NURS 340 EXAM 2 NEWEST NURS 340 HEALTH

Rationale:

NURS 340 EXAM 2 NEWEST / /NURS 340 HEALTH

ASSESSMENT EXAM AND PRACTICE QUESTIONS

NEWEST / ACTUAL EXAM 150 QUESTIONS AND

CORRECT DETAILED ANSWERS AND RATIONALES

(VERIFIED ANSWERS) |ALREADY GRADED A+

Five minutes after receiving a preoperative sedative medication by IV injection, a patient asks to get up to go to the bathroom to urinate. What is the most appropriate action for the nurse to take?

• Offer the patient to use the urinal/bedpan after explaining the need to maintain safety
• Assist the patient to the bathroom and stay next to the door to assist patient back to bed when done.
• Allow the patient to go to the bathroom since the onset of the medication will be more than 5

minutes.

• Ask the patient to hold the urine for a short period since a urinary catheter will be placed in the

operating room - CORRECT ANSWER-A Rationale: The prime issue after administration of either sedative or opioid analgesic medications is safety. Because the medications affect the central nervous system, the patient is at risk for falls and should not be allowed out of bed, even with assistance. The other options would not be safe for the patient.

What is the primary reason for accurately recording the patient's current medications during a preoperative assessment?

• Some medications may alter the patient's perceptions about surgery.
• Many anesthetics alter renal and hepatic function, causing toxicity of other drugs.
• Some medications may interact with anesthetics, altering the potency and effect of the drugs.
• Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after

surgery. - CORRECT ANSWER-C Rationale: Drug interactions may occur between prescribed medications and anesthetic agents used during surgery. For this reason, it is important to take a careful medication history and check that they have been communicated to the anesthesia care provider. Routine medications may or may not be prescribed for use the day of surgery. 1 / 4

Rationale:

While performing preoperative teaching, the patient asks when she needs to stop drinking water before the surgery. Based on the most recent practice guidelines established by the American Society of Anesthesiologists, the nurse tells the patient that?

• she must be NPO after breakfast.
• she needs to be NPO after midnight.
• she can drink clear liquids up to 2 hours before surgery.
• she can drink clear liquids up until she is moved to the OR. - CORRECT ANSWER-C

Rationale: Practice guidelines for preoperative fasting state the minimum fasting period for clear liquids is 2 hours. Evidence-based practice no longer supports the long-standing practice of requiring patients to be NPO after midnight.

The nurse is admitting a patient to the same-day surgery unit. The patient tells the nurse that he was so nervous he had to take kava last evening to help him sleep. Which nursing action would be most appropriate?

• Tell the patient that using kava to help sleep is often helpful.
• Inform the anesthesiologist of the patient's recent use of kava.
• Tell the patient that the kava should continue to help him relax before surgery.
• Inform the patient about the dangers of taking herbal medicines without consulting his health care

provider. - CORRECT ANSWER-B Rationale: Kava may prolong the effects of certain anesthetics. Thus the anesthesiologist needs to be informed of recent ingestion of this herbal supplement. Patients should not take anything before surgery without the health care provider's knowledge.

A 78-year-old patient is having surgery. What risk areas will the nurse need to be especially aware of for this patient during surgery?Sterility 2 / 4

Rationale:

• Paralysis
• Urine output
• Skin integrity - CORRECT ANSWER-D

Rationale:

Skin of older adults has lost elasticity and is at increased risk for injury from tape, electrodes, warming or cooling blankets, and dressings. Pooling cleansing solution may create skin burns or abrasions. The nurse is responsible for monitoring patient safety and adjusting patient position as necessary to prevent pressure or misalignment. Sterility and urine output would be monitored for all patients. Paralysis would not be unusual during some types of surgery but would have an impact on any patient's skin integrity.

The patient is going to have a colonoscopy. Which type of anesthesia should the nurse expect to be used?Local anesthesia

• Moderate sedation
• General anesthesia
• Monitored anesthesia care (MAC) - CORRECT ANSWER-D

The nurse should expect monitored anesthesia care (MAC) to be used for the patient having a colonoscopy because it can match the sedation level to the patient needs and procedural requirements.Local anesthesia would not be used because the area affected by a colonoscopy is larger than loss of sensation could be provided for with topical, intracutaneous, or subcutaneous application. Moderate sedation is used for procedures performed outside the OR, and the patient remains responsive. General anesthesia is not needed for a colonoscopy, and it requires advanced airway management.

In which surgical area will the patient's skin be prepped for surgery, and what clothing will the person doing the prepping be wearing?Surgical suite wearing a lab coat

• Preoperative holding area wearing street clothes
• Postanesthesia care unit (PACU) wearing scrubs 3 / 4

Rationale:

• Operating room wearing surgical attire and masks - CORRECT ANSWER-D

Rationale:

Surgical attire includes pants and shirts (or scrubs), a cap or hood, masks, and protective eyewear. All surgical attire is worn when the patient's skin is being prepped in the operating room to avoid contamination of the site. The surgical suite includes all unrestricted, semirestricted, and restricted areas of the controlled surgical environment. A lab coat is usually worn by the staff over their scrubs when they leave the surgical area. The staff will not wear street clothes in the preoperative holding area, although the family may. The holding area and PACU will not include prepping the patient for surgery.

Unless contraindicated by the surgical procedure, which position is preferred for the unconscious patient immediately postoperative?Supine

• Lateral
• Semi-Fowler's
• High-Fowler's - CORRECT ANSWER-B
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