MedSurg Diagnostics and Periop for the NCLEX®

The nurse is treating a child who sustained a fall. An x-ray shows that the child’s bone has been angulated beyond the limit, causing a compression in the bent side of the bone, and a slight break to the tension side of the bone. Which of the following fractures does the nurse suspect?

A client arrives in the emergency room with rib fractures. The nurse and healthcare provider are reviewing the x-ray and would be most concerned about rib fractures in which of the following locations?

A nurse is preparing a client for an x-ray of the nose for a possible fracture. The nurse knows the client will need which of the following?

The nurse is caring for a client after surgery. The client’s lung sounds are clear on the left and soft, distant crackles on the right side. The nurse reviews the image above on the morning chest x-ray. Which intervention would be most appropriate for this client?

A healthcare provider orders a cat scan of a client, requesting all sagittal views. How would the nurse expect to see the images divide?

A client is scheduled for a pre-operative CT scan to better visualize gastric cancer. Which of the following is a priority nursing assessment prior to this exam?

The nurse is working with a client whose provider has just written orders. The provider wants an IV started, blood work drawn, a urine sample, 4 mg IV morphine prn, 4 mg zofran prn, an X-ray, and a CT scan with IV contrast. Which of the following allergies would make the nurse question the orders?

A client with pulmonary edema is going for a CT. When the client lays flat, she turns blue and is gasping for air. Which of the following is the priority for this client?

The client has a CT scan with IV contrast ordered. The nurse reviews the client’s allergies and notes the client is allergic to peanuts, penicillin, and sulfa drugs. What should the nurse do next?

A nurse is preparing a client to undergo a diagnostic test in which slices of x-ray are used to evaluate the details of internal organs. What is the proper name for this test?

A nurse is caring for a client who needs an MRI for a back injury. The client is deaf. The nurse has provided written information for the client but needs to find out if there are any questions. In which way would the nurse most likely act as the client’s advocate?

A nurse is caring for a diabetic client who uses an insulin pump. The client is in the hospital for diagnostic testing of kidney disease and the provider has ordered an MRI. Which action of the nurse is most appropriate?

A nurse is caring for a client undergoing an MRI (Magnetic Resonance Imaging) scan. What is the priority nursing action prior to this scan?

A client has a new order for an MRI of the abdomen and the nurse knows to notify radiology about which of the following to ensure client safety?

A client is scheduled for an MRI today with PO contrast. The nurse knows that the client should drink the contrast at which of the following times?

A client is in recovery after a cerebral angiography is completed. The client is waking up and the nurse should position the client in which of the following positions?

A client is scheduled for cerebral angiography and arrives to the hospital. The client is finishing breakfast as the nurse enters to begin the admission history and assessment. Which of the following is the priority for the nurse?

A nurse is preparing a client for a cerebral angiography. The nurse knows to prep and clean the site before the catheter is inserted. The nurse would be correct to prep which of the following areas?

A nurse is caring for a client that has just had a cerebral angiography. The nurse knows to do which of the following for the client? Select all that apply.

A client arrives with a suspected brain aneurysm. The nurse knows that which of the following diagnostic tests should be done?

Before assisting with angiography for heart disease, which of the following information would be the most concerning for the nurse to determine about the client?

A client is scheduled to have an angiography done to visual the vessels that lead to the heart. The nurse knows to check for which labs prior to the procedure?

A nurse has an order to set up an echocardiogram for a client with a history of heart valve disease. Which of the following should the nurse instruct the client to do before the echocardiogram? Select all that apply.

A client with heart failure receives an echocardiogram that shows the heart muscle has been damaged and grown very thick due to high blood pressure. What is the most appropriate term for this condition?

A newborn has a suspected ventricle septal defect (VSD). The nurse expects that which procedure will be ordered by the healthcare provider?

A nurse is assisting a provider with obtaining informed consent about a medical procedure. Which of the following best describes the nurse’s role in obtaining informed consent?

If the client provides informed consent the nurse knows that the client can explain all of the following regarding their procedure except which of the following?

The nurse is having a conversation with the client who is scheduled to start their third round of chemotherapy. The client states “I do not want to do this, my spouse is forcing me.” The nurse knows that which of the following components of informed consent is being broken?

A nurse is preparing a client for a surgical procedure. At the last minute, the nurse realizes that the client has not signed an informed consent for the procedure. Which of the following actions of the nurse is most appropriate?

A 12-year-old client needs to have treatment that involves a surgical procedure that will save the child’s life. The parents refuse to give consent for the procedure based on their personal convictions. Which of the following is allowable for the healthcare team in response?

The nurse is interviewing a client going to the operating room for a total hip replacement. During the interview, the client is unable to state their name or birthdate. The client takes medication for dementia. The nurse would expect which of the following when obtaining the informed consent? Select all that apply.

The nurse witnessed a non-English-speaking client sign informed consent utilizing the interpreter phone. Which of the following actions are appropriate for the nurse to take? Select all that apply.

The nurse is caring for a client who is signing informed consent for a procedure. The nurse knows that the client needs to understand which of the following relating to informed consent? Select all that apply.

The nurse is speaking with a client in the preoperative area before their scheduled cervical fusion. The client states they are planning on completing a triathlon next week. Which of the following is the best action for the nurse to take?

The staff in the emergency room provide care and treatment for an unconscious client who was brought in by ambulance with no family present. In this emergency situation, the law allows for implied consent, which means which of the following?

Clients who are allergic to bananas are also likely to be allergic to:

The pre-operative nurse is preparing a client for surgery. Which of the following actions should the nurse perform to ensure client readiness? Select all that apply.

An 88-year-old client from a local nursing home is having surgery for a bladder tumor. The nurse knows that which of the following are ways to assess the cognitive abilities of the client? Select all that apply

When the perioperative nurse assesses the client for surgery, the BMI is assessed as low. The nurse knows that which of the following could be a concern? Select all that apply.

The client who is about to have surgery is complaining to the nurse that the hospital is “starving me to death”. Which of the following is the nurse’s best response to the client?

The nurse is getting a client ready for a hysterectomy when the client asks, “Will I have a tube down my throat?” Which of the following is the best response?

Your client is a 4-year-old scheduled for a tonsillectomy. During the preoperative assessment the mother informs the nurse that the client was eating fruit snacks on the way to the hospital. Because of this the surgery has been cancelled. The nurse knows that which of following is the best response to give the mother regarding NPO education?

The nurse knows that educating the surgical client is extremely important for client safety. The nurse knows that which of the following would be the priority to educate the client on prior to surgery?

A 30-year-old client is scheduled for an endometrial ablation and is concerned about “what everyone will see” during the procedure. The nurse knows that which of the following is the best response to this comment?

The nurse knows that all of the following are goals of education for the surgical patient except which of the following?

A client is sitting in the preoperative holding area when they casually tell you that they aren’t really sure why they are having the procedure. As the preoperative nurse you should do which of the following?

A nurse is working with a client who is preparing to have surgery for an umbilical hernia. The provider has discussed information about the procedure, the risks, benefits, and alternatives to the procedure with the client. After the provider has discussed the situation, the client decides against signing the consent and informs the nurse of the decision. Which of the following is the best example of the nurse acting as a client advocate in this situation?

The nurse knows that all are true of playing a role in preventing wrong-site surgery preoperatively except which of the following?

The preoperative nurse is preparing a client for a robotic assisted cholecystectomy. The client is asked when they last had anything to eat or drink and admits to having eggs with coffee for breakfast. Which of the following risks is the nursing priority for the preoperative nurse?

The circulating nurse in the operating room realizes the client did not receive an antibiotic ordered to start preoperatively. Which of the following preoperative nursing priorities was overlooked?

The nurse is caring for a client with a prescription for fentanyl. Which of the following is a condition that is appropriate for this medication to treat?

An 82-year-old client has returned to have a left knee replacement a year after having their right knee replaced. While inserting an IV the client states “I don’t think I was awake last time, I think they put my IV in after I was asleep.” Having an understanding of general anesthesia which of the following is the best response for the nurse to give the client?

The preoperative nurse is asked by the client when they will be able to leave. The nurse knows that which of the following is the best response to give the client?

You are the circulating nurse and receiving a client from the emergency room for surgery. During report from the emergency room nurse you are told that the client is American Society of Anesthesiologists (ASA) physical status classification VI. Which of the following clients would best describes the client you are going to take care of?

The PACU nurse is providing discharge teaching to a client who just underwent a bunionectomy under general anesthesia. The nurse knows that which of the following information should be provided regarding anesthesia? Select all that apply

While preparing your client for surgery the client tells you how afraid they are to feel pain while under anesthesia. Based on your knowledge of general anesthesia which of the following is the most appropriate response to the client?

The nurse is caring for a client scheduled to have general anesthesia. While reviewing their chart the nurse notices that the client told the preoperative nurse that one of their family members temperature “went up really high” during surgery. Which of the following is the best next action for the nurse to take?

The nurse is reviewing discharge instructions with a client to prepare them to go home after an outpatient hernia repair that was under general anesthesia. The client signs the discharge papers and the nurse gets a wheelchair to take the client out of the hospital. The client starts searching for the car keys and states “I wish my spouse could be here to take me home”. Which of the following is best response by the nurse to the client?

Based on the nurse’s knowledge of local anesthesia the nurse realizes that the type of local anesthesia is chosen by the provider with all of the following in mind except which of the following?

You are the preoperative nurse and you are getting your client ready for their procedure and realize the client does not understand that they are receiving local anesthesia when they say which of the following?

Based on the nurse’s understanding of local anesthesia which of the following clients would give concern for the procedure? Select all that apply.

The preoperative nurse is preparing the client for surgery and the client asks you what will happen during surgery with local anesthesia. Which of the following is the best response by the nurse?

The perioperative nurse who is monitoring the client during the procedure has a good understanding of signs and symptoms associated with local anesthesia including local anesthesia systemic toxicity. The nurse knows that which of the following are signs of this issue? Select all that apply.

The perioperative nurse and you have been assigned as the preceptor for a nursing student. The student is observing the case of a client under moderate sedation. The nursing student understands that sedation levels must be assessed in these clients but does not know how. Which of the following is the best response by the nurse?

The preoperative nurse is doing a preoperative assessment on a client who is scheduled for a procedure under moderate sedation. The client state that they drink 8 beers a day. Which of the following is correct about alcohol and receiving moderate sedation?

There are four clients in the preoperative holding area who are scheduled for a procedure under moderate sedation. The nurse knows that a client with which of the following would be most concerning to the anesthesiologist for proper ventilation during the procedure?

You are a perioperative nurse and have just been hired to work for private practice. The healthcare provider that you are working for has informed you that the next client will be under moderate sedation and you will be giving the drugs to the patient. Which of the following is the best next action to take?

A nurse providing moderate sedation to a client undergoing a surgical procedure is assessing vital signs, sedation level, and level of consciousness. The nurse realizes the client is not responding to the nurse’s questions. Which of the following administrations would be necessary? Select all that apply.

Your client has a known family history of malignant hyperthermia. The nurse knows that which of the following ways would keep the client safe? Select all that apply.

You are the circulating nurse and when speaking to the client they casually state that a long time ago their mother had to be “cooled down” during surgery. Having knowledge of the risks associated with malignant hyperthermia, which of the following would be the best next action?

There are four clients waiting in the surgical holding area and after the nurse reviews each of their charts which of the following would the nurse be most concerned about?

The preoperative nurse is preparing a client for a thyroidectomy. Which of the following comments makes the nurse concerned about malignant hyperthermia?

You are the perioperative nurse caring for a client under general anesthesia. The nurse anesthetist is concerned that the client is showing signs of malignant hyperthermia. You would expect to see which of the following signs and symptoms? Select all that apply.

The PACU nurse is waiting for the client to arrive to the recovery unit from surgery. Based on nursing knowledge of postoperative clients, which of the following is the most important nursing action to perform first?

The post-anesthesia care unit (PACU) nurse is receiving hand-off report from the peri-operative nurse. What information will the peri-operative nurse share about the client? Select all that apply

The post-anesthesia care unit (PACU) nurse caring for a client who just underwent a carpal tunnel procedure. The nurse completed the immediate admission assessment, initial assessment, implementation of interventions, and evaluation. The nurse knows that which of the following is one tool to evaluate the client’s readiness for discharge?

The nurse working in the PACU knows that which of the following can be expected to learn from the anesthesia provider during the hand-off report? Select all that apply

The nurse is caring for a client who had surgery yesterday afternoon. The client is now complaining of abdominal pain and the nurse notes the abdomen is firm. The nurse reviews the provider orders seen in the graphic. Which of the following is most likely the cause of the client’s condition?

A post anesthesia care unit (PACU) nurse knows that confusion and agitation can be common after anesthesia postoperatively. The nurse know that which of the following can contribute to these issues? Select all that apply.

A client has just finished surgery and is coming to the PACU for recovery. Postoperative hypothermia is a complication of the surgical client and the nurse knows that which of the following is true regarding this complication? Select all that apply.

A nurse is caring for a client in the recovery room who has developed post-operative nausea and vomiting as a result of anesthesia. Which of the following is a complication of post-operative nausea and vomiting? Select all that apply.

The nurse is preparing a 40-year-old client for surgery when they explain they are concerned about blood clots. Based on the nurse’s knowledge of postoperative complications which of the following statements is true? Select all that apply

A client who is recovering from surgery has developed a fever and the nurse notes that the client has significant pain and the incision site is red and warm. Which response from the nurse is most appropriate?

The nurse receives a client to the unit from the post-anesthesia care unit for a craniotomy for a tumor biposy. The client was extubated approximately 45 minutes before arrival to the unit. The client has a right internal jugular central venous catheter and left radial arterial line that were placed during the case. The client’s vitals are SpO2 89%, BP 95/60, HR 123, temp 97.5F oral, and RR 29. The client reports moderate chest discomfort, rating 6/10. As the nurse completes the client assessment, accessory muscle use during inspiration and expiration is noted. What is should be the nurse’s first action?

Postoperative nausea and vomiting (PONV) is a common complication in surgical clients and the nurse knows that all except which of the following increase the risk of PONV?

A nurse is caring for a client postoperatively that has just had abdominal surgery. The nurse knows that surgical clients are at risk for certain surgical issues like dehiscence. The nurse knows that which of the following statements are true regarding dehiscence? Select all that apply.

The nurse is caring for a client who has just been admitted to the floor following a knee replacement surgery. The client received a total of 100 mcg fentanyl in the PACU, of which 25 mcg were administered just before the trip to the floor. During the initial assessment, the nurse notes the client’s respirations are 8, he requires sternal pressure to open his eyes but then falls back asleep again, and his oxygen saturation is 82%. What is the nurse’s priority intervention at this time?

The nurse is preparing to discharge the client after a carpal tunnel procedure. Which of the following is true regarding the discharge process of postoperative surgical clients? Select all that apply

The nurse is aware of the various postoperative complications that should be reported by the client. In discharge teaching the nurse should include all except which of the following signs to report?

The PACU nurse understands that the success of discharge teaching can depend greatly on which of the following? Select all that apply