Deck 19: Nursing Management: Intraoperative Care

Question 1

Which of these actions included in the perioperative patient plan of care can the perioperative nurse delegate to a surgical technologist?

A) Complete the patient's admission assessment.
B) Pass sterile instruments and supplies to the surgeon.
C) Teach the patient about what to expect in the operating room (OR).
D) Give the postoperative report to the postanesthesia care unit (PACU) nurse.

Answer 1

Pass sterile instruments and supplies to the surgeon.

Question 2

Which action by an inexperienced member of the surgical team requires rapid intervention by the charge nurse?

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

Answer 2

Walking into the hallway outside an operating room without the hair covered

Question 3

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.

Answer 3

nursing station or information desk.

Question 4

After orienting a new staff member to the scrub nurse role, the nurse preceptor will know that the teaching 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 5

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

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

Question 6

When preparing the patient for surgery, which actions will the nurse include in the surgical time-out procedure (select all that apply)?

A) Check for placement of IV lines.
B) Have the surgeon identify the patient.
C) Confirm the hospital chart identification ( ID ) number.
D) Have the patient state name and date of birth.
E) Ask the patient to state the surgical procedure.
F) Verify the patient ID band number.

Question 7

When the nurse caring for a patient before surgery has a question about a sedative medication to be given before sending the patient to the surgical suite, the nurse will communicate with the

A) surgeon.
B) anesthesiologist.
C) circulating nurse.
D) registered nurse first assistant ( RNFA ).

Question 8

A patient with a dislocated shoulder is prepared for a closed, manual reduction of the dislocation with monitored anesthesia care ( MAC ). The nurse anticipates the administration of

A) IV midazolam ( Versed ).
B) inhaled desflurane ( Suprane ).
C) epidural lidocaine ( Xylocaine ).
D) eutectic mixture of local anesthetics ( EMLA ).

Question 9

Which action will the nurse include in the plan of care immediately after surgery for a patient who received ketamine (Ketalar) as an anesthetic agent?

A) Administer larger doses of analgesic agents.
B) Monitor for severe slowing of the heart rate.
C) Provide a quiet environment in the postanesthesia care unit.
D) Avoid the use of benzodiazepines in the postoperative period.

Question 10

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) bronchospasm.
D) weak chest-wall movement.

Question 11

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

Question 12

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 given to you 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) "General anesthesia is now given by injecting medication into your veins, so you will not need a mask over your face."
D) "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."

Question 13

Which nursing action should the operating room ( OR ) nurse manager delegate to the registered nurse first assistant ( RNFA )?

A) Make surgical incisions and suture incisions as needed.
B) Coordinate transfer of the patient to the operating table.
C) Provide postoperative teaching about coughing to the patient.
D) Set up instrument tables at the beginning of the surgical procedure.

Question 14

Which outcome measure will be best for the operating room (OR) nurse manager to use in determining the effectiveness of the physical environment and traffic control measures in the operating room?

A) Smooth functioning of the OR team
B) Effective protection of patient privacy
C) Rapid completion of surgical procedure
D) Low incidence of perioperative infection

Question 15

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 must be performed under local anesthetic to prevent development of a sudden, extreme increase in body temperature.
D) surgery will be delayed until the patient is genetically tested to determine whether he or she is susceptible to malignant hyperthermia.

Question 16

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

Question 17

Which description best defines the role of the nurse anesthetist as a member of the surgical team?

A) Functions independently in the administration of anesthetics
B) Has the same credentials and responsibilities as an anesthesiologist
C) Is responsible for intraoperative administration of anesthetics ordered by the anesthesiologist
D) Requires supervision by the anesthesiologist or surgeon while administering anesthesia to a patient

Question 18

Which action will the scrub nurse use to maintain aseptic technique during surgery?

A) Use waterproof shoe covers.
B) Wear personal protective equipment.
C) Insist that all operating room (OR) staff perform a surgical scrub.
D) Change gloves after touching the upper arm of the surgeon's gown.