Perioperative Nursing Sample Test

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Perioperative Nursing

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Question 1

Which statement best explains the scientific rationale for performing urinary catheterization on a client following an abdominal hysterectomy if she is unable to void within 8 hours?

	The bladder is removed along with the uterus
	Infection from surgery interferes with the client’s ability to void
	Surgically induced menopause impairs the client urinary function
	Temporary atony may result from surgical manipulation in the area

Question 1 Explanation:With a hysterectomy, the area around the bladder typically undergoes surgical manipulation. This causes edema and nerve trauma, possibly leading to temporary atony. Therefore if the client cannot void within 8 hours, urinary catheterization is performed to prevent urinary retention.

Question 2

Following a thyroidectomy, the client experiences hemorrhage. The nurse would prepare for which emergency intervention?

	I.V administration of calcium
	Creation of a tracheostomy
	Insertion of an oral airway
	I.V administration of thyroid hormone

Question 2 Explanation:following a thyroidectomy, postoperative hemorrhage may cause compression of the trachea, necessitating an emergency tracheostomy to maintain airway patency. Calcium and thyroid hormones may be administered postoperatively, but these agents are unrelated to hemorrhage. Insertion of an oral airway would be ineffective in maintaining airway patency because the compression from the hemorrhage is below the airway insertion site.

Question 3

An adult client has the following laboratory results: white blood cells 6,300/ mm3; platelets 250,000 mm3; serum sodium 140 mEq/L; serum potassium 6 mEq/L. which condition is present?

	Hypernatremia
	Thrombocytopenia
	Hyperkalemia
	Leukocytosis

Question 3 Explanation:The client’s serum potassium level is above the normal range of 3.5 to 5.5 mEq/L. indicating hyperkalemia.

Question 4

Correction of a drooping upper eyelid;

	Correction of entropion
	Blepharaptosis repair
	Canthotomy
	Excision of chalazion

Question 4 Explanation:Blepharaptosis repair is the Correction of a drooping upper eyelid. Correction of Entropion is the correction of an eversion and drooping of the lower eyelid. Canthotomy is the incision of the canthus. Exicision of the chalazion is the incision and curettage if a granulomatous swelling of the meibomian glands.

Question 5

It is the resection of the half of the colon and a segment of the terminal ileum and their mesenteries.

	Colostomy
	Transverse colectomy
	Ileostomy
	Hemicolectomy

Question 5 Explanation:Hemicolectomy is the resection of the half of the colon and a segment of the terminal ileum and their mesenteries. Colostomy is the formation of a permanent or temporary opening into the colon brought out onto the abdominal wall as a stoma. Transverse colectomy is the resection of a segment of the transverse colon with an end-to-end anastomosis to reestablish continuity of the colon.

Question 6

A client is 4 hours postoperative abdomino-peritoneal resection with sigmoid colostomy. He is complaining of rectal pain that ranks 8 on a scale of 1 to 10. Which interventions should he nurse implement? (select all that apply)

	Assessing the client’s blood pressure and pulse
	Assessing the abdominal incision
	Notifying the health care provider that the stoma is pink
	Medicating the client as ordered
	Assisting the client with distraction to help the pain

Question 6 Explanation:The nurse should rule out surgical complications, such as hemorrhage, by assessing the client’s blood pressure and pulse. The nurse also should medicate the client immediately because the client is only 4 hours postoperative. The client will not have an abdominal incision with the surgery (rectal dressing). The nurse would be concerned if the stoma is purple not pink. The clients need medication not distraction at 4 hours postoperative. Sitting on the side of the bed will not help the client’s pain.

Question 7

Which instruction is most important to provide when discharging a client from the emergency department following penetrating foot injury?

	Refrain from crossing the legs at the knee or ankle
	Watch for signs and symptoms of anaphylaxis from the tetanus toxoid
	Avoid smoking until the entire wound is no longer open to the air
	Call the health care provider at the first signs of any red streaks appearing on the foot or leg

Question 7 Explanation:The appearance of red streaks indicates lymphadenitis and evidence of spreading infection. The client should call the health care provider because further treatment is necessary. Not crossing the legs will aid in venous return but foot edema is not a serious threat to health as a spreading infection. Avoiding smoking is always an important health consideration. However, their effect is not an immediate as those of the spreading infection. Signs and symptoms of anaphylactic shock would most likely occur immediately after the administration of tetanus toxoid while the client is still in the health care facility.

Question 8

After obtaining 3 L of fluid from a client via parecentesis, the nurse would be alert for which complication?

	Vascular collapse
	Bleeding from the site
	Encephalopathy
	Respiratory distress

Question 8 Explanation:the removal of large amount of fluid, such as 2-3 L, via paracentesis may lead to acute fluid shifting and hypotension, subsequently leading to vascular collapse

Question 9

A client arrives at the clinic for a routine physical examination. During the examination, the nurse performs as otoscopic examination. Which finding would nurse expect as normal?

	Positive red reflex
	Pearly gray tympanic membrane
	Tactile fremitus
	Pale optic disk

Question 9 Explanation:an otoscopic examination uses an otoscope to inspect the external canal and middle ear, specifically the tympanic membrane and its landmarks. Normally, the tympanic membrane appears pearly gray ad intact. A pale optic disk is an abnormal fining during an ophthalmoscopic examination of the eyes. A positive red reflex is a normal finding with an ophthalmoscopic examination, not an otoscopic examination. Tactile frmitus is an abnormal finding when the chest is palpated.

Question 10

Following a bee sting a client who develops shortness of breath and hives on his face and neck receives an epinephrine injection. Which assessment data would indicate that the epinephrine is effective?

	Reduced pain at the sting site
	Increased itching
	Easier breathing
	Drowsiness

Question 10 Explanation:The client is exhibiting allergi reaction to the beesting. Epinephrine acts as a bronchodilator to ease the client’s breathing. It has no effect on pain and will not cause drowsiness or increase itching.

Question 11

Which intervention should the nurse implement first when beginning preoperative teaching?

	Assessing the client’s knowledge base related to the surgical procedure
	Having the client read the printed instructional booklet
	Using a standardized preoperative teaching plan for consistency
	Describing the possible risks of the surgical procedure

Question 11 Explanation:Before beginning any teaching program; the nurse must first assess the client’s knowledge base. Doing so allows the nurse to identify the client’s teaching needs, avoid repetition of areas the client is already familiar with, and identify or correct in misconceptions or misinformation that the client might have.

Question 12

Which topic would be most important to include in the postoperative teaching for the client scheduled for a vaginal hysterectomy?

	Availability of support persons
	Lower-extremity exercises and deep breathing
	Pelvic muscle strengthening exercises
	Use of a bedpan and call light

Question 12 Explanation:Use of lithotomy position for a vaginal hysterectomy predisposes the client to DVT. Additionally, atelectasis from surgery may also occur. Thus, the client needs instructions on lower extremity exercises to minimize the risk of DVT. She also needs deep breathing exercises to prevent atelectasis.

Question 13

Prior the operation the nurse checks the client receiving warfarin sodium, an anticoagulant, has a prothrombin time of 22 and a partial thromboplastin time of 39. The control values are PT 12.9; and PTT 37. The International Normalized Ratio (INR) is 2.8. Which nursing intervention would be most appropriate?

	Notifying the health care provider immediately
	Administering the medication as ordered
	Holding the medication and assessing for bleeding
	Preparing to administer protamine sulfate

Question 13 Explanation:When a client is receiving warfarin, the PT value should be 1.5 to 2 times the control value. The INR should be between 2 to 3. The client’s INR value is therapeutic, so the medication should be administered as ordered.

Question 14

Open glove method is preferred to use except:

	Intravenous cutdown or administering of spinal anesthesia
	Changing a glove during an operation
	In the emergency department when donning sterile gloves for suturing lacerations
	When donning gloves for procedures requiring gown

Question 14 Explanation:Open glove technique is used when only sterile gloves are worn, as far intravenous cutdown or administering of spinal anesthesia, or in the emergency department when donning sterile gloves for suturing lacerations. It is also for changing a glove during an operation and for procedures not requiring gown.

Question 15

Which intervention must be implemented first during the initial assessment of a client with major burn injury?

	Treating for burn shock
	Ensuring a patent airway
	Inserting a nasogastric tube
	Eliminating the source of the burn

Question 15 Explanation:Before any other action can be taken, the source of the burn injury must be eliminated. The airway patency is ensured, any associated injuries are assessed, and then burn shock is treated.

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Fundamentals of Nursing Practice Test Set 2

Fundamentals of Nursing Practice Test Set 1

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The Nclex Exam are in a world of their own. Majority of the items are made specifically to test an applicant’s level of cognition. These questions are based on established nursing principles.

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