Question 1

A surgical patient received a volatile liquid as an inhalation anaesthetic during surgery.What would the nurse expect the patient to experience postoperatively?&#10;A) Early onset of pain&#10;B) Nausea and vomiting&#10;C) Respiratory depression&#10;D) Significant cardiac depression

Accepted Answer

Early onset of pain

Question 2

Which assessment finding would the nurse expect to observe in a patient with malignant hyperthermia?&#10;A) Decreased heart rate&#10;B) Low,irregular respirations&#10;C) Decreased temperature&#10;D) Ventricular dysrhythmias

Accepted Answer

Malignant hyperthermia is a life-threatening complication of anesthesia that can cause severe muscle rigidity, hyperthermia, metabolic acidosis, and eventually, multiple organ failure. It is associated with ventricular dysrhythmias, not decreased heart rate, low, irregular respirations, or decreased temperature.

Question 3

The nurse notes that a preoperative patient is drowsy,but oriented,in the receiving area.In addition to checking her hospital number and identification band,what should the nurse check?&#10;A) Ask family members to verify the patient's identity.&#10;B) Check that the operative procedure is noted on the chart.&#10;C) Ask the surgeon to identify the patient and the planned surgical procedure.&#10;D) Ask the patient to state her name,her doctor's name,and the operative procedure planned.

Accepted Answer

The nurse should ask the patient to state her name, her doctor's name, and the planned operative procedure to ensure that the correct patient is receiving the correct procedure. This is a common practice known as "time-out" before surgery to prevent errors. Asking family members or the surgeon may not provide adequate verification of the patient's identity or the planned procedure. Checking that the operative procedure is noted on the chart is important, but it is not the most essential step in this situation.

Question 4

A patient with a dislocated shoulder is prepared for a closed,manual reduction of the dislocation with conscious sedation.Which of the following would the nurse anticipate would be administered preoperatively?

A) Inhaled nitrous oxide
B) IV midazolam
C) Intramuscular ketamine (Ketalar)
D) Intramuscular fentanyl-droperidol (Innovar)

Accepted Answer

IV midazolam is a common medication used for conscious sedation as it has sedative, anxiolytic, and amnestic properties. Inhaled nitrous oxide is not typically used for conscious sedation for this procedure. Intramuscular ketamine and intramuscular fentanyl-droperidol are not commonly used for conscious sedation and would be more appropriate for general anesthesia.

Question 5

What is one of the most important goals of the registered nurse first assistant?&#10;A) Safety of the patient&#10;B) Monitoring of the activities of others&#10;C) Documentation of the intraoperative care&#10;D) Admission of the patient to the OR

Accepted Answer

Safety of the patient is the most important goal of the registered nurse first assistant. The RNFA plays a critical role in ensuring that the patient remains safe throughout the surgical procedure. This includes monitoring vital signs, administering medications, and assisting the surgical team in any way necessary to ensure the patient's safety. The RNFA's primary responsibility is to act as an advocate for the patient and to ensure that their needs are met at all times.

Question 6

What are the physical environment and traffic control measures of the OR primarily designed to do?&#10;A) Protect the patient's privacy.&#10;B) Prevent transmission of infection.&#10;C) Ensure the proper function of electrical equipment.&#10;D) Promote the development of teamwork among the OR staff.

Accepted Answer

The physical environment and traffic control measures of the OR are primarily designed to prevent transmission of infection. This includes maintaining cleanliness, controlling airflow, and ensuring proper waste management. Protecting patient privacy, ensuring the proper function of electrical equipment, and promoting the development of teamwork among the OR staff are secondary goals of the OR environment.

Question 7

Which of the following data obtained during the perioperative nurse's assessment of an older patient in the preoperative holding area would indicate a need for special protection techniques during surgery?

A) A history of spinal and hip arthritis
B) Verbalization of anxiety by the patient
C) The patient asking about the details of the surgical procedure
D) An 8-mm Hg increase in systolic blood pressure from the time of hospital admission

Accepted Answer

A history of spinal and hip arthritis may indicate reduced mobility, which can increase the risk of injury during surgical positioning. Special protection techniques, such as padding and repositioning, may be necessary to prevent injury. Verbalization of anxiety, asking about the details of the surgical procedure, or a small increase in blood pressure may not necessarily indicate a need for special protection techniques.

Question 8

Which of the following is part of the minimum requirements for the health record in ambulatory surgery facilities?&#10;A) Postoperative checklist&#10;B) Consult request&#10;C) Documentation of consent&#10;D) Detailed surgical procedure report

Accepted Answer

Documentation of consent is a requirement for the health record in ambulatory surgery facilities according to the minimum requirements outlined by the Centers for Medicare and Medicaid Services (CMS). A postoperative checklist and detailed surgical procedure report may be included, but they are not specifically mentioned as minimum requirements. A consult request may be included if applicable to the procedure.

Question 9

What is the primary reason 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 (OR)?

A) To ensure the proper identification of the patient before surgery
B) To protect the patient from cross-contamination with other patients
C) To assist the perioperative nurse to perform a complete patient history
D) To help minimize patient anxiety

Accepted Answer

Allowing a family member or friend to remain with the patient in the preoperative holding area helps to minimize patient anxiety and provide support during this stressful time. While proper identification of the patient is important, this can be done by the perioperative nurse and other healthcare providers without the need for a family member or friend to be present. Cross-contamination is also a concern, but this is typically addressed through standard infection control procedures and does not require a family member or friend to be present. The perioperative nurse will also obtain a complete patient history prior to surgery without the need for family member or friend assistance.

Question 10

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

A) Nausea and vomiting
B) Agitation and seizures
C) Laryngospasm or bronchospasm
D) Adequacy of respiratory muscle movement

Accepted Answer

Neuromuscular blocking agents can affect respiratory muscle movement, so it is important for the nurse to monitor the patient's respiratory function and ensure adequate gas exchange. Nausea and vomiting, agitation and seizures, and laryngospasm or bronchospasm are also potential complications, but monitoring for adequate respiratory function is the most important.

Question 11

Which of the following is a principle of basic aseptic technique in the OR?&#10;A) All supplies for the day are opened at the beginning of the shift in the sterile surgical room.&#10;B) Torn items can be used as long as they are opened in the sterile room.&#10;C) Sterile items can be opened and flipped onto the sterile table.&#10;D) Each wrapper should be checked for wrapper integrity and changed chemical indicators.

Accepted Answer

The answer of Which of the following is a principle...

Question 12

A preoperative patient in the holding area asks the nurse whether he will be &#34;put to sleep&#34; with a mask over his face.What is the most appropriate response?&#10;A) &#34;A drug will be injected through your intravenous line,which will cause you to go to sleep almost immediately.&#34;&#10;B) &#34;Only your surgeon can tell you for sure what method of anaesthesia will be used.Should I ask your surgeon?&#34;&#10;C) &#34;Masks are not used anymore for anaesthesia.A tube will be inserted into your throat to deliver a gas that will put you to sleep.&#34;&#10;D) &#34;You will be so sleepy from the preoperative medication you have received that you will not be aware of the anaesthetic administration.&#34;

Accepted Answer

The answer of A preoperative patient in the holding area...

Question 13

The nurse would implement postoperative monitoring of a patient's sedation score when the patient had received which one of the following anaesthetics?&#10;A) Lidocaine (local spinal)&#10;B) Fentanyl (analgesic spinal)&#10;C) Lidocaine (local epidural)&#10;D) Sufentanil (analgesic epidural)

Accepted Answer

The answer of The nurse would implement postoperative monitoring of...

Question 14

Which one of the following intraoperative patient positions would the nurse anticipate for the patient who is being prepared for abdominal surgery?&#10;A) Prone&#10;B) Supine&#10;C) Trendelenburg&#10;D) Lateral decubitus

Accepted Answer

The answer of Which one of the following intraoperative patient...

Question 15

What is the intraoperative activity that is performed by the perioperative nurse and is specific to the circulating function?&#10;A) Identifying and assessing the patient&#10;B) Counting sponges,needles,and instruments&#10;C) Passing instruments to the surgeon and assistants&#10;D) Preparing the instrument table and organizing sterile equipment

Accepted Answer

The answer of What is the intraoperative activity that is...

Question 16

The nurse from the general surgical unit brings the patient's hearing aid to the surgical suite because the patient left the unit without it and it is needed to communicate with the patient.At the surgical suite,what areas can the general surgical unit nurse enter?

A) Clean core
B) Scrub sink areas
C) Information or nursing station
D) Corridors of the ORs

Accepted Answer

The answer of The nurse from the general surgical unit...

Deck 21: Nursing Management: Intraoperative Care