NursGuru

    Exam Review

    1. A postoperative client who had abdominal surgery 6 hours ago begins to exhibit signs of hypovolemic shock. Which assessment findings should the nurse expect? (Select all that apply)
      (SATA)
      A)
      Decreased blood pressure
      B)
      Rapid, thready pulse
      C)
      Warm, flushed skin
      D)
      Bounding peripheral pulses
      E)
      Increased respiratory rate
      F)
      Restlessness and anxiety
    2. A postoperative client who had abdominal surgery 6 hours ago becomes restless and pale, with a blood pressure of 84/50 mm Hg, pulse 124 bpm, and respirations 28/min. The nurse suspects hypovolemic shock. Which nursing action should the nurse take first?
      A)
      Notify the healthcare provider
      B)
      Increase the IV fluid rate
      C)
      Check the client's incision and drainage for bleeding
      D)
      Place the client in a supine position with legs elevated
    3. The most common postoperative cardiac complications include:
      A)
      Arterial insufficiency and mitral valve prolapse
      B)
      Vasodilation and peripheral vascular disease
      C)
      Aortic stenosis and pulseless electrical activity
      D)
      Hypotension and dysrhythmias
    4. A patient is found to have a respiratory rate of 4 breaths per minute after having received morphine for postoperative pain. The LPN knows the reversal agent for opioid toxicity is:
      A)
      naproxen
      B)
      protamine sulfate
      C)
      vitamin K
      D)
      naloxone

    Exam Review

    1. The nurse is caring for a client with a head injury who is being treated for increased intracranial pressure (ICP). Which instruction should the nurse include in the client's care plan?
      A)
      Encourage coughing and deep breathing every 2 hours
      B)
      Instruct the client to avoid coughing, sneezing, or straining during bowel movements
      C)
      Place the client in a flat position to promote cerebral blood flow
      D)
      Encourage the client to perform Valsalva maneuvers to expand the lungs
    2. The nurse working in the postoperative area knows that a client that takes which medication is at an increased risk of infection due to the mechanism of action of the drug?
      A)
      Metoprolol
      B)
      Simvastatin
      C)
      Lisinopril
      D)
      Prednisone
    3. The nurse is planning care for an older adult client scheduled for surgery. Which considerations are important for this client's perioperative care? (Select all that apply)
      (SATA)
      A)
      It may take longer to provide teaching in the pre and post operative stage
      B)
      Older adults have an increased ability to recover quickly from blood loss
      C)
      Older adults have a slower metabolism of anesthetic agents and medications
      D)
      Presence of coexisting conditions
      E)
      Older adults have lower morbidity and mortality rate
      F)
      Skin is more fragile and prone to injury from tape and positioning devices
      G)
      Older adult have a faster recovery time
    4. A client is recovering from abdominal surgery and reports sharp pain at the incision site when coughing. What should the nurse teach the client to do to reduce discomfort and protect the incision?
      A)
      Splint the lower abdomen with a pillow
      B)
      Keep the client flat with feet flexed
      C)
      Turn the client on their side
      D)
      Have the client cough with their mouth open

    Exam Review

    1. A nurse is preparing a client for surgery and notes that Betadine will be used for skin cleansing. Which preoperative assessment takes priority before the surgical prep is applied?
      A)
      Blood sugar level
      B)
      Consent form is signed
      C)
      Past medical history
      D)
      Allergies
    2. The nurse is caring for a client who returned from abdominal surgery 3 hours ago. Which finding is the most concerning for the nurse?
      A)
      Increased restlessness and apprehension
      B)
      Bradycardia and hypertension
      C)
      Bilateral legs with warm, dry skin
      D)
      Increased urinary output
    3. The nurse is preparing to administer ondansetron (Zofran) to a postoperative client. Which statement by the client indicates understanding of the purpose of this medication?
      A)
      "This medicine will help prevent me from feeling sick to my stomach."
      B)
      "This medication will help me relax and sleep better tonight."
      C)
      "This medicine will help relieve my pain after surgery."
      D)
      "This medication will help lower my blood pressure after surgery."
    4. A postoperative client is at risk for developing venous stasis due to decreased mobility. Which nursing intervention is most effective in reducing the risk of venous stasis and thrombosis?
      A)
      Keep the client on strict bed rest for the first 48 hours after surgery
      B)
      Elevate the client's legs above heart level continuously throughout the day
      C)
      Encourage the client to perform leg exercises and ambulate as soon as possible
      D)
      Apply warm compresses to the lower legs every 2 hours

    Exam Review

    1. Which action should the nurse take first when a postoperative client reports feeling a "pop" in the abdominal incision area after sneezing?
      A)
      Assess the incision site for opening being prepared to apply a moist sterile dressing if wound dehiscence is present
      B)
      Tell the client to remain still and call the surgeon
      C)
      Apply an abdominal binder tightly
      D)
      Administer a PRN dose of pain medication
    2. A nurse is assessing a postoperative client who has not voided for 8 hours since surgery. The nurse suspects bladder distention. What is the best way to assess the client for bladder distention?
      A)
      Palpate the lower abdomen for fullness and tenderness above the symphysis pubis
      B)
      Observe for restlessness and increased respiratory rate
      C)
      Ask the client if they feel pressure in their rectal area
      D)
      Measure intake and output for the last 24 hours
    3. A 45-year-old client is 1 day postoperative following an open cholecystectomy. The client reports severe abdominal pain rated 10 out of 10, stating, "The pain is unbearable." The nurse reviews the provider's medication orders: Acetaminophen (Tylenol) 650 mg PO every 6 hours as needed for mild pain Hydrocodone/acetaminophen (Norco) 5 mg/325 mg PO every 4 hours as needed for severe pain Ibuprofen (Motrin) 400 mg PO every 6 hours as needed for moderate pain Based on the client's pain level, which medication should the nurse administer?
      A)
      acetaminophen
      B)
      ibuprofen
      C)
      hydrocodone/acetaminophen
      D)
      Hold all medications and reassess pain in 30 minutes
    4. The nurse is reviewing the preoperative assessment forms for four clients scheduled for surgery this morning. Based on the data below, which client is at the highest risk for postoperative complications?
      A)
      A 25-year-old client having an elective knee arthroscopy with no medical history
      B)
      A 68-year-old client with type 2 diabetes and chronic obstructive pulmonary disease (COPD) scheduled for bowel resection
      C)
      A 45-year-old client with controlled hypertension scheduled for gallbladder removal
      D)
      A 58-year-old client with mild osteoarthritis scheduled for cataract surgery

    Exam Review

    1. A postoperative client has a prescription for "Enoxaparin 40 mg SQ daily." The nurse understands that the primary purpose of this medication in the postoperative period is to:
      A)
      Prevent the formation of deep vein thrombosis (DVT)
      B)
      Treat a diagnosed pulmonary embolism
      C)
      Stimulate the production of red blood cells
      D)
      Provide supplemental pain relief
    2. A client is being prepared for abdominal surgery. The nurse is assigned as the circulating nurse in the operating room. Which action is the primary responsibility of the circulating nurse?
      A)
      Documenting the specifics of the procedure
      B)
      Handing instruments to the surgeon during the procedure
      C)
      Identifying and handling surgical specimens correctly
      D)
      Assisting with surgical draping of the client
    3. The nurse receives a report at the beginning of shift regarding the surgical client's abdominal incision healing by "primary intention". What does healing by "primary intention" mean?
      A)
      The client has poor circulation for healing
      B)
      The wound has little drainage with approximated edges
      C)
      Purulent drainage is present at the incision site
      D)
      The wound is still open and not healing
    4. During the preoperative assessment, the nurse notes that the client reports a severe allergy to latex. Which nursing action is most appropriate to ensure client safety during the perioperative period?
      A)
      Notify the kitchen to omit peaches from client's tray
      B)
      Apply a medical alert band to the client's wrist
      C)
      Place the client in an isolation room
      D)
      Document the allergy in the clients chart

    Exam Review

    1. In the first hour after surgery, the client is in the post-anesthesia care unit (PACU), during that time the nurse should assess the client's blood pressure:
      A)
      Every 4 hours
      B)
      Every hour
      C)
      Every 15 minutes
      D)
      Every half hour
    2. A 58-year-old client with a 30-year history of smoking has just returned to the surgical unit after abdominal surgery. The nurse recognizes that this client is at increased risk for:
      A)
      Impaired mobility
      B)
      Imbalanced nutrition
      C)
      Impaired skin integrity
      D)
      Ineffective airway clearance
    3. A post-mastectomy client will be discharged with a Jackson-Pratt drain. The nurse should instruct the client to immediately report which symptom to the healthcare provider?
      A)
      Drainage that totaled 20 ml over the past 24 hours
      B)
      A reduction in the amount of drainage each day
      C)
      Drainage that is pale yellow or straw-colored
      D)
      Pain, edema, erythema, or warmth around the site
    4. The nurse is preparing a client for surgery and presents the informed consent form for signature. Which client should the nurse recognize as not legally able to provide informed consent?
      A)
      A 60-year-old client who is alert and oriented but speaks limited English and has an interpreter present
      B)
      A 95-year-old client who has advanced dementia
      C)
      A 32-year-old client with type 1 diabetes who is anxious about surgery
      D)
      A 16-year-old client who is married and scheduled for a cesarean birth