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What is the purpose of a surgical time out?

To discuss post-operative care instructions with the patient

To update the patient's medical record

To ensure that the correct procedure is being performed on the correct patient

To provide the surgical team with a break

Answer and Explanation

The Correct Answer is C

A. To discuss post-operative care instructions with the patient:

Postoperative care discussions typically occur after surgery, not during a time out.

B. To update the patient's medical record:

While documentation is important, the time out is not for record-keeping but for patient safety.

C. To ensure that the correct procedure is being performed on the correct patient:

A surgical time out is a critical safety protocol done immediately before surgery to verify the patient’s identity, the procedure, and the surgical site, helping to prevent wrong-site or wrong-person surgery.

D. To provide the surgical team with a break:

The time out is a focused safety measure, not a rest period.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Adjust the suction pressure, assess the client's response, don clean gloves, insert the suction catheter without suction, apply suction while withdrawing the catheter:

Gloves must be sterile, not clean, for trach suctioning. Also, suction must be tested before insertion.

B. Don sterile gloves, adjust suction pressure, apply suction while inserting the suction catheter, withdraw the catheter without suction, assess the client's response:

Suction should never be applied while inserting the catheter-this can damage mucosa and cause hypoxia.

C. Adjust suction pressure, don sterile gloves, test suction, insert the suction catheter without suction, apply suction while withdrawing the catheter, assess the client's response:

This is the proper sequence for safe and effective suctioning.

D. Don sterile gloves, assess the client's response, adjust the suction pressure, insert the suction catheter without suction, apply suction while withdrawing the catheter:

Suction pressure should be adjusted before donning sterile gloves, and suction should be tested before catheter insertion.

A. Reposition the client and offer her a back rub. B. Determine the time the client last received pain medication. C. Measure the client's vital signs, including temperature. D. Ask the client to rate her pain on a scale from 0 to 10.

Correct Answer is D

Explanation

A. Reposition the client and offer her a back rub:

Non-pharmacologic interventions are helpful, but only after assessing the pain level.

B. Determine the time the client last received pain medication:

This is done after establishing the pain score to decide on safe administration of further analgesia.

C. Measure the client's vital signs, including temperature:

Vital signs may help assess systemic complications, but they do not measure pain directly.

D. Ask the client to rate her pain on a scale from 0 to 10:

The first step in pain management is to assess the intensity, location, and nature of the pain using a pain scale.

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What is the purpose of a surgical time out?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is the correct order for trach suctioning?

Correct Answer is C

Explanation

A nurse is caring for a client who is 1 day postoperative following surgery and reports incisional pain. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

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