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The perioperative nurse is encouraging a family member to remain with a patient in the preoperative holding area until the patient is taken into the operating room. Which of the following reasons is the primary reason for this encouragement?
- A. Ensure proper identification of the patient before surgery.
- B. Protect patient from cross-contamination with other patients.
- C. Assist perioperative nurse to obtain a complete patient history.
- D. Help relieve the stress of surgery for the patient and family member.
Correct Answer: D
Rationale: The presence of a family member or friend reduces the patient's anxiety and stress associated with the preoperative period. Although the family may give information about the patient's name and history, this information is obtained and confirmed by the nurse in other ways. Nursing staff, rather than family members, are responsible for prevention of cross-contamination.
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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 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 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.
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.
The nurse is caring for a preoperative adult patient who is scheduled for a routine surgery and is in the holding area. The patient asks the nurse, 'Will the doctor put me to sleep with a mask over my face?' Which of the following responses is most appropriate?
- A. A drug will be given to you through your IV line, which will cause you to go to sleep almost immediately.'
- B. Only your surgeon can tell you for sure what method of anaesthesia will be used. Should I ask your surgeon?'
- C. General anaesthesia is now given by injecting medication into your veins, so you will not need a mask over your face.'
- D. Masks are not used anymore for anaesthesia. A tube will be inserted into your throat to deliver a gas that will put you to sleep.'
Correct Answer: A
Rationale: The first step in virtually all routine surgeries for general anaesthesia is the injection of an intravenous (IV) induction agent, which rapidly induces sleep. The anaesthesiologist (not the surgeon) determines the method of anaesthesia used. Masks may still be used for inhalation, although many patients are intubated. Total IV anaesthesia may be used for some patients but inhalation anaesthetics also are commonly used.