65-year-old Dominic is being transferred into the PACU from the OR. Once there, initial assessment will focus on:

Correct Answer: A

Rationale: In the context of a 65-year-old patient being transferred into the Post-Anesthesia Care Unit (PACU) from the Operating Room (OR), the initial assessment should prioritize addressing immediate life-threatening issues. Option A, focusing on airway, breathing, circulation, and wound site, is the correct choice. This approach aligns with the ABCs of emergency care - ensuring a patent airway, adequate breathing, and optimal circulation, while also assessing the surgical wound for any signs of bleeding, infection, or complications. Options B, C, and D are incorrect for several reasons. Option B, which mentions intake, output, and intravenous access, is more relevant to ongoing monitoring and management in the PACU rather than the immediate postoperative assessment. Option C, involving abdominal sounds, oxygen setting, and level of consciousness, is important but should come after the ABC assessment to ensure the patient's physiological stability. Option D, focusing on pulse oximeter, pupil responses, and deep tendon reflexes, is more indicative of a neurological assessment and would not address the immediate concerns of airway, breathing, and circulation. Educationally, understanding the prioritization of assessments in the PACU is crucial for nursing students and healthcare providers. Emphasizing the ABC approach ensures that critical issues are addressed promptly, potentially preventing adverse outcomes in postoperative patients. By explaining the rationale behind the correct choice and why the other options are less appropriate, learners can develop a solid foundation in perioperative care.

Correct Answer: D

Rationale: In preparation for ambulatory surgery, providing procedural information to patients is crucial for ensuring their understanding, cooperation, and overall positive outcomes. Option D, which includes information about what odors and sensations may be experienced, as well as techniques for coughing and deep breathing if appropriate, is the correct choice. Explaining potential odors and sensations helps to prevent anxiety or confusion during the surgery, while teaching coughing and deep breathing techniques can aid in postoperative recovery by preventing complications like atelectasis and pneumonia. Option A, while important, only addresses pain management, which is just one aspect of the preoperative education. Option B, fluid and food restrictions, is essential but primarily pertains to preoperative fasting guidelines rather than procedural information. Option C, characteristics of monitoring equipment, is more relevant to intraoperative or postoperative care and may not directly impact the patient's preparation for surgery. Educationally, understanding the rationale behind providing detailed procedural information to patients emphasizes the importance of holistic patient care, informed decision-making, and active patient engagement in their own health management. By empowering patients with knowledge, healthcare providers can enhance patient satisfaction, compliance, and outcomes in the perioperative setting.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D, which is a White Blood Cell (WBC) count of 18,500/µL. An elevated WBC count indicates a potential infection or inflammation in the body, which is crucial information for the surgeon to be aware of before proceeding with surgery. This result should be brought to the surgeon's attention immediately to assess the patient's condition and consider appropriate interventions. Option A, a Serum K+ of 3.8 mEq/L, is within the normal range and does not pose an immediate threat to the patient's preoperative status. Similarly, option B, a Hemoglobin of 15 g/dL, and option C, a Blood glucose of 100 mg/dL, are also within normal limits and do not require immediate attention in this context. From an educational perspective, understanding the significance of abnormal laboratory values in preoperative patients is critical for nurses to provide safe and effective care. This question highlights the importance of recognizing abnormal findings and prioritizing communication with the healthcare team to ensure patient safety and optimal outcomes. Nurses must be vigilant in monitoring and interpreting laboratory results to advocate for their patients' well-being during the perioperative period.

Correct Answer: A

Rationale: In surgical settings, maintaining sterile technique is crucial to prevent infections. In this scenario, the correct answer is option A) the mask with sterile gloved hands. This action is considered a break in sterile technique because the mask is considered a sterile field and touching it with gloved hands can introduce potential contaminants. Option B) touching the gown at chest level with sterile gloved hands is incorrect as the gown is part of the sterile field and should not be touched during surgery. Option C) touching the drape at the incision site with sterile gloved hands is incorrect because the drape covers the surgical site and must remain sterile to prevent infection. Option D) touching the lower arm to the instruments on the instrument tray is incorrect as it introduces the risk of contaminating the instruments which are meant to be sterile. Educationally, understanding and adhering to sterile technique principles are fundamental for healthcare professionals working in surgical environments to ensure patient safety and prevent surgical site infections. It is essential to continuously reinforce these principles through training and practice to maintain aseptic conditions during surgical procedures.

Correct Answer: D

Rationale: The correct answer is D) Patients remain responsive and breathe without assistance. In the context of moderate sedation, it is crucial for the nurse to communicate with the family about what to expect during the procedure. Moderate sedation, also known as conscious sedation, is a controlled state of sedation where the patient is able to maintain their own airway and respond to verbal or tactile stimulation. This allows for procedures such as realignment of fractures to be performed with the patient in a more relaxed state without the need for general anesthesia. Option A) Includes inhalation agents is incorrect because moderate sedation typically involves medications administered intravenously, not through inhalation. Option B) Induces high levels of sedation is incorrect as moderate sedation is meant to keep the patient in a state of reduced consciousness but still able to respond. Option C) Frequently used for traumatic injuries is incorrect because while moderate sedation can be used for various procedures including those for traumatic injuries, it is not specific to this type of situation. Educationally, it is important for nurses to have a clear understanding of different levels of sedation and be able to effectively communicate with patients and their families about what to expect during procedures involving sedation. This information helps in ensuring patient safety and managing the expectations of those involved in the care process.