Deck 17: Care of Intraoperative Patients

Question 1

The nurse is caring for a client who will be having surgery with spinal anesthesia.The client says to the nurse,"I changed my mind-I don't want to be awake during surgery!" What is the nurse's best response?

A) "Spinal anesthesia is safer than being put to sleep with general anesthesia."
B) "The anesthesiologist has already determined this is best for your surgery."
C) "It's too late to change now because all the equipment is in place."
D) "I will call the anesthesiologist to come and talk to you."

Answer 1

"I will call the anesthesiologist to come and talk to you."

Question 2

A client is having epidural anesthesia for knee replacement surgery.Which action by the nurse is the priority during this surgery?

A) Provide emotional support for the client.
B) Position the client comfortably and safely.
C) Stay with the client until sedation is effective.
D) Teach the client cough and deep-breathing exercises.

Answer 2

Position the client comfortably and safely.

Question 3

The nurse is helping to position a client on the operating bed when the client states,"I am really nervous about having the breathing tube put down my throat." What is the nurse's best response?

A) "I will give you some medication so that it won't hurt."
B) "The tube is very small and you will hardly know it is there."
C) "The anesthesiologists are experts at this procedure."
D) "The anesthetist will put the tube in your throat after you are asleep."

Answer 3

"The anesthetist will put the tube in your throat after you are asleep."

Question 4

The nurse is preparing to bring a young female client to the operating room for a total abdominal hysterectomy (TAH).The client says to the nurse,"I am so glad that I will still be able to have children after this surgery." What is the nurse's best response?

A) "That is very good news. How many children do you want?"
B) "Weren't you taught about your surgery earlier?"
C) "You must have misunderstood your surgeon."
D) "I will call the surgeon to speak with you before surgery."

Question 5

An older adult client is being positioned on the operating bed for surgery.Which action is the highest priority for the nurse?

A) Placing gel pads under the client's shoulders and head
B) Placing a soft pillow between the client's knees
C) Ensuring that the head is elevated to working height
D) Assessing skin condition for the need for additional padding

Question 6

The nurse is assisting a client to the operating bed and notes that the client is hyperventilating and cannot keep still.The client states,"I am really very anxious right now." What is the nurse's best action?

A) Call the chaplain to calm the client down.
B) Tell the client you will stay with him or her.
C) Inform the surgeon so the procedure can be cancelled.
D) Inform the anesthesiologist and suggest antianxiety medication.

Question 7

Which action by the surgical nursing staff indicates that additional teaching is required about nurses' roles and responsibilities in the operating room?

A) The circulating nurse and the anesthesiologist accompany the client to the postanesthesia care unit.
B) The circulating nurse goes to the blood bank to pick up 2 units of fresh-frozen plasma for the client.
C) The scrub nurse monitors the amount of irrigation fluid that is used during surgery.
D) The circulating nurse prepares the surgical site before the client is covered with sterile drapes.

Question 8

Which observed action indicates that the nurse is performing the surgical scrub correctly?

A) A small brush is used to scrub under nails and wedding ring.
B) The surgical mask is put on before starting the surgical scrub.
C) The soap is rinsed off so that the water runs down to the hands.
D) A paper towel is used to turn off the faucet handle.

Question 9

An anesthetized client must be repositioned from the supine to the prone position midway through a surgical procedure.What is the priority action of the nurse?

A) Log roll the client to prevent dislocation of the shoulder.
B) Keep the client covered to maintain dignity and minimize heat loss.
C) Ensure that the client's endotracheal tube does not become dislodged or kinked.
D) Make sure that the client's indwelling catheter is kept lower than the bladder.

Question 10

Surgery is almost completed for an obese client with diabetes,and the surgeon prepares to close a large abdominal incision.What is the scrub nurse's best action?

A) Count the number of sponges used.
B) Ask the circulating nurse to count sponges.
C) Assist the surgeon with retention sutures.
D) Administer an antibiotic.

Question 11

Which statement indicates accountability by the scrub nurse during a surgical procedure?

A) "The client should have epidural anesthesia rather than general anesthesia."
B) "The client's endotracheal tube is secured and all monitors are in place."
C) "I will have retention sutures ready for the surgeon."
D) "A surgical sponge is missing so I will do a re-count."

Question 12

Which action indicates to the operating room supervisor that the scrub nurse requires additional teaching about sterile technique?

A) A small amount of sterile saline is poured out before it is poured into the basin.
B) The nurse disposes of any equipment packages that are in poor condition.
C) Sterile surgical supplies are placed in the center of the sterile field.
D) The sterile saline bottle cap is placed in the center of the sterile field.

Question 13

The client is to have a surgical procedure under (moderate)conscious sedation.The client is anxious and asks the nurse what to expect.What is the nurse's best response?

A) "You will be awake and alert during the procedure but you will feel no pain."
B) "You will not be able to move your feet or toes during the procedure."
C) "You will not be able to swallow or talk during the procedure."
D) "You will be very sleepy and we will monitor you closely."

Question 14

A client is recovering from abdominal surgery and reports unusual muscle pain.The nurse reviews the operative record and notes that the client received propofol (Diprivan)and ketamine (Ketalar).Which action by the nurse is most appropriate?

A) Request a physical therapy consult.
B) Encourage the client to ambulate.
C) Administer the ordered pain medication.
D) Call the surgeon and request a potassium level.

Question 15

Before the nurse brings the client to the operating room (OR)for knee surgery,the client reports to the nurse that he did not mark the operative knee with the surgeon.What is the priority action of the nurse?

A) Proceed with transferring the client to the OR as planned.
B) Call a "time out" so the site can be marked before surgery begins.
C) Call the surgeon to mark the site with the client before transfer to the OR.
D) Have the client mark the site before transfer to the OR.

Question 16

A client is having spinal anesthesia for knee surgery.Which statement by the client indicates a good understanding of this type of anesthesia?

A) "I won't have to worry about having an allergic reaction."
B) "I will be able to walk sooner after your surgery."
C) "I will have less risk of developing pneumonia after surgery."
D) "I will have less risk of bleeding with epidural anesthesia."

Question 17

Before a client's surgery begins,the circulating nurse notes that the nurse anesthetist did not perform a surgical scrub before coming into the operating room.Which action by the circulating nurse is most appropriate?

A) Direct the nurse anesthetist to perform the surgical scrub immediately.
B) Proceed with positioning the client on the operating bed.
C) Notify the nursing supervisor that sterile technique has been violated.
D) Proceed with setting up the instruments to be used during surgery.

Question 18

The nurse is caring for a client who has had conscious sedation.What is the primary advantage of this type of anesthesia?

A) The client can talk through the procedure.
B) The client is able to follow directions.
C) No respiratory support is needed.
D) No defensive reflexes are lost.

Question 19

What is the priority action for the scrub person at the conclusion of a surgical procedure?

A) Assist with transferring the client to the postanesthesia care unit.
B) Document the procedure in the client's medical record.
C) Set up the sterile field and drape the client appropriately.
D) Document how many sponges and sharps have been utilized.

Question 20

Before undergoing general anesthesia,the client states,"My brother and my father had bad reactions to anesthesia.I hope that doesn't happen to me!" What are the nurse's best actions?

A) Hook up leads to a temporary pacemaker.
B) Have a nasogastric tube ready for insertion.
C) Assess the client's chest x-ray before surgery.
D) Have a cooling blanket ready.
E) Obtain a chest tube insertion kit.
F) Have a Foley catheter kit ready.
G) Provide an emergency tracheostomy kit at the bedside.
H) Inform the anesthesiologist and the surgeon of the client's statement.

Question 21

A client is having an operation.Which assessment findings concern the nurse the most?

A) Potassium level of 4.2 mEq/dL
B) Calcium level of 12 mg/dL
C) Heart rate of 110 beats/min
D) Oxygen saturation of 95%
E) pH of 7.37
F) Blood pressure of 90/40 mm Hg

Question 22

Which clients does the nurse determine have the highest risk for wound infection?

A) Client who has psoriasis
B) Middle-aged woman with a body mass index (BMI) of 30
C) Older adult client with a creatinine level of 4.0
D) Client with a family history of malignant hyperthermia
E) Client with peripheral vascular disease
F) Teenager with diabetes mellitus type 1

Question 23

A client is undergoing an operation under general anesthesia.What are the nurse anesthetist's best actions to prevent hypoventilation during the operation?

A) Monitor breathing and circulation continuously.
B) Monitor blood pressure and heart rate every 5 minutes.
C) Make sure the anesthesia provider remains in the room.
D) Elevate the head of the client's bed or stretcher.
E) Monitor the cardiac rhythm every 30 minutes.