1. A local anesthetic with epinephrine should not be injected into digits because it causes:

1. Vasodilation.
2. Vasoconstriction.
3. Neuropathy.
4. Increased absorption of the anesthetic agent.

Correct answer is B.
Reference: Phippen, M.L., Ulmer, B.C., and Wells, M.P. (2009). Competency for safe patient care during operative and invasive procedures, p. 340. Denver, CO: CCI.
Rationale: Epinephrine is a potent vasoconstrictor; its use in digits can result in ischemia and tissue necrosis. Its vasoconstrictive property prolongs the action of the drug by decreasing its rate of absorption.

2. When considering delegation of a nursing task to unlicensed assistive personnel, all of the following should be taken into account except:

1. Competency of the delegate.
2. Potential for harm.
3. State board’s practice act.
4. Age of the patient Correct

Correct answer is D.
Reference: Rothrock, J. (2011). Alexander’s care of the patient in surgery, p. 10. St. Louis, MO: Elsevier/Mosby.
Rationale: Appropriate delegation is governed by state boards of nursing. Delegated tasks must not require nursing judgment and should be assigned to staff with demonstrated competence.

3. The best method for maintaining a patient’s hemodynamic status while moving her from the lithotomy to supine position is to remove the legs from the stirrups, bring them together simutaneously, and lower them:

1. As rapidly as possible.
2. Slowly, and one leg at a time .
3. Slowly, and both legs at the same time.
4. With the knees flexed and hips adducted

Correct answer is B.
Reference: AORN. (2011). Recommended practices: Positioning the patient. In Perioperative standards and recommended practices, p. 349. Denver, CO: Author.
Rationale: To maintain hemodynamic status, legs should be slowly returned to the bed and one at a time if possible.

4. The primary priority in moving an anesthetized patient is:

1. Patency of IV lines.
2. Correct body alignment.
3. Maintenance of a patent airway.
4. Protection of bony prominences.

Correct answer is C.
Reference: AORN. (2011). Recommended practices: Positioning the patient. In Perioperative standards and recommended practices, p. 344. Denver, CO: Author.
Rationale: Attention should be given to protecting the patient’s airway at all times during patient transfer and positioning.

1. Placing the laser in standby mode when not in use.
2. Having a carbon dioxide fire extinguisher in the room.
3. Using an uncuffed endotracheal (ET) tube.
4. Providing dry towels for draping the patient’s head.

Correct answer is A.
Reference: Rothrock, J. (2011). Alexander’s care of the patient in surgery, pp. 236,673. St. Louis, MO: Elsevier/Mosby.
Rationale: A fire extinguisher is used to extinguish a fire, not to prevent its occurrence. Cuffed tubes should be used; cuff should be filled with saline and a dye to enable rapid identification of a puncture. Wet towels should be used near the laser target area.