Intraoperative Quiz Questions And Answers

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Intraoperative Quiz Questions And Answers - Quiz

With the help of our intraoperative quiz with questions and answers, find out more about the intraoperative phase extends from the time the client is admitted to the operating room, to the time of anesthesia administration, the performance of the surgical procedure, and until the client is transported to the recovery room or postanesthesia care unit (PACU). While taking the quiz, consider each question carefully before answering. All the best!


Questions and Answers
  • 1. 

    1.  The nursing student is preparing an elderly patient for surgery. The patient is scheduled for a general anesthetic. Which side effect should the nurse monitor the patient for?

    • A.

      A) Hypothermia

    • B.

      B) Pulmonary edema

    • C.

      C) Cerebral ischemia

    • D.

      D) Increased ability to resist stress

    Correct Answer
    A. A) Hypothermia
    Explanation
    The nurse should monitor the patient for hypothermia because general anesthesia can cause a decrease in body temperature. This is due to the anesthesia's effects on the body's thermoregulation mechanisms and the patient's decreased ability to shiver or generate heat. Hypothermia can lead to complications such as impaired wound healing, increased risk of infection, and cardiovascular issues. Therefore, it is important for the nurse to monitor the patient's temperature closely and take measures to prevent and treat hypothermia during and after surgery.

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  • 2. 

    2.  You are the circulating nurse. Which task are you solely responsible for?

    • A.

      A) Monitoring the patient and documents

    • B.

      B) Estimating the patient's blood loss

    • C.

      C) Setting up the sterile tables

    • D.

      D) Keeping track of drains and sponges

    Correct Answer
    A. A) Monitoring the patient and documents
    Explanation
    As the circulating nurse, you are solely responsible for monitoring the patient and documenting their condition. This includes keeping track of vital signs, documenting any changes in the patient's condition, and ensuring that all necessary documentation is complete and accurate. This role requires constant vigilance and attention to detail to ensure the patient's safety and well-being throughout the surgical procedure.

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  • 3. 

    3.  A 21-year-old patient is positioned on the OR bed prior to knee surgery. The anesthesiologist administers the anesthetic. What is the next step in the care of this patient?

    • A.

      Grounding

    • B.

      B) Hanging IV fluids

    • C.

      C) Giving blood

    • D.

      D) Intubating

    Correct Answer
    D. D) Intubating
    Explanation
    After the anesthesiologist administers the anesthetic, the next step in the care of this patient would be to intubate them. Intubation involves inserting a tube into the patient's airway to ensure proper ventilation and oxygenation during surgery. This is a crucial step to maintain the patient's breathing and prevent any complications during the procedure.

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  • 4. 

    4.  You are the circulating nurse in an operating room that has several surgeries scheduled. You would know to monitor which patient during the intraoperative period because he or she is at increased risk for hypothermia?

    • A.

      A) A 72-year-old woman

    • B.

      B) A 17-year-old boy

    • C.

      C) A 45-year-old woman

    • D.

      D) A 12-year-old girl

    Correct Answer
    A. A) A 72-year-old woman
    Explanation
    As people age, their ability to regulate body temperature decreases, making them more susceptible to hypothermia. Therefore, the 72-year-old woman in this scenario would be at increased risk for hypothermia during the intraoperative period.

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  • 5. 

    5.  The anesthetist is coming to the unit to see a patient prior to surgery that is scheduled for tomorrow morning. What information, obtained during the admission assessment, should be given to the anesthetist during the visit?

    • A.

      A) Last bowel movement

    • B.

      B) Latex allergy

    • C.

      C) Number of pregnancies

    • D.

      D) Difficulty falling asleep

    Correct Answer
    B. B) Latex allergy
    Explanation
    The anesthetist needs to be informed about the patient's latex allergy because it is crucial for the safety of the patient during surgery. Latex is commonly found in medical equipment and supplies, such as gloves and catheters. If the patient has a latex allergy, it is important for the anesthetist to take necessary precautions and use latex-free alternatives to prevent an allergic reaction during the surgery. This information is vital for the anesthetist to provide appropriate care and ensure the patient's well-being.

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  • 6. 

    6.  Surgical asepsis is a requirement in the restricted zone of the operating suite. What personal protective equipment should the nurse wear at all times in the restricted zone of the operating room?

    • A.

      A) Reusable shoe covers

    • B.

      B) Mask covering the nose and mouth

    • C.

      C) Goggles

    • D.

      D) Gloves

    Correct Answer
    B. B) Mask covering the nose and mouth
    Explanation
    In the restricted zone of the operating room, surgical asepsis is necessary to prevent the introduction of microorganisms into the surgical field. Wearing a mask covering the nose and mouth is essential for the nurse to prevent the spread of their own respiratory droplets and to protect against inhaling any potential airborne pathogens. Reusable shoe covers, goggles, and gloves are also important for maintaining a sterile environment, but the mask is specifically required to protect the respiratory system.

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  • 7. 

    7.  As an OR nurse, you have an increased awareness regarding asepsis. You know that a basic guideline for maintaining surgical asepsis is what?

    • A.

      A) Sterile surfaces or articles may touch other sterile surfaces.

    • B.

      B) Sterile supplies can be used on another patient if the packages are intact.

    • C.

      C) The outer lip of a sterile solution is considered sterile.

    • D.

      D) The scrub nurse may pour a sterile solution from a nonsterile bottle.

    Correct Answer
    A. A) Sterile surfaces or articles may touch other sterile surfaces.
    Explanation
    The correct answer is A) Sterile surfaces or articles may touch other sterile surfaces. This guideline is important for maintaining surgical asepsis because it ensures that contamination is minimized during surgery. By allowing sterile surfaces or articles to touch other sterile surfaces, the risk of introducing pathogens or contaminants into the surgical field is reduced. This helps to maintain a sterile environment and prevent surgical site infections.

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  • 8. 

    8.  Your patient is a 35-year-old female who has been administered general anesthesia. The patient is in stage II (the excitement stage) of anesthesia. Which intervention might you need to implement during this stage?

    • A.

      A) Rub the patient's back

    • B.

      B) Restrain the patient

    • C.

      C) Encourage the patient to express feelings

    • D.

      D) Stroke the patient's hand

    Correct Answer
    B. B) Restrain the patient
    Explanation
    During the excitement stage of anesthesia, patients may exhibit restlessness, confusion, and uncontrolled movements. Restraint may be necessary to ensure the safety of the patient and the healthcare team. Restraint can help prevent the patient from accidentally harming themselves or others, and it allows for the administration of further anesthesia or necessary medical procedures. Rubbing the patient's back, encouraging the patient to express feelings, or stroking the patient's hand may not be effective interventions during this stage.

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  • 9. 

    9.  What is the best rationale for intubation during a surgical procedure?

    • A.

      A) The tube provides an airway for ventilation.

    • B.

      B) The tube protects the esophagus.

    • C.

      C) The patient may receive an anti-emetic through the tube.

    • D.

      D) The patient's heart rate can be monitored with the tube.

    Correct Answer
    A. A) The tube provides an airway for ventilation.
    Explanation
    Intubation during a surgical procedure is primarily done to provide an airway for ventilation. This means that the tube helps to ensure that the patient is able to breathe properly during the procedure. It allows for the delivery of oxygen and anesthesia gases to the lungs, while also facilitating the removal of carbon dioxide. This is essential for maintaining adequate oxygenation and ventilation, especially when the patient is under anesthesia and unable to breathe on their own. The other options, such as protecting the esophagus, administering anti-emetics, or monitoring heart rate, are not the primary reasons for intubation during a surgical procedure.

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  • 10. 

    10.  You are the circulating nurse in an outpatient surgery center. Your patient is scheduled to receive moderate sedation. You know that a patient receiving this form of anesthesia should what?

    • A.

      A) Never be left unattended by the nurse

    • B.

      B) Receive an anti-emetic

    • C.

      C) Remember most of the procedure

    • D.

      D) Be able to maintain his or her own airway

    Correct Answer
    A. A) Never be left unattended by the nurse
    Explanation
    A patient receiving moderate sedation should never be left unattended by the nurse because sedation can cause changes in the patient's level of consciousness and respiratory function. The nurse needs to closely monitor the patient's vital signs, level of sedation, and airway patency to ensure their safety and intervene promptly if any complications arise. Leaving the patient unattended could lead to potential risks and complications, making it essential for the nurse to remain present throughout the procedure.

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  • 11. 

    11.  A nurse is caring for a patient following surgery under a spinal anesthetic. What interventions can the nurse implement to prevent a spinal headache?

    • A.

      A) Have the patient sit in a chair

    • B.

      B) Ambulate the patient

    • C.

      C) Limit fluids

    • D.

      D) Keep the patient lying flat

    Correct Answer
    D. D) Keep the patient lying flat
    Explanation
    Keeping the patient lying flat after surgery under a spinal anesthetic can help prevent a spinal headache. When the patient remains in a supine position, it reduces the risk of cerebrospinal fluid leakage from the spinal puncture site, which is a common cause of spinal headaches. By maintaining this position, the nurse can ensure that the puncture site heals properly and minimize the chances of the patient experiencing a spinal headache.

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  • 12. 

    12.  You are the nurse caring for a patient who will receive a transsacral block. In what surgeries would a transsacral block be useful for pain control?

    • A.

      A) Thoracotomy

    • B.

      B) Inguinal hernia repair

    • C.

      C) Breast reduction

    • D.

      D) Closed reduction of a right humerus

    Correct Answer
    B. B) Inguinal hernia repair
    Explanation
    A transsacral block would be useful for pain control in inguinal hernia repair surgeries. This type of block involves injecting local anesthetic into the sacral hiatus, which is located at the base of the spine. By blocking the nerves in this area, the patient can experience pain relief during the surgery. Transsacral blocks are not typically used for thoracotomy, breast reduction, or closed reduction of a right humerus surgeries.

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  • 13. 

    13.  You are the circulating nurse caring for a 78-year-old patient who is scheduled for a total hip replacement. Which of the factors should you consider during the preparation of the patient in the operating room?

    • A.

      A) The patient should be placed in Trendelenburg position.

    • B.

      B) The patient must be firmly restrained at all times.

    • C.

      C) Pressure points should be assessed and well padded.

    • D.

      D) The preoperative shave should be done by the circulating nurse.

    Correct Answer
    C. C) Pressure points should be assessed and well padded.
    Explanation
    During the preparation of the patient in the operating room for a total hip replacement, it is important to consider assessing and padding pressure points. This is because pressure points are areas of the body where the bones are close to the skin's surface, making them vulnerable to pressure ulcers or skin breakdown. Assessing and padding these pressure points helps to distribute the patient's weight evenly and reduce the risk of complications.

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  • 14. 

    14.  The operating room nurse is taking the patient into the OR when the patient informs the operating nurse that his grandmother spiked a 104°F temperature in the operating room and nearly died 15 years ago. What relevance does this information have regarding your patient?

    • A.

      A) The patient may be nervous.

    • B.

      B) The patient may be at risk for developing malignant hyperthermia.

    • C.

      C) The grandmother's surgery has no relevance to the patient's surgery.

    • D.

      D) The patient may be at risk for hypothermia.

    Correct Answer
    B. B) The patient may be at risk for developing malignant hyperthermia.
    Explanation
    The patient's statement about his grandmother's experience of spiking a high temperature in the operating room and nearly dying suggests a potential risk for the patient developing malignant hyperthermia. Malignant hyperthermia is a rare but potentially life-threatening condition that can be triggered by certain medications used during anesthesia. This information is relevant because it indicates that the patient may have a genetic predisposition to this condition, which would require special precautions during surgery.

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  • 15. 

    15.  You note a colleague making an inappropriate remark about the patient's weight. The patient is unconscious at the time. What should you do?

    • A.

      A) Ignore the comment because the patient is unconscious.

    • B.

      B) Discourage the comments.

    • C.

      C) Report the comment to the supervisor.

    • D.

      D) Realize humor is needed in the workplace.

    Correct Answer
    B. B) Discourage the comments.
    Explanation
    In this scenario, it is important to address the inappropriate remark made by the colleague about the patient's weight, even though the patient is unconscious. Ignoring the comment would not address the issue and could perpetuate a negative workplace culture. By discouraging the comments, you are actively taking a stand against inappropriate behavior and promoting a respectful and inclusive environment. Reporting the comment to the supervisor may also be necessary to ensure appropriate action is taken. Realizing humor is needed in the workplace is not a suitable response in this situation.

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  • 16. 

    16.  You are caring for a male patient who has had spinal anesthesia. The patient is under a physician's order to lie flat postoperatively. When the patient asks to go to the bathroom, you encourage him to comply with the physician's order. What is the rationale for complying with this order?

    • A.

      A) Hypotension

    • B.

      B) Respiratory depression

    • C.

      C) A headache

    • D.

      D) Pain at the lumbar injection site

    Correct Answer
    C. C) A headache
    Explanation
    Complying with the physician's order for the patient to lie flat postoperatively is important because it helps prevent the development of a headache. After spinal anesthesia, the patient may experience a headache due to leakage of cerebrospinal fluid from the puncture site. By lying flat, the patient can help reduce the risk of this complication. Hypotension, respiratory depression, and pain at the lumbar injection site are not directly related to the need for the patient to lie flat.

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  • 17. 

    17.  You are packing a patient's abdominal wound with sterile, half-inch Iodoform gauze. You drop some of the gauze onto the patient's abdomen 2 inches (5 cm) away from the wound. What should you do?

    • A.

      A) Apply povidone-iodine (Betadine) to that section of the gauze and continue packing the wound.

    • B.

      B) Pick up the gauze and continue packing the wound after irrigating the abdominal wound with Betadine solution.

    • C.

      C) Continue packing the wound and inform the physician that an antibiotic is needed.

    • D.

      D) Discard the gauze packing and repack the wound with new Iodoform gauze.

    Correct Answer
    D. D) Discard the gauze packing and repack the wound with new Iodoform gauze.
    Explanation
    Dropping the gauze onto the patient's abdomen introduces potential contamination to the sterile gauze. To maintain a sterile environment, it is necessary to discard the contaminated gauze and repack the wound with new sterile gauze. This ensures that the wound is properly packed without the risk of introducing infection.

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  • 18. 

    18.  You are the nurse performing wound care on a 68-year-old male patient. Which of the following practices violates surgical asepsis?

    • A.

      A) Holding sterile objects above the waist

    • B.

      B) Considering a 1 inch (2.5 cm) edge around the sterile field as being contaminated

    • C.

      C) Pouring solution onto a sterile field cloth

    • D.

      D) Opening the outermost flap of a sterile package away from the body

    Correct Answer
    C. C) Pouring solution onto a sterile field cloth
    Explanation
    Pouring solution onto a sterile field cloth violates surgical asepsis because it introduces a non-sterile substance onto the sterile field. Surgical asepsis requires maintaining a sterile field and preventing any contamination by non-sterile objects or substances. Therefore, pouring solution onto a sterile field cloth would introduce potential contaminants and compromise the sterile environment.

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  • 19. 

    19.  A patient is scheduled for surgery the next day. What is the best approach to this surgery?

    • A.

      A) A surgical approach

    • B.

      B) A medical approach

    • C.

      C) An interdisciplinary approach

    • D.

      D) A nursing approach

    Correct Answer
    C. C) An interdisciplinary approach
    Explanation
    An interdisciplinary approach is the best approach to surgery because it involves collaboration and coordination between multiple healthcare professionals from different disciplines. This ensures that all aspects of the patient's care are addressed, including medical, surgical, nursing, and any other relevant disciplines. By working together, healthcare professionals can provide comprehensive and holistic care to the patient, improving outcomes and patient satisfaction.

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  • 20. 

    20.  What is the basis of the collaboration of the surgical team that results in the best outcome for the patient?

    • A.

      A) Historical precedence

    • B.

      B) Patient request

    • C.

      C) Physician need

    • D.

      D) Evidence-based practice

    Correct Answer
    D. D) Evidence-based practice
    Explanation
    The basis of the collaboration of the surgical team that results in the best outcome for the patient is evidence-based practice. This means that the decisions and actions of the surgical team are guided by the best available evidence from scientific research, clinical expertise, and patient values and preferences. By relying on evidence-based practice, the surgical team can ensure that their interventions are based on proven effectiveness and are tailored to meet the specific needs and circumstances of each patient, ultimately leading to the best possible outcome.

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  • 21. 

    21.  Which of the following events subjects the surgical patient to possible injury in the intraoperative phase of the surgical experience? (Mark all that apply.)

    • A.

      A) Reflexes

    • B.

      B) Ability to communicate

    • C.

      C) Loss of pain sense

    • D.

      D) Consciousness

    • E.

      E) Normal vital signs

    Correct Answer(s)
    A. A) Reflexes
    B. B) Ability to communicate
    C. C) Loss of pain sense
    Explanation
    During the intraoperative phase of the surgical experience, reflexes, ability to communicate, and loss of pain sense can subject the surgical patient to possible injury. Reflexes can cause involuntary movements that may interfere with the surgical procedure or cause harm to the patient. The ability to communicate is important for the patient to express any discomfort or concerns during the surgery. Loss of pain sense can prevent the patient from feeling pain, which may result in injury if they are not aware of any potential harm or complications.

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  • 22. 

    22.  You are a circulating nurse in the day surgery center. You know that each patient has the potential for complications intraoperatively. What are these complications? (Mark all that apply.)

    • A.

      A) Malignant hypothermia

    • B.

      B) Pain

    • C.

      C) Hypothermia

    • D.

      D) Anaphylaxis

    • E.

      E) Nausea

    Correct Answer(s)
    C. C) Hypothermia
    D. D) Anaphylaxis
    E. E) Nausea
    Explanation
    As a circulating nurse in a day surgery center, it is important to be aware of potential complications that can occur during surgery. Hypothermia can occur due to the cold environment in the operating room and the use of anesthesia, leading to a decrease in body temperature. Anaphylaxis is a severe allergic reaction that can occur in response to medications or substances used during surgery. Nausea is a common side effect of anesthesia and can occur postoperatively. Pain is also a potential complication that can occur intraoperatively, but it is not listed as an option in the answer choices. Therefore, the correct answers are C) Hypothermia, D) Anaphylaxis, and E) Nausea.

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  • 23. 

    23.  You are preparing to take your patient into the operating room. As the circulating nurse, one of your responsibilities is to review the patient's record. What are you reviewing the record for?

    • A.

      A) Progress notes

    • B.

      B) History and physical

    • C.

      C) Admission papers signed by patient

    • D.

      D) Intake and output record

    Correct Answer
    B. B) History and physical
    Explanation
    As the circulating nurse, reviewing the patient's record is important to ensure that the necessary information about the patient's medical history and current physical condition is available. This includes details about any pre-existing conditions, allergies, medications, and any recent diagnostic tests or procedures. By reviewing the history and physical, the nurse can gather crucial information that will help in planning and providing appropriate care during the surgery. Progress notes, admission papers, and intake and output records may also be important, but the history and physical provide a comprehensive overview of the patient's health status.

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  • 24. 

    24.  You are the circulating nurse for several surgeries today. What would be one of your major goals for each of these patients?

    • A.

      A) Latex-allergy symptoms treated rapidly

    • B.

      B) Surgery unsuccessful

    • C.

      C) Maintenance of the patient's dignity

    • D.

      D) Complications treated rapidly

    Correct Answer
    C. C) Maintenance of the patient's dignity
    Explanation
    One of the major goals for each patient as a circulating nurse is to maintain their dignity. This means ensuring that the patient's privacy and modesty are respected throughout the surgical process. It involves providing them with appropriate draping and ensuring that their personal belongings are secure. It also includes communicating with the patient in a respectful and compassionate manner, addressing their concerns and answering their questions. Maintaining the patient's dignity helps to create a positive and supportive environment, promoting their overall well-being and comfort during their surgical experience.

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  • 25. 

    25.  The circulating nurse meets the patient in a warm and friendly manner. The nurse discusses what the patient can expect in surgery. What basic communication skills does the nurse use?

    • A.

      A) Talk slowly and softly

    • B.

      B) Use medically acceptable terms

    • C.

      C) Give pre-operative medications first

    • D.

      D) Touch

    Correct Answer
    D. D) Touch
    Explanation
    The nurse uses touch as a basic communication skill. Touch can convey warmth, comfort, and reassurance to the patient. It can help establish a connection and build trust between the nurse and the patient. Touch can also be used to provide physical support and comfort during the surgical process.

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  • 26. 

    26.  What position used for surgery can cause irreparable nerve damage?

    • A.

      A) Trendelenburg

    • B.

      B) Prone

    • C.

      C) Dorsal recumbent

    • D.

      D) Lithotomy

    Correct Answer
    A. A) Trendelenburg
    Explanation
    The Trendelenburg position is a position used in surgery where the patient's head is lower than their feet. This position can cause irreparable nerve damage because it increases the pressure on the nerves in the lower body, particularly in the legs and feet. The increased pressure can compress the nerves and potentially lead to nerve damage. Therefore, the Trendelenburg position should be used with caution and the patient's position should be regularly monitored to prevent any nerve damage.

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  • 27. 

    27.  The patient's surgery is nearly finished. The surgeon has decided to use tissue adhesives to close the surgical wound. As the nurse, you know that this puts the patient at increased risk for what?

    • A.

      A) Hypothermia

    • B.

      B) Anaphylaxis

    • C.

      C) Infection

    • D.

      D) Malignant hyperthermia

    Correct Answer
    B. B) Anaphylaxis
    Explanation
    Using tissue adhesives to close a surgical wound can put the patient at an increased risk for anaphylaxis. Anaphylaxis is a severe allergic reaction that can occur in response to certain substances, including tissue adhesives. This reaction can be life-threatening and requires immediate medical attention. Therefore, it is important for the nurse to be aware of this risk and monitor the patient closely for any signs or symptoms of anaphylaxis during and after the surgery.

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  • 28. 

    28.  As a circulating nurse, you are the advocate of each of your patients. What does patient advocacy in the operating room entail?

    • A.

      A) Use of safety straps

    • B.

      B) Maintaining adequate pain medication

    • C.

      C) Maintaining patient's privacy

    • D.

      D) Decreasing risk of infection

    Correct Answer
    C. C) Maintaining patient's privacy
    Explanation
    Patient advocacy in the operating room entails maintaining the patient's privacy. This means ensuring that the patient's personal information, medical history, and any other sensitive information are kept confidential. It also involves providing a private and secure environment for the patient during procedures, such as closing curtains or doors to protect their privacy. Maintaining patient privacy is an essential aspect of providing quality healthcare and respecting the patient's rights and dignity.

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  • 29. 

    29.  The nurse is caring for a patient who is scheduled to have a needle biopsy of the pleura. The patient tells the anesthesiologist he wants a local conduction block. Which local conduction block can be used to block the nerves leading to the chest?

    • A.

      A) Transsacral block

    • B.

      B) Brachial plexus block

    • C.

      C) Peudental block

    • D.

      D) Paravertebral block

    Correct Answer
    D. D) Paravertebral block
    Explanation
    A paravertebral block can be used to block the nerves leading to the chest. This technique involves injecting local anesthetic into the paravertebral space, which is located just outside the spinal column. By blocking the nerves in this area, the patient can experience pain relief in the chest region during the needle biopsy procedure. Transsacral block, brachial plexus block, and peudental block are not appropriate for blocking the nerves leading to the chest.

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  • 30. 

    30.  Which nursing diagnosis would a circulating nurse use on her intraoperative patients who have a general anesthetic? (Mark all that apply.)

    • A.

      A) Disturbed sensory perception

    • B.

      B) Risk for hypovolemia

    • C.

      C) Risk of latex allergy response

    • D.

      D) Disturbed body image

    • E.

      E) Anxiety

    Correct Answer(s)
    A. A) Disturbed sensory perception
    C. C) Risk of latex allergy response
    E. E) Anxiety
    Explanation
    A circulating nurse in the intraoperative setting may use the nursing diagnosis of disturbed sensory perception for patients under general anesthesia as they may experience altered sensations or perceptions during the procedure. The nurse may also consider the risk of latex allergy response as a diagnosis for patients who may be at risk of developing an allergic reaction to latex products used in the operating room. Additionally, anxiety may be a relevant nursing diagnosis for patients undergoing surgery, as they may experience heightened levels of stress and worry.

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  • 31. 

    31.  As a nurse, you know that one of the risks for a surgical patient is vomiting. What can aspirated vomitus lead to?

    • A.

      A) Choking

    • B.

      B) Hypoxia

    • C.

      C) Malignant hyperthermia

    • D.

      D) Hypothermia

    Correct Answer
    B. B) Hypoxia
    Explanation
    Aspirated vomitus can lead to hypoxia. When a person vomits and inhales the vomit into their lungs, it can cause a blockage in the airways. This blockage can prevent oxygen from reaching the lungs and being transported to the rest of the body. Without sufficient oxygen, the body's tissues and organs may not function properly, leading to hypoxia.

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  • 32. 

    32.  You are a new nurse in the operating room. Your preceptor is teaching you about malignant hyperthermia. Which symptom is often the earliest sign of malignant hyperthermia?

    • A.

      A) Increased temperature

    • B.

      B) Oliguria

    • C.

      C) Tachycardia

    • D.

      D) Hypotension

    Correct Answer
    C. C) Tachycardia
    Explanation
    Tachycardia is often the earliest sign of malignant hyperthermia. Malignant hyperthermia is a rare but potentially life-threatening reaction to certain medications used during general anesthesia. It is characterized by a rapid increase in body temperature, muscle rigidity, and metabolic acidosis. Tachycardia, or a fast heart rate, is one of the first signs that the body is experiencing this hypermetabolic state. It is important for nurses in the operating room to recognize this early sign and take immediate action to prevent further complications.

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  • 33. 

    33.  As a perioperative nurse, you know that the 2009 National Patient Safety Goals all pertain to the perioperative areas. Which of the 2009 National Patient Safety Goals has the most direct relevance to the operating room?

    • A.

      A) Improve safety of using medications

    • B.

      B) Reduce the risk of patient harm resulting from falls

    • C.

      C) Reduce the risk of health care–associated infections

    • D.

      D) Reduce the risk of surgical fires

    Correct Answer
    D. D) Reduce the risk of surgical fires
    Explanation
    The most direct relevance to the operating room among the 2009 National Patient Safety Goals is to reduce the risk of surgical fires. This goal is specifically focused on preventing fires that can occur during surgical procedures, which is a significant concern in the operating room. The goal aims to improve safety measures and protocols to minimize the risk of fires and ensure the safety of patients and healthcare providers during surgeries.

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  • 34. 

    34.  You have a 72-year-old female patient who is scheduled for a left total knee replacement. Which complication is this patient at increased risk for because of her aging cardiovascular system?

    • A.

      A) Hypovolemia

    • B.

      B) Hypopnea

    • C.

      C) Hyperkalemia

    • D.

      D) Hyperphosphatemia

    Correct Answer
    A. A) Hypovolemia
    Explanation
    As individuals age, their cardiovascular system undergoes changes that can increase the risk of hypovolemia, which is a decreased volume of blood in the body. This can be attributed to factors such as decreased cardiac output, decreased elasticity of blood vessels, and decreased kidney function. In the case of a 72-year-old female patient undergoing a total knee replacement, the surgical procedure itself can lead to blood loss and fluid shifts, further increasing the risk of hypovolemia. Therefore, this patient is at an increased risk for hypovolemia due to her aging cardiovascular system.

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  • 35. 

    35.  The nurse knows that elderly patients are at higher risk for complications and adverse outcomes during the intraoperative period. What is the best rationale for this phenomenon?

    • A.

      A) The elderly patient has more boney prominences than a younger person.

    • B.

      B) The elderly patient has reduced ability to adjust rapidly to emotional and physical stress.

    • C.

      C) The elderly patient has impaired thermoregulatory mechanisms, which increase susceptibility to hyperthermia.

    • D.

      D) The elderly patient has an impaired ability to decrease his or her metabolic rate.

    Correct Answer
    B. B) The elderly patient has reduced ability to adjust rapidly to emotional and physical stress.
    Explanation
    Elderly patients are at higher risk for complications and adverse outcomes during the intraoperative period because they have a reduced ability to adjust rapidly to emotional and physical stress. This can lead to difficulties in maintaining homeostasis and responding to the physiological changes that occur during surgery. The body's stress response, including the release of stress hormones and activation of the sympathetic nervous system, may be blunted in older adults, making it harder for them to adapt to the demands of surgery. Additionally, age-related changes in organ function and decreased reserve capacity can further increase their vulnerability to complications.

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  • 36. 

    36.  As an intraoperative nurse, you know that the patient's emotional state can influence the outcome of his or her surgical procedure. How would you best reinforce the patient's ability to influence their outcome?

    • A.

      A) Teach the patient guided imagery

    • B.

      B) Assess the patient's coping strategies

    • C.

      C) Incorporate cultural, ethnic, and religious considerations as appropriate

    • D.

      D) Give him or her anti-anxiety medication

    Correct Answer
    C. C) Incorporate cultural, ethnic, and religious considerations as appropriate
    Explanation
    Incorporating cultural, ethnic, and religious considerations can help reinforce the patient's ability to influence their outcome by respecting their beliefs, values, and preferences. This can help create a supportive and inclusive environment for the patient, which can positively impact their emotional state and overall surgical experience. It shows that the healthcare team acknowledges and respects the patient's individuality, which can enhance their sense of control and empowerment during the surgical procedure. Assessing coping strategies and teaching guided imagery can also be beneficial, but incorporating cultural, ethnic, and religious considerations is a more comprehensive approach that addresses the patient's unique needs and preferences. Giving anti-anxiety medication may not necessarily empower the patient to influence their outcome, as it focuses more on symptom management rather than addressing the underlying emotional state.

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  • 37. 

    37.  As an intraoperative nurse, you know that maintaining an aseptic environment in the operating room is essential. When moving around surgical areas, what distance must be kept from the sterile field?

    • A.

      A) 2 feet

    • B.

      B) 18 inches

    • C.

      C) 1 foot

    • D.

      D) 6 inches

    Correct Answer
    C. C) 1 foot
    Explanation
    When moving around surgical areas, a distance of 1 foot must be kept from the sterile field. This is important to prevent contamination and maintain the aseptic environment in the operating room. Keeping a distance of 1 foot helps to minimize the risk of accidentally touching or contaminating the sterile field, which could lead to surgical site infections or other complications.

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  • 38. 

    38.  As an intraoperative nurse, what is your responsibility to your patient in relation to malignant hyperthermia? (Mark all that apply.)

    • A.

      A) Recognize the signs and symptoms

    • B.

      B) Be knowledgeable about the protocol

    • C.

      C) Know how to call a code in the OR

    • D.

      D) Have the appropriate medication available

    • E.

      E) Direct the surgeon and anesthesiologist through the protocol

    Correct Answer(s)
    A. A) Recognize the signs and symptoms
    B. B) Be knowledgeable about the protocol
    D. D) Have the appropriate medication available
    Explanation
    As an intraoperative nurse, it is your responsibility to recognize the signs and symptoms of malignant hyperthermia, be knowledgeable about the protocol for managing it, and have the appropriate medication available. This is important because malignant hyperthermia is a potentially life-threatening condition that can occur during anesthesia, and prompt recognition and appropriate management are crucial to ensure patient safety. Directing the surgeon and anesthesiologist through the protocol may not be the nurse's responsibility, as it is typically the role of the anesthesia provider to lead the management of malignant hyperthermia.

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  • 39. 

    39.  Your patient is asleep on the operating table. As the circulating nurse, you are aware of the potential environmental hazards to your patient. What is an environmental hazard in the operating room?

    • A.

      A) Lasers

    • B.

      B) Needlestick injuries

    • C.

      C) Exposure to sterile fluids

    • D.

      D) Exposure to bodily fluids

    Correct Answer
    A. A) Lasers
    Explanation
    In the operating room, lasers can be considered as an environmental hazard. Lasers are commonly used in surgical procedures to cut or cauterize tissue. However, if not used properly, lasers can cause harm to the patient, such as burns or damage to surrounding tissues. Therefore, the circulating nurse needs to be aware of the potential risks associated with laser use and take necessary precautions to ensure the safety of the patient.

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  • 40. 

    40.  A part of the intraoperative nurse's role is being a patient advocate. What is an advocacy activity of the intraoperative nurse?

    • A.

      A) Checking the patient's armband against his or her medical record

    • B.

      B) Respecting the patient's cultural values

    • C.

      C) Dehumanizing the patient

    • D.

      D) Maintaining the patient's privacy while he or she is awake

    Correct Answer
    B. B) Respecting the patient's cultural values
    Explanation
    The correct answer is B) Respecting the patient's cultural values. As an advocate, the intraoperative nurse ensures that the patient's cultural values and beliefs are respected and taken into consideration during their care. This includes being sensitive to their cultural practices, preferences, and beliefs, and incorporating them into the patient's care plan. By doing so, the nurse promotes patient-centered care and helps create a supportive and inclusive healthcare environment.

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  • 41. 

    41.  Your patient is a 25-year-old obstetric patient. You know that she is at increased risk for what?

    • A.

      A) Infection

    • B.

      B) Hypothermia

    • C.

      C) Anesthesia awareness

    • D.

      D) Moderate sedation

    Correct Answer
    C. C) Anesthesia awareness
    Explanation
    Anesthesia awareness refers to a rare but serious condition where a patient becomes aware or conscious during surgery or a medical procedure that is supposed to be performed under general anesthesia. This patient being an obstetric patient puts her at an increased risk for anesthesia awareness because pregnant women have a higher risk due to physiological changes in their body, increased blood volume, and altered metabolism. Therefore, anesthesia awareness is the correct answer for this patient.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 07, 2012
    Quiz Created by
    Justin82
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