Nokea
The nurse is completing an inventory of medications on the unit. Which of the following anaesthesia medications should the nurse expect to observe under refrigeration?
- A. Atracurium
- B. Pancuronium
- C. Rocuronium
- D. Neostigmine bromide
- E. Succinylcholine
Correct Answer: A,E
Rationale: Succinylcholine and atracurium both require refrigeration. The other medications listed do not require refrigeration.
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Which of the following actions should the nurse include in the plan of care immediately after surgery for a patient who received ketamine as an anaesthetic agent?
- A. Administer larger doses of analgesic agents.
- B. Monitor for severe slowing of the heart rate.
- C. Provide a quiet environment in the postanaesthesia care unit.
- D. Avoid the use of benzodiazepines in the postoperative period.
Correct Answer: C
Rationale: Hallucinations are an adverse effect associated with the dissociative anaesthetics such as ketamine, so the postoperative environment should be kept quiet to decrease the risk of hallucinations. Since ketamine causes profound analgesia lasting into the postoperative period, larger doses of analgesics are not needed. Ketamine causes an increase in heart rate. Benzodiazepine use with ketamine may be used to decrease the incidence of hallucinations and nightmares.
Which of the following actions by a member of the surgical team requires rapid intervention by the charge nurse?
- A. Wearing street clothes into the nursing station
- B. Wearing a surgical mask into the holding room
- C. Walking into the hallway outside an operating room without the hair covered
- D. Putting on a surgical mask, cap, and scrubs before entering the operating room
Correct Answer: C
Rationale: The corridors outside the OR are part of the semirestricted area where personnel must wear surgical attire and head coverings. Surgical masks may be worn in the holding room, although they are not necessary. Street clothes may be worn at the nursing station, which is part of the unrestricted area. Wearing a mask and scrubs is essential when going into the OR.
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.
Which of the following actions should the scrub nurse use to maintain aseptic technique during surgery?
- A. Use waterproof shoe covers.
- B. Wear personal protective equipment.
- C. Insist that all operating room (OR) staff perform a surgical scrub.
- D. Change gloves after touching the thigh of a surgeon's sterile gown.
Correct Answer: D
Rationale: Once gloved, a nurse's hands are not to go below his or her waist, therefore, touching the surgeon's thigh would contaminate the nurse's gloves. Hands are always to be kept above waist level. Shoe covers are not sterile. Personal protective equipment is designed to protect caregivers, not the patient, and is not part of aseptic technique. Staff members such as the circulating nurse do not have to perform a surgical scrub before entering the OR.
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.