PRETEST: 1. The best time to provide preoperative teaching on deep breathing, coughing and turning exercises is: a.

Before the administration of preoperative medicatios b. The afternoon or evening prior to surgery c. Several days prior to surgery d. Upon admission of the client in the recovery room 2. Which of the following is the primary purpose of maintaining NPO for 6-8 hours before surgery? a. To prevent malnutrition b. To prevent electrolyte imbalance c. To prevent aspiration pneumonia d. To prevent intestinal obstruction 3. Regarding the surgical patient, which of the following terms refers to the period of time that constitutes the surgical experience? a. Preoperative phase b. Intraoperative phase c. Postoperative phase d. Perioperative phase 4. When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as: a. Emergency b. Urgent c. Required d. elective

5. When a person with history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period? a. Immediately, upon admission b. Up to 72 hours after alcohol withdrawal c. Upon awakening in the PACU d. Up to 24 hours after alcohol withdrawal 6. Which of the following categories of medications may result in seizure activity if withdrawn suddenly? a. Adrenal corticosteroids b. Anti-depressants c. Tranquilizers d. diuretics 7. When the patient is encouraged to concentrate on a pleasant experience or restful scene, the cognitive coping strategy employed by the nurse is a. optimistic self recitation b. progressive muscular relaxation c. distraction

d. imagery 8. According to the American Society of Anesthesiology Physical Status Classification System, a patient with a severe systemic disease that is not incapacitating would be assigned which Classification number? a. I b. II c.III d.IV

9. Which stage of anesthesia is termed as surgical anesthesia? a. I b. II c.III d.IV

10. How frequent should the nurse monitor the VS of the patient in the recovery room? a. Every 15 minutes b. Every 30 minutes c. Every 45 minutes d. Every 60 minutes 11. Which of the following manifestations is often the earliest sign of malignant hyperthermia? a. Hypotension b. Elevated temperature c. Tachycardia(heart rate above 150 bpm) d. oliguria 12. Which of the following terms refer to protrusion of abdominal organs through the surgical incision? a. Hernia b. Dehiscence c. erythema d. evisceration

13. What method of wound healing is describe when wound edges are not surgically approximated and integumentary continuity is restored by granulations. a. Primary intention healing b. Second intention healing c. First intention healing d. Third intention healing 14. When the surgeon performs an appendectomy, the nurse recognizes that the surgical category will be identified as: a. Clean b. Contaminated c. Dirty

d. Clean contaminated 15. The nurse knows that there are ways of sterilizing surgical equipments. Which of the following is not a form of sterilization? A. High pressure steam B. Cold chemical C. Dry heat D. Alcohol

16. What is the responsibility of the nurse regarding informed consent? A. To explain surgical options B. To explain operative risks C. To explain surgical procedure to be done D. To witness the patients signature

17. In order to maintain pulmonary ventilation post operative period, a skillful nurse positions the client in: A. side lying B. flat on bed C. Semi-prone position D. prone position

18. What is the prime reason why indwelling catheter is in place after surgery? A. Epidural anesthesia blocks the innervations of the bladder leading to inability to void. B. To measure accurately the intake and output of the patient. C. To ensure that the client voids after operation. D. To reduce risk for fluid volume overload. 19. Which of the following conditions indicates that a sterile field has been contaminated? A. Wetness on the sterile cloth on top of the nonsterile table. B. Sterile objects are held above the waist of the scrub nurse C. Sterile packages are opened with the first edge away from the nurse D. the outer inch of the sterile towel hangs over the side of the table 20. If spinal anesthesia rises to high in her spinal cord, the nurse should be prepared to: a. Elevate the foot of the bed b. administer artificial respiration c. Elevate head of the bed above the extremities D. begin external cardiac massage 21. Hypotension may occur as a complication following induction of spinal anesthesia, which may be due to: A. Traction of various structures within the abdomen

B. Loss of cerebrospinal fluid to cushion the brain C. Paralysis of the vasomotor nerve D. Depression of the respiratory system 22. The final skin preparation is done in the operating room during: A. First stage of anesthesia B. Second stage of anesthesia C. Third Stage of anesthesia D. Fourth stage of anesthesia

23. The preoperative teaching of a nurse is directed towards: A. Instruction of post op exercises B. Acceptance of grief C. encouragement of verbalize feelings D. Discussion of surgical procedure

24 . After a patient has been given his preoperative medication, the nurse should: A. Raise side rails B. Remove his head pillow C. encourage him to void D. apply extra blanket

25. The patient is receiving intravenous fluids intraoperatively with the main reason to: A. Maintain circulatory volume B. Replace fluid being lost from the body C. restore serum electrolyte levels D. increase urinary output

26 . Status post tonsillectomy patient is in the PACU, early manifestation of bleeding is: A. inflammation B. decrease blood pressure 27 . A wound dehiscence can be prevented by: A. suturing the wound with steel wire Instead of silk B. postponing surgery of patients with persistent cough C.bed rest for at least two days post operatively D. applying good support like abdominal binder C. frequent swallowing D. distended abdomen

28. Which of the following nursing measures will be most helpful in the prevention of pulmonary atelectasis post operatively? A. having client cough every 1-2 hours B. wearing of elasticized stocking C. placing client on supine position D. increase oral fluid at least 1.5 liter

29 . A patient fear her impending operation is an expected problem encountered by the perioperative nurse because it is natural to equate anesthesia with: A. amnesia B. insanity C. intoxication D. death

30. A chemical agent used to inhibit the growth of microorganisms on skin and mucus membranes is called as: A. Sporicide B. Disinfectant C. Antihistamine D. Antiseptic

31. Which of the following categories of surgery that is done at the clients life-threatening situation? A. Elective Surgery B. Emergency Surgery C. Required Surgery D. Elective Surgery

32. Which sign alerts the nurse to wound evisceration? A. acute bleeding B. pink serous drainage C. purple drainage D. severe pain

33. A client has been admitted to the recovery room following surgery, upon initial assessment, the recovery room nurse notes the client is restless, has a rapid thread pulse, intercostals retractions and noisy respirations. Which term describes what should be suspected by the nurse? A. Shock B. Hemorrhage C. Respiratory obstruction D. Pain

34. Which statement describes the technique of choice for removing sutures? A. Sterile technique is used when removing suture. B. each suture is clipped as far away from the skin as possible. C. tweezers are necessary only for removal of the continuous stitch sutures. D. the suture is clipped close to the skin and pulled through from the other side. 35. Which factor in the clients history adversely affects wound healing?

A. weight B. occupation

C. Age D. Smoking

36. Three days after surgery, client states: something popped and gushed when I coughed. What action should be taken by the nurse? A. Cover the area with dry, sterile abdominal binder B. Cover the area with sterile towels soaked in saline C. Leave the area open to air D. Apply an abdominal binder

37. What is the purpose of a penrose drain protruding from a post operative surgical incision site? A. provide an entry for wound irrigation obliterating B. prevent the entry of microorganisms Into the wound 38. Preoperatively, a patient is given Atropine sulfate. Which of these findings would indicate that the desired effects of the medication have been achieved? A. increase in heart rate B. dryness of the lips C. onset of drowsiness D. relief of nausea C. promote healing of underlying tissues by dead space D. promote hemostasis of the wound

39. What is the method and practices that prevent cross-contamination in the surgery? A. Surgical scrubbing B. Sterilization C. Contamination D. Aseptic technique

40. What do you call the process of destroying tissue by using chemical corrosion, electricity or heat. It is done by using a small probe, which has an electrical current running through it, to burn or destroy the tissue. A. Laser surgery B. Cryosurgery C. General surgery D. Cauterization

41. Which of the following would be the nurses best response to a female client scheduled for an emergency surgery that is crying and voicing that she is afraid of being put to sleep? A. Squeeze her hand and tell her theres nothing to be afraid of. B. Check her name band and ask the anesthesiologist to give her a sedative.

C. Stand by her side and quietly ask her to describe what she is feeling. D. Let her cry and tell others to leave her alone until she is anesthetized. 42. What do you call the maneuver use to displace the esophagus by applying pressure in the cricoids cartilage; it is usually done prior to insertion of the endotracheal tube? A. Leopolds maneuver B. Sellicks maneuver C. Shellicks maneuver D. Ritgens maneuver

43. The nurse is caring for a client with a chest tube. On the second post operative day, the chest tube accidentally disconnects from the drainage tube. The first action the nurse should take is: A. Clamp the chest tube B. Raise the collection chamber above the patients chest 44. Which of the following is the primary purpose of maintaining NPO for 6-8 hours before surgery? A. prevent malnutrition B. prevent electrolyte imbalance C. prevent aspiration pneumonia D. prevent intestinal obstruction C. Call the physician D. Reconnect the tube

45. The nurse is assessing a clients nutritional status preoperatively. Which of the following observations would indicate poor nutrition in a 5-foot 7-inch female client who is 21 years of age? A. poor posture B. brittle nails C. dull expression D. weight of 128lbs.

46. A client scheduled for outpatient surgery will receive IV Midazolam hydrochloride for premedication. The nurse should prepare a teaching plan for the client that indicates that the medication is intended to produce which of the following effects? A. amnesia B. mild agitation C. Nausea D. blurred vision

47. Which of the following clients is most at risk for potential hazards from the surgical expeience? A. a 68-year-old client C. a 50-year-old client

B. a 30-year-old client

D. a 13-year-old client

48. The nurse should keep in mind while helping to prepare the patient for surgery that the most common problem of the elderly is: A presence of various diseases B. dehydration and malnourishment C. hypersensitivity to variety of drugs D. mental confusion.

49. The nurse understands that the client who has epidural pain management post operatively can ambulate: A. because the epidural catheter is in place for occasional use only B. because a low concentration of local anesthesia is used C. because only analgesia is used D. because of a low pain threshold 50. Which of the following interventions should the nurse implement to help prevent post operative pulmonary embolism? A. have the client perform leg exercises every hour while awake B. encourage the client to cough and deep-breathe C. massage the calves of the clients legs D. have the client wear antiembolic stockings when out of bed 51. Which is the best explanation for the nurse to give a child about general anesthesia induction? A.Your premedication will put you to sleep B. You will breathe oxygen through a facial make you sleepy C. You will breathe in medication through a facial mask and make you sleepy D. You will receive IV medications to make you sleepy 52. The nurse explains to the family that they cannot go with the client past the doors that separate the public from the restricted area of the OR suite because traffic control measures are designed to: mask and receive IV medication to

A. protect the privacy of clients B. separate the family from the surgical team while they are working on the client C. prevent any electrical sparks that could ignite the anesthetic gases D. provide an antiseptic environment to prevent infection

53. Which of the following client statements indicates that the client understands the nurse's teaching about postoperative wounds? A. I should expect a slight odor from the surgical dressing. B. I should call my doctor if my wound is intact and has no drainage. C. I should not clean my surgical wound until i go back to my doctor in 2 weeks. D. I should call my healthcare provider if i have a temperature of 102 degrees 54. Which of the following nursing actions help the patient decrease anxiety during 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 professionals 55. A wound dehiscence or wound disruption can be prevented by: A. suturing the wound with steel wire instead of silk B. postponing surgery of patients with persistent cough C. bed rest for at least two days post op D. applying a good support abdominal binder 56. The position of choice for administering the above anesthesia is to have the patient on A. sides with legs well flexed B. sides with legs well extended C. abdomen with her arms on her sides

D. abdomen with her arms folded under her head 57. When receiving drugs from the circulator, the scrub nurse should: A. clean the top of the vial before inserting the needle B. ask the circulator to read the label before withdrawing the solution C. keep the medication vial on the back table until the procedure is over D. read aloud the name of the drug,strength and/or amount of drug and the expiration date 58. What is the proper attire for the semirestricted area in the operating room suite? 1. Street clothes 2. Scrubsuit and cap and OR shoes 3. OR shoes/slippers and masks 4. Eye shields and sterile gloves A. 1 only C. 3 and 4 B. 2 only D. 1 and 2

59. Who is responsible for the patient's safety inside the operating room? A. surgeon C. nurse B anesthesiologist D. entire surgical team

60. What is the safest and most practical means for sterilizing heat and moist- stable items? A. saturated steam under pressure B. ethylene oxide gas C.activated glutaraldehyde D. boiling water 61. Which of the following sutures is absorbable? a. Vicryl b. Prolene c. Silk d. Mersilk

62. The perioperative nurse is teaching the client about patient-controlled analgesia (PCA_ planned for post operative care. Which statement would indicate further teaching is needed?

a. I will be receiving continuos doses of medication b. I should call the nurse before I take additional doses c. I will call for assistance 63. A client undergoes a traditional cholecystectomy and choledochotomy and returns from surgery with a T-tube. To evaluate the effectiveness of the T0tube, the nurse should understand that the primary reason for the T-tube is to accomplish which of the following goals? a. Promote drainage b. Provide a way to irrigate the biliary tract c. Minimize the passage of bile into the duodenum d. Prevent the bile from entering the peritoneal cavity 64. How much bile would the nurse expect the T-tube to drain during the first 24 hours aftr choledocholithotomy? a. 50-100 ml b. 150-250 ml c. 300-500ml d. 550-700 ml 65. The nurse measures the amount of bile drainage from a T-tube and records it by which one of the following methods? a. Adding it the clients urine output? b. Charting it separately on the output record c. Adding it to the amount of wound drainage d. Subtracting it from the total intake of the day 66. A client with cholecystitis is complaining of severe right upper quadrant pain. Which of the following medications would the nurse anticipate administering to relieve the clients pain? a. Meperidine (Demerol) b. Acetaminophen with codeine

c. Promethazine (Phenergan) d. Morphine sulfate 67. Which of the following serum enzymes is most accurate in assessing liver function? a. AST b. LDH c.ALT d. ALP

68. The client will undergo cholecystectomy. Which of the following drugs would you expect to be given during the preop period? a. Vit A b. Vit D c. Vit E d. Vit K

69. The client is for cholecystectomy and choledochotomy. The procedure involves removal of the gall bladder and a. Drainage of the gall bladder b. Opening of the common bile duct c. Removal of CBD d. Insertion of a drainage tube into the cystic duct 70. Because of the high abdominal incision in cholecytectomy, a major post op complication is: a. Hemorrhage b. Atelectasis c. pneumonia d. infection

71. A client undergoes transurethral resection of the prostate (TURP) under spinal anesthesia. He eturns to his room with continuous bladder irrigation (CBI). Which of the following statements best explains the reason for the CBI? a. To decrease bladder atony b. To remove blood clots from the bladder c. To maintain patency of the urethral catheter d. To dilute the concentrated urine

72. If effective traction must be maintained, the following must be maintained, the following nursing measures must be implemented EXCEPT: a. Provision of adequate countertraction b. Weights should hang freely c. Remove weights intermittently d. Line of pull should be in line with the deformity 73. Which of the following is inappropriate nursing action when caring for the client with cast? a. Support newly casted extremity with the palms of the hand b. Keep the casted extremity dependent on the mattress c. Promote dryness of the cast by exposing the casted extremity d. Do neurovascular assessment on the affected extremity 74. When caring for the patient in traction, the nurse is guided by which of the following principles? a. Skeletal traction is never interrupted b. Weights should rest on the bed c. Knots in the ropes should touch the pulley d. Weights are removed routinely 75. An 84-year old man has just returned to the nursing unit after a TURP. He has a 3-way Foley catheter for continuous bladder irrigation connected to straight drainage. Immediately after surgery, the nurse would expect his urine to be: A. Clear B. Light yellow C. Pink or dark red D. Bright red

76. Nursing actions help the patient decrease anxiety during 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 77. Which of the following is the most dangerous complication during induction of spinal anesthesia? a. Tachycardia b. Hypotension c. Hyperthermia d. bradypnea

78. The preoperative teaching of a nurse is direcred towards a. Instructing in post op exercises b. Learning to grieve c. Encouragement to verbalize d. Discussing his medications and treatments 79. When assisting patient to cugh post operatively, which of this objectives should the nurse have? a. To prevent hemorrhage and promote wound healing b. To constrict the abdomen and prevent ileal retraction c. To lessen pain d. To promote pulmonary ventilation 80. Following abdominal surgey, Mrs Bautista says that she does not like to tae a deep breath or cough due to: a. Trauma of tissue incurred during surgery b. Psychological action commonly experience by surgical patients. c. Proximity of the diaphragm to the incision d. The sutures which act as the invading foreign bodies 81. If the patient develops thrombophlebitis post operativey, the nurse should be prepared to give care that will prevent: a. Arteriole collapse b. Cerebrovascular aneurysm c. Pulmonary emboli

d. Contractive deformities of the legs 82. When patient develops a wound infection, the nurse studies a laboratory analysis od the patients blood findings. Most indicative of patient having a wound infection present when he has a. Low platelet count b. Elevated RBC c. Low hemoglobin count d. Elevated WBC 83. If the patient administered with regional anesthesia develops a postoperative bladder infection, the factor most likely predisposed her to infection is having a. Limited ambulation b. Urinary incontinences c. Low fluid intake d. Bladder catheterization 84. Mrs .Kaingin has not responded to conservative management and was scheduled for gastric and duodenal resection with anastomosis to the jejunum. This surgery is called: a. Billroth 1 b. Billroth II c. Miles Surgery d. Gastrorrhaphy

85. The best position for the client following thyroid surgery is a. Lateral b. Supine c. semi- Fowlers d. prone

86. For post operative subtotal thyroidectomy, the nurse asks the client to state her name as soon as she regains consciousness. The PACU nurse does this primarily to monitor for which of the following complication? A. Intestinal hemorrhage B. Upper airway obstruction C. Laryngeal nerve damage D. Lower airway obstruction

87. The following are appropriate nursing interventions for a client with appendicitis EXCEPT

a. Maintain NPO b. Apply ice cap over the RLQ of the abdomen c. Promote bed rest d. Administer laxative 88. An adolescent male client scheduled for an emergency appendectomy is to be transferred directly from the emergency room to the operating room. Which of the following statements by the client would the nurse interpret as most significant? A. All of the sudden it doesnt hurt at all. B. The pain is centered around my navel stomach C. I feel like Im going to throw up D. It hurts when you press on my

89. During the shock phase of burns, the following are manifested by the client EXCEPT: a. Hypovolemia, increased hct b. Dieresis c. Hyperkalemia, hyponatremia d. Fluid shifts from IVC to ISC 90. . The primary cause of dehydration during the first 48 hours of burn is: a. Increased insensible losses b. Shifting of plasma c. Fluid loss through blister formation d. Actual fluid destruction by the burning 91. Which of the following should be given highest priority in client with burns: a. Initiation of fluid replacement b. Securing an airway c. Initiation of total parenteral nutrition d. Prevention of infection 92. The drug of choice for burn clients because it penetrates eschar is

a. Silver nitrate b. Silver sulfadiazine

c. mafenide acetate d. povidone iodine

93. Which of the following chemical agents may not cause pain? a. P-substance b. Histamine c. Endorphins d. bradykinin 94. The pain center that functions in the interpretation of pain is: a. Cerebral cortex b. Thalamus c. Skin d. Medulla oblongata 95. To perform mechanical debridement, which of the following method is done? a. Dry to dry dressing b. Wet to dry dressing c. Wet to wet dressing d. Dry to wet dressing 96. What is the percentage of burns of an adult client who had experienced burns in the entire right arm and entire right lower extremity? a. 9% b. 18% 97. A major goal in the discharge teaching is: a. Prevention of fluid-electrolyte imbalances b. Prevention of systemic infection c. Prevention of stress ulcer c. 27% d. 36%

d. Prevention of excessive scar formation 98. When the emergency nurse learns that the patient suffered injury from a flash flame, the nurse anticipates which depth of burn? a. Deep Partial thickness b. Superficial partial thickness c. Full thickness d. Superficial 99. 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 100. 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