Question 1

A preoperative client has called the nurse about his or her upcoming surgical procedure, 6 weeks from now. He or she is concerned about receiving blood after surgery for fear of acquiring a blood-borne disease. What is the nurse's most appropriate response?

Accepted Answer

Because of the fears of hepatitis B and human immunodeficiency virus infection associated with blood transfusion, donation of autologous blood (one's own blood) for surgery is becoming a common practice. If the client wishes, provide the necessary information about blood donation if the client is seen a number of weeks before surgery.

Question 2

The client has been transported to the operating suite and positioned on the operating table. Suddenly, the client states, "I don't want to do this. Get me out of here now!" Which action should occur?

Accepted Answer

The client has the right to ask any questions and to withdraw consent at any point before the surgery begins.

Question 3

The healthy adult client is given a narcotic prior to a surgical procedure. The nurse is completing the chart and notices the consent form was not signed by the client. Which of the following should the nurse do first?

Accepted Answer

Do not administer any medications that might alter judgment or perception before the client signs the consent form because many drugs commonly administered as preoperative medications, such as narcotics or barbiturates, can alter cognitive abilities and invalidate informed consent.

Question 4

The nurse is preparing to start an IV in a client who is to go to surgery. The nurse would likely choose which gauge of IV catheter?

Accepted Answer

For any surgical client, a large-gauge (e.g., 18 gauge) IV device should be used in case a blood transfusion is necessary during the surgical or postoperative period.

Question 5

The adult male client with significant body hair is being prepared for abdominal surgery. The client states, "My dad had the same surgery many years ago and was shaved prior to the procedure." The nurse would explain to the client:

Accepted Answer

A surgical "prep," or shaving of the hair in the affected area, was a common preoperative procedure a decade ago. Current research indicates that preoperative shaving increases the risk for surgical site infection by causing tiny breaks in skin integrity.

Question 6

The nursing instructor is discussing the role of the circulating nurse in the operative suite with the student nurses. What would the nursing instructor include as duties of the circulating nurse? Select all that apply.

Accepted Answer

The circulating nurse ensures that the client's rights are protected and coordinates client care in the operating room. Protection involves controlling the environment for cleanliness, temperature, humidity, and lighting. The circulating nurse ensures that the patient's rights are protected and coordinates patient care in the operating room. Coordinating activities of related personnel (e.g., laboratory, x-ray) and monitoring aseptic practices are also the circulating nurse's responsibilities. The circulating nurse and the scrub person are responsible for accounting for all sponges and instruments throughout the surgical procedure.

Question 7

The nurse is caring for the postoperative client in the PACU. The client is concerned about the abdominal staples closing the wound for fear they will open and the client's "insides will fall out." What is the best response by the nurse?

Accepted Answer

A client may have absorbable sutures closing the viscera and staples approximating the wound edges.

Question 8

Following a surgical procedure, who is generally responsible for moving the client to the recovery area?

Accepted Answer

After the intraoperative phase of the surgical procedure has been completed, the circulating nurse, the anesthesia provider, and the surgeon safely transport the client to the PACU, taking care to maintain the client's airway during this critical time.

Question 9

The recovery nurse is caring for a surgical client in the PACU. The client's blood pressure is dropping and the heart rate is increasing. The nurse suspects the client is:

Accepted Answer

Decreasing blood pressure and an increased pulse rate in the postoperative client are significant because they may signify hemorrhage or shock.

Quiz 23: Perioperative Nursing