During a procedure under local anesthesia, the patient complains of circumoral numbness,
blurred vision, and dizziness. What should be the immediate action of the perioperative nurse
monitoring this patient?
a. Recheck the dose of local anesthesia given
b. Ensure an airway
c. Set the IV line to full flow
d. Call for 20% lipid emulsion to be brought to the room - answer✔b
The circulating nurse reports that the needle count is incorrect. The surgeon continues to close
the wound, stating, "I know it is not in the wound and I am not going to stop to look for it." The
best plan of action is to:
a. Accept the surgeon's response without comment and fill out an incident report
b. Inform the surgeon of hospital policy and document subsequent actions
c. Order X-rays regardless of the surgeon's wishes
d. Notify the OR supervisor and ask for advice - answer✔b
A new employee unknowingly dispensed an unsterile solution to the sterile field. The following
day, the supervisor learns of the incident. The supervisor's first action would be to:
a. Initiate an incident report
b. Instruct the employee on the technique of reading labels
c. Counsel the employee verbally
d. Notify the surgeon of the break in technique - answer✔d
Due to an emergency, the perioperative nurse is unable to conduct the sponge, sharps, and
instrument counts. At the conclusion of the surgery, the nurse should:
a. Ask the surgeon to sign the count
b. Immediately notify the OR supervisor
c. Document the absence of counts
d. Refuse to sign the sponge count record - answer✔c
The optimum patient position provides:
a. Access and exposure, maintains circulatory and respiratory functions, and does not
compromise neuromuscular structures.
b. Optimum access and exposure to surgical site, with no permanent compromise to
neuromuscular structures.
c. Access for the surgeon, does not compromise the neuromuscular structures, and maintains an
adequate airway for the anesthetist.
d. Sustained circulatory and respiratory functions, does not compromise neuromuscular
structures, and maintains body alignment. - answer✔a
A patient who is 8 months pregnant is to undergo an emergency laparotomy. In planning nursing
care for this patient, the perioperative nurse should have available a wedge cushion or pillow to
place under the patient's:
a. Knees
b. Left side
c. Right side
d. Shoulders - answer✔c
You're loading the sterilizer with trays and wrapped towels. The correct configuration would be:
a. The towels are on the bottom shelf and the trays on the top shelf
b. The towels are on the top shelf and the trays are on the bottom shelf
c. The trays and towels go on the top shelf and leave the bottom shelf empty
d. There is no specific configuration when there is a mixed load of trays and wrapped textiles -
answer✔b
During the induction of anesthesia, the perioperative nurse may notice fasciculation as a response
to which of the following depolarizing muscle relaxants?
a. Tubocurarine chloride (curare)
b. Succinylcholine chloride (Anectine)
c. Atracurium besylate (Tracrium)
d. Pancuronium bromide (Pavulon) - answer✔b
The ER notifies you that it has an 18-yr-old patient who was in a sledding accident and who is
accompanied by his parents. The patient is alert, oriented, in pain, has a blood pressure of 80/60,
pulse of 120, and RR of 24. The abdomen is distended and tender. After being transferred to the
OR bed, the patient is very apprehensive and complains of being cold. The nurse should confirm
the patient's name, allergies, and operative procedure by:
a. Speaking with the patient and reading the patient's chart
b. Telephone conversation with the ER nurse
c. Use of the ER record provided
d. Telephone conversation with a parent of the patient - answer✔a
A critically injured patient requires immediate surgery, but all unassigned personnel have limited
OR experience. In this situation, the charge nurse should:
a. Assist the available personnel in caring for the patient
b. Reassign experienced personnel to the emergency procedure
c. Personally assume care for the critically injured patient
d. Call in additional personnel to handle the emergency - answer✔b
The nurse's initial response to a patient who develops signs of cyanosis during the preoperative
assessment is to:
a. Administer O2 and start an IV line
b. Begin CPR
c. Read the history and physical to determine health status
d. Assess for breath sounds and airway obstruction - answer✔d
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-Must be sterile
-Will enter sterile tissue or the vascular system - answer✔critical
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-Instruments
-Cutting endoscopic accessories and endoscopes (ex. BIOPSY FORCEPS)
-Cardiac and urinary catheters (still fall into this category even though it does not meet the
TRUE definition) - answer✔critical
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-SHOULD be sterile, but high-level disinfection (kills everything EXCEPT SPORES) acceptable
if manufacturers' instructions require (going to be sterilized unless manufacturer specifically says
not to)
-Contacts broken skin or mucous membrane - answer✔semi-critical
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-Respiratory therapy
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