Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13e Edition
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13e Edition
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Chapter 18 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e Edition
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | The nurse is preparing an elderly patient for a scheduled removal of orthopedic hardware, a procedure to be performed under general anesthetic. For which adverse effect should the nurse most closely monitor the patient? | |
| A) | Hypothermia | |
| B) | Pulmonary edema | |
| C) | Cerebral ischemia | |
| D) | Arthritis | |
| Ans: | A | |
| Feedback: | ||
| Inadvertent hypothermia may occur as a result of a low temperature in the OR, infusion of cold fluids, inhalation of cold gases, open body wounds or cavities, decreased muscle activity, advanced age, or the pharmaceutical agents used (e.g., vasodilators, phenothiazines, general anesthetics). The anesthetist monitors for pulmonary edema and cerebral ischemia. Arthritis is not an adverse effect of surgical anesthesia. | ||
| 2. | The OR nurse acts in the circulating role during a patient’s scheduled cesarean section. For what task is this nurse solely responsible? | |
| A) | Performing documentation | |
| B) | Estimating the patient’s blood loss | |
| C) | Setting up the sterile tables | |
| D) | Keeping track of drains and sponges | |
| Ans: | A | |
| Feedback: | ||
| Main responsibilities of the circulating nurse include verifying consent; coordinating the team; and ensuring cleanliness, proper temperature and humidity, lighting, safe function of equipment, and the availability of supplies and materials. The circulating nurse monitors aseptic practices to avoid breaks in technique while coordinating the movement of related personnel as well as implementing fire safety precautions. The circulating nurse also monitors the patient and documents specific activities throughout the operation to ensure the patient’s safety and well-being. Estimating the patient’s blood loss is the surgeon’s responsibility; setting up the sterile tables is the responsibility of the first scrub; and keeping track of the drains and sponges is the joint responsibility of the circulating nurse and the scrub nurse. | ||
| 3. | A 21-year-old patient is positioned on the OR bed prior to knee surgery to correct a sports-related injury. The anesthesiologist administers the appropriate anesthetic. The OR nurse should anticipate which of the following events as the team’s next step in the care of this patient? | |
| A) | Grounding | |
| B) | Making the first incision | |
| C) | Giving blood | |
| D) | Intubating | |
| Ans: | D | |
| Feedback: | ||
| When the patient arrives in the OR, the anesthesiologist or anesthetist reassesses the patient’s physical condition immediately prior to initiating anesthesia. The anesthetic is administered, and the patient’s airway is maintained through an intranasal intubation, oral intubation, or a laryngeal mask airway. Grounding or blood administration does not normally follow anesthetic administration immediately. An incision would not be made prior to intubation. | ||
| 4. | A circulating nurse provides care in a surgical department that has multiple surgeries scheduled for the day. The nurse should know to monitor which patient most closely during the intraoperative period because of the increased risk for hypothermia? | |
| A) | A 74-year-old woman with a low body mass index | |
| B) | A 17-year-old boy with traumatic injuries | |
| C) | A 45-year-old woman having an abdominal hysterectomy | |
| D) | A 13-year-old girl undergoing craniofacial surgery | |
| Ans: | A | |
| Feedback: | ||
| Elderly patients are at greatest risk during surgical procedures because they have an impaired ability to increase their metabolic rate and impaired thermoregulatory mechanisms, which increase susceptibility to hypothermia. The other patients are likely at a lower risk. | ||
| 5. | The anesthetist is coming to the surgical admissions unit to see a patient prior to surgery scheduled for tomorrow morning. Which of the following is the priority information that the nurse should provide to the anesthetist during the visit? | |
| A) | Last bowel movement | |
| B) | Latex allergy | |
| C) | Number of pregnancies | |
| D) | Difficulty falling asleep | |
| Ans: | B | |
| Feedback: | ||
| Due to the increased number of patients with latex allergies, it is essential to identify this allergy early on so precautions can be taken in the OR. The anesthetist should be informed of any allergies. This is a priority over pregnancy history, insomnia, or recent bowel function, though some of these may be relevant. | ||
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