2024 INTRAOPERATIVE CARE
CHAPTER 18 EXAM WITH CORRECT
ANSWERS
Which action will the perioperative nurse take after surgery is completed for
a patient who received ketamine as an anesthetic agent?
a. Question the order for giving a benzodiazepine.
b. Ensure that atropine is available in case of bradycardia.
c. Provide a quiet environment in the postanesthesia care unit.
d. Anticipate the need for higher than usual doses of analgesic agents. -
CORRECT-ANSWERSAnswer: c. Provide a quiet environment in the
postanesthesia care unit.
Rationale: Hallucinations are an adverse effect associated with the
dissociative anesthetics such as ketamine. Therefore, the postoperative
environment should be kept quiet to decrease the risk of hallucinations.
Because ketamine causes profound analgesia lasting into the postoperative
period, higher doses of analgesics are not needed. Ketamine causes an
increase in heart rate. Benzodiazepine may be used with ketamine to
decrease the incidence of hallucinations and nightmares.
While in the holding area, a patient reveals to the nurse that his father had a
high fever after surgery. What action by the nurse is a priority?
a. Place a medical alert sticker on the front of the patient's chart.
b. Alert the anesthesia care provider of the family member's reaction to
surgery.
c. Give 650 mg of acetaminophen (Tylenol) per rectum as a preventive
measure.
d. Reassure the patient that his temperature will be monitored closely after
surgery. - CORRECT-ANSWERSAnswer: b. Alert the anesthesia care provider
of the family member's reaction to surgery.
Rationale: The anesthesia care provider (ACP) needs to be notified and made
aware of the patient's family history of anesthesia reactions. Malignant
hyperthermia (MH) is a valid concern because the patient's father appears to
have had a reaction to surgery. The ACP needs to be notified immediately
rather than waiting for a sticker to be noticed on the chart. Administering
acetaminophen may not prevent MH. General anesthesia can be
, administered to patients with MH if precautions to avoid MH are taken and
preparations are made to treat MH if it does occur.
A patient in surgery receives a neuromuscular blocking agent as an adjunct
to general anesthesia. While in the postanesthesia care unit (PACU), what
assessment finding is most important for the nurse to report?
a. Lethargy.
b. Report of nausea.
c. Disorientation to time.
d. Weak chest movement. - CORRECT-ANSWERSAnswer: d. Weak chest
movement.
Rationale: The most serious adverse effect of the neuromuscular blocking
agents is weakness of the respiratory muscles, which can lead to
postoperative hypoxemia. Nausea, lethargy, and disorientation are possible
adverse effects of anesthetic drugs, but they are not as great of concern as
respiratory depression.
A patient in the surgical holding area is being prepared for a spinal fusion.
Which action by a member of the surgical team requires immediate
intervention by the charge nurse?
a. Wearing street clothes into the nursing station.
b. Wearing a surgical mask into the holding room.
c. Walking into the hallway outside the operating room with hair uncovered.
d. Putting on a surgical mask, cap, and scrubs before entering the operating
room. - CORRECT-ANSWERSAnswer: c. Walking into the hallway outside the
operating room with hair uncovered.
Rationale: The corridors outside the operating room (OR) are part of the
semirestricted area where personnel must wear surgical attire and head
coverings. Surgical masks may be worn in the holding room, although they
are not necessary. Street clothes may be worn at the nursing station, which
is part of the unrestricted area. Wearing a mask and scrubs is essential when
going into the OR.
Which nursing action should the operating room (OR) nurse manager
delegate to the registered nurse first assistant (RNFA) when caring for a
surgical patient?
a. Adjust the doses of administered anesthetics.
b. Make surgical incisions and suture as needed.
c. Provide postoperative teaching about coughing.
d. Coordinate transfer of the patient to the operating table. - CORRECT-
ANSWERSAnswer: b. Make surgical incisions and suture as needed.
CHAPTER 18 EXAM WITH CORRECT
ANSWERS
Which action will the perioperative nurse take after surgery is completed for
a patient who received ketamine as an anesthetic agent?
a. Question the order for giving a benzodiazepine.
b. Ensure that atropine is available in case of bradycardia.
c. Provide a quiet environment in the postanesthesia care unit.
d. Anticipate the need for higher than usual doses of analgesic agents. -
CORRECT-ANSWERSAnswer: c. Provide a quiet environment in the
postanesthesia care unit.
Rationale: Hallucinations are an adverse effect associated with the
dissociative anesthetics such as ketamine. Therefore, the postoperative
environment should be kept quiet to decrease the risk of hallucinations.
Because ketamine causes profound analgesia lasting into the postoperative
period, higher doses of analgesics are not needed. Ketamine causes an
increase in heart rate. Benzodiazepine may be used with ketamine to
decrease the incidence of hallucinations and nightmares.
While in the holding area, a patient reveals to the nurse that his father had a
high fever after surgery. What action by the nurse is a priority?
a. Place a medical alert sticker on the front of the patient's chart.
b. Alert the anesthesia care provider of the family member's reaction to
surgery.
c. Give 650 mg of acetaminophen (Tylenol) per rectum as a preventive
measure.
d. Reassure the patient that his temperature will be monitored closely after
surgery. - CORRECT-ANSWERSAnswer: b. Alert the anesthesia care provider
of the family member's reaction to surgery.
Rationale: The anesthesia care provider (ACP) needs to be notified and made
aware of the patient's family history of anesthesia reactions. Malignant
hyperthermia (MH) is a valid concern because the patient's father appears to
have had a reaction to surgery. The ACP needs to be notified immediately
rather than waiting for a sticker to be noticed on the chart. Administering
acetaminophen may not prevent MH. General anesthesia can be
, administered to patients with MH if precautions to avoid MH are taken and
preparations are made to treat MH if it does occur.
A patient in surgery receives a neuromuscular blocking agent as an adjunct
to general anesthesia. While in the postanesthesia care unit (PACU), what
assessment finding is most important for the nurse to report?
a. Lethargy.
b. Report of nausea.
c. Disorientation to time.
d. Weak chest movement. - CORRECT-ANSWERSAnswer: d. Weak chest
movement.
Rationale: The most serious adverse effect of the neuromuscular blocking
agents is weakness of the respiratory muscles, which can lead to
postoperative hypoxemia. Nausea, lethargy, and disorientation are possible
adverse effects of anesthetic drugs, but they are not as great of concern as
respiratory depression.
A patient in the surgical holding area is being prepared for a spinal fusion.
Which action by a member of the surgical team requires immediate
intervention by the charge nurse?
a. Wearing street clothes into the nursing station.
b. Wearing a surgical mask into the holding room.
c. Walking into the hallway outside the operating room with hair uncovered.
d. Putting on a surgical mask, cap, and scrubs before entering the operating
room. - CORRECT-ANSWERSAnswer: c. Walking into the hallway outside the
operating room with hair uncovered.
Rationale: The corridors outside the operating room (OR) are part of the
semirestricted area where personnel must wear surgical attire and head
coverings. Surgical masks may be worn in the holding room, although they
are not necessary. Street clothes may be worn at the nursing station, which
is part of the unrestricted area. Wearing a mask and scrubs is essential when
going into the OR.
Which nursing action should the operating room (OR) nurse manager
delegate to the registered nurse first assistant (RNFA) when caring for a
surgical patient?
a. Adjust the doses of administered anesthetics.
b. Make surgical incisions and suture as needed.
c. Provide postoperative teaching about coughing.
d. Coordinate transfer of the patient to the operating table. - CORRECT-
ANSWERSAnswer: b. Make surgical incisions and suture as needed.
