Ch. 15 Study Guide

A surgical nurse is preparing to enter the restricted zone of the operating room. Which surgical attire should this nurse wear? Select all that apply. A. Street clothes B. Cap C. Mask D. Shoe covers E. Scrub clothes

- Cap - Mask - Shoe covers - Scrub clothes

The nurse is developing a plan of care for a client having surgery under general anesthesia. Which nursing diagnos(es) would be appropriate? Select all that apply. A. Risk for compromised human dignity related to general anesthesia B. Risk for impaired nutrition: less than body requirements related to anesthesia C. Risk of latex allergy response related to surgical exposure D. Disturbed body image related to anesthesia E. Anxiety related to surgical concerns

- Risk for compromised human dignity related to general anesthesia. - Risk of latex allergy response related to surgical exposure. - Anxiety related to surgical concerns.

An intraoperative nurse is applying interventions that will address surgical clients' risks for perioperative positioning injury. What factors contribute to this increased risk for injury in the intraoperative phase of the surgical experience? Select all that apply. A. Absence of reflexes B. Diminished ability to communicate C. Loss of pain sensation D. Nausea resulting from anesthetic E. Reduced blood pressure

- absence of reflexes - Diminished ability to communicate - Loss of pain sensation

Maintaining an aseptic environment in the OR is essential to client safety and infection control. When moving around surgical areas, what distance must the nurse maintain from the sterile field? A. 2 feet (60 cm) B. 18 inches (45 cm) C. 1 foot (30 cm) D. 6 inches (15 cm)

1 foot (30 cm)

An older adult client is scheduled for a bilateral mastectomy. The OR nurse has come out to the holding area to meet the client and quickly realizes that the client is profoundly anxious. What is the most appropriate intervention for the nurse to apply? A. Reassure the client that modern surgery is free of significant risks. B. Describe the surgery to the client in as much detail as possible. C. Clearly explain any information that the client seeks. D. Remind the client that the anesthetic will render the client unconscious.

Clearly explain any information that the client seeks.

The operating room nurse is participating in the appendectomy of a client who has a dangerously low body mass index. The nurse recognizes the client's consequent risk for hypothermia. Which action should the nurse implement to prevent the development of hypothermia? A. Ensure that intravenous (IV) fluids are warmed to the client's body temperature. B. Transfuse packed red blood cells to increase oxygen-carrying capacity. C. Wrap the client in drape that has been soaked in hot water. D. Monitor the client's blood pressure and heart rate vigilantly.

Ensure that intravenous (IV) fluids are warmed to the client's body temperature.

A client will be undergoing a total hip arthroplasty later in the day and it is anticipated that the client may require blood transfusion during surgery. How can the nurse best ensure the client's safety if a blood transfusion is required? A. Prime IV tubing with a unit of blood and keep it on hold. B. Check that the client's electrolyte levels have been assessed preoperatively. C. Ensure that the client has had a current cross-match. D. Keep the blood on standby and warmed to body temperature.

Ensure that the client has had a current cross-match.

The anesthetist is coming to the surgical admissions unit to see a client prior to surgery scheduled for tomorrow morning. What is the priority information that the nurse should provide to the anesthetist during the visit? A. Last bowel movement B. Latex allergy C. Number of pregnancies D. Difficulty falling asleep

Latex allergy

An adult client is scheduled for a hemorrhoidectomy. The OR nurse should anticipate assisting the other team members with positioning the client in what manner? A. Dorsal recumbent position B. Trendelenburg position C. Sims position D. Lithotomy position

Lithotomy position

The operating room nurse acts in the circulating role during a client's scheduled cesarean section. For which task is this nurse responsible? A. Performing documentation B. Estimating the client's blood loss C. Setting up the sterile tables D. Gives the surgeon instruments during surgery

Performing documentation

The nurse knows that older clients are at higher risk for complications and adverse outcomes during the intraoperative period. What is the best rationale for this phenomenon? A. A more angular bone structure than a younger person B. Reduced ability to adjust rapidly to emotional and physical stress C. Increase susceptibility to hyperthermia D. Impaired ability to decrease one's metabolic rate

Reduced ability to adjust rapidly to emotional and physical stress.

An operating room nurse is participating in an interdisciplinary audit of infection control practices in the surgical department. The nurse should know that a basic guideline for maintaining surgical asepsis is which of the following? A. Sterile surfaces or articles may touch other sterile surfaces. B. Sterile supplies can be used on another client if the packages are intact. C. The outer lip of a sterile solution is considered sterile. D. The scrub nurse may pour a sterile solution from a nonsterile bottle.

Sterile surfaces or articles may touch other sterile surfaces.

The nurse is taking the client into the operating room (OR) when the client informs the nurse that the client's grandparent spiked a very high temperature in the OR and nearly died 15 years ago. What relevance does this information have regarding the client? A. The client may be experiencing presurgical anxiety. B. The client may be at risk for malignant hyperthermia. C. The grandparent's surgery has minimal relevance to the client's surgery. D. The client may be at risk for a sudden onset of postsurgical infection.

The client may be at risk for malignant hyperthermia.

The circulating nurse in an outpatient surgery center is assessing a client who is scheduled to receive moderate sedation. Which principle should guide the care of a client receiving this form of anesthesia? A. The client must never be left unattended by the nurse. B. The client should begin a course of antiemetics the day before surgery. C. The client should be informed that the client will remember most of the procedure. D. The client must be able to maintain the client's own airway.

The client must never be left unattended by the nurse.

A circulating nurse provides care in a surgical department that has multiple surgeries scheduled for the day. The nurse should know to monitor which client most closely during the intraoperative period because of the increased risk for hypothermia? A. A 74-year-old client with a low body mass index B. A 17-year-old client with traumatic injuries C. A 45-year-old client having an abdominal hysterectomy D. A 13-year-old client undergoing craniofacial surgery

A 74-year-old client with a low body mass index

The nurse is performing wound care on a postsurgical client. Which practice violates the principles of surgical asepsis? A. Holding sterile objects at chest level B. Allowing a sterile instrument to touch a sterile drape C. A circulating nurse touching a sterile drape D. Considering an unopened sterile package to be sterile

A circulating nurse touching a sterile drape.

The nurse is caring for a client who is scheduled to have a needle biopsy of the pleura. The client has had a consultation with the anesthesiologist, and a conduction block will be used. Which local conduction block can be used to block the nerves leading to the chest? A. Transsacral block B. Brachial plexus block C. Pudendal block D. Paravertebral block

Paravertebral block

The client's surgery is nearly finished and the surgeon has opted to use tissue adhesives to close the surgical wound. This requires the nurse to prioritize assessments related to what complication? A. Hypothermia B. Anaphylaxis C. Infection D. Malignant hyperthermia

Anaphylaxis

The intraoperative nurse advocates for each client who receives care in the surgical setting. How can the nurse best exemplify the principles of client advocacy? A. By encouraging the client to perform deep breathing preoperatively B. By limiting the client's contact with family members preoperatively C. By maintaining the privacy of each client D. By eliciting informed consent from clients

By maintaining the privacy of each client.

The intraoperative nurse is implementing a care plan that addresses the surgical client's risk for vomiting. Interventions that address the potential for vomiting reduce the risk of what subsequent surgical complication? A. Impaired skin integrity B. Hypoxia C. Malignant hyperthermia D. Hypothermia

Hypoxia

The nurse is packing a client's abdominal wound with sterile, half-inch Iodoform gauze. During the procedure, the nurse drops some of the gauze onto the client's abdomen 2 inches (5 cm) away from the wound. What should the nurse do? A. Apply povidone-iodine (Betadine) to that section of the gauze and continue packing the wound. B. Pick up the gauze and continue packing the wound after irrigating the abdominal wound with Betadine solution. C. Continue packing the wound and inform the health care provider that an antibiotic is needed. D. Discard the gauze packing and repack the wound with new Iodoform gauze.

Discard the gauze packing and repack the wound with new Iodoform gauze.

While the surgical client is anesthetized, the scrub nurse hears a member of the surgical team make an inappropriate remark about the client's weight. How should the nurse best respond? A. Ignore the comment because the client is unconscious. B. Discourage the colleague from making such comments. C. Report the comment immediately to a supervisor. D. Realize that humor is needed in the workplace.

Discourage the colleague from making such comments.

Prior to a client's scheduled surgery, the nurse has described the way that members of diverse health disciplines will collaborate in the client's care. What is the main rationale for organizing perioperative care in this collaborative manner? A. Historical precedent B. Client requests C. Health care providers' needs D. Evidence-based practice

Evidence- based practice

The nurse is caring for a client who has had spinal anesthesia. The client is under a health care provider's order to lie flat postoperatively. When the client asks to go to the bathroom, the nurse encourages the client to adhere to the health care provider's order. Prevention of which outcome should the nurse include in the rationale for complying with this order? A. Hypotension B. Respiratory depression C. Headache D. Pain at the lumbar injection site

Headache

The nurse is preparing an elderly client for a scheduled removal of orthopedic hardware, a procedure to be performed under general anesthetic. For which adverse effect should the nurse most closely monitor the client? A. Hypothermia B. Pulmonary edema C. Cerebral ischemia D. Arthritis

Hypothermia

The intraoperative nurse knows that the client's emotional state can influence the outcome of the surgical procedure. How should the nurse best address this? A. Teach the client strategies for distraction. B. Pair the client with another client who has better coping strategies. C. Incorporate cultural and religious considerations, as appropriate. D. Give the client antianxiety medication.

Incorporate cultural and religious considerations, as appropriate.

Verification that all required documentation is completed is an important function of the intraoperative nurse. The intraoperative nurse should confirm that the client's accompanying documentation includes which of the following? A. Discharge planning B. Informed consent C. Analgesia prescription D. Educational resources

Informed consent

The operating room nurse will be caring for a client who will receive a transsacral block. The use of a transsacral block for pain control would be most appropriate for a client undergoing which procedure? A. Thoracotomy B. Inguinal hernia repair C. Reduction mammoplasty D. Closed reduction of a right humerus fracture

Inguinal hernia repair

A nurse is caring for a client following knee surgery that was performed under a spinal anesthetic. What intervention should the nurse implement to prevent a spinal headache? A. Seat the client in a chair and have them perform deep breathing exercises. B. Ambulate the client as early as possible. C. Limit the client's fluid intake for the first 24 hours' postoperatively. D. Keep the client positioned supine.

Keep the client positioned supine.

An operating room (OR) nurse is teaching a nursing student about the principles of surgical asepsis as a requirement in the restricted zone of the operating suite. Which personal protective equipment should the nurse wear at all times in the restricted zone of the OR? A. Bubble mask B. Mask covering the nose and mouth C. Goggles D. Gloves

Mask covering the nose and mouth

The circulating nurse will be participating in a 78-year-old client's total hip replacement. Which consideration should the nurse prioritize during the preparation of the client in the operating room? A. The client should be placed in Trendelenburg position. B. The client must be firmly restrained at all times. C. Pressure points should be assessed and well padded. D. The preoperative shave should be done by the circulating nurse.

Pressure points should be assessed and well padded.

A surgical client has been given general anesthesia and is in stage II (the excitement stage) of anesthesia. Which intervention would be most appropriate for the nurse to implement during this stage? A. Rub the client's back. B. Provide for client safety. C. Encourage the client to express feelings. D. Stroke the client's hand.

Provide for client safety.

The perioperative nurse knows that the National Client Safety Goals have the potential to improve client outcomes in a wide variety of health care settings. Which of these goals has the most direct relevance to the OR? A. Improve safety related to medication use. B. Reduce the risk of client harm resulting from falls. C. Reduce the incidence of health care-associated infections. D. Reduce the risk of fires.

Reduce the risk of fires.

The perioperative nurse is constantly assessing the surgical client for signs and symptoms of complications of surgery. Which symptom should first signal to the nurse the possibility that the client is developing malignant hyperthermia? A. Increased temperature B. Oliguria C. Tachycardia D. Hypotension

Tachycardia

A client waiting in the presurgical holding area asks the nurse, "Why exactly do they have to put a breathing tube into me? My surgery is on my knee." What is the best rationale for intubation during a surgical procedure that the nurse should describe? A. The tube provides an airway for ventilation. B. The tube protects the client's esophagus from trauma. C. The client may receive an antiemetic through the tube. D. The client's vital signs can be monitored with the tube.

The tube provides an airway for ventilation.

A client who underwent a bowel resection to correct diverticula suffered irreparable nerve damage. During the case review, the team is determining if incorrect positioning may have contributed to the client's nerve damage. What surgical position places the client at highest risk for nerve damage? A. Trendelenburg B. Prone C. Dorsal recumbent D. Lithotomy

Trendelenburg

The circulating nurse is admitting a client prior to surgery and proceeds to greet the client and discuss what the client can expect in surgery. Which aspect of therapeutic communication should the nurse implement? A. Wait for the client to initiate dialogue. B. Avoid making eye contact. C. Give preoperative medications prior to discussion. D. Use a tone that decreases the client's anxiety.

Use a tone that decreases the client's anxiety.

The operating room nurse is providing care for a major trauma client who has been involved in a motorcycle accident. Which intraoperative change may suggest the presence of anesthesia awareness? A. Respiratory depression B. Sudden hypothermia and diaphoresis C. Vital sign changes and client movement D. Bleeding beyond what is anticipated

Vital sign changes and client movement