Tiêu đề WORKBOOK - PERIOP (KEY) ✅

COMPREHENSIVE PHASE WORKBOOK PERIOP NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. The intern in charge did the skin preparation and catheterization of the client. The circulating nurse noticed that the intern withdrew the catheter from the vaginal orifice instead of the urinary meatus and is about to re insert the same catheter. What is your PRIORITY action? A. Stop the intern and do the catheterization yourself B. Alcoholize the tip of the catheter before reinserting the catheter again C. Offer to change the catheter D. Stop the intern from reinserting the catheter by tapping his shoulder 2. When the intern in-charge did the skin prep and catheterized the client, the circulating nurse noticed when the intern withdraws the catheter from the vagina. What is your APPROPRIATE and IMMEDIATE action? A. Hold the hand of the intern to stop him from reinserting the catheter B. Alcoholize the tip of the catheter before reinserting the catheter C. Offer to change the catheter D. Stop the intern and do the catheterization yourself 3. The surgeon asked for a suture to close the peritoneum. Which of the following should have been done by the scrub nurse before suture is handed to the surgeon? A. Specimen passed to the circulating nurse B. Needle holder passed to the surgeon C. Needle mounted on the needle holder D. Surgical count completed. 4. When the surgeon asked for suture to close the abdomen, sponge count has not been completed. Which of the following is the APPROPRIATE action of the scrub nurse? A. Continues to count the sponges B. Request the surgeons to recheck the abdomen for sponges if any. C. Informs the surgeon that sponge count has not been completed. D. Hands obligingly the suture for closure to the surgeon. 5. Nurse Abby is setting up for an emergency Caesarean Section. The sterile linen packs were damp. The MOST appropriate action is to: A. allow the sterile linen packs to dry before opening B. discard the sterile linen packs C. open the sterile linen packs in front of an electric fan D. bring the sterile linen packs back to the sterilizer 6. Nurse Mary is setting up for an emergency Cesarean Section. The linen packs were damp although these were just taken from the sterilizer. The nurse’s APPROPRIATE action is: A. bring the linen packs back to the Central Supply Section for quality control B. change the damp linen pack C. open the linen pack and allow to dry D. do not use the damp linen 7. After a ten minute surgical hand scrub, the assistant surgeon came into the OR suite swinging her hands casually. The scrub nurse would do which of the following APPROPRIATE action? A. Offer a sterile towel to dry hands B. Oblige the assistant surgeon to scrub again C. Instruct the circulating nurse to pour alcohol 70% to the assistant surgeon’s hands D. Serve the assistant surgeon the sterile gown and gloves as usual 8. The nurse welcomes a preoperative client as she enters the operating room suite. The nurse shall interpret that the client appreciated her presence if the client: A. Clasped the nurse’s hands B. Put her blanket all the way to cover her face C. Turned to the opposite direction from the nurse D. Closed her eyes as though asleep 9. After the last stitch the surgeon is ready to apply dressings on the incision wound. Which of the following does the nurse expects the surgeon to do? A. Tape the dressings and remove gloves B. Apply the dressings and tape, then remove his gloves C. Put the dressings, remove his gloves to apply the tape D. Remove his gloves and apply the dressings 10. After the surgeon finished doing the surgical hand scrub, she came in to the OR suite swinging her hands casually. The scrub nurse would do which of the following APPROPRIATE action? A. Tell the circulating nurse to pour alcohol 70% to the surgeon’s hands B. Serve the surgeon her sterile gown and gloves as usual C. Remind the surgeon to scrub again D. Offer a sterile towel to dry her hands 11. During a surgical procedure, the circulating nurse poured sterile saline solution into the basin and accidentally spilled the solution into the sterile table drape. Identify the APPROPRIATE action of the scrub nurse. A. Pat dry the wet portion of the table drape B. Ignore the wet drape C. Discard the saline solution D. Cover the wet table drape with sterile towel 12. A life saving instruction on the purposes of withholding food and water intake prior to surgery is a must to all surgical clients. This necessitates that nurses should ensure that children for surgery should be scheduled as: A. upon patient’s preference B. first case C. alternate D. last case 13 The surgeon of a client for Dilatation and Curettage (D & C) who is on triple Anti TB drugs complained why his case is scheduled “last” for the day. The OR nurse offers which of the following BEST reason? A. “Foremost, we considered the safety of others clients.” B. “Your anesthesiologist preferred the time slot.” C. “The case is relatively short and easy.” D. “There is no emergent need to do the case ahead of the other schedule”. 14. Immediately before opening and presenting any sterile item to the sterile field. The circulating nurse should inspect for which of the following indicators? TOP RANK REVIEW ACADEMY, INC. Page 1 | 4
1. Package integrity 2. Date when manufactured 3. Sterilization indicator 4. Expiration Date 5. Purchase price 6. Device specification A. 1, 2, 3, 5 B. All of these C. 1, 3, 4 only D. 1, 2, 3, 6 15. The clinical instructor assigned a nursing student to assist in the operation. When the nursing student entered the OR suite, her curly long hair was not completely covered by the head cap. What would the circulating nurse do? A. Do not allow the nursing student to scrub in B. Welcome the nursing student to the OR C. Request the clinical instructor to tell the nursing student to use the head cap properly D. Assist the nursing student to tuck in all her hair inside the head cap 16. Which of the following nursing intervention is done when examining the incision wound and changing the dressing? A. Observe the dressing and type and odor of drainage if any B. Get patient's consent C. Wash hands D. Request the client to expose the incision wound 17. You are to do the initial assessment. Which standard precaution guideline should be observed? A. Drape the client appropriately B. Introduce yourself C. Greet the client by her first name D. Observe hand hygiene 18. Before any member of the sterile surgical team to do the surgical hand scrub, she/he should have complete operating room attire. Identify all the attire appropriate for this case. 1. Head cap 2. Goggles 3. Face mask 4. Sterile gown 5. Gloves A. 2, 3, 4 B. 1, 3, 4 C. 1, 2, 3 D. 3, 4, 5 19. A Mastectomy would not be classified as what surgery. Select all that apply: 1. Major 2. Constructive 3. Ablative 4. Minor A. 1 and 2 B. 2 and 4 C. 1 and 3 20. Which of the following is true regarding preoperative medication? A. After receiving preoperative medication, the patient is generally encouraged to ambulate on the nursing unit to encourage deep breathing B. The patient who has received an opioid analgesic usually requires a larger amount of anesthetic once in surgery C. The preoperative phase is the optimal time to introduce the concept of pain management to the patient D. After surgery, all preoperative medications are automatically resumed for the patient 21. Which of the following is NOT an OR attire? A. Scrub suit B. Surgical mask C. Shoe covers D. Gloves 22. Persons in this zone must wear attire consists of scrub clothes, and caps. A. Unrestricted zone B. Semi-restricted zone C. Outside the OR D. Strict zone 23. Which technique demonstrates surgical asepsis? A. Putting on sterile gloves then opening a container of sterile saline B. Cleaning the wound with a circular motion, moving from outer circles toward the center C. Changing the sterile field after sterile water is spilled on it D. Placing a sterile dressing 1⁄2” (1.3 cm) from the edge of the sterile field 24. During the surgery, which of the following indicates the scrub nurse has broken sterile technique? A. When arms are kept above the waist level B. When hands are placed on the top of the surgical drape C. When instruments are passed to the surgeon D. When the surgical head cap is touched 25. Carmen is suspected to have breast cancer. She is scheduled in your room for frozen section. How will you prepare the specimen for laboratory? A. Refrigerator and send it along with the day’s specimen B. Send to pathology immediately without soaking solution C. Soak in NSS D. Soak in formalin 26. Which of the following instruments can be used to apply pressure? A. Kelly B. Osteotomes C. Bandage D. Richardson 27. When you say sterile, it means: A. The material is clean B. The material as well as the equipments are sterilized and had undergone a rigorous sterilization process C. There is a black stripe on the paper indicator D. The material has no microorganism nor spores present that might cause an infection 28. Sterile is the condition of almost all items, devices or supplies used in the OR for any surgical procedure. Shelf life of sterile items is event related and depends on the following except: A. Type of sterilizer used to sterilize items B. Amount of handling C. Quality of packaging material used D. Storage conditions 29. Spaulding categorized instruments according to use. Where do you classify endoscopic instruments? A. Decontaminated instruments B. High level disinfected instruments C. High technology instruments D. Sterile instruments 30. Should surgery be done under general anesthesia, the nurse prepares the client appropriately. Which of these measures is wrong? A. Encourage the client to have a bath in early morning B. Remove dentures, contact lenses and jewelries C. Injects the pre-anesthetic agent as ordered D. Informs the client that the anesthesia will be injected into his spine 31. In the immediate postoperative period, a nurse should immediately report: A. Systolic blood pressure lower than 90 mmHg B. A temperature reading between 100 and 102 degrees F TOP RANK REVIEW ACADEMY, INC. Page 2 | 4
C. Respirations between 20 and 25 per minute D. All of the above assessments 32. After spinal anesthesia, 30% of the patient develops spinal headache. This is due to: A. Severe hypotension associated with Vasodilation due to the anesthetics. B. Increase volume of the cerebrospinal fluid due to anesthesia induction. C. Cerebral edema due to rapid absorption of the anesthetics. D. CSF leakage due to the puncture created by the spinal needle in the membrane that surrounds the spinal cord. 33. The nurse instructs a client scheduled for surgery about the correct use of the incentive spirometer. Place the following instructions, given by the nurse, in the correct order. 1. Instruct the client to hold his breath for 2-3 seconds. 2. Demonstrate how to place the mouthpiece of the spirometer. 3. Instruct the client to exhale slowly. 4. Instruct the client to assume a high Fowler position. 5. Set the device for the volume level to be achieved with each breath. 6. Instruct the client to inhale slowly. A. 452613 B. 543162 C. 245316 D. 163254 34. General anesthesia consists of four stages, each associated with specific clinical manifestations. This stage of anesthesia is characterized variously by struggling, talking, singing, laughing or crying. Pupils dilate, but contract if exposed to light, the pulse rate is raid and respirations may be irregular. A. Stage I: Beginning B. Stage II: Delirium C. Stage III: Surgical Anesthesia D. Stage IV: Medullary Depression 35. The nurse is removing the client’s staples from an abdominal incision when the client sneezes and the incision splits open, exposing the intestines. Which of the following actions should the nurse take next? A. Press the emergency alarm to call the resuscitation team B. Cover the abdominal organs with sterile dressings moistened with NSS C. Have all visitors and family leave the room D. Call the surgeon to come to the client’s room immediately. 36. Another nursing check that should not be missed before the induction of general anesthesia is: A. Check for presence of underwear B. Check for presence of dentures C. Check patient’s identification D. Check vital signs 37. Before you use a disinfected instrument it is essential that you: A. Rinse with tap water followed by alcohol B. Dry the instrument thoroughly C. Wrap the instrument with sterile water D. Rinse with water 38. A surgical "time out" is performed when: A. the procedure is about to begin B. the atmosphere becomes tense and a “time out” is needed to relax and refocus the surgical team C. a surgical team member must leave the room because of illness or the need to use the restroom D. new staff enter the room to take over the scrub role 39. Which of the following is a nursing activity done during “sign in” at the OR? A. Team members introduce themselves by name and role B. Nursing reviews sterility of the area C. Name of the specimen is labeled D. Site of the operation is marked as necessary 40. Which of the following is the priority nursing diagnosis for intraoperative clients? A. Risk for infection related to break in skin integrity B. Potential for peripheral neurovascular dysfunction related to intraoperative positioning C. Deficient fluid volume related to blood loss D. Impaired skin integrity related to surgical incision 41. It is done before the patient leaves from the operating room A. Sign-in B. Time-out C. Sign-out D. Time-in 42. A post-operative patient develops hypovolemic shock from blood loss from surgery. The nurse caring for the client expects the following except: A. BP of 70/60 with small pule pressure B. Increase urine specific gravity C. Heart rate of 119 D. Elevated CVP 43. A patient is two days post-operative following an abdominal surgery developed diminished breath sounds in both lungs. The nurse best interprets this as. A. Atelectasis B. Pneumonia C. COPD D. A normal event 44. A client is experiencing headache, photophobia and double vision after a spinal anesthesiA. The nurse should A. Place patient flat on bed B. Limit fluid intake C. Administer steroid medication D. Notify surgeon 45. A post-operative client has a history of sickle cell disease. What nursing diagnosis should be the priority to addressed A. Anxiety B. Impaired skin integrity C. Deficient fluid volume D. Ineffective airway clearance 46. An adult patient post-operative is in need of transfusion of 2 bags of packed RBC. The nurse knows that the best IV gauge for blood transfusion is A. G - 18 B. G- 20 C. G - 22 D. G - 24 47. The following are symptoms of malignant hyperthermia except A. Muscle rigidity B. Rapid shallow breathing C. Slow pulse D. Excessive sweating 48. A client was given Morphine sulfate due to severe pain post-surgery. The nurse knows that she should watch out for A. Hypertension B. Tachypnea C. Respiratory depression D. Increase bleeding time 49. The nurse observe that the respiratory rate of the patient is gradually decreasing. The nurse is aware that the antidote for opioid toxicity. A. Naloxone B. Protamine sulfate C. Vitamin K D. Magnesium sulfate TOP RANK REVIEW ACADEMY, INC. Page 3 | 4
50. This type of surgical instrument are used in holding incisions open or holding an organ out of the way during a surgical procedure. A. Cutting instruments B. Grasping instruments C. Holding instrument D. Retractor instrument TOP RANK REVIEW ACADEMY, INC. Page 4 | 4