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 Right Ans - 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 Right Ans - 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 Right Ans - 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 Right Ans - 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. Right Ans - 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 Right Ans - 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 Right Ans - 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) Right Ans - 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 Right Ans - 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 Right Ans - 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 Right Ans - d
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-Must be sterile
-Will enter sterile tissue or the vascular system Right Ans - 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) Right Ans - 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 Right Ans - semi-critical
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-Respiratory therapy
-Anesthesia equipment
-Bronchoscopes
-GI endoscopes Right Ans - semi-critical
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-Intermediate or low-level disinfection or cleaning
-Will come in contact with skin
-Ex. washing with soap and water/wiping equipment down/laundry Right
Ans - non-critical
*SPAULDING CLASSIFICATION SYSTEM*
Critical, semi-critical, or non-critical?
-OR bed
-Linens
-EKG leads
-BP cuffs
-Tourniquets Right Ans - non-critical
TRUE OR FALSE