Pre-Operative nursing

(Q17) Which risk factor should the nurse include in the preoperative plan of care for a patient who smokes?

1) Angina pain

2) Gastrointestinal upset

3) Cognitive impairment

4) Respiratory depression

ANS: 4

(4) respiratory depression is a risk factor that should be included in preoperative plan of care.

since the surgical procedure will use OPIOIDS, the damaged lungs will have a harder time to expel this, which leads to lesser RRs

TOPIC: smoking risks (pg. 3)

(Q1) The nurse administers the preoperative medication to the patient one hour before elective surgery, and then discovers the preoperative consent is not signed. Which action by the nurse is the most appropriate?

1) Have the patient sign the consent quickly, before the medication begins taking effect.

2) Have a family member or medical power of attorney sign the consent.

3) Send the patient to the holding area without a signed consent.

4) Notify the health-care provider that surgery will need to be canceled.

ANS: 4

TOPIC: consent/legal (pg. 3)

(2) The nurse is completing the preoperative checklist on the night shift in preparation for the patient’s surgery, scheduled for 0800. Which tasks could the nurse complete at this time?

1) Documenting the time of last voiding

2) Checking the medical record for the history, physical, and signed informed consent

3) Administering preoperative medication

4) Removing the prosthesis

ANS: 2

the night shift nurse has a test of (2) checking medical record for history, physical and signed informed consent. they make sure that the patient is fully ready and legally prepared for the surgery that they are undergoing the next day.

🧠 Allegory: Night shift is like checking your travel documents before your flight the next morning.

TOPIC: consent/legal (pg. 3)

(10) Which is the priority nursing action when providing patient care during the preoperative phase of care?

1) Ensuring NPO status

2) Monitoring vital signs

3) Obtaining informed consent

4) Completing a preoperative checklist

ANS: 4

as a nurse caring for a patient in a preoperative phase, the PRIORITY is to (4) complete the preoperative checklist. this must be all completed before the transfer to a surgical suite,

TOPIC: consent/legal (pg. 3)

(13) Which information should the nurse collect during the health history that is conducted during the preoperative period?

1) Caretaker after discharge

2) Oral intake over the last day

3) Date of last sexual encounter

4) Previous response to anesthesia

ANS: 4

when collecting information in the health history portion of the preoperative period, the nurse must know about the (4) previous response to anesthesia. this is important because it predicts complications.

TOPIC: health history (pg. 3)

(15) Which is the priority action by the nurse when a patient discloses a medication allergy during the health history prior to a surgical procedure?

1) Asking the patient to describe the reaction that occurs

2) Documenting the information on the patient’s medical record

3) Placing an alert bracelet on the patient prior to leaving the unit

4) Verifying the information with the patient’s family members at the bedside

ANS: 3

if the patient tells the nurse about an allergy before surgical procedure, the nurse must (3) place an alert bracelet on the patient prior to leaving the unit. this is an immediate safety action for the patient to evade any severe complications.

TOPIC: health history (pg. 3)

(9) Which should the nurse teach the patient regarding NPO status prior to a surgical procedure?

1) Nothing by mouth for 12 hours prior to surgery

2) Nothing solid by mouth for six hours prior to surgery

3) No clear liquids by mouth for four hours prior to the surgery

4) No clear liquids by mouth for two hours prior to the surgery

ANS: 4

the following are the NPO guidelines (bold, is the accurate one in the MCQ)

○ No solid food 8 hr before surgery

○ Infant formula 6 hr before surgery

○ Breast milk up to 4 hr before surgery

○ Clear liquids 2 hr (4)

remember: 2-4-6-8 (the thicker / more artificial, the longer NPO)

TOPIC: NPO guidelines (PG.3)

(16) Which parameter for NPO status is appropriate when providing care to a pediatric patient in the preoperative period?

1) Ensuring nothing by mouth for six hours prior to the surgical procedure

2) Ensuring no solid foods by mouth for six hours prior to the surgical procedure

3) Allowing formula to be included in the child’s intake for up to six hours prior to the surgical procedure

4) Allowing breast milk to be included in the child’s intake for up to six hours prior to the surgical procedure

ANS: 3

the following are the NPO guidelines (bold, is the accurate one in the MCQ)

○ No solid food 8 hr before surgery

○ Infant formula 6 hr before surgery (3)

○ Breast milk up to 4 hr before surgery

○ Clear liquids 2 hr

remember: 2-4-6-8 (the thicker / more artificial, the longer NPO)

TOPIC: NPO guidelines (pg.3)

(3) The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed amiodarone?

1) Obtaining a baseline ECG

2) Monitoring blood pressure

3) Assessing for hyperglycemia

4) Tapering the drug two days prior to surgery

ANS: 1

Amiodarone is a cardiac medication, so it is important to (1) obtain a baseline ECG before surgery

TOPIC: pre-op orders: medication management

(4) The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed warfarin?

1) Obtaining a baseline ECG

2) Monitoring blood pressure

3) Assessing for hyperglycemia

4) Tapering the drug two days prior to surgery

ANS: 4

Warfarin is an anticoagulant. this must be (4) tapered two days prior to surgery. this evades the risk of bleeding during surgery.

TOPIC: pre-op orders: medication management

(5) The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed metoprolol?

1) Obtaining a baseline ECG

2) Monitoring blood pressure

3) Assessing for hyperglycemia

4) Tapering the drug two days prior to surgery

ANS: 2

metoprolol is a blood pressure medication. the nurse should (2) monitor blood pressure before the surgery.

TOPIC: pre-op orders: medication management

(6) The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed dexamethoasone?

1) Obtaining a baseline ECG

2) Monitoring blood pressure

3) Assessing for hyperglycemia

4) Tapering the drug two days prior to surgery

ANS: 3

dexamethasone is a steroid. this effects blood sugar, so the nurse should (3) assess for hyperglycemia.

TOPIC: pre-op orders: medication management

(7) The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed phenobarbital?

1) Obtaining a baseline ECG

2) Monitoring blood pressure

3) Maintaining the drug during the perioperative period

4) Assessing blood glucose levels closely during the perioperative period

ANS: 3

phenobarbital as a seizure med. this should be (3) maintained during the perioperativ period. we do not want the patient to experience any seizures during the surgery.

TOPIC: pre-op orders: medication management

(8) The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed insulin?

1) Obtaining a baseline ECG

2) Monitoring blood pressure

3) Holding the drug during the perioperative period

4) Assessing blood glucose levels closely during the perioperative period

ANS: 4

insulin manages blood glucose of a diabetic patient. this should be (4) assessed (blood glucose levels) closely during perioperative period

this is done to have a close look if the patient will experience any glucose changes due to the [1] physical stress inflicted by the surgery, and as well as [2] fasting glucose.

TOPIC: pre-op orders: medication management

(12) Which identifier should the nurse use during the initial time-out to determine the right patient?

1) Date of birth

2) Maiden name

3) Medical record number

4) Photo placed in the medical record

ANS: 1

DOB is a standard identifier.

TOPIC: verify patient (pg. 3)

(20) Which should the nurse ask the patient to verify during the initial time-out, the “pause for cause”?

1) “What is the name of your surgeon?”

2) “Which procedure are you having done today?”

3) “Is the information on your identification band correct?”

4) “Which side of the body is your procedure going to be completed on?”

5) “Have you signed your informed consent for the scheduled procedure?”

ANS: 1,2,3,4

asking for (1) name of surgeon, (2) which procedure is done, (3) accuracy of ID band and (4) location of surgery is all correct to ask before officially letting the patient enter the surgical room, the only thing that is NOT included is

(5) asking for the signed informed consent. this should’ve been done before the actual surgery.