Question 1

What is the normal range of central venous pressure when measured with a transducer?
A)2 to 6 mmHg
B)7 to 10 mmHg
C)12 to 20 mmHg
D)25 to 50 mmHg

Accepted Answer

The normal range of central venous pressure is 2 to 6 mmHg when measured with a transducer. This reading reflects the pressure in the right atrium of the heart. The catheter is advanced to lie in the superior vena cava or the right atrium and is a reflection of the patient's fluid volume levels.

Question 2

Which of the following is considered a disadvantage of using skin staples to close a surgical wound?
A)The skin stapler is difficult to load and to use.
B)Staples leave large scars at the incision site.
C)Staples must be removed after approximately one week.
D)Using the skin stapler requires advanced certification.

Accepted Answer

Skin staples must be removed approximately one week after the surgical procedure. This process requires a staple remover but typically produces only mild discomfort for the patient. A skin stapler is fast and easy to use and leaves only small scars at the location of the staples over the incision line.

Question 3

When classifying instruments used during surgery, a Straight Mayo would be considered what type of instrument?
A)Clamp
B)Scissors
C)Retractor
D)Forceps

Accepted Answer

A Straight Mayo is the name for a type of surgical scissors. Straight Mayo scissors have straight blades instead of curved and have slightly blunted ends. They are typically used for cutting sutures or superficial tissue.

Question 4

The perioperative nurse is setting up the operating suite before the procedure. Which of the following is part of the process of preparing the room?
A)Set up the instrument table with a drape and supplies and push it against the wall to stay out of the way.
B)Position the operating table approximately three feet from the overhead light to avoid glare, and lock it into place.
C)Drape the ring stand and move it next to the instrument table to be available during the procedure.
D)Cover the Mayo stand and move it so that it stays clear of the sterile field during surgery.

Accepted Answer

When setting up the room, drape the ring stand and move it next to the instrument table to be available during the procedure. The ring stand normally holds instrument sets and will be part of the sterile field once the procedure begins. The instrument table should be close to the operating table and not pushed against the wall. The operating table should be positioned directly under the overhead light for better visualization.

Question 5

What is the purpose of the kick bucket during the surgical procedure?
A)It is used to collect sponges that have become soiled during surgery.
B)It is used to collect excess fluid from suctioning during surgery.
C)It is an extra place to put used instruments during surgery.
D)It is kept by the patient's head in case they vomit during surgery.

Accepted Answer

The kick bucket is used to collect sponges that have been soiled during surgery. This bucket is on wheels and is moved with the feet to avoid contaminating the sterile field. Soiled sponges need to be collected during the procedure so they can be counted at the end. This avoids potentially leaving a sponge inside a body cavity during the procedure.

Question 6

When preparing for surgery, a patient is on the table in the lithotomy position and the nurse is applying the drapes. In what order should the nurse drape this patient to prepare the sterile field?
A)Drape the abdomen first, then the legs, and end with a drape under the buttocks.
B)Drape the legs first, then the abdomen, and end with a drape under the buttocks.
C)Place a drape under the buttocks first, then the legs, and end with a drape on the abdomen.
D)Drape the legs first, then apply a drape under the buttocks, and end with a drape on the abdomen.

Accepted Answer

A patient in the lithotomy position is draped in the following order: place a drape under the buttocks first, then the legs, and end with a drape on the abdomen. The area under the buttocks should be draped first as the patient will need to lift themself slightly off the table in order to place the drape. This may disturb the other drapes that are already in place. The nurse should then work upward from this point, draping the legs and finally, the abdomen.

Question 7

Which of the following is necessary for the nurse to have in the room during a femoral-popliteal bypass?
A)Hand-held Doppler
B)Cell-saver
C)Surgical stapler
D)Both A and C

Accepted Answer

During a fem-pop bypass, the nurse should obtain a hand-held Doppler. A Doppler is necessary to check circulation in the foot following the vein anastomosis. The Doppler is typically used to locate the pedal pulse. The patient's angiography results should be made available during the procedure in order to determine patency of the vessel or graft.

Question 8

What is the rationale for using a low-pressure cuff on a tracheostomy tube?
A)To provide less pressure on the vocal cords, thereby allowing the patient to talk.
B)To place less pressure on the tracheal structure, reducing the incidence of ulceration.
C)To provide a seal against air leaks during ventilation.
D)Both B and C

Accepted Answer

A low-pressure cuff on a tracheostomy tube is in place to put less pressure on the tracheal structure, reducing the incidence of ulceration, while also providing a seal against air leaks during ventilation. The tracheostomy tube may contribute to friction and pressure against the structures of the trachea, which can result in tissue breakdown over time. A low-pressure cuff reduces this stress, but does not necessarily affect the vocal cords or speech.

Question 9

A patient's ventilator continues to alarm of increased peak airway pressure. What nursing interventions are most appropriate in this situation?
A)Notify the physician immediately.
B)Suction the endotracheal tube.
C)Prepare the patient for insertion of a chest tube.
D)Call the respiratory therapist to change out the ventilator.

Accepted Answer

In this situation, the nurse should initially suction the endotracheal tube. Increased peak airway pressure may occur due to tube occlusion, which may be the result of excess secretions. The tube could also have become kinked, and suctioning will help the nurse to determine if the tubing is occluded because it is twisted. The nurse may need to assess for other sources of increased pressure, such as poor lung compliance or a pneumothorax, if suctioning does not resolve the problem.

Question 10

The patient on the operating table has started bleeding from several different orifices, including their mucous membranes and intravenous lines. What type of medication should the nurse administer in this situation?
A)Erythropoietin
B)Benazepril
C)Lactulose
D)Heparin

Accepted Answer

In this situation, the nurse should administer heparin. Bleeding from all orifices such as the mucous membranes and intravenous lines indicates disseminated intravascular coagulopathy (DIC). The condition results from extensive clotting in the small vessels, which in turn decreases the level of platelets in the body, leading to extensive bleeding. Heparin is an anticoagulant that will resolve the widespread clotting, allowing the body to correct the bleeding.

Question 11

Which of the following is a nursing intervention performed during an upper gastrointestinal fiberoscopy?
A)Positioning the patient in the supine position for ease of access.
B)Administering corticosteroids to relax the smooth muscles of the intestinal tract.
C)Administering atropine to reduce secretions in the gastrointestinal tract.
D)Assisting with intubation of the patient for controlled ventilation during the procedure.

Accepted Answer

A nursing intervention for an upper gastrointestinal fiberoscopy is to administer atropine to reduce secretions in the gastrointestinal tract. Increased secretions may prevent the physician from visualizing the interior structures during the procedure. The patient should lie on their left side for ease of access and does not need to be intubated for this procedure.

Question 12

When a nurse is preparing a patient for neurosurgery, when is the best time to remove hair on the head?
A)After admission, following the preoperative teaching period
B)In the holding area, once all other preoperative therapeutic measures are complete
C)On the operating table, once the patient has been anesthetized
D)On the operating table, just before the surgeon needs to cut

Accepted Answer

The most appropriate time to remove hair from a patient's head before neurosurgery is on the operating table, once the patient has been anesthetized. Clipping off hair from the head may be upsetting to a patient who may already be anxious about having neurosurgery. Although cutting off the hair must be done, it may be less traumatic if it is performed after anesthesia. The nurse should prepare the patient ahead of time by explaining the need for shaving the head.

Question 13

A patient is being prepped for surgery on the cervical spine. At what level will the nurse most likely need to shave the head?
A)The back of the neck only
B)The back of the neck and up into the hairline to the level of the ears
C)The back of the neck and up into the hairline to the top of the head
D)The entire head must be shaved.

Accepted Answer

When preparing for surgery on the cervical spine, the nurse will most likely need to shave the back of the neck and up into the hairline to the level of the ears. Removing hair from this area keeps the point of the surgical incision at the cervical spine clean and free from debris. Long hair above this level may be pinned above the head and away from the incision. It may then be let down to cover the shaved area following the procedure.

Question 14

Which of the following complications must the perioperative nurse consider when caring for a patient who is positioned prone for a surgical procedure?
A)Increased right atrial pressure
B)Increased pressure in the eyes
C)Tachycardia
D)Both A and B

Accepted Answer

When a patient is positioned prone the nurse must consider possible complications involving increased pressure on the eyes. When the patient is face downward for a long period of time during surgery, blood may accumulate in the front of the face and head. This may put pressure on the structures of the face, eyes and neck. Using proper support devices such as headrests is essential for protecting the patient from injury.

Question 15

The nurse is prepping a woman who is getting ready for a double mastectomy and who asks, "Will I be able to have another surgery to fix my appearance after this?" What factors affect whether a woman is able to have breast reconstruction surgery?
A)The availability of breast tissue after the mastectomy
B)The patient undergoing radiation therapy
C)The patient's recent mastectomy procedure
D)Metastasis that has spread to the liver

Accepted Answer

Metastasis that has spread to the liver affects whether a woman is able to undergo breast reconstruction surgery. Reconstruction surgery may be performed immediately after a woman has a mastectomy. If she does not have enough breast tissue, the surgeon may use implants or tissue expanders to increase the amount of tissue for the reconstruction.

Question 16

What additional pieces may be added to a basic plastics instrument set for a woman undergoing reduction mammoplasty?
A)Specimen scale
B)Areola marker
C)Doppler probe
D)Both A and B

Accepted Answer

A specimen scale and an areola marker are additional devices needed along with a basic plastics tray for performing a reduction mammoplasty. The specimen scale is necessary when taking breast tissue off the body; weighing the tissue from each breast will help to maintain symmetry. An areola marker is included to mark the area before cutting. In most cases, the nipple is not completely removed during the procedure.

Question 17

Which of the following are activities of the circulating nurse in the operating room during the surgical procedure?
A)Maintaining cleanliness and proper temperature in the operating suite.
B)Assisting the surgeon during the procedure.
C)Predicting the need for and providing certain types of sponges or instruments for the surgeon.
D)Counting needles and sponges following wound closure.

Accepted Answer

The circulating nurse is responsible for maintaining cleanliness and proper temperature in the operating suite. The circulating nurse's main functions are ensuring that the patient stays safe during the procedure while monitoring and assisting staff in the operating room. The circulating nurse provides needed supplies and maintains conditions so the surgical team can work safely and effectively.

Question 18

What is the purpose of the mass spectrometer during the surgical procedure?
A)To determine the patient's level of consciousness.
B)To verify the amount of the patient's pain during the procedure.
C)To compare the patient's blood pressure changes throughout the procedure.
D)To reveal how much anesthetic remains in the patient's body following the procedure.

Accepted Answer

The mass spectrometer is used to reveal how much anesthetic remains in the patient's body following the procedure. The mass spectrometer is typically used by the anesthesiologist or nurse anesthetist while administering anesthesia. It can determine if the patient has received too much anesthetic; it is also able to verify if the patient still has too much anesthetic in the body to breathe on their own.

Question 19

Which of the following is an advantage of using nitrous oxide as part of anesthesia for surgery?
A)It does not cause nausea or vomiting postoperatively.
B)Its induction and effects are slow and long-lasting.
C)It can be combined with other agents.
D)It also works as an analgesic.

Accepted Answer

Nitrous oxide can be combined with other agents for anesthesia. Nitrous oxide is used as a type of inhalation anesthesia and it works very rapidly. It also may wear off rapidly, which is why it should be combined with other types of anesthesia for longer effects through the surgical procedure. It is always combined with oxygen for administration and its gas particles enter the patient's bloodstream to induce loss of consciousness.

Quiz 5: Intraoperative

What is the normal range of central venous pressure when measured with a transducer?

Which of the following is considered a disadvantage of using skin staples to close a surgical wound?

When classifying instruments used during surgery, a Straight Mayo would be considered what type of instrument?

The perioperative nurse is setting up the operating suite before the procedure. Which of the following is part of the process of preparing the room?

What is the purpose of the kick bucket during the surgical procedure?

When preparing for surgery, a patient is on the table in the lithotomy position and the nurse is applying the drapes. In what order should the nurse drape this patient to prepare the sterile field?

Which of the following is necessary for the nurse to have in the room during a femoral-popliteal bypass?

What is the rationale for using a low-pressure cuff on a tracheostomy tube?

A patient's ventilator continues to alarm of increased peak airway pressure. What nursing interventions are most appropriate in this situation?

The patient on the operating table has started bleeding from several different orifices, including their mucous membranes and intravenous lines. What type of medication should the nurse administer in this situation?

Which of the following is a nursing intervention performed during an upper gastrointestinal fiberoscopy?

When a nurse is preparing a patient for neurosurgery, when is the best time to remove hair on the head?

A patient is being prepped for surgery on the cervical spine. At what level will the nurse most likely need to shave the head?

Which of the following complications must the perioperative nurse consider when caring for a patient who is positioned prone for a surgical procedure?

The nurse is prepping a woman who is getting ready for a double mastectomy and who asks, "Will I be able to have another surgery to fix my appearance after this?" What factors affect whether a woman is able to have breast reconstruction surgery?

What additional pieces may be added to a basic plastics instrument set for a woman undergoing reduction mammoplasty?

Which of the following are activities of the circulating nurse in the operating room during the surgical procedure?

What is the purpose of the mass spectrometer during the surgical procedure?

Which of the following is an advantage of using nitrous oxide as part of anesthesia for surgery?