The nurse is caring for a patient who is scheduled to undergo a surgical procedure. The nurse is completing an assessment and reviews the patient's laboratory tests and allergies and prepares the patient for surgery. In which perioperative nursing phase is the nurse working?

Correct Answer: B

Rationale: The correct answer is B: Preoperative. In the preoperative phase, the nurse assesses the patient, reviews relevant information (such as lab tests and allergies), and prepares the patient for surgery. This phase occurs before the surgical procedure takes place. A: Perioperative includes preoperative, intraoperative, and postoperative phases. C: Intraoperative refers to the phase during the actual surgical procedure. D: Postoperative occurs after the surgery is completed. Therefore, the nurse is working in the preoperative phase as she is preparing the patient before the surgery.

Correct Answer: B

Rationale: The correct answer is B: Pulmonary embolism. In this case, the patient has sudden onset of severe shortness of breath, tachypnea, a rapid pulse, and a swollen right calf with tenderness, which are classic signs of a pulmonary embolism. A pulmonary embolism occurs when a blood clot travels to the lungs, blocking blood flow and causing respiratory distress. The presentation of symptoms in this patient aligns with a pulmonary embolism rather than the other choices. Acute myocardial infarction typically presents with chest pain, not primarily shortness of breath. Tension pneumothorax presents with asymmetrical chest rise, tracheal deviation, and absent breath sounds. Severe asthma attack typically presents with wheezing and prolonged expiratory phase.

Correct Answer: C

Rationale: Certainly! Lead aVR is located on the right side of the body and does not view a specific area of the heart. This is because it is aVR, meaning augmented vector right, which views the heart from the right shoulder towards the center of the heart. Leads V4, I, and aVL are positioned on the left side of the body and each provides a specific view of different areas of the heart. Lead V4 views the left ventricle, lead I views the lateral wall of the left ventricle, and lead aVL views the high lateral wall of the left ventricle. Therefore, the correct answer is C (aVR) as it is on the right side and does not view a specific area of the heart.

Correct Answer: D

Rationale: The correct answer is D: 80 joules. When performing transcutaneous pacing in a conscious patient, it is essential to start with a higher energy setting to ensure electrical capture. Starting with the highest or minimum setting may not provide adequate energy to capture the myocardium. 80 joules is a commonly recommended starting energy level for transcutaneous pacing in conscious patients, as it provides a good chance of achieving capture without causing excessive discomfort or harm. 50 joules may not be sufficient to capture the myocardium effectively. Therefore, the initial energy setting of 80 joules is the most appropriate choice in this scenario.

Correct Answer: B

Rationale: The correct answer is B: O-negative packed red blood cells. In hypovolemic shock, the primary issue is a significant loss of red blood cells leading to decreased oxygen-carrying capacity and subsequent hypotension. Packed red blood cells contain a concentrated amount of red blood cells, which can help improve the patient's oxygenation status and hemodynamic stability more effectively than whole blood or other blood products. O-negative blood is used to avoid potential reactions due to ABO incompatibility. Administering packed red blood cells upon arrival at the hospital is crucial to rapidly address the underlying cause of hypovolemic shock. Choices A, C, and D are incorrect because whole blood or packed red blood cells without plasma may not provide the necessary oxygen-carrying capacity to address the patient's condition effectively. Additionally, using O-positive blood products for a female patient can lead to potentially harmful reactions due to ABO incompatibility.