chapter 18 prep u – Flashcards
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During the surgical procedure, the client's temperature falls to 96.6°F. Which of the following nursing actions is inappropriate? Warm IV and irrigating fluids. Place a cooling blanket under the client. Remove wet gowns and drapes. Increase the temperature of the OR environment.
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Place a cooling blanket under the client.
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As a circulating nurse, what task are you solely responsible for? Estimating the client's blood loss. Keeping records. Handing instruments to the surgeon. Counting sponges and needles.
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Keeping records.
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A nurse who is part of the surgical team is involved in setting up the sterile tables. The nurse is functioning in which role? Circulating nurse Scrub role Registered nurse first assistant Anesthetist
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Scrub role
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A nurse is working as a registered nurse first assistant as defined by the state's nurse practice act. This nurse practices under the direct supervision of which surgical team member? Circulating nurse Surgeon Anesthetist Scrub nurse
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Surgeon
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During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which of the following complications? Hypothermia Fluid volume excess Infection Malignant hyperthermia
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Malignant hyperthermia This inherited disorder occurs when body temperature, muscle metabolism, and heat production increase rapidly, progressively, and uncontrollably in response to stress and some anesthetic agents. If the client's temperature begins to rise rapidly, anesthesia is discontinued, and the OR team implements measures to correct physiologic problems, such as fever or dysrhythmias. Hypothermia is a lower than expected body temperature. Signs of infection would not present during the procedure. Increased body temperature would not indicate fluid volume excess.
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A patient is undergoing a lumbar puncture. The nurse educates the patient about surgical positioning. Which of the following statements by the nurse is appropriate? "You will be on your back with the head of the bed at 30 degrees." "You will be placed flat on the table, face down." "You will be flat on your back with the table slanted so your head is below your feet." "You will be lying on your side with your knees to your chest."
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"You will be lying on your side with your knees to your chest."
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A 78-year-old woman is undergoing right hip surgery to repair a hip fracture. What nursing action is appropriate during the intraoperative phase? Appropriately position the patient using adequate padding and support. Withhold pain medication due to decreased renal functioning. Discuss the need for higher doses of anesthetic agents with the anesthesiologist. Maintain an operating room temperature of 18°C to prevent hypothermia.
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Appropriately position the patient using adequate padding and support.
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The circulating nurse is documenting all medications administered during a surgical procedure. The anesthesiologist administers an opioid analgesic. What medication would the nurse check as having being administered? Metocurine (Metubine) Fentanyl (Sublimaze) Etomidate (Amidate) Mivacurium (Mivacron)
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Fentanyl (Sublimaze)
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What are the circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities? Setting up the sterile tables Passing instruments Assisting the surgeon Coordinating the surgical team
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Coordinating the surgical team
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The patient is having a repair of a vaginal prolapse. What position does the nurse place the patient in? Lithotomy position Prone position Trendelenburg Left lateral Sim's
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Lithotomy position
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Which of the following clinical manifestations is often the earliest sign of malignant hyperthermia? Elevated temperature Oliguria Hypotension Tachycardia (heart rate above 150 beats per minute)
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Tachycardia (heart rate above 150 beats per minute) Tachycardia is often the earliest sign of malignant hyperthermia. Hypotension is a later sign of malignant hyperthermia. The rise in temperature is actually a late sign that develops rapidly. Scant urinary output is a later sign of malignant hyperthermia.
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Which statement by the client indicates further teaching about epidural anesthesia is necessary? "A needle will deliver the anesthetic into the area around my spinal cord." "I will be able to hear the surgeon during the surgery." "I will become unconscious." "I will lose the ability to move my legs."
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"I will become unconscious.
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The OR personnel responsible for maintaining the safety of the client and the surgical environment is the: Circulating nurse Scrub nurse Surgeon Anesthesiologist
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Circulating nurse
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Which intervention should the nurse plan to implement to decrease the client's risk for injury during the intraoperative period? Verify the client's preoperative vital signs. Allow the client to verbalize fears. Keep the family informed of the client's status. Assess the client for allergies.
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Assess the client for allergies.
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Nursing students are reviewing information about agents used for anesthesia. The students demonstrate understanding when they identify which of the following as an inhalation anesthetic? Halothane Fentanyl Propofol Succinylcholine
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Halothane
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After teaching a patient scheduled for ambulatory surgery using moderate sedation, the nurse determines that the patient has understood the teaching based on which of the following statements? "I'll be sleepy but able to respond to your questions." "Only the surgical area will be numb." "I'm so glad that I will be unconscious during the surgery." "I won't feel it, but I'll have a tube to help me breathe."
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"I'll be sleepy but able to respond to your questions."
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In which zone of the surgical area are street clothes allowed? Limited Semi-restricted Restricted Unrestricted
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Unrestricted
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The nurse is caring for a client during an intra operative procedure. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately? Respiratory rate of 18 breaths/min Pulse rate of 110 beats/min Blood pressure of 104/62 mm Hg Temperature of 102.5° F
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Temperature of 102.5° F
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There are four stages of general anesthesia. Select the stage during which the OR nurse knows not to touch the patient (except for safety reasons) because of possible uncontrolled movements. Stage I: beginning anesthesia Stage III: surgical anesthesia Stage II: excitement Stage IV: medullary depression
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Stage II: excitement
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Which of the following is an inappropriate nursing action by the surgical nurse? Changing shoe covers that become torn Covering the hair with a surgical cap Wearing a surgical jacket with knitted cuffs on the sleeves Wearing sterile gloves over artificial nails
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Wearing sterile gloves over artificial nails
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he scrub nurse is responsible for: Calling the "time-out" to verify the surgical site and procedure Preparing the sterile instruments for the surgical procedure Monitoring the operating-room personnel for breaks in sterile technique Monitoring the administration of the anesthesia
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Preparing the sterile instruments for the surgical procedure
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The nurse understands that the purpose of the "time out" is to: clarify the roles of the OR personnel. verify all necessary supplies are available. maintain the safety of the client. identify the client's allergies.
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maintain the safety of the client.
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A patient is to receive general anesthesia with sevoflurane. The nurse anticipates the need for which of the following? Rocuronium Lidocaine Alfentanil Oxygen
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Oxygen
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You are working in the preoperative area with a client going to surgery for a cholecystectomy. The client has histamine2-receptor antagonists ordered preoperatively. The client asks you why these medications are needed. What would be your best answer? "These medications decrease the amount of anesthesia you will need." "These medications decrease gastric acidity and volume." "These medications slow motor activity." "These medications decrease anxiety before surgery."
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"These medications decrease the amount of anesthesia you will need."
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he anesthesiologist administered a transsacral conduction block. Which of the following documentation by the nurse is consistent with the anesthesia being administered? No movement in right lower leg Yelling and pulling at equipment Unresponsive to verbal or tactile stimuli Denies sensation to perineum and lower abdomen
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Denies sensation to perineum and lower abdomen
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A patient is brought to the operating room for an elective surgery. What is the priority action by the circulating nurse? Verify consent. Document start of surgery. Acquire ordered blood products. Obtain a sponge and syringe count.
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Verify consent.
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A student nurse is scheduled to observe a surgical procedure. The nurse provides the student nurse with education on the dress policy and provides all needed attire to enter a restricted surgical zone. Which observation by the nurse requires immediate intervention? Shoe covers are used. Hair is pulled back and covered by a cap. Mask is placed over nose and extends to bottom lip. Scrub top and drawstring are tucked into pants.
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Mask is placed over nose and extends to bottom lip.
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What intravenous anesthetic administered by the anesthesiologist has a powerful respiratory depressant effect sufficient to cause apnea and cardiovascular depression? Versed Pentothal Amidate Ketalar
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Pentothal
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The nurse caring for a patient who is at risk for malignant hyperthermia subsequent to general anesthesia would assess for the most common early sign of: Tachycardia (HR >150 bpm). Tachypnea (>35 breaths/min). Hypertension (BP >130/90). Oliguria (urinary output <400 mL/day).
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Tachycardia (HR >150 bpm).
