PrepU ML Quiz Ch 18
A client is undergoing a perineal surgical procedure. The nurse should place the client in which position? A. Lithotomy B. Trendelenburg C. Dorsal recumbent D. Sims
A
Fentanyl is categorized as which type of intravenous anesthetic Agent? A. Opioid Neuroleptanalgesic Dissociative agent Tranquilizer
A
A client is placed on the operating room table for the surgical procedure. Which surgical team member is responsible for handing sterile instruments to the surgeon and assistants? A. First assistant B. Scrub nurse C. Certified registered nurse anesthetist D. Circulating nurse
B
A 70-year-old patient who is to undergo surgery arrives at the operating room (OR). The nurse, when reviewing the patient's medical record, understands that this patient will require a lower dose of anesthetic agent because of which of the following? A. Increased tissue elasticity B. Increased anxiety level C. Decreased lean tissue mass D. Impaired thermoregulation
C
A client develops malignant hyperthermia. What client symptom would the nurse most likely observe as the first indicator of the disorder? A. tetanus-like jaw movements B. generalized muscle rigidity C. heart rate over 150 beats per minute D. body temperature increase of 1 °C to 2 °C (2 °F to 4 °F)
C
Which stage of anesthesia is referred to as surgical anesthesia? A. I B. IV C. III D. II
C
When integrating the principles for maintaining surgical asepsis during surgery, which of the following would be most appropriate? A. Positioning the sterile drape on a table from back to front B. Allowing circulating nurses to contact sterile equipment C. Considering the gown sterile from mid-thigh to neck D. Ensuring gown sleeves remain sterile 2 inches above the elbow to cuff
D
During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer: A. potassium chloride B. dantrolene sodium (Dantrium) C. verapamil (Isoptin) D. an acetaminophen suppository
B
A client has been administered ketamine for moderate sedation. What is the priority nursing intervention? A. Administering oxygen B. Providing a quiet dark room for recovery C. Frequently monitoring vital signs D. Assessing for hallucinations
C
What medication should the nurse prepare to administer in the event the client has malignant hyperthermia? A. Dantrolene sodium B. Naloxone C. Thiopental sodium D. Fentanyl citrate
A
The anesthesiologist will use moderate (conscious) sedation during the client's surgical procedure. The circulating nurse will expect the client to: A. Be anxious throughout the procedure B. Respond verbally during the procedure C. Need pain control throughout the procedure D. Need an endotracheal tube
B
The nurse recognizes that the older adult is at risk for surgical complications due to: A. increased cardiac output B. decreased renal function C. decreased adipose tissue D. increased skeletal mass
B
What is the most important postoperative instruction a nurse must give to a client who has just returned from the operating room after receiving a subarachnoid block? A. "Avoid eating milk products for 24 hours." B. "Remain supine for the time specified by the physician." C. "Notify a nurse if you experience blood in your urine." D. "Avoid drinking liquids until the gag reflex returns."
B
What is the priority action by the scrub nurse when the surgeon begins to close the surgical wound? A. Label the tissue specimen. B. Count the sponges. C. Hand equipment to the surgeon as needed. D. Prepare the necessary sutures.
B
A client who is scheduled for knee surgery is anxious about the procedure, saying, "You hear stories on the news all the time about doctors working on the wrong body part. What if that happens to me?" What is the nurse's best response? Select all that apply. A. "Our surgical team would never make that mistake." B. "The client will be involved in the verification process prior to surgery." C. "The client can be involved in marking the knee, the site for the surgery." D. "The surgeon on the team has never been involved in such a mix-up." E. "The surgical team performs a 'time-out' prior to surgery to conduct a final verification."
B, C, E
A client is brought to the operating room for an elective surgery. What is the priority action by the circulating nurse? A. Count sponges and syringes. B. Acquire ordered blood products. C. Verify consent. D. Document the start of surgery.
C
A nurse is administering moderate sedation to a client with chronic obstructive pulmonary disease (COPD). The nurse bases her next action on the principle that: A. inserting a Foley catheter can decrease fluid retention. B. this client may need intubation. C. it may be necessary to raise the head of this client's bed. D. administering I.V. antibiotics can prevent pneumonia.
C
A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention? A. Blood-tinged stools B. Heart rate of 84 beats/minute C. Oxygen saturation (SaO2) of 85% D. Decreased cough and gag reflexes
C
A scrub nurse is diagnosed with a skin infection to the right forearm. What is the priorityaction by the nurse? A. Ensure the infection is covered with a dressing. B. Return to work after taking antibiotics for 24 hours. C. Report the infection to an immediate supervisor. D. Request a role change to circulating nurse.
C
The circulating nurse is unsure whether proper technique was followed when an object was placed in the sterile field during a surgical procedure. What is the best action by the nurse? A. Mark the client's chart for future review of infections. B. Remove the item from the sterile field. C. Ask another nurse to review the technique used. D. Remove the entire sterile field from use.
D
The nurse recognizes the client has reached stage III of general anesthesia when the client: A. displays agitation due to noise B. exhibits shallow respirations and a weak, thready pulse C. shouts, talks, or sings D. lies quietly on the table
D
The surgical client has been intubated and general anesthesia has been administered. The client exhibits cyanosis, shallow respirations, and a weak, thready pulse. The nurse recognizes that the client is in which stage of general anesthesia? A. Stage III B. Stage II C. Stage I D. Stage IV
D
What medication should the nurse prepare to administer in the event the client has malignant hyperthermia? A. Thiopental sodium B. Dantrolene sodium C. Naloxone D. Fentanyl citrate
B
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? A. "I'll be sleepy but able to respond to your questions." B. "I'm so glad that I will be unconscious during the surgery." C. "I won't feel it, but I'll have a tube to help me breathe." D. "Only the surgical area will be numb."
A
The OR personnel responsible for maintaining the safety of the client and the surgical environment is the: A. Circulating nurse B. Scrub nurse C. Anesthesiologist D. Surgeon
A
The nurse is teaching the client about usual side effects associated with spinal anesthesia. Which of the following should the nurse include when teaching? A. Headache B. Itching C. Seizures D. Sore throat
A
The nurse is 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 the nurse why these medications are needed. What would be the nurse's best answer? A. "These medications decrease gastric acidity and volume." B. "These medications slow motor activity." C. "These medications decrease anxiety before surgery." D. "These medications decrease the amount of anesthesia you will need."
A
The patient asks the nurse how long the local infiltration anesthetic will last. What is the nurse's best response? A. "The anesthetic may last for 3 hours." B. "The anesthetic may last for 1 hour." C. "The anesthetic may last for 5 hours." D. "The anesthetic may last for 7 hours."
A
The physician is concerned about aspiration during a surgical procedure and orders a medication to increase gastric pH. Which medication would the nurse document as being administered? A. Sodium citrate B. Vecuronium C. Midazolam D. Famotadine
A
The circulating nurse must be vigilant in monitoring the surgical environment. Which of the following actions by the nurse is inappropriate? A. Maintain the positive pressure OR environment. B. Allow unnecessary personnel to enter the OR environment. C. Monitor for faulty electrical equipment. D. Alert personnel who break sterile technique.
B
The client vomits during the surgical procedure. The best action by the nurse is: A. Administer an anti-emetic to alleviate nausea. B. Suction the client to remove saliva and gastric secretions. C. Increase the IV infusion rate to compensate for lost fluids. D. Lower the head of the operating table to promote circulation to the brain.
B
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? A. Pulse rate of 110 beats/min B. Temperature of 102.5°F (39°C) C. Blood pressure of 104/62 mm Hg D. Respiratory rate of 18 breaths/min
B
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. A. Stage III: surgical anesthesia B. Stage II: excitement C. Stage I: beginning anesthesia D. Stage IV: medullary depression
B
Which clinical manifestation is often the earliest sign of malignant hyperthermia? A. Elevated temperature B. Tachycardia (heart rate >150 beats per minute) C. Oliguria D. Hypotension
B
Which nursing diagnosis should the nurse plan to address first in the client upon arrival in the intraoperative setting? A. Disturbed sensory perception related to the effects of general anesthesia B. Anxiety related to ineffective coping with surgical concerns C. Risk of latex allergy response related to possible exposure in the OR environment D. Risk for perioperative positioning injury related to positioning in the OR
B
Which of the following techniques least exhibits surgical asepsis? A. Placing the sterile field at least one foot away from personnel B. Suctioning the nasopharyngeal cavity of a client C. Keeping sterile gloved hands above the waist D. Adding only sterile items to a sterile field
B
An instructor is developing for a class a teaching plan about agents used for intravenous (IV) anesthesia. Which of the following would the instructor include in this plan about these agents and this type of anesthesia? Select all that apply. A. Long duration of action B. Ease of administration C. Associated with more nausea D. More pleasant onset of anesthesia E. Need for little equipment
B, D, E
An unconscious patient with normal pulse and respirations would be considered to be in what stage of general anesthesia? A. Medullary depression B. Beginning anesthesia C. Surgical anesthesia D. Excitement
C
As a circulating nurse, what task are you solely responsible for? A. Estimating the client's blood loss. B. Handing instruments to the surgeon. C. Keeping records. D. Counting sponges and needles.
C
During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which complication? A. infection B. hypothermia C. malignant hyperthermia D. fluid volume excess
C
The nurse positions the client in the lithotomy position in preparation for A. Pelvic surgery B. Abdominal surgery C. Perineal surgery D. Renal surgery
C
The patient asks the nurse how long the local infiltration anesthetic will last. What is the nurse's best response? A. "The anesthetic may last for 5 hours." B. "The anesthetic may last for 7 hours." C. "The anesthetic may last for 3 hours." D. "The anesthetic may last for 1 hour."
C
Which nursing diagnosis is most important for the client who is undergoing a surgical procedure expected to last several hours? A. Anxiety related to ineffective coping with surgical concerns B. Disturbed sensory perception related to the effects of general anesthesia C. Risk for perioperative positioning injury related to positioning in the OR D. Risk of latex allergy response related to possible exposure in the OR environment
C
A client is receiving general anesthesia. The nurse anesthetist starts to administer the anesthesia. The client begins giggling and kicking her legs. What stage of anesthesia would the nurse document related to the findings? A. IV B. I C. III D. II
D
A client is to receive general anesthesia with sevoflurane. What does the nurse anticipate would be given with the inhaled anesthesia? A. lidocaine B. rocuronium C. alfentanil D. oxygen
D
A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention? A. Blood-tinged stools B. Decreased cough and gag reflexes C. Heart rate of 84 beats/minute D. Oxygen saturation (SaO2) of 85%
D
During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer: A. an acetaminophen suppository B. verapamil (Isoptin) C. potassium chloride D. dantrolene sodium (Dantrium)
D
Hypothermia may occur as a result of A. being young. B. increased muscle activity. C. the infusion of warm fluids. D. open body wounds.
D
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? A. Fentanyl B. Succinylcholine C. Propofol D. Halothane
D