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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.
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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.
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.
Which of the following actions by a member of the surgical team requires rapid intervention by the charge nurse?
- A. Wearing street clothes into the nursing station
- B. Wearing a surgical mask into the holding room
- C. Walking into the hallway outside an operating room without the hair covered
- D. Putting on a surgical mask, cap, and scrubs before entering the operating room
Correct Answer: C
Rationale: The corridors outside the OR are part of the semirestricted area where personnel must wear surgical attire and head coverings. Surgical masks may be worn in the holding room, although they are not necessary. Street clothes may be worn at the nursing station, which is part of the unrestricted area. Wearing a mask and scrubs is essential when going into the OR.
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).
A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anaesthesia. At completion of the surgery, it is most important that the nurse monitor the patient for which of the following adverse effects?
- A. Nausea
- B. Confusion
- C. Bronchospasm
- D. Weak chest-wall movement
Correct Answer: D
Rationale: The most serious adverse effect of the neuromuscular blocking agents is weakness of the respiratory muscles leading to postoperative hypoxemia. Nausea and confusion are possible adverse effects of these drugs, but they are not as great a concern as respiratory depression. Because these medications decrease muscle contraction, laryngospasm and bronchospasm are not concerns.