Rafols, Janna Mae L. 3F-2C OR Questions

Rafols, Janna Mae L.
3F-2C
OR questions
1. The most common source of pathogens in the surgical suite is:
A. Surgical team
R: The most common microorganisms causing surgical site infection are
Staphylococcus aureus
2.Why do we administer stool softener or laxative to patients who undergo

hemorrhoidectomy? A. to assist with bowel movements soon after surgery
and to reduce risk of stricture.
3.When is surgical asepsis used?
A. Surgical asepsis is used for wound care
R- during all invasive procedures including surgical procedures and other

invasive procedures such as endoscopy, for the administration of intravenous
medications, for wound care, and for the insertion of an indwelling urinary
catheter as well as other internally placed tubes . Surgical asepsis is necessary
for surgery, it helps protect patients from dangerous germs.
4. Which of the following statements are true for optimal perioperative

care?
A Volume loss should be promptly treated by large intravenous (IV)
infusions of
fluid.
B Hypothermia and pain are to be avoided.
C Starvation needs to be combated.
D Avoid immobility.
E Helpful measures can be taken.
A. B, C, D, E
As a result of hypovolaemia, receptors in the carotid artery, aortic arch and
left atrium act to release aldosterone and antidiuretic hormone (ADH).
Aldosterone is also released by the renin– angiotensin system activated by the
juxtaglomerular apparatus (see Fig. 1.3). Aldosterone and ADH help in
sodium and water retention. Therefore large volumes of fluid infusion should
not be used, as it will result in oedema, peripheral and visceral, the latter
causing delayed gastric emptying.
5.Which of the following statements about surgical site infections (SSIs) are
true?
A Infection in the musculofascial tissues is known as deep SSI.
B The patient may have systemic signs in a minor SSI.
C Infection causing delay in hospital discharge is a major SSI.
D The differentiation between major and minor SSIs is not important.
E Surveillance for surgical site infection should be done for a year after
implanted joint surgery.
A.
6. A, C, E
R- A major SSI is defined as a wound that either discharges significant
quantities of pus spontaneously or needs a secondary procedure to drain it.
The patient may have systemic signs such as tachycardia, pyrexia and a
raised white count (SIRS). It results in delayed return home.
7.
Which of the following statements are true?
A. Wounds are best managed by delayed primary or secondary closure.
R-
The choice of antibiotics may need to be empirical initially as it is illogical to
withhold antibiotics until the organisms and their sensitivities are known. If
an infected wound is under tension, or there is clear evidence of suppuration,
sutures or clips need to be removed, with curettage if necessary, to allow pus
to drain adequately.
1. The client has severe rectal bleeding with 16 diarrheal stools a day,
severe abdominal pain, dehydration, tenesmus. Due to these symptoms
the nurse should be alert for the other problems associated with what
disease?
A.ulcerative colitis
R: The symptoms may be associated with ulcerative colitis. It is a chronic

inflammatory condition producing edema and ulceration that may affect the
entire colon. Ulcerations lead to sloughing that causes stools as many as 20
times a day which is filled with blood, mucous and pus. The other symptoms
are mentioned accompany the problem.
9. The nurse needs to carefully assess the complaints of pain of the elderly
because old people
A. Experience reduced sensory perception
R: During the old age the degenerative changes occur. The response of pain
in the olderly may be lessened because of reduced acuity of touch,
alternations of the neural pathways and diminished process of sensory data.
10.After Billroth II surgery, the client developed dumping syndrome. Which

of the following should be nurse exclude in the plan of care?
A. Sir upright after meals

R. One of the cause of peptic ulcer is H. Pylori infection. It releases toxin that
destroys the gastric and duodenal mucosa which decrease the gastric
epithelium's resistance to acid digestion. Giving antibiotics will control the
infection and Ranitidine which is a histamine-2 blockers, will reduce the acid
secretion that lead to ulcer.
11. What instruction should the client be given before undergoing a

paracentesis?
A. Empty bladder
R: Paracentesis involves the removal of ascitic fluid from the peritoneal
cavity through a puncture made below the umblicus. The client needs to void
before the procedure to prevent accidental puncture of a distended bladder
during the procedure.
12. Which of the following nursing actions

should be given highest priority when
admitting the patient into the operating room?
A. Patient identification and correct operative consent
R.
13. What is the goal of a perioperative nurse?

A. Has one continuous goal
R:to provide a standard of excellence in the care of the client before, during,
and after surgery.
14.What are the 3 phases of Perioperative Nursing?

A. Preoperative (Pre-Surgical Testing)
Intraoperative (Circulator/Scrub)
Postoperative (Post Anesthesia Care Unit PACU)
15. A nurse is preparing the client for transfer to the operating room (OR).
The nurse should take which of the following actions in the care of this client
at this time?
A.Ensure that the client has voided.

R: The nurse should ensure that the client has voided if a Foley catheter is not
in place. The nurse does not administer all daily medications just prior to
sending a client to the OR. Rather, the physician writes a specific order
outlining which medications may be given with a sip of water. The client has
nothing by mouth for 8 hours prior to surgery, not 24. The time of transfer to
the OR is not the time to practice breathing exercises. This should have been
accomplished earlier.
16. What does a health care provider perform before treating a patient who
requires contact isolation?
A. Wear an isolation gown and gloves for all patient contact.
R. Personal protective equipment is worn for all direct and indirect patient
contact. So touching the skin or removing dirty linens both necessitate
wearing gown and gloves
17.Trauma patient is unconscious and needs emergent surgery. The family is

2 hours away but on the way. What does the circulating nurse should do?
A. Have the surgeon document the case is emergent and proceed with the set
up
R: If the injury is life or limb threatening, implied surgical consent is
assumed. The location of the family is irrelevant. Even if they were present
you would still have implied consent as long as the staff notes include the
threat to life or limb.
18. The lowest postoperative infection rates are associated with cases where
the hair was:
A.not removed
R: The lowest infection rates are when the hair is left where it is. Even neuro
cases can be done leaving the hair by using a non-flammable gel to spread the
hair away from the incisional site.
19. What type of medication is mostly used in patients who undergo
hemorrhoidectomy?
A. Topical
R:- Topical medication is a medication that is applied to a particular place on

or in the body in a way that it reduce swelling, pain, and/or itching in order to
make the patient more comfortable.
20.A 72-year-old female client is lifted to the surgery table in preparation for
a total knee replacement. The client is in stage III of inhalation anesthesia. An
appropriate nursing action for this client is:
A. Prepare the operative site

R:. Stage III extends from the loss of lid reflex to cessation of voluntary
respirations.
Operative procedures are performed during stage III of inhalation anesthesia.
21. A 35-year-old female client has returned to her room following

surgery on her right femur. She has an IV of D5 1/2 NS infusing at 125
cc/hr, and is receiving morphine sulfate 10-15 mg IM q4h prn for pain.
The client last voided 5 1/2 hours ago when she was given her
preoperative medication. To monitor and promote the return of urinary
function after surgery, the nurse should:
A. report to the surgeon if the client is unable to void within 8 hours of
surgery.
R: If the postoperative client with normal kidney function cannot void 8
hours after surgery,
the client is retaining urine. The client may need catheterization or
medication. The
physician will provide orders for either, as necessary.
22.Following a gastric resection, a 70-year-old male client is admitted to the

Post-Anesthesia Care Unit (PACU). The client was extubated prior to leaving
the OR suite. Upon arrival at the PACU, the nurse should first:
A. check the client's airway to feel for the amount of air exchange, noting the
rate, depth, and quality of respirations
R: Adequate air exchange and tissue oxygenation depends upon competent
respiratory
function. Checking the airway is the nurse's priority action
23. . A very obese female client returns to her room after abdominal surgery.
The client is drowsy, but oriented; her abdominal dressing is dry and intact;
and her vital signs are T 98.4, P 87, R 18, and BP 146/72. An appropriate
postoperative nursing diagnosis would be:
A. alteration in comfort, abdominal pain
R: Pain is a common phenomenon in clients who have had surgery.
Postoperative pain is
related to the manipulation of and the injury to tissues during the surgical
procedure.
24. A 27-year-old client who is three hours postoperative complains of right

leg pain after knee reduction surgery. The first action by the nurse should be
to:
A. perform a lower extremity neurovascular check

R: Assessment of the postoperative area is important to determine the
presence of
bleeding, swelling, or decreased circulatio
25. The nurse documents a client's surgical incision as having red granulated
tissue. This indicates that the wound is:
A. Healing
R: D. The wound is healing properly. It is filled with red granulated tissue
and fragile capillaries.
26. A 35-year-old client is admitted for elective tubal ligation. During the
preoperative teaching, the client states, 'The anesthesiologist said she was
going to give me balanced anesthesia
A. . is a combination of several anesthetic agents or drugs, which produce a
smooth
induction with minimal complications
R: Balanced anesthesia is a combination of a number of anesthetic agents that
produce a
smooth induction, appropriate depth of anesthesia, and appropriate muscle
relaxation with minimal complications.
27. A 44-year-old male client had abdominal surgery this morning. The nurse
noticed a small amount of bloody drainage on the client's surgical dressing.
This type of drainage is:
A. Sanguineous
R: An incision with a Penrose drain may be expected to have a moderate
amount of
serosanguineous drainage in the first 24 hours, but in general drainage from a
surgical incision is initially sanguineous (red), proceeding to serosanguineous
(pink), then to serous (straw-colored)
28. A client is having a left pneumonectomy. In planning this client's
postoperative care, nursing interventions for a postoperative left
pneumonectomy would include:
A. monitoring the right lung for an increase in rales
R: Rales are commonly heard over the base of the remaining lung. An
increase could
indicate circulatory overload. Rales should be closely monitored.
29. client is scheduled for a cholecystectomy in the morning. In planning the

postoperative care, the priority nursing diagnosis for the client will be at
high-risk for:
A. ineffective breathing pattern
R: Because of the location of the incision, the cholecystectomy client is
reluctant to breath deeply and is at risk for developing pneumonia. These
clients have to be reminded and encouraged to take deep breaths.
30. If not corrected, dehydration caused by hyperemesis results in fluid and
electrolyte imbalance. Which of the following signs indicates a problem other
than dehydration?
A. Bulgingfontanels
R: . A bulging fontanel indicates increased intracranial pressure, whereas a
sunken fontanel
indicates fluid deficiency

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Rafols, Janna Mae L.

2.Why do we administer stool softener or laxative to patients who undergo

3.When is surgical asepsis used?

A. Surgical asepsis is used for wound care

R- during all invasive procedures including surgical procedures and other

4. Which of the following statements are true for optimal perioperative

A. Wounds are best managed by delayed primary or secondary closure.

R: The symptoms may be associated with ulcerative colitis. It is a chronic

10.After Billroth II surgery, the client developed dumping syndrome. Which

A. Sir upright after meals

11. What instruction should the client be given before undergoing a

12. Which of the following nursing actions

13. What is the goal of a perioperative nurse?

14.What are the 3 phases of Perioperative Nursing?

Postoperative (Post Anesthesia Care Unit PACU)

A.Ensure that the client has voided.

17.Trauma patient is unconscious and needs emergent surgery. The family is

R:- Topical medication is a medication that is applied to a particular place on

A. Prepare the operative site

21. A 35-year-old female client has returned to her room following

22.Following a gastric resection, a 70-year-old male client is admitted to the

24. A 27-year-old client who is three hours postoperative complains of right

A. perform a lower extremity neurovascular check

29. client is scheduled for a cholecystectomy in the morning. In planning the

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