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The circulating nurse is admitting a patient prior to surgery and proceeds to greet the patient and discuss what the patient can expect in surgery. What aspect of therapeutic communication should the nurse implement?
- A. Wait for the patient to initiate dialogue.
- B. Use medically acceptable terms.
- C. Give preoperative medications prior to discussion.
- D. Use a tone that decreases the patients anxiety.
Correct Answer: D
Rationale: When discussing what the patient can expect in surgery, the nurse uses basic communication skills, such as touch and eye contact, to reduce anxiety. The nurse should use language the patient can understand. The nurse should not withhold communication until the patient initiates dialogue; the nurse most often needs to initiate and guide dialogue, while still responding to patient leading. Giving medication is not a communication skill.
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An OR nurse is teaching a nursing student about the principles of surgical asepsis as a requirement in the restricted zone of the operating suite. What personal protective equipment should the nurse wear at all times in the restricted zone of the OR?
- A. Reusable shoe covers
- B. Mask covering the nose and mouth
- C. Goggles
- D. Gloves
Correct Answer: B
Rationale: Masks are worn at all times in the restricted zone of the OR. Shoe covers are worn one time only; goggles and gloves are worn as required, but not necessarily at all times.
A nurse is caring for a patient following knee surgery that was performed under a spinal anesthetic. What intervention should the nurse implement to prevent a spinal headache?
- A. Have the patient sit in a chair and perform deep breathing exercises.
- B. Ambulate the patient as early as possible.
- C. Limit the patients fluid intake for the first 24 hours postoperatively.
- D. Keep the patient positioned supine.
Correct Answer: D
Rationale: Measures that increase cerebrospinal pressure are helpful in relieving headache. These include maintaining a quiet environment, keeping the patient lying flat, and keeping the patient well hydrated. Having the patient sit or stand up decreases cerebrospinal pressure and would not relieve a spinal headache. Limiting fluids is incorrect because it also decreases cerebrospinal pressure and would not relieve a spinal headache.
A 59-year-old male patient is scheduled for a hemorrhoidectomy. The OR nurse should anticipate assisting the other team members with positioning the patient in what manner?
- A. Dorsal recumbent position
- B. Trendelenburg position
- C. Sims position
- D. Lithotomy position
Correct Answer: D
Rationale: The lithotomy position is used for nearly all perineal, rectal, and vaginal surgical procedures. The Sims or lateral position is used for renal surgery and the Trendelenburg position usually is used for surgery on the lower abdomen and pelvis. The usual position for surgery, called the dorsal recumbent position, is flat on the back, but this would be impracticable for rectal surgery.
Verification that all required documentation is completed is an important function of the intraoperative nurse. The intraoperative nurse should confirm that the patients accompanying documentation includes which of the following?
- A. Discharge planning
- B. Informed consent
- C. Analgesia prescription
- D. Educational resources
Correct Answer: B
Rationale: It is important to review the patients record for the following: correct informed surgical consent, with patients signature; completed records for health history and physical examination; results of diagnostic studies; and allergies (including latex). Discharge planning records and prescriptions are not normally necessary. Educational resources would not be included at this stage of the surgical process.
An OR nurse is participating in an interdisciplinary audit of infection control practices in the surgical department. The nurse should know that a basic guideline for maintaining surgical asepsis is what?
- A. Sterile surfaces or articles may touch other sterile surfaces.
- B. Sterile supplies can be used on another patient if the packages are intact.
- C. The outer lip of a sterile solution is considered sterile.
- D. The scrub nurse may pour a sterile solution from a nonsterile bottle.
Correct Answer: A
Rationale: Basic guidelines for maintaining sterile technique include that sterile surfaces or articles may touch other sterile surfaces only. The other options each constitute a break in sterile technique.