RN A v2: Prophecy- Core Mandatory (Nursing) Exam 2022.

Prophecy- Core Mandatory (Nursing) Exam 2022. What type of support would you place to alleviate pressure on the brachial plexus nerve when a patient is in a side-lying position You are the circulating nurse confirming consent with a patient scheduled for an exploratory laparotomy with colostomy. The patient states they do not want a colostomy. What should you do? What equipment is most important for a patient undergoing an emergency trauma surgery who declines a donated blood transfusion You have been asked to take a specimen from an OR during a bronchoscopy and immediately take it to the lab. What must you do first You suspect long-term substance abuse during the pre-op interview with your patient. Which of the following assessment findings would support this suspicion After applying an alcohol-based skin preparations for a laser procedure, what should you do next What medication should be administered to a patient who has received moderate sedation with midazolam who has unexpected respiratory depression After starting a blood transfusion, you observe that a patient undergoing moderate sedation has a temperature increase from 98.2 to 101.3 and coarse breath sounds. What is the first thing you should do What is the minimum distance unscrubbed personnel should remain from the sterile field You are preparing a patient for a laparotomy. What instrument do you anticipate seeing on the back table Which of the following medications is contraindicated for a patient with a family history of malignant hyperthermia You are caring for a patient who is infected with Methicillin- Resistant Staphylococcus Aureus (MRSA). What infection control practice must you implement after transferring the patient Upon opening a sterile major tray, you discover the chemical indicators are missing. What should you do? As a circulator, where do you stand during induction You are the perioperative nurse who is doing the preoperative skin preparation on a clean abdominal case. Where should you start the skin preparation A patient was prepared for intubation by mask ventilation with a mixture of sevoflurane, nitrous oxide, and oxygen. One minute after intubation their heart rate increased from 160 to 195 b/m. Soon the patient's end tital carbon dioxide concentration was increased from 35 to 65 mmHg. Also, the patient's oral temperature increased to 38.9 within 5 minutes after induction. What is the patient experiencing After draping the left side of the patient, how should you drape the right side What is the safest location for sharps during a surgical procedure You review the patient's chart and discover that the patient has an allergy to penicillin. What medication order should you be worried about Upon arrival to PACU you notice your patient is having a laryngospasm. What is the first action When should a surgical "Time Out" be performed Your OR patient has a suspected diagnosis of pulmonary tuberculosis. What type of transmission based precaution is needed The scrub tech is preparing to count for a laparoscopic cholecystectomy and notices that the lap sponges on the back table have no visible x-ray detectable strip. What should the circulator do In the preoperative holding area, the patient's preoperative lab values are K+2.9, Hgb 14.3, Hct 42.0 and glucose 89. What should you do? A patient is scheduled to have a total knee arthroplasty. What lab value should you be most concerned about and need to inform the surgeon? What type of medication might be used during ophthalmic surgery for severe allergic condition When prepping a patient for general surgery with laparoscopy, in what order should you drape them? What is the most important action for the circulator to do to prevent post-orthopedic surgery infection In what order should you apply a sterile drape You are taking a patient to PACU who just had a fractured mandible repaired. What supply do you need to transport with your patient When should you and surgical team members perform a surgical count for an open thoracotomy? You are the scrub nurse on a case in which a vendor is present. The vendor has a packaged product that they would like to hand to the surgeon. What should you do? You are the circulating nurse and have received 2 units of packed red blood cells that are to be transfused immediately. Present in the room are the surgeon, surgical tech, CRNA and radiology technician. Who should you ask to assist with checking the blood before the transfusion The anesthesiologist informs you that the next patient is a difficult intubation. Which equipment will you expect to have in the room? You are near the entrance to the operating room department when a vendor approaches you and asks where to go. What should you do first? What is an important step for the prevention of biofilm developing on a flexible endoscope You are the circulating nurse. What class of surgical wound would you document for a patient with preoperative fever who underwent tonsillectomy in the presence of a large amount of purulent drainage for which the surgeon has ordered intravenous antibiotics The scub nurse has asked you for a heavy sterile instrument that is wrapped. After opening the package, how should you give them the instrument You are scubbed in during the middle of a procedure when you see a blood soaked sponge on the floor 2 feet from the sterile field. What should you do Which of the following assignments can a circulator delegate to a non licensed surgical associate Immediately after surgery, your patient is exhibiting symptoms of dizzyness, cyanosis, shivering, and disoriented. These findings most likely indicate what condition which type of endoscope should you have present for use during a low anterior colon resection Who is responsible for documenting the operative time out The room has already been set up with latex gloves when your patient reports a mild rash on contact with latex. What should you do first What is proper surgical attire for non sterile scrubbed personnel What is the primary purpose of slowly lowering a patient's legs from the lithotomy position The surgeon is preparing to clamp bleeding vessels. What type of instrument should you prepare for the surgeon You are preparing the OR for a total knee replacement. What supply do you anticipate needing What type of gloves should be worn when transporting endoscopes to and from storage cabinets A patient is extubated after surgery and is receiving 6l O2 via mask. Upon arrival to the PACU the nurse notices a decrease in SaO2 to 89% from 99% and snoring. What is the first action to take Before a case, what reference should you use to understand how the surgical team wants their instruments and equipment to be positioned Immediately upon bringing a medication to the sterile field, the circulator and scrub technologist should ensure that it is labeled, at the minimum, with medication name and what two other pieces of information As you prepare the room for an open exploratory laparotomy, what pieces of basic equipment should you prepare to setup A patient is allergic to shellfish and is scheduled for an exploratory laparotomy. What is the solution of choice for prepping the abdomen considering the patient's allergy If a patient reports a family history of malignant hyperthermia, you should be prepared to administer which medication should such an emergency arise The surgeon has asked you to hand them a piece of equipment. How should you use closed loop communication to respond The first patient in the OR was closed at 0650 and left the OR for PACU at 0700. The surgeon left the room at 0655. The next patient arrives in the OR at 0718. What is the turnover time in this situation What is the surgical start time based on the following events: intubation occurred at 0618, the surgeon entered the room at 0622, the first incision was made at 0631, and the implant was placed at 0714 in the preoperative holding area the patient's vital signs reveal a heart rate of 45 bpm and blood pressure of 171/95 mmHg. What is your priority action You assist with transporting a patient to the PACU with the anesthesia provider. The patient is sedated and the PACU nurse is at the bedside. What should you do next You are assisting with dental cases. During the procedure the team observes the patient having uncontrollable shaking. What is the team's priority action What temperature is considered the threshold for hypothermia in the postoperative setting What nerve is most likely to be affected when the patient has a loss of sensation in the lateral portion of a hand and an inability to abduct or oppose the fifth finger (claw hand) You are in the operating room with a patient and the anesthesia provider after surgery. As you prepare to transport the patient to PACU you notice that the surgical dressing is saturated with blood. What should be the most appropriate nursing action A patient with allergy to penicillin receives a test dose of cefazolin and starts to develop hives. What medication would you consider giving You are the circulating nurse working on a case with a surgical technologist who is confrontational and has an aggressive communication. During the case, the surgical tech repeatedly tells you how to perform nursing tasks. What is the best response