1. 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
ANS: A
Rationale: Inadvertent hypothermia may occur as a result of a low temperature in the OR, infusion of
cold fluids, inhalation of cold gases, open body wounds or cavities, decreased muscle activity,
advanced age, or the pharmaceutical agents used (e.g., vasodilators, phenothiazines, general
anesthetics). Older adults are particularly susceptible to this. The anesthetist monitors for pulmonary
edema and cerebral ischemia. Arthritis is not an adverse effect of surgical anesthesia.
2. 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
ANS: A
Rationale: Main responsibilities of the circulating nurse include verifying consent; coordinating the
team; and ensuring cleanliness, proper temperature and humidity, lighting, safe function of equipment,
and the availability of supplies and materials. The circulating nurse monitors aseptic practices to avoid
breaks in technique while coordinating the movement of related personnel as well as implementing fire
safety precautions. The circulating nurse also monitors the client and documents specific activities
throughout the operation to ensure the client's safety and well-being. Estimating the client's blood loss
is the surgeon's responsibility; setting up the sterile tables is the responsibility of the first scrub; and
giving the surgeon sterile instruments during surgery is the responsibility of the scrub nurse.
PTS: 1 REF: p. 419
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 15: Intraoperative Nursing Management
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
3. 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
ANS: A
Rationale: Older clients are at greatest risk during surgical procedures because they have an impaired
ability to increase their metabolic rate and impaired thermoregulatory mechanisms, which increase
susceptibility to hypothermia. The other clients are likely at a lower risk.
4. 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
ANS: B
Rationale: Due to the increased number of clients with latex allergies, it is essential to identify this
allergy early on so precautions can be taken in the OR. The anesthetist should be informed of any
allergies. This is a priority over pregnancy history, insomnia, or recent bowel function, though some of
these may be relevant.
PTS: 1 REF: p. 431
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 15: Intraoperative Nursing Management
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
5. 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
ANS: B
Rationale: Masks are worn at all times in the restricted zone of the OR. In hospitals where numerous
total joint procedures are performed, a complete bubble mask may be used. This mask provides
full-barrier protection from bone fragments and splashes. Goggles and gloves are worn as required, but
not necessarily at all times.
PTS: 1 REF: p. 421
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 15: Intraoperative Nursing Management
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
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