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Pre-op, intra-op, Post-op Care exam 1-4 Complete questions and answers with verified quiz.
Pre-op, intra-op, Post-op Care exam 1-4 Complete questions and answers with verified quiz.
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Pre-op, intra-op, Post-op Care exam 1-4Complete questions and answers with
verified quiz
Two days after colectomy for an abdominal mass, the patient reports gas pains and
abdominal distension. The nurse plans care for the patient on the basis of the
knowledge that these symptoms occur as a result of which condition?
1 Constipation
2 Nasogastric suctioning
3 Slowed gastric emptying
4 Inflammation of the bowel at the anastomosis site - ANSWER-Correct3
Until peristalsis returns to normal after anesthesia, the patient may experience slowed
gastric motility, leading to gas pains and abdominal distension. Colectomy does not
require a nasogastric tube; the bowel should not be inflamed following surgery unless
infection is present. Constipation may occur following surgery; however, with bowel
manipulation, slowed gastric emptying is the most common reason for gas pains and
abdominal distention because of gas.
A patient with a history of psychosis has newly developed anxiety and is combative with
the nurse. What does the nurse know may be causes of this change in behavior?
1 Delirium
2 Excessive sleep
3 Hyperoxygenation
4 Electrolyte imbalances - ANSWER-Correct4
The nurse knows electrolyte imbalances can cause an acute change in a patient's
behavior. A new onset of anxiety and combativeness may cause delirium rather than the
other way around. Sleep deprivation, not excessive sleep, would cause anxiety and
aggression. Hyperoxygenation would not cause such behavior changes; hypoxemia
does.
,Test-Taking Tip: Sometimes the reading of a question in the middle or toward the end of
an exam may trigger your mind with the answer or provide an important clue to an
earlier question.
A patient on the postoperative unit reports difficulty breathing. The nurse discovers that
the patient received large doses of skeletal muscle relaxants during surgery. What
should the nurse include in the patient's plan of care to promote breathing?
1 Administering opioids
2 Loosening the dressings
3 Repositioning the patient
4 Administering drugs for reversal of paralysis - ANSWER-Correct4
The use of skeletal muscle relaxants may paralyze the muscles required for breathing.
Administering drugs for reversal of paralysis may make breathing easier. Use of opioids
aggravates the condition by causing respiratory depression. Loosening the dressing and
repositioning the patient are helpful when the breathing difficulty is caused by
mechanical restriction but may not help in this case.
The nurse caring for a postoperative patient assesses clinical manifestations of early
pulmonary edema. What manifestations does the nurse determine correlates with this
disorder?
1 Early-morning cough
2 Increased urine output
3 Paroxysmal nocturnal dyspnea
4 Crackles heard on auscultation - ANSWER-Correct3
The most common cause of pulmonary edema is left-sided congestive heart failure,
which commonly manifests as shortness of breath and crackles in the lungs. Between
the two, shortness of breath in the form of paroxysmal nocturnal dyspnea is the earlier
symptom, although crackles are more common. An early-morning cough may be seen
with respiratory infection or chronic obstructive pulmonary disease but is not usually a
symptom of pulmonary edema. In pulmonary edema, urine output is typically decreased
due to fluid retention. Crackles heard on auscultation of the lungs are one of the more
common symptoms of pulmonary edema, along with coughing of frothy pink-tinged
sputum.
,The nurse is monitoring a patient who is about to be transferred to the clinical unit from
the postanesthesia care unit (PACU). Which assessment data require the most
immediate attention? READ THE Q CAREFULLY
1 Oxygen saturation of 94%
2 Pulse rate 128 beats/minute
3 Respiratory rate of 13/minute
4 Temperature of 99.8° F (37.7° C) - ANSWER-Correct2
The most important aspect of the cardiovascular assessment is frequent monitoring of
vital signs. They usually are monitored every 15 minutes in Phase I, or more often until
stabilized, and then at less frequent intervals in Phase II. Notify the anesthesia care
provider (ACP) or the health care provider if the pulse rate is less than 60 beats/minute
or greater than 120 beats/minute. The oxygen saturation should be above 90%, so 94%
is good. A respiratory rate of 13 is normal. A temperature of 99.8 is expected.
A patient is being discharged after having a laparoscopic cholecystectomy. The nurse
should instruct the patient to notify the surgeon immediately if which condition
develops?
1 Constipation
2 Right shoulder pain
3 Decreased appetite
4 Temperature of 103° F - ANSWER-Correct4
The primary health care provider should be notified immediately if the patient
experiences an increase in temperature higher than 101° F because this may be
indicative of an infectious process that will require immediate interventions to resolve.
Right shoulder pain is expected after a laparoscopic surgery and is resolved within 48 to
72 hours. Constipation and decreased appetite may occur. If these do not resolve after
discharge, the patient should be instructed to contact the primary health care provider.
A nurse cares for a patient with acute pulmonary edema. What findings would the nurse
expect to assess?
1 Vertigo and headache
2 Palpitations and nausea
3 Anxiety and distended neck veins
4 Dry, hacking cough and chest pain - ANSWER-Correct3
, The patient experiencing acute pulmonary edema would most likely experience anxiety
related to hypoxia. Distended neck veins would be present because of decreased
cardiac output resulting in right-sided heart congestion, causing blood to back up into
the neck veins. Vertigo and headaches, and palpitations and nausea, may be present
but are not as distinct and common as anxiety, distended neck veins, and shortness of
breath. The cough associated with pulmonary edema will be moist and productive. In
severe cases, this may present as pink and frothy sputum. Chest pain may also be
present.
A postoperative patient is delirious, restless, and shouting at the nurse about pain. What
does the nurse consider may be a cause of this behavior?
1 A new diagnosis of psychosis
2 Increased ability to tolerate pain
3 Anesthetic agents used in surgery
4 Inadequately timed administration of pain medication - ANSWER-Correct3
Anesthetic agents used in surgery can cause short-term psychotic type behaviors that
are relieved after the anesthetic drugs have cleared the body. A new diagnosis of
psychosis is not warranted in the acute phase following surgery. The patient may not be
tolerating the pain, but the delirium, yelling, and restlessness denote short-term
psychotic-like behavior caused by the anesthetic agents and postoperative pain
medications. The nurse should administer pain medications as soon as safely possible.
The nurse is caring for a group of patients. What patient should the nurse be sure to
institute interventions for the prevention of thrombophlebitis?
1 A patient with a 25-year smoking history
2 A female patient in the fifth month of pregnancy
3 An older adult patient taking anticoagulant medications
4 A hospitalized patient who has been on bed rest for 3 days - ANSWER-Correct4
Patients at highest risk for thrombophlebitis are those who stand, sit, or remain on bed
rest for prolonged periods. Hypercoagulable states, such as pregnancy, and vessel wall
trauma due to the effects of smoking also may place a person at risk for
thrombophlebitis. An older adult patient taking anticoagulant medications would be at
less risk for thrombophlebitis.
The nurse finds that a postoperative patient has low oxygen saturation and crackles on
auscultation. Which is an appropriate nursing action?
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