Question 1

A patient is being prepared for surgery on the right arm. Which actions should the nurse take to prevent brachial plexus nerve injury? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

C) Pad the table extension on which the arm is positioned: This helps to prevent compression of the nerves in the brachial plexus by providing cushioning to the arm and reducing pressure.
D) Protect the arm from pressure exerted by operative equipment: This includes positioning the arm in a way that avoids stretching or compression of the brachial plexus nerves by the weight of the equipment.
E) Consider intraoperative position changes if possible: Changing the position of the arm during surgery can reduce the risk of nerve injury by avoiding prolonged pressure on the nerves.

Question 2

While in the postanesthesia care unit, a patient recovering from spinal surgery tells the nurse that he cannot feel his right hand and that his right shoulder is painful. The nurse's initial concern is in regard to which complication?

Accepted Answer

The patient's symptoms suggest a possible brachial plexus nerve injury. This can occur as a complication of spinal surgery, and it is important to assess for and manage this potential complication promptly to prevent permanent damage. Thromboembolism in the brachial artery, residual effects of spinal anesthesia, and an infiltrated intravenous access site may also cause similar symptoms, but they are less likely to be the primary concern in this situation.

Question 3

At the conclusion of a surgical procedure, it has been determined that one sponge is missing. How should the nurse manage this situation?

Accepted Answer

C

Question 4

The surgical team is participating in a surgical time-out. What activities are part of this procedure? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

A surgical time-out is a safety procedure conducted before the start of a surgical procedure. It involves the entire surgical team taking a brief pause to verify critical information and prevent wrong-site surgery. The activities that are a part of this procedure include verifying the correct patient, the correct surgical site, and the correct procedure planned. Additionally, the body side on which the surgery will occur is determined to avoid any confusion during the surgery. A pause to allow last-minute preparation of the surgical suite and a final surgical hand scrub are not part of the surgical time-out procedure.

Question 5

Before a patient goes into the surgical suite, the nurse anesthetist assesses the patient's previous experience with anesthesia and answers any questions the patient might have about the anesthesia plan for the surgery. In which category of nurse anesthetist practice is this nurse functioning?

Accepted Answer

The nurse anesthetist is conducting preanesthetic preparation and evaluation by assessing the patient's previous experience with anesthesia and answering any questions the patient may have about the anesthesia plan.

Question 6

A patient fearful of anesthesia asks the nurse to make sure that she wakes up after surgery just so she can see her family one more time if she is going to die. What should the nurse do to support this patient?

Accepted Answer

The nurse should attempt to reduce the patient's fears and discuss these fears with the surgical team. This may include having the anesthesiologist speak with the patient about the safety measures taken during the procedure to ensure that the patient wakes up. It is important to address the patient's concerns and provide reassurance, rather than dismissing or minimizing their fears.

Question 7

A patient who is having surgery in a teaching hospital tells the nurse she wants only the surgeon and other necessary people in the operating room. She does not want the surgeon to be teaching medical students while conducting the surgery. How can the nurse support the patient's request?

Accepted Answer

Ensuring that the patient's request is documented on the consent form and communicated to the surgical team are appropriate ways for the nurse to support the patient's request. This ensures that the patient's wishes are respected and can be followed during the surgery. Options B, C, and D are not appropriate responses and do not address the patient's concerns.

Question 8

The nurse anesthetist stops to see a patient recovering from surgery in the postanesthesia care unit to make sure the patient is not experiencing any untreated side effects from the anesthesia. The nurse anesthetist is conducting which aspect of patient care?

Accepted Answer

The nurse anesthetist is conducting postanesthesia care by checking on the patient's recovery and ensuring there are no untreated side effects from the anesthesia.

Question 9

A registered nurse is assisting the surgeon in conducting an exploratory laparoscopy. The nurse holds the tissue retractors, biopsies tissue, and sutures the patient at the conclusion of the case. Which role is this nurse fulfilling?

Accepted Answer

A registered nurse first assistant (RNFA) is an advanced practice nurse who is trained to assist the surgeon during invasive surgical procedures. The duties of an RNFA include retracting tissue, suturing, and positioning the patient during the procedure. A circulating nurse is responsible for managing the overall operation of the operating room and ensuring that proper operating room protocols are followed, while a scrub nurse is responsible for setting up the sterile field and maintaining sterile technique during the procedure. A certified registered nurse anesthetist is responsible for administering anesthesia and monitoring the patient's vital signs during the surgery.

Question 10

A patient who received epidural anesthesia for surgery develops hypotension during the procedure. The nurse anticipates which intervention to support this patient?

Accepted Answer

Hypotension is a common side effect of epidural anesthesia, especially during surgery. Providing normal saline intravenously helps to increase the blood volume and stimulates venous return, which helps to raise blood pressure. Increasing pain medication or the amount of anesthesia being administered can cause further hypotension. Intubation is not necessary for hypotension and may also worsen the situation.

Question 11

A patient tells the nurse that her brother had surgery done on the wrong hand, and she wants to make sure the surgeon knows she is having surgery on her left shoulder. What should the nurse do to address the patient's concerns?

Accepted Answer

The most effective way to address the patient's concern is to explain the standard procedure of marking the site of surgery directly on the patient during a preoperative visit. This is a safety measure that helps to ensure that the correct surgery is performed on the correct site. Option A is not effective because the patient may lose the paper or it may not be noticed by the surgical team. Option C is not effective because it relies on communication between multiple parties, which could lead to errors. Option D may provide some reassurance, but it does not address the patient's concern about ensuring that the correct site is marked for surgery.

Question 12

The scrub nurse is preparing to access a sterilized item; however, the item is missing the appropriate sterilization tag. What action should the nurse take?

Accepted Answer

It is important to use only sterilized items when performing surgical procedures. Since the missing sterilization tag raises doubts about the item's sterility, the best action the scrub nurse can take is to request another item that has the appropriate sterilization tag. Using the item without the tag could compromise patient safety, and substituting it with another similar item could also be risky since the sterilization status of the new item is not known. Informing the physician about the missing tag is also not sufficient, as the physician may choose to use the item anyway.

Question 13

After the anesthesiologist inserts the anesthetic agent into the patient's spinal column, the nurse assists the patient into a supine position with the neck flexed. What is the rationale for the nurse's action?

Accepted Answer

Positioning the patient with the neck flexed helps to distribute the anesthetic agent evenly in the spinal column, ensuring it reaches the appropriate level for the intended effect.

Question 14

Prior to bringing a patient into the operating room, the nurse examines an instrument that will be used for the surgical procedure. What is the rationale for this action?

Accepted Answer

The rationale for examining the instrument before the surgical procedure is to ensure the patient's safety when the instrument is used for the procedure. It is important to make sure the instrument is functioning properly and is sterilized to prevent infection or harm to the patient.

Question 15

An omission of information occurred when the nurse anesthetist informed the nurse in the postanesthesia care unit about a patient's surgical procedure. The risk management nurse would review the standards of which process?

Accepted Answer

The omission of information occurred during the handoff communication process between the nurse anesthetist and the nurse in the postanesthesia care unit. The risk management nurse should review the standards and protocols for handoff communication to prevent future errors.

Question 16

The nurse is assigned as the surgical scrub nurse for today's outpatient cases. In addition to regular surgical attire, which equipment will the nurse wear? Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is assigned as the surgical...

Question 17

During a surgical procedure, the nurse assesses the patient's response to anesthesia and determines the amount of pain medication to provide. Which role is this nurse fulfilling?

Accepted Answer

The certified registered nurse anesthetist is responsible for assessing the patient's response to anesthesia and determining the appropriate medication dosage. The scrub nurse assists the surgeon during the procedure by passing instruments and maintaining a sterile field. The registered nurse first assistant provides hands-on assistance to the surgeon during the procedure. The circulating nurse is responsible for managing the overall care of the patient during surgery, including monitoring vital signs and ensuring the safety of the patient.

Question 18

A patient has lost over 1,000 mL of blood during a surgical procedure that is estimated to continue for at least another 2 hours. The nurse anesthetist prepares to administer packed red blood cells during the procedure. Which patient care activity is the nurse anesthetist conducting?

Accepted Answer

Administering packed red blood cells during a surgical procedure to compensate for significant blood loss is considered perianesthetic clinical support. This activity supports the patient's physiological status during the perioperative period, which includes before, during, and after anesthesia.

Question 19

A patient has just had surgery and is being transported to the postanesthesia care unit. Which team member will accompany the nurse when transporting the patient?

Accepted Answer

The nurse anesthetist would be the best choice to accompany the nurse when transporting the patient, as they are trained to manage the patient's airway and monitor their vital signs during the immediate postoperative period. The scrub nurse and surgeon are typically not involved in postoperative care, and the circulating nurse may need to stay in the operating room to assist with cleaning up after the surgery.

Question 20

The surgical team is assembled and is preparing to conduct a procedure on a patient. Which health care professional is responsible for the overall functioning of the surgical team?

Accepted Answer

The surgeon is responsible for leading and coordinating the surgical team, making decisions about the procedure, and ensuring that all team members are working together effectively. While other healthcare professionals, such as circulating and scrub nurses, play important roles in the surgical team, they do not have the overall responsibility for the team's functioning. The registered nurse first assistant may assist the surgeon during the procedure, but does not have the same level of responsibility as the surgeon.

Quiz 18: Intraoperative Nursing

A patient is being prepared for surgery on the right arm. Which actions should the nurse take to prevent brachial plexus nerve injury? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.