Deck 25: Coordinated Roles of the Scrub Person and the Circulating Nurse

Question 1

The circulating nurse must remain at the patient's side during the induction of general anesthesia.

Answer 1

True
During the induction of general anesthesia,the circulating nurse remains at the patient's side.The anesthesia provider should be assisted during induction and intubation.Maintain a quiet environment.Tactile or auditory stimulation may produce excitement in the patient during induction.

Question 2

The two best ways to load a knife blade onto a handle are by using a heavy needle holder or simply by hand.

Answer 2

False
Always use an instrument such as a heavy Kelly clamp to attach a blade to its handle.Avoid using a needle holder because that would weaken the jaws.Never use the fingers because that could cause injury.

Question 3

Instrument counts are recommended for all surgical procedures.

Answer 3

True
To ensure that no instrument has been left in a patient's wound,an instrument count is done to reconcile the presence of all instruments at the end of the case that were present at the beginning.

Question 4

Surgical team members need to work a case quickly and precisely primarily to maintain the OR schedule and finish the case before the next case is scheduled to start.

Question 5

Once the initial skin incision has been made,the scalpel must be removed from the field to avoid injuring the patient or a surgical team member.

Question 6

The nurse should anticipate the needs of the surgeon and try to stay one step ahead.

Question 7

If the countable items count results in an incorrect count,the circulating nurse is responsible only for informing the surgeon.

Question 8

The paper band on a pack of x-ray detectable laparotomy tapes or sponges should not be broken after they are counted.

Question 9

A scrub person should not gown and glove from the main field,but rather use a separate surface to place an open gown and gloves after scrubbing.

Question 10

The surgeon and assistants should never take their towels from the primary sterile field.

Question 11

Counted sharps must not be taken from the OR during the surgical procedure.

Question 12

As a sterile team member draping an unsterile table with a separate drape,you would unfold the drape outward toward the opposite side away from yourself first,then toward yourself.

Question 13

The splash basin is a popular item used during the case to hold fluids for washing powder off the surgical team's gloves and also to hold irrigation fluid that will be used to irrigate the surgical wound.

Question 14

Sponges and tapes that have been counted and bagged can be tied and thrown into the trash and removed from the room after being bagged.

Question 15

A minimum of two people is needed to transfer an anesthetized patient from the OR table to the stretcher using a roller device.

Question 16

If a sterile towel is used to pack a wound during a case for use as a retractor,the circulating nurse does not have to be told because it is not radiographically detectable and it is not a countable item.

Question 17

Which is a piece of standard equipment needed for a surgical procedure?

A) Electrosurgical unit (ESU)
B) Flat-screen computer
C) Document shredder
D) Steam sterilizer

Question 18

It is acceptable to open sterile supplies into a rigid container because all the edges are sterile.

Question 19

The temperature of irrigation solution should be between 110° F and 115° F so that the patient's tissues will not be burned.

Question 20

Small sutures do not need to be accounted for at the end of a procedure because they probably will not show up on a radiograph if the suture count is not correct.

Question 21

Where is an optimal location to place the dispersive electrode pad for use with an ESU?

A) Over scar tissue
B) Over a hairy area
C) Over a large muscle mass
D) Over a bony prominence

Question 22

Which is a reason the instrument table and Mayo stand must remain sterile until the patient has left the room?

A) To ensure instruments remain sterile in case of hemorrhage
B) To increase turnover time
C) To ensure instruments have adequate time to dry
D) To adequately use the entire time allotted for the procedure

Question 23

Which is an unacceptable method of transferring sterile items to the sterile field?

A) Reaching over the sterile field and shaking the item from its package
B) Placing the item on the edge of the sterile field with the inside of the wrapper everted over your hand
C) Flipping small,rigid items onto the sterile field
D) Exposing the contents so that the scrub person can remove the item from the wrapper

Question 24

When does the "timeout" occur during a surgical procedure?

A) After the incision has been made
B) While the patient is being intubated
C) Prior to the incision being made with the surgeon present in the room
D) When the patient is in PACU

Question 25

Which area is counted first during the first closing count?

A) Field
B) Garbage
C) Table
D) Floor

Question 26

What level of movement of the upper extremity involves the opening of a peel-pack package?

A) Class 1
B) Class 2
C) Class 3
D) Class 4

Question 27

Where should the safety belt be placed on a patient?

A) Over the patient's chest
B) Over the patient's abdomen
C) Over the patient's thighs
D) On the patient's knees

Question 28

What principle is not associated with motion economy?

A) Make each movement purposeful
B) Work quietly and quickly
C) Keep the work areas orderly
D) Use asymmetric motions

Question 29

Which of the following is not a type of dissecting sponge?

A) Peanut
B) Swab,or gauze,sponge
C) Tonsil
D) Kitner

Question 30

Which is a responsibility of the circulating nurse as the patient enters the room for a surgical procedure?

A) Ask the patient for insurance information.
B) Introduce yourself to patient.
C) Ask the patient to remove street clothes and place them under stretcher.
D) Ask patient to sign the consent form.

Question 31

When is the baseline count done?

A) As the tray is being assembled
B) During the setup before the procedure
C) During the procedure
D) When the incision is being closed

Question 32

Which is not an example of the economical use of supplies in the OR?

A) Combining contaminated trash with noncontaminated trash
B) Turning off lights when not needed
C) Opening sutures only as needed
D) Pouring just enough antiseptic solution for the skin prep

Question 33

Where should the needle counter be placed on the sterile field?

A) The Mayo stand
B) The back table
C) The edge of the drape
D) Nearest to the sterile field

Question 34

Which is a type of syringe used for injection?

A) Asepto
B) Luer-Lok
C) Tapered bulb syringe
D) Toomey

Question 35

What instrument should be immediately handed up after a suture ligature is passed to the surgeon?

A) A Kelly clamp
B) ESU pencil
C) Scissors
D) Mahoney dilator

Question 36

When opening blades onto a sterile field,where is the best place to lay them?

A) On a sterile metal basin
B) Near other sutures to keep all sharps together
C) On top of gloves or a gown so that the scrub person will notice them
D) On the working end of the sterile field

Question 37

The correct way for the scrub person to receive a local medication on the field is:

A) to use a sterile syringe and hypodermic needle and draw up the drug offered from the circulating nurse.
B) to place a cup near the edge of the sterile table and have the circulator pour the drug from the container after removing the lid.
C) to have the circulating nurse draw up the drug in the syringe and dispense the drug after the needle is removed from the syringe.
D) to wrap the drug vial in a sterile drape and have the scrub person draw it up themselves.

Question 38

If a surgeon is working deep within the peritoneal cavity,what is the best choice of sponge to hand up?

A) A Ray-Tec sponge
B) A laparotomy tape
C) A pattie
D) 2×2 gauze sponge

Question 39

Who is responsible for doing the initial count?

A) Circulating nurse
B) Anesthesia provider
C) Sterile processing staff
D) Surgeon

Question 40

What is included in the verbal report given to the PACU nurse once the patient reaches the recovery area?

A) Type of insurance the patient has
B) Type of procedure done
C) Where the patient lives
D) Employment status

Question 41

When packs or sets have been wrapped with double wrappers,the outer wrap is considered the ____________________,and the inner wrap is considered the ____________________.

Question 42

The ____________________ (scrub person or circulating nurse)keeps the instrument count sheets and verifies the instruments on the sterile field so that the baseline count is identical to the closing count.