Nokea
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).
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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 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.
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 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.
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.