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Which activities are the circulating nurse's responsibilities in the operating room?
- A. Monitor the position of the client, prepare the surgical site, and ensure the client's safety.
- B. Give preoperative medication in the holding area and monitor the client's response to anesthesia.
- C. Prepare sutures; set up the sterile field; and count all needles, sponges, and instruments.
- D. Prepare the medications to be administered by the anesthesiologist and change the tubing for the anesthesia machine.
Correct Answer: A
Rationale: The circulating nurse monitors positioning, preps the site, and ensures safety, maintaining a non-sterile role. Medications, sterile field setup, and anesthesia tubing are other roles.
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The client is complaining of left shoulder pain. Which intervention should the nurse implement first?
- A. Assess the neurovascular status of the left hand.
- B. Check the medication administration record (MAR).
- C. Ask if the client wants pain medication.
- D. Administer the client's pain medication.
Correct Answer: A
Rationale: Assessing neurovascular status rules out referred pain from cardiac or vascular issues, the priority per ABCs. MAR checks, asking about medication, and administration follow.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients on a surgery unit. Which task would be most appropriate to delegate to the UAP?
- A. Explain to the client how to cough and deep breathe.
- B. Discuss preoperative plans with the client and family.
- C. Determine the ability of the caregivers to provide postoperative care.
- D. Assist the client to take a povidone-iodine (Betadine) shower.
Correct Answer: D
Rationale: Assisting with a Betadine shower is a non-invasive task within UAP scope. Teaching, discussing plans, and assessing caregivers require nursing judgment.
The postoperative client complains of hearing a 'popping sound' and feeling 'something opening' when ambulating in the room. Which intervention should the nurse implement first?
- A. Notify the surgeon the client has had an evisceration.
- B. Contact the surgery department to prepare for emergency surgery.
- C. Assess the operative site and cover the site with a moistened dressing.
- D. Explain this is a common feeling and tell the client to continue with activity.
Correct Answer: C
Rationale: A popping sound and opening sensation suggest dehiscence or evisceration; assessing and covering with a moist dressing stabilizes the site, the first step. Notification and surgery prep follow, and dismissing the symptom is unsafe.
The nurse identifies the nursing diagnosis 'risk for injury related to positioning' for the client in the operating room. Which nursing intervention should the nurse implement?
- A. Avoid using the cautery unit which does not have a biomedical tag on it.
- B. Carefully pad the client's elbows before covering the client with a blanket.
- C. Apply a warming pad on the OR table before placing the client on the table.
- D. Check the chart for any prescription or over-the-counter medication use.
Correct Answer: B
Rationale: Padding elbows prevents pressure injuries during positioning, addressing the diagnosis. Cautery, warming pads, and medication checks are unrelated to positioning.
The circulating nurse notes a discrepancy in the needle count. What intervention should the nurse implement first?
- A. Inform the other members of the surgical team about the problem.
- B. Assume the original count was wrong and change the record.
- C. Call the radiology department to perform a portable x-ray.
- D. Complete an occurrence report and notify the risk manager.
Correct Answer: A
Rationale: Informing the team prompts a recount and investigation, the first step to prevent retained needles. Assuming errors, ordering x-rays, or reporting are premature.