112 Perioperative

A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in outpatient surgery. Which information is of most concern to the nurse?

• The patient is planning to drive home after surgery.
• The patient had a sip of water 4 hours before arriving.
• The patient’s insurance does not cover outpatient surgery.
• The patient has not had surgery using general anesthesia before.

Which action indicates to the operating room supervisor that the scrub nurse requires additional teaching about sterile technique?

• A small amount of sterile saline is poured out before it is poured into the basin.
• The nurse disposes of any equipment packages that are in poor condition.
• Sterile surgical supplies are placed in the center of the sterile field.
• The sterile saline bottle cap is placed in the center of the sterile field.

What is the priority action for the scrub person at the conclusion of a surgical procedure?

• Assist with transferring the client to the postanesthesia care unit.
• Document the procedure in the client’s medical record.
• Set up the sterile field and drape the client appropriately.
• Document how many sponges and sharps have been utilized.

The client is to have a surgical procedure under (moderate) conscious sedation. The client is anxious and asks the nurse what to expect. What is the nurse’s best response?

• “You will be awake and alert during the procedure but you will feel no pain.”
• “You will not be able to move your feet or toes during the procedure.”
• “You will not be able to swallow or talk during the procedure.”
• “You will be very sleepy and we will monitor you closely.”

The nurse is caring for a client who has had conscious sedation. What is the primary advantage of this type of anesthesia?

• The client can talk through the procedure.
• The client is able to follow directions.
• No respiratory support is needed.
• No defensive reflexes are lost.

Before the nurse brings the client to the operating room (OR) for knee surgery, the client reports to the nurse that he did not mark the operative knee with the surgeon. What is the priority action of the nurse?

• Proceed with transferring the client to the OR as planned.
  The client can talk through the procedure.
• Call a “time out” so the site can be marked before surgery begins.
• Call the surgeon to mark the site with the client before transfer to the OR.
• Have the client mark the site before transfer to the OR.

Which action by the surgical nursing staff indicates that additional teaching is required about nurses’ roles and responsibilities in the operating room?

• The circulating nurse and the anesthesiologist accompany the client to the postanesthesia care unit.
• The circulating nurse goes to the blood bank to pick up 2 units of fresh-frozen plasma for the client.
• The circulating nurse goes to the blood bank to pick up 2 units of fresh-frozen plasma for the client.
• The circulating nurse prepares the surgical site before the client is covered with sterile drapes.

Which statement indicates accountability by the scrub nurse during a surgical procedure?

• “The client should have epidural anesthesia rather than general anesthesia.”
• “The client should have epidural anesthesia rather than general anesthesia.”
• “I will have retention sutures ready for the surgeon.”
• “A surgical sponge is missing so I will do a re-count.”

A client voluntarily signed the operative consent form. What is the nurse’s next action?

• Teach the client about the surgery.
• Have family members witness the signature.
• Sign under the client’s name as a witness.
• Call for the physician to sign the form.

A client will be undergoing palliative surgery. The client’s daughter asks what this means. What is the nurse’s best response?

• “The surgery will relieve the symptoms but will not cure your father.”
• “There are fewer risks with this type of surgery.”
• “There is no guarantee of the outcome of the surgery.”
• “The surgery must be performed immediately to save your father’s life.”