Contemporary Medical Surgical Nursing 2nd Edition Daniels Nicoll Test Bank
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Below you will find some free nursing test bank questions from this test bank:
Chapter 21–Intraoperative Nursing Management
1. A nurse is considering additional training to become a perioperative nurse. Which of the following
skills are implemented by the perioperative nurse?
1. Conducts telephone interviews with the preoperative client
2. Applies principles of aseptic technique
3. Instructs the preoperative client on exercises to use while recovering from surgery
4. Plans for the postoperative client’s discharge to home
Skills of the perioperative nurse include applying principles of aseptic technique and explaining how
this knowledge applies to other areas within the operating suite. The perioperative nurse does not
conduct telephone interviews with the preoperative client, instruct the preoperative client in
postoperative exercises, nor plan for the postoperative client’s discharge to home.
REF: The Role of the Perioperative Nurse
2. Even though the nurse realizes that the ideal time period to plan for postoperative pain management
for a pediatric client begins in the operating room, the nurse will begin the assessment process:
1. at the time the decision is made that the client needs surgery.
2. in the family’s home.
3. during the admission process.
4. in the operating room after anesthesia wears off.
Pain management cannot begin before the patient is admitted, and starting after the surgery is too late.
It begins at the admission when the type of surgery indicates which type of medication will be needed,
and medication skills will be taught to the client and the family. Planning for pain management cannot
begin in the client’s home nor at the time the decision is made that the client needs surgery.
REF: Pain Management in Pediatric Patients
3. The perioperative nurse realizes that the surgical environment is designed to ensure which of the
1. Calming effect on the client
2. Ease of use by personnel
3. Control surgical asepsis
4. Reduce postoperative pain
The design of the intraoperative environment is to maintain surgical asepsis. The design is not to have
a calming effect on clients. Intraoperative environments are not designs for ease of use by personnel or
to reduce postoperative pain.
REF: The Surgical Environment
4. The scrub nurse is preparing the sterile field by opening an instrument package that was sterilized in an
autoclave with direct exposure to steam. This type of sterilization is considered to be:
1. high-pressure/high-temperature steam.
2. cold chemical.
3. dry heat.
High-pressure/high-temperature steam sterilization is the use of an autoclave to directly expose the
instruments to steam for a specified period of time. Cold chemical sterilization is the submersion of
instruments in a sterilizing solution for a predetermined period of time. Dry heat utilizes static air or
forced air to sterilize items. Alcohol is a commonly used disinfectant. It is not an effective sterilant
and, therefore, is not acceptable.
REF: Box 21-5 Sterilization Methods
5. Prior to the surgeon’s making an incision into a client, the client’s skin is bathed with a bacteriostatic
solution. The nurse realizes that this solution will:
1. sterilize the client’s skin.
2. disinfect the client’s skin.
3. sanitize the client’s skin.
4. inhibit the number of bacteria on the client’s skin.
A bacteriostatic solution is one that will inhibit the increase in the number of bacteria. Sterilization,
disinfection, and sanitization are all methods to reduce or destroy microorganisms on objects. These
methods cannot be used on skin.
REF: Table 21-2 Sterilization Terms and Definitions
6. The operating room personnel are applying masks and either goggles or face shields prior to beginning
a surgical procedure. The purpose of these items is to:
1. facilitate vision.
2. protect against splashes or sprays of blood.
3. facilitate breathing.
4. facilitate communication.
These pieces of personal protective equipment (PPEs) are used to protect personnel from splashes and
sprays of blood and body fluids. Masks, goggles, and face shields do not facilitate vision, breathing, or
REF: Personal Protective Equipment
7. The nurse is preparing to participate in a surgical procedure and has completed the surgical scrub.
Which of the following should the nurse do now in preparation for the surgery?
1. Don a surgical gown.
2. Apply sterile gloves.
3. Adjust the surgical mask.
4. Apply covering over the hair.
Gowns should be put on after completing a surgical scrub and before gloving. The surgical mask
should be adjusted before applying sterile gloves. Head covering should be applied before conducting
the surgical scrub.
REF: Personal Protective Equipment
8. A client with a suspected degenerative brain disease is having surgery to place an intracerebral shunt.
Which of the following should be done with the instruments after this surgical procedure?
1. Sterilize with high-pressure steam.
2. Sterilize with the special treatment to eliminate prions.
3. Wash with bacteriostatic solution and submerge in an appropriate chemical bath.
4. Rinse with disinfectant and place in a gas sterilizer.
Prion diseases are rare, but they can survive some sterilization processes, and chemical disinfectants
are not strong enough to eliminate them. These instruments will need to be sterilized with a special
treatment to eliminate the prions. High-pressure steam, bacteriostatic solutions, chemicals,
disinfectants, and gas sterilizers are not known sterilization methods to eliminate prions.
REF: Personal Protective Equipment
9. A client received general anesthesia for a surgical procedure. Which of the following assessments will
the nurse complete first for this client?
1. Surgical dressing
2. Intravenous sites
Clients often require assistance in maintaining a patent airway after use of general anesthesia. The first
assessment the nurse should make is that of the client’s airway. The surgical dressing, intravenous
sites, and pain can be assessed after the client’s airway has been established.
REF: Box 21-7 Types of Anesthesia
10. The student nurse observing a surgical procedure begins to feel lightheaded and nauseated. Which of
the following should the student do at this time?
1. Tell someone she does not feel well.
2. Leave the operating room immediately.
3. Nothing since this feeling will pass.
4. Immediately sit down on the floor.
If feelings of lightheadedness or nausea occur during an observation of a surgical procedure, the first
thing to do is head for the door or at least to a wall away from the surgical field. The student should
not tell someone that she is not feeling well. The student should not ignore these feelings since they are
signs of fainting. The student should not immediately sit on the floor since this could be in the area of
the sterile field and could compromise the surgical procedure.
REF: Box 21-2 Tips for the Student When Observing in Operating Room
11. A nurse is filling the role of circulator during a surgical procedure. Which of the following will this
nurse do to provide care to the client during the case?
1. Maintain the sterile field.
2. Assist the surgeon.
3. Serve as the client advocate.
4. Assist with the administration of anesthesia.
The circulating nurse serves as the client advocate while the client is least able to care for himself.
Maintaining the sterile field is a responsibility of the scrub nurse. Assisting the surgeon is an activity
of the registered nurse first assistant. Assisting with the administration of anesthesia is an activity of
the nurse anesthetist.
REF: Circulator/Circulating Nurse
12. An elderly client is scheduled for a surgical procedure. The nurse realizes that the outcome of the
client’s operation will depend upon the client’s:
2. severity of illnesses.
3. nutritional status.
4. activity status.
Severity of illness is a much better predictor of outcome of surgery when compared to age. Nutritional
status and activity status would be characteristics that are associated with severity of illness.
DIF: Analyze REF: Geriatric Considerations
13. During a surgical procedure, the client’s body temperature spikes to a dangerous level. Which of the
following will be done to help this client?
1. Reduce the flow of the anesthetic agent.
2. Provide 50% oxygen.
3. Stop the surgery for cardiac dysrhythmias.
4. Administer a Dantrolene infusion.
Malignant hyperthermia is a medical emergency. The anesthetic agent should be stopped immediately
and the client should be hyperventilated with 100% oxygen. The surgery should be stopped if it is an
elective case. Dantrolene should be provided.
REF: Malignant Hyperthermia
1. A perioperative nurse is identified as being the scrub nurse for a surgical procedure. Which of the
following is this nurse’s responsibilities during the surgery? (Select all that apply.)
1. Don surgical attire and personal protective equipment.
2. Maintain the sterile field.
3. Pass instruments and supplies to the surgeon.
4. Prepare medication.
5. Remove used instruments.
6. Organize the sterile field for use.
ANS: 2, 3, 4
Responsibilities of the scrub nurse during a surgical procedure include maintaining the sterile field,
passing instruments and supplies to the surgeon, and preparing medication. Donning surgical attire and
organizing the sterile field are responsibilities done before the surgery begins. Removing used
instruments are done after the surgery has concluded.
REF: Box 21-3 Duties of the Scrub Nurse
2. The perioperative nurse is identifying nursing diagnoses appropriate for a client currently having
surgery. Which of the following would be appropriate for the client at this time?
1. Risk for infection
2. Risk for impaired skin integrity
3. Risk for injury
4. Risk for inadequate nutrition
5. Risk for hypothermia
6. Risk for fluid volume overload
ANS: 1, 2, 3, 5
Nursing diagnoses for the perioperative client include risk for infection, risk for impaired skin
integrity, risk of injury, and risk of hypothermia. Risk for inadequate nutrition and risk for fluid
volume overload would be more appropriate during the postoperative period of client care.
REF: NANDA and the Nursing Process
3. Which of the strategies can a perioperative nurse use to make a child feel less anxious prior to a
surgical procedure? (Select all that apply.)
1. Take the client on a tour of the operating room.
2. Allow the client to bring a toy or stuffed animal.
3. Allow the parents to stay with the child as much as possible.
4. Have the chaplain say a prayer with the child.
5. Use age-appropriate explanations.
6. Respond to questions in a straightforward manner.
ANS: 1, 2, 3, 5, 6
Strategies to help a preoperative pediatric client feel less anxious prior to a surgical procedure include
taking the client on a tour of the operating room, allowing the client to bring a toy or stuffed animal,
allowing the parents to stay with the client as much as possible, using age-appropriate explanations,
and responding to questions in a straightforward manner. Having a chaplain say a prayer with the child
is good, but it may not be age appropriate.
REF: Pediatric Considerations
4. The circulating nurse is performing a “time out” prior to the beginning of a surgical procedure. Which
of the following will be assessed during this time out? (Select all that apply.)
1. Correct client
2. Correct procedure
3. Correct site and side
4. Correct surgeon
5. Correct day
6. Correct time
ANS: 1, 2, 3, 4
A correctly performed time out includes verifying the right client; the correct procedure; the correct
site and side; the correct surgeon; the correct position; the correct equipment, instruments, and
implants if necessary. The correct day and time are not parts of the surgical ‘time out.”
REF: Time Out
5. The nurse determines that a client is experiencing a risk associated with the use of anesthesia for a
surgical procedure. Which of the following are considered risks of anesthesia? (Select all that apply.)
1. Nausea and vomiting
2. Sore throat
4. Postoperative myocardial infarction
5. Surgical wound infection
ANS: 1, 2, 3, 4, 6
Risks of anesthesia include adverse reaction to the anesthetic, nausea and vomiting, sore throat,
seizure, myocardial infarction, hypothermia, malignant hyperthermia, numbness or loss of function of
a body part, and disseminated intravascular coagulation. Surgical wound infection is not a risk
associated with anesthesia.
REF: Red Flag: Risks of Anesthesia