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Chapter 18: Intraoperative Care

Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis

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Chapter 18: Intraoperative Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. The nurse facilitates student clinical experiences in the surgical suite. Which action, if performed by a student, would require the nurse to intervene?
a. The student wears a mask in the semirestricted area.
b. The student wears street clothes in the semirestricted area.
c. The student wears surgical scrubs in the semirestricted area.
d. The student covers head and facial hair in the semirestricted area.

 

 

ANS:  B

Wearing street clothes in the semirestricted area is not permitted. The surgical suite is divided into three distinct areas: unrestricted—staff and others in street clothes can interact with those in surgical attire; semirestricted—staff must wear surgical attire and cover all head and facial hair; and restricted—includes the operating room, the sink area, and clean core where masks are required in addition to surgical attire.

 

DIF:    Cognitive Level: Apply (application)           REF:               315

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe and Effective Care Environment

 

  1. Which statement, if made by a new circulating nurse, reflects understanding of the circulating nurse role?
a. “I will assist in preparing the operating room for the patient.”
b. “I will don sterile gloves to obtain items from the unsterile field.”
c. “I will remain gloved while performing activities in the sterile field.”
d. “I will assist with suturing of incisions and maintaining hemostasis as needed.”

 

 

ANS:  A

Preparing the operating room for the patient describes the role of a circulating nurse. All other answer options describe specific roles and actions of scrub nurses. The circulating nurse performs activities in the unsterile field and is not scrubbed, gowned, or gloved. The scrub nurse follows the designated scrub procedure, is gowned and gloved in sterile attire, and performs activities in the sterile field.

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   319

TOP:   Nursing Process: Planning               MSC:  NCLEX: Safe and Effective Care Environment

 

  1. Which action best describes the role of the certified registered nurse anesthetist (CRNA) on the surgical care team?
a. Performs the same responsibilities as the anesthesiologist.
b. Gives intraoperative anesthetics ordered by the anesthesiologist.
c. Releases or discharges patients from the postanesthesia care area.
d. Manages a patient’s airway under the direct supervision of the anesthesiologist.

 

 

ANS:  C

A nurse anesthetist is a registered nurse who has graduated from an accredited nurse anesthesia program (minimally a master’s degree program) and successfully completed a national certification examination to become a CRNA. The CRNA scope of practice includes, but is not limited to, the following:

  1. Performing and documenting a preanesthetic assessment and evaluation
  2. Developing and implementing a plan for delivering anesthesia
  3. Selecting and initiating the planned anesthetic technique
  4. Selecting, obtaining, and administering the anesthesia, adjuvant drugs, and fluids
  5. Selecting, applying, and inserting appropriate noninvasive and invasive monitoring devices
  6. Managing a patient’s airway and pulmonary status
  7. Managing emergence and recovery from anesthesia
  8. Releasing or discharging patients from a postanesthesia care area

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   318

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe and Effective Care Environment

 

  1. Which action describes how the scrub nurse protects the patient with aseptic technique during surgery?
a. Uses waterproof shoe covers
b. Wears personal protective equipment
c. Changes gloves after touching the upper arm of the surgeon’s gown
d. Requires that all operating room (OR) staff perform a surgical scrub

 

 

ANS:  C

The sleeves of a sterile surgical gown are considered sterile only to 2 inches above the elbows, so touching the surgeon’s upper arm would contaminate the nurse’s gloves. Shoe covers are not sterile. Personal protective equipment is designed to protect caregivers, not the patient, and is not part of aseptic technique. Staff members such as the circulating nurse do not have to perform a surgical scrub before entering the OR.

 

DIF:    Cognitive Level: Apply (application)           REF:               320

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe and Effective Care Environment

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