As the placenta was delivered and the uterus prepared for closure, the scrub person gathered up all of the sponges and dropped them in the kick bucket while the circulating nurse frantically stuffed them into sponge bag pockets. Sharps, sponges, and instrument counts were correct on closure of the uterus and again on closure of the peritoneum. On final sharps and sponge counts before skin closure, a needle was missing. Select the appropriate order of corrective action for the team.

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Perioperative Care NCLEX Questions Questions

Question 1 of 5

As the placenta was delivered and the uterus prepared for closure, the scrub person gathered up all of the sponges and dropped them in the kick bucket while the circulating nurse frantically stuffed them into sponge bag pockets. Sharps, sponges, and instrument counts were correct on closure of the uterus and again on closure of the peritoneum. On final sharps and sponge counts before skin closure, a needle was missing. Select the appropriate order of corrective action for the team.

A. Count and verify suture packs, dump and count packs in sterile suture bag, check floor, check back table and Mayo stand, notify surgeon, and check linen and clean and red trash bags. Open clean trash bags tied up in the corner from sterile table setup. B. Recalculate numbers on white board, check back table and Mayo stand, dump and check linen and trash, verify suture packs, notify team of possible missing needle. C. Notify team of needle discrepancy; recount needles on and off sterile field and white board; check sterile field, Mayo stand, and back table; check floor, under OR table, bottoms of shoes, pants' cuffs, and sterile sleeve cuffs; check sponge bags and kick bucket. D. Recount needles on and off sterile field, check sterile field and Mayo stand and back table; check floor, wait to notify team until miscount verified; check red bag trash, compare empty suture packs, total number on white board.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 2 of 5

During a surgical procedure using ketamine as the induction and maintenance agent, the perioperative nurse should:

A. promote a safe, quiet, and low-stimulus environment of care. B. maintain close proximity to the patient and anesthesia provider in case the patient has hallucinations. C. have the difficult airway cart in the room in case of respiratory distress. D. monitor the dosage and amount of ketamine used.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 3 of 5

Select the nursing activity that would reduce the impact of an extrinsic factor that could cause a pressure injury to the patient.

A. Assisting the anesthesia provider with checking and hanging albumin before anesthesia induction B. Washing the patient's back, heels, scapulae, and elbows with chlorhexidine gluconate (CHG) wipes before transfer to the OR bed C. Fluffing the surface of the OR bed with warm bath blankets and eggcrate foam before patient transfer to the OR bed D. Removing all but one layer of linen from the dry polymer elastomer gel mattress surface of the OR bed before patient transfer

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

A frail and thin 91-pound, 83-year-old woman is scheduled for a right pneumonectomy for non-small cell lung cancer. She will be positioned in left lateral position for her procedure. Based on the perioperative nurse's preoperative assessment, identify three position-related nursing diagnoses for this procedure and four relevant nursing interventions. Select from the options to fill in the blanks.

A. Falls; pain; impaired physical mobility; remain at patient's side during induction; use under- and over-body forced air-warming blanket; prevent fluid pooling under dependent areas; pad all bony prominences with foam or gel pads B. Hypothermia, impaired skin integrity; impaired comfort; use under- and over-body forced air-warming blanket; prevent fluid pooling under dependent areas; pad all bony prominences with foam or gel pads; unlock OR bed and transport vehicle after transfer C. Impaired skin integrity; falls; pain; remain at patient's side during induction; use at least four people to assist with lift and transfer; pad all bony prominences with foam or gel pads; unlock OR bed and transport vehicle after transfer. D. Hypothermia; impaired skin integrity; falls; remain at patient's side during induction; use under- and over-body forced air-warming blanket; use at least four people to assist with lift and transfer; pad all bony prominences with foam or gel pads

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 5 of 5

A veteran perioperative nurse remembers a time when all suture needles had eyes, and she even had her own needle rack. She hand-threaded all sutures according to the surgeon's preference. The newer sutures were originally called 'atraumatic' sutures because they did not double back through a needle eye and cause tissue trauma during pulling or suturing through the tissue. Today, we call this manufacturing process of connecting the suture thread to the needle:

A. engineered crimp. B. controlled release. C. reverse cutting. D. swaged.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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