Nokea
Which solution is reasonable and safe for this transition of care?
- A. Gabrielle's mom will be given time alone with Gabrielle in the preoperative room to provide comfort to Gabrielle
- B. Gabrielle's mom will accompany Gabrielle to the surgical suite and remain with Gabrielle until the inhaled anesthesia takes effect
- C. Gabrielle's mom will be at the preoperative bedside while the nurse initiates IV therapy and administers an IV sedative
- D. Gabrielle's mom will administer an oral sedative to Gabrielle under the supervision of the nurse
Correct Answer: B
Rationale: Allowing Gabrielle's mother to accompany her to the surgical suite until anesthesia takes effect is a safe and reasonable solution. It provides comfort and reduces anxiety during the transition, while ensuring clinical safety under controlled conditions.
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The nurse documents attainment of expected outcomes in the preoperative phase as part of the perioperative plan of care. Which outcomes were met for Gabrielle? Select all that apply.
- A. Correct return demonstration of postoperative activities designed to prevent complications
- B. Physical and emotional readiness for operative procedure; appropriate for age
- C. Decreased risk for surgical site, catheter-based, and community-acquired infections
- D. Caregiver articulation of when to call the provider for follow-up and/or intervention
- E. Pulse oximetry >98% on room air
Correct Answer: B,D,E
Rationale: Gabrielle's nervous but smiling response indicates physical and emotional readiness (B). The scenario implies her mother was engaged in discussions about postoperative care, suggesting caregiver articulation of follow-up needs (D). Pulse oximetry >98% on room air (E) is a standard preoperative outcome, assumed met given no contrary indications.
A scrub nurse is assisting a surgeon with a kidney transplant. What are the patient responsibilities of the scrub nurse? Select all that apply.
- A. Maintaining sterile technique
- B. Draping and handling instruments and supplies
- C. Identifying and assessing the patient on admission
- D. Integrating case management
- E. Preparing the skin at the surgical site
- F. Providing exposure of the operative area
Correct Answer: A,B
Rationale: The scrub nurse is a member of the sterile team who maintains sterile technique while draping and handling instruments and supplies. Two duties of the circulating nurse are to identify and assess the patient on admission to the OR and prepare the skin at the surgical site. The perioperative registered nurse actively assists the surgeon by providing exposure of the operative area. The advanced practice registered nurse coordinated nurse and integrates care activities, collaborates with physicians and nurses in all phases of perioperative and postanesthesia care, and integrates care management, critical paths, and research into care of the surgical patient.
During preoperative teaching about pain management, the patient asks the nurse to explain how a PCA pump works. What will the nurse teach the patient about PCA?
- A. It allows the patient to be completely free of pain during the postoperative period.
- B. It allows the patient to take unlimited amounts of medication as needed.
- C. It allows the patient to choose the type of medication given postoperatively.
- D. It permits the patient to self-administer limited doses of pain medication.
Correct Answer: D
Rationale: The nurse educates the patient that the PCA pump allows patients to self-administer doses of pain-relieving medication within health care provider-prescribed times and dose limits. It is not realistic to promise absence of pain or unlimited access to medication nor allow the patient to select the pain medication prescribed.
An older adult who is scheduled for a hip replacement is taking several medications on a regular basis. Which group of medications does the nurse identify as a surgical risk for this patient?
- A. Anticoagulants
- B. Antacids
- C. Laxatives
- D. Sedatives
Correct Answer: A
Rationale: Anticoagulant medications increase the risk for hemorrhage intra- and postoperatively.
While assessing a patient in the PACU following abdominal surgery, a nurse promptly contacts the surgeon for which of these findings? Select all that apply.
- A. Tachycardia
- B. IV with normal saline solution
- C. Wound drainage
- D. Patient restless
- E. Patient reports incisional pain 8/10
Correct Answer: A,C,D
Rationale: Increased wound drainage, restlessness, increasing pulse, and decreasing blood pressure are symptoms of blood loss/hemorrhage and must be promptly identified to prevent shock. Diminished bowel sounds are expected after surgery and anesthesia. Incisional pain is anticipated; the nurse uses prescriptions for analgesia to help resolve pain. Due to NPO status and blood loss from surgery, IV fluids are administered.