Which member of the surgical team does not scrub in the OR?

Correct Answer: B

Rationale: In the Operating Room (OR), the circulating nurse is the member of the surgical team who does not scrub in. The circulating nurse plays a crucial role in ensuring the smooth functioning of the surgical procedure by managing the overall flow of the OR, obtaining additional supplies or equipment as needed, documenting the procedure, and maintaining communication between the OR team and other areas of the hospital. The surgeon (option A) is directly involved in the surgery and must scrub in to maintain a sterile environment. The scrub nurse or surgical tech (option C) assists the surgeon during the procedure and is responsible for maintaining the sterile field. The holding area nurse (option D) cares for the patient before they are taken into the OR and is not a member of the surgical team in the OR. Understanding the roles of each member of the surgical team is essential for providing safe and effective patient care in the perioperative setting. Educating healthcare professionals on these roles ensures that they can work collaboratively and efficiently to deliver optimal patient outcomes during surgical procedures.

Correct Answer: A

Rationale: In the context of adult medical surgical care, a paralytic ileus is a condition characterized by the temporary cessation of normal bowel motility. The correct answer, A) Intravenous fluid replacement and a nasogastric tube connected to suction, is appropriate for managing this condition. Intravenous fluids help maintain hydration and electrolyte balance, while a nasogastric tube connected to suction helps decompress the bowel and reduce abdominal distension caused by gas and fluid accumulation. Option B) Surgical correction of the problem is not the first-line treatment for a paralytic ileus. Surgery is usually reserved for cases where complications like bowel perforation or ischemia occur. Option C) Endoscopic injection of botulinum toxin or esophageal dilation is not indicated for a paralytic ileus, as these interventions are more commonly used for conditions like achalasia or esophageal strictures. Option D) Endoscopy to allow biopsy followed by broad-spectrum antibiotics is not the standard management for a paralytic ileus. Biopsy and antibiotics are usually not indicated unless specific infectious or inflammatory conditions are suspected. Educationally, understanding the appropriate management of a paralytic ileus is crucial for nurses and healthcare providers caring for patients with this condition. Recognizing the signs and symptoms of a paralytic ileus and knowing the appropriate interventions can help prevent complications and promote optimal patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Decreased oxygen-carrying capability of the blood. Anemia is a condition characterized by a decreased number of red blood cells or hemoglobin in the blood, leading to reduced oxygen-carrying capacity. This results in fatigue because the body's tissues and organs do not receive an adequate supply of oxygen to function optimally. Option A) Destruction of red blood cells (hemolysis) is not the primary cause of fatigue in anemia. While hemolysis can lead to anemia, the underlying issue is the decreased oxygen-carrying capability of the blood. Option B) Paleness of the skin is a symptom of anemia due to decreased oxygen levels in the blood, but it does not directly explain why the patient is fatigued. Option C) Lack of nutritional intake of essential nutrients like iron or B12 can lead to certain types of anemia, but the root cause of fatigue in anemia is the decreased oxygen-carrying capacity of the blood. Educationally, understanding the relationship between anemia and fatigue is crucial for healthcare providers to effectively educate patients about their condition. By knowing the underlying mechanisms of anemia-related fatigue, nurses can provide appropriate interventions and support to help manage the patient's symptoms and improve their quality of life.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Pruritis (itching). When there is a build-up of bile salts in the body, it can lead to a condition known as cholestasis. Cholestasis is characterized by the impaired flow of bile from the liver, leading to the accumulation of bile salts in the bloodstream. This build-up can trigger systemic symptoms such as pruritis. Option A) Hypotension is incorrect because hypotension is low blood pressure, which is not directly related to the build-up of bile salts. Option C) Ecchymosis (bruising) is incorrect because bruising is not a typical systemic symptom associated with the accumulation of bile salts. Option D) Urticaria (hives) is incorrect because hives are more commonly associated with allergic reactions rather than bile salt build-up. From an educational perspective, understanding the systemic manifestations of conditions like cholestasis is crucial for nurses and healthcare professionals working in adult medical-surgical settings. Recognizing these symptoms can help in early identification, intervention, and management of patients with such conditions. It also underscores the importance of a comprehensive assessment and knowledge of potential complications in adult medical-surgical care.

Correct Answer: C

Rationale: In the context of septic shock, monitoring airway, breathing, and circulation (ABC) would have the highest priority. This is because septic shock is a life-threatening condition characterized by a systemic inflammatory response to infection, leading to severe hypotension and inadequate tissue perfusion. Monitoring ABC ensures that the patient's vital functions are maintained and supported, which is crucial in stabilizing their condition and preventing further deterioration. Monitoring temperature (Option A) is important in septic shock to assess for fever, a common symptom, but it is not the highest priority compared to ensuring the patient's airway, breathing, and circulation are intact. Monitoring pupillary reaction (Option B) is more relevant in neurological assessments and is not as critical in the immediate management of septic shock. Monitoring ANA and RF levels (Option D) is not a priority in the acute phase of septic shock. These laboratory tests are more related to autoimmune conditions and would not guide the immediate resuscitative actions needed in septic shock. In an educational context, understanding the priority of interventions in managing septic shock is crucial for nurses and healthcare providers in providing timely and effective care to critically ill patients. Emphasizing the ABCs as the foundation of patient assessment and care in emergencies like septic shock reinforces the principles of prioritizing interventions based on the patient's immediate needs to achieve the best outcomes.