Perioperative Nursing

1.) Which of the following is most dangerous complication

during induction of spinal anesthesia?
A.)Tachycardia
B.)Hypotension
C.)Hyperthermia
D.)Bradypnea
2.) Which type of surgery is most likely to predispose a patient
to postoperative atelectasis, pneumonia or respiratory failure?
A.)Upper abdominal surgery on an obese patient with a
long history of smoking
B.)Upper abdominal surgery on a patient with normal
pulmonary function
C.)Lower abdominal surgery on a young patient with diabetes
mellitus
D.)Surgery on the extremities of a nonsmoking football player
3.) Which of the following characterizes excitement stage of
anesthesia
A.) Occurs from the administration of anesthesia to the loss of
consciousness
B.) Extends from the loss of consciousness to the loss of lid
reflex, characterized by struggling and talking
C.) From the loss of lid reflex to the loss of most reflexes
D.) From the loss of most reflexes to respiratory and
circulatory failure
4.) To prevent headache after spinal anesthesia the patient
should be positioned:
A.) Semi-fowlers
B.) Flat on bed for 6 to 8 hours
C.) Prone position
D.) Modified trendelenburg
5.) Which of the following nursing actions should be given
highest priority when admitting the patient into the operating
room?
A.) Level of consciousness
B.) Vital signs
C.) Patient identification and correct operative consent
D.) Positioning and skin preparation
6.) What is the primary reason for the gradual change of
position of the patient after surgery?
A.) To prevent muscle injury
B.) To prevent sudden drop of BP
C.) To prevent respiratory distress
D.) To promote comfort
7.) Which of the following assessment data is most important
to determine when caring for a patient who has received spinal
anesthesia?
A.) The time of return of motion and sensation in the legs
and toes
B.) The character of respiration
C.) Level of consciousness
D.) Amount of wound drainage
Ans: A

8.) Which of the following postop findings should the nurse

report to the M.D.?
A.) The patient pushes out the oral airway wit h his tounge
B.) Urine output is 20ml/hr for the past two hours
C.) VS are as follows:
BP=110/70;PR=95;RR=19,Temp=36.8C
D.) Wound drainage is serosanguinous
Ans: B
9.) Which of the following is the earliest sign of poor
respiratory function?
A.) Cyanosis
B.) Fast thready pulse
C.) Restlessness
D.) Faintness
Ans: C
10.) If wound eviscerations occurs, the immediate nursing
action is:
A.) Cover the wound with sterile gauze moistened with
sterile NSS
B.) Cover the wound with water-soaked gauze
C.) Cover the wound with sterile dry gauze
D.) Leave the wound uncovered and pull the skin edges
together
Ans: A
11.) Appendectomy is classified as
A.) Ablative
B.) Constructive
C.) Reconstructive
D.) Palliative
Ans: A
12.) The worst of all fears among clients undergoing surgery
is:
A.) Fear of financial burden
B.) Fear of death
C.) Fear of the unknown
D.) Fear of loss of job
Ans: C
13.) The best time to provide preoperative teaching on deep
breathing, coughing and turning exercises is:
A.) Before administration of preoperative medications
B.) The afternoon or evening prior to surgery
C.) Several days prior to surgery
D.) Upon admission of the client in the recovery room
Ans: B
14.) The following are the appropriate nursing actions before
administration of preoperative medications EXCEPT:
A.) Ascertain the consent has been signed
B.) Ensure that NPO has been maintained
C.) Instruct patient to empty his bladder
D.) Shave the skin at the site of surgery
Ans: D

15.) The patient has been observed pacing along the hallway,
goes to the bathroom frequently and asks questions repeatedly
during preoperative assessment. The most likely cause of the
behavior is:
A.) She is anxious about the surgical procedure
B.) She is worried about separation from the family
C.) She has urinary tract infection
D.) She has an underlying emotional problem

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 patients position

Ans: A

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

16.) Which of the following nursing actions would help the

patient decrease anxiety during the preoperative period?
A.) Explaining all procedures thoroughly in chronological
order
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
Ans: B
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
Ans: C
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

Ans: C

Ans: A
23.) Which of the following drugs is given to relieve nausea
and vomiting?
A.) Mepivacaine
B.) Aquamephyton
C.) Nubain
D.) Plasil
Ans: D
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
Ans: C
25.) Which of the following primarily prevents postop
complications?
A.) Adequate fluid intake
B.) Early ambulation
C.) Well-balanced diet
D.) Administration of antimicrobials

Ans: C
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
Ans: D
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

Ans: B
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
Ans: D

Ans: B

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 preanesthesia meds
Ans: D
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
Ans: C

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
Ans: A
35.) A client in shock must be placed in:
A.) High-fowlers position
B.) Sims position
C.) Modified trendelenburg
D.) Prone position
Ans: C

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
Ans: A
30.) Immediately following spinal anesthesia, the greatest risk
is:
A.) Severe hemorrhage
B.) Severe Hypotension
C.) Severe Hypoglycemia
D.) Hypertensive crisis
Ans: B
31.) Nursing measures to promote the clients 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

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
Ans: C
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
Ans: B
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
Ans: A

Ans: C
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

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
Ans: C

Ans: C
33.) Early signs of poor respiratory function include which of
the following
A.) Cyanosis
B.) Hypotension
C.) Loss of consciousness
D.) Restlessness

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
Ans: C

Ans: D

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 breath while taking a large pulp of water
D.) Administer high concentration of oxygen
Ans: D
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
Ans: A
43.) Which of the following is not appropriate nursing
intervention after modified radical mastectomy?
A.) Place in semi fowlers 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
Ans: D
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

conscientious about encouraging a client to cough and deepbreathe 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
Ans: B
48.) Prior to having a subtotal gastrectomy, a client is told
about the dumping syndrome. The nurse explains that it is:
A.) The bodys 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 stomach into the
portal system
D.) Rapid emptying of food and fluid from the stomach
into the jejunum
Ans: D
49.) Which of the following statements by a client recovering
from a subtotal gastrectomy would indicate a need for
additional teaching about the diet protocol for dumping
syndrome?
A.) I plan to eat a diet low in carbohydrates and high in
protein and fat
B.) I plan to eat a diet high in CHO and low in CHON
and fat
C.) I will eat slowly and avoid drinking fluids during meals
D.) I will try to assume a recumbent position after meals for
30 mins to 1 hour to enhance digestion and relieve symptoms

Ans: A
Ans: B
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
Ans: A
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
Ans: B
47.) During the immediate postoperative period following
gastric surgery, why must the nurse be particularly

50.) A 40 y/o female client has arrived in the post anesthesia

room following a cholecystectomy and a common bile duct
exploration. She is semi conscious. Her vital signs are within
normal limits. Which of the following nursing actions would
be inappropriate?
A.) Apply a warm blanket to her body
B.) Place her in a semi-fowlers position
C.) Attached her T-tube to gravity drainage
D.) Set up low, intermittent suction for her NGT
Ans: B