ATI Care of Intraoperative Patients, Questions and Answers with Explanations, 100% Correct, Download to Score A

Test Bank

MULTIPLE CHOICE

1. Which observed action indicates that the nurse is performing the surgical scrub correctly?

a.            A small brush is used to scrub under nails and wedding ring.

b.            The surgical mask is put on before starting the surgical scrub.

c.             The soap is rinsed off so that the water runs down to the hands.

d.            A paper towel is used to turn off the faucet handle.

ANS: B

The facemask must be donned before the surgical scrub is started. Jewelry is removed before scrubbing. The hands and the arms are positioned so that water falls away from them and does not run “up” or “down” the hands and arms. Water flow is controlled by foot pedals.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 270

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Standard Precautions/Transmission-Based Precautions/Surgical Asepsis)

MSC: Integrated Process: Nursing Process (Implementation)

2. A client is having epidural anesthesia for knee replacement surgery. Which action by the nurse is the priority during this surgery?

a.            Provide emotional support for the client.

b.            Position the client comfortably and safely.

c.             Stay with the client until sedation is effective.

d.            Teach the client cough and deep-breathing exercises.

ANS: B

The client’s safety is the nurse’s priority during this surgery. The other actions are appropriate but are not the highest priority.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications From Surgical Procedures and Health Alterations)

MSC: Integrated Process: Nursing Process (Implementation)

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

a.            A small amount of sterile saline is poured out before it is poured into the basin.

b.            The nurse disposes of any equipment packages that are in poor condition.

c.             Sterile surgical supplies are placed in the center of the sterile field.

d.            The sterile saline bottle cap is placed in the center of the sterile field.

ANS: D

The outside of the bottle cap is not sterile and should not be placed on the sterile field. The other actions indicate good understanding of sterile technique.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Standard Precautions/Transmission-Based Precautions/Surgical Asepsis)

MSC: Integrated Process: Nursing Process (Implementation)

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

a.            Assist with transferring the client to the postanesthesia care unit.

b.            Document the procedure in the client’s medical record.

c.             Set up the sterile field and drape the client appropriately.

d.            Document how many sponges and sharps have been utilized.

ANS: D

The scrub person or nurse should document how many sponges and sharps are utilized after the procedure. The scrub person may assist with transferring, but the client will not leave the operating room until the counts are correct. Documentation is important and ongoing, but at the conclusion of an operation, counting supplies is vital to prevent accidentally leaving them in the client. Draping the client and setting up the field are done before the surgical procedure is begun.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Accident/Injury Prevention) MSC: Integrated Process: Nursing Process (Planning)

5. Before a client’s surgery begins, the circulating nurse notes that the nurse anesthetist did not perform a surgical scrub before coming into the operating room. Which action by the circulating nurse is most appropriate?

a.            Direct the nurse anesthetist to perform the surgical scrub immediately.

b.            Proceed with positioning the client on the operating bed.

c.             Notify the nursing supervisor that sterile technique has been violated.

d.            Proceed with setting up the instruments to be used during surgery.

ANS: B

The nurse anesthetist does not need to perform a sterile scrub before the client’s surgery is performed. The circulating nurse can proceed with positioning the client on the operating room bed.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Standard Precautions/Transmission-Based Precautions/Surgical Asepsis)

MSC: Integrated Process: Nursing Process (Implementation)

6. A client is having spinal anesthesia for knee surgery. Which statement by the client indicates a good understanding of this type of anesthesia?

a.            “I won’t have to worry about having an allergic reaction.”

b.            “I will be able to walk sooner after your surgery.”

c.             “I will have less risk of developing pneumonia after surgery.”

d.            “I will have less risk of bleeding with epidural anesthesia.”

ANS: C

With epidural anesthesia, the client remains conscious, respiratory function is unaffected, and intubation is not necessary. This results in less risk for atelectasis or pneumonia after surgery.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Health Promotion and Maintenance (Principles of Teaching/Learning)

MSC: Integrated Process: Teaching/Learning

7. 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?

a.            “You will be awake and alert during the procedure but you will feel no pain.”

b.            “You will not be able to move your feet or toes during the procedure.”

c.             “You will not be able to swallow or talk during the procedure.”

d.            “You will be very sleepy and we will monitor you closely.”

ANS: D

A physician or a specially credentialed registered nurse may administer agents for conscious sedation. This rapid and short-acting type of anesthesia, used for brief but uncomfortable procedures, does not render the client completely unconscious. Clients have a reduction in intensity or awareness of the pain without loss of defensive reflexes.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 276

TOP: Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)

MSC: Integrated Process: Communication and Documentation

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

a.            The client can talk through the procedure.

b.            The client is able to follow directions.

c.             No respiratory support is needed.

d.            No defensive reflexes are lost.

ANS: C

The client undergoing a moderate sedation procedure will not need respiratory support; this is the first and foremost advantage of this kind of sedation. The client will be able to follow directions during the procedure, but maintaining his or her own airway and not requiring mechanical ventilation decrease potential complications.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 276

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications From Surgical Procedures and Health Alterations)

MSC: Integrated Process: Nursing Process (Analysis)

9. 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?

a.            Proceed with transferring the client to the OR as planned.

b.            Call a “time out” so the site can be marked before surgery begins.

c.             Call the surgeon to mark the site with the client before transfer to the OR.

d.            Have the client mark the site before transfer to the OR.

ANS: C

According to The Joint Commission, the surgical site should be marked by both the client and the surgeon before anesthesia is administered and surgery begins when the surgery involves a specific side.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Error Prevention)

MSC: Integrated Process: Nursing Process (Implementation)

10. The nurse is preparing to bring a young female client to the operating room for a total abdominal hysterectomy (TAH). The client says to the nurse, “I am so glad that I will still be able to have children after this surgery.” What is the nurse’s best response?

a.            “That is very good news. How many children do you want?”

b.            “Weren’t you taught about your surgery earlier?”

c.             “You must have misunderstood your surgeon.”

d.            “I will call the surgeon to speak with you before surgery.”

ANS: D

TAH includes removal of the uterus, which will leave the client unable to have children. The surgeon should be called to speak with the client and explain the surgery before the client is moved to the operating room.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Informed Consent)

MSC: Integrated Process: Nursing Process (Implementation)