InstructiоnsReаd eаch questiоn cаrefully.Answer each questiоn by bubbling your answer on the Scantron answer sheet.After you have finished answering all questions, select TRUE.Click Finish Attempt at the bottom of the page.On the next page, click Submit All and Finish.If a confirmation message appears, click Submit All and Finish again to complete your submission.Once your assessment has been submitted successfully, notify your proctor that you are finished. Please wait for the proctor's instructions before proceeding to the next step.Chapters 18-20 Key/Version C____ 1. When should a prophylactic intravenous antibiotic generally be administered? a. Within 30 to 60 minutes before the incision c. After the patient develops a postoperative fever b. Within six hours after arrival in the recovery unit d. After the incision has been closed and dressed ____ 2. Which assessment receives priority when emergence delirium appears in the recovery unit? a. Determine the patient’s preferred sleeping position. c. Review the patient’s long-term nutritional pattern. b. Ask the caregiver about the patient’s occupational history. d. Evaluate airway patency, ventilation, and oxygenation. ____ 3. Which intervention combination best promotes resolution of postoperative atelectasis? a. Fluid restriction, bed rest, shallow breathing, and cough suppression c. Humidified oxygen, deep breathing, incentive spirometry, and mobilization b. Supine positioning, opioid administration, sedation, and limited activity d. Gastric decompression, bowel rest, catheterization, and wound irrigation ____ 4. Which group of findings most strongly indicates early local anesthetic systemic toxicity? a. Constipation, abdominal distention, nausea, and decreased bowel sounds c. Incisional redness, purulent drainage, fever, and leukocytosis b. Confusion, metallic taste, oral numbness, and dizziness d. Bradycardia, hypothermia, shivering, and reduced urine output ____ 5. Which nursing intervention best applies anxiety-management principles when anxiety limits preoperative learning? a. Administer a sedative before determining the source of anxiety. c. Continue teaching until all written material has been reviewed. b. Ask the caregiver to provide all remaining surgical information d. Address immediate concerns and report the need for additional information. ____ 6. Which action is required when the entire sterile field becomes contaminated? a. Continue the procedure after covering the contaminated area. c. Clean the contaminated materials with an antiseptic solution. b. Remove only the instruments nearest the contaminated location. d. Discard the field and establish a new sterile setup. ____ 7. Which procedural requirement most strongly supports the use of general anesthesia? a. Loss of sensation limited to a small superficial area c. Control of ventilation and prolonged skeletal muscle relaxation b. Maintenance of full consciousness throughout a brief skin procedure d. Preservation of motor function during a regional nerve block ____ 8. Which method correctly applies an alcohol-containing surgical skin preparation? a. Clean the entire area randomly and remove the solution with sterile gauze. c. Clean from the outer area toward the proposed incision and drape immediately. b. Clean from the incision outward and allow the solution to dry completely. d. Apply the solution until it pools beneath the patient for prolonged exposure. ____ 9. Which intervention combination is appropriate for postoperative hypothermia with shivering? a. Expose the skin, administer cold fluids, and reduce oxygen delivery. c. Apply active warming, monitor temperature, and provide oxygen as prescribed. b. Apply ice packs, restrict blankets, and encourage rapid ambulation. d. Discontinue monitoring after the first increase in body temperature. ____ 10. Which patient characteristic most appropriately supports the selection of ambulatory surgery? a. The patient requires prolonged postoperative mechanical ventilation. c. The patient requires intensive monitoring for unstable cardiac disease. b. The patient needs treatment for multiple acute medical conditions. d. The patient can return home with a caregiver within several hours. ____ 11. What preoperative finding requires immediate communication to the anesthesia care provider? a. A family history of malignant hyperthermia during surgery c. A previous incision that healed without complications b. A history of mild nausea after taking antibiotics d. A preference for music during the waiting period ____ 12. Which practice is required when sterile supplies are open in a restricted surgical area? a. Allow street clothing when covered by a clean laboratory coat. c. Wear surgical masks and minimize unnecessary traffic. b. Permit unrestricted traffic while the procedure is being prepared. d. Remove head coverings to improve communication among personnel. ____ 13. Which laboratory value receives priority evaluation before surgery for a patient taking a diuretic? a. Platelet count c. Total bilirubin level b. Serum potassium level d. Serum albumin level ____ 14. Which finding is required before discharge following ambulatory surgery? a. The patient reports uncontrolled pain and persistent vomiting. c. The patient remains drowsy and requires continuous airway support. b. The patient plans to drive home without adult assistance. d. The patient is stable and has a responsible adult available for transportation. ____ 15. Which assessment is most important for evaluating neurologic changes in an older surgical patient? a. Recording the frequency of previous hospital admissions c. Comparing appetite before and after the procedure b. Establishing the patient’s baseline cognitive function d. Determining the patient’s preferred method of learning ____ 16. Which action should precede urinary catheterization when postoperative voiding has not occurred? a. Insert an indwelling catheter based only on elapsed time. c. Restrict oral and intravenous fluids until spontaneous voiding occurs. b. Assess bladder fullness with palpation or a bladder scan. d. Administer a diuretic without assessing circulating volume. ____ 17. Which intervention should be applied first when the tongue obstructs the airway after anesthesia? a. Administer an opioid antagonist without assessing respirations. c. Give an oral fluid to stimulate swallowing and airway movement. b. Stimulate the patient and perform a head-tilt or jaw-thrust maneuver. d. Place the patient flat and flex the neck toward the chest. ____ 18. Which action is appropriate when opioid-related postoperative hypoventilation develops? a. Delay intervention until the oxygen saturation decreases below 80%. c. Stimulate the patient, support ventilation, and prepare an opioid antagonist. b. Encourage oral fluids and discontinue respiratory monitoring. d. Place the patient flat and administer another opioid dose. ____ 19. Which action best prevents aspiration when postoperative vomiting occurs during reduced consciousness? a. Raise both legs and restrict all airway interventions. c. Encourage the patient to suppress coughing and swallowing. b. Turn the patient laterally and keep suction equipment available. d. Maintain a flat supine position and offer clear fluids. ____ 20. Which responsibility is assigned to the scrub nurse during surgery? a. Maintaining the sterile field and passing instruments to the surgeon c. Documenting intraoperative care from outside the sterile field b. Coordinating communication with personnel outside the operating room d. Transporting laboratory specimens to the appropriate department ____ 21. Which information appropriately addresses the sensory component of preoperative teaching a. The operating room may feel cold and contain bright lights and unfamiliar sounds. c. The patient will move through the holding area, operating room, and recovery unit. b. The caregiver will receive updates while waiting during the surgical procedure. d. The intravenous catheter will be inserted before anesthesia is administered. ____ 22. Which intervention set receives priority when malignant hyperthermia is suspected? a. Administer flumazenil, encourage coughing, and obtain a urine culture. c. Administer naloxone, lower the head, and begin fluid restriction. b. Stop triggering agents, give dantrolene, provide oxygen, and initiate cooling. d. Continue inhalation anesthesia, apply warm blankets, and restrict oxygen. ____ 23. Which allergy history most strongly indicates the need for latex precautions? a. Reactions to seafood, iodized salt, and dairy products c. Reactions to bananas, avocados, chestnuts, and potatoes b. Sensitivity to caffeine, chocolate, and carbonated beverages d. Intolerance to milk products and gluten-containing foods ____ 24. Which requirement distinguishes monitored anesthesia care from moderate sedation? a. It requires the patient to remain fully alert throughout the procedure. c. It requires an anesthesia provider capable of converting to general anesthesia. b. It never includes analgesic or anxiolytic medication. d. It eliminates the need for airway assessment and monitoring. ____ 25. What assessment sequence receives priority immediately after admission to the postanesthesia care unit? a. Temperature, bowel sounds, urinary output, and surgical history c. Airway, breathing, circulation, and neurologic responsiveness b. Orientation, mobility, teaching readiness, and family support d. Pain, elimination, nutrition, and wound appearance ____ 26. Which action correctly applies the surgical time-out procedure? a. The circulating nurse completes verification without interrupting the team. c. The surgeon confirms only the procedure after the incision is completed. b. All team members stop and verify the patient, procedure, and surgical site. d. The anesthesia provider verifies the patient after general anesthesia begins. ____ 27. Which communication method best supports a complete perioperative handoff? a. Allowing documentation to replace direct communication c. Limiting the report to unexpected surgical events b. Providing only the patient’s diagnosis and procedure d. Organizing information using the SBAR framework ____ 28. Which action is appropriate when a patient has signed the surgical consent but cannot explain the procedure? a. Administer the prescribed sedative to decrease anxiety. c. Witness the form again and continue surgical preparation. b. Ask a family member to provide the missing explanation. d. Contact the surgeon before administering sedating medication. ____ 29. Which position is most appropriate for an unconscious patient recovering from general anesthesia? a. Lateral recovery position with the airway maintained c. Supine with the head flat and legs fully elevated b. Upright with the chin resting against the chest d. Prone with the head positioned directly downward ____ 30. Which medication-related finding requires further evaluation before surgery? a. Administration of a prescribed thyroid replacement medication c. Concurrent use of an herbal supplement and an antiplatelet medication b. Completion of a prescribed preoperative antimicrobial treatment d. Use of an inhaled bronchodilator for controlled asthma ____ 31. Which postoperative pain-management plan best applies multimodal analgesia? a. Withholding analgesics until pain becomes severe c. Using only a high-dose opioid for every level of pain b. Combining an opioid with acetaminophen or an anti-inflammatory drug d. Combining two opioids with identical mechanisms of action ____ 32. Which assessment finding is most consistent with autonomic blockade following spinal anesthesia? a. Hypertension accompanied by tachycardia and dry mucous membranes c. Fever accompanied by muscle rigidity and elevated carbon dioxide b. Hypotension accompanied by possible bradycardia and nausea d. Wheezing accompanied by facial swelling and generalized urticaria ____ 33. Which intervention is appropriate following administration of ketamine anesthesia? a. Restrict respiratory monitoring because spontaneous breathing is preserved. c. Maintain intense lighting to promote rapid neurologic stimulation. b. Provide a calm environment and anticipate treatment for hallucinations. d. Encourage frequent visitors to improve immediate orientation. ____ 34. Which intervention best addresses normal postoperative fluid retention during the first three days? a. Discontinue all intravenous fluids until urinary output returns to baseline. c. Monitor intake, output, weight, cardiopulmonary status, and infusion rate closely. b. Administer potassium without evaluating kidney function or urine output. d. Administer unrestricted intravenous fluids to replace every reduction in urine output. ____ 35. When should clear liquids generally be discontinued before elective surgery in a healthy patient? a. At least two hours before anesthesia c. Immediately before entering the operating room b. At least eight hours before anesthesia d. At least six hours before anesthesia ____ 36. Which action is essential when transferring a patient onto the operating-room bed? a. Apply monitoring equipment before moving the patient between beds. c. Transfer the patient before locking the wheels to preserve momentum. b. Lock both beds and maintain staff on each side until secured. d. Ask the sedated patient to transfer without physical assistance. ____ 37. Which action best maintains communication and safety during final preoperative preparation? a. Remove the identification band when the surgical gown is applied. c. Allow removable dentures to remain during anesthesia induction. b. Leave the hearing aid in place until communication is no longer required. d. Store eyeglasses without recording where they were placed. ____ 38. Which surgical procedure best applies the purpose of palliative surgery? a. Performing a lymph node biopsy to determine disease extent c. Excising a suspicious mole to prevent malignant transformation b. Removing a ruptured appendix to eliminate an acute disease d. Creating a colostomy to bypass an inoperable bowel obstruction ____ 39. ‘Which action best promotes perioperative safety for a patient with diabetes? a. Clarify antidiabetic medication orders and measure the morning glucose level. c. Replace prescribed insulin with an oral hypoglycemic medication. b. Administer the usual insulin dose without reviewing the surgical orders. d. Withhold all glucose monitoring until the patient resumes oral intake. ____ 40. Which finding most strongly indicates that postoperative hypotension is related to hypovolemia? a. Normal pulse with warm, dry peripheral skin c. Bounding pulse with flushed skin and elevated temperature b. Slow pulse with warm skin and normal mentation d. Rapid weak pulse with pale, cold, clammy skin
When tаking а pаtient histоry, a cоmpetent radiоlogic and imaging sciences professional: