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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
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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)
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 You review the patient's chart and discover that the patient has an allergy to penicillin. What medication order should you be worried about ✔✔Ancef Upon arrival to PACU you notice your patient is having a laryngospasm. What is the first action ✔✔Apply positive pressure ventilation When should a surgical "Time Out" be performed ✔✔When all team members are in the room, the patient is prepped and draped and prior to initial incision
Your OR patient has a suspected diagnosis of pulmonary tuberculosis. What type of transmission based precaution is needed ✔✔Airborne The scrub tech is preparing to count for a laparoscopic cholecystectomy and notices that the lap sponges on the back table have no visible x-ray detectable strip. What should the circulator do ✔✔Remove the lap sponges from the OR and open a new package of sponges In the preoperative holding area, the patient's preoperative lab values are K+2.9, Hgb 14.3, Hct 42.0 and glucose 89. What should you do? ✔✔Notify Anesthesia provider A patient is scheduled to have a total knee arthroplasty. What lab value should you be most concerned about and need to inform the surgeon? ✔✔WBC 12.5 K/UL What type of medication might be used during ophthalmic surgery for severe allergic condition ✔✔Corticosteroids When prepping a patient for general surgery with laparoscopy, in what order should you drape them? ✔✔Lap sheet, sterile towels, impervious drape impervious drape, sterile towel, lap sheet
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
What type of gloves should be worn when transporting endoscopes to and from storage cabinets ✔✔clean A patient is extubated after surgery and is receiving 6l O2 via mask. Upon arrival to the PACU the nurse notices a decrease in SaO2 to 89% from 99% and snoring. What is the first action to take ✔✔check for airway obstruction Before a case, what reference should you use to understand how the surgical team wants their instruments and equipment to be positioned ✔✔preference card Immediately upon bringing a medication to the sterile field, the circulator and scrub technologist should ensure that it is labeled, at the minimum, with medication name and what two other pieces of information ✔✔volume and concentration expiration date and volume expiration date and concentration dosage and concentration wrong
As you prepare the room for an open exploratory laparotomy, what pieces of basic equipment should you prepare to setup ✔✔ESU, suction set up, major abdominal instrument set A patient is allergic to shellfish and is scheduled for an exploratory laparotomy. What is the solution of choice for prepping the abdomen considering the patient's allergy ✔✔Chlorahexadine gluconate If a patient reports a family history of malignant hyperthermia, you should be prepared to administer which medication should such an emergency arise ✔✔dantrolene The surgeon has asked you to hand them a piece of equipment. How should you use closed loop communication to respond ✔✔state the name of the equipment in your response The first patient in the OR was closed at 0650 and left the OR for PACU at 0700. The surgeon left the room at 0655. The next patient arrives in the OR at 0718. What is the turnover time in this situation ✔✔18 minutes 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
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
