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PNR 201 MED SURG 1 EXAM 2 KEY
POINTS REVISION QUESTIONS
/ACCURATE ANSWERS /GRADED
A+/24/
2. The use of lasers, fiberoptic endoscopes with high-resolution video cam- eras, operating microscopes, and robotic technology has revolutionized surgery.: 3. Autologous transfusion or bloodless surgery techniques are reducing prob- lems that can be caused by blood transfusions from outside donors.: 4. A thorough assessment is performed, during which any risk factors for surgery are identified (see Focused Assessment).: 5. Older adult patients are at much greater risk from surgery and anesthesia than are younger adults.:
- Cultural factors and preferences should always be assessed and consid- ered.: - What is your primary language?
- Do you have any cultural or spiritual practices that you would like to observe during this period of surgery and recovery?
- What are your cultural customs regarding privacy, blood transfusions, and disposal of body parts? 7. An appropriate individual nursing care plan is formulated for the preopera- tive period.: 8. The surgeon must obtain informed consent from the patient before surgery is performed.: 9. Preoperative procedures are performed in a timely manner.: 10. The method to be used for postoperative pain control is explained and discussed with the patient.: 11. Preoperative teaching of exercises to be performed postoperatively is very important; the patient is taught turning, leg, deep-breathing, and coughing exercises.: 12. Immediate preoperative care includes checking to see that all jewelry and metal objects have been removed from the patient.: 13. A signed surgical consent form is checked before preoperative medication is administered.: 14. Once preoperative sedation (if ordered) is administered, the patient is cautioned to stay in bed to prevent falls.: 15. The Universal Protocol is followed to prevent wrong-site surgery.:
18. The OR is kept as microbe-free as possible.: 19. Surgical asepsis is the responsibility of the entire OR staff.: 20. The scrub person and the circulating nurse, along with the surgeon and anesthesiologist or CRNA, provide care for the patient while in the OR.: 21. A "time-out" occurs just before the start of the surgical procedure to recheck the patient's identity, the surgical procedure to be performed, and the site of the surgery.: 22. The circulating nurse and the scrub person have distinctly different roles.: 23. Anesthesia is used to prevent pain; to achieve adequate muscle relaxation; and to calm fear, allay anxiety, and induce amnesia of an unpleasant experi- ence.: 24. Inhalant gases and IV medications are used to induce general anesthesia, and the patient progresses through stages of induction to total anesthesia.: 25. Regional anesthesia, procedural (moderate) sedation, or local anesthesia is used for many surgical procedures.: 26. There is a risk of several complications during the intraoperative period.: 27. Patients are positioned carefully, and pressure points and joints are padded to prevent injury.: 28. The circulating nurse, anesthesia care provider, and surgeon observe for symptoms of complications, and measures are taken immediately to avert a problem.:
29. Nurses in the recovery unit monitor patients very closely until they have stable vital signs and are arousable from anesthesia.: 30. Maintaining a patent airway is the highest priority.: 31. You are vigilant for signs of complications and perform frequent assess- ments during the postoperative period.: 32. Nursing interventions are aimed at providing pain control, comfort, and fluid balance; protecting the patient from injury; maintaining vital functions; and preventing infection.: 33. You try to prevent or intervene in the many potential complications from surgery.: 34. Discharge planning begins at admission and covers all areas of basic needs, wound care, and activity restrictions.: 35. Written instructions regarding all aspects of postoperative care should be sent home with the patient.: 36. Normal flora are needed to help prevent harmful microorganisms from colonizing or infecting the body.: 37. An infection is the presence and growth of pathogenic microorganisms in a susceptible host to the extent that tissue damage occurs.:
48. Blood or other body fluid specimens for culture must be collected before the start of any antimicrobial agent.: 49. Assess how much the patient already knows about preventing the spread of infection and teach about hand hygiene, the correct use of antimicrobial agents, cleaning of wounds, and keeping the home environment clean.: 50. You must model scrupulous hand hygiene compliance for patients and family members.: 51. The immune and lymphatic systems protect the body against microscopic threats to homeostasis.: 52. The inflammatory response is the first step in the immune response.: 53. Antibodies are proteins that fight antigens.: 54. B and T lymphocytes are major forces in fighting infection.: 55. The body produces a humoral (immediate) and cellular (delayed) response to antigens.: 56. Active artificially acquired immunity occurs by vaccination or immuniza- tion.: 57. Chronic consumption of alcohol can alter the body's ability to launch an immune response.: 58. Immunizations introduce pathogens to the body in a controlled way, allow- ing the body to produce antibodies to prevent future illness.:
59. You play a major role in providing patient education regarding the impor- tance of immunizations to public health.: 60. Decreased immune response puts the patient at risk for infection.: 61. Good nutrition and healthy lifestyle choices are important for a healthy immune system.: 62. Measures such as hand hygiene and strict adherence to Standard Precau- tions should always be implemented, regardless of immune status, to prevent health care-associated infections.: 63. Immunosuppression can be caused by treatment for conditions such as asthma, autoimmune disorders, and cancer.: 64. In immune deficiency disorders there is an insufficient production of antibodies, immune cells, or both, and the disorders may be congenital or acquired.: 65. Immunosuppression may be used therapeutically for a variety of condi- tions, such as tissue transplants, rheumatoid arthritis, and NHL.: 66. Body temperature should be closely monitored for significant changes, although immune-deficient patients may not have a temperature elevation even in the presence of infection.: 67. HIV disease in the United States is now a chronic, controllable disease.:
77. Lymphoma starts in the lymph tissue when malignant lymphocytes mul- tiply and crowd out normal cells; treatment depends on staging and the aggressiveness of the type of disease.: 78. In HL, R-S cells are seen on microscopic examination of tissue.: 79. In NHL, R-S cells are not present. NHL is further identified as B-cell or T-cell lymphoma.: 80. Nursing care for lymphomas focuses on preventing infection, managing the symptoms, and reducing the side effects of the therapies.: 81. In fibromyalgia, the most common feature is musculoskeletal pain that is diffuse and multifocal with flare-ups and remissions.: 82. Any agent that causes a severe hypersensitivity reaction can cause ana- phylaxis.: 83. Nursing responsibilities in caring for patients with allergic conditions include assisting in the diagnosis of hypersensitivity, helping to identify sub- stances that trigger an allergic response, assisting the patient to avoid or limit exposure to allergens, and relieving symptoms.: 84. Emergency equipment and medications must be available for an anaphy- lactic reaction, which is a life-threatening condition.: 85. Eye disorders are caused by injury, disease, or genetic predisposition.: 86. Everyone older than 40 years should have a complete eye examination.: 87. After age 65 years, an eye examination is recommended every 1 to 2 years.:
88. Control of diabetes mellitus and hypertension can help preserve vision.: 89. Obtaining a good history is important to data collection regarding vision.: 90. A problem with refraction is the most common eye disorder.: 91. Cataracts cause a blurring or loss of vision and usually develop slowly.: 92. Cataract surgery with lens implant usually restores vision.: 93. The increase in IOP that occurs with glaucoma will eventually cause blind- ness if untreated.: 94. Unless treated quickly and successfully, retinal detachment causes vision loss: 95. Glaucoma medication typically must be used for the rest of the patient's life.: 96. Symptoms of retinal detachment include flashing colored lights followed by the appearance of "floaters.": 97. Positioning and restriction of movement are crucial after eye surgery.: 98. Retinopathy is a disorder that occurs most commonly in people with diabetes or hypertension.: 99. Strict glucose control helps prevent diabetic retinopathy.: 100. Retinopathy is commonly treated by laser.: 101. Keratoplasty may be performed to repair damaged corneas.:
116. Tinnitus is common with a variety of ear disorders.: 117. A variety of treatments are available to help patients with tinnitus; biofeedback and masking help many people.: 118. Lip-reading or speech reading is helpful to people with hearing impair- ments but is difficult to learn.: 119. Various types of hearing aids are available, but using one takes practice.: 120. Cochlear implants are available for patients who have severe hearing loss.: 121. Nurses should actively educate the community about ways to prevent hearing loss.: 122. Otitis media is a common malady that may be induced by allergy or upper respiratory infection.: 123. Impacted cerumen or foreign bodies in the ear interfere with hearing.: 124. Otosclerosis is generally hereditary.: 125. Tympanoplasty may be performed for otosclerosis or for tympanic mem- brane dysfunction.: 126. Labyrinthitis and Ménière disease cause vertigo and tinnitus.:
