Review Scrub nurse: preparation of supplies and equipment on the sterile

Perioperative Nursing > Medical Surgical

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Scrub nurse: preparation of supplies and equipment on the sterile

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Total Questions : 5

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Question 1:

A nurse is preparing to assist with a surgical procedure that involves electrocautery. Which of the following actions should the nurse take to prevent burns to the patient?

A. Place a grounding pad on the patient's skin near the surgical site. B. Apply petroleum jelly to the patient's skin around the surgical site. C. Cover the patient's hair with a wet towel. D. Remove any metal jewelry from the patient.

Answer and Explanation

Choice A:

Placing a grounding pad on the patient's skin near the surgical site is the correct action to prevent burns to the patient during electrocautery. The grounding pad provides a low-current-density pathway for the high-frequency cautery current to return to the electrosurgical unit, thus avoiding injury to other body areas.

Choice B:

Applying petroleum jelly to the patient's skin around the surgical site is not a correct action to prevent burns to the patient during electrocautery. Petroleum jelly is flammable and can ignite during electrocautery, causing fire and thermal injury to the patient.

Choice C:

Covering the patient's hair with a wet towel is not a correct action to prevent burns to the patient during electrocautery. A wet towel can create a conductive pathway for the cautery current to flow through, resulting in burns or shocks to the patient or the staff.

Choice D:

Removing any metal jewelry from the patient is a correct action to prevent burns to the patient during electrocautery, but it is not sufficient by itself. Metal jewelry can cause electrical arcing or heating, leading to skin burns or fire hazards. However, removing metal jewelry alone does not ensure a safe return pathway for the cautery current, which requires a grounding pad as well.

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Question 2:

A nurse is assisting with a surgical procedure that requires a large number of instruments and supplies. Which of the following strategies should the nurse use to facilitate counting and prevent foreign body retention? (Select all that apply.).

A. Use a standardized counting method and sequence for each procedure. B. Separate sponges into groups of five or ten and count them as one unit. C. Keep instruments and supplies on separate trays according to their function. D. Use a white board or paper to record the counts and update them as needed. E. Discard any unused items before the final count.

Answer and Explanation

Choice A:

Using a standardized counting method and sequence for each procedure helps to ensure consistency and accuracy in the counting process. It also reduces the risk of confusion or miscommunication among the surgical team members. This is a recommended standard of practice by the Association of Surgical Technologists (AST).

Choice B:

Separating sponges into groups of five or ten and counting them as one unit helps to facilitate counting and prevent foreign body retention. It also allows for easier identification of missing sponges in case of an incorrect count. This is another recommended standard of practice by the AST.

Choice C:

Keeping instruments and supplies on separate trays according to their function does not necessarily facilitate counting or prevent foreign body retention. It may help to organize the surgical field, but it does not address the issue of counting or documenting the items used during the procedure. Therefore, this is not a correct answer.

Choice D:

Using a white board or paper to record the counts and update them as needed helps to facilitate counting and prevent foreign body retention. It provides a visual reference for the surgical team members and allows for easy verification of the counts at any time during the procedure. It also helps to document any discrepancies or changes in the counts. This is another recommended standard of practice by the AST.

Choice E:

Discarding any unused items before the final count does not facilitate counting or prevent foreign body retention. It may actually increase the risk of losing track of the items used during the procedure or leaving some items inside the patient. Therefore, this is not a correct answer.

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Question 3:

A nurse is assisting with a surgical procedure that involves suturing a wound. Which of the following statements should the nurse make to the surgeon when handing a suture needle?

A. "Here is a curved needle with a cutting edge.” B. "This is a straight needle with a tapered point.” C. "You have a half-circle needle with a reverse cutting edge.” D. "This is an eyed needle with a blunt point.”

Answer and Explanation

Choice A:

This is incorrect because a curved needle with a cutting edge is used for general closure of skin, subcutaneous tissue, and other tissues that are tough or difficult to penetrate A cutting edge needle has a triangular point that can cause more tissue damage and scarring than a tapered point needle.

Choice B:

This is incorrect because a straight needle with a tapered point is used for easily accessible tissues, such as mucous membranes, gastrointestinal tract, or blood vessels A tapered point needle has a round body that gradually tapers to a point, allowing it to pierce through tissues without cutting them.

Choice C:

This is correct because a half-circle needle with a reverse cutting edge is used for suturing at sites that have limited space and require precise placement of stitches, such as ophthalmic, plastic, or cardiovascular surgery A reverse cutting edge needle has a triangular point with the cutting edge on the outer convex curvature of the needle, which helps prevent the suture from tearing through the tissue.

Choice D:

This is incorrect because an eyed needle with a blunt point is used for suturing tissues that are easy to separate, such as liver, kidney, or spleen A blunt point needle has a round body that ends in a blunt tip, which pushes aside the tissue fibers rather than cutting them An eyed needle has an eye at the end of the needle where the suture thread is inserted, which can cause more drag and tissue trauma than a swaged needle that has the suture attached to the end of the needle.

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Question 4:

A nurse is assisting with a surgical procedure that involves applying a dressing to the wound. Which of the following statements should the nurse make to the patient after the procedure?

A. "You should change your dressing every day and keep it dry.” B. "You can shower with your dressing on, but do not soak it in water.” C. "You should inspect your dressing for signs of infection, such as redness, swelling, or drainage.” D. "You can remove your dressing after 24 hours and leave the wound open to air.”

Answer and Explanation

Choice A:

This is incorrect because changing the dressing every day and keeping it dry may not be appropriate for all types of wounds. Some wounds may require more frequent dressing changes or moist wound healing environment to promote healing and prevent infection.

Choice B:

This is incorrect because showering with the dressing on may cause the dressing to become wet and contaminated, which can increase the risk of infection and delay healing. The dressing should be changed before and after showering, and the wound should be protected from water as much as possible.

Choice C:

This is correct because inspecting the dressing for signs of infection, such as redness, swelling, or drainage, is an important part of wound care. The patient should be taught how to recognize and report these signs to the health care provider as soon as possible. Early detection and treatment of infection can prevent complications and promote healing.

Choice D:

This is incorrect because removing the dressing after 24 hours and leaving the wound open to air may not be advisable for some wounds, especially those that are deep, large, or at risk of infection. The wound may need to be covered with an appropriate dressing for a longer period of time to protect it from contamination, maintain moisture balance, and support healing.

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Question 5:

A nurse is assisting with a surgical procedure that involves placing a drain in the wound. Which of the following actions should the nurse take to ensure proper functioning of the drain?

A. Compress the drain reservoir before closing the wound. B. Secure the drain tubing to the patient's skin with tape. C. Empty the drain reservoir when it is half full and measure the output. D. Flush the drain tubing with saline solution every 4 hours.

Answer and Explanation

Choice A:

Compressing the drain reservoir before closing the wound creates a vacuum that helps to suction out the fluid from the wound and prevent infection. This is a common practice for bulb-type drains that apply gentle suction.

Choice B:

Securing the drain tubing to the patient's skin with tape is not necessary and may cause skin irritation or damage. The drain tubing can be attached to the patient's clothes with a safety pin or secured near the bandage.

Choice C:

Emptying the drain reservoir when it is half full and measuring the output is part of the drain care at home, not during the surgical procedure. The patient or caregiver should empty the drain 2 to 3 times a day (or more), depending on the amount of output, and record it in a chart.

Choice D:

Flushing the drain tubing with saline solution every 4 hours is not recommended and may introduce infection or clog the tubing. The tubing should be kept clear by squeezing or "milking” it occasionally to prevent clots from forming. : Instructions for Surgical Drain Care - Cleveland Clinic : How to Care for Your Surgical Drain at Home - Verywell Health : Surgical Drain Care: Care Instructions | Kaiser Permanente.

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Scrub nurse: preparation of supplies and equipment on the sterile

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