Deck 19: Nursing Management: Intraoperative Care

Question 1

The nurse recognizes that the use of local anesthesia would be particularly beneficial to a patient when

A) same-day discharge is desirable after surgery.
B) the patient has recently taken food and fluids.
C) the surgical procedure requires major-muscle relaxation.
D) the patient is very apprehensive about having surgery.

Answer 1

the patient has recently taken food and fluids.

Question 2

A patient's family history reveals that the patient may be at risk for malignant hyperthermia (MH) during anesthesia. The nurse explains to the patient that

A) anesthesia can be administered with minimal risks with the use of appropriate precautions and medications.
B) as long as succinylcholine (Anectine) is not administered as a muscle relaxant, the reaction should not occur.
C) surgery will be delayed until the patient is genetically tested to determine whether he or she is susceptible to malignant hyperthermia.
D) surgery must be performed under local anesthetic to prevent development of a sudden, extreme increase in body temperature.

Answer 2

anesthesia can be administered with minimal risks with the use of appropriate precautions and medications.

Question 3

A preoperative patient in the holding area asks the nurse, "Will the doctor put me to sleep with a mask over my face?" The most appropriate response by the nurse is,

A) "A drug will be injected through your IV line, which will cause you to go to sleep almost immediately."
B) "Only your surgeon can tell you for sure what method of anesthesia will be used. Should I ask your surgeon?"
C) "Masks are not used anymore for anesthesia. A tube will be inserted into your throat to deliver a gas that will put you to sleep."
D) "General anesthesia is now given by injecting medication into your veins, so you will not need a mask over your face.

Answer 3

"A drug will be injected through your IV line, which will cause you to go to sleep almost immediately."

Question 4

When evaluating the effectiveness of the OR physical environment and flow of traffic and supplies, the most important information for the nurse to obtain is

A) infection rates of patients.
B) average length of time for surgical procedures.
C) amount of OR staff turnover.
D) patient satisfaction with the surgical experience.

Question 5

A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anesthesia. At completion of the surgery, it is most important that the nurse monitor the patient for

A) nausea.
B) confusion.
C) laryngospasm or bronchospasm.
D) weak chest-wall movement.

Question 6

After orienting a new staff member to the scrub nurse role, the charge nurse will know that the education was effective if the new staff member

A) documents all patient care accurately.
B) labels all specimens to send to the lab.
C) keeps both hands above the operating table level.
D) takes the patient to the postanesthesia recovery area.

Question 7

A surgical patient received a volatile liquid as an inhalation anesthetic during surgery. Postoperatively the nurse should monitor the patient for

A) incisional pain.
B) hypertension.
C) tachypnea.
D) myoclonia.

Question 8

When maintaining aseptic technique in the operating room, the perioperative nurse who is in the scrubbing role will

A) use waterproof shoe covers to keep the shoes sterile.
B) wear personal protective equipment such as gloves and face shields.
C) ensure that all staff in the OR have performed a surgical scrub.
D) change gloves after touching the upper arm of the surgeon's gown.

Question 9

The physical environment and traffic control measures of the operating room are designed primarily to

A) protect the privacy of the patient.
B) prevent transmission of infection.
C) ensure efficient completion of surgical procedures.
D) allow smooth functioning of the operating room team.

Question 10

The nurse notes that a preoperative patient is drowsy but oriented in the receiving area. To identify the patient, the nurse should

A) ask family members to verify the patient's identity, the surgeon, and the planned operative procedure and location.
B) check the patient's hospital ID number with the ID band and patient chart.
C) ask the surgeon to identify the patient and the planned surgical procedure.
D) have the patient state name, doctor's name, and the operative procedure planned in addition to checking the hospital number, ID band, and chart.

Question 11

For which of these actions by an inexperienced staff member would the charge nurse be required to intervene?

A) Wearing a surgical mask into the holding room
B) Walking into the hallway outside an operating room without the hair covered
C) Wearing street clothes into the nursing station
D) Putting on a surgical mask, cap, and scrubs before entering the operating room

Question 12

When gathering data to evaluate patient outcomes, the nurse should include the

A) patient's complaints of pain during the perioperative period.
B) number of personnel required for the operative procedure.
C) clarity of any narrative charting in the patient record.
D) educational level of staff working in the operating room.

Question 13

A patient with a dislocated shoulder is prepared for a closed, manual reduction of the dislocation with conscious sedation. The nurse anticipates the administration of

A) inhaled nitrous oxide.
B) intramuscular fentanyl/droperidol (Innovar).
C) intramuscular ketamine (Ketalar).
D) IV midazolam (Versed).

Question 14

The description that best defines the role of the nurse anesthetist as a member of the surgical team is that he or she

A) may function independently in the administration of anesthetics.
B) has the same credentials and responsibilities as an anesthesiologist.
C) has supervision by the anesthesiologist or surgeon while administering anesthesia to a patient.
D) is responsible for intraoperative administration of anesthetics ordered by the anesthesiologist.

Question 15

The intraoperative activity that is performed by the perioperative nurse and is specific to the circulating function is

A) admitting, identifying, and assessing the patient.
B) counting sponges, needles, and surgical instruments.
C) passing instruments to the surgeon and assistants.
D) preparing the instrument table and sterile equipment.

Question 16

Data obtained during the perioperative nurse's assessment of a patient in the preoperative holding area that would indicate a need for special protection techniques during surgery include

A) a history of spinal and hip arthritis.
B) verbalization of anxiety by the patient.
C) a stated allergy to cats and dogs.
D) having a sip of water 2 hours previously.

Question 17

The nurse from the general surgical unit is asked to bring the patient's hearing aid to the surgical suite. The nurse will take the hearing aid to the

A) clean core.
B) scrub sink areas.
C) nursing station or information desk.
D) corridors of the operating room area.

Question 18

The perioperative nurse encourages a family member or a friend to remain with a patient in the preoperative holding area until the patient is taken into the operating room primarily to

A) ensure the proper identification of the patient prior to surgery.
B) help relieve the stress of separation for the patient and significant others.
C) assist the perioperative nurse to obtain a complete patient history.
D) protect the patient from cross-contamination with other patients.