Fluid Electrolyte Imbalance | Operation Room Technique | Management of Patient | Mock Test | Staff Nurse | Guides Academy

Fluid electrolyte imbalance, operation room technique, management of patient undergoing surgery – preoperative, Intraoperative and post operative

Time: 15:00

A patient who has been on prolonged nasogastric suctioning is at the highest risk for developing which acid-base imbalance due to the loss of gastric acid?

[a] Respiratory Acidosis.

[b] Metabolic Acidosis.

[c] Metabolic Alkalosis.

[d] Respiratory Alkalosis.

What is the primary role of the nurse when a surgeon is obtaining informed consent from a patient before a procedure?

[a] To explain the surgical procedure in detail to the patient.

[b] To decide if the patient is competent to sign the consent form.

[c] To act as a patient advocate and witness the patient's voluntary signature.

[d] To provide a list of alternative treatments to the surgery.

In the operating room, which action by a scrubbed team member would be considered a breach of sterile technique?

[a] Facing the sterile field at all times.

[b] Passing other scrubbed members back-to-back.

[c] Keeping hands clasped in front between the waist and chest level.

[d] Reaching over the sterile field to retrieve an instrument.

Upon arrival to the Post Anesthesia Care Unit (PACU), a patient's vital signs are BP 110/70, HR 88, RR 9 breaths/min, and SpO2 89% on room air. What is the nurse's first priority action?

[a] Assess the surgical site for bleeding.

[b] Stimulate the patient and encourage deep breathing.

[c] Administer the prescribed analgesic for pain.

[d] Check the patient's core body temperature.

A nurse inflates a blood pressure cuff on a patient's arm and observes carpal spasm (Trousseau's sign). This clinical finding is a classic indication of which electrolyte imbalance?

[a] Hyperkalemia.

[b] Hyponatremia.

[c] Hypocalcemia.

[d] Hypermagnesemia.

The "Surgical Safety Checklist" includes a "Time Out" which is performed immediately before the initial skin incision. What is the primary purpose of this pause?

[a] To ensure all preoperative medications have been given.

[b] To allow the surgeon a moment to rest before starting.

[c] To confirm correct patient, correct procedure, and correct surgical site.

[d] To document the start time of the surgery accurately.

The most reliable and universally used method for sterilizing heat-resistant surgical instruments and linens in a hospital is:

[a] Ethylene oxide gas.

[b] Steam under pressure (autoclaving).

[c] Dry heat sterilization.

[d] Soaking in 2% glutaraldehyde solution.

A patient admitted with diabetic ketoacidosis (DKA) is experiencing deep, rapid respirations. The nurse correctly identifies this breathing pattern as:

[a] Cheyne-Stokes respirations.

[b] Apneustic breathing.

[c] Kussmaul respirations.

[d] Biot's respirations.

A nurse is providing preoperative teaching to a patient about using an incentive spirometer. What is the main reason for this intervention in the postoperative period?

[a] To improve cardiac output.

[b] To promote wound healing.

[c] To assess the patient's respiratory rate.

[d] To prevent atelectasis and pneumonia.

A patient develops a deep vein thrombosis (DVT) on the third postoperative day. Which preoperative and postoperative nursing intervention is most effective in preventing this complication?

[a] Maintaining strict bed rest.

[b] Administering opioid analgesics regularly.

[c] Encouraging early ambulation and leg exercises.

[d] Providing a high-carbohydrate diet.

Which surgical position places the patient on their back with their legs elevated and separated in stirrups, commonly used for gynecological or urological procedures?

[a] Supine position.

[b] Lithotomy position.

[c] Prone position.

[d] Trendelenburg position.

A physician orders an infusion of 3% Saline, a hypertonic solution, for a patient with severe hyponatremia. The nurse understands this fluid will cause water to move:

[a] From the intravascular space to the interstitial space.

[b] Equally between all compartments.

[c] From the intracellular and interstitial spaces to the intravascular space.

[d] From the intravascular space into the cells.

Which member of the surgical team is primarily responsible for maintaining the patient's operative record, managing non-sterile equipment, and ensuring supplies are available for the scrub team?

[a] Circulating nurse.

[b] Scrub nurse.

[c] Anesthesiologist.

[d] Surgical technician.

A nurse assesses a postoperative patient's abdominal wound and finds that the surgical incision has separated and internal organs are protruding. The nurse should document this finding as:

[a] Dehiscence.

[b] Evisceration.

[c] A keloid formation.

[d] An abscess.

A patient with chronic renal failure has a serum potassium level of 6.5 mEq/L. The nurse should be most alert for which life-threatening complication on the cardiac monitor?

[a] Flattened T-waves and U-waves.

[b] A shortened QT interval.

[c] Tall, peaked T-waves and a widened QRS complex.

[d] Development of a pathological Q-wave.

The primary rationale for keeping a patient NPO (nil per os) for 6-8 hours before a surgery requiring general anesthesia is to:

[a] Reduce the need for postoperative catheterization.

[b] Prevent electrolyte imbalances.

[c] Ensure the gastrointestinal tract is clean.

[d] Minimize the risk of pulmonary aspiration of gastric contents.

What is the correct principle to follow when rinsing hands and forearms after a surgical scrub?

[a] Rinse from the elbows down to the fingertips.

[b] Use a sterile towel to dry from elbows to fingertips.

[c] Keep hands elevated above the elbows to allow water to drain away.

[d] Shake excess water off vigorously before entering the OR.

A postoperative patient with a head injury is confused, has a decreased level of consciousness, and has a serum sodium level of 122 mEq/L. These findings are consistent with which fluid and electrolyte disturbance?

[a] Hypernatremia.

[b] Hyponatremia.

[c] Hypokalemia.

[d] Hypercalcemia.

During a surgical procedure, a patient under general anesthesia develops sudden muscle rigidity, tachycardia, and a rapid rise in end-tidal CO2 and body temperature. The surgical team should immediately prepare to manage which life-threatening intraoperative emergency?

[a] Anaphylactic shock.

[b] Hemorrhagic shock.

[c] Malignant hyperthermia.

[d] Neurogenic shock.

What is the immediate and most appropriate nursing action when wound evisceration occurs?

[a] Attempt to gently reinsert the protruding organs.

[b] Place the patient in a high Fowler's position.

[c] Cover the wound with a sterile dressing soaked in normal saline.

[d] Apply firm, direct pressure to the wound.

A patient receiving an IV infusion of Normal Saline develops a bounding pulse, shortness of breath, and bilateral crackles in the lungs. The nurse recognizes these as signs of which complication?

[a] Dehydration.

[b] Anaphylactic reaction.

[c] Fluid volume excess (hypervolemia).

[d] Speed shock.

In the context of surgical wound closure, which of the following is an example of a non-absorbable suture material?

[a] Catgut.

[b] Vicryl (Polyglactin 910).

[c] Monocryl (Poliglecaprone 25).

[d] Silk.

A patient is scheduled for surgery and reports taking warfarin, an anticoagulant, daily. The nurse anticipates that the surgeon will order which laboratory test to assess the patient's clotting status?

[a] Complete Blood Count (CBC).

[b] Serum electrolyte panel.

[c] Prothrombin Time / International Normalized Ratio (PT/INR).

[d] Activated Partial Thromboplastin Time (aPTT).

A patient is admitted with severe vomiting and diarrhea. Which set of assessment findings would the nurse expect to see?

[a] Bradycardia, hypertension, and jugular vein distention.

[b] Tachycardia, hypotension, and poor skin turgor.

[c] Bounding pulses, peripheral edema, and crackles in lungs.

[d] Polyuria, hypertension, and decreased hematocrit.

Which assessment finding is the most reliable indicator that a patient's peristalsis is returning after abdominal surgery?

[a] The presence of hunger.

[b] The absence of nausea or vomiting.

[c] Auscultation of bowel sounds.

[d] The passage of flatus or a bowel movement.