Deck 21: Nursing Management Intraoperative Care

Question 1

The nurse is preparing a client for surgery. Which of the following actions should 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 client.
C)Confirm the hospital chart identification (ID) number.
D)Have the client state name and date of birth.
E)Ask the client to state the surgical procedure.
F)Verify the client ID band number.

Answer 1

Confirm the hospital chart identification (ID) number.
Have the client state name and date of birth.
Ask the client to state the surgical procedure.
Verify the client ID band number.

Question 2

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 implements which of the following actions?

A)Documents all client care accurately.
B)Labels all specimens to send to the laboratory.
C)Keeps both hands above the operating table level.
D)Takes the client to the postanaesthesia recovery area.

Answer 2

Keeps both hands above the operating table level.

Question 3

A client in surgery receives a neuro-muscular blocking agent as an adjunct to general anaesthesia. At completion of the surgery, it is most important that the nurse monitor the client for which of the following adverse effects?

A)Nausea
B)Confusion
C)Bronchospasm
D)Weak chest-wall movement

Answer 3

Weak chest-wall movement

Question 4

The nurse is positioning a client in the operating room for a transurethral resection of the prostate. Which of the following client positions should the nurse place this client in?

A)Prone
B)Supine
C)Trendelenburg
D)Lithotomy

Question 5

The nurse is caring for a client before surgery who has a question about the preoperative medication. Which of the following people will the nurse communicate this information to?

A)Scrub nurse
B)Anaesthesiologist
C)Circulating nurse
D)Registered nurse first assistant (RNFA)

Question 6

A client's family history reveals that the client may be at risk for malignant hyperthermia (MH) during anaesthesia. Which of the following information should the nurse include when providing preoperative client teaching?

A)Anaesthesia can be administered with minimal risks with the use of appropriate precautions and medications.
B)As long as succinylcholine is not administered as a muscle relaxant, the reaction should not occur.
C)Surgery must be performed under local anaesthetic to prevent development of a sudden, extreme increase in body temperature.
D)Surgery will be delayed until the client is genetically tested to determine susceptibility to malignant hyperthermia.

Question 7

Which of the following actions should the nurse include in the plan of care immediately after surgery for a client who received ketamine as an anaesthetic agent?

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

Question 8

The nurse from the general surgical unit is asked to bring the client's hearing aid to the surgical suite. The nurse will take the hearing aid to which one of the following areas?

A)Clean core
B)Scrub sink area
C)Nursing station or communication centre
D)Corridors of the operating room area

Question 9

Asurgical client received a volatile liquid as an inhalation anaesthetic during surgery. Which of the following symptoms should the nurse monitor for in the immediate postoperative period?

A)Tachypnea
B)Myoclonia
C)Hypertension
D)Incisional pain

Question 10

Which of the following actions should 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 thigh of a surgeon's sterile gown.

Question 11

The nurse is completing an inventory of medications on the unit. Which of the following anaesthesia medications should the nurse expect to observe under refrigeration? (Select all that apply.)

A)Atracurium
B)Pancuronium
C)Rocuronium
D)Neostigmine bromide
E)Succinylcholine

Question 12

Which of the following nursing actions should the preoperative nurse perform to prepare a client for cranial surgery that requires hair removal?

A)Consult with the surgeon to consider cancellation of the surgery.
B)Use a depilatory agent to remove hair from the surgical area.
C)Shave the scalp surgical area with a 1 cm border.
D)No special preoperative action is required.

Question 13

Which of the following descriptions best define the role of the nurse anaesthetist as a member of the surgical team?

A)Is able to administer anaesthetics
B)Has the same credentials and responsibilities as an anaesthesiologist
C)Is responsible for intraoperative administration of anaesthetics ordered by the anaesthesiologist
D)Does not require supervision by the anaesthesiologist while administering anaesthesia to a client

Question 14

The perioperative nurse is encouraging a family member to remain with a client in the preoperative holding area until the client is taken into the operating room. Which of the following reasons is the primary reason for this encouragement?

A)Ensure proper identification of the client before surgery.
B)Protect client from cross-contamination with other clients.
C)Assist perioperative nurse to obtain a complete client history.
D)Help relieve the stress of surgery for the client and family member.

Question 15

The nurse is preparing a client with a dislocated shoulder for a closed, manual reduction of the dislocation with procedural sedation. Which of the following medications should the nurse anticipate administering for this procedure?

A)IV midazolam
B)Inhaled desflurane
C)Epidural lidocaine
D)Eutectic mixture of local anaesthetics (EMLA)

Question 16

Data that were obtained during the perioperative nurse is assessing a client in the preoperative holding area. Which of the following findings would indicate a need for special protection techniques during surgery?

A)A stated allergy to cats and dogs
B)A history of spinal and hip arthritis
C)Verbalization of anxiety by the client
D)Having a sip of water 2 hours previously

Question 17

Which of the following actions by a 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

Question 18

The nurse is caring for a preoperative adult client who is scheduled for a routine surgery and is in the holding area. The client asks the nurse, "Will the doctor put me to sleep with a mask over my face?" Which of the following responses is most appropriate?

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 anaesthesia will be used. Should I ask your surgeon?"
C)"General anaesthesia 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 anaesthesia. A tube will be inserted into your throat to deliver a gas that will put you to sleep."

Question 19

Which of the following outcome measures is 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 client privacy
C)Rapid completion of surgical procedure
D)Low incidence of perioperative infection