Intraoperative Nursing Roles Practice Questions
19 free Intraoperative Nursing Roles practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
A circulating nurse is monitoring a client during a surgical procedure. Which action is a primary responsibility of the circulating nurse as opposed to the scrub nurse?
- A Handing sterile instruments to the surgeon
- B Assisting with the application of sterile drapes
- C Maintaining an accurate count of sponges on the sterile field
- D Coordinating the movement of personnel in the operating room
Correct answer: Coordinating the movement of personnel in the operating room
The circulating nurse works in the non-sterile field and is responsible for managing the nursing care within the OR, including coordinating personnel and equipment. The scrub nurse remains within the sterile field to handle instruments and assist the surgeon directly.
During a surgical procedure, the scrub nurse notices a small tear in their sterile glove. Which action should the scrub nurse take first?
- A Notify the circulating nurse and step away from the field to change
- B Wait until the current surgical step is completed to change the glove
- C Apply a second sterile glove over the torn one to maintain the barrier
- D Ask the surgeon to pause while the circulating nurse tapes the tear
Correct answer: Notify the circulating nurse and step away from the field to change
Immediate action is required to maintain surgical asepsis when a breach occurs. The scrub nurse must notify the team, step away from the sterile field to prevent contamination, and replace the glove using proper technique.
A client is being positioned in the lithotomy position for a gynecological procedure. Which nerve is at the highest risk for injury in this position?
- A Peroneal nerve
- B Radial nerve
- C Vagus nerve
- D Phrenic nerve
Correct answer: Peroneal nerve
The lithotomy position puts significant pressure on the lateral aspect of the knee if not padded correctly. This can compress the common peroneal nerve, leading to foot drop or sensory loss.
The surgical team is performing a 'Time Out' before the first incision. Which information must be verified during this process according to The Joint Commission?
- A The client's insurance provider and billing codes
- B The surgeon's medical license number and years of experience
- C The number of family members present in the waiting room
- D The correct client, correct site, and correct procedure
Correct answer: The correct client, correct site, and correct procedure
The Universal Protocol requires a 'Time Out' immediately before starting the procedure. The entire team must verify the client's identity, the surgical site (often marked), and the specific procedure to be performed.
While monitoring a client under general anesthesia, the circulating nurse notes a sudden rise in end-tidal CO2, muscle rigidity, and a temperature of 102°F (38.9°C). Which medication should the nurse prepare to administer?
- A Epinephrine
- B Naloxone
- C Atropine sulfate
- D Dantrolene
Correct answer: Dantrolene
These are classic signs of malignant hyperthermia, a life-threatening hypermetabolic crisis. Dantrolene is the primary pharmacologic treatment used to stop the release of calcium from the sarcoplasmic reticulum.
The scrub nurse is preparing the sterile field. Which area of the sterile gown is considered sterile?
- A The entire back of the surgical gown
- B The neckline and both shoulder areas
- C The axillary areas and sleeve cuffs of the gown
- D The front of the gown, chest to sterile field
Correct answer: The front of the gown, chest to sterile field
Sterile gowns are only considered sterile on the front from the chest to the sterile field level and the sleeves from 2 inches above the elbow to the cuffs. The back, neckline, and axillary regions are considered unsterile due to moisture or lack of visibility.
Which action by the circulating nurse best promotes client safety during the use of an electrosurgical unit (ESU)?
- A Placing the grounding pad over a bony prominence
- B Applying the grounding pad to an area with excessive hair
- C Placing the grounding pad over a metal prosthesis
- D Placing the pad on a well-muscled area close to the site
Correct answer: Placing the pad on a well-muscled area close to the site
A grounding pad (dispersive electrode) must be placed on clean, dry skin over a large muscle mass to ensure a good electrical return path. Placing it over bone, hair, or metal can cause electrical burns.
A client is undergoing surgery under spinal anesthesia. The nurse should monitor most closely for which adverse effect?
- A Hypotension
- B Hypertension
- C Tachycardia
- D Hyperreflexia
Correct answer: Hypotension
Spinal anesthesia can cause vasodilation due to the blockade of the sympathetic nervous system. This often results in a rapid drop in blood pressure, necessitating close monitoring and fluid resuscitation.
The circulating nurse is documenting the intraoperative care. Which entry is most important regarding the sponge and instrument count?
- A The count is reconciled and correct before wound closure.
- B The count was performed by the surgeon and scrub nurse.
- C The counts were performed twice during the pre-operative phase.
- D The count was omitted because the surgery was an emergency.
Correct answer: The count is reconciled and correct before wound closure.
The circulating nurse and scrub nurse must perform and document counts before the procedure, when new items are added, and before the wound is closed. Reconciling the count ensures no foreign objects are left inside the client.
A client in the OR is receiving moderate sedation (conscious sedation). Which assessment is the priority for the nurse?
- A Level of consciousness and respiratory status
- B Deep tendon reflexes in the lower extremities
- C Bowel sounds in all four quadrants
- D Urinary output via Foley catheter
Correct answer: Level of consciousness and respiratory status
Moderate sedation allows the client to maintain their own airway and respond to commands. However, the nurse must prioritize airway patency, oxygenation, and the ability to be aroused to ensure the client is not sliding into deep anesthesia.
When moving a client from the stretcher to the operating table, what is the nurse's priority for preventing injury?
- A Keeping the client's arms crossed over their chest
- B Ensuring the stretcher wheels are locked
- C Placing the client in a Trendelenburg position immediately
- D Covering the client with a warm blanket
Correct answer: Ensuring the stretcher wheels are locked
Safety during transfer is paramount. Locking the wheels of both the stretcher and the operating table prevents the surfaces from separating, which could lead to the client falling between them.
The scrub nurse is assisting with a procedure and the surgeon requests a suture. How should the scrub nurse pass the needle holder?
- A Point the sharp needle tip toward the surgeon's open, waiting palm
- B Place the needle holder in the surgeon's hand, tip pointing away
- C Toss the suture packet onto the sterile field for the surgeon
- D Let the needle hang loose from the needle holder during the pass
Correct answer: Place the needle holder in the surgeon's hand, tip pointing away
Surgical instruments, especially sharps, should be passed in a way that prevents injury to the team. The needle holder should be placed firmly in the surgeon's hand with the needle tip visible and pointing away from the surgeon's hand.
The circulating nurse observes a break in sterile technique by a surgical resident. Which action is most appropriate?
- A Wait until after the surgery to discuss the break with the resident
- B Report the resident to the Chief of Surgery immediately
- C Point out the break immediately and assist in correcting it
- D Ignore it if the surgeon does not seem concerned
Correct answer: Point out the break immediately and assist in correcting it
The circulating nurse is an advocate for the client and must maintain the 'surgical conscience.' Any break in technique must be addressed immediately to prevent surgical site infections.
A client is positioned in the prone position for spinal surgery. The nurse ensures that the chest is supported on bolsters primarily to:
- A Prevent pressure-related skin breakdown over the knees
- B Allow full chest expansion and lung ventilation
- C Keep the client from sliding off the operating table
- D Improve surgical access to the femoral artery
Correct answer: Allow full chest expansion and lung ventilation
In the prone position, the weight of the body can compress the chest and abdomen, making ventilation difficult. Bolsters support the chest and pelvis, allowing the abdomen to hang free and the chest to expand fully.
The nurse is caring for a client receiving general anesthesia. Which stage of anesthesia is associated with the loss of the lid reflex and the onset of regular breathing?
- A Stage I: Analgesia
- B Stage II: Excitement
- C Stage III: Surgical Anesthesia
- D Stage IV: Medullary Depression
Correct answer: Stage III: Surgical Anesthesia
Stage III is the goal for most surgeries, characterized by unconsciousness, regular respirations, and the absence of certain reflexes. Stage II is dangerous due to irregular breathing and potential laryngospasm.
Which task can the circulating nurse safely delegate to an unlicensed assistive personnel (UAP) in the OR?
- A Obtaining extra sterile supplies from the storage room
- B Performing the final sponge count with the scrub nurse
- C Monitoring the client's cardiac rhythm during induction
- D Positioning the client on the operating table
Correct answer: Obtaining extra sterile supplies from the storage room
A UAP can perform non-clinical tasks such as retrieving supplies. Counts, monitoring, and positioning (which involves clinical judgment regarding nerve and skin protection) must be done by licensed nursing staff.
During surgery, the surgeon uses a large amount of irrigation fluid. What is the circulating nurse's primary responsibility regarding this fluid?
- A Tasting a sample of the fluid to confirm it is normal saline
- B Recording the total amount of fluid used to calculate blood loss
- C Ensuring the fluid is ice cold to prevent bleeding
- D Warming the fluid to body temperature to prevent hypothermia
Correct answer: Warming the fluid to body temperature to prevent hypothermia
Maintaining normothermia is a critical intraoperative nursing goal. Using warmed irrigation fluids helps prevent core body temperature drops, which can lead to poor wound healing and coagulopathy.
A client is being prepared for surgery. The nurse notes the client has a history of latex allergy. Which action is most important?
- A Administering an antihistamine 10 minutes before the surgical incision
- B Scheduling the client as the very first case of the day
- C Removing all latex items from the OR and using latex-free carts
- D Double-gloving with latex gloves to provide an extra barrier
Correct answer: Removing all latex items from the OR and using latex-free carts
For a client with a known latex allergy, a latex-free environment must be created. This includes using non-latex gloves, tubing, and supplies to prevent a type I hypersensitivity reaction.
Which member of the surgical team is responsible for managing the client's physiological status, including fluid balance and airway?
- A The Surgeon
- B The Scrub Nurse
- C The Anesthesia Care Provider
- D The First Surgical Assistant
Correct answer: The Anesthesia Care Provider
The Anesthesia Care Provider (Anesthesiologist or CRNA) is responsible for the client's vital signs, level of anesthesia, and overall physiological homeostasis during the intraoperative period.