Exam 1: NSG123/ NSG 123 (Latest 2024/ 2025 Update) Med Surg 1| Questions and Verified Answers| 100% Correct| Grade A- Herzing
Exam 1: NSG123/ NSG 123 (Latest 2024/
2025 Update) Med Surg 1| Questions and
Verified Answers| 100% Correct| Grade AHerzing
Q: Why is food and fluid withheld before surgery?
Answer:
The purpose of withholding food and fluid before surgery is to prevent aspiration.
Q: Obese patients are at higher risk for what kind of postoperative complications? & why?
Answer:
Pulmonary Complications
An obese patient tends to have shallow respirations when supine, increasing the risk of
hypoventilation and postoperative pulmonary complications.
Q: T/F
Dehydration, hypovolemia, and electrolyte imbalances can lead to significant problems in
patients with comorbid medical conditions or in older adults.
Answer:
True
Q: What are patients with diabetes at a higher risk for with surgery? & why?
Answer:
The patient with diabetes is at risk for hypoglycemia either during anesthesia or postoperatively
WHY?
Inadequate carbohydrates or excessive administration of insulin.
Q: T/F
Age alone confers enough surgical risk that it is a clinical predictor of cardiovascular
complications related to anesthesia and surgery.
Answer:
True
Q: T/F
Throughout surgery, nursing responsibilities include providing for the safety and well-being of
the patient, coordinating the OR personnel, and performing scrub and circulating activities.
Answer:
True
Q: T/F
Nursing assessment of the intraoperative patient involves obtaining data from the patient and the
patient’s medical record to identify factors that can affect care.
Answer:
True, only monitor during sleeping patient which is during the intraoperative phase
Q: T/F
Constant surveillance and conscientious technique in carrying out aseptic practices are necessary
to reduce the risk of contamination and infection.
Answer:
True
Q: T/F
Rewarming a patient after surgery must be accomplished rapidly to prevent further hypothermia.
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T/FSurgery classification based on the degree of urgency is considered emergent if it is scheduled within 24 to 30 hours (e.g., acute gallbladder infection). False, emergent is without delay, urgent is 24-30 hours
T/FIt is the doctor’s responsibility to provide appropriate information concerning surgery and obtain the written surgical consent. True, nurse whitnesses conformed consent. If patient does not understand, call doctor back to re educate them. Emergency and they are not awake is an exception
T/F Any nutritional deficiency prior to surgery should be corrected before surgery to provide adequate protein for tissue repair and collagen deposition. True, check especially in patients who are on corticosteroids, diabetes, dehydration, and malnourishment
T/FPatients who smoke are urged to stop 1 to 3 weeks before surgery to significantly reduce pulmonary and wound healing complications. False, stop smoking 30 days prior
T/FAspirin, a common over-the-counter (OTC) medication that inhibits platelet aggregation, should be prudently discontinued 7 to 10 days before surgery or the patient may be at increased risk for bleeding. True, anything that will cause clotting issues
Scrub nurses and circulating nurses care for patients during which perioperative phase? Scrub nurses and circulating nurses care for patients during the intraoperative phase of perioperative nursing.
Why is food and fluid withheld before surgery? The purpose of withholding food and fluid before surgery is to prevent aspiration.
Obese patients are at higher risk for what kind of postoperative complications? & why? Pulmonary ComplicationsAn obese patient tends to have shallow respirations when supine, increasing the risk of hypoventilation and postoperative pulmonary complications.
T/FDehydration, hypovolemia, and electrolyte imbalances can lead to significant problems in patients with comorbid medical conditions or in older adults. True
What are patients with diabetes at a higher risk for with surgery? & why? The patient with diabetes is at risk for hypoglycemia either during anesthesia or postoperativelyWHY? Inadequate carbohydrates or excessive administration of insulin.
T/FAge alone confers enough surgical risk that it is a clinical predictor of cardiovascular complications related to anesthesia and surgery. True
T/FThroughout surgery, nursing responsibilities include providing for the safety and well-being of the patient, coordinating the OR personnel, and performing scrub and circulating activities. True
T/FNursing assessment of the intraoperative patient involves obtaining data from the patient and the patient’s medical record to identify factors that can affect care. True, only monitor during sleeping patient which is during the intraoperative phase
T/FConstant surveillance and conscientious technique in carrying out aseptic practices are necessary to reduce the risk of contamination and infection. True
T/FRewarming a patient after surgery must be accomplished rapidly to prevent further hypothermia. False, slowly rewarm them in the PACU
As the surgical incision is closed, the scrub person and the circulating nurse………… count all needles, sponges, and instruments to be sure they are accounted for and not retained as a foreign body in the patient.
What stage of general anesthesia is characterized by struggling, shouting, laughing, or crying and can often be avoided if the anesthetic is administered smoothly and quickly? Excitement Stage
T/FPatient advocacy in the OR entails maintaining the patient’s physical and emotional comfort, privacy, rights, and dignity True
The preferred anesthetic method in any surgical procedure is? Local because it causes less side effects, but the patient is still awake
The primary objective in the immediate postoperative period is to………. maintain ventilation and prevent hypoxemia and hypercapnia.
T/FThe nurse who admits the patient to the PACU reviews essential information with the anesthesiologist or CRNA and the circulating nurse. True
Nausea and vomiting occurs in about 10% of patients in the PACU. The nurse should not intervene at the patient’s first report of nausea, rather should wait for it to progress to vomiting. False, treat nausea. Some doctors may pre treat if that is possible from knowledge of previous anesthetic use
The first symptom of deep vein thrombosis may be………… a pain or a cramp in the calf.
In phase III of postanesthesia care, the patient would be prepared for……….. Discharge
The primary cardiovascular complications seen in the PACU include…….. hypotension and shock, hemorrhage, hypertension, and dysrhythmias.
Orthostatic Hypotension can result from……… & Actions to preform blood loss, hypoventilation, position changes, pooling of blood in the extremities, or side effects of medications and anesthetics. Actions:don’t raise patient’s head up, feet up & head down, check their medications
What is the scale used to determine patients condition after anesthetics and their ability to transfer to PACU? Many hospitals use a scoring system, called the aldrete score, which is used to determine the patient’s general condition and readiness for transfer from the PACU.
A major nursing diagnosis in the postoperative period may include……… decreased cardiac output related to shock or hemorrhage.
Which medication classification must be assessed during the preoperative period because it can cause an electrolyte imbalance during surgery? Diuretics
What types of patients may need special consideration during and after they have surgery? Obese patientsPatients with disabilitiesPatients undergoing emergency and ambulatory surgeryOlder adultsPatient’s who take medications that affect surgery
uWhat information needs to be included in valid informed consent? Patient SignatureProcedureRisks & BenefitsWhat exactly is going to be done during procedure
Who is able to sign their informed consent? over age of 18 and mentally competent
Legally appointed representative of family may consent if patient is….. a minorunconsciousmentally incompetent
The nurse is preparing to administer a premedication. Which of the following actions should the nurse take first? Have patient use the bathroom to prevent safety issues after medication is given if they try to get up alone.
2 Huge responsibilities of circulating nurse Verifying consentEnsuring that the second verification of the surgical procedure and site takes place and is documented.
Roles of circulating nurse Manages the OR and protects the patient’s safety and health by monitoring the activities of the surgical teamChecking the OR conditions Continually assessing the patient for signs of injury and implementing appropriate interventions.Ensures cleanliness, proper temperature, humidity, appropriate lighting, safe function of equipment, and the availability of supplies and materials. monitors aseptic practices to avoid breaks in technique coordinating the movement of related personnel (medical, x-ray, and lab
Who can be a scrub nurse? RNLPNSurgical Tech
What are some of the roles of registered nurse first assistant (RNFA) RNFA practices under the direct supervision of the surgeon. RNFA responsibilities may include handling tissue, providing exposure at the operative field, suturing, and maintaining hemostasis
What are scrub nurse roles? Including performing hand hygiene; setting up the sterile equipment, tables and sterile field; preparing sutures, ligatures, and special equipment (e.g., a laparoscope, assisting the surgeon and the surgical assistants during the procedure by anticipating the instruments and supplies that will be required, such as sponges, drains, and other equipment.The scrub person and the circulating nurse count all needles, sponges, and instruments to be sure that they are accounted for and not retained as a foreign body in the patient. Labelling tissues specimen .
T/FThe circulating nurse is responsible for monitoring the surgical team and verifying the correct surgical site has been identified by the surgeon and documented?. True
Main Types of Anesthesia Regional anesthesia (epidural, spinal, and local conduction blocks).Moderate sedation (monitored anesthesia care [MAC]),Local anesthesiaGeneral anesthesia (inhalation, IV).
What is malignant hyperthermia? A rare inherited muscle disorder that is chemically induced by anesthetic agentCan happen up to 24 hour after surgery
Pathophysiology of Malignant Hyperthermia malignant hyperthermia is related to a hypermetabolic condition that involves altered mechanisms of calcium function in skeletal muscle cells.
Clinical Manifestations of Malignant Hyperthermia Tachycardia (heart rate greater than 150 bpm) may be an early sign. Rigidity in the client jaw due to abnormal calcium transport.Ventricular dysrhythmia, hypotension, decreased cardiac output, oliguria, and, later, cardiac arrestRise in temperature is a late sign.
First step to treat malignant hyperthermia Recognizing symptoms early and discontinuing anesthesia promptly are imperative
T/FThe most frequent early sign for a patient at risk for malignant hyperthermia subsequent to general anesthesia is bradycardia. False, tachycardia
Phases of Postanesthesia Care Phase I : used during the immediate recovery phase, intensive nursing care is provided. Respiratory assessment is a priority during this phase.Phase II: The patient is prepared for self-care or an extended care setting.Phase III: Prepares the patients for discharge.
Who is responsible for transferring the patient from OR to PACU? Transferring the postoperative patient from the OR to the PACU is the responsibility of the anesthesiologist or certified registered nurse anesthetist (CRNA) and other licensed members of the OR team. During transport from the OR to the PACU, the anesthesia provider remains at the head of the stretcher (to maintain the airway), and a surgical team member remains at the opposite end.
The primary nursing goal in the immediate postoperative period is maintenance of pulmonary function and prevention of laryngospasm False, The primary nursing goal in the immediate postoperative period is maintenance of pulmonary function and prevention of hypoxemia and hypercapnia
How to treat a hemorrhage? Blood transfusion
Patients at risk for atelectasis Atelectasis is a risk for the client who is not moving well or ambulating or who is not performing deep-breathing and coughing exercises or using an incentive spirometer.
Signs and Symptoms of Atelectasis Signs and SymptomsDecreased breath sounds over the affected areaCracklesCough.