Clinical Practicum in Surgery Exam Preparation
Guide
Course Introduction
Clinical Practicum in Surgery is an immersive, hands-on course designed to provide students with practical experience in the surgical environment. Under the supervision of experienced surgeons, students participate in preoperative, intraoperative, and postoperative care, observing and assisting in a variety of surgical procedures. Emphasis is placed on developing core surgical skills, understanding sterile techniques, adhering to safety protocols, and fostering effective communication within the surgical team. The course combines clinical rotations, skills workshops, and reflective learning to prepare students for responsible practice in surgical settings.
Recommended Textbook
Alexanders Care of the Patient in Surgery 14th Edition by Jane C. Rothrock
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30 Chapters
784 Verified Questions
784 Flashcards
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Chapter 1: Concepts Basic to Perioperative Nursing
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) The ambulatory surgery unit is planning to develop a standardized skin preparation practice for their unit.The best process to gather scientific information is to:
A) conduct a survey of skin prep policies at the next AORN chapter meeting.
B) review their surgical site infection data from the last 6 months.
C) conduct a literature search on antimicrobial agents and infection prevention.
D) review the scientific literature from the leading manufacturers of prep solutions.
Answer: C
Q2) During the admission interview,the nurse initiated the discharge teaching and demonstrated crutch-walking activities.The teaching activities are what stage of the nursing process?
A) Nursing assessment
B) Nursing implementation
C) Nursing outcome preparation
D) Nursing evaluation
Answer: B
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Chapter 2: Patient Safety and Risk Management
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25 Flashcards
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Sample Questions
Q1) Spencer Robertson is a 4-week-old frail neonate who had a rectal exam and dilatation under anesthesia following prior surgery for imperforate anus.When the drapes were removed from Spencer,the perioperative nurse noted an area of redness,swelling,and abrasions on the buttocks of the patient.Spencer had been positioned prone for 20 minutes.The nurse who noted the skin condition had relieved the circulating nurse and quickly reviewed the perioperative record and patient chart,but had not seen the patient before positioning.Which of the following safety factors may have contributed to this event?
A) Neonates have extremely delicate skin prone to injury.
B) Preoperative skin condition was not assessed and documented.
C) The relieving nurse did not receive a hand-off report from the circulating nurse.
D) All of these options are contributing factors.
Answer: D
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Chapter 3: Infection Prevention and Control in the
Perioperative Setting
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) Within a steam sterilizer,at a temperature of 100° C (212° F),the water condensation and the steam are the same temperature.This scientific phenomenon is called ___ and will __.
A) Steam saturation;not kill microorganisms
B) Steam distribution;promote microbial kill
C) Sterilization;kill all microorganisms to 106
D) Saturated steam;kill microbes at 106
Answer: A
Q2) Willard Braun was admitted to the ICU 3 weeks ago for heart failure and intractable atrial fibrillation.He has had diarrhea for 4 days that has cultured C.difficile.The transmission-based precautions sign on the door to his room alerts the staff to employ:
A) Contact Precautions with eye protection.
B) both Standard Precautions and Contact Precautions.
C) body substance isolation.
D) droplet Precautions with standard isolation technique.
Answer: B
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Page 5
Chapter 4: Anesthesia
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40 Flashcards
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Sample Questions
Q1) Postoperative nausea and vomiting (PONV)is often a side effect of the inhalational anesthetic _ and the analgesic ___.
A) nitrous oxide;morphine
B) desflurane;sublimaze
C) halothane;meperidine
D) desflurane;morphine
Q2) Vanessa Cavelle,an experienced CRNA,administered MAC to a 29-year-old female undergoing local scar revision surgery for an old abdominal incision.She titrated midazolam and propofol to dull the patient's level of consciousness.She was alerted by the dropping SpO reading and the patient's loss of chest movement.The patient did not respond to a head tilt-chin lift maneuver.Vanessa's next response to this event is to:
A) alert the surgeon and ventilate the patient's lungs with a self-inflating bag/valve/mask.
B) increase the O to 10 L/min,gently tap the patient's shoulder,and call the patient's name.
C) begin chest compressions.
D) call for the code cart and difficult airway cart.
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Page 6
Chapter 5: Positioning the Patient for Surgery
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Sample Questions
Q1) Prolonged lithotomy positioning can result in neuropathies of the legs.The most frequently injured nerves are the obturator,sciatic,femoral,and _ nerve,which can result in injury from __.
A) tibial;hyperextension
B) common peroneal;full leg sequential compression wraps
C) iliopsoas;hyperabduction and contact with candy cane stirrup pole
D) patellar;deep tissue injury from contact pressure with underside of Mayo stand
Q2) Select the positioning devices and accessories commonly used for bariatric surgery.
A) Air-filled,roller,or slider transfer device
B) Upper body ramp
C) Elevated padded armboards
D) All of the options are correct
Q3) Mrs.Faulkner's Braden scale score is 11.This places her at __ risk.
A) low
B) mild
C) high
D) very high
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Chapter 6: Sutures, Needles, and Instruments
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20 Flashcards
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Sample Questions
Q1) The perioperative nurse and the surgical technologist have a responsibility to maintain a safe environment of care for the surgical patient.A surgical complication concerning surgical counts that poses serious harm for the patient and potential consequences for the involved staff is called:
A) a malpractice suit.
B) a retained foreign object.
C) "res ipsa loquitur."
D) criminal negligence.
Q2) The surgeon needs a suture material that will not degrade over time,but becomes encapsulated and supports a tissue structure that will continue to be exposed to pressure and stretching forces throughout the patient's life.These physical properties are best described by a suture that:
A) is nonabsorbable,has good tensile and knot strength,and is the appropriate diameter for the tissue.
B) has a large diameter,is nonabsorbable,is highly reactive,and is a monofilament.
C) is a monofilament,is synthetically manufactured,is absorbable,and has a large diameter.
D) has good tensile strength,memory,and ease of tying and is absorbable.
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Chapter 7: Surgical Modalities
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Distal tip,flexible movement,lenses,air-water nozzle,CCD chip
Q2) The light transmission through an endoscope is achieved by way of:
A) a charge-coupled device chip in the tip of the scope.
B) a chain of small connected micro light bulbs.
C) bundles of fiberoptic glass rods.
D) electrified silicon cables.
Q3) Susie Reynolds,a 9-year-old softball player,has arrived in the OR for emergency repair of superficial facial and deep arm lacerations when she ran into the chain link fence during practice after school.The perioperative nurse discovers that Susie has diabetes and has an insulin pump that should remain connected during the short procedure.The best option for energy-generated hemostasis is:
A) battery-generated eye electrosurgery.
B) bipolar electrosurgery.
C) hemoelectrocoagulated plasma capacitor.
D) monopolar electrosurgery.
Q4) Flexible tube with channels for suction,biopsy,irrigation,light
Q5) Angulation knobs,air-water channel buttons,biopsy port
Q6) Suction,air,water,and light connection adaptors to energy source
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Chapter 8: Wound Healing, Dressings, and Drains
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25 Flashcards
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Sample Questions
Q1) In the care of the postoperative patient,which statement reflects a best practice over which surgical team members have considerable influence? Select all that apply.
A) Maintain an intact sterile dressing over the closed wound for 24 to 48 hours.
B) Change dressings using sterile technique.
C) Employ basic hand hygiene before and after changing the postoperative dressing.
D) Teach the patient and family about incision care.
Q2) Samantha Green sought the consult of a plastic surgeon to repair a large 2-year-old surgical scar on her right leg that was healed but remained darkly pigmented,uneven,and raised.The plastic surgeon reviewed the operative report from Samantha's prior surgery,which revealed an uneventful procedure,wound classification I,closure with uninterrupted 4-0 nylon,and no drain.The underlying cause of the uneven healing was probably due to:
A) failed remodeling phase resulting from inadequate skin care after initial healing.
B) unknown interruption in the normal healing process during proliferative and remodeling phases.
C) failed proliferative phase caused by improper postoperative dressings.
D) the possibility that Samantha is prone to keloid and adhesion formation.
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Chapter 9: Postoperative Patient Care and Pain Management
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20 Flashcards
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Sample Questions
Q1) Select the treatment strategy for PONV that is considered a best practice in the perioperative and perianesthesia setting.
A) Scopolamine patch left on up to 24 hr,comfort measures and aromatherapy of patient's selection,droperidol for refractory nausea
B) Prophylactic antiemetic agent(s) of two different receptor sites,bimodal pain management,H2 blockers,antacids,and oxygen therapy
C) Normalized hydration and blood pressure,appropriate rescue antiemetic (rescue antiemetic should affect a different receptor site than prophylactic agents already given),multimodal pain management
D) Intraoperative IV dexamethasone 8 mg and ondansetron (ODT) 4 mg,followed by a 1-mg oral disintegrating ondansetron tablet taken on discharge and each of the next two mornings
Q2) Select the appropriate example of physiologic symptoms of pain.
A) A proxy pain rating by someone who knows the patient well
B) Facial grimacing and crying
C) The patient's self-report of pain
D) Physiologic indicators,such as elevated vital signs
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Page 11
Chapter 10: Gastrointestinal Surgery
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) An abdominal perineal resection,or APR,for a patient at high risk for colon cancer without anal/rectal involvement (e.g.,familial adenopolyposis [FAP])can be accomplished through an open laparotomy or laparoscopic-assisted ileoanal pull-through approach,per surgeon preference and appropriate patient selection.Which of these statements about approaches for APR is correct?
A) Both open and laparoscopic approaches require an abdominal skin incision(s) and perineal incision(s).
B) Neither approach requires two or more skin incisions.
C) Both procedures require only an abdominal skin incision(s) as the rectal segment is removed and anastomosed intraluminally.
D) The laparoscopic-assisted approach only has an abdominal skin incision(s).
Q2) Which statement about the McBurney incision is most correct?
A) It is an oblique inguinal incision in the left lower quadrant.
B) It is the incision of choice to repair a direct inguinal hernia.
C) It is an oblique inguinal incision in the right lower quadrant.
D) The direction is more transverse than oblique.
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Chapter
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Sample Questions
Q1) The liver,pancreas,and spleen share many similarities.Select the statement about these organs that is true.
A) All three are solid organs and very vascular.
B) All three are metabolic organs.
C) All three organs have terminal attachments to the duodenum.
D) All of the options are false.
Q2) Steven Morganstein,a 51-year-old male with hepatobiliary disease,is scheduled for surgery.The perioperative nurse,during the preoperative assessment,questions and examines the patient for signs and symptoms of jaundice,petechiae,and lethargy and:
A) reviews his chart for bleeding and coagulation times and the platelet count.
B) asks Steven his blood type and when he last donated blood.
C) palpates Steven's abdomen for left upper quadrant tenderness and liver margins.
D) reviews the findings of his endoscopic retrograde cholangiopancreatoscopy (ERCP).
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13
Chapter 12: Repair of Hernias
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Sample Questions
Q1) A study was conducted that compared laparoscopic and open-mesh methods of inguinal hernia repair and also compared TEP and TAPP techniques for cost and patient outcome effectiveness.Some of the factors measured included patient's return to prior activities,persisting pain and numbness,infection,length of operation time,and complications.The researchers discovered several compelling findings and many differences between the two approaches.Select two statements that reflect true findings from the study.
A) TEP and TAPP techniques were of similar cost to the patient.
B) Mesh infection rate was low with both techniques.
C) There was no significant difference in complication rates.
D) There was no apparent difference in the rate of hernia recurrence.
E) Return to work and activity was similar for the two techniques.
F)TEPP and open-mesh techniques shared equal costs to the patient.
Q2) Identify the triad of anatomic sites of abdominal wall weakness with a potential for hernias.
A) Groin,ventral line,umbilicus
B) Inguinal rings,femoral canal,incision
C) Inguinal canal,femoral rings,umbilicus
D) Ventral line,aponeurosis,inguinal canal
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Page 14
Chapter 13: Gynecologic and Obstetric Surgery
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Ova travel through the fallopian tubes toward the uterus by which type of action?
A) Peristalsis
B) Gravity
C) Brownian motion
D) Intra-abdominal pressure
Q2) Select the congenital anomaly that best reflects indications for fetal surgery.
A) Imperforate anus
B) Tracheoesophageal fistula
C) Congenital diaphragmatic hernia
D) Nonobstructive uropathy
Q3) From the list below,select the statement that is true about fallopian tube cancer.
A) Fallopian tube cancer metastasizes to the ovaries and cervix.
B) Fallopian tube cancer is fast-growing in women with genital herpes.
C) Fallopian tube cancer is very rare,with an incidence of less than 1%.
D) Fallopian tube cancer is seen primarily as a metastasis from the small intestine.
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Chapter 14: Genitourinary Surgery
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24 Flashcards
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Sample Questions
Q1) During urologic surgery large quantities of irrigating fluids are infused intraoperatively.An appropriate nursing intervention would include:
A) monitoring and recording the volume of IV and irrigating fluids instilled.
B) maintaining a closed urinary drainage system.
C) providing the patient with information on preventing recurrent urinary tract infections.
D) monitoring blood loss and volume replacement.
Q2) Select the appropriate triad of corrective actions for the management of TURP syndrome in the intraoperative patient.
A) Determine electrolyte levels,measure irrigation fluid volume deficits,administer hypertonic IV saline.
B) Administer hypertonic IV saline,administer IV diuretics,terminate surgery if reaction is severe.
C) Evaluate electrolyte values,give IV diuretics,listen to breath sounds for signs of pulmonary edema.
D) Determine the irrigation fluid volume deficit,reduce pressure on irrigation bag system,administer IV diuretics.
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Chapter 15: Thyroid and Parathyroid Surgery
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Sample Questions
Q1) Linda Martinez,a 61-year-old woman with nontoxic nodular goiter,is scheduled for a subtotal thyroidectomy to relieve esophageal obstruction and rule out a malignant nodule.Select the statement that best describes Linda's thyroid dysfunction and cause.
A) Hypothyroidism resulting from inflammatory impairment of cells that produce hormones
B) Hyperthyroidism resulting from overproduction of enlarged normal thyroid cells
C) Hypothyroidism resulting from insufficient hormone production,increasing thyroid tissue proliferation
D) Hyperthyroidism resulting from malignant spread of mutated hormone producing tissue
Q2) The pyramidal lobe of the thyroid is described as:
A) a small lobe often involved in 30% of cases of thyroid dysfunction.
B) a protrusion of an immature thyroglossal duct cyst overgrowth.
C) a thin upward protrusion of thyroid tissue from the isthmus.
D) a vestige of an embryonic thyroid cyst.
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Chapter 16: Breast Surgery
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Sample Questions
Q1) The goal of breast cancer surgery is removal of the mass with a margin of normal tissue and a good cosmetic result.The choice of procedure depends on the size and site of the mass,the characteristics of the cells,the stage of the disease,and the patient's choice.Select the statement that best reflects the difference between minimally invasive excisional breast biopsy with stereotactic image-guided location and removal of tissue.
A) The stereotactic biopsy produces a specimen for cytologic study,while the excisional biopsy produces a histologic specimen.
B) The excisional biopsy is performed under direct visualization,while the stereotactic approach is image-guided.
C) The excisional approach requires drain placement,while stereotactic biopsy rarely requires a drain.
D) Stereotactic biopsy is recommended for lesions in the areola,high in the axilla,or chest wall while excisional biopsy is not appropriate for these areas.
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18
Chapter 17: Ophthalmic Surgery
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Sample Questions
Q1) When preparing for pars plana vitrectomy in the posterior segment,the perioperative nurse must be aware that a combined scleral buckling procedure may be necessary.Other important information the perioperative nurse should know before preparing the OR for the procedure includes the location of the ocular problem,the surgeon's plan to address the problem,and the instrumentation and biomedical equipment and devices to be used.Technologic advances in ophthalmic surgery require that perioperative nurses be familiar with complex biomedical equipment.A best practice,stated below,relevant to the safe use of complex equipment would be:
A) determine the presence and appropriate date (not expired) of the biomedical monitoring label.
B) demonstrate competence with equipment and check each piece carefully before the patient arrives in the OR.
C) schedule the manufacturer's representative to be present to provide technical support.
D) schedule the biomedical clinical engineer to check all equipment before each procedure.
Q2) Evisceration
Q3) Enucleation
Q4) Exenteration
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Chapter 18: Otorhinolaryngologic Surgery
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Sample Questions
Q1) Select the structure of the trachea that is a landmark during bronchoscopy.
A) Cartilaginous ring
B) Cricoid cartilage
C) Carina
D) Right main bronchus
Q2) Microlaryngoscopy facilitates improved diagnosis and allows the laryngologist to view,with relative ease,areas that previously were inaccessible or difficult to visualize.What are the two most common indications for microlaryngoscopy?
A) Chronic hoarseness and cough
B) Laryngeal polyps and nodules
C) Epiglottitis and frequent choking
D) Laryngeal injury and cancer
Q3) The palatine and lingual tonsils are situated in the oropharynx,while the adenoids are located in the nasopharynx.Both adenoids and tonsils consist of:
A) lymphoid tissue.
B) glandular tissue.
C) vascular tissue.
D) mucosal tissue.
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Chapter 19: Orthopedic Surgery
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Sample Questions
Q1) Tough,long strands of fibers that form the ends of muscles
Q2) The scaphoid,also called the navicular,links the proximal row of carpal bones as it:
A) articulates with each metacarpal head.
B) attaches its rough surfaces to the ligaments.
C) stabilizes and coordinates the movement of the proximal and distal rows.
D) articulates proximally with its matching carpal row.
Q3) A long bone fracture in a child can have devastating consequences in terms of the child's skeletal maturity and potential for limb shortening and malformation when the fracture line involves the:
A) epiphysis.
B) diaphysis.
C) epiphyseal plate.
D) cancellous bone.
Q4) Hematoma formation
Q5) Identify the layer of connective tissue that covers all bone.
A) Periosteum
B) Calcium
C) Cartilage
D) Fascia
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Chapter 20: Neurosurgery
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Sample Questions
Q1) What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp?
A) Pericranial plane
B) Galea
C) Subgaleal space
D) Outer skull periosteum
Q2) The most frequently occurring tumors of the spine are metastatic,and the spine is the most common site for skeletal metastasis.From what organs or disease processes do most secondary spinal tumors originate?
A) Lung,breast,lymphoma,and myeloma
B) Intestines,thyroid,soft tissue sarcoma,and breast
C) Osteosarcoma,meningioma,lymphoma,and pancreas
D) Myeloma,gastric,biliary,and lung
Q3) An important area of the brain that is critical for learning and memory is the ___,while emotion and social behavior are regulated by the .
A) parahippocampal gyri;limbic system
B) amygdal;cingulate
C) hypothalamus;septum
D) hippocampus;amygdala
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Page 22
Chapter 21: Plastic and Reconstructive Surgery
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Sample Questions
Q1) Denise Michaelson,a 46-year-old woman with an early-stage second primary cancer in her left breast,has elected to have a bilateral mastectomy with saline implants.She has requested that the surgeon also revise a small unsightly scar on her right knee and pierce her ears.While Denise's breast tumor could be treated with an excisional biopsy,she has decided to have a mastectomy of both breasts,which is considered an appropriate preemptive (preventative)surgery for a woman of her age with two primary cancers of the breast.The saline implant insertion surgery is considered a ___ procedure,the scar revision is considered a ___ procedure,and the ear piercing is considered a ___ procedure.
A) reconstructive;reconstructive;reconstructive
B) reconstructive;cosmetic;reconstructive
C) cosmetic;reconstructive;cosmetic
D) reconstructive,cosmetic and cosmetic
Q2) A broad range of implant materials are used in plastic and reconstructive surgery.Select the implant that represents a biologic composition of a surgical implant.
A) Autologous human tissue
B) Medical-grade sterile silicone
C) Gold
D) Polypropylene
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Chapter 22: Thoracic Surgery
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Sample Questions
Q1) Video-assisted thoracic surgery (VATS)is a minimally invasive operative technique that has evolved over the past decade.It uses an endoscopic approach to visualize the thoracic cavity for diagnosis of pleural disease or treatment of pleural and lung conditions.In the adult,the surgeon creates a 2- to 3-cm incision between the intercostal spaces for insertion of the 10- or 12-mm trocar.The trocar sites can also be used for insertion of a .
A) fourth and sixth;robotic EndoWrist grasper
B) fifth and seventh;chest tube
C) fifth and seventh;zero-degree scope
D) sixth and eighth;video camera
Q2) An example of a true statement about TNM and staging diagnostic classification for lung cancer is:
A) the staging system is based on the TNM classification system.
B) the TNM system is based on the staging classification.
C) nodal involvement refers to a second primary lung cancer tumor.
D) a patient with T ,N0,M0 has a benign tumor.
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Chapter 23: Vascular Surgery
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Sample Questions
Q1) Identify the venous structure that prevents blood backflow.
A) Semilunar intimal folds
B) Coarctation segments
C) Pressure receptors
D) Venules
Q2) Karen Masterson,the perioperative nurse circulator,is preparing the OR for a vascular procedure where heparin will be used.She has obtained the heparin from the medication dispensing system and is preparing to mix the heparin in IV saline according to the dosage on the surgeon's preference/pick list.The scrub person,Judy Rothman,also a perioperative nurse,is preparing the sterile back table.What expected and appropriate risk reduction strategies related to the use of heparin would both Karen and Judy perform?
A) Label syringe,medicine cup,and IV saline bag with the drug name,dosage,strength,date,and expiration date.
B) Verify the drug and labels with three qualified individuals including the surgeon.
C) Be aware of sound-alike cautions by not placing the heparin vial next to Hespan.
D) Comply with the 7 rights of medication storage and documentation.
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Page 25
Chapter 24: Cardiac Surgery
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Sample Questions
Q1) An implantable cardioverter defibrillator (ICD)is an electronic device designed to monitor cardiac electrical activity and deliver prompt defibrillation.These devices are capable of pacing as well as defibrillating,consisting of a generator and sensing and defibrillator electrodes.Myocardial or thoracic subcutaneous patches may be added if the transvenous catheters alone do not adequately defibrillate the heart.Patients with previously implanted defibrillator patches may present for removal of a patch or patches.What nursing action would be appropriate during this procedure? Select all that apply.
A) Be prepared for emergency intervention if there is electrical overdrive.
B) Be prepared for emergency intervention if there is excessive bleeding.
C) Be prepared for emergency intervention if there is a lethal dysrhythmia.
D) Be prepared for emergency intervention if there is a generator failure.
Q2) The internal mammary arteries are frequently used as grafts during coronary bypass surgery.Where are they located?
A) They diverge from the anterior interventricular branch of the right coronary artery.
B) They diverge from the subclavian arteries behind the sternum.
C) They diverge from the subclavian arteries anterior to the sternum.
D) They diverge from the innominate artery.
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26
Chapter 25: Pediatric Surgery
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Q1) Children classified in the early childhood phase or who are preschool age begin to imagine and explore.Their thinking is dominated by perceptions and,often,distorted reasoning.They are magical thinkers.What would be an appropriate intervention for preschool age children?
A) Allow them to play with a saline-filled syringe to decrease their fear of injections.
B) Allow them to play with their own mask and place on their stuffed bunny's face.
C) Tell them a scary story during anesthesia induction.
D) Draw faces on inflated latex gloves and give each glove a name of a surgical team member.
Q2) Young children are predisposed to parasympathetic hypertonia (increased vagal tone),which can be induced by:
A) painful stimuli such as eye surgery or abdominal retraction.
B) anxiety stimuli such as separation from a parent.
C) environmental stimuli such as loud noise or flashes of light.
D) thermal stimuli such as ambient excessive heat or cold.
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Chapter 26: Geriatric Surgery
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Sample Questions
Q1) The predominant reason for urologic surgery in elderly men is benign prostatic hypertrophy (BPH).What appropriate assessment question would the perioperative nurse ask the patient scheduled for a TURP during the preoperative interview?
A) If he has symptoms that describe evidence of straining at urination (micturition)
B) If he has symptoms that describe evidence of painful urination (dysuria)
C) If he has symptoms that describe evidence of blood in the urine (hematuria)
D) All of the options are correct.
Q2) The perioperative nurse,Lynne,assigns the patient scheduled for cataract surgery the following nursing diagnosis:Ineffective Breathing Patterns attributable to the patient's chronic lung disease.Lynne also documents a secondary nursing diagnosis:High Risk for Injury related to increased intraocular pressure.What potential event can result in this secondary nursing diagnosis?
A) The patient may cough while lying in the supine position.
B) The patient may be anxious and try to raise his or her head during the procedure.
C) Patients with cataracts have glaucoma and may move their head to relieve the pressure.
D) Hypoxia from chronic lung disease can increase intraocular pressure.
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Chapter 27: Trauma Surgery
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Q1) Sherita Noonan,a 9-year-old girl,is admitted to the operating room for elevation of a depressed skull fracture without evidence of a hematoma.She has a history of seizure disorders.The anesthesia provider administers a loading dose of medication to prevent seizure activity under anesthesia.What is the appropriate medication to give and what nursing actions would be indicated?
A) Phenobarbital 15-20 mg/kg IV,monitor cardio/respiratory function during loading dose
B) Phenytoin 15-20 mg/kg IV;monitor for hypotension and drug interactions
C) Phenobarbital 15-20 mg/kg IV,monitor cardio/respiratory function during loading dose and phenytoin 15-20 mg/kg IV;monitor for hypotension and drug interactions
D) Neither phenobarbital 15-20 mg/kg IV,monitor cardio/respiratory function during loading dose nor phenytoin 15-20 mg/kg IV;monitor for hypotension and drug interactions
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Chapter 28: Interventional Radiology
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Q1) Select the diagnostic and interventional radiology procedure that is not classified as a vascular procedure.
A) Percutaneous nephrolithotomy
B) Carotid interventions
C) Portal hypertension management (TIPS)
D) Uterine artery embolization
Q2) Small amounts of a thrombolytic drug can be instilled into portacaths and aspirated to ensure patency of the device.An example of a true statement regarding thrombolytics is:
A) thrombolytic drugs break down the fiber matrix of active plasmin.
B) there are no reported complications to thrombolytic drugs.
C) thrombolytic drugs work best on a fresh clot.
D) thrombolytic drugs convert plasminogen to fibrin.
Q3) What are the indications for using a power injector during an interventional radiology vascular procedure?
A) To propel contrast agents and also emergency drugs into the arterial system
B) To ensure precise timing and rate of injection of contrast media
C) To provide torque to guide the catheter through stenosed vessels
D) To decrease the procedure and radiation exposure time for the patient
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Page 30
Chapter 29: Integrated Health Practices:Complementary and Alternative Therapies
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Sample Questions
Q1) Patients may be reluctant to communicate information about their use of herbal products,botanicals,or dietary supplements,because they may be unsure of the reaction of healthcare professionals to their use of alternative substances.Many herbal products have actions that could be dangerous during surgery.Select all the true statements about herbal supplements and perioperative drugs.
A) Some herbal supplements may accentuate the toxicity of anesthetics.
B) Some herbal supplements may interfere with drug metabolism or clearance.
C) Some herbal supplements may have significant sedative actions.
D) Some herbal supplements may cause central nervous system depression.
E) Some herbal supplements inhibit the binding of naloxone.
Q2) Herbal,orthomolecular,individual biologic therapies and special dietary treatments are encompassed in biologically based therapies.Which of the biologically based therapies listed below are classified as therapeutic nutrition?
A) The diets of Drs.Atkins,Pritikin,and Weil
B) Cartilage products from cattle,sheep,or sharks
C) Bee pollen
D) All of the options are correct.
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Page 31
Chapter 30: Workplace Issues and Staff Safety
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Q1) Healthcare professionals should employ strategies to reduce their risk of allergic reaction to latex in the perioperative environment.Select a best practice for minimizing the risk of latex allergy development in nonallergic patients,and the risk of reaction in sensitive or allergic patients.
A) Use powder-free gloves that have low levels of protein and chemical allergens.
B) Use sterile oil-based hand creams before donning gloves if latex gloves must be worn.
C) Use nonlatex gloves for activities not likely to involve contact with infectious materials.
D) Wear an OR hat without an elastic band and do not wear rubber tennis shoes.
Q2) What vaccine should healthcare workers receive if they are caring for immunocompromised patients?
A) Live attenuated influenza vaccine (LAIV)
B) Inactivated influenza vaccine
C) Immunoglobulin
D) Bordetella vaccine
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