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What type of support would you place to alleviate pressure on the brachial plexus nerve when a patient is in a side-lying position - Axillary Roll You are the circulating nurse confirming consent with a patient scheduled for an exploratory laparotomy with colostomy. The patient states they do not want a colostomy. What should you do? - Do not take the patient to the operating room and consult the surgeon immediately What equipment is most important for a patient undergoing an emergency trauma surgery who declines a donated blood transfusion - Cell Saver You have been asked to take a specimen from an OR during a bronchoscopy and immediately take it to the lab. What must you do first - Confirm the specimen label and patient name You suspect long-term substance abuse during the pre-op interview with your patient. Which of the following assessment findings would support this suspicion - nasal irritation and frequent
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What type of support would you place to alleviate pressure on the brachial plexus nerve when a patient is in a side-lying position - Axillary Roll You are the circulating nurse confirming consent with a patient scheduled for an exploratory laparotomy with colostomy. The patient states they do not want a colostomy. What should you do? - Do not take the patient to the operating room and consult the surgeon immediately What equipment is most important for a patient undergoing an emergency trauma surgery who declines a donated blood transfusion - Cell Saver You have been asked to take a specimen from an OR during a bronchoscopy and immediately take it to the lab. What must you do first - Confirm the specimen label and patient name You suspect long-term substance abuse during the pre-op interview with your patient. Which of the following assessment findings would support this suspicion - nasal irritation and frequent sniffing, needle tracks on arms, and burns on fingers and lips After applying an alcohol-based skin preparations for a laser procedure, what should you do next - assess for pooling or moisture from the prep What medication should be administered to a patient who has received moderate sedation with midazolam who has unexpected respiratory depression - romazicon (flumazenil) After starting a blood transfusion, you observe that a patient undergoing moderate sedation has a temperature increase from 98.2 to 101.3 and coarse breath sounds. What is the first thing you should do - Stop the transfusion and notify the surgeon What is the minimum distance unscrubbed personnel should remain from the sterile field - 12 inches
You are preparing a patient for a laparotomy. What instrument do you anticipate seeing on the back table - malleable Which of the following medications is contraindicated for a patient with a family history of malignant hyperthermia - Quelicin (succinylcholine) You are caring for a patient who is infected with Methicillin- Resistant Staphylococcus Aureus (MRSA). What infection control practice must you implement after transferring the patient - Clean and disinfect all patient care equipment Upon opening a sterile major tray, you discover the chemical indicators are missing. What should you do? - Remove and replace the major tray As a circulator, where do you stand during induction - at the head of the bed You are the perioperative nurse who is doing the preoperative skin preparation on a clean abdominal case. Where should you start the skin preparation - site of incision and move to the periphery A patient was prepared for intubation by mask ventilation with a mixture of sevoflurane, nitrous oxide, and oxygen. One minute after intubation their heart rate increased from 160 to 195 b/m. Soon the patient's end tital carbon dioxide concentration was increased from 35 to 65 mmHg. Also, the patient's oral temperature increased to 38.9 within 5 minutes after induction. What is the patient experiencing - Malignant Hyperthermia After draping the left side of the patient, how should you drape the right side - From the left side open the drape over the patient Shake the drape open as your assistant places the drape Reach over the patient to place the drape Walk around the operating room table What is the safest location for sharps during a surgical procedure - in knife holder/needle board on back table
In what order should you apply a sterile drape - from sterile area to unsterile, draping nearest first You are taking a patient to PACU who just had a fractured mandible repaired. What supply do you need to transport with your patient - wire cutter When should you and surgical team members perform a surgical count for an open thoracotomy? - Prior to skin incision, at the beginning of closure of body cavity or first tissue layer, and during skin closure You are the scrub nurse on a case in which a vendor is present. The vendor has a packaged product that they would like to hand to the surgeon. What should you do? - Ask the vendor to hand the product to the circulating nurse You are the circulating nurse and have received 2 units of packed red blood cells that are to be transfused immediately. Present in the room are the surgeon, surgical tech, CRNA and radiology technician. Who should you ask to assist with checking the blood before the transfusion - CRNA The anesthesiologist informs you that the next patient is a difficult intubation. Which equipment will you expect to have in the room? - Glidescope You are near the entrance to the operating room department when a vendor approaches you and asks where to go. What should you do first? - walk them to the area designated by facility policy What is an important step for the prevention of biofilm developing on a flexible endoscope - allowing the scope to dry completely after use****wrong** You are the circulating nurse. What class of surgical wound would you document for a patient with preoperative fever who underwent tonsillectomy in the presence of a large amount of purulent drainage for which the surgeon has ordered intravenous antibiotics - Class I Class II *****Class III**** WRONG The scub nurse has asked you for a heavy sterile instrument that is wrapped. After opening the package, how should you give them the instrument - let the scub nurse grasp it out of the package
You are scubbed in during the middle of a procedure when you see a blood soaked sponge on the floor 2 feet from the sterile field. What should you do - tell the other team members about it and ask the circulating nurse to remove it without touching the sterile field Which of the following assignments can a circulator delegate to a non licensed surgical associate - retrieving sterile trays Immediately after surgery, your patient is exhibiting symptoms of dizzyness, cyanosis, shivering, and disoriented. These findings most likely indicate what condition - hypothermia which type of endoscope should you have present for use during a low anterior colon resection - proctoscope Who is responsible for documenting the operative time out - OR nurse The room has already been set up with latex gloves when your patient reports a mild rash on contact with latex. What should you do first - Notify the surgical team and discard sterile field set up What is proper surgical attire for non sterile scrubbed personnel - a long sleeved scrub jacket closed in front What is the primary purpose of slowly lowering a patient's legs from the lithotomy position - promotes proper body alignment prevents hip pain reduces the risk of hypotension decreases strain on abdominal muscles The surgeon is preparing to clamp bleeding vessels. What type of instrument should you prepare for the surgeon - hemostats You are preparing the OR for a total knee replacement. What supply do you anticipate needing - stockinette
What is the surgical start time based on the following events: intubation occurred at 0618, the surgeon entered the room at 0622, the first incision was made at 0631, and the implant was placed at 0714 - 0631 in the preoperative holding area the patient's vital signs reveal a heart rate of 45 bpm and blood pressure of 171/95 mmHg. What is your priority action - contact the anesthesia provider You assist with transporting a patient to the PACU with the anesthesia provider. The patient is sedated and the PACU nurse is at the bedside. What should you do next - help put the patient on the monitor You are assisting with dental cases. During the procedure the team observes the patient having uncontrollable shaking. What is the team's priority action - maintaining the airway What temperature is considered the threshold for hypothermia in the postoperative setting - less than 38 degree C (100.4 F) less than 37 degree C (98.6 F) less than 36 degree C (96.8 F) less than 35 degree C (95.0 F) wrong What nerve is most likely to be affected when the patient has a loss of sensation in the lateral portion of a hand and an inability to abduct or oppose the fifth finger (claw hand) - Ulnar You are in the operating room with a patient and the anesthesia provider after surgery. As you prepare to transport the patient to PACU you notice that the surgical dressing is saturated with blood. What should be the most appropriate nursing action - reinforce the dressing and notify the surgeon A patient with allergy to penicillin receives a test dose of cefazolin and starts to develop hives. What medication would you consider giving - prednisone You are the circulating nurse working on a case with a surgical technologist who is confrontational and has an aggressive communication. During the case, the surgical tech repeatedly tells you how to perform nursing tasks. What is the best response - speak with them privately after the case