Nokea
The OR will be caring for a patient who will receive a transsacral block. For what patient would the use of a transsacral block be appropriate for pain control?
- A. A middle-aged man who is scheduled for a thoracotomy
- B. An older adult man who will undergo an inguinal hernia repair
- C. A 50-year-old woman who will be having a reduction mammoplasty
- D. A child who requires closed reduction of a right humerus fracture
Correct Answer: B
Rationale: A transsacral block produces anesthesia for the perineum and lower abdomen. Both a thoracotomy and breast reduction are in the chest region, and a transsacral block would not provide pain control for these procedures. A closed reduction of a right humerus is a procedure on the right arm, and a transsacral block would not provide pain control.
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During the case review, the team is determining if incorrect positioning may have contributed to the patients nerve damage. What surgical position places the patient at highest risk for nerve damage?
- A. Trendelenburg
- B. Prone
- C. Dorsal recumbent
- D. Lithotomy
Correct Answer: A
Rationale: Shoulder braces must be well padded to prevent irreparable nerve injury, especially when the Trendelenburg position is necessary. The other listed positions are less likely to cause nerve injury.
The nurse is performing wound care on a 68-year-old postsurgical patient. Which of the following practices violates the principles of surgical asepsis?
- A. Holding sterile objects above the level of the nurses waist
- B. Considering a 1 inch (2.5 cm) edge around the sterile field as being contaminated
- C. Pouring solution onto a sterile field cloth
- D. Opening the outermost flap of a sterile package away from the body
Correct Answer: C
Rationale: Whenever a sterile barrier is breached, the area must be considered contaminated. Pouring solution onto a sterile field cloth violates surgical asepsis because moisture penetrating the cloth can carry microorganisms to the sterile field via capillary action. The other options are practices that help ensure surgical asepsis.
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.
As an intraoperative nurse, you are the advocate for each of the patients who receives care in the surgical setting. How can you best exemplify the principles of patient advocacy?
- A. By encouraging the patient to perform deep breathing preoperatively
- B. By limiting the patients contact with family members preoperatively
- C. By maintaining each of your patients privacy
- D. By eliciting informed consent from patients
Correct Answer: C
Rationale: Patient advocacy in the OR entails maintaining the patients physical and emotional comfort, privacy, rights, and dignity. Deep breathing is not necessary before surgery and obtaining informed consent is the purview of the physician. Family contact should not be limited.
A patient will be undergoing a total hip arthroplasty later in the day and it is anticipated that the patient may require blood transfusion during surgery. How can the nurse best ensure the patients safety if a blood transfusion is required?
- A. Prime IV tubing with a unit of blood and keep it on hold.
- B. Check that the patients electrolyte levels have been assessed preoperatively.
- C. Ensure that the patient has had a current cross-match.
- D. Keep the blood on standby and warmed to body temperature.
Correct Answer: C
Rationale: Few patients undergoing an elective procedure require blood transfusion, but those undergoing high-risk procedures may require an intraoperative transfusion. The circulating nurse anticipates this need, checks that blood has been cross-matched and held in reserve, and is prepared to administer blood. Storing the blood at body temperature or in IV tubing would result in spoilage and potential infection.