Deck 4: Emergencies

Question 1

Which of the following is a true statement regarding a laryngeal mask airway?

A)The laryngeal mask airway can be used when the patient is difficult to intubate.
B)The laryngeal mask airway is most commonly used with regional anesthesia.
C)The laryngeal mask airway cannot be used on children.
D)Both B and C.

Answer 1

The laryngeal mask airway can be used when the patient is difficult to intubate.

Question 2

A patient has been admitted to the post-anesthesia care unit and during assessment, begins to develop shortness of breath and wheezing respirations. Their oxygen saturations are falling. The patient is awake and becomes extremely anxious as they try to breathe. What is the nurse's response?

A)Tell the patient to calm down, they are just being anxious.
B)Reposition the patient on their left side and have them take several deep breaths.
C)Hyperextend the patient's neck and provide oxygen via bag-mask ventilation.
D)Call the physician for an emergency tracheotomy.

Answer 2

Hyperextend the patient's neck and provide oxygen via bag-mask ventilation.

Question 3

When providing an alarm system for an operating suite to use in case of emergency, which of the following are important design factors?

A)All surgical personnel should know how to activate the alarm and what to do when it is turned on.
B)The alarm should clearly notify personnel of an emergency by flashing lights and emitting a loud noise within the surgical suite.
C)The alarm should notify personnel who are outside of the operating room, such as those at the nurse's station nearby.
D)Both A and C

Answer 3

Both A and C

Question 4

Which of the following are essential aspects of preparing staff for emergency situations in the operating room?

A)Requiring staff to read the policy about emergency procedures upon hiring.
B)Deciding on the person who will be the head of the chain of command when an emergency arises.
C)Performing routine practice drills for staff to be prepared in case of emergency.
D)Both A and B

Question 5

Which of the following measures can the nurse perform to prevent the risk of a fire breaking out in the operating suite?

A)Wrapping an extension cord snugly around equipment to avoid damage to the cord.
B)Teaching scrub nurses about what to do in case of fire and performing proficiency testing annually.
C)Inspecting electrical equipment regularly to look for cracks or damage that could contribute to a fire.
D)Unplugging electrical cords by grasping the cord to pull, rather than the head of the cord.

Question 6

Which of the following measures is an example of patient burn prevention in the perioperative period?

A)Cleaning tables and supplies with acetone solution.
B)Placing towels under the patient during the skin preparation to collect fluid.
C)Storing flammable liquids next to the patient monitor, away from the electrosurgical unit.
D)Both B and C

Question 7

A patient with a previously unknown latex allergy suddenly develops respiratory distress and wheezing when exposed to latex materials in the surgical suite. What is the nurse's initial reaction in this situation?

A)Remove the offending products and arrange for another cart of latex-free products to be brought to the operating room.
B)Assess the patient's heart rate, blood pressure, and respiratory rate, provide oxygen and continue to monitor.
C)Administer epinephrine via autoinjector into the patient's thigh.
D)Contact the hospital administrator for action against the distribution center that provided latex products.

Question 8

A patient is given anesthesia during the induction period and begins to develop muscle stiffness and cyanosis. His temperature is noted to be increasing at a rate of two degrees Celsius approximately every five minutes. What condition has this patient most likely developed?

A)Latex allergy reaction
B)Pulmonary embolism
C)Malignant hyperthermia
D)Stroke

Question 9

Following a surgical procedure, a patient must remain intubated and will be eventually be transferred to the intensive care unit. During transfer to the post-anesthesia care unit, the patient's oxygen saturation levels begin to drop and they appear cyanotic. What is the appropriate action of the nurse?

A)Increase oxygen amount administered and check oxygen saturation levels again in five minutes.
B)Listen to breath sounds to determine if the endotracheal tube is still in place.
C)Turn the patient to their side and suction their mouth.
D)Pull the endotracheal tube and begin ventilating by bag and mask.

Question 10

During a surgical procedure, the patient develops uncontrollable bleeding and is quickly progressing into shock. The nurse begins the process of fluid resuscitation. What types of fluids should be administered in this situation?

A)Crystalloids, such as Ringer's lactate
B)Colloids, such as albumin
C)Hypotonic solutions, such as 0.45% NaCl
D)Both A and B

Question 11

What is the process for managing an overdose of anesthesia during the surgical procedure?

A)Extubate the patient and stop the surgical process.
B)Decrease the amount of anesthesia while increasing oxygen.
C)Stop the anesthetic and administer a narcotic antagonist.
D)Both A and C

Question 12

The anesthesiologist has started the induction of anesthesia and the patient begins to shout and is struggling on the bed. The nurse responds to this appropriately by:

A)Taking the patient by the arms and holding them down.
B)Getting the patient's attention by clapping their hands in the patient's face.
C)Stroking the patient's forehead and calmly whispering in their ear.
D)Staying next to the patient and keeping everyone else in the room quiet.

Question 13

A patient is given spinal anesthesia for a surgical procedure on the abdomen. After several minutes, the patient states, "I can't feel my stomach," and then develops respiratory distress. The surgical team must provide respiratory assistance to maintain the patient's oxygenation levels. What is the most likely cause of this situation?

A)The patient developed a pulmonary embolism from lying on the bed for so long.
B)The spinal block moved too far toward the head, paralyzing the respiratory muscles.
C)The patient became extremely anxious when they realized that they could not feel their abdomen.
D)The patient had an unknown medical condition that caused respiratory failure.

Question 14

Following a surgical procedure with spinal anesthesia, a patient is moved to the PACU where they develop cyanosis around the mouth and their pulse becomes weak and thready. Their blood pressure drops, they start to breathe rapidly, and their skin becomes cool and diaphoretic. Which of the following is the most likely cause of this situation?

A)Deep vein thrombosis
B)Postoperative psychosis
C)Neurogenic shock
D)Pneumonia

Question 15

Following surgery, a patient with no previous mental health problems is experiencing hallucinations, trying to crawl out of bed, and is threatening the nurse. Which of the following actions is most appropriate in this situation?

A)Contact psychiatric services to admit the patient to the mental health unit.
B)Notify the house supervisor about the need for patient restraints.
C)Contact the physician for an order for restraints.
D)Isolate the patient, remove potentially harmful objects, and continue to try and calm the patient.

Question 16

A perioperative nurse is assessing a patient recovering from abdominal surgery. As they check the incision site, blood rushes out, followed by loops of intestine. Which intervention is necessary for an abdominal evisceration?

A)Put on sterile gloves and carefully push the loops of bowel back into the wound.
B)Place sterile dressings moistened with saline over the intestines.
C)Notify the surgeon of the need for surgical intervention.
D)Both B and C

Question 17

A patient has developed a pleural effusion during the post-surgical procedure and is short of breath. Which of the following treatments is performed to relieve excess fluid and improve the patient's breathing?

A)Thoracotomy
B)Thoracentesis
C)Incentive spirometry
D)Thoracoscopy

Question 18

A patient is receiving thrombolytic therapy to treat a large clot that has formed as a pulmonary embolism while on the post-surgical unit. The patient begins to bleed profusely from the nose and the intravenous line. What is the nurse's response?

A)Apply direct pressure to major sites of bleeding to induce clotting.
B)Increase the rate of fluid and electrolytes while decreasing the thrombolytic therapy.
C)Apply cold compresses to bleeding sites and assess respiratory function.
D)Stop the thrombolytic therapy completely and notify the physician.

Question 19

Which of the following must be considered when resuscitating a patient using a bag and mask to provide oxygen?

A)Place the mask on the patient's face, covering the mouth, and secure with the thumb and index finger.
B)Extend the patient's neck to open the airway by pulling the chin and jaw upward.
C)Squeeze the bag to its full volume with the hand opposite that holding the mask.
D)Both B and C

Question 20

The perioperative nurse assists with an emergency intubation of a patient who has developed respiratory distress. The patient's oxygen saturation levels are increasing and there is symmetrical chest expansion. What is the nurse's next action?

A)Suction the endotracheal tube to clear secretions.
B)Obtain a chest x-ray to verify correct placement of the tube.
C)Secure the tube to the patient's face to prevent accidental extubation.
D)Trim down any excess length of the tube to prevent kinking.

Question 21

A patient has been placed on a ventilator as part of recovery following surgery. After several hours, they begin to show jerking muscle movements and are trying to breathe around the ventilator, causing increased airway pressure. What is the nurse's most appropriate intervention at this point?

A)Change the settings on the ventilator so the alarm does not continue.
B)Administer a muscle relaxant to calm the patient and prevent breathing around the ventilator.
C)Call respiratory therapy to change the circuits on the ventilator.
D)Administer a paralytic agent to suppress the patient's muscle activity and prevent excess breathing around the ventilator.

Question 22

The perioperative nurse is caring for a patient with a chest tube when they notice an extensive amount of bubbling in the water seal chamber of the device. The patient has developed cyanosis and shallow breathing. What is the nurse's next action?

A)Tell the patient to take a deep breath and cough.
B)Milk the tubing to dislodge any clots that may have developed.
C)Replace the chest tube.
D)Notify the physician.

Question 23

A patient is admitted for a traumatic abdominal injury, which requires surgery. While in the operating room, the perioperative nurse sets up to insert an indwelling catheter and notices blood coming from the patient's urinary meatus. What is the nurse's next intervention?

A)Insert the catheter and check for the presence of blood in the urine output.
B)Insert a straight catheter instead of an indwelling catheter to empty the bladder in case of injury.
C)Insert the catheter and perform an ultrasound of the bladder.
D)Do not insert the catheter and notify the physician.

Question 24

What is the purpose of critical incident stress debriefing for a patient with an adverse outcome?

A)To discuss painful feelings related to the situation.
B)To talk about what interventions were incorrect when caring for the patient.
C)To protect the nurses and physicians involved from liability.
D)To give caregivers involved in the situation time off from work.

Question 25

While preparing a patient for surgery, the patient suddenly begins to have a seizure. Sputum is collecting around their mouth and lips. What is the nurse's response?

A)Take the patient by the arms and hold them to their sides.
B)Insert a bite block between the teeth to prevent choking.
C)Stay by the patient and prevent him from injuring themself.
D)Turn the patient to their side and cover them with a blanket.

Question 26

In the middle of a surgical procedure, the patient on the table goes into cardiac arrest and needs CPR. What is the first action of the perioperative nurse?

A)Turn on the alarm to notify others of the need for assistance.
B)Verify that the patient does not have a heart rate.
C)Administer oxygen by bag and mask ventilation.
D)Begin chest compressions at a rate of 100 per minute.

Question 27

During a laparoscopic abdominal procedure, a patient has been placed in the reverse Trendelenburg position and given anesthesia. The patient begins to develop hypotension and their blood pressure drops to 96/52 mmHg. What is the first intervention of the nurse?

A)Open the intravenous line to instill more fluids.
B)Change the bed position so the patient's head is level.
C)Call the Blood Bank for volume expanders to treat hypotension.
D)Increase the CO2 rate on the insufflator.

Question 28

A patient is admitted with severe burns over 50 percent of their body. The nurse inserts an IV to begin fluid administration and for medications. What is the typical process of fluid shift for this type of patient within the first 48 hours?

A)Fluid is pulled out of the blood vessels and into the tissues.
B)Fluid is pulled out of the tissues and into the blood vessels.
C)Fluid maintains equilibrium between the blood vessels and the tissues.
D)Fluid movement depends on the type of burn and the patient's electrolyte status.

Question 29

During a surgical procedure, the patient develops an atrial fibrillation. Which of the following conditions is a potential adverse outcome for failing to manage this condition?

A)Hypotension
B)Blood clots
C)Impaired wound healing
D)Death

Question 30

A patient who is normally on blood pressure medication has stopped taking their medicine before having surgery. While in the hospital, they develop a hypertensive emergency, requiring intravenous medication to bring their blood pressure down. Which of the following is a potential complication associated with a hypertensive emergency?

A)Blood clots
B)Stroke
C)Pain
D)Vomiting

Question 31

A nurse is assisting with a cesarean section and notes that the fetus appears to be in distress. Upon delivery, the baby is limp and pale, with meconium staining the amniotic fluid. What is the most appropriate action of the nurse?

A)Move the baby to a radiant warmer and stimulate it to breathe and cry.
B)Turn the baby prone and slap the soles of its feet.
C)Provide tracheal suctioning to remove meconium from the airway.
D)Wrap the baby up in a blanket and take it to see its mother.

Question 32

Which of the following measures is necessary when working with a patient who has been exposed to anthrax?

A)Anthrax spreads from person to person through blood and body fluids, so personal protective equipment is essential.
B)The nurse should wear a positive air pressure ventilator or N95 mask when working with this type of patient.
C)Anthrax causes no symptoms within the first 48 hours, making it very dangerous for transmission.
D)Over 95 percent of people who become infected with anthrax will fully recover.