A nurse is assisting with positioning a patient on the operating table in the Trendelenburg position. The patient asks, "Why do I have to be in this position?” What should the nurse say?

"This position helps to improve your blood pressure and blood flow to your brain.”

"This position helps to reduce the risk of bleeding and infection in your lower abdomen or pelvis.”

"This position helps to prevent pressure ulcers and nerve damage in your back and legs.”

"This position helps to increase the space and visibility in your upper abdomen or chest."

Answer and Explanation

The Correct Answer is D

Choice A reason:

This is incorrect because the Trendelenburg position does not improve blood pressure or blood flow to the brain. In fact, it may increase intracranial pressure and reduce cerebral perfusion.

Choice B reason:

This is incorrect because the Trendelenburg position does not reduce the risk of bleeding or infection in the lower abdomen or pelvis. It may increase the risk of aspiration, respiratory compromise, and venous congestion.

Choice C reason:

This is incorrect because the Trendelenburg position does not prevent pressure ulcers or nerve damage in the back and legs. It may cause nerve injury due to stretching of the brachial plexus and pressure on the peroneal nerve.

Choice D reason:

This is correct because the Trendelenburg position helps to increase the space and visibility in the upper abdomen or chest by displacing the abdominal organs downward. This may facilitate surgical procedures such as cholecystectomy, hiatal hernia repair, or thoracic surgery.

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Correct Answer is ["A","B","D"]

Explanation

Choice A reason:

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 reason:

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 reason:

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 reason:

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 reason:

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.

A. It allows optimal exposure of the abdominal cavity. B. It prevents injury to the spinal cord and nerves. C. It facilitates drainage of secretions from the mouth and throat. D. It enhances circulation and oxygenation to the brain.

Correct Answer is C

Explanation

Choice A reason:

This is incorrect because the supine position does not allow optimal exposure of the abdominal cavity. The supine position is used for surgeries involving the anterior surface of the body, such as cardiac, thoracic, and cranial surgeries. For abdominal surgeries, other positions such as Trendelenburg or lithotomy may be used to improve access and visualization of the abdominal organs.

Choice B reason:

This is incorrect because the supine position does not prevent injury to the spinal cord and nerves. In fact, the supine position may cause nerve damage or pressure ulcers if the patient's arms, legs, and head are not properly supported and padded. The patient's arms should be abducted less than 90 degrees and the palms should face up to avoid stretching or compressing the brachial plexus and ulnar nerves. The patient's legs should be uncrossed and the heels should be padded to prevent pressure on the peroneal nerve and the skin. The patient's head should rest on a pad or pillow and the neck should be in a neutral position to avoid injury to the cervical spine and nerves.

Choice C reason:

This is correct because the supine position facilitates drainage of secretions from the mouth and throat. The supine position is commonly used during induction and emergence of anesthesia, which can impair the patient's ability to clear their airway. By lying on their back with their face up, the patient can benefit from gravity-assisted drainage of secretions from the mouth and throat, reducing the risk of aspiration or airway obstruction.

Choice D reason:

This is incorrect because the supine position does not enhance circulation and oxygenation to the brain. The supine position may actually decrease the functional residual capacity (FRC) of the lungs, which is the amount of air remaining in the lungs after a normal expiration. This can lead to reduced oxygenation and ventilation of the blood. Additionally, the supine position may cause venous congestion in the head and neck, which can impair cerebral perfusion and increase intracranial pressure. To enhance circulation and oxygenation to the brain, other positions such as reverse Trendelenburg or sitting may be used.

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A nurse is assisting with positioning a patient on the operating table in the Trendelenburg position. The patient asks, "Why do I have to be in this position?” What should the nurse say?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is preparing a patient for surgery in the supine position. What is the rationale for this position?

Correct Answer is C

Explanation

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