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A patient scheduled for hip replacement surgery in the early afternoon is NPO but receives and ingests a breakfast tray with clear liquids on the morning of surgery. What response does the nurse expect when the anesthesia care provider is notified?
- A. Surgery will be done as scheduled.
- B. Surgery will be rescheduled for the following day.
- C. Surgery will be postponed for 8 hours after the fluid intake.
- D. A nasogastric tube will be inserted to remove the fluids from the stomach.
Correct Answer: A
Rationale: Clear liquids are generally acceptable up to 2 hours before surgery, allowing the procedure to proceed as planned.
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Mr. Johnstone is treated for removal of foreign bodies in both eyes and is discharged with patches on both eyes. In teaching Mr. Johnstone's family to assist him in walking, the nurse advises the family member to
- A. grasp him by the arm and walk behind him
- B. grasp him by the arm and walk in front of him
- C. offer your arm and walk in front of him
- D. offer your arm and walk behind him
Correct Answer: C
Rationale: Offering an arm and walking slightly ahead provides guidance and support while allowing the visually impaired person to follow safely.
Expected age-related changes of the pulmonary system include:
- A. Significant airway obstruction
- B. Shortness of breath
- C. Development of emphysema
- D. A modest,gradual decline in pulmonary function
Correct Answer: D
Rationale: While lung capacity decreases with age, it typically results in a gradual decline rather than significant obstruction or diseases like emphysema unless other factors (e.g., smoking) are present.
Which task is appropriate to delegate to the nursing assistant?
- A. Chest compressions
- B. Bag-valve mask ventilation
- C. Assisting with oral intubation
- D. Placing the defibrillator pads
Correct Answer: A
Rationale: Chest compressions are a physical task that can be delegated to a nursing assistant under supervision.
A 44-year-old male client had abdominal surgery this morning. The nurse noticed a small amount of bloody drainage on the client's surgical dressing. This type of drainage is:
- A. serosanguineous.
- B. purulent.
- C. sanguineous.
- D. catarrhal.
Correct Answer: C
Rationale: Drainage from a surgical incision is initially sanguineous (red), proceeding to serosanguineous (pink), then to serous (straw-colored). Purulent drainage usually indicates infection. This drainage should not be seen initially from a surgical incision. An incision with a Penrose drain may be expected to have a moderate amount of serosanguineous drainage in the first 24 hours, but in general drainage from a surgical incision is initially sanguineous (red), proceeding to serosanguineous (pink), then to serous (straw-colored). Catarrhal is a type of exudate seen in upper respiratory infections, not in surgical incisions.
If the SpO2 level is above 90%, what can be assumed about the PaO2?
- A. Hypoxia
- B. Hypercapnia
- C. Acidosis
- D. Alkalosis
Correct Answer: C
Rationale: Acidosis occurs when blood pH drops below 7.35 due to an accumulation of hydrogen ions, commonly resulting from respiratory or metabolic imbalances.