Prep u missed questions preoperative

1. Clients who have received corticosteroids preoperatively are at risk for which
type of insufficiency?
a. Pituitary
b. Adrenal
c. Thyroid
d. Parathyroid
2. A nurse evaluates the potential effects of a client's medication therapies
before surgery. Which drug classification may cause respiratory depression
from an associated electrolyte imbalance during anesthesia?
a. corticosteroids
b. diuretics
c. insulin
d. anticoagulants
3. A fractured skull would be classified under which category of surgery based
on urgency?
a. Elective ---> osteoarthritis
b. Required
c. Urgent
d. Emergent ---> only surgery that does not need informed consent
Explanation: Emergent surgery occurs when the client requires immediate attention.
An elective surgery is classified as a surgery that the client should have. A required
surgery means that the client needs to have surgery. An urgent surgery occurs
when the client requires prompt attention.
Note:

 Insertion of PICC line required informed consent

 Postop management of blood sugar level (avoiding hyperglycemic peaks will help in WOUND
HEALING and recovery)
4. A client having a surgical procedure takes aspirin 325 mg daily for
prevention of platelet aggregation. When should the client stop taking the
aspirin before the surgery?
a. 2 weeks
b. 4 weeks
c. 7 to 10 days---> yes stop anticoagulants a week before the surgery
d. 2 to 3 days
5. The nurse is aware that which of the following helps to stimulate T-cell
response:
a. Arginine----> increased wound strength
 b. Biotin
c. Vitamin D
d. Zinc
6. A nurse is teaching a client about diaphragmatic breathing. What client
action indicates that further teaching is needed?
a. The client places the hands on the lower chest to feel the rise and fall with breathing.
b. The client performs diaphragmatic breathing in a semi-Fowler's position.
c. The client exhales forcefully with a short expiration.
d. The client breathes in deeply through the nose and mouth.
7. Which question is most important for the nurse to ask the client when
obtaining the preoperative admission history?
a. "Who is here with you?"
b. "Did you bring a copy of your health care power of attorney?"
c. "When is the last time you ate or drank?"
d. "Did you bring any valuables with you?"
8. What action by the nurse best encompasses the preoperative phase?

a. Educating clients on signs and symptoms of infection

b. Documenting the application of sequential compression devices (SCDs)
c. Monitoring vital signs every 15 minutes
d. Shaving the client using a straight razor
9. The nurse expects informed consent to be obtained for insertion of:

a. An indwelling urinary catheter

b. An intravenous catheter
c. A gastrostomy tube
d. A nasogastric tube
10. The nurse is reviewing a preoperative informed consent when preparing the
client for surgery. Which contents of the informed consent are required?
Select all that apply.
a. Explanation of procedure
b. Estimated time of procedure
c. Potential risks
d. Benefits of surgery
e. Personnel present
f. Description of alternatives
11. Which of the following nursing activities would not be part of the
preoperative phase of care? Select all that apply.
a. Discussing and reviewing the advanced directive document
b. Establishing an intravenous line
c. Ensuring that the sponge, needle, and instrument counts are correct
d. Administering medications, fluid, and blood component therapy, if prescribed
 e. Beginning discharge planning
12. The nurse should determine that a client is coughing effectively after surgery
if the nurse observes which of the following activities?
a. The client breathes through her nose, holds her breath, and then exhales slowly before
coughing.
b. The client takes short, panting breaths and coughs from the throat to expectorate
sputum.
c. The client takes a deep abdominal breath and then “huff” or "hack" coughs three or four
times.
d. The client takes three deep breaths and then coughs forcefully.
Intraoperative :

1. The scrub nurse is responsible for:

a. Calling the "time-out" to verify the surgical site and procedure
b. Monitoring the administration of the anesthesia
c. Monitoring the operating-room personnel for breaks in sterile technique
d. Preparing the sterile instruments for the surgical procedure
2. A client receiving moderate sedation for a minor surgical procedure begins to
vomit. What should the nurse do first?
a. Roll the client onto his or her side.
b. Suction the mouth.
c. Provide a basin.
d. Administer an antiemetic medication.
3. What action during a surgical procedure requires immediate intervention by
the circulating nurse?
a. The scrub nurse calling the blood bank to obtain blood products
b. The surgeon reaching within the sterile field to obtain equipment
c. The anesthesiologist monitoring blood gas levels
d. The registered nurse’s first assistant suturing the surgical wound
Explanation: The scrub nurse is “scrubbed” in and should only come in contact with
sterile equipment. Using the phone to call the blood bank is the responsibility of
the circulating nurse and it would break the sterility of the scrub nurse. The
surgeon has “scrubbed” in and should only touch items within the sterile field. The
anesthesiologist should monitor blood gas levels as needed, and it is appropriate
for the registered nurse's first assistant to suture the surgical wound.
4. A client at risk for malignant hyperthermia returns to the surgical unit. For
what time period will the nurse monitor the client for development of
malignant hyperthermia?
a. Malignant hyperthermia occurs in the operating room only.
b. A client can develop malignant hyperthermia only with intravenous anesthesia after
surgery.
 c. The client can develop malignant hyperthermia up to 24 hours after surgery.
d. The client will need to be discharged with special instructions.
5. The client vomits during the surgical procedure. The best action by the nurse
is:
a. Increase the IV infusion rate to compensate for lost fluids.
b. Suction the client to remove saliva and gastric secretions.
c. Lower the head of the operating table to promote circulation to the brain.
d. Administer an anti-emetic to alleviate nausea.
6. A client is undergoing a perineal surgical procedure. The nurse should place
the client in which position?
a. Lithotomy
b. Trendelenburg
c. Sims
d. Dorsal recumbent
7. A client is undergoing a lumbar puncture. The nurse educates the client
about surgical positioning. Which statement by the nurse is appropriate?
a. “You will be placed flat on the table, face down.”
b. “You will be on your back with the head of the bed at 30 degrees.”
c. “You will be lying on your side with your knees to your chest.”
d. “You will be flat on your back with the table slanted so your head is below your feet.”
8.