Chapter 18 - Intraoperative Care
Answer: c. Releases or discharges patients from the postanesthesia care area.
Rationale: A nurse anesthetist is a registered nurse who has graduated from an accredited
nurse anesthesia program (minimally a master's degree program) and successfully completed a
national certification examination to become a CRNA. The CRNA scope of practice includes, but
is not limited to, the following:
1. Performing and documenting a preanesthetic assessment and evaluation.
2. Developing and implementing a plan for delivering anesthesia.
3. Selecting and initiating the planned anesthetic technique.
4. Selecting, obtaining, and administering the anesthesia, adjuvant drugs, and fluids.
5. Selecting, applying, and inserting appropriate noninvasive and invasive monitoring devices.
6. Managing a patient's airway and pulmonary status 7. Managing emergence and recovery
from anesthesia.
8. Releasing or discharging patients from a postanest - ANS-Which statement best describes
the role of the certified registered nurse anesthetist (CRNA) on the surgical care team?
a. Performs the same responsibilities as the anesthesiologist.
b. Gives intraoperative anesthetics ordered by the anesthesiologist. c. Releases or discharges
patients from the postanesthesia care area.
d. Manages a patient's airway with direct supervision of the anesthesiologist.
Answer: c. Keep both hands above the operating table level.
Rationale: The scrub nurse role includes maintaining asepsis in the operating field. The
circulating nurse would perform the other actions. - ANS-The operating room nurse is providing
orientation to a student nurse. Which action would the nurse describe as a routine responsibility
of a scrub nurse?
a. Document all patient care accurately.
b. Label all specimens to send to the laboratory.
c. Keep both hands above the operating table level.
d. Take the patient to the postanesthesia recovery area.
Answer: b. "I will check with the anesthesia care provider to find out what is planned."
Rationale: Routine general anesthesia is usually induced by the IV route with a hypnotic,
anxiolytic, or dissociative agent. However, general anesthesia may be induced by IV or
inhalation. The nurse should consult with the anesthesia care provider to determine the method
selected for this patient. The anesthesia care provider will select the method of anesthesia, not
the surgeon. Inhalation agents may be given through an endotracheal tube or a laryngeal mask
, airway. - ANS-A patient scheduled to undergo total knee replacement surgery under general
anesthesia asks the nurse, "Will the doctor put me to sleep with a mask over my face?" Which
response by the nurse is most appropriate?
a. "Only your surgeon can tell you what method of anesthesia will be used."
b. "I will check with the anesthesia care provider to find out what is planned."
c. "General anesthesia is given by injecting drugs into your veins, so you will not need a mask
over your face."
d. "Masks are no longer used for anesthesia. A tube inserted into your throat will deliver gas that
puts you to sleep."
Answer: d. Laryngospasm
Rationale: Possible complications of inhalation anesthetics include coughing, laryngospasm,
and increased secretions. Hypertension and tachypnea are not associated with general
anesthetics. Myoclonus may occur with nonbarbiturate hypnotics but not with the inhalation
agents. - ANS-Postoperatively, the nurse should monitor the patient who received inhalation
anesthesia for which complication?
a. Tachypnea
b. Myoclonus
c. Hypertension
d. Laryngospasm
Answer: a. Ensure correct placement of the grounding pad.
Rationale: Care must be taken to correctly place the grounding pad and all electrosurgical
equipment to prevent injury from burns or fire. It is important to ensure that fire extinguishers are
available and that sprinklers protect everyone in the operating room in case of a fire but placing
the grounding pad will prevent direct burn injury to the patient. Verifying that electrosurgical
equipment is working properly does not protect the patient unless the grounding pad is placed
correctly. - ANS-Which action should the perioperative nurse take to protect the patient from
burn injury during surgery?
a. Ensure correct placement of the grounding pad.
b. Check emergency sprinklers in the operating room.
c. Verify that a fire extinguisher is available during surgery.
d. Confirm that all electrosurgical equipment is working properly.
Answer: a. Starting an IV in the patient's unaffected arm.
Rationale: For MAC, IV sedatives, such as the benzodiazepines, are given. Therefore, the
patient needs IV access. Inhaled and epidural agents are not included in MAC. RNs who are
trained and are allowed by agency protocols and state nurse practice acts can provide
Answer: c. Releases or discharges patients from the postanesthesia care area.
Rationale: A nurse anesthetist is a registered nurse who has graduated from an accredited
nurse anesthesia program (minimally a master's degree program) and successfully completed a
national certification examination to become a CRNA. The CRNA scope of practice includes, but
is not limited to, the following:
1. Performing and documenting a preanesthetic assessment and evaluation.
2. Developing and implementing a plan for delivering anesthesia.
3. Selecting and initiating the planned anesthetic technique.
4. Selecting, obtaining, and administering the anesthesia, adjuvant drugs, and fluids.
5. Selecting, applying, and inserting appropriate noninvasive and invasive monitoring devices.
6. Managing a patient's airway and pulmonary status 7. Managing emergence and recovery
from anesthesia.
8. Releasing or discharging patients from a postanest - ANS-Which statement best describes
the role of the certified registered nurse anesthetist (CRNA) on the surgical care team?
a. Performs the same responsibilities as the anesthesiologist.
b. Gives intraoperative anesthetics ordered by the anesthesiologist. c. Releases or discharges
patients from the postanesthesia care area.
d. Manages a patient's airway with direct supervision of the anesthesiologist.
Answer: c. Keep both hands above the operating table level.
Rationale: The scrub nurse role includes maintaining asepsis in the operating field. The
circulating nurse would perform the other actions. - ANS-The operating room nurse is providing
orientation to a student nurse. Which action would the nurse describe as a routine responsibility
of a scrub nurse?
a. Document all patient care accurately.
b. Label all specimens to send to the laboratory.
c. Keep both hands above the operating table level.
d. Take the patient to the postanesthesia recovery area.
Answer: b. "I will check with the anesthesia care provider to find out what is planned."
Rationale: Routine general anesthesia is usually induced by the IV route with a hypnotic,
anxiolytic, or dissociative agent. However, general anesthesia may be induced by IV or
inhalation. The nurse should consult with the anesthesia care provider to determine the method
selected for this patient. The anesthesia care provider will select the method of anesthesia, not
the surgeon. Inhalation agents may be given through an endotracheal tube or a laryngeal mask
, airway. - ANS-A patient scheduled to undergo total knee replacement surgery under general
anesthesia asks the nurse, "Will the doctor put me to sleep with a mask over my face?" Which
response by the nurse is most appropriate?
a. "Only your surgeon can tell you what method of anesthesia will be used."
b. "I will check with the anesthesia care provider to find out what is planned."
c. "General anesthesia is given by injecting drugs into your veins, so you will not need a mask
over your face."
d. "Masks are no longer used for anesthesia. A tube inserted into your throat will deliver gas that
puts you to sleep."
Answer: d. Laryngospasm
Rationale: Possible complications of inhalation anesthetics include coughing, laryngospasm,
and increased secretions. Hypertension and tachypnea are not associated with general
anesthetics. Myoclonus may occur with nonbarbiturate hypnotics but not with the inhalation
agents. - ANS-Postoperatively, the nurse should monitor the patient who received inhalation
anesthesia for which complication?
a. Tachypnea
b. Myoclonus
c. Hypertension
d. Laryngospasm
Answer: a. Ensure correct placement of the grounding pad.
Rationale: Care must be taken to correctly place the grounding pad and all electrosurgical
equipment to prevent injury from burns or fire. It is important to ensure that fire extinguishers are
available and that sprinklers protect everyone in the operating room in case of a fire but placing
the grounding pad will prevent direct burn injury to the patient. Verifying that electrosurgical
equipment is working properly does not protect the patient unless the grounding pad is placed
correctly. - ANS-Which action should the perioperative nurse take to protect the patient from
burn injury during surgery?
a. Ensure correct placement of the grounding pad.
b. Check emergency sprinklers in the operating room.
c. Verify that a fire extinguisher is available during surgery.
d. Confirm that all electrosurgical equipment is working properly.
Answer: a. Starting an IV in the patient's unaffected arm.
Rationale: For MAC, IV sedatives, such as the benzodiazepines, are given. Therefore, the
patient needs IV access. Inhaled and epidural agents are not included in MAC. RNs who are
trained and are allowed by agency protocols and state nurse practice acts can provide
