SURGICAL CONCEPTS

A CLIENT WHO IS TO RECEIVE GENERAL ANESTHESIA HAS A SERUM POTASSIUM LEVEL OF 5.8 MEQ/L. WHAT SHOULD BE THE
NURSE'S FIRST RESPONSE?
A. CALL THE SURGEON.
B. SEND THE CLIENT TO SURGERY.
C. MAKE A NOTE ON THE FRONT OF THE CHART.
D. NOTIFY THE ANESTHESIOLOGIST.

THE INTRAOPERATIVE NURSE ASKS THE CLIENT WHETHER HE HAS ANY ALLERGIES. THE CLIENT RESPONDS, “DOESN'T ANYONE
COMMUNICATE WITH ANYONE? I HAVE BEEN ASKED THAT QUESTION OVER AND OVER!” WHAT IS THE NURSE'S BEST
RESPONSE?
A. “I'M SORRY! I JUST HAVE TO ASK THAT QUESTION FOR THE RECORD.”
B. “IT'S AN IMPORTANT QUESTION AND WE JUST HAVE TO CHECK.”
C. “YOU WILL HEAR IT AGAIN AND AGAIN AS YOU GO THROUGH SURGERY.”
D. “THIS QUESTION IS ASKED FOR VERIFICATION AND SAFETY WITH EACH NEW PHASE OF TREATMENT.”

A CLIENT IS ADMITTED FOR AN ARTHROSCOPY OF THE RIGHT SHOULDER THROUGH SAME-DAY SURGERY. WHICH NURSE IS
RESPONSIBLE FOR STARTING THE CLIENT'S DISCHARGE PLANNING?
A. THE PREADMISSION NURSE.
B. THE PREOPERATIVE NURSE.
C. THE INTRAOPERATIVE NURSE.
D. THE POSTOPERATIVE NURSE.

THE NURSE IS PREPARING TO ADMINISTER A PREMEDICATION. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE
FIRST?
A. HAVE THE FAMILY PRESENT.
B. ENSURE THAT THE PREOPERATIVE SHAVE IS COMPLETED.
C. HAVE THE CLIENT EMPTY HIS BLADDER.
D. MAKE SURE THE CLIENT IS COVERED WITH A WARM BLANKET

OPERATING ROOM PERSONNEL ARE REQUIRED TO WEAR SPECIFIC, CLEAN OR ATTIRE AND COVER HAIR AND SHOES. WHAT IS
THE RATIONALE FOR THIS CLOTHING?
A. TO PROMOTE A TOTALLY STERILE ENVIRONMENT
B. TO EXCLUDE THE ENVIRONMENT OUTSIDE OF SURGERY
C. TO PROVIDE UNIFORMS THAT ARE NON-STATIC
D. TO ISOLATE THE CLIENT'S DISEASES FROM OR STAFF

THE CIRCULATING NURSE REFUSES TO LET THE CONSULTING SURGEON COME INTO THE OR WEARING A STERILE GOWN THAT
WAS WORN IN ANOTHER SURGERY IN ANOTHER THEATRE. THIS ACTION IS BASED ON:
A. VALUE JUDGMENT
B. CRITICAL THINKING
C. PRINCIPLES OF ASEPSIS
D. ASSERTIVENESS

WHICH OF THE FOLLOWING IS WITHIN THE STERILE FIELD?

A. ITEMS ABOVE THE LEVEL OF THE DRAPED PATIENT
B. ITEMS BELOW THE LEVEL OF THE DRAPED PATIENT
C. THE GOWNED AND GLOVED PROVIDER'S BACK
D. FROM THE GOWNED AND GLOVED PROVIDER'S HEAD TO THE CHEST

WHICH OF THE FOLLOWING IS CORRECT REGARDING THE SURGICAL ATTIRE?

A. STURDY FOOTWEAR THAT COMPLETELY COVERS THE FOOT AND IS WORN ONLY IN THE SURGICAL IS AVAILABLE, SHOE
COVERS ARE NOT NEEDED FOR INFECTION PREVENTION PURPOSES
B. STERILE GLOVES ARE CONSIDERED STERILE EVEN GLOVED HANDS DROP BELOW THE WAIST LEVEL
C. WHEN REMOVING SURGICAL GLOVES, ALWAYS REMOVE THE GOWN SIMULTANEOUSLY
D. CAPS AND MASKS WORN IN THE OR SHOULD BE STERILE

THE NURSE IS UNFAMILIAR WITH A NEW PIECE OF OR EQUIPMENT THAT IS SCHEDULED TO BE USED TODAY. WHAT IS THE BEST
COURSE OF ACTION?
A. ASK ANOTHER NURSE FOR INSTRUCTIONS ON HOW TO USE IT
B. WAIT UNTIL S/HE HAS ATTENDED CLASS ON USING THE EQUIPMENT BEFORE USING IT
C. GET ANOTHER NURSE WHO IS FAMILIAR WITH THE EQUIPMENT TO OPERATE IT
D. READ THE INSTRUCTIONS PROVIDED WITH THE EQUIPMENT

THE NURSE KNOWS WHICH OF THE FOLLOWING IS THE PROPER TECHNIQUE FOR MEDICAL ASEPSIS?
A. GLOVING FOR ALL CLIENT CONTACT
B. CHANGING HOSPITAL LINEN WEEKLY
C. USING YOUR HANDS TO TURN OFF THE FAUCET AFTER HANDWASHING
D. GOWNING TO CARE FOR A ONE YEAR OLD CHILD WITH INFECTIOUS DIARRHEA
THE NURSE IS CONDUCTING A CLASS ON ASEPTIC TECHNIQUE AND UNIVERSAL PRECAUTIONS. WHICH OF THE FOLLOWING IS
CORRECT AND SHOULD BE INCLUDED IN THE DISCUSSION?
A. UNIVERSAL PRECAUTION ARE DESIGNED TO REDUCE THE NUMBER OF POTENTIALLY INFECTIOUS AGENTS
B. MEDICAL ASEPSIS IS DESIGNED TO DECREASE EXPOSURE TO BLOODBORNE PATHOGENS
C. MEDICAL ASEPSIS IS DESIGNED TO CONFINE MICROORGANISMS TO A SPECIFIC AREA, LIMITING THE NUMBER, GROWTH AND
TRANSMISSION OF MICROORGANISM
D. THE TERM UNIVERSAL PRECAUTIONS IS SYNONYMOUS WITH DISEASE OR CATEGORY – SPECIFIC ISOLATION PRECAUTIONS

THE NURSE IS TO OPEN A STERILE PACKAGE FROM CENTRAL SUPPLY. WHICH IS THE CORRECT DIRECTION TO OPEN THE FIRST
FLAP?
A. TOWARD THE NURSE
B. AWAY FROM THE NURSE
C. TO THE NURSE'S LEFT OR RIGHT SIDE
D. IT DOES NOT MATTER AS LONG AS THE NURSE ONLY TOUCHES THE OUTSIDE EDGE

SURGICAL CLOSURE OF THE SKIN SURFACES USUALLY INVOLVES THE USE OF WHICH TYPE OF NEEDLE?
A. CURVED NEEDLE
B. ROUNDED NEEDLE
C. “EYE LESS” NEEDLE
D. STRAIGHT NEEDLE

THE SURGEON CLOSES THE CLIENT'S ABDOMINAL TISSUE LAYER. THE NURSE KNOWS THAT CLOSURE OF THE ABDOMINAL
TISSUE LAYERS BEGINS WITH THE PERINEUM, EXTRA PERITONEAL FAT , TRANSVERSALIS FASCIA, FOLLOWED BY:
A. DEEP FASCIA, MUSCLE SUBCUTANEOUS TISSUE, SKIN
B. MUSCLE, DEEP FASCIA, SUBCUTANEOUS TISSUE, SKIN
C. SUBCUTANEOUS TISSUE, DEEP FASCIA, MUSCLE SKIN
D. SKIN, MUSCLE, SUBCUTANEOUS TISSUE, DEEP FASCIA

WHICH OF THE FOLLOWING PROCEDURES FOR USING AN INCENTIVE SPIROMETER IS APPROPRIATE FOR THE NURSE TO PROVIDE
THE CLIENT WITH DURING PREOPERATIVE INSTRUCTIONS?
A. INHALE COMPLETELY AND EXHALE RAPIDLY THROUGH THE SPIROMETER
B. EXHALE COMPLETELY, TAKE SLOW DEEP BREATH THROUGH THE SPIROMETER, HOLD BREATH THEN EXHALE THROUGH
PURSED LIP
C. INHALE COMPLETELY THROUGH THE SPIROMETER, EXHALE AND HOLD BREATH
D. EXHALE THROUGH THE SPIROMETER, HOLD THEN INHALE

WHAT COMMON SIDE EFFECT SHOULD THE NURSE MONITOR IN A CLIENT WHO JUST RECEIVED EPIDURAL ANESTHESIA?
A. FEVER
B. HYPOTENSION
C. BRADYCARDIA
D. PALLOR

WHICH OF THE FOLLOWING COMPLICATIONS CAN RESULT FROM THE USE OF GENERAL ANESTHESIA DURING SURGERY?
A. FLUID LOSS
B. PERIPHERAL FLUID RETENTION
C. ATELECTASIS
D. MUSCLE RIGIDITY

THE OR NURSE CAUTIONS THE SCRUB TEAM TO BE VERY QUIET JUST AS THE CLIENT IS RECEIVING A GENERAL ANESTHETIC.
EVALUATION OF RESPONSE TO ANESTHESIA AT THIS POINT WOULD DEMONSTRATE WHICH OF THE FOLLOWING?
A. THE CLIENT HAS AN INCREASED RISK OF APNEA
B. THE CLIENT EXPERIENCES NOISES AS EXAGGERATED IN STAGE I
C. THE CLIENT MAY BECOME EXCITED AND STRUGGLE
D. THE CLIENT EXPERIENCES AN EXTENSION OF TIME TO GET TO STAGE III