. C
C) Attached her T-tube to gravity
drainage 41. d
D) Set up low, intermittent suction for 42. a
her NGT 43. d
44. a
45. a
Answer: 46. b
1. b 41. d 47. b
2. a 42. a 48. d
3. b 43. d 49. b
4. b 44. a 50. b