Nokea
The perioperative nurse is assessing a patient in the preoperative holding area. Which of the following findings would indicate a need for special protection techniques during surgery?
- A. A stated allergy to cats and dogs.
- B. A history of spinal and hip arthritis.
- C. Verbalization of anxiety by the patient
- D. Having a sip of water 2 hours previously
Correct Answer: B
Rationale: The patient with arthritis may require special positioning to avoid injury and postoperative discomfort. Preoperative anxiety and having a sip of water 2-3 hours before surgery are not unusual for the preoperative patient. An allergy to cats and dogs will not impact the care needed during the intraoperative phase.
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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.
A patient's family history reveals that the patient may be at risk for malignant hyperthermia (MH) during anaesthesia. Which of the following information should the nurse include when providing preoperative patient teaching?
- A. Anaesthesia can be administered with minimal risks with the use of appropriate precautions and medications.
- B. As long as succinylcholine is not administered as a muscle relaxant, the reaction should not occur.
- C. Surgery must be performed under local anaesthetic to prevent development of a sudden, extreme increase in body temperature.
- D. Surgery will be delayed until the patient is genetically tested to determine susceptibility to malignant hyperthermia.
Correct Answer: A
Rationale: General anaesthesia can be administered to patients with MH as long as precautions to avoid MH are taken and preparations are made to treat MH if it does occur. Other factors besides succinylcholine administration are associated with MH. Predictions about whether MH will occur based on family history are inconsistent, and it may not be possible to delay surgery.
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.
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.
A surgical patient received a volatile liquid as an inhalation anaesthetic during surgery. Which of the following symptoms should the nurse monitor for in the immediate postoperative period?
- A. Tachypnea
- B. Myoclonia
- C. Hypertension
- D. Incisional pain
Correct Answer: D
Rationale: Because volatile liquid inhalation agents are rapidly metabolized, postoperative pain occurs soon after surgery. Hypertension and tachypnea are not associated with general anaesthetics. Myoclonia may occur with nonbarbiturate hypnotics but not with the inhaled inhalation agents.