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Nursing
Date
Nov 24, 2024
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AORN Periop 101 Questions
In addition to the surgeon, which surgical team members wear sterile gowns and
gloves during the procedure? -
ANS Scrub Person AND Surgical assistant
The pathology laboratory and blood bank are usually situated in which of the
following areas? -
ANS Unrestricted area
What phases of the nursing process does the periopeartive nurse practice during
the preoperative phase of the surgical experience? -
ANS Assessment,
Identification of desired outcome, Nursing diagnosis, Planning
Data collection is part of which phase in the nursing process -
ANS
Assessment
Which of the following is considered a critical perioperative nursing diagnosis
within the PNDS? -
ANS Risk for perioperative positioning injury
Competency statements -
ANS Direct a nurse's activity in the perioperative
arena; Provide a basic model to evaluate the quality of nursing practice;
Ascertain a level of skills and abilities necessary to fulfill the professional role (All
of the above)
Defining nursing goals and intervention strategies is a part of which phase in the
nursing process -
ANS Outcome identification
Match each staff member with the appropriate responsibility -
ANS Scrub
person- Monitors aseptic technique; RN circulator- Creates and maintains a safe
environment; Housekeeping- Cleans the furniture at the end of the OR day;
Nurse anesthetist- administers anesthesia to the patient
Creating cultures that supports patient safety through which of the following
mechanisms? -
ANS Convene and communicate with members about safety;
Incorporate attention to patient safety into training programs; Collaborate across
disciplines.
The IOM report describes the importance of setting standards and expectations
for patient safety. Setting standards can_____ -
ANS Set expectations for the
health professionals; Establish consistency across individuals and organizations;
Help set expectations of consumers and purchases.
Which of the following AORN Position Statement on Correct site of surgery is
true? -
ANS The staff member should verbally verify the correct site with each
member of the surgical team
Maintaining a safe OR environment, staff members are required to -
ANS
Monitor, identify, and reports safety hazards; Understand and comply with the
emergency power outage plan; Practice sound, basic and OR specific electrical
and fire safety.
The elements required to create a cultures of safety include -
ANS A sense of
trust among team members; A sincere commitment of affirming safety as the first
priority; Development and support of a proactive approach rather than a reactive
blaming approach; Dissemination of receipt of information to all levels of staff.
Which of the following practices should be used ti implement the Joint
Commission's Universal Protocol for preventing Wrong Site, Wrong Procedure,
Wrong Person Surgery? -
ANS Using a time-out procedure before beginning
the procedure
The purpose of the National Patient Safety Goals is to -
ANS Promote specific
improvements in patient safety; Highlight problematic areas in health care;
Describe evidence and expert-based system-wide solutions to the problems
AORN's Guidelines for Perioperative Practice provides -
ANS Information on
administrative topics; Information that can be used to develop institution-specific
policies; Scientific evidence for clinical practices.
Which of the following are true about AORN's Guidelines for Perioperative
Practice? -
ANS They are based on what nurses do in ideal situations; They
may be fulfilled to varying degrees in different situations.
Why is it important for perioperative nurses to have a basic understanding of
business principles? -
ANS To enable them to plan safe and effective care that
is also cost-effective; To facilitate competition for patient volume; To manage and
allocate resources wisely
Match the type of budget with its description -
ANS Gross revenue- All monies
received by the facility for goods and services; Fixed expenses- Medical records
and administration; Net revenue- gross revenue minus expenses; Variable costs-
Costs directly related to patient volume
Which of the following definitions are correct? -
ANS Liable means to bind or to
be responsible to or to be under obligation to; Negligence means the failure to
exercise care that a prudent person would perform under the same
circumstances.
Professionalism in nursing means -
ANS Showing personal accountability in
understanding the Nurse Practice Act; Maintaining a current knowledge base;
Participating in professional organizations.
Which of the following social media practices are important for the professional
nurse to follow? -
ANS Acknowledge that anything you post on the internet is
there forever; Do no speak on behalf of your employer unless you have been
authorized to do so; Facebook mixes your personal and professional lives and
requires careful attention.
Benefits of evidence based practice include which of the following? -
ANS The
professional perioperative nurse can base his or her practice on evidence;
Provides point of care clinicians with tools that can assist in improving patient
care, The evidence collected is rated for quality and strength.
Which of the following statements reflects the findings from a research study of
more than 11,000 nurses conducted in 2007 related to the importance of
certification? -
ANS Enhances feelings of personal accomplishment; Validates
specialized knowledge.
For a professional nurse, personal accountability means -
ANS Willingness to
take responsibility for one's actions;
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Being dependable in all situations;
Making the best decisions with the input available;
Willingness to bare consequences for one's actions
Which of the following statements are true about objective data? -
ANS Data
that is the information written in the patient's record and nursing notes;
History, physical, and laboratory data are examples of objective data
Match the age groups with their ability for learning and understanding -
ANS
Birth to one month- The child is able to express only through crying;
1-12 months- The baby will smile, babble, and gurgle;
One to three years- The baby is able to understand and respond to simple
commands;
Three to six years- The child is able to literally interpret terms.
Patients in which of the following age groups have the greatest blood volume per
unit of body weight? -
ANS Children
During the preoperative interview, why should the perioperative nurse ask
patients about their use of herbal preparations, alcohol, tobacco, and recreational
drugs? -
ANS Herbal supplements may affect the metabolism of drugs
administered;
Recreational drug use may affect the choice of preoperative sedation;
Smoking may affect circulatory and respiratory system assessment results.
Which items are included in a psychosocial assessment? -
ANS Coping styles;
cultural beliefs and practices;
Expectations of perioperative care;
Spiritual or religious beliefs
Which of the following statements is true? -
ANS Lung capacity decreases with
increasing age
Which of the following factors make geriatric patients more sensitive to injury and
cold? -
ANS Decrease in subcutaneous fat
Why is it important to assess the use of herbal supplements or recreational drugs
before surgery? -
ANS Herbal preparations can affect bleeding times;
Herbal preparations can interfere with drug metabolism;
Recreational drug use can result in withdrawal symptoms;
Recreational drug users may require higher doses of anesthetic medications.
What interventions can the perioperative nurse perform to protect elderly
patients? -
ANS Employ DVT prophylactic devices;
Position the patient for effective air exchange;
Use warming devices to maintain the normothermia
A child in which of the following age groups can be described as "likes to
socialized and can interpret terms"? -
ANS 3 to 6 years
The goal of patient and family education is to -
ANS Provide information to the
patient;
Improve knowledge;
Achieve long lasting changes in behavior;
Take ownership of the patient's care;
Improve the patient's outcome.
The importance of patient and family education is reflected by which of the
following phrases? -
ANS Improvement in quality of care;
Increase in patient satisfaction;
Increase in patient compliance;
Ethical and legal mandates for patient education
Which of the following form part of patient's ongoing education needs as a
patient? -
ANS Contact information for questions or concerns after surgery;
Counseling on modified diet to be followed after surgery;
List of foods that might interfere with prescribed mediation;
Medications to be given and time intervals for taking.
Factors that affect the patient's ability to learn include -
ANS Disability;
Fear of dying;
Pain;
Self-esteem
The perioperative nurse provides care to each patient undergoing a surgical
intervention in a manner that preserves and protects -
ANS Patient autonomy,
dignity, and human rights
Patient and family education is a combination process involving -
ANS
Influencing behavior;
Producing changes in knowledge;
Producing change in attitudes and skills
Factors that may affect an adult patient's ability to learn include -
ANS Age;
Attitude;
Emotional state;
Intellectual ability;
Physical ability
The perioperative nurse should use the directive interview technique over a
nondirective interview technique when the information he or she needs -
ANS
Consists of predetermined questions;
Consists of questions in a predetermined order;
Is to document the patient's health history
A preoperative patient's DNR order is -
ANS Reconsidered to ensure that the
risks and benefits of anesthesia and surgery are discussed before surgery
Obtaining informed consent is a two step process of -
ANS Communicating
information and documenting the decision
How does the perioperative nurse test the patient's level of understanding? -
ANS By asking questions about the procedure and evaluating the answer
A directive interview is -
ANS Structures with predetermined questions
Factors that may affect the amount of pain the patient will experience
postoperatively are -
ANS The surgical site;
The nature and intended purpose of the surgery;
the patient's fears regarding anesthesia or surgery
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Which of the three elements required for an infection to occur is related to
inanimate environmental surfaces? -
ANS Source or Reservoir
One of the most effective ways to prevent disease transmission and control
infections in health care settings is -
ANS Hand Hygiene
Match the three types of transmission based precautions with the correct
examples of precautions that should be implemented -
ANS Contact- Donning
PPE and environmental cleaning;
Droplet- Donning PPE and patient placement
Airborne- Donning PPE and waring a surgical mask with a respirator level of N95
or higher
The OSHA Bloodborne Pathogen standard requires health care personnel to
wear the following when splashes, spray, spatter, or droplets occur -
ANS
Masks;
Shoe coverings;
Eye protection devices;
Gloves
Which factors determine the likelihood of transmission and persistence of multi
drug resistant organisms -
ANS Effectiveness of prevention methods;
Numbers of colonized patients;
Vulnerability of the patients
Several types of infections may be acquired in the perioperative settting -
ANS
Surgical site infections- SSIs;
Multidrug resistant organisms- MDROs;
Central line associated blood stream nfections- CLABSIs;
Catheter associated urinary tract infections- CAUTIs
Effective methods for preventing SIs include -
ANS Effective environmental
cleaning procedures;
Performance of sterile technique;
Use of surgical attire and other barriers (All of the above)
Immunizations and testing for health care workers should include all of the
following except -
ANS Shingles
Match the correct wound elements with the wound classification -
ANS Class I
Clean- Procedure does not involve the respiratory, alimentary, or genitourinary
tract and no infection or inflammation is present.
Class 2 Clean Contaminated- alimentary, or genitourinary tract is entered under
controlled condition.
Class 3 Contaminated- Gross spillage from GI tract occurs or unsterile
instruments are used .
Class 4 Dirty- A clinical infection exists or an internal organ perforation is present.
Droplet precautions include all of the following except -
ANS Consulting with
the risk manager
The single most important factor in preventing the spread of infection is -
ANS
Hand Hygiene
Damp dusting of the OR as part of the preliminary room preparation should be
done -
ANS In the morning before bringing in any surgical supplies
Which methods are most effective for terminal cleaning floors in the OR -
ANS
Wet vacuum or single use mop
Which of the following is correct regarding the disposal of contents from reusable
suction systems? -
ANS done according to federal, state, and local regulations
Correct statements about spray bottles -
ANS Spray bottles can aerosolize
potentially infectious materials;
Spray bottles are not used to apply disinfectant
The proper device for the disposal of blades, needles, stapling devices, pins, and
cautery tips should be -
ANS A sharps disposal container
The goals of performing post procedure cleaning of the OR/procedure room
include the following -
ANS It renders the environment safe for the patient
following in that room to prevent cross contamination;
It breaks the cycle of contamination from the patient to the environment and from
the environment to OR personnel and then to subsequent patients;
It is the patient's right to have a clean and safe environment.
Terminal cleaning must be done -
ANS Once during each 24 hour period
During post procedure cleaning -
ANS All kick buckets, hampers, and similar
receptacles must be inspected and disinfected as needed;
Transport vehicles are to be considered contaminated after patient contact;
All horizontal surfaces of tables and equipment, including the anesthesia
machine, should be wiped down with a lint free cloth moistened with a hospital
approved disinfectant.
Identify the pathogens that can be commonly found in the OR environement -
ANS Escherichia coli;
Methicilin resistant STaph aureus;
Serratia marcescens.
In which surgical wound category should a total abdominal hysterectomy be
classified? -
ANS Clean contaminated wound
Match terms -
ANS Disinfection- A chemical or physical process of destroying
all pathogenic microorganisms, except spores, on inanimate objects.
Decontamination- The use of physical or chemical means to remove, inactivate,
or destroy bloodborne or other pathogens on a surface or item.
Sterilization- The process of destroying all microorganisms on a substance by
exposure to physical and chemical agents; the complete elimination of all forms
of microorganisms.
High level disinfection- A process that destroys all microorganisms with the
exception of high numbers of bacterial spores.
Immediate use steam sterilization can be used -
ANS In urgent situations
A packing system for items undergoing sterilization should -
ANS Permit
aseptic delivery of contents to the sterile field
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Complete sterilization in ethylene oxide is dependent upon four primary
variables: proper time, gas concentration, temperature, and -
ANS Chamber
humidity
Which of the following is true about ethylene oxide sterilization -
ANS EO
exposure is potentially carcinogenic and mutagenic to personnel and patients
Which of the following is true about the use of peracetic acid on surgical items -
ANS Items must be immersible
An integrator is a multiparameter indicator designed to measure which of the
following parameters -
ANS Temperature, time, and presence of steam
Which of the following are true about low temperature hydrogen peroxide gas
plasma sterilization -
ANS Items can be stored for future use;
No toxic residue is produced;
The sterilant is bactericidal, viruicidal, and fungicidal;
It can be used for items that are heat sensitive.
Shelf life is related to -
ANS Exposure to external events;
Type of packaging material used;
Number of personnel who may have handled the package.
Match the basic categories of surgical instrument with their uses -
ANS
Graspers- To handle tissues and dressings.
Retractors- To provide exposure of the operative site.
Cutting instruments- To incise, cut, dissect, or separate tissue.
Clamps- To hold join, or compress parts together.
A mosquito is classified as a -
ANS Clamp
When passing sharps during a procedure, the best way to protect yourself and
surgeon is by using -
ANS A neutral zone
Curved Mayo scissors are used for which of the following? -
ANS To cut heavy
tissue
What biting instrument is used for cutting tough tissue or bone? -
ANS A
Rongeur
while passing scissors, which of their parts should be visible to the surgeon? -
ANS Tip
Which of the concepts are appropriate for the care of forceps during a
procedure? -
ANS Cleaning the tips of blood or tissue frequently.
Handing them off the sterile field to the circulating RN if the surgeon says that
they are not working properly.
Atraumatic forceps are most often used in -
ANS Cardiovascular surgery
the point of the forceps should be facing __________ when passing it to the
surgeon? -
ANS Downward
Which powered cutting instruments are used in orthopedic surgery? -
ANS
Tissue shavers;
Bone reamers.
Plastic incise drapes -
ANS May increase moisture and bacterial growth under
the drape;
Are NOT recommended for use.
Which of the following best describes sterile technique -
ANS Implemented
during surgical procedures to prevent microbial contamination
Match the terms given below with their definitions. -
ANS 1. Surgical
conscience-Allows for no compromise in the principles of sterile technique
2. Sterile- The absence of all living microorganisms.
3. Sterile Technique- The use of specific actions and activities to prevent
contamination and sterility of identified areas during operative or other invasive
procedures.
Recommendations for draping include -
ANS -handling sterile drapes as little
as possible
- cuffing the drape material over the gloved hands
- holding the drapes in a controlled manner
Select the areas of the sterile gown that are considered sterile. -
ANS - Gown
sleeves from two inches above the elbow to the cuff, circumferential.
- The front of the gown from the chest to the level of the sterile field.
Select the statements below that are correct -
ANS closed assisted gloving
should be used to glove team members during initial gowning and gloving;
Once the scrubbed team member's hands pass through the cuff, the cuffs are
considered contaminated;
Scrubbed team members should wear two pairs of surgical gloves.
In creating a sterile field, which of the following are recommended by AORN? -
ANS a. Cuff the drapes over your gloved hand to prevent contamination.
c. Place drapes in sequence from the surgical site to peripheral areas.
d. Place drapes on the patient and any furniture and equipment that will be in the
sterile field.
e. When placing drapes do not lean across unsterile areas.
What action below is the best course to take when a hair is found in an
instrument tray on the back table? -
ANS c. The entire sterile field should be
broken down and a sterile field reestablished.
Which of the following practices are NOT examples of the recommendation that
"A sterile field should be maintained and monitored constantly"? -
ANS A sterile
field that has been set up for more than 1 hour before the procedures begins
should be broken down and a new set up prepared.
If a delay occurs after a sterile field is set up, the personnel may leave the room
as long as the room as been secured.
When transferring medication and solutions to the sterile field the perioperative
nurse should -
ANS Avoid removing stoppers from vials.
Discard unused, opened irrigation or IV solutions at the end of the procedures.
Dispense the entire contents to the container slowly.
Use a sterile transfer device.
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Accurate preoperative documentation of the patient admission is an integral part
of the nursing process. This includes -
ANS Patient identification;
Preoperative orders;
Patient assessment.
The primary purpose of documentation is to -
ANS Record the chronological
order of events during the nursing are of a patient.
When documenting the placement of a surgical drain, which of the following
components should be included? -
ANS Where the drain was placed on the
patient.
Which of the following is true about the use of abbreviations in perioperative
documentation? -
ANS They can put patients at risk for medication errors.
When documenting, the perioperative nurse should -
ANS Document in a
timely manner;
Use nursing diagnoses based on sound judgement;
Use patient statements to verify the nurse's findings.
Which of the following statements are true about informed consent? -
ANS
Needs to state the indications for the proposed intervention;
Is a physician's duty, and RNs are witnesses to the patient's signature;
Must contain the name of the health care facility.
When documenting the use of a pneumatic tourniquet, which items must be
included? -
ANS Cuff pressure;
Location where the cuff was placed;
Name of person who applied the tourniquet cuff;
Serial number of the unit
The concept of a standard of care related to documentation -
ANS Requires the
nurse to document and act as a reasonably qualified nurse would in a similar
situation
An individualized patient care plan that was initiated during the preoperative
phase includes -
ANS A cultural or religious preferences;
Emotional considerations;
Psychosocial considerations
The primary reason for documenting sharp, sponge, and instrument counts is -
ANS to prevent injury to the patient from a retained foreign object
Scrubbing Procedures Steps -
ANS 1. Inspection of hands and arms
2. Open the gown and place on the table
3. Open the sterile scrub sponge package
4. Wet and later the hands and forearms
5. Clean under the fingernails of both hands with the nail cleaner
6. Scrub fingertips, nails, palm, and wrist to two inches above elbow
7. Repeat the procedure for other hand
8. Rinse hands and arms keeping the fingers pointed upward
The purpose of performing a surgical hand scrub include -
ANS To reduce the
resident microbial count to a minimum;
To inhibit rapid rebound growth of microorganisms;
To remove soil, debris, and transient microorganisms
After the surgical hand scrub, the scrub person should keep the fingers pointed in
which direction to allow water to drip off away from the attire? -
ANS Upwards
What actions can the RN circulator take to assist the scrub personnel during
gowning? -
ANS Touch only the ties, Velcro, or snaps to secure the back of the
gown at the neck and the waist;
Adjust the gown by grasping the bottom edge and pulling down to eliminate any
blousing.
Because skin is a major source of contamination in the surgical environment,
which of the following statements is true? -
ANS Health care personnel who
have cuts on their hands should not provide direct patient care
You have just finished a surgical procedures and are removing your gown and
gloves. -
ANS 1. Pull the gown downward from the shoulders and off the arms.
2. Fold the contaminated side of the gown to the inside, roll it up, and discard it.
3. Remove and discard the gloves using a glove to glove and skin to skin
technique.
4. Wash hands with soap and water.
Which of the following statements is true? -
ANS The open method is used for
subsequent gloving;
The open glove method is used while performing sterile procedures when a gown
is not worn.
The surgical hand scrub controls resident microorganisms by -
ANS The
chemical action of microbial agents used.
Which of the following statements are true in relation to scrubbing for the first
procedure of the day? -
ANS First, wash your hands under running water with
soap.
Use an approved antimicrobial scrub agent on wet hands and arms.
Where should the scrub person's sterile gown be opened? -
ANS c. On a
separate mayo stand
Correct surgical attire for the restricted areas include: -
ANS b. Head covering
that covers all hair
d. Scrub top tucked into scrub pants and a warm-up jacket
Which of the following practices is recommended when transferring a patient
from the OR bed to a gurney? -
ANS Lock the wheels of the gurney and the OR
bed before beginning the transfer
Which of the following practices is recommended to reduce the patient's risk of
intraoperative skin injury? -
ANS Protect sensitive areas of the skin with
appropriate padding
Which activities should the transport person complete before transferring a
patient? -
ANS Identify the patient and the surgical procedure;
Verbally confirm that the preoperative orders have been completed;
Reconcile any medications the patient may have been taking preoperatively
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Mechanical issues and problems that can cause skin injury include: SATA -
ANS
a. placing heavy objects on the pt
c. dragging the pts body across the sheets
d. improperly applying sequential compression stockings
AORN guidelines for the time out recommend that all team members verbally
verify their agreement on the following: SATA -
ANS b. the name of the pt.
c. the site of the procedure including R/L distinction
d. the procedure to be performed
Which of the following factors increase the patient's risk for skin injury? -
ANS
Unusual positions or positioning devices;
Use of electrical equipment;
Use of chemical agents;
Prolonged length of surgery
When using chemical products, the perioperative nurse should -
ANS Use skin
prep solutions according to the manufacturer's recommendations;
Ensure the prep solution does not pool on the drapes;
Apply blotting towels before performing a skin prep;
allow skin prep solutions to dry before draping
sponge and instrument counts are performed according to facility policy and
procedure. Generally, the times during sx procedure that sponges are counted
are: SATA -
ANS a. at skin closure
c. before the procedure begins
d. when new sponges are added to the field
e. when wound closure begins
when a count discrepancy occurs, what should be the FIRST action by the RN
circulator? -
ANS c. inform the surgical team of the discrepancy
Which of the following actions should be included in the perioperative nursing
care of a patient with a suspected latex allergy? -
ANS Assess the patient's
cross sensitivities and previous reactions to latex;
Indicate latex precautions on door signs for every room that the patient occupies;
Use latex free supplies for IVs, hair covering, and dressing materials;
Verify that the surgeon is aware of the allergy.
Which of the following would be an appropriate action for the perioperative nurse
when assisting with anesthesia? -
ANS Apply cricoid pressure if needed during
intubation
Which of the following is NOT included in basic monitoring of the patient for
anesthesia? -
ANS Arterial line
Which drug is used to reverse valium and midazolam? -
ANS Flumazenil
Which method is used to prevent aspiration during endotracheal intubation? -
ANS Applying cricoid pressure
How can the perioperative nurs assist the anesthesia provider with placement of
a spinal or epidural block? -
ANS Calm the patient
During intravenous regional anesthesia (Bier Block), the tourniquet should be
deflated slowly to prevent which of the following from entering the circulation? -
ANS Bolus of anesthetic
What is the most consistent indicator of MH during a surgical intervention? -
ANS Unexplained increase in end tidal CO2
Depending on state laws and hospital policies, which of the following types of
anesthesia can be performed without a professional anesthesia provider? -
ANS
Moderate sedation
Which assessment factor is important to include when screening patients for
potential risk of MH? -
ANS Family history of problems related to anesthesia
Match medications -
ANS Antibiotics- controlling infection.
Anticoagulants- Delays the coagulation of blood.
Hemostatic agents- Assist in blood clotting.
Cardiac agents- Test patency and integrity of a graft
Anti inflammatory agents- Reduce post operative edema.
By which route are antibiotics most commonly administered by the perioperative
nurse during the intraoperative phase? -
ANS Irrigation solution
The perioperative nurse's role in preparing and administering medications
includes -
ANS Assessing the patient's medication allergies and use of herbal
or dietary supplements;
Verifying the administration of the correct medication, dose, and route;
Checking expiration date of medication
Identify the true statements from those given -
ANS Radiographic dyes are a
risk to patients allergic to iodine and shellfish;
Radiographic dyes are instilled directly into an organ or duct with a catheter or
tube;
Miotic agents are used to reduce intraocular pressure.
In addition to hyponatremia, which of the following conditions can be a result of
improper fluid management? -
ANS b. Hypervolemia
During the medication administration phase of the medication use process,
nursing assessment should include which of the following factors? -
ANS
Current medications, including herbal;
Medication allergies;
Patient weight in pounds and kilograms
What are the most common roles of the perioperative nurse in preparing
medications and solutions? -
ANS Preparing medications and solutions per the
physiciansrpeference card;
Preparing and labeling medications and solutions;
Document and verify by verbally reading back to the provider all verbal orders,
per facility policy
When medication is administered from the sterile field, it is removed from an
original container by the RN circulator and presented to the scrub person. It
should be immediately and speedily labeled with -
ANS Concentration and
amount;
Date prepared;
Expiration time if less than 24 hours;
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Initials of the RN preparing the medication
Match each Surgical Position with its correct Physiological Effect -
ANS Supine-
Increase in cardiac output;
Trendelenburg- Elevated blood pressure;
Reverse Trendelenburg- decreased cardiac return;
Lithotomy- Potential femoral, obturator, and perineal nerve damage;
Sitting or Semi Sitting- Hypotension related to the position;
Prone- Compression of the diaphragm;
Lateral recumbent- Pooing of blood in the dependent limb.
Potential sources of fuel for surgical fires include -
ANS Draping materials
The nominal hazard zone for laser use is the -
ANS Space where direct,
scattered, or reflected laser radiation exceeds maximal permissible exposure
Match the following terms with their definitions -
ANS Volatile liquid- a liquid
that evaporates quickly;
Combustible skin agent- A skin antiseptic agent that will burn with a flash point of
greater than 100 degrees F;
Flammable skin agent- A skin antiseptic agent that has a flash point of less than
100 degrees F;
Combustible rating- An established rating used with skin antiseptic solutions that
can be found by reviewing the material safety data sheet
Risks to patients and staff members associated with laser use include -
ANS
Eye injury;
Fire hazards;
Inhalation of laser plume
Nursing documentation for pneumatic tourniquete use includes -
ANS
Identification/serial number and model of the specific tourniquete;
Location of the cuff;
Skin and tissue integirty under the cuff before the use of the pneumatic
tourniquet;
Time of inflation and deflation
Which of the following is a correct application of the AORN Guidelines for use of
appropriate eyewear during laser use? -
ANS The eyewear should be matched
to the type of laser, optical density, and wavelength
Safety measures to prevent complications or injury due to the use of a pneumatic
tourniquet includes -
ANS Keep fluids from pooling under the cuff;
Only minimal effective pressure should be used to create a bloodless field;
There should be a complete preoperative patient assessment;
The cuff should fit properly on the patient;
The inflation time should be monitored
When working with electrical equipment, the perioperative nurse must -
ANS
Ensure that warming therapy devices are used at appropriate settings;
Ensure that users are educated in the safe use of all electrical equipment;
Never place the hose of a patient warmer directly under the patient's blankets
In addition to back up electrical power in the case of power outage, ORs may
plan for outage by -
ANS Identifying which outlets in the OR are connected to
emergency power;
Maintaining battery operated lights in each OR;
Routinely checking the operation and availability of back up equipment
Radiation exposure safety controls include -
ANS Nonessential personnel
should leave the room;
Pregnant health car workers should avoid or limit exposure;
Lead protective aprons, gloves, and thyroid collars should be worn
Indirect fire hazards and risks specific to the OR include -
ANS Anesthetic
complication risks;
Postoperative infections;
Postoperative surgical complications
To follow the AORN guidelines for positioning the patient, the perioperative nurse
should -
ANS Use additional precautions as appropriate based on unique
patient considerations
Which of the following physiological effects is most likely to results from
positioning a patient in the lithotomy position? -
ANS Circulatory and respiratory
compromise due to pressure on the abdomen
The following safety measures should be considered when placing a patient in
the lateral position -
ANS The upper leg is straight and supported with pillows
between the legs;
Lower arm on same plane as OR bed mattress, forearm and wrist in neutral
position, palm up;
The patient's dependent ear should be assessed to ensure that it is not folded.
Documentation of the perioperative nursing care should include, but not be
limited to -
ANS Type of positioning devices used;
Names of persons positioning the patient
Which of the following patient factors should be considered int he perioperative
assessment -
ANS Age;
Nutritional status;
Preexisting conditions
Which intraoperative factors should be considered during periop assessment? -
ANS Type of anesthesia delivered;
Duration of the surgery;
Position required
The table is flexed 90 degrees for the _____ position, which is a variation of the
_____ position. -
ANS Jack-knife (Kraske), prone
Which surgical position adversely affects the diaphragmatic movement? -
ANS
Trendelenburg position;
Prone position;
Lateral position
the use of the PNDS helps a periop nurse to -
ANS Plan the nursing
interventions;
Assess and develop the nursing diagnoses;
Assess and evaluate the patient's status;
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Evaluate response to positioning
What response is the results of tissue layers moving on each other -
ANS
Shearing
chlorhexidine gluconate CHG is a antimicrobial skin prepping agent used -
ANS
For topical skin application only below the neck
What agents are effective in removing resident microorganisms -
ANS chemical
agents
Which of the following are desired characteristics of antimicrobial agents? -
ANS Broad spectrum;
High log reduction capacity;
Effective for long periods of time
Which of the following statements is correct regarding hair removal from a
surgical patient? -
ANS Hair should be removed from the surgical site only
when the hair is so thick that it will interfere with the procedure
What does AORN's guideline for preop patient skin antisepsis recommend for
prepping areas with high microbial counts? -
ANS Prep them last
Which of the following should be avoided during hair removal -
ANS Nicking or
cutting the skin
Which of the following observations are critical when doing skin antisepsis on
pediatric patients? -
ANS Take measures to prevent the loss of body heat
Which actions should the perioperative nurse take in prepping an extremity when
a tourniquete is used -
ANS Start the prep at the incision site and extend both
distally and proximally to include the entire extremity;
Use an assistive device to support the extremity during the prep;
Use an impervious drape to protect the tourntiquet
Which of the following is TRUE about iodophor paint and iodophor scrub? -
ANS A scrub has a detergent additive, a paint does not
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Perioperative nursing documentation of the sin prep procedure should include
which of the following components? -
ANS Antiseptic agent used;
Hair removal if performed;
Name of the person performing the prep;
Preoperative assessment of the skin at the operative site
To ensure proper handling of surgical specimens, which unique identifiers should
the perioperative nurse verify before the patient enters the OR? -
ANS Patient's
medical record number;
Spelling of the patient's name;
Surgeon's name
Which of the following are recommended guidelines for preserving a bullet
collected as forensic evidence? -
ANS Do not drop bullet into metal basin or
bowl;
Rinse the bullet with water if requested by local authorities;
Handle as little as possible
What is the rationale for wearing gloves when handling or transporting surgical
specimens? -
ANS To avoid exposure to biohazardous substances
Biopsies that require specialized methods of preparation and preservation to
preserve the cells include... -
ANS Bone marrow;
Muscle;
Nerve;
Testicular
Proper handling of an explant removed because of an apparent defect or failure
includes -
ANS Completing a risk management report;
Documentation of the serial number in the medical record and on the pathology
requisition
Which of the following actions should the scrub person perform for most
specimens after receiving them from the surgeon? -
ANS Keep it in a sterile
basin until it can be passed to the RN circulator;
Keep it moist with saline
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Surgical tissue banking is -
ANS The retrieval, processing, preserving, and
storing of selected human tissue for later transplantation back into the patient or
into another patient
Which pathology specimens require fresh preparation and the use of a sterile
container? -
ANS Breast tissue for hormonal assay;
Cerebral spinal fluid;
Semen for infertility studies
The patient, the surgeon, and the scrub person all interact with the circulator in
the management of specimens and each have special roles -
ANS Patient-
Concerned with diagnosis, speed of diagnosis, psychosocial concerns.
Surgeon- communicates identifying characteristics to the scrub person and to the
circulator.
Scrub person- Ensure accurate identification of the specimen by having a sterile
marking pen to write location and type of tissue.
Circulator- Sensitive to the scrub person's needs and to actions that facilitate
accurate specimen management
Which of the following forensic specimens should be placed in a paper envelope,
labeled, and sealed? -
ANS Finger nails;
Carpet remnants
Songs counts are done for all the following reasons, EXCEPT -
ANS Because
state laws require specific count procedures
Which of the following are reasons to avoid using radiopaque sponges for
postoperative dressings? -
ANS Possible invalidation of subsequent sponge
counts if the patient were returned to the OR with intact dressings;
Radiopaque sponges may appear as a foreign body on postop x-rays
Which classification of hemostatic methods involves pressure or the use of
ligating clips? -
ANS Mechanical
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What precaution should be taken when microfibrillar collagen is used as a
hemostatic agent intraoperatively? -
ANS Avoid using it with an autologous
blood salvage unit
Which of the following drains allows for passive drainage of fluid from the body? -
ANS Penrose;
T-tube
The benefits of a standardized count procedure include which of the following? -
ANS Assists in achieving accuracy during the count procedure;
Assists in conducting efficient counts;
Human error studies have shown that many errors results from deviation
Which type of dressing is used to prevent drying of the wound and increase the
proliferation of epithelial cells? -
ANS Occlusive
Which of the following is true in handling hemostatic agents such as collagen or
gelatin sponges? -
ANS Must not be injected or allowed to enter large vessels,
as extensive intravascular clotting may occur
Match the suture with its appropriate description -
ANS Surgical silk- Gives
good support during early ambulation and promotes rapid healing, used to close
fascia when on infection is present.
Virgin silk- Composed of natural fibers, used for ophthalmic surgery.
Dermal silk- Strands are encased in a gelatin or protein substance; used for skin
sutures.
Surgical cotton- Weakest of the nonabsorbable material choices, gains strength
when wet.
Linen- Tensile strength is inferior to other nonabsorbables, used for GI surgery.
Steel- Used in ortho; may also be used in the presence of infection.
Match the suture with its appropriate example -
ANS Monofilament nylon-
Ethilon and Dermalon.
Coated multifilament nylon- Surgilon.
Uncoated polyester fiber- Mersilene and Dacron.
Coated polyester fiber- Ticron, Ethibond, Teflon, Polydek, and Tevdek.
Polybutester- Novafil.
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Polyethylene- Dermalene.
Polypropylene- Prolene and Surgilene.
Match the needle point with its appropriate description -
ANS Conventional
cutting point- Cutting edge on the inside curvature, creating a very small path that
heals quickly.
Reverse cutting point- Curved needles with cutting edges on the outer curvature.
Side cutting point- These needles do not penetrate underlying tissues, but rather
split tissue layers, used for ophthalmic surgery.
Trocar point- Used to punch through tough tissues.
Taper point- pushes the tissue aside when passing through.
Taper cut- Has cutting edges at the point only.
Blunt point- used on organs, as they are less apt to puncture the vessels within
organs, used for dissection of friable tissue.
A designation of "4-0" on a suture package indicates the suture material's: -
ANS a. diameter
Which type of staplers are used in the alimentary tract and in thoracic
procedures? -
ANS Linear staples
When does the body's reaction to the suture material start? -
ANS At the time
of insertion
Match the physical descriptor of a suture to the definition -
ANS Memory-
Capacity of a suture to regain former shape after being reformed.
Elasticity- Ability to regain original form and length after being stretched.
Knot tensile strength - When knotted, the force, in pounds, which the suture can
withstand before it breaks.
Capillarity- Ability to soak up fluid along a strand.
Which of the following a natural absorbable suture materials? -
ANS Chromic
catgut;
collagen
select the suture material below that is a synthetic absorbable suture -
ANS c.
polyglycolic acid
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Which of the following skin closure products involve the use of liquid polymers? -
ANS Skin adhesives
Trocar needle points are used for which type of tissue? -
ANS Penetration of
tough tissues
During which phase of wound healing does contraction occur? -
ANS
Proliferation
Identify the proper sequence of events in the body's defense mechanism -
ANS
Hemostasis- cleaning up the pathogens;wound sealing;regeneration of epidermal
covering;repairing deeper tissue damage
At what point in the healing process do most wound disruptions occur? -
ANS
Beginning of proliferative phase- Phase 2- 2 to 10 days
Match each type of wound with its appropriate example -
ANS Clean
wounds-Thyroidectomy.
Clean contaminated wounds- Colon resection.
Contaminated wounds- Open or fresh traumatic wounds.
Dirty wounds- Ruptured appendix.
Prolonged high dosages of steroids preoperatively delay______ -
ANS
collagen formation
The CDC's classification of Surgical Wounds system is intended to_______ -
ANS monitor postoperative infections and suggest steps to take to reduce these
infections
Factors that Negatively affect wound healing -
ANS -A surgical complication
-Failure to eliminate dead space when closing the incision
-Implantation of orthopedic hardware
-Surgical incisions in an area of high mobility
Match the Topical Hemostatic Method with the appropriate method of Action -
ANS Passive- Provide barrier
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Flowables- mechanically obstruct flow of blood
Fibrin Sealants- Increase amount of fibrinogen at site
Active- Enhanced clotting
Methods of producing hemostasis include which of the following? -
ANS
Administering blood;
Applying pressure;
Using electrocautery;
Using topical hemostatic agents
The process of digestion of pathogens by neutrophils and macrophages is known
as ______ -
ANS phagocytosis
In what areas would you most likely find a perianesthesia nurse? -
ANS
Extended Care Unit;
Postanesthesia Care Unit;
Preadmission Testing Unit;
Preoperative Holding
During admission of a patient to Phase 1 of postanesthesia care, the
perianesthesia nurse is responsible for -
ANS -assessing the patient's level of
consciousness
-assessing the patient's pain level
-maintaining a patent airway
-monitoring blood pressure, heart rate, and oxygen saturation
What would be the most important information for a nurse in preadmission
Testing (PAT) to collect on a insulin dependent diabetic patient? -
ANS The type
of insulin that patient takes
Match the phase or unit or age group with the correct nurse patient ratio -
ANS
Extended Care Unit- 1:3/5;
Patients are under age 8: 1:2;
Upon admission: 1:1;
Patient recovering in CCU: 2:1
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Which factors contributed to the creation of a specialized care unit for the
surgical patient? -
ANS -use of anesthetic gases
-use of specialized equipment
-introduction of PACU standards
In Phase II, patient education becomes a critical task. What aspects of
post-discharge life should the nurse be teaching the patient? -
ANS -how to
empty drainage fluid
-coughing and deep breathing exercises
-how to take the prescribed medications
What are the complications associated with laparoscopic surgery? -
ANS
-Wound infections
-CO2 embolism
Identify some methods used to maintain a sterile camera head -
ANS -Put the
camera head in a sterile pouch
-Gas-sterilize the camera head
Which pieces of equipment are used in laparoscopic surgery? -
ANS -CO2
insufflators
-electrosurgical unit
-smoke evacuators
Which actions can the scrub person take to help prevent incidental thermal
burns? -
ANS -Inspect laparoscopic instruments for excessive wear or obvious
breaks and replace when necessary
-Replace instruments that have damaged insulation
Identify one characteristic difference between laparoscopic instruments and
those used in open procedures -
ANS Laparoscopic instruments have long, thin
shafts to accommodate trocar cannulas
Which region of the patient's abdomen is traditionally used to establish
pneumoperitoneum for laparoscopic surgery? -
ANS Periumbilical
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What is an important safety consideration when using a light source? -
ANS
Place the light source in standby mode whenever it is not in use
Carbone Dioxide is the gas used for abdominal insufflation because it -
ANS -Is
inexpensive
-suppresses combustion
-is rapidly eliminated from the body
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