WorksheetsSurgery – Chapter 17 MS (Worksheet Extraction)
Total questions: 97
Worksheet time: 49mins
Perioperative nurses provide care before surgery, during surgery, and after surgery.
Before surgery
During surgery
After surgery
Only in intensive care
Which task is included among the responsibilities of perioperative nurses?
Admit surgical patients
Perform initial assessments and prepare patients for surgery
Coordinate and assist in the procedures
Provide immediate postoperative care
Manage hospital finances
Which location is listed as a setting where surgical procedures are performed?
Physicians’ offices
Home health agencies
School health rooms
Mobile health vans
Which term describes surgery performed to relieve symptoms without curing the disease?
Palliative surgery
Diagnostic surgery
Ablative surgery
Cosmetic surgery
Which term refers to surgery that removes diseased tissue or body parts?
Ablative surgery
Reconstructive or restorative surgery
Procurement for transplant
Cosmetic surgery
Which purpose of surgery aims to improve appearance?
Cosmetic surgery
Diagnostic surgery
Palliative surgery
Constructive surgery
Which term identifies surgery conducted to obtain tissue or organs for another patient?
Procurement for transplant
Diagnostic surgery
Reconstructive or restorative surgery
Ablative surgery
Which item from the list is a stated purpose of surgery?
Constructive surgery
Preventive surgery
Exploratory laparotomy
Emergency trauma care
Which variables from the diagram are identified as affecting surgical outcomes?
Age
Drugs
Habits
Weather patterns
Which variables from the diagram affect surgical outcomes?
Nutritional status
Fluid and electrolyte balance
Medical diagnoses
Favorite music
Which effect listed in the table is associated with ginseng use in patients undergoing surgery?
Has risk of cardiac effects
Causes immune suppression and liver inflammation
May increase bleeding
Has potential liver toxicity
Which effect listed in the table is associated with echinacea?
Can cause immune suppression and liver inflammation
Has sedative effects and can cause risk of bleeding especially if taken with aspirin and ginkgo
Can cause blood pressure changes and risk of prolonged bleeding
Has potential liver toxicity and increases risk of additive effect to medications
Which effect listed in the table is associated with garlic?
Can cause blood pressure changes and risk of prolonged bleeding
May increase bleeding
Has risk of cardiac effects
Can cause sedation and blood pressure changes with interaction risks
Which effect listed in the table is associated with ginger?
Has sedative effects and can cause risk of bleeding especially if taken with aspirin and ginkgo
Has risk of cardiac effects
Can cause immune suppression and liver inflammation
Has potential liver toxicity and increases risk of additive effect to medications
Which effect listed in the table is associated with ginkgo?
May increase bleeding
Has sedative effects
Has risk of cardiac effects
Can cause immune suppression
Which effect listed in the table is associated with kava?
Has potential liver toxicity and increases risk of additive effect to medications
Has risk of cardiac effects
Can cause immune suppression and liver inflammation
May increase bleeding
Which effect listed in the table is associated with St. John’s wort?
Can cause sedation, blood pressure changes, and has risk of interaction with other medications that prolong effects of anesthesia
Has risk of cardiac effects
May increase bleeding
Has potential liver toxicity
Preoperative assessment — Health history. Identifying data include recording identifying information such as the patient's age and marital status. Which item is part of identifying data?
Patient's age
Laboratory values
Anesthesia plan
Insurance claim number
Preoperative assessment — Health history. History of present illness requires describing the problem that is being treated surgically. Which statement best reflects this instruction?
Explain the surgical problem being addressed
List prior hospital admissions
Summarize family medical history
Document postoperative care needs
Preoperative assessment — Health history. Record chronic health problems. Which of the following are examples of chronic conditions that must be recorded? Select all that apply.
Diabetes
Heart failure
Pulmonary disease
Kidney disease
Preoperative assessment — Health history. Document allergies. Which allergy types should be specifically documented? Select all that apply.
Food
Drug
Tape
Chemical
Preoperative assessment — Review of systems. Collect data about each body system and note abnormalities, disabilities, or limitations. Which problems must be documented if they may be significant during the surgical experience? Select all that apply.
Vision or hearing loss
Partial paralysis or joint stiffness
Weakness
Cognitive impairment
Preoperative assessment — Functional assessment. Which activities are included in the functional assessment? Select all that apply.
Describe usual activity pattern including occupation, roles, and responsibilities
Determine usual diet and fluid intake and use of tobacco and alcohol
Note exercise and rest patterns
Ask about sources of stress and support and usual ways of coping
Preoperative assessment — Physical examination. Which elements are included in the physical examination? Select all that apply.
Height and weight
Vital signs
Skin
Thorax
Abdomen
Interventions — Anxiety. The nurse should determine the presence and level of anxiety, contributing factors, and need for intervention. What is the appropriate initial action?
Assess anxiety level and contributing factors
Administer sedatives immediately
Delay all procedures until surgery
Provide discharge instructions
Interventions — Deficient knowledge. Patient teaching may occur in the physician’s office, clinic, during preadmission workup, or after hospital admission. In which settings or times can preoperative teaching take place? Select all that apply.
Physician’s office
Clinic
During preadmission workup
After hospital admission
Interventions — Teaching methods. Which teaching methods are identified for preoperative patients? Select all that apply.
Direct teaching by the nurse used most often
Hospital classes for all preoperative patients
Books and pamphlets
Audiotapes and videotapes
Interventions — Preparation for surgery. When does preparation for surgery typically start?
Before or shortly after admission
Only on the day of surgery
After discharge from hospital
Only after informed consent is signed
Interventions — Informed consent. Which statements describe informed consent for surgery? Select all that apply.
Patient is informed and agrees to procedure, alternative treatments, and risks
Written consent protects from unwanted procedures
Consent protects the health care facility and caregivers
Patient must be fully alert and aware of the content when signing
Interventions — Preparation of the digestive tract. This intervention depends on the type of anesthesia and surgery. Which purposes of digestive tract preparation are stated? Select all that apply.
Reduces risk of contamination from fecal matter during the operation
Helps prevent postoperative distention until normal bowel function returns
Avoids constipation and straining in the postoperative period
Improves appetite immediately after anesthesia
Interventions — Preparation of the digestive tract. On what does the need for digestive tract preparation depend?
Type of anesthesia and surgery
Patient’s insurance coverage
Length of hospital stay
Availability of postoperative classes
Interventions — Food and fluid restriction: Nothing by mouth (nil per os, NPO) is required from midnight before the scheduled surgery. Which instruction best reflects this guideline?
Do not take anything by mouth from midnight before the scheduled surgery
Only clear liquids are permitted until 2 hours before surgery
Solid food is allowed until midnight but fluids are unrestricted
A small snack is permitted at 5 a.m. on the day of surgery
Interventions — Food and fluid restriction: If a patient routinely takes an oral medication that is considered essential, how should it be managed on the morning of surgery?
Withhold all medications until after surgery
It may be ordered early with a few sips of water or given parenterally
Take it with a light breakfast
Double the dose the night before surgery
Interventions — Skin preparation to reduce the number of organisms near the incision site includes which action?
Scrubbing and removing hair from a wide margin around the planned surgical site
Applying body oil to the operative area
Avoiding any washing the day before surgery
Using talc powder to dry the skin
Interventions — Skin preparation: When is the operative site scrubbed by the perioperative nurse or operating room technician?
Shortly before surgery
After the incision is made
Exactly 24 hours prior to surgery
During induction of anesthesia
Interventions — Dress and grooming: Which instruction is appropriate regarding clothing and personal items before surgery?
Provide a clean gown and remove all undergarments unless agency policy dictates otherwise
Keep all jewelry on for identification purposes
Leave hairpins or clips in place
Nail polish may remain if it is clear
Interventions — Dress and grooming: How should long hair be managed before surgery?
Braid or secure long hair with a rubber band
Shave the head completely
Leave hair loose for comfort
Dye the hair with antiseptic solution
Interventions — Prostheses: Why are prostheses usually removed, marked, and secured before surgery?
To prevent loss or damage and to avoid injury during anesthesia
To improve cosmetic appearance during transport
To facilitate early ambulation in the recovery room
To reduce postoperative pain immediately after surgery
Interventions — Preoperative medications: When are these medications often ordered to be given?
Shortly before transport to surgery or when the patient is in a holding area
Two days before surgery during preadmission testing
Immediately after transfer to the operating table
Only after the consent form is signed
Interventions — Preoperative medications: Which combination reflects typical preoperative medication goals?
Opioid to decrease anxiety and promote sedation, antiemetic to control nausea and vomiting, anticholinergic to decrease secretions
Antibiotic to reduce pain, diuretic to reduce fluids, beta-blocker to increase secretions
Vitamin C to improve immunity, laxative to empty bowels, antihistamine to increase secretions
Corticosteroid to induce anesthesia, expectorant to thin secretions, antipyretic to raise temperature
Interventions — Preoperative medications: After preoperative medication is given, what safety measures should be taken?
Raise side rails, place the call bell within reach, and instruct the patient to remain in bed
Encourage ambulation to prevent stiffness
Provide a full meal tray to prevent nausea
Lower side rails to reduce restraint
From the table of perioperative medications, which drug class is used to prevent bradycardia and reduce pulmonary secretions during surgery?
Benzodiazepine
Anticholinergic
Opioids
Sedative
According to the perioperative medications table, what is the primary perioperative use of opioids such as morphine and fentanyl?
Decrease anxiety
Decrease pain
Maintain general anesthesia
Facilitate intubation
Which example listed under benzodiazepine in the perioperative medications table is used to decrease anxiety and promote amnesia?
Midazolam (Versed)
Dexmedetomidine (Precedex)
Atropine
Pancuronium (Pavulon)
In the perioperative medications table, which agent is identified to relax skeletal muscle to prevent movement during surgery and facilitate intubation?
Morphine
Propofol
Pancuronium (Pavulon)
Etomidate (Amidate)
Which medication in the perioperative table is associated with maintaining general anesthesia?
Dexmedetomidine (Precedex)
Ketamine (Ketalar)
Midazolam (Versed)
Atropine
From the perioperative medications table, which statement best matches the perioperative use of benzodiazepines?
Decrease pain and cause immobility
Decrease anxiety and promote amnesia
Induce anesthesia and maintain anesthesia
Prevent bradycardia and reduce pulmonary secretions
In the second perioperative medications table, which hypnotic is listed to induce anesthesia?
Propofol (Diprivan)
Ketamine (Ketalar)
Etomidate (Amidate)
Midazolam (Versed)
According to the second table, which medication is categorized as an intravenous anesthetic with uses of sedation, control pain, cause amnesia, and immobility?
Ketamine (Ketalar)
Pancuronium (Pavulon)
Atropine
Dexmedetomidine (Precedex)
In the second perioperative medications table, which sedative-hypnotic is used to induce anesthesia and maintain anesthesia?
Etomidate (Amidate)
Propofol (Diprivan)
Morphine
Fentanyl
From the preoperative checklist interventions, which action must be completed before the patient leaves the unit?
Insert a central venous catheter
Complete and sign the preoperative checklist
Administer postoperative antibiotics
Apply sequential compression devices
Based on the preoperative checklist interventions, which set of items must be verified with the chart and patient before transfer?
Radiology reports present; jewelry, prostheses, and nail polish removed; patient voided; premedication given; vital signs recorded; consent form signed
Only laboratory reports present; patient kept NPO; side rails up
Antibiotics administered; surgical site marked; pain score documented
Blood products available; ICU bed assigned; family notified
From the illustrated pre op checklist, which identification item is explicitly listed as part of the day-of-surgery preparation?
Insurance card
ID Band
Social Security card
Driver’s license
According to the illustrated pre op checklist, which patient preparation item is included regarding diet and bowel status?
Encourage high-fiber breakfast
NPO – Bowel Prep
Administer carbohydrate drink
No restrictions on eating
From the illustrated pre op checklist, which statement reflects the required documentation before transfer?
Verbal consent obtained at the bedside
Preoperative education postponed until after transfer
Informed consent signed
All medications held without charting
According to the illustrated pre op checklist, which item addresses removal of cosmetics before surgery?
Makeup and nail polish removed
Hair washed and styled
Perfume applied
Sunscreen applied
From the illustrated pre op checklist, which action regarding valuables is included?
Valuables kept with patient at all times
Documentation/checklist of valuables
All valuables handed to surgeon
Valuables stored without record
According to the Preoperative Checklist, during Time Out the team must verbally agree after performing the Time Out. Which verification is explicitly listed as part of Time Out?
Correct patient identity
Insurance pre-authorization
Patient fasting status
Availability of volunteers
During Time Out on the Preoperative Checklist, which verification confirms the location for the procedure?
Correct site and side
Room temperature within range
Preoperative lab turnaround noted
Visitor policy posted
Which Time Out verification relates to imaging or testing according to the Preoperative Checklist?
Diagnostic study confirmation of site and side
Nurse staffing ratios for the shift
Blood bank operating hours
Cafeteria menu availability
Regarding equipment on the Preoperative Checklist, what does the Time Out section require the team to verify?
Availability of implants
Availability of special equipment
Both are listed
Neither is listed
In the Fire Risk Assessment on the Preoperative Checklist, which item is listed as an ignition source?
Cautery, laser, fiberoptic light source
Wet drapes
Patient identification armband
Sterile gloves
According to the Fire Risk Assessment on the Preoperative Checklist, what action is indicated when the score is 3?
Initiate routine protocol
Initiate high risk fire protocol (see side 2 for specifics)
Cancel the procedure
Notify nonclinical services
In Component #2 Site Marking on the Preoperative Checklist, after verification is completed, what word is the patient instructed to write with a permanent marker on or as near the site as possible if able?
Yes
Correct
Operate
Mark
Within Component #1 Verification Process on the Preoperative Checklist, if site marking is required, what does the form instruct?
Go to component 2
Skip to Fire Risk Assessment
Sign discharge paperwork
Call scheduling
How many Time Outs can be documented on the Preoperative Checklist with time and initials fields?
One
Two
Three
Four
In the Fire Risk Assessment on the Preoperative Checklist, which anatomical reference is used to assess procedure site location?
Xiphoid
Patella
Scapula
Malleolus
Which example of an open oxygen source is explicitly listed in the Fire Risk Assessment on the Preoperative Checklist?
Nasal cannula
Endotracheal tube with closed circuit
Oxygen concentrator in storage
Pulse oximeter sensor
In Component #1 Verification Process on the Preoperative Checklist, what must be verbalized by the patient or decision maker?
Planned procedure
Insurance policy number
Preferred meal choice
Visitor hours
According to Component #1 Verification Process on the Preoperative Checklist, which item confirms the planned procedure?
Schedule
Cafeteria roster
Parking permit
Facility directory map
Which document is listed as confirming the planned procedure in Component #1 Verification Process on the Preoperative Checklist?
Consent
Community newsletter
Gift shop receipt
Building map
In a hand off using SBAR, which component focuses on describing the patient’s current condition.
Situation
Background
Assessment
Recommendation
In a hand off using SBAR, which component presents proposed actions for care.
Situation
Background
Assessment
Recommendation
The images depict the perioperative period identified by the title shown.
Preoperative phase
Intraoperative phase
Postoperative phase
Recovery room phase
According to the Universal Protocol Time-Out principles, who usually marks the procedure site and where.
The surgeon in the preoperative area
The circulating nurse in the operating room
The anesthesia care provider in the PACU
A resident on the hospital ward
During the operating room time-out described, which actions are required before an incision is made.
Involve active members of the procedure team
Confirm the patient identity, site, and procedure
Start the procedure even if questions remain
Document the time-out
Which role listed is the team member who circulates.
Registered nurse who circulates
Registered nurse first assistant
Surgical technician who scrubs
Anesthesia care provider
Which roles shown are included in the surgical team list on the slide.
Surgeon
Assistant surgeon
Pharmacist
Other specialized technical personnel
Which preoperative nursing responsibility is explicitly stated on the diagram.
Record vital signs prior to transfer
Leave jewelry and valuables in place
Apply nail polish and makeup
Keep dentures, eyeglasses, and hearing aids without assessment
Which items are included in the preoperative routines discussed immediately prior to transport to the operating room.
Explain and review the informed consent form
Review physical preparation such as skin, bowels, and NPO status
Discuss what to expect in the operating room
Administer postoperative antibiotics
During regional anesthesia, which nursing consideration is emphasized on the diagram.
Monitor return of sensation
Encourage deeper general anesthesia
Promote respiratory depression
Increase blood pressure proactively
Under general anesthesia nursing concerns on the diagram, which risk is highlighted.
Respiratory depression requiring patent airway management
Elevated urinary output as the only issue
Hypertension prevention without hydration
Immediate ambulation after induction
According to the Local Anesthesia section, which drug is listed as a local anesthetic agent used to alter sensation for procedures performed painlessly and safely?
lidocaine hydrochloride (Xylocaine)
thiopental sodium (Pentothal)
isoflurane (Forane)
ketamine hydrochloride (Ketalar)
In the Local Anesthesia section, how may local anesthetics be administered? Select all that apply.
topically
by local infiltration
by nerve‑blocking techniques
by intravenous infusion
Local anesthetics are often the agents of choice for which patients because of other medical conditions?
older adult patients
pediatric patients
pregnant patients
elite athletes
Which procedures in the Local Anesthesia section are commonly done when general anesthesia is not needed or desired? Select all that apply.
dental procedures
eye surgery
repair of lacerations
open‑heart surgery
Regional anesthesia is achieved using local anesthetics that block the conduction of nerve impulses in a specific area. What effect does regional anesthesia have on patient consciousness?
It does not cause the patient to lose consciousness.
It causes deep unconsciousness similar to coma.
It produces brief loss of memory without sensory changes.
It guarantees complete paralysis of all muscles.
Which description best defines a nerve block in the Regional Anesthesia section?
Injection of an anesthetic agent around a nerve to block the transmission of impulses
Application of anesthetic cream on the skin surface
Continuous inhalation of anesthetic gases through a mask
Electrical stimulation of a nerve to reduce pain
Which options are examples of regional nerve blocks listed in the Regional Anesthesia section? Select all that apply.
epidural anesthesia
subarachnoid anesthesia
inhalational anesthesia
topical anesthesia
What complication of spinal anesthesia is explicitly identified in the Regional Anesthesia section?
post spinal headache
malignant hyperthermia
laryngospasm
urinary retention
Which interventions are listed as management strategies for post spinal headache? Select all that apply.
keeping the patient flat
"blood patch"
offer fluids postoperatively if not contraindicated
encourage immediate ambulation
General anesthesia acts on the central nervous system. Which effects are listed in the General Anesthesia section? Select all that apply.
loss of consciousness
loss of sensation
loss of reflexes, pain perception, and memory
marked bradycardia as the primary intended effect
According to the General Anesthesia section, which routes are used to administer general anesthesia?
inhalation
intravenous infusion
intramuscular injection
topical application
Which of the following are listed inhalation agents in the Inhalation Agents section? Select all that apply.
isoflurane (Forane)
sevoflurane (Ultane)
nitrous oxide
propofol (Diprivan)
Identify the device depicted securing the airway in the diagram accompanying the Inhalation Agents section.
endotracheal tube
nasogastric tube
urinary catheter
central venous catheter
Which agents listed in the Intravenous Agents section are intravenous anesthetics or adjuncts? Select all that apply.
thiopental sodium (Pentothal)
propofol (Diprivan)
midazolam (Versed)
isoflurane (Forane)
Which opioid analgesics appear in the Intravenous Agents section list of IV agents?
fentanyl (Duragesic) and sufentanil (Sufenta)
nitrous oxide and desflurane (Suprane)
lidocaine hydrochloride (Xylocaine) and tetracaine (Pontocaine)
ketamine hydrochloride (Ketalar) and etomidate (Amidate)
