Chapter 15: Intraoperative Nursing Management
questions with accurate answers
A 70-year-old patient who is to undergo surgery arrives at the operating
room (OR). The nurse, when reviewing the patient's medical record,
understands that this patient will require a lower dose of anesthetic agent
because of which of the following?
Increased tissue elasticity
Impaired thermoregulation
Increased anxiety level
Decreased lean tissue mass Ans✓✓✓ Decreased lean tissue mass
Explanation:
Elderly patients require lower doses of anesthetic agents because of
decreased tissue elasticity and reduced lean tissue mass. An increased
amount of anesthetic would be needed with an increased anxiety level.
Impaired thermoregulation increases the patient's susceptibility to
hypothermia.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, The Surgical
Team, p. 418.
,A client asks the nurse how an inhalant general anesthetic is expelled by
the body. What is the best response by the nurse?
"The kidneys will eliminate the inhalant with urination."
"The skin will eliminate the anesthesia through evaporation."
"The lungs primarily eliminate the anesthesia."
"The liver will eliminate the inhalant anesthesia." Ans✓✓✓ "The lungs
primarily eliminate the anesthesia."
Explanation:
When inhalant anesthetic administration is discontinued, the vapor or
gas is eliminated through the lungs.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, Types of
Anesthesia and Sedation, p. 425.
A client at risk for malignant hyperthermia returns to the surgical unit.
For what time period will the nurse monitor the client for development
of malignant hyperthermia?
Malignant hyperthermia occurs in the operating room only.
A client can develop malignant hyperthermia only with intravenous
anesthesia after surgery.
,The client can develop malignant hyperthermia up to 24 hours after
surgery.
The client will need to be discharged with special instructions.
Ans✓✓✓ The client can develop malignant hyperthermia up to 24
hours after surgery.
Explanation:
Although malignant hyperthermia usually manifests about 10 to 20
minutes after induction of anesthesia, it can also occur during the first 24
hours after surgery. Malignant hyperthermia can be triggered by inhalant
anesthesia with muscle relaxants.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, Potential
Intraoperative Complications, p. 432.
A client is brought to the operating room for an elective surgery. What is
the priority action by the circulating nurse?
Document the start of surgery.
Acquire ordered blood products.
Count sponges and syringes.
Verify consent. Ans✓✓✓ Verify consent.
, Explanation:
Surgery cannot be performed without consent. Documentation of the
start of surgery can only happen once the surgery has started. Blood
products must be administered within an allotted time frame and
therefore should not be acquired unless needed. The sponge and syringe
count is a safety issue that should be completed before surgery and while
the wound is being sutured, but if the client has not consented, the
surgery should not take place.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, The Circulating
Nurse, p. 419.
A client is placed on the operating room table for the surgical procedure.
Which surgical team member is responsible for handing sterile
instruments to the surgeon and assistants?
First assistant
Certified registered nurse anesthetist
Scrub nurse
Circulating nurse Ans✓✓✓ Scrub nurse
Explanation:
questions with accurate answers
A 70-year-old patient who is to undergo surgery arrives at the operating
room (OR). The nurse, when reviewing the patient's medical record,
understands that this patient will require a lower dose of anesthetic agent
because of which of the following?
Increased tissue elasticity
Impaired thermoregulation
Increased anxiety level
Decreased lean tissue mass Ans✓✓✓ Decreased lean tissue mass
Explanation:
Elderly patients require lower doses of anesthetic agents because of
decreased tissue elasticity and reduced lean tissue mass. An increased
amount of anesthetic would be needed with an increased anxiety level.
Impaired thermoregulation increases the patient's susceptibility to
hypothermia.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, The Surgical
Team, p. 418.
,A client asks the nurse how an inhalant general anesthetic is expelled by
the body. What is the best response by the nurse?
"The kidneys will eliminate the inhalant with urination."
"The skin will eliminate the anesthesia through evaporation."
"The lungs primarily eliminate the anesthesia."
"The liver will eliminate the inhalant anesthesia." Ans✓✓✓ "The lungs
primarily eliminate the anesthesia."
Explanation:
When inhalant anesthetic administration is discontinued, the vapor or
gas is eliminated through the lungs.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, Types of
Anesthesia and Sedation, p. 425.
A client at risk for malignant hyperthermia returns to the surgical unit.
For what time period will the nurse monitor the client for development
of malignant hyperthermia?
Malignant hyperthermia occurs in the operating room only.
A client can develop malignant hyperthermia only with intravenous
anesthesia after surgery.
,The client can develop malignant hyperthermia up to 24 hours after
surgery.
The client will need to be discharged with special instructions.
Ans✓✓✓ The client can develop malignant hyperthermia up to 24
hours after surgery.
Explanation:
Although malignant hyperthermia usually manifests about 10 to 20
minutes after induction of anesthesia, it can also occur during the first 24
hours after surgery. Malignant hyperthermia can be triggered by inhalant
anesthesia with muscle relaxants.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, Potential
Intraoperative Complications, p. 432.
A client is brought to the operating room for an elective surgery. What is
the priority action by the circulating nurse?
Document the start of surgery.
Acquire ordered blood products.
Count sponges and syringes.
Verify consent. Ans✓✓✓ Verify consent.
, Explanation:
Surgery cannot be performed without consent. Documentation of the
start of surgery can only happen once the surgery has started. Blood
products must be administered within an allotted time frame and
therefore should not be acquired unless needed. The sponge and syringe
count is a safety issue that should be completed before surgery and while
the wound is being sutured, but if the client has not consented, the
surgery should not take place.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer,
2022, Chapter 15: Intraoperative Nursing Management, The Circulating
Nurse, p. 419.
A client is placed on the operating room table for the surgical procedure.
Which surgical team member is responsible for handing sterile
instruments to the surgeon and assistants?
First assistant
Certified registered nurse anesthetist
Scrub nurse
Circulating nurse Ans✓✓✓ Scrub nurse
Explanation:
