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Quiz sobre Care of the Surgical Patient, criado por asissons em 12-04-2015.

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Care of the Surgical Patient

Questão 1 de 53

1

The goals of perioperative nursing are

Selecione uma ou mais das seguintes:

  • assist the patient and family through the surgery

  • promote positive patient outcomes

  • assist the patient to achieve his/her optimal level of function after the surgery

Explicação

Questão 2 de 53

1

what are the three phases of surgery?

Selecione uma ou mais das seguintes:

  • preoperative care

  • intraoperative care

  • postoperative care (next week)

Explicação

Questão 3 de 53

1

Role of the nurse in Pre-op admission clinic (PAC)

Selecione uma ou mais das seguintes:

  • patient interview

  • nursing assessment

  • preoperative teaching

  • day of surgery prep

Explicação

Questão 4 de 53

1

In the patient interview what information should you obtain?

Selecione uma ou mais das seguintes:

  • determine pt expectations about surgery and anesthesia

  • provide and clarify information about the surgical experience

  • assess patient's emotional state and readiness for surgery

  • determine if pt has enough information to make an informed decision

  • may being some post op teaching

Explicação

Questão 5 de 53

1

Informed consent involves

Selecione uma ou mais das seguintes:

  • 1. adequate disclosure of diagnosis

  • understanding and comprehension of the information being provided

  • must be given voluntarily

Explicação

Questão 6 de 53

1

Assess for ABCDE

Selecione uma ou mais das seguintes:

  • Airway

  • breathing

  • Circulation

  • Diability

  • Exposure

Explicação

Questão 7 de 53

1

What kind of allergies are you looking for?

Selecione uma ou mais das seguintes:

  • Medication

  • foods

  • Chemicals

  • Tape

  • Pollen

  • perfumes

  • latex

Explicação

Questão 8 de 53

1

For a pt about to undergo surgery ask about subjective health history

Selecione uma ou mais das seguintes:

  • have you had surgeries in the past? which ones? did you have any complications?

  • Have you or any family members experienced any problems with anaesthesia

  • Do you have any past hospitalizations?

  • any chronic health conditions

Explicação

Questão 9 de 53

1

Health history assessment

Selecione uma ou mais das seguintes:

  • weight and height

  • limitations in neck mobility

  • history of drug or opiate abuse

  • hx of ETOH use

  • HX of smoking

Explicação

Questão 10 de 53

1

Conduct lab and diagnostic tests

Selecione uma ou mais das seguintes:

  • CBC

  • electrolyte panel

  • LFT

  • Renal Panel

  • Coagulation studies

  • Type and cross match

  • 12 lead ECG

  • Blood Glucose levels

  • CXR

Explicação

Questão 11 de 53

1

What types of preoperative information is there?

Selecione uma ou mais das seguintes:

  • Sensory - sights, smells sounds

  • Procedural - what to wear, what to eat, physical prep

  • Process - flow of surgery, family needs

Explicação

Questão 12 de 53

1

An adult learner

Selecione uma ou mais das seguintes:

  • likes to have choices

  • has a variety of learning styles and preferences

  • needs to have abilities and achievements recognized

  • does best in an environment where they feel safe, accepted and respected

Explicação

Questão 13 de 53

1

What are the steps involved in client education

Selecione uma ou mais das seguintes:

  • assessment of the need to learn

  • assessment of readiness

  • setting of objectives

  • teaching - learning

  • evaluation and re-teaching if necessary

Explicação

Questão 14 de 53

1

Check all that are involved in a surgical team

Selecione uma ou mais das seguintes:

  • 2 RNs

  • practical nurse

  • Surgeon and assistant

  • RN first assistant

  • Anaesthetist

Explicação

Questão 15 de 53

1

What does SBAR-R stand for

Selecione uma ou mais das seguintes:

  • S: Situation

  • B: background

  • A: Assessment

  • R: Recommendation

  • Repeat - repeat back so it is said properly

Explicação

Questão 16 de 53

1

During the preoperative interview, a patient scheduled for an elective hysterectomy to treat benign tumours of the uterus tells the nurse that she does not know whether she can go through with the surgery because she knows she will die in surgery, as her mother did. What is the most appropriate response?

Selecione uma das seguintes:

  • “Tell me more about what happened to your mother.”

  • “Think positively! Positive thoughts have been shown to influence a positive surgical outcome.

Explicação

Questão 17 de 53

1

Why is it especially important for the nurse to determine the patient’s current use of medications during the preoperative assessment?

Selecione uma das seguintes:

  • These medications may alter the patient’s perceptions about surgery.

  • Other medications may cause interactions with anaesthetics, altering the potency and effect of the drugs.

Explicação

Questão 18 de 53

1

The nurse visits the patient to have him sign the operative permit as directed in the physician’s preoperative orders. The patient tells the nurse that the physician has not really told him what is involved in the surgical procedure. What should the nurse do?

Selecione uma das seguintes:

  • Explain what the planned surgical procedure entails before having the patient sign the consent form.

  • Delay the patient’s signature on the consent form, and notify the physician that the informed-consent process is not complete.

Explicação

Questão 19 de 53

1

What does appropriate preoperative teaching for a patient scheduled for abdominal surgery include?

Selecione uma das seguintes:

  • How to breathe deeply and cough

  • How to care for the wound

Explicação

Questão 20 de 53

1

An 82-year-old man is admitted to the hospital the evening before a prostatectomy for cancer of the prostate. He is alert and oriented but has difficulty seeing and hearing. His wife is at his bedside and answers most questions directed to the patient. What should the nurse do to accomplish preoperative teaching with the patient?

Selecione uma das seguintes:

  • Provide additional time for the patient to understand preoperative instructions and carry out procedures

  • Ask the patient’s wife to wait in the hall in order to focus on preoperative teaching with the patient himself

Explicação

Questão 21 de 53

1

What are the physical environment and traffic control measures of the OR primarily designed to do?

Selecione uma das seguintes:

  • Protect the patient’s privacy.

  • Prevent transmission of infection

Explicação

Questão 22 de 53

1

Which one of the following intraoperative patient positions would the nurse anticipate for the patient who is being prepared for abdominal surgery?

Selecione uma das seguintes:

  • Prone

  • Supine

Explicação

Questão 23 de 53

1

The nurse notes that a preoperative patient is drowsy, but oriented, in the receiving area. In addition to checking her hospital number and identification band, what should the nurse check?

Selecione uma das seguintes:

  • Ask the patient to state her name, her doctor’s name, and the operative procedure planned.

  • Ask the surgeon to identify the patient and the planned surgical procedure.

Explicação

Questão 24 de 53

1

The nurse from the general surgical unit brings the patient’s hearing aid to the surgical suite because the patient left the unit without it and it is needed to communicate with the patient. At the surgical suite, what areas can the general surgical unit nurse enter?

Selecione uma das seguintes:

  • Clean core

  • Scrub sink areas

  • Information or nursing station

  • Corridors of the ORs

Explicação

Questão 25 de 53

1

Which assessment finding would the nurse expect to observe in a patient with malignant hyperthermia

Selecione uma das seguintes:

  • Decreased heart rate

  • Low, irregular respirations

  • Decreased temperature

  • Ventricular dysrhythmias

Explicação

Questão 26 de 53

1

What is one of the most important goals of the registered nurse first assistant?

Selecione uma das seguintes:

  • Safety of the patient

  • Documentation of the intraoperative care

Explicação

Questão 27 de 53

1

You are the clinic nurse doing a preoperative assessment on a patient who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the patient's medical history, you note that this patient had a kidney transplant 8 years ago. The patient is taking immunosuppressive drugs. What is this patient at increased risk for when having surgery?

Selecione uma das seguintes:

  • infection

  • death

Explicação

Questão 28 de 53

1

An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?

Selecione uma das seguintes:

  • Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.

  • older adults are more malnourished

Explicação

Questão 29 de 53

1

How should a nurse teach a patient to perform deep breathing and coughing to use postoperatively?

Selecione uma das seguintes:

  • 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.

  • The patient should do box breathing

Explicação

Questão 30 de 53

1

Which of the following clinical manifestations is often the earliest sign of malignant hyperthermia?

Selecione uma das seguintes:

  • Tachycardia

  • bradycardia

Explicação

Questão 31 de 53

1

A client who had abdominal surgery 4 days ago reports that "something gave way" when he sneezed. The nurse observes a wound evisceration. Which nursing action is the first priority?

Selecione uma das seguintes:

  • Applying a sterile, moist dressing

  • suturing the wound

Explicação

Questão 32 de 53

1

A postanesthesia care unit (PACU) nurse is caring for a patient with the following assessment data: pale, cool, moist skin; thready pulse of 122; blood pressure 78/60; urine output of 25 mL/h; temperature 99.2°F. What interventions by the nurse are appropriate? Select all that apply.

Selecione uma ou mais das seguintes:

  • Maintain a patent airway.
    • Frequently monitor neurological status.

    .

  • • Apply oxygen per orders

  • • Administer blood products per orders.

  • apply warm blankets

Explicação

Questão 33 de 53

1

Which of the following terms refers to a protrusion of abdominal organs through the surgical incision?

Selecione uma ou mais das seguintes:

  • Eviseration

  • desiccation

Explicação

Questão 34 de 53

1

Nursing assessment findings reveal a temperature of 96.2°F, pulse oximetry 90%, shivering, and client complains of chilling. The findings are indicative of which nursing diagnosis?

Selecione uma ou mais das seguintes:

  • Ineffective thermoregulation

  • ineffective airway clearance

Explicação

Questão 35 de 53

1

The nurse is caring for a client during the immediate postoperative period and is assessing for signs of shock. What signs and symptoms indicate that the client may be in shock?

Selecione uma ou mais das seguintes:

  • weak and rapid pulse

  • bounding and rapid pulse

Explicação

Questão 36 de 53

1

The client asks the nurse about ways to control pain other than taking pain medication. Which strategy should the nurse include when responding to the client? Select all that apply

Selecione uma ou mais das seguintes:

  • Listening to music

  • Watching television

  • • Changing position

  • yelling

Explicação

Questão 37 de 53

1

The primary objective in the immediate postoperative period is

Selecione uma das seguintes:

  • maintaining pulmonary ventilation.

  • preventing infection

Explicação

Questão 38 de 53

1

In the transfer of accountability what is transferred?

Selecione uma ou mais das seguintes:

  • rights

  • duties

  • obligations

  • charting

Explicação

Questão 39 de 53

1

What is included in the post operative report/handover?

Selecione uma ou mais das seguintes:

  • general patient information

  • patient history

  • intraoperative management

  • post anasesthesia care plan

Explicação

Questão 40 de 53

1

Post operative orders (select all that apply)

Selecione uma ou mais das seguintes:

  • iv fluids

  • resumption of diet and fluids

  • positioning

  • special wound care instructions

  • oxygen therapy

  • medications

  • emergency contact

  • number of nurse in PACU

Explicação

Questão 41 de 53

1

what is part of your initial assessment of a post surgical patient?

Selecione uma ou mais das seguintes:

  • ABCs

  • LOC

  • V/S

  • O2 therapy

  • Intake/output

  • IV lines/fluid

  • drains and tubes

  • Surgical site

  • pain

Explicação

Questão 42 de 53

1

When assessing neurological systems what should you look for?

Selecione uma ou mais das seguintes:

  • LOC

  • orientation

  • ability to follow commands

  • shine a pen light in their eye

Explicação

Questão 43 de 53

1

what percent of patients have emergence delirium?

Selecione uma das seguintes:

  • 10%

  • 5%

Explicação

Questão 44 de 53

1

a neurological scale used to give reliable and objective way of recording the conscious state of a patient is a

Selecione uma das seguintes:

  • glasgow coma scale

  • orientation scale

Explicação

Questão 45 de 53

1

to prevent pulmonary complications what should you do?

Selecione uma ou mais das seguintes:

  • keep head of bed at 25-45 degrees at all times

  • T and P q 2hs

  • leg exercises

  • teach splinting when coughing

Explicação

Questão 46 de 53

1

list potential cardiovascular complications after surgery

Selecione uma ou mais das seguintes:

  • hemorrhage

  • hypovolemia

  • hypotension

  • syncope/arrhythmias

  • deep vein thrombosis

Explicação

Questão 47 de 53

1

what are some interventions to prevent cardiac complications?

Selecione uma ou mais das seguintes:

  • IV management

  • early ambulation

  • t and p while in bed

  • leg exercises

  • anticoagulants

Explicação

Questão 48 de 53

1

what are some GI function risks for post surgery

Selecione uma ou mais das seguintes:

  • Nausea and vomitting

  • abdominal distention

  • paralytic ileus

  • constipation

  • acites

Explicação

Questão 49 de 53

1

Potential dysfunction in GU function

Selecione uma ou mais das seguintes:

  • Oliguria <30 ml/hr

  • anuria (no urine)

  • Urinary retention

  • UTI

Explicação

Questão 50 de 53

1

when is the original dressing removed?

Selecione uma das seguintes:

  • by the surgeon

  • by the nurse

Explicação

Questão 51 de 53

1

when is a surgical dressing changed?

Selecione uma das seguintes:

  • after 24 hours

  • after 48 hours

Explicação

Questão 52 de 53

1

What are some of the benefits of discharge planning?

Selecione uma ou mais das seguintes:

  • patient satisfaction

  • improved self care

  • decreased LOS

  • Decrease readmission rates

  • decreased cost

Explicação

Questão 53 de 53

1

if a drug is equianlgesic it means

Selecione uma das seguintes:

  • dose of one drug is equivalent in pain relieving effects compared with another drug

  • that the drugs work the same

Explicação