Nokea
After orienting a new staff member to the scrub nurse role, the nurse preceptor will know that the teaching was effective if the new staff member implements which of the following actions?
- A. Documents all patient care accurately.
- B. Labels all specimens to send to the laboratory.
- C. Keeps both hands above the operating table level.
- D. Takes the patient to the postanaesthesia recovery area.
Correct Answer: C
Rationale: The scrub nurse role includes maintaining asepsis in the operating field and both hands must stay above waist level to ensure that they are above the operating table level. The other actions would be appropriate to the circulating nurse role.
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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.
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.
The nurse from the general surgical unit is asked to bring the patient's hearing aid to the surgical suite. The nurse will take the hearing aid to which one of the following areas?
- A. Clean core
- B. Scrub sink area
- C. Nursing station or communication centre
- D. Corridors of the operating room area
Correct Answer: C
Rationale: The nurse from the general unit would not be wearing surgical scrub attire or a head covering and would be restricted to the nursing station or communication centre, which are unrestricted areas. The clean core, scrub sink area, and corridors are semirestricted areas that require staff members wear surgical scrub attire and head coverings.
The nurse is positioning a patient in the operating room for a transurethral resection of the prostate. Which of the following patient positions should the nurse place this patient in?
- A. Prone
- B. Supine
- C. Trendelenburg
- D. Lithotomy
Correct Answer: D
Rationale: The lithotomy position is used for genitourinary procedures such as vaginal hysterectomy and transurethral resection of the prostate. Although supine is the most common position, it is not used for this surgery; rather it is appropriate for abdominal, cardiac, and breast surgeries. A variation of the supine is the Trendelenburg position, used in lower abdominal or pelvic surgery, for which it is necessary to see the pelvic organs. The prone position allows easy access for back surgeries (e.g., laminectomies).
A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anaesthesia. At completion of the surgery, it is most important that the nurse monitor the patient for which of the following adverse effects?
- A. Nausea
- B. Confusion
- C. Bronchospasm
- D. Weak chest-wall movement
Correct Answer: D
Rationale: The most serious adverse effect of the neuromuscular blocking agents is weakness of the respiratory muscles leading to postoperative hypoxemia. Nausea and confusion are possible adverse effects of these drugs, but they are not as great a concern as respiratory depression. Because these medications decrease muscle contraction, laryngospasm and bronchospasm are not concerns.