Nokea
The nurse is caring for a patient before surgery who has a question about the preoperative medication. Which of the following people will the nurse communicate this information to?
- A. Scrub nurse
- B. Anaesthesiologist
- C. Circulating nurse
- D. Registered nurse first assistant (RNFA)
Correct Answer: B
Rationale: The anaesthesiologist is responsible for prescribing and answering questions about preoperative medications. The RNFA and surgeon are responsible for the surgery, but not for the preoperative sedation. The circulating nurse does not have authority to make a change in any medication.
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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 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.
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.
Which of the following nursing actions should the preoperative nurse perform to prepare a patient for cranial surgery that requires hair removal?
- A. Consult with the surgeon to consider cancellation of the surgery.
- B. Use a depilatory agent to remove hair from the surgical area.
- C. Shave the scalp surgical area with a 1 cm border.
- D. No special preoperative action is required.
Correct Answer: B
Rationale: For surgeries that require hair removal, the hair is either clipped or a depilatory agent is used for hair removal. There is no need to consider cancelling the surgery. Shaving the hair is contraindicated.
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.