Nokea
Which of the following descriptions best define the role of the nurse anaesthetist as a member of the surgical team?
- A. Is able to administer anaesthetics.
- B. Has the same credentials and responsibilities as an anaesthesiologist.
- C. Is responsible for intraoperative administration of anaesthetics ordered by the anaesthesiologist.
- D. Does not require supervision by the anaesthesiologist while administering anaesthesia to a patient.
Correct Answer: A
Rationale: The registered nurse anaesthesia assistant (RNAA) is able to administer anaesthetic agents. Although the responsibilities of a RNAA and an anaesthesiologist have some overlap, the credentialing and roles are different. Supervision by an anaesthesiologist is necessary during anaesthetic administration by a RNAA as the RNAA works in collaboration with and under the supervision of an anaesthesiologist.
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The nurse is preparing a patient with a dislocated shoulder for a closed, manual reduction of the dislocation with procedural sedation. Which of the following medications should the nurse anticipate administering for this procedure?
- A. IV midazolam
- B. Inhaled desflurane
- C. Epidural lidocaine
- D. Eutectic mixture of local anaesthetics (EMLA)
Correct Answer: A
Rationale: IV sedatives, such as the benzodiazepines, are administered for procedural sedation. Inhaled, epidural, and topical agents are not included in procedural sedation.
The nurse from the general surgical unit is asked to bring the patient's hearing aid to the surgical suite. The nurse will take the hearing aid to which one of the following areas?
- A. Clean core
- B. Scrub sink area
- C. Nursing station or communication centre
- D. Corridors of the operating room area
Correct Answer: C
Rationale: The nurse from the general unit would not be wearing surgical scrub attire or a head covering and would be restricted to the nursing station or communication centre, which are unrestricted areas. The clean core, scrub sink area, and corridors are semirestricted areas that require staff members wear surgical scrub attire and head coverings.
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 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.
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.