Question 1

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

The nurse can ensure that the patient's request is documented on the consent form and communicate it to the surgical team. This will help ensure that the patient's wishes are respected during the surgery. The nurse should also advocate for the patient's rights while still following hospital policies and procedures. The other options are not appropriate responses and do not support the patient's request.

Question 2

The surgical team is participating in a surgical time-out. What activities are part of this procedure?. Select all that apply.

Accepted Answer

The surgical time-out is a critical safety measure that helps prevent wrong-site, wrong-procedure, or wrong-patient surgeries. During the time-out, the surgical team verifies important information, such as the patient's identity, the surgical site, and the planned procedure. A last-minute preparation of the suite or a final surgical hand scrub are not part of the time-out procedure.

Question 3

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 is to ensure the patient's safety when the instrument is used for the procedure. The nurse needs to check that the instrument is in good working condition, without any defects or damage that might pose a danger to the patient during the surgery.

Question 4

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

The answer of At the conclusion of a surgical procedure,...

Question 5

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 includes providing education about the safety of anesthesia and addressing any concerns or questions the patient may have. It is important for the nurse to support the patient and help them feel comfortable and confident in the care they will receive. Simply dismissing the patient's fears or telling them they won't die is not helpful or appropriate.

Question 6

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 supine with the neck flexed can help the anesthetic agent to reach the appropriate level in the spinal column, allowing for better anesthesia and pain control.

Question 7

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 brachial plexus nerve injury, which can occur as a complication of spinal surgery. The brachial plexus is a network of nerves that runs from the spinal cord through the shoulder and down the arm. Injury to this area can cause weakness or loss of sensation in the affected limb. Thromboembolism in the brachial artery or infiltrated IV access site would not typically present with these symptoms, and residual effects of spinal anesthesia are unlikely given that the patient is in the postanesthesia care unit.

Question 8

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? Select all that apply.

Accepted Answer

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

Question 9

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 best choice is to explain to the patient that the surgeon will mark the site of surgery directly on the patient during a preoperative visit. This is the standard practice in surgery to prevent errors such as operating on the wrong body part. The patient can also confirm with the surgeon directly during the preoperative visit to ensure that the correct site is marked.

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 during epidural anesthesia is a common side effect due to vasodilation caused by the anesthesia. Providing normal saline intravenously with medications to stimulate venous return can help support the patient's blood pressure. Increasing pain medication, intubating the patient, or increasing the amount of anesthesia being administered are not appropriate interventions for hypotension during epidural anesthesia.

Question 11

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 the surgical team and overseeing the overall functioning of the team during the procedure. While other members of the team have important roles, such as the circulating nurse who manages the sterile field and the scrub nurse who assists the surgeon, the ultimate responsibility for the procedure lies with the surgeon.

Question 12

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

The nurse is fulfilling the role of a registered nurse first assistant. Circulating nurses assist with patient care outside of the sterile field, scrub nurses assist in setting up the sterile field and handing instruments to the surgeon, and certified registered nurse anesthetists administer anesthesia. Only the registered nurse first assistant performs the roles described in the question.

Question 13

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 should accompany the patient when transporting them from the operating room to the postanesthesia care unit, as they have been responsible for the patient's anesthesia during the surgery and have the knowledge and skills to manage any potential complications or adverse reactions during transport.

Question 14

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 in the recovery unit to ensure there are no untreated side effects from the anesthesia.

Question 15

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 16

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

The nurse should always prioritize patient safety and never use a sterilized item without proof of its sterilization. Therefore, the nurse should request another item that has the appropriate sterilization tag.

Question 17

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 performing preanesthetic preparation and evaluation, which involves assessing the patient's history with anesthesia and answering any questions about the anesthesia plan.

Question 18

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 (CRNA) is responsible for administering anesthesia and monitoring the patient's response to it. They also determine the amount of pain medication to provide.

Question 19

A patient is being prepared for surgery on the right arm. Which actions should the nurse take to prevent brachial plexus nerve injury?. Select all that apply.

Accepted Answer

To prevent brachial plexus nerve injury during surgery on the right arm, the nurse should pad the table extension on which the arm is positioned to prevent pressure and shearing forces that could cause nerve injury. The nurse should also protect the arm from pressure exerted by operative equipment, such as tourniquets or tubing. Additionally, the nurse should consider intraoperative position changes if possible to relieve pressure on the brachial plexus nerve. Aligning the arm at a 135-degree angle from the body or pronating the wrist are not necessarily preventions of nerve injury and may even increase the risk of injury if not done properly.

Question 20

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 between the nurse anesthetist and the nurse in the postanesthesia care unit, so the risk management nurse would review the standards of the handoff communication process. The discharge summary, end-of-shift report, and surgical time-out do not necessarily address this particular issue.

Quiz 18: Intraoperative Nursing