Pre and Post operaive Nclex Questions PDF

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Your Answers & what you got Right & Wrong: 1.) A patient is now in the recovery room after having vaginal surgery. Due to the positioning of the procedure, you would want to assess for what while the patient is in recovery? •

A. Bowel Sounds

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B. Dysrhythmia

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C. Homan's Sign

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D. Hemoglobin Level

The answer is C. Vaginal surgeries require the patient to be in the lithotomy position. This position can put the patient at risk for a deep vein thrombosis. Therefore, the nurse would want to check for this by using Homan's Sign.

2.) After surgery your patient is semicomatose with vital signs within normal limits. As the nurse, what position would be best for this patient? •

A. Semi-Fowlers

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B. Prone

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C. Low-Fowlers

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D. Side positioning preferably on the left side

The answer is D. A patient who are semicomatose are at risk for aspiration (due to secretions pooling in the mouth or vomiting which is a common side effect of sedation). Placing the patient onto their side preferably the left will help decrease the risk of aspiration and help promote cardiovascular circulation.

3.) After surgery your patient starts to shiver uncontrollably. What nursing intervention would you do FIRST? •

A. Apply warm blankets & continue oxygen as prescribed

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B. Take the patient's rectal temperature

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C. Page the doctor for further orders

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D. Adjust the thermostat in the room

The answer is A. Shivering is an early sign that the patient is starting to experience hypothermia. Immediately, the nurse would need to control the shivering by applying warm blankets and continue oxygen. When the patient starts to experience hypothermia, vital organs are not receiving as much oxygenated blood due to the vasoconstriction. Therefore, oxygen would need to be continued. Then the nurse would take the patient's temperature.

4.) The nurse is monitoring the patient who is 24 hours post-opt from surgery. Which finding requires intervention? •

A. BP 100/80

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B. 24-hour urine output of 300 ml

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C. Pain rating of 4 on 1-10 scale

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D. Temperature of 99.3' F

The answer is B. The nurse needs to watch the patient's urinary output closely. Urinary output within a 24-hour period should be at least 30 ml/hr. In this case, the patient is only urinating 12.5 ml/hr.

5.) A patient is 6 days post-opt from abdominal surgery. The patient is to be discharged later today. The patient uses the call light and asks you to come to his room and look at his surgical site. On arrival, you see that approximately 2 inches of internal organs are protruding through the incision. What intervention would you NOT do? •

A. Put the patient in prone position with knees extended to put pressure on the site

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B. Cover the wound with sterile normal saline dressing

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C. Monitor for signs of shock

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D. Notify the MD and administer as prescribed antiemetic to prevent vomiting

The answer is A. The patient is experiencing wound evisceration. This is an emergent situation. The patient should be placed in low Fowler's position with the knees bent to prevent abdominal tension.

6.) A patient reports he hasn't had a bowel movement or passed gas since surgery. On assessment, you note the abdomen is distended and no bowel sounds are noted in the four quadrants. You notify the MD. What non-invasive nursing interventions can you perform without a MD order? •

A. Insert a nasogastric attached to intermittent suction

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B. Administer IV fluids

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C. Encourage ambulation, maintain NPO status, and monitor intake & output

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D. Encourage at least 3000 ml of fluids per day

The answer is C. This patient is most likely experiencing a paralytic ileus which is failure for the bowels to move its contents. The only correct non-invasive option is to encourage ambulation, maintain NPO status, and monitor intake & output. Inserting a NG tube or administering IV fluids is invasive and requires a MD order. Patients with potential paralytic ileus are to be NPO (nothing by mouth) so encouraging fluid intake is incorrect.

7.) What is a potential postoperative concern regarding a patient who has already resumed a solid diet? •

A. Failure to pass stool within 12 hours of eating solid foods

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B. Failure to pass stool within 48 hours of eating solid foods

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C. Passage of excessive flatus

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D. Patient reports a decreased appetite

The answer is B. After a patient resumes solid food, they should have a bowel movement within 48 hours. The patient may be experiencing constipation and appropriate interventions must be followed.

8.) A nurse is developing a care plan for a patient who is at risk for developing pneumonia after surgery. Which of the following is not an appropriate nursing intervention? •

A. Encourage patient intake of 3000 ml/day of fluids if not contraindicated

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B. Encourage patient to use the incentive spirometer device 10 times every 1-2 hours while awake

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C. Encourage early ambulation and patient to eat meals in beside chair

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D. Repositioning every 3-4 hours

The answer is D. All options are correct expect for repositioning every 3-4 hours. If the patient is unable to reposition themselves or ambulate, they must be repositioned every 1 to 2 hours minimally.

9.) When assessing your patient who is post-opt, you notice that the patient's right calf vein feels hard, cord-like, and is tender to the touch. The patient reports it is aching and painful. What would NOT be an appropriate nursing intervention for this patient? •

A. Allow the patient to dangle the legs to help increase circulation and alleviate pain

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B. Instruct the patient to not sit in one position for a long period of time

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C. Elevate the extremity 30 degrees without allowing any pressure on affected area

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D. Administer anticoagulants as ordered by MD

The answer is A. All options are correct except for "Allow the patient to dangle the legs to help increase circulation and alleviate pain". The patient should NOT dangle the legs because this causes blood to pool in the lower extremities which will put the patient at risk for another blood clot formation.

10.) A patient is recovering from surgery. The patient is very restless, heart rate is 120 bpm and blood pressure is 70/53, skin is cool/clammy. As the nurse you would? •

A. Continue to monitor the patient

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B. Notify the MD

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C. Obtain an EKG

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D. Check the patient's blood glucose

The answer is B. This is an emergency situation. The patient is more than likely experiencing a hemorrhage of some type. Notifying the MD would be the first line of action and then you could check the patient's blood glucose and obtain an EKG. This patient is probably going to need a surgical intervention.

11.) A patient is taking Aspirin 325 mg PO by mouth daily. The patient is scheduled for surgery in a week. What education do you provide the patient with before surgery? •

A. Educate the patient to take the scheduled dose of Aspirin the day of surgery to help prevent blood clots

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B. To hold his morning dose of Aspirin because the nurse will give it to him before surgery

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C. None of the above are correct

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D. The medication should be discontinued for 48 hours prior to the scheduled surgery date

The answer is D. Aspirin alters the normal clotting factors and increases the patient's chances of hemorrhaging. Therefore, it should be held for at least 48 hours prior to surgery as specified by the surgeon.

12.) You are observing your patient use the incentive spirometry. What demonstration by the patient lets you know the patient understands how to use the device properly? •

A. The patient inhales slowly on the device and maintains the flow indicator between 600 to 900 level

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B. The patient blows on the mouthpiece rapidly.

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C. The patient uses the incentive spirometry once a day

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D. The patient rapidly inhales on the devices and exhales

The answer is A. All of the options are wrong expect for "The patient inhales slowly on the device and maintains the flow indicator between 600 to 900 level". The other options do not demonstrate how to properly use the incentive spirometry.

13.) As the nurse you are getting the patient ready for surgery. You are completing the preoperative checklist. Which of the following is not part of the preoperative checklist? •

A. Assess for allergies

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B. Conducting the Time Out

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C. Informed consent is signed

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D. Ensuring that the history and physical examination has been completed

The answer is B. The time out is conducted by the OR nurse prior to surgery. All of the other options are conducted by the nurse getting the patient ready for surgery.

14.) You are completing the history on a patient who is scheduled to have surgery. What health history increases the risk for surgery for the patient? •

A. Urinary Tract infections

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B. History of Premature Ventricle Beats

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C. Abuse of street drugs

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D. Hyperthyroidism

The answer is C. If a patient has a history of street drug abuse this puts them at risk in surgery. This information is very important for the anesthesiologist due to the complications that can arise from the anestheisa. All of the other options are important to note but not a risk for surgery.

15.) As a nurse, which statement is incorrect regarding an informed consent signed by a patient? •

A. The nurse is responsible for obtaining the consent for surgery

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B. Patients under 18 years of age may need a parent or legal guardian to sign a consent form

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C. The nurse can witness the client signing the consent form

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D. It is the nurse's responsibility to ensure the patient has been educated by the physician about the procedure before informed consent is obtained

The answer is A. All statements are correct except that it's the nurse's responsibility for obtaining the consent for surgery. It is the surgeon's responsibility....