Intraoperative NCLEX Exam 2023 with Questions and

Intraoperative NCLEX Exam 2023 with Questions and Answers

The nurse requests the client to sign a surgical informed consent form for an emergency appendectomy. Which statement by the client indicates further teaching is needed?

1."I will be glad when this is over so I can go home today." 2."I will not be able to eat or drink anything prior to my surgery." 3."I can practice relaxing by listening to my favorite music." 4."I will need to get up and walk as soon as possible." - ANSWER 1 The client will be in the hospital for a few days. This is not a day-surgery procedure. The client needs more teaching.The nurse in the holding area of the surgery department is interviewing a client who requests to keep his religious medal on during surgery. Which intervention should the nurse implement?

1.Notify the surgeon about the client's request to wear the medal.

2.Tape the medal to the client and allow the client to wear the medal.

3.Request the family member take the medal prior to surgery.

4.Explain taking the medal to surgery is against the policy. - ANSWER 2

The medal should be taped and the client should be allowed to wear themedal because meeting spiritual needs is essential to this client's care.The nurse must obtain surgical consent forms for the scheduled surgery. Which client would not be able to consent legally to surgery?

1.The 65-year-old client who cannot read or write.

2.The 30-year-old client who does not understand English.

3.The 16-year-old client who has a fractured ankle.

4.The 80-year-old client who is not oriented to the day. - ANSWER 3 A 16-year-old client is not legally able togive permission for surgery unless the adolescent has been given an emancipated status by a judge. This information was not given in the stem.The nurse is preparing a client for surgery. Which intervention should the nurse implement first?

1.Check the permit for the spouse's signature.

2.Take and document intake and output.

3.Administer the "on call" sedative.

4.Complete the preoperative checklist. - ANSWER 4 Completing the preoperative checklist has the highest priority to ensure all details are completed without omissions.The nurse is interviewing a surgical client in the holding area. Which information should the nurse report to the anesthesiologist? Select all that apply.

1.The client has loose, decayed teeth.

2.The client is experiencing anxiety.

3.The client smokes two (2) packs of cigarettes a day.

4.The client has had a chest x-ray which does not show infiltrates.

5.The client reports using herbs. - ANSWER 1 Loose teeth or caries need to be re-ported to the anesthesiologist so he or she can make provisions to prevent breaking the teeth and causing the client to possibly aspirate pieces.Which task would be most appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)?

1.Complete the preoperative checklist.

2.Assess the client's preoperative vital signs.

3.Teach the client about coughing and deep breathing.

4.Assist the client to remove clothing and jewelry. - ANSWER 4

The UAP can remove clothing and jewelry.

The nurse is assessing a client in the day surgery unit who states, "I am really afraid of having this surgery. I'm afraid of what they will find." Which statement would be the best therapeutic response by the nurse?

1."Don't worry about your surgery. It is safe." 2."Tell me why you're worried about your surgery." 3."Tell me about your fears of having this surgery." 4."I understand how you feel. Surgery is frightening." - ANSWER 3 This statement focuses on the emotion which the client identified and is therapeutic.The 68-year-old client scheduled for intestinal surgery does not have clear fecal contents after three (3) tap water enemas. Which intervention should the nurse implement first?

1.Notify the surgeon of the client's status.

2.Continue giving enemas until clear.

3.Increase the client's IV fluid rate.

4.Obtain STAT serum electrolytes. - ANSWER 1 The nurse should contact the surgeon because the client is at risk for fluid and electrolyte imbalance after three (3) enemas. Clients who are NPO, elderly clients, and pediatric clients are more likely to have these imbalances.The nurse is caring for a male client scheduled for abdominal surgery. Which interventions should the nurse include in the plan of care? Select ALL that apply.

1.Perform passive range-of-motion exercises.

2.Discuss how to cough and deep breathe effectively.

3.Tell the client he can have a meal in the PACU.

4.Teach ways to manage postoperative pain.

5.Discuss events which occur in the post-anesthesia care unit. - ANSWER 2, 4, 5 Coughing effectively aids in the removal of pooled secretions which can cause pneumonia. Deep-breathing exercises keep the alveoli inflated and prevent atelectasis.

The client's postoperative pain should be kept within a tolerable range.

These interventions help decrease the client's anxiety.

The nurse is caring for a client scheduled for total hip replacement. Which behavior indicates the need for further preoperative teaching?

1.The client uses the diaphragm and abdominal muscles to inhale through the nose and exhale through the mouth.

2.The client demonstrates dorsiflexion of the feet, flexing of the toes, and moves the feet in a circular motion.

3.The client uses the incentive spirometer and inhales slowly and deeply so the piston rises to the preset volume.

4.The client gets out of bed by lifting straight upright from the waist and then swings both legs along the side of the bed. - ANSWER 4

The correct way to get out of bed postoperatively is to roll onto the side,grasp the side rail to maneuver to the side, and then push up with one hand while swinging the legs over the side. The client needs further teaching.

The nurse is completing a preoperative assessment on a male client who states, "I am allergic to codeine." Which intervention should the nurse implement first?