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Perioperative Nursing Questions and Answers Correct
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Perioperative Nursing Questions
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Perioperative Nursing QuestionsThe circulating nurse sees that a sponge is dropped onto the floor from the instrument
table after the first surgical incision is opened. What is this nurse's best action?
a. Obtain an additional sterile sponge to replace the contaminated one and place it on
the instrument table.
b. Place the sponge in the circulating area to include in the final count before incision
closure.
c. Pick up the sponge and throw it out so on one slip on it
d. Hand the sponge back to the scrub nurse. - answerb. Place the sponge in the
circulating area to include in the final count before incision closure.
The post anesthesia recovery unit nurse is receiving a handoff report from the nurse
anesthetist and the circulating nurse for an 82-year-old client who had a 2-hour open
reduction of a fractured elbow. For which reported information about the client or
surgery does the receiving nurse ask the reporting team for more details?
a. The client is Jewish
b. The estimated blood loss is 150ml.
c. The client reported an allergy to codeine
d. The total intraoperative urine output is 25ml. - answerd. The total intraoperative urine
output is 25ml.
The patient received lidocaine viscous before a gastroscopy was performed. Which of
the following would be priority for the nurse to assess during the postprocedural period?
a. Ability to stand
b. Ability to urinate
c. Leg pain
d. Return of gag reflex - answerd. Return of gag reflex
The patient is admitted to PACU after surgery with general anesthesia. Which of the
following assessment findings would the PACU nurse expect during recovery?
a. Bradycardia
b. Hypertension
c. Respiratory depression
d. Severe headache
e. Urinary frequency - answera,c
,Because of an unexpected emergency case, a client is scheduled for colon surgery at 8
AM has been rescheduled for 11 AM. What is the nurse's best action related to the
preoperative prophylactic antibiotic administration according to the Surgical Care
Improvement Project (SCIP) guidelines?
A. Administer the preoperative antibiotic at 7 AM as originally prescribed.
B. Administer the antibiotic at the same time as the other prescribed preoperative drugs.
C. Adjust the antibiotic administration time to be within 1 hour before the surgical
incision.
D. Hold the preoperative antibiotic until the client is actually in the operating room and
has been anesthetized. - answerC. Adjust the antibiotic administration time to be within
1 hour before the surgical incision.
Rationale: A goal of prophylaxis is to establish bactericidal tissue and serum levels at
the time of skin incision. The SCIP recommendations are that the antibiotic be
administered 1 hour before the actual surgical incision. Giving the drug at 7 am
seriously interferes with maintaining the blood (serum) level at the proper level when the
surgery is actually taking place. Administering the antibiotic with the other preoperative
drugs may or may not be within the recommended time frame. Waiting until the client is
anesthetized is too late for best antibiotic action and peak serum levels.
An 81-year-old client, scheduled for a long orthopedic procedure, appears to have a low
body mass index. In addition to the body mass index value, which additional client
information is most important for the nurse to report to the surgeon and perioperative
team as indicating an increased risk for skin breakdown?
A. Negative nitrogen balance.
B. Previous abdominal surgery.
C. Allergy to latex products.
D. Change in mental status upon admission. - answerA. Negative nitrogen balance.
Rationale: A negative nitrogen balance can be a sign of inadequate protein intake and
malnutrition, resulting in a low BMI. These factors contribute to skin breakdown.
Although the change in mental status can increase the risk for skin breakdown after
surgery if the client is not aware of the need to change position, it is not the most critical
risk factor at this time. The allergy to latex products is critical information to
communicate to the perioperative team but does not contribute to skin breakdown.
The preoperative admitting nurse notices that the client scheduled for total joint
replacement surgery in 2 hours has a smell of alcohol on his breath even though he has
just stated that he has fasted completely for the past 10 hours. What is the nurse's best
first action?
A. Accept the client's statement and continue the preoperative preparation.
B. Report the discrepancy to the surgeon and anesthesiologist immediately.
C. Tell the client the observation and provide the opportunity for him to explain.
, D. Remind the client that the alcohol consumption may require changes in anesthesia
procedure. - answerC. Tell the client the observation and provide the opportunity for him
to explain.
Rationale: Although alcohol consumption before a surgical procedure with anesthesia
can cause serious problems, the nurse should not "jump to conclusions" with his or her
observations. Before informing the surgeon and anesthesiologist, the nurse should
provide the client with the opportunity to explain the alcohol smell on his breath. Some
mouthwashes contain chemicals and alcohol that could leave a perceptible odor. Also,
the nurse could be mistaken about the odor.
The patient states the surgeon discussed the addition of a second procedure to the one
indicated on the consent. The patient is visibly upset that the consent he is asked to
sign with the surgical resident reflects only one procedure and cannot understand why
the nurse and resident do not have the authority to "fix" the consent. In addition, he
states he will not take his wedding ring off because it has never left his hand since his
wife put it there 30 years ago.
1. How would you address the patient's immediate concern regarding the consent? -
answerFocus your answer on the safety aspect of the situation while acknowledging the
patient's frustration. Inform the patient that you will contact the surgeon to clarify the
consent in terms of accuracy and that neither you nor the surgical resident not have the
authority to alter the consent without the surgeon's knowledge. Document it in the
medical record.
2. Under what conditions could the second procedure be performed? - answerThe
second procedure could be performed if a new consent is developed with both
procedures listed and signed by the patient. This new consent can only be used if the
patient is not under the influence of preoperative drugs that could cloud his judgment
and if the patient has received adequate information regarding both procedures to be
able to make an informed choice.
3. What remedy would you propose to prevent such occurrences in the future? -
answerDiscuss the occurrence with the perioperative team, review existing policy, and
make changes as needed. Propose a process for facilitating communication among
departments and team members.
4. How will you respond to the patient's unwillingness to remove his wedding ring? -
answerExplain to him that removal of the ring is not necessary if the finger is not the
operative site. Tape the ring in place if agency policy permits. If the agency does not
permit this action, explain why and have his wife keep the ring with her until she sees
him after surgery.
In going through the preoperative checklist, the nurse notices that the client's armband
does not match the handwritten name on the informed consent, but it matches the
stamped name. What does the nurse do first?
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