Nokea
A surgical patient 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
Correct Answer: D
Rationale: Because volatile liquid inhalation agents are rapidly metabolized, postoperative pain occurs soon after surgery. Hypertension and tachypnea are not associated with general anaesthetics. Myoclonia may occur with nonbarbiturate hypnotics but not with the inhaled inhalation agents.
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The perioperative nurse is encouraging a family member to remain with a patient in the preoperative holding area until the patient is taken into the operating room. Which of the following reasons is the primary reason for this encouragement?
- A. Ensure proper identification of the patient before surgery.
- B. Protect patient from cross-contamination with other patients.
- C. Assist perioperative nurse to obtain a complete patient history.
- D. Help relieve the stress of surgery for the patient and family member.
Correct Answer: D
Rationale: The presence of a family member or friend reduces the patient's anxiety and stress associated with the preoperative period. Although the family may give information about the patient's name and history, this information is obtained and confirmed by the nurse in other ways. Nursing staff, rather than family members, are responsible for prevention of cross-contamination.
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 patient.
Correct Answer: A
Rationale: The registered nurse anaesthesia assistant (RNAA) is able to administer anaesthetic agents. Although the responsibilities of a RNAA and an anaesthesiologist have some overlap, the credentialing and roles are different. Supervision by an anaesthesiologist is necessary during anaesthetic administration by a RNAA as the RNAA works in collaboration with and under the supervision of an anaesthesiologist.
The nurse is caring for a preoperative adult patient who is scheduled for a routine surgery and is in the holding area. The patient 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.'
Correct Answer: A
Rationale: The first step in virtually all routine surgeries for general anaesthesia is the injection of an intravenous (IV) induction agent, which rapidly induces sleep. The anaesthesiologist (not the surgeon) determines the method of anaesthesia used. Masks may still be used for inhalation, although many patients are intubated. Total IV anaesthesia may be used for some patients but inhalation anaesthetics also are commonly used.
The nurse is preparing a patient 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)
Correct Answer: A
Rationale: IV sedatives, such as the benzodiazepines, are administered for procedural sedation. Inhaled, epidural, and topical agents are not included in procedural sedation.
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 patient privacy
- C. Rapid completion of surgical procedure
- D. Low incidence of perioperative infection
Correct Answer: D
Rationale: The primary focus when setting up the OR is the prevention of cross-contamination and transmission of infection to the patient. Patient privacy, efficient completion of procedures, and smooth functioning of the OR team are also important, but the priority is protection of the patient from infection.