WorksheetsSurgical Nursing Worksheet — Extracted Questions
Total questions: 55
Worksheet time: 28mins
The clinical instructor will repeat the session if the student mentions which of the following as a characteristic of closed reduction.
It involves surgical intervention and internal fixations may be used
Helps restore the bone in alignment
May be performed under general or local anesthesia.
Pain management is necessary
A cast may be applied following reduction.
The common cause of secondary brain injury is;
Concussion
Contusion
Scalp laceration
Herniation
Cerebral edema
A client had a transurethral prostatectomy for benign prostatic hypertrophy. He’s currently being treated with a continuous bladder irrigation and is complaining of an increase in severity of bladder spasms. Which of the interventions should be done first?
Administer a belladonna and opium suppository as ordered by the physician.
Check for the presence of clots and make sure the catheter is draining properly.
Stop the irrigation and call the physician.
Administer antibiotic
Administer an oral analgesic.
In management of heparin overdose for the client undergoing cardiac surgery the following is used as antidote.
Vitamin K
Naloxone
Protamine phosphate
Protamine sulfate
Protamine monophosphate
Individuals involved in heavy weight lifting are at increased chance of getting.
All types of hernia
Inguinal hernia
Femoral hernia
Hiatal hernia
Umbilical hernia
After the surgical removal of the gall bladder the nurse was interested in providing nutrition education to the patient and advised to decrease the intake of;
Complex fibers
Proteins
Lipids
Only cholesterol
Carbohydrates
The nurse working in the recovery room received a patient diagnosed to have BPH and transurethral resection of the prostate (TURP) was done. In monitoring the patient catheter drainage, the nurse saw clots and bright red blood increasing in the urine bag. What is the priority action for the nurse to take;
Hang the normal saline and irrigate to remove the clots
Call the surgeon and discuss possibility of post op bleeding
Do nothing as this is expected in the initial hours post op
Administer anticoagulants to prevent further clots
Change the catheter
The nursing student need to provide more instruction if he mentions which of the following as nurses responsibility during time out.
Right patient
Correct procedure
Correct site
Correct anesthesia
Correct count
The nurse caring for a patient following chest tube insertion should expect the following.
You should see the movement of air in the tube as the patient breaths
The color of the drainage should change from blood-stained to cloudy
Continue the flow of the drainage if the collection chamber is above the level of the bed
The absence of air movements may indicate obstruction or kinking of the tube
The bubbling in the collection chamber should be less vigorous
Which is the primary purpose for maintaining nothing per oral for 6-8 hours before surgery.
Prevent electrolyte imbalance
Reduce risk of infection by GI contents
To prevent aspiration pneumonia
To prevent malnutrition
Prevent intestinal obstruction
Immobilization and Reduction are among fracture management approach; it is done either through casting, fixation or application of traction. Based on this concept, which of the following are purposes of immobilization of fractured bones? (Select all that apply.)
To realign the bone to its anatomical origin
To reduce pain from the injured part
To prevent further damage and complications associated with fractures
To increase joint mobility immediately after injury
To promote muscle hypertrophy at the fracture site
Immobilization and Reduction are among fracture management approach; it is done either through casting, fixation or application of traction. Which of the following are types of fixation described for fractures? (Select all that apply.)
Internal fixation
External fixation
Skin traction
Skeletal traction
Functional bracing
Immobilization and Reduction are among fracture management approach; it is done either through casting, fixation or application of traction. Which factors are considered in selection of reduction method to use? (Select all that apply.)
Type and nature of fracture
Age of patient
Severity and size of fracture
Site of fracture
Overall patient condition
Immobilization and Reduction are among fracture management approach; it is done either through casting, fixation or application of traction. Which clinical manifestations indicate compartment syndrome as a complication of casting? (Select all that apply.)
Pain
Paralysis
Pallor
Pulselessness
Parasthesia (Tingling)
For patients who sustained spinal cord injury, quadriplegia is commonly expected if which section is involved.
T8–T12
Lumbar and sacral
C1–C8
T1–T7
C8
When caring a patient sustained fracture of the femur the nurse can do the following.
Place the patient in trendelenburg position
Teaching patient to use wheelchair on his own
Place the hip adducted
Use elevated seat toilet
Allow the hip to rotate only internally and cross legs for comfortability
The patient is planned for chest tube insertion to drain pus from the pleural space. Which of the following term is the correct diagnosis of the patient?
Empyema
Pleural sepsis
Pneumothorax
Hemothorax
Emphysema
The patient admitted in the in the surgical ward presents with severe lower abdominal pain especially in the right inguinal area. The knows the definitive treatment for this type of hernia is
Administration of prophylactic antibiotics
Position change to relief pain
Administration of analgesics to relief symptoms
Massage at the pain location
Consult for surgical intervention
Which assessment finding strongly suggests that a client’s reduced volume of voided urine is due to an obstructive disorder such as an enlarged prostate gland?
The client experiences abdominal cramps.
The client’s bladder is below the pubis.
The client’s urine appears dark amber.
The client feels a continued need to void.
The client cannot tolerate the urge to urinate
Intra-operative phase begins when
Patient is brought on the operating table
Decision for surgery is made
Patient is brought to the post anaesthesia care unit
Patients arrives in the operating theatre
The nurse announce cutting time
The common post op arrhythmias complication of patient from cardiac surgery includes
Sinus bradycardia
Dysrhythmias
Sinus tachycardia
Sinus Rhythm
Bradycardia
The formation of stones by accumulation of cholesterol in the gall bladder or ducts is referred as;
Cystitis
Urolithiasis
Cholecystitis
Bladder stones
Cholelithiasis
The clinical instructor corrects the nursing student if she mentions which statement with regard to care of patient with spinal cord injury
Move the patient only with adequate personnel
Perform logrolling maneuver to change position
Airway opening by head tilt chin lift is safer
Stabilize head and neck before transferring
Provide oxygen support as needed
A patient who is received at the district hospital following motor traffic accident is suspected to have basal skull fracture. Clinical signs suggesting basal skull fracture include
Otorrhea, leaking of cerebral spinal fluids through the ear
Rhinorrhea, leaking of cerebral spinal fluids through the nose
Hearing and visual disturbances
Bulging or swelling of the tympanic membrane
Battle's sign, ecchymosis or blood under the skin behind the ear
For a patient suspected of basal skull fracture, which of the following are appropriate investigations to recommend
History taking and physical assessment
Neurological evaluation
CT scan
MRI (magnetic resonance imaging)
Blood test
The nursing student was instructed to make a balloon for the patient from the chest tube insertion procedure. The student knows the purpose of the balloon is
Reduce the risk of bed sores
Prevent lung trauma by the tube
Restore neurological functions
Exercise abdominal muscles
For lungs to regain their strength
Which one of the following best describes a patient with Benign Prostatic Hypertrophy?
The medical therapy is a beta-blocker
Rectal examination confirms the diagnosis
BPH is an uncommon cause of hematuria
Decreased force of the urinary stream
BPH is common in men in their 30s
The nurse monitoring a patient for 12 hours following chest tube insertion finds no increase in drainage in the collection chamber. Which is the best initial action for the nurse to take
Try to flush to remove the clots
Change the position of the patient to the side of the drainage system
Document as an expected outcome
Notify the physician for a possible chest tube change
Clamp the tube with forceps and release it in 30 minutes
Which nursing action is most appropriate before transporting the client with a chest tube to have X-rays must be taken?
Hang the drainage system on top of the bed stand
Clamp the chest tubes before leaving the room
Attach a portable suction machine to the chest tubes
Keep the drainage system below the insertion sites
Provide mechanical ventilation during transport
The nurse caring for a patient who sustained head injury monitors the Inter-cranial pressure to be within which range
100-139 mmHg
7-15 mmHg
8-30 mmHg
60-100 mmHg
2-6 mmHg
For proper healing of the burn injury, grafting was done where the skin layer from the abdomen was surgically removed to cover open wound on the upper arm. The nurse defined this as
Allograft
Biobrane
Heterograf
Homograft
Autograft
A patient has a chest tube for treatment of a pneumothorax in the left lung. Which finding during your assessment requires immediate nursing intervention?
The patient complained of an air leak at the drainage system
The patient has a slight tracheal deviation to the right side
The water seal chamber fluctuates while the patient inhales and exhales
The water seal chamber has intermittent bubbling
The patient complains of tenderness at the chest tube insertion site
The following are the common complications associated with BPH and its surgical interventions except
Hydro-nephrosis
Hypovolemic shock
Fistula
Urethra stricture
Gallbladder infection
The nursing student is correct if he mentions which of the following as the complication of not clamping the chest tube when emptying the drainage system
Pneumothorax
Hydrothorax
Empyema
Hemothorax
Air embolism
The new patient is received in the ward post laparotomy with the wound well dressed. The nurse knows that the dressings may be changed
Anytime if they are soaked, dirty or 48 hours post op
24 hours post
Whenever the patient requests
Just as normal ward routine
When the doctor orders
Fracture to the pelvic and long bones is commonly associated with which complication
Nerve injury
Fat embolism
Blood clot embolism
Amputation
Air embolism
The nurse requires more clarification if the student mentions which of the following complication of spinal cord injury
Deep Vein thrombosis
Paralytic ileus
Vomiting
Neurogenic shock
Respiratory failure
The patient who sustained fracture of the femur was received post operatively to the orthopedic ward. The patient was doing well but immediately his condition changed and embolism is suspected. The nurse plans for further teaching if the student mentions which of the following as signs/symptoms of embolism
Cyanosis
Complain of acute chest pain
Low oxygen saturation
Bradypnea
Tachycardia
The following is/are the possible cause of renal failure in patients following cardiac surgery
Blood clotting in vessels and fluid retention
Fluid retention and insufficient blood flow to the kidney
Kidney stone due and fluid retention
Insufficient blood flow to the kidney and blood clotting in vessels
Blood clotting in vessel and kidney stone
The patient admitted in the surgical ward is diagnosed to have cholecystitis. The nurse questions the diagnosis if the patient reported the following sign/symptom;
Pain localized in the right lower quadrant
Nausea and vomiting
Dark orange and foamy urine
Abdominal pain that radiates left shoulder
Which of the following is the best position for the patient admitted to the trauma with the diagnosis of head injury;
Trendelenburg position
Supine with the head of the bed flat.
Head of the bed slightly elevated at 30º
Head of the bed elevated 90º
The ideal time interval to monitor a patient in post anaesthesia care unit is
Every 45 minutes
Depends on workload
Every 30 minutes
Every hour
The role of the nurse in informed consent is
Explain the procedure
Witness the voluntary signature
Sign on behalf of the incapacitated patients
To inform the patient on possible surgical team faults
The clinical instructor plans for more instructions if the student mentions which of the following as an example of primary head injury;
Contusion
Concussion
Skull fracture
Scalp laceration
Which is the most serious symptom that may accompany benign prostatic hypertrophy (BPH).
Hesitancy in starting urination.
Decreased force of the urinary stream.
Severe lower abdominal pain.
Urinary retention, acute.
The nurse knows the nursing student is correct if he mentions which statement regarding position of a patient with spinal cord injury
Flat bed for proper spine alignment
Recovery position to prevent tongue fall back
Reverse trendelenburg to reduce cranial pressure
Trendelenburg position with soft pillows on pressure areas
The client is admitted to the hospital with BPH, and a transurethral resection of the prostate is performed. Four hours after surgery the nurse takes the client’s VS and empties the urinary drainage bag. Which of the following assessment findings would indicate the need to notify the physician?
Urinary output of 200 ml greater than intake
Red bloody urine
Blood pressure of 100/50 and pulse 130
Cloudy urine
Which of the following are appropriate nursing interventions for a patient with increased intracranial pressure? Select all that apply.
Administer osmotic diuretics, for example Mannitol, to draw water from the head into the intravascular compartment.
Close monitoring of vital signs and manage symptoms.
Put the patient in a good position, such as elevation of the head of bed to 30–45 degrees.
Administer IV fluids like normal saline that will draw water from the head into the intravascular compartment.
The nurse has been unsuccessful in catheterizing a patient with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the physician using to drain the patient’s bladder?
Scheduling the patient for emergency prostatectomy
Medication administration to relax the bladder muscles
Insertion of a suprapubic catheter
Administration of strong fast-acting diuretics
Which of the following nursing interventions are of paramount importance when caring for a patient after open heart surgery? Select all that apply.
Vital signs monitoring with interventions to stabilize hemodynamics as needed
Pain management using appropriate assessment and analgesia
Oxygen support/respiratory care including breathing exercises and oxygen if desaturating
Wound care using aseptic technique to prevent infection and bleeding complications
Promote mobility and prevent complications through assisted range-of-motion and exercise
The common cause of spinal cord injury in Tanzania is;
Sports
Diving
Alcoholism
Motor vehicle accidents
When the nurse monitors the chamber with the underwater seal drainage, which finding suggests that the system is functioning correctly?
The fluid rises and falls with respirations.
The volume of drainage gets reduced.
The fluid level is lower than when first filled.
The fluid rise and falls with change in position
Which type of hernia is most common with about 75% of all cases?
Diaphragmatic hernia
Inguinal hernia
Femoral hernia
Umbilical hernia
The patient who comes for consultation is planned for surgical repair that involve reinforcement of the posterior abdominal wall using a synthetic mesh. The correct term for this procedure is
Plastic surgery
Hernioplasty
Herniorrhaphy
Herniectomy
Before resuming oral diet, the nurse confirms the return of bowel movements by
Give the client warm sips of sterile water
Auscultation of bowel sounds
Ask the client to go for toilet
Assess for patients ability to swallow
