AORN PERIOP 101 FINAL EXAM LATEST 2023-2024 ALL 1OO QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)/AGRADE

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1.This type of needle point is what you would expect to be needed for suturing friable tissue such as the liver.
What is a Blunt needle point?

2.These particular wound closing items are available in a wide variety of instrument sizes.
What are disposable stapler sets?

3.Give one example from TJC list of Do-Not-Use Abbreviations, Acronyms, and Symbols.
What is cc?

5.The surgical wound classification for a total abdominal hysterectomy.
What is Clean contaminated?

4.Following an excisional breast biopsy, the circulating nurse would anticipate the need to have available this type of drain
What is a Jackson-Pratt?

6.This position can cause physiological effects of circulatory and respiratory compromise due to pressure on the abdomen.
What is Lithotomy Position?

7.To protect sensitive areas of the skin with appropriate padding is a recommended practice for this:
What is to reduce the patient’s risk of intraoperative skin injury.

8.An environmental sanitation practice that is required to limit the transmission of microorganisms to personnel when handling body fluid spills
What is personal protective equipment?

9.It is recommended to inspect the active electrode for insulation defects to prevent this from occurring during MIS
What is capacitive coupling?

10. According to AORN RP for positioning the patient, the perioperative nurse should:
    What is…
    a. Use a consistent method of procedure-specific position for each patient
    b. Rely on the surgeon’s and anesthesia provider’s assessments to guide positioning
    c. use additional precautions as appropriate based on unique patient considerations
    d. Depend on the patient’s natural defense mechanisms to indicate the need for positioning alterations
    c. use additional precautions as appropriate based on unique patient considerations

11.The disadvantage of using this type of wound closure is because they often cause more scarring than other skin closure methods.
What is skin clips?

12.An automatic intraoperative suspension of a do-not-resuscitate decision violates a patient’s ethical right to…
What is Self-determination?

13. This type of human factor error is responsible when a perioperative nurse is trying to attend to several tasks at once
    What is situational-based error?

14.Restricting pathogenic organisms from the patient, environment, equipment, and supplies is the definition of….
What is aseptic technique?

The most important consideration when selecting these materials is to prevent risk of contaminating patients with endogenous and exogenous microorganisms; and risk of exposing healthcare workers to patient’s blood and body fluids
What are draping materials?

16.Patient and caregiver education for continuing post-op care at home is the primary focus of this Phase of post anesthesia care.
What is Phase II?

17.According to the Institute of medicine recommendations for improving patient safety, this organization has the greatest potential impact to make changes on improving pt safety
What are Healthcare organizations?

18. This statement about gloving technique is true
    What is…
    a. When gloving another person, always glove the left hand first.
    b. The scrub gown should be fastened in the back before donning gloves
    c. Open glove technique is used for initial donning of the sterile gown and gloves.
    d. Closed glove technique is used to glove the surgeon or assistant.
    b. The scrub gown should be fastened in the back before donning gloves
19. Draping material is this source in the fire triangle? (fuel, ignition, oxidizer)
    What is fuel source?
20. The safest way to pass a cutting instrument to a surgeon is:
    What is place it in a designated neutral zone with a verbal cue
21. To place a patient safely in this particular position the knees are over the break in the procedure bed to allow for knee flexion.
    What is Trendelenberg?
22. A packaging system for items undergoing sterilization should possess this characteristic:
    What is….
23. Made of only disposable materials
24. to permit aseptic delivery of contents to the sterile field
25. Maintain sterility of the items for a specified length of time.
26. Compatible with all sterilization processes
27. to permit aseptic delivery of contents to the sterile field
28. Silicone catheters should be stocked on this particular cart in the surgical suite.
    What is a Latex-safe cart?
29. Open this package carefully over a small basin to prevent splashing of the packaging solution.
    What is handling natural absorbable sutures (plain, chromic)
30. An example of administrative controls to assure safe use of lasers, is the appointment of a person in this role:
    What is a laser safety officer?
31. This statement about the perioperative nurse’s role in bioethical decision making is most justifiable. The perioperative nurse should… WHAT IS…
    a. Try to avoid involvement in ethical dilemmas unless they are personally engaged in a situation.
    b. Refer all ethical dilemmas to the institution’s ethics committee to decide the best course of action.
    c. act according to the terms of agreement establishing the nature of the relationship between the pt and the nurse
    d. Defer to surgeons judgment when there is disagreement about the right course of action.
    c. act according to the terms of agreement establishing the nature of the relationship between the pt and the nurse
32. A precaution that should be taken when using this hemostatic agent intraoperatively is to avoid using it with an autologous blood salvage unit (cell saver).
    What is microfibrillar collagen
33. A designation of 4-0 on a suture package indicates this about the suture material.
    What is the diameter?
34. A recommended means of promoting the safety of personnel in the surgical suite is:
    What is….
    a. Routine screening of patients for HIV and hepatitis C
    b. Providing access to MSDS (material safety data sheets) for hazardous agents in that environment
    c. Double-glove for every procedure
    d. Leaving the room when x-rays are being used, even if scrubbed.
    b. Providing access to MSDS (material safety data sheets) for hazardous agents in that environment
35. This type of healing the wound remains open
    What is Granulation?
36. An abstract concept that has been developing since Socrates.
    What is Critical thinking?
37. This item is placed as close to the operative site as possible
    What is the dispersive electrode?
38. This is desired patient outcome most closely related to the use of local anesthesia for a procedure: What is….
    a. The pt is the recipient of competent and ethical care within legal standards of practice.
    b. The pt is normothermic at the conclusion of the procedure
    c. The patient reports adequate pain control throughout the perioperative process
    d. The pt’s respiratory function is consistent with preoperative baseline levels.
    c. The patient reports adequate pain control throughout the perioperative process
39. Antibiotics are most commonly administered during the intraoperative phase through this route
    What is Irrigation solution?
40. Recent research studies on the value of certification found that: WHAT is….
    a. Non-certified nurse managers saw little value in certification related to professional growth.
    b. The most frequent reason for achieving certification is the expectation of higher salary and career advancement
    c. Most facilities do not offer any incentives for achieving certification.
    d. Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse.
    d. Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse.
41. The recommended practice for flash sterilization is the item should be processed with this:
    What is a routine process monitoring device (chemical indicator, integrator).
42. When documenting the placement of surgical drains, it should include:
    What is location of drain?
43. The action that the perioperative nurse should take if the pt states he/she is allergic to shellfish and breaks out in hives when ingested.
    What is Alert surgeon for the need for appropriate selection of skin prep solution?
44. Principles of care for forceps during a procedure should include this: WHAT IS…
    a. Stand them upright along the sides of the instrument tray so that handles are easily grasped when needed
    b. Move them from the mayo stand to the back table if the surgeon says that they are not working properly.
    c. frequently inspect tips and wipe clean of blood or tissue as needed
    d. Organize them on the may stand or back table by placing one inside another.
    c. frequently inspect tips and wipe clean of blood or tissue as needed
45. A critical perioperative nursing diagnosis within the PNDS is:
    What is risk for perioperative positioning injury?
46. There are 3 process monitors in the sterilization process; this particular monitor indicates that the intended physical conditions in the sterilizer were met.
    What is biological monitoring?
47. This is the most reliable early indication of malignant hyperthermia
    What is unexplained increase in end-tidal CO2?
48. This statement concerning the use of AORN Recommended Practices is true:
    a. RPs supersede departmental and institutional policies
    b. Work setting and situation variations may determine the extent to which the RPs can be applied
    c. RPs are based on scientific evidence of how nurses actually practice in perioperative settings
    d. Licensed and accredited institutions are required to comply with the RPs
    b. Work setting and situation variations may determine the extent to which the RPs can be applied
49. Lock the wheels of the stretcher and the OR bed is a recommendation when:
    What is transferring pt from OR bed to gurney?
50. Begin this task with higher surfaces and finish with the lowest levels
    What is recommended for damp dusting in the OR?
51. Name one step that should be used to follow TJC universal protocol for preventing wrong site, wrong procedure, and wrong person surgery.
    What is using a time-out before beginning the procedure?
52. This can be performed through smaller incisions
    What is the Difference between MIS and open surgical procedures?
53. After this is procured by the surgeon, the scrub person should keep it moist with saline and in a sterile basin until it can be passed to the circulating nurse.
    What is a surgical specimen?
54. Documentation of the serial number in the medical record and on the pathology requisition when an apparent defect or failure occurs.
    What is proper handling of explants

Skin prep agent contraindicated for use during reconstruction of the external ear.
What is CHG?

51. AORN RP states, this should be matched to the type of laser, optical density, and wavelength
    What is appropriate eyewear during laser surgery?
52. Use a sterile transfer device
    What is recommended for transferring medication from a multi-use vial to the sterile field?
53. Family history of problems related to anesthesia; and pts previous experience with anesthesia
    What are assessment factors when screening pts for potential risk of malignant hyperthermia?
54. The space where direct, scattered, or reflected laser radiation exceeds maximal permissible exposure
    What is the nominal hazard zone for laser use?
55. First step in the sterilization process of surgical instruments that have been used in a procedure
    What is decontamination?
56. This is affected by pt and staff beliefs, staff attitudes, and individual and collective values
    What is the culture of a clinical setting?
57. Decreased color and depth perception
    What are sensory assessment findings common among elderly patients?
58. Principle of asepsis that is most directly related to the concept of surgical conscience
    What is consider items of doubtful sterility contaminated?
59. Most important reason for maintaining endoscopic instruments at optimal level of function
    What are insulation defects that can cause unseen thermal burns?
60. What type of thinking is required to deliver safe patient care based on the statement “safe care requires teamwork and care tailored to the individual patient?”
    What is critical thinking?

Evaluation of pt outcomes, Nursing plan of care, Occurrence of any unusual events, and Periop nurses legal signature are components that should be included in this
perioperative nursing documentation.

62. According to Dewey and Glaser this statement about critical thinking is incorrect.
    a. Logical inquiry and thoughtful reasoning
    b. Active, persistent and careful consideration of the evidence supporting a decision
    c. Passive acceptance of an unreflective jump to conclusion required in the OR.
    d. Skill in applying the methods of logical inquiry and reasoning
    Passive acceptance of an unreflective jump to conclusion required in the OR.
63. During this phase of wound healing contraction occurs
    What is proliferation phase?
64. Placing the light in standby mode when not in use
    What are guidelines for safe use of an endoscopic light source?
65. What is a kocher?
    an example of an occluding clamp
66. The surgical team member responsible for preparing the surgical specimen to be sent to the lab
    Who is the circulating nurse?
67. Exposure to this sterilization method is potentially carcinogenic and mutagenic to personnel and patients.
    What is EO
68. The AORN RP that most directly pertains to this phase of cleaning in the Periop environment states that a safe, clean environment should be reestablished after each surgical procedure.
    What is interim cleaning?
69. Placing it in a sterile plastic container is the proper handling of this item when removed from a patient for forensic evidence.
    What is a bullet?
70. During which phase of Cleaning includes the entire floor, moving the OR bed to clean 3-4 feet around it
    What is the activity performed during post-procedure cleaning of the OR?
71. Clinical nurse progression from Novice to Expert requires enhancement of this, and the development and refinement of this is affected by Clinical narratives, simulation, questioning; Partnering with proficient nurses; and the nurse’s level of knowledge and experience
    What is critical thinking skills?
72. When performing a skin prep on a patient scheduled for a bunionectomy what steps should be included?
    a. Prop the foot to allow ample access to all surfaces during the prep
    b. use an impervious drape to protect the tourniquet
    c. start at the incision site, include toes and move up the leg.
73. Name the perioperative nurse’s role in pt and family education?
    a. Explain what the patient will experience –
    b. Provide emotional support to enhance coping –
    c. Teaching specific skills that the pt will need to perform post-op –
74. Why should the perioperative nurse ask about a patient’s use of herbal preparations, alcohol, tobacco products, and recreational drugs during the perioperative interview.
    a. Herbal supplements may affect the metabolism of drugs administered –
    b. Recreational drug use may affect choice of preoperative sedation –
    c. Smoking may affect circulatory and respiratory system assessment results –
75. List 4 team members who wear sterile gowns and gloves.
    a. Scrub person –
    b. Surgical assistant –
    c. Surgeon
    d. Medical student/resident/PA/NP
76. Name 3 risks to patients and staff members associated with laser use:
    a. Eye injury –
    b. Fire hazards –
    c. Inhalation of laser plume –
77. Name 4 types of powered cutting instruments used in surgery
    a. Bone reamers –
    b. Dissectors –
    c. Saws –
    d. Tissue shavers –
78. Name 2 ways that health care workers are most likely to become sensitized to latex
    a. Airborne contact –
    b. Cutaneous contact –
79. During admission of a patient to Phase 1 in PACU, what is the Perianesthesia nurse responsible for?
    a. Assessing patient’s level of consciousness –
    b. Assessing the patient’s pain level –
    c. Assessing the surgical dressing –
    d. Maintaining a patent airway –
    e. Monitoring BP, HR, and O2 saturation –
80. Name 4 types of biopsies that require specialized methods of preparation and preservation to preserve the cells
    a. Bone marrow-
    b. Muscle-
    c. Nerve-
    d. Testicular-
81. List 4 items necessary included in Preoperative documentation
    a. Administration of ordered preoperative medications-
    b. Oral verification by the pt of the procedure to be performed-
    c. Patient allergies to medications and materials used in the surgical suite-
    d. Patient identification, using oral verification and patient records-
82. List Clinical manifestation of a true allergic response to latex
    a. Contact urticarial-
    b. Periorbital edema and itching-
    c. Wheezing-
83. List 4 components that should be included in documentation of intraoperative patient position.
    a. Names of personnel assisting with positioning-
    b. Placement of arms-
    c. Position that pt is placed in for procedure-
    d. Use of specific positioning devices-
84. AORN guidelines for a “time-out” specify that all surgical team members must agree on the following 3 things
    a. Name of pt-
    b. Procedure to be performed-
    c. Site of procedure-
85. 4 Barriers to effective pt and family education in the perioperative setting.
    a. Anxiety about an uncertain outcome-
    b. Discomfort or pain-
    c. Fear of unknown-
    d. Short period of time for assessment and teaching-

a. Anxiety about an uncertain outcome
b. Discomfort or pain
c. Fear of unknown
d. Short period of time for assessment and teaching
a. Diabetes-
b. Protein deficiency-
c. Smoking-
d. Steroid use-

The purposes of the surgical hand scrub
a. Reduce risk of microbial contamination-
b. Remove soil and debris-
c. Suppress growth of microorganisms-

88. List Recommended Practices for sponge count procedures
    a. Count all sponges at the beginning of the case-
    b. Separate sponges as they are counted-
    c. Simultaneous counting by two people, including an RN circulator-
    d. Count out loud
    e. Document all counts
89. List 2 ways that the Perioperative nurse assists with general anesthesia induction
    a. Apply cricoid pressure if needed during intubation-
    b. Remain at the pts side to offer reassurance and promote safety-
90. List 3 steps that should be followed to remove of the gown and gloves at the end of the procedure
    a. Grasp gown at shoulders and pull downward, turning sleeves inside out-
    b. Remove gown first-
    c. Use a glove-to-glove and skin-to-skin technique to remove gloves-
91. List 5 actions that should be included in the perioperative nursing care of a pt with a suspected latex allergy.
    a. Assess pts cross-sensitivities and previous reactions to latex-
    b. Indicate latex precaution on door signs for every room pt occupies-
    c. Use latex-free supplies for IVs, hair covering, dressing materials, etc.-
    d. Verify surgeon is aware of the allergy-
    e. Schedule pt as first case of the day if possible
92. List 5 steps that should be followed in correctly draping the sterile field
    a. Drape from sterile to unsterile areas-
    b. Drape from operative site outward-
    c. Form a cuff with the drape and place gloved hands under the cuff-
    d. Handle each drape as little as possible-
    e. If draping without assistance, walk around the OR bed to drape the other side-
93. State 4 reasons why perioperative pt and family education is important
    a. Conveying genuine caring for the pts well-being-
    b. Increasing pt and family adherence to the plan of care-
    c. Increasing pts and family satisfaction with quality of care-
    d. Legal, ethical, and regulatory mandates-

2 Characteristics included in the elements of a culture of safety within a healthcare organization:
a. Commitment to safety as the first priority in providing care*
b. Trust among healthcare team members*

95. 4 things the perioperative nurse should do when setting up the insufflation equipment for an abdominal endoscopic procedure
    a. Have a back up tank available-
    b. Verify that CO2 pressure and supply alarms are on and functioning-
    c. Position the insufflator at pts heart level or above
    d. Verify that the tank valve is open
96. Name 2 methods or items that accomplish hemostasis by occluding a severed blood vessel, and causing platelets to clump together
    a. Ligatures-
    b. Pledget-
97. Name 4 ways to prevent or minimize ESU injuries to the pt
    a. Assure that prep solutions have dried and vapors evaporated before the device is used-
    b. Confirm each requested power setting change orally with the surgeon-
    c. Inspect each circuit component if the surgeon repeatedly requests higher power settings-
    d. Inspect the ESU unit before use to verify electrical integrity
98. List 3 things the perioperative nurse should do when a Bier Block is used during a procedure
    a. Check the calibration of the tourniquet before applying it-
    b. Monitor the length of time the tourniquet is inflated-
    c. Deflate the tourniquet slowly
    d. Inflate the proximal cuff first
99. Name 2 unique identifiers to ensure proper handling of surgical specimens verified by the perioperative nurse before the pt enters the OR.
    a. Pts medical record number-
    b. Spelling of pts name-
100. A psychosocial assessment of your pt should include:
     a. Cultural beliefs and practices-
     b. Expectations of perioperative care-
     c. Spiritual or religious beliefs-
     d. Understanding of the surgical procedure-
101. The Perioperative nurse’s documents of the skin prep procedure should include
     a. Body area prepped-
     b. Name of person performing prep-
     c. Preoperative assessment of skin at the operative site-
     d. Skin prep agent-
     e. Type and extent of hair removal if ordered-
102. What special care procedures are required for microsurgical instruments
     a. Keep stainless steel and titanium instruments separated-
     b. Use a non-fibrous sponge wipe to clean the instrument tip if recommended-
     c. Use tip covers or protective sleeves when instruments are not being used-
103. Name factors regarding the proper attire of surgical team member
     a. Sterile gowns should resist fluid strike-through-
     b. Head covering should be donned before pulling on the scrub top-
     c. Scrub top must be secured at the waist or tucked into the pants-
     d. Shoe covers are optional
     e. Masks are changed after each patient
104. What phases of the nursing process that the perioperative nurse practices during the preoperative phase of the surgical experience?
     a. Assessment-
     b. Identification of desired outcome-
     c. Nursing diagnosis-
     d. Planning-
105. Name 4 practices you should follow during the surgical scrub procedure
     a. Fingernails should be cleaned under running water-
     b. Stand slightly back from the sink and lean over to prevent splashing scrub suit-
     c. Forearms scrubbed 2″ above the elbow
     d. Hands held higher than the elbows to scrub and rinse
106. What are practices from AORN RP V that states “a sterile field should be maintained and monitored constantly.”
     a. The sterile field should be constantly monitored-
     b. The sterile field should be prepared as close as possible to the time of use-
     c. The sterile field may be covered with a sterile drape-
107. What are 3 Safety precautions when handling and caring for powered instrument
     a. Hand the powered instrument to the surgeon with the safety mechanism on-
     b. Have irrigation ready to use with the drill or saw-
     c. Use the instrument with the blade or drill guard in place-
108. A patient is unable to transfer independently to the procedure bed. To achieve the PNDS outcomes related to safe patient transfer, which measures may be used to prevent shearing injury?
     a. Request additional personnel to assist with pt transfer-
     b. Use a friction-reducing transfer sheet-
     c. Use a slider or roller board-
     d. Use the draw sheet to lift the pt slightly to allow the skin to realign with skeletal structure-
109. What Practices are recommended during decontamination of used instruments
     a. Open box locks and disassemble instrument with multiple parts-
     b. Use enzymatic detergent on heavily soiled instruments-
     c. Wear PPE-
110. What is the Perioperative nurses role in preparing and administering meds
     a. Assess pts medication allergies and use of herbal or dietary supplements-
     b. Verify the administration of the correct med, dose, and route-
     c. Writing down and reading back the surgeons oral orders before preparing medication-
     d. Verify expiration date
111. The OR management team has responsibility for safety in the surgical suite which includes:
     a. Establishing policies related to electrical, fire, radiation, pt management safety-
     b. Monitoring adherence to safety policies and practices-
     c. Providing education to staff members regarding safety policies and procedures-
     d. Reporting safety hazards and violations to appropriate authorities-
112. The OR staff members are responsible for maintaining a safe OR environment which include:
     a. Adhering to facility policies related to safety-
     b. Consistently applying OR-specific safety practices-
     c. Reporting safety hazards and violations to appropriate authorities-
113. The EPA registered germicides labeled as hospital disinfectants must demonstrate effectiveness against these 3 microorganisms:
     a. Pseudomonas aeruginosa-
     b. Salmonella cholera suis-
     c. Staphylococus aureus-
114. When applying the concept of surgical conscience which of the following statement should be considered? Select all that apply.
115. A. It involves mental discipline & the ability to speak out
116. B. It is essential to the delivery of optimal care and prevent harm.
117. D. Surgical conscience allows for no compromise in the principles of aseptic technique.
118. In preparing for a regulatory survey, your quality consultant questions you about the restricted zone in your OR suite. The following statements are true:
119. A. Air flow in the OR rooms should be cleaned by HEPA filters.
120. C. Mask are required when open sterile supplies are present.
121. E. Temperature is maintained between 68 and 75 degree
122. F.
123. You are assigned to relieve a surgical technologist for lunch. You will need:
124. A. A sterile gown and gloves opened on a table (other than the main instrument table) for closed gloving.
125. The Joint Commission Universal Protocol consists of: Select all that apply.
126. A. Preoperative verification
127. B. Surgical site marking
128. C. Time Out
129. Which of the following procedures reflects best practice for transferring a medication vial to the sterile field?
130. D. Use a sterile transfer device
131. Which of the following practices is recommended for handling of natural absorbable suture?
132. C. Open the package carefully over a small basin to prevent splashing of the packaging solution
133. Recommended sponge count procedures include all of the following EXCEPT?
134. B. Counting silently so it doesn’t distract other personnel.
135. What is the correct definition of incisional biopsy?
136. D. A small portion of tissue is incised and sent for examination.
137. Which of the following methods listed below may prevent mishap, event, or fire from occurring when handling electrosurgical equipment? Select all that apply.
138. A. Allow enough time for alcohol based skin preparations to completely dry.
139. B. Do not use in an oxygen-enriched environment, such as the trachea when oxygen is being “blown over” the patient.
140. D. Visually check the integrity and insulation of all cords and coagulation instruments before use.
141. Intrinsic and extrinsic factors that may lead to development of preoperative pressure ulcer include: Select all that apply.
142. A. Duration of the procedure
143. B. Exaggerated positions
144. C. Circulatory disorders
145. D. Malnutrition
146. Which of the following statements reflect the concept of critical thinking? Select all that apply.
147. C. Informed practice
148. D. Holistic thinking
149. E. Unbiased thinking
150. F. Reasoned application of a step by step process
151. What is the best drape to use for an umbilical hernia repair?
152. B. Laparotomy
153. Which of the following statements correctly describes recommendations for preoperative patient skin antisepsis?
154. D. Prep should start at the site of the incision and move outwards.
155. What are the 3 main factors to consider when assessing the patient for allergies?
156. C. Prior reaction, heredity, type of reaction
157. The following steps can be used to reduce personnel exposure to specimen fixatives such as formalin. Select all that apply.
158. A. Avoid splashing while pouring
159. C. When pouring wear gloves and a mask.
160. D. Use absorbent material and then triple rinse with water any area or surface where accidental formalin spillage occurs.
161. E. Store fixatives securely so they are inaccessible to persons unfamiliar with their use.
162. After initial administration, which statement below the proper order of the 4 stages of general anesthesia affecting the patient?
163. A. Administration, excitement, intrasurgery, respiratory failure
164. What responsibilities do OR staff members have in maintaining a safe OR environment? Select all that apply.
165. A. Adhering to facility policies related to safety
166. B. Consistently applying OR specific safety practices
167. D. Monitor, identify and report safety hazards.
168. In addition to giving Dantrolene, which of the following treatment options for malignant hyperthermia should the nurse anticipate and prepare for?
169. B. Provide 100% oxygen, used iced saline to cool patient.
170. An important difference between minimally invasive (MIS) and open surgical procedures is that MIS:
171. A. Can be performed through smaller incisions.
172. While monitoring a patient undergoing local anesthesia, the nurse should be suspicious of systemic toxicity related to which of the following patient complaints? Select all that apply.
173. B. Metallic taste
174. C. Numbness of the lips
175. D. Tinnitus
176. E. Visual Disturbances
177. To place a patient safely in TRENDELENBURG position, which of the following practices is indicated?
178. B. Position knees over the break in the procedure bed to allow for knee flexion.
179. The first step in the sterilization process of surgical instruments that have been used in case is:
180. A. Cleaning
181. By using a high radio frequency electrical current, surgeons routinely use electrosurgery to _ the tissue.
182. C. Cut and coagulate
183. The preoperative team implements aseptic technique practices to meet all of the following primary goals EXCEPT?
184. A. Improve patient satisfaction
185. Which of the following examples is included on the “Joint Commission” list of DO-NOT-USE abbreviations, Acronyms and Symbols?
186. A. MS
187. When a “Time Out” discrepancy occurs, the nurse’s priority action should be to:
188. A. Call the patient’s family to make them aware of the situation.
189. B. Document the “Time Out” discrepancy
190. C. Notify the manager or administrator
191. D. Stop the procedure from beginning until the discrepancy is resolved
192. Which of the following statements about the immediate use steam sterilization is the recommended practice?
193. D. Instruments may be immediate use steam sterilized only when there is insufficient time tot process by the preferred wrapped or container method.
194. Which of the following practices is recommended when transferring from gurney to the OR bed? Select all that apply.
195. A. Ensure that wheels are locked on both the OR bed and gurney prior to beginning transfer.
196. D. Secure lines and catheters prior to the move and dislodging.
197. Which of the following statements about regional anesthesia is correct?
198. B. Continuous nerve stimulation helps ensure proper needle placement during peripheral nerve blocks.
199. What are the perioperative nurses responsibilities for the informed consent process? Select all that apply.
200. B. Act as a witness attesting to the authenticity of the patient’s signature; the voluntary nature of the patient’s consent, and that the patient is competent to give consent.
201. D. Ensure that the surgeon has discussed the proposed intervention and the risks involved with the patient and the patient has signed the consent.
202. Which PNDS outcome is the most important when draping the surgical patient?
203. A. The patient is free from signs and symptoms of infection
204. Which of the following components should be included in documentation of intraoperative patient position? Select all that apply.
205. A. Identification of specific positioning devices used
206. B. Names of personnel assisting with positioning
207. C. Placement of arms
208. D. Position that the patient is placed in for the procedure
209. The preoperative nurse’s documentation of the skin prep procedure should include: Select all that apply.
210. A. The body area prepped
211. B. Name of the person performing the prep
212. C. Preoperative assessment of the skin at the operative site.
213. D. Skin prep agent used.
214. Which of the following statements about proper attire of surgical team members are true? Select all that apply.
215. C. Sterile gowns should resist fluid strike-through
216. D. The scrub top must be secured at the waist or tucked into the pants
217. Preoperative safety concerns that should be considered when caring fro a patient with an implanted electrical device (IED) include which of the following? Select all that apply.
218. A. Bipolar surgery should be used whenever possible
219. B. The active electrode and dispersive electrode are close together but as far away from the IED as possible.
220. D. The patient should be monitored closely for signs of complications and IED malfunction
221. A patient is scheduled for reconstruction of her external ear following a dog bite injury. Which of the following skin prep agents is contraindicated for use in this case?
222. C. Chlorhexidine gluconate
223. A __ is a designated area on the sterile field where the scrub person and the surgeon place all sharp instruments.
224. A. Neutral zone
225. Intraoperative responsibilities of the nurse caring for a patient undergoing a procedure with general anesthesia may include which of the following? Select all that apply
226. A. Applying cricoid pressure during intubation if necessary
227. B. Double checking blood if administered
228. D. Obtaining warming blankets and emergency equipment as necessary
229. E. Assessing the patient throughout the operative procedure
230. Which of the following nursing tools does not reflect critical thinking and clinical reasoning?
231. A. A single procedure list used for all patients scheduled for that procedure.
232. Your manager has asked you to provide an in-service to team members regarding hand hygiene. Important information for you to include is:
233. D. Skin is a major source of contamination in the surgical environment
234. Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply.
235. A. The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges
236. C. Traffic should be controlled to limit access to those trained in handling of sterile supplies
237. D. Sterile supplies are able to bet stored in a manner that allows adequate air circulation.
238. E. When storing items on the top shelf of a supply cart one to consider the distance between the top of an item and the ceiling
239. The types of questions that a novice perioperative nurse might NOT ask her preceptor about an upcoming cardiovascular surgery include which of the following?
240. A. How does the conduction system of the heart work?
241. Which of the following are advantages of disposable drapes? Select all that apply.
242. A. Disposable drapes are lint free.
243. D. Using disposable drapes can minimize strike-through because of their moisture repellent quality.
244. During your preoperative assessment of a patient undergoing a laparoscopic cholecystectomy, which of the following considerations would be important to you as a preoperative nurse. Select all that apply.
245. A. Patients previous abdominal surgery.
246. B. History of DVT.
247. C. Voiding in the prep area prior to going to the
248. OR.
249. Which of the following is the best definition of sterile technique? Sterile technique is:
250. D. Implemeted during surgical procedures to prevent microbial contamination
251. Which of the following is NOT a characteristic that promotes a culture of safety within a healthcare organization?
252. C. Prompt disciplinary action when errors occur.
253. When setting up insufflation equipment for an abdominal endoscopic procedure the preoperative nurse should: Select all that apply.
254. A. Have a backup tank available
255. C. Verify that the CO2 pressure and supply alarms are on and functioning
256. When faced with an electrical power outage in the OR it is most important for the preoperative RN to remember that:
257. C. The nurse is responsible for knowing, understanding and complying with the facilities emergency electrical outage pace
258. What interventions can the preoperative nurse preform to protect elderly patients? Select all that apply
259. A. Employ deep vein thrombosis prophylactic devices
260. B. Position the patient for effective air exchange
261. D. Use warming devices to maintain normothermia
262. Which type of human factor is responsible for an error that occurs when a preoperative nurse is trying to attend to several tasks at once?
263. C. Situational
264. A surgical hand scrub includes the following steps: Select all that apply:
265. A. Clean the sublingual areas of both hands using a disposable nail cleaner
266. B. Dispense an approved antimicrobial scrub agent onto wet arms and forearms
267. D. Wash all four sides of each finger, hand, and arm and repeat on the opposite side
268. E. Wash your hands and forearms with soap and running water
269. Put the following steps in order when opening a wrapped sterile package:
270. Open the farthest wrapper flap
271. Open side flaps
272. Open the nearest wrapper flap
273. Preoperative documentation should include: Select all that apply:
274. A. Administration of ordered preoperative medication
275. C. Performance of the Universal Protocol for preventing wrong site, wrong procedure, wrong person surgery
276. D. Skin assessment
277. The following information is important in the management of forensic specimens. Select all that apply.
278. A. Forensic specimens include but are not limited to hair, fibers, debris, body fluids and foreign bodies
279. B. Forensic specimens require special handling when the surgeon is using metal instruments
280. C. Hospitals need to have policies to give guidance to the preoperative nurse about the management of forensic specimens
281. According to the CDC, which surgical wound classification should be documented for the patient who underwent a laparoscopic appendectomy with the diagnosis of perforated appendicitis?
282. D. Class IV (Dirty/Infected)
283. The preoperative nurse should avoid placing the dispersive electrode on the following areas. Match the area with the rational listed below:
284. A. Scar tissue: May act as insulation
285. B. Tattoo sites: contain metallic elements that could attract current
286. C. Implanted prosthesis: Contain metal which could attract current and impede return current flow
287. D. Hairy sites: Inhibits the flow of electrical current
288. Which of the following strategies should be considered for implementing successful infection control?
289. B. Washing your hands prior to greeting the patient in the pre-operative room
290. Which of the following practices help to prevent contamination in the surgical suite? Select all that apply
291. B. All horizontal surfaces should be damp dusted before the first scheduled procedure of the day.
292. C. hands should be washed with soap and water for at least 15 seconds
293. D. Surgical suites should be cleaned after each surgical procedure with a lint free or microfiber cloth moistened with detergent for disinfectant and water.
294. Which of the following statements about counts is correct? Select all that apply.
295. A. All preoperative personnel involved in a surgical procedure are responsible for the accuracy of sponge counts
296. B. All preoperative personnel involved in a. surgical procedure have a duty to remain aware of the location of sponges on the sterile field and in the wound.
297. C. All sponges must remain in the OR room until the sponge count is complete.
298. E. Two people, one of them whom is the RN circulator, must preform the sponge count
299. An immediate latex allergic response has 3 stages. Which of the following states is matched with the appropriate symptoms?
300. C. Can progress to a sudden drop in blood pressure, increased heart rate and potential circulatory collapse
301. The surgeon’s preference for the preoperative skin pre includes the application of an alcohol and chlorhexidine gluconate (CHG) solution. The primary reason for allowing this prep to dry prior to draping is because:
302. B. Fumes trapped underneath the drapes and could ignite
303. Which of the following is a method for preventing blood-borne pathogen exposure?
304. A. Changing gloves during regular intervals during a procedure
305. Which elements are required to create an environment where the culture of safety is embraced? Select all that apply.
306. A. A sense of trust among all team members
307. B. Development of a proactive approach instead of a reactive approach
308. D. Sincere commitment to affirming safety as the first priority
309. E. Verification of receipt of all information at all levels of the organization
310. Which of the following are qualities of skin adhesive products? Select all that apply.
311. B. They can be used in place of sutures.
312. D. They are primarily used on facial, extremity, and torso wounds.
313. Which of the following practices violates a patient’s ethical right to self-determination?
314. A. Automatic intrapoperative suspension of a don-not-resusucitate decision
315. Which of the following is NOT an example of an ethical dilemma that preoperative nurses may encounter?
316. C. Family disagreement about a below knee amputation of an 19 year old who has already given consent
317. Identify the general guidelines for identifying and labeling specimens. Select all that apply
318. A. Ask the surgeon to identify the specimen
319. B. Complete the laboratory or pathology requisition
320. C. Label the outside of the specimen container with the patients name, identification number, description and source of the specimen and surgeon
321. Which of the following statements about the gowning procedure are correct?
322. D. Step back from the table into an unobstructed area to let the gown unfold
323. A psychosocial assessment may include the patient’s: Select all that apply
324. A. Cultural beliefs and practices
325. B. Expressed level of anxiety or stress
326. C. Spiritual or religious beliefs
327. D. Understanding of the surgical procedure
328. Proper OR attire for restricted areas includes: Select all that apply
329. C. Two-piece scrub suit with top tucked into the pants and secured at the waist
330. D. Warm-up jacket snapped, with cuffs down to wrists
331. How can the preoperative nurse directly contribute to financial efficiency in the OR? Select all that apply.
332. B. Manage the length of cases by having all needed supplies ready
333. C. Participate in product evaluation and waste reduction activities
334. D. Reducing turnover time
335. E. Working to attain on-time starts
336. All of the following organization provide guidance related to tissue banking EXCEPT:
337. D. American National Standards Institute (ANSI)
338. After setting up for a total joint procedure, a dirty instrument is discovered on the sterile back table while waiting for the patient to enter the OR. What actions should be taken to correct the contamination? Select all that apply
339. B. Change the gown and gloves of the contaminated team members
340. C. Break down the entire back table and re-establish a sterile field
341. Important skills affecting the clinical setting include which of the following?
342. D. Problem solving and situational awareness
343. If you have completed your case and must transport your patient to PACU. To give report to the PACU nurse, your facility requires the use of SBAR format, which includes:
344. C. Situation, Background, Assessment, Recommendation
345. The dispersive electrode should:
346. C. Be placed as close to the operative site as possible
347. Which of the following latex sensitivity categories match the description provided?
348. C. Irritant contact dermatitis: non allergic skin reaction usually aggravated by glove power and chemical agents added to raw latex
349. If the preoperative team is unable to extinguish the fire in the OR, recommendations include:
350. C. Evacuating the patient and the preoperative team following the organization fire plan
351. The best intervention to prevent intraoperative pressure ulcer development on the patient’s heels would be to:
352. A. Elevate (offload) heels off the bed
353. Important values affecting the clinical setting include which of the following?
354. C. Fair and equitable care
355. During which phase of wound healing does contraction occur?
356. C. Proliferation
357. Which of the following recommendation for enhancing the future of nursing included in the 21011 Institute of Medicine report? Select all that apply.
358. A. Nurses should engage in life long learning
359. C. Nurses should achieve higher levels of education
360. D. Academic institutions should improve their systems to provide academic progression
361. Safety precaution when handling and caring for powered instruments include: Select all that apply.
362. A. Handling powered instrument to the surgeon with the safety mechanism on
363. B. Having irrigation ready to use the drill or saw
364. D. Using the instrument with the blade guard or drill guard in place
365. During admission of a patient to Phase 1 of post anesthesia care, the perianesthesis nurse is responsible for which of the following? Select all that apply
366. A. Assessing the patient’s level of consciousness
367. B. Assessing the patients pain level
368. C. Maintaining a patent airway
369. D. Monitoring blood pressure, heart rate and oxygen saturation
370. Which of the following environmental sanitation practices is used to limit transmission of microorganisms?
371. D. Use personal protective equipment when handling body fluid spills
372. Which type of needle point should you expect to be needed for suturing viable tissue such as the liver?
373. A. Blunt
374. You have been asked to give a presentation for your unit colleagues on preventing surgical site infections, which of the following discussion points is NOT recommended in AORN guidelines?
375. C. Using soap and water to perform surgical skin prep
376. A patient is unable to transfer independently to the procedure bed, to achieve the outcomes related to safe patient transfer, which measures may be used to prevent shearing injury? Select all that apply.
377. B. Request additional personnel to assist with patient transfer
378. C. Use a friction-reducing transfer sheet.
379. D. Use a slider or roller board
380. E. Use the draw sheet to lift the patient slightly to allow the skin to realign with the skeletal structures
381. When documenting medications, which of the following elements should be included? Select all that apply.
382. B. Drug name, concentrations, route of administration, dose and time it was administered.
383. D. Verbal orders
384. During an inguinal hernia repair the surgeon asks for a self-retaining retractor. Which of the following retractors would be most appropriate to chose?
385. D. Weitlaner
386. The Aldrete scale, used to determine readiness for discharge, measures all of the following EXCEPT:
387. A. Circulation
388. C. Patient mobility
389. D. Pulse oximetry
390. E. respiratory status
391. Match the thermal hemostasis device with the correct action
392. Laser: an intense and concentrated beam of light that coagulates and cuts at the same time while minimizing tissue destruction
393. Electrosurgery: The electrosurgical unit ESU is used to apply electrical current through the patient’s tissue to cute and/or coagulate the tissue
394. Argon Beam: a device that uses ionized gas and electrical current.
395. In which order do the body’s defense mechanisms take place during healing?
396. Stop the blood loss
397. Clean up pathogens and debris in the wound
398. Seal the wound against infection
399. Regenerate the natural epidermal covering
400. Repair the deeper tissue damage.
401. Which process should be performed before construction begins, after demolition, and at the end of an OR construction project?
402. A. Air sampling
403. An area of painful skin that is abraded, blistered, or had shallow craters would be classified as which stage of ulcer?
404. B. Stage II
405. Types of powered cutting instruments include: Select all that apply.
406. A. Bone Reamers
407. C. Saw
408. D. Tissue shavers
409. When setting up the insufflator for a robotic hysterectomy procedure, the perioperative nurse should do all of the following except:
410. D. Set the initial insufflators pressure to 12mmHg
411. A 72 year old man is scheduled for a procedure to repair his right hip fracture. He has a history of smoking and diabetes, and is currently taking prednisone for his rheumatoid arthritis. You are concerned about his wound healing post-operatively based on the following factors: Select all that apply
412. B. Corticosteroids may potentially delay wound healing
413. C. People with diabetes have a higher risk for infection due to the increase in glucose levels
414. D. Smoking as been documented to increase the probability of nonunion at a fracture site
415. When making the preoperative assessment, the nurse should take the following into considerations. Select all that apply
416. A. Mobility
417. C. Planned duration of the procedure
418. D. Preexisiting healthy conditions
419. E. Type of anesthesia
420. Barriers to effective patient and family education in perioperative settings include: select all that apply
421. A. Anxiety about an uncertain outcome
422. B. Discomfort or pain
423. C. Fear of the unknown
424. D. Limited time for assessment and teaching
425. Place the four basic steps of fire safety in the correct order:
426. RACE:
427. Rescue patients and staff members in immediate danger
428. Notify the fire department
429. Confine the fire. Shut the doors
430. Evacuate according to the facility plan
431. Preoperative fluid management is important because excessive amounts of fluid could lead to which of the following conditions? Select all that apply.
432. B. Hypervolemia
433. C. Hyponatremia
434. Performance of the “time out” for patient safety includes verbal team agreement on which of the following items: Select all that apply.
435. A. Patient identification using two patient identifiers
436. B. Site of the procedure, including right-left distinction
437. D. Procedure to be performed
438. The principle elements required for an infection to occur are: Select all that apply.
439. A. A method of transmission
440. B. A source or reservoir
441. C. A susceptible host with a portal of entry to receive an infection
442. While waiting for the prep solution to dry, the circulator observes the laparotomy drape fall below the waist level of the scrub person. What is the best action for the nurse to take?
443. A. Alert the team that the drape is contaminated and replace with a sterile drape
444. The purpose of conducting postoperative phone calls within 24-48 horns for outpatient procedures is: Select all that apply.
445. A. Ask about patient satisfaction with care
446. D. Direct future hospital performance activities
447. E. Note any surgical complications
448. The goals of patient and family education include all of the following EXCEPT:
449. A. Achieve long-lasting improvements in patient health status
450. B. Improve patient satisfaction
451. C. Provide information/knowledge to the patient and and family
452. What are the three methods used to accomplish hemostasis?
453. A. Mechanical, chemical and thermal
454. Which of the following statement is true concerning the use of the AORN Guideline for Preoperative Practices?
455. D. Work setting and situations variations may determine the extent to which the AORN Guidelines can be applied
456. Which of the following statements about gloving is true?
457. B. The gown should be fastened in the back before donning gloves
458. All of the following statements indicate an understanding of the recommended attire for the circulating nurse during and invasive procedure EXCEPT:
459. C. Jewelry should on the outside of surgical attire to be constantly monitored
460. The preoperative nurse’s role in the patient and family education should include: Select all that apply
461. A. Explaining what the patient will experience
462. C. Providing emotional support to enhance coping
463. D. Teaching specific skills that the patient will need to perform postoperatively
464. Interventions to help prevent a surgical site infection (SSI) in the patient undergoing a laparoscopic appendectomy include: Select all that apply
465. A. Performing the surgical skin prep beginning at the planned incision site and moving out towards the periphery in all directions
466. C. Confirming that antibiotics are administered as ordered before the start of the case
467. Which of the following components should be included in documenting the placement of a surgical drain?
468. B. Location of the drain
469. Which of the following practices is recommended to reduce the patient’s risk of intraoperative skin injury
470. D. Protect sensitive areas of the skin with appropriate padding
471. Which of the following is an example of synthetic absorbable material?
472. D. Vicryl
473. Which of the following physiological effects is most likely to result from positioning a patient in lithotomy position?
474. A. Circulatory and respiratory compromise due to pressure on the abdomen
475. When you are receiving a handoff report at a shift change, you notice there appears to be an unlabeled medication on the field. What is the best course of action in this situation?
476. C. Discard the medication and replace with an unopened container
477. Which AORN guideline most directly pertains to interim cleaning in the perioperative environment?
478. A. A safe, clean environment should be reestablished after each surgical procedure.
479. The Joint Commission Universal Protocol consists of: Select all that apply
480. A. Preoperative verification
481. B. Surgical site marking
482. C. Time Out
483. Preoperative documentation should include: Select all that apply
484. A. Administration of ordered medications
485. C. Performance of the universal protocol for preventing wrong site, wrong procedure, wrong person surgery
486. D. Skin assessment
487. The preoperative nurse’s role in preparing and administering medications includes:
488. B. Assessing the patient’s medication allergies and use of herbal or dietary supplements
489. C. Documenting and reading back the surgeon’s oral orders before preparing medications
490. D. Verifying the administration of the correct medication, dose and route
491. What special care procedures are required for microsurgical instruments? Select all that apply
492. B. Keep stainless and titanium instruments separated
493. C. Use a non-birous sponge wipes to clean the instruments recommended
494. D. Use tip covers or protective sleeves when instruments are not used.
495. To minimize the potential for injury to patients related to the use of the ESU, the perioperative nurse should employ which of the following safety measure? Select all that apply
496. A. Ensure that the audible alarm can be heard if it is activated
497. B. If expecting fluids, encase the footswitch in an impervious cover
498. C. Never pour fluids on the generator or foot switch
499. You are preparing your OR for a laparoscopic splenectomy. Which of the following would you need to address after inspecting the surgical environment prior to starting your case? Select all that apply
500. A. One of the surgical lights are dim
501. D. There are no specimen containers available
502. To follow the AORN Guidelines for positioning the patient , the perioperative nurse should:
503. D. Use additional precautions as appropriate based on unique considerations
504. WHICH OF THE FOLLOWING STATEMENTS ABOUT DRAINS ARE CORRECT? SELECT ALL THAT APPLY.
505. B. Drains expedite healing by removing blood, serosanguinous fluid and purulent material
506. C. Drains function by passive (gravity) or active means (suction)
507. D. Hand-off report to the PACU nurse should include; the type location and patency of the drain
508. Types of powered cutting instruments include: Select all that apply.
509. A. Bone Reamers
510. B. Ultrasonic dissectors
511. C. Saws
512. D. Tissue shavers
513. Based on your understanding of chemical safety issues, identify the best strategy to reduce the risk associated with ignition of prep solution vapor.
514. A. Allow the prep to dry before draping to allow vapors to dissipate
515. The goals of the surgical skin prep are to: Select all that apply.
516. A. Inhibit rapid rebound growth of microorganisms
517. B. Reduce the risk of postoperative site infection
518. C. Remove soil and transient microorganisms and to reduce the number of resident microorganisms
519. Endoscopic instrumentation maintenance may be enhanced by all of the following EXCEPT:
520. C. Irrigating channels with normal saline at the end of each case
521. Which of the following statements concerning mentors and preceptors are correct? Select all that apply
522. A. Both model professional nursing behaviors
523. B. Mentors guide nurses through global professional activities
524. C. Preceptors guide nurses through defined clinical activities
525. Which nursing diagnosis is a PRIORITY for the patient who is being positioned for a posterior lumbar laminectomy? Select all that apply.
526. A. Impaired gas exchange
527. D. Risk for preoperative positioning injury
528. When performing a plastic surgery skin closure, which choice of suture size would be most appropriate?
529. C. 5-0
530. Over-oressurizaiton of a tourniquet cull may cause:
531. B. Compression injuries to blood vessels
532. The most important reason for maintaining endoscopic instruments at an optimal level of suction that
533. A. Insulation defects can cause unseen burns
534. Which is the following a disadvantage of using skin clips?
535. C. They often cause more scarring than other skin closure methods
536. Which of the following practices is recommended for damp dusting in the OR? Damp dusting should:
537. D. Begin with higher surfaces and finish with lower surfaces
538. At the end of an orthopedic case, all of the following instrument care guidelines should be followed EXCEPT?
539. B. Place heavy instruments in top of smaller instruments to promote cleaning
540. Which of the following sensory assessment findings is common among elderly patients?
541. A. Decreased color and depth perception
542. Which of the following practices should be used to implement the Joint Commissions Universal Protocol for Preventing wrong site, wrong procedure, wrong person surgery?
543. C. Using the time-out procedure before beginning the procedure
544. Which of the following is a strategy to reduce medication errors?
545. D. Using only computerized physician order entry for medication management
546. Documentation of intraoperative surgical specimens includes which of the following? Select all that apply.
547. A. Identification of the specimen in the intraoperative record and the pathology requisition
548. B. No Abbreviations
549. C. Notation of markers or tags such as clips or sutures, with a statement of what they represent
550. What steps should be followed in correctly draping the sterile field? Select all that apply.
551. A. Drape from sterile to unsterile
552. B. Drape from operative site outward
553. C. Form a cuff with the drape and place gloved hands under the cuff
554. D. Handle each drape as little as possible
555. Which of the following best describes capacitive coupling?
556. C. The transfer of electrical current form the active electrode though intact insulation to adjacent conductive items such as tissue to trocars
557. Which of the following questions would you expect to hear in a preoperative interview? Select all that apply.
558. A. Could you tell me about any past surgeries
559. B. Has your surgeon reviewed the surgical procedure with you? Do you have any questions?
560. C. What medications do you take on a regular basis
561. Which of the following statement about regional anesthesia is correct?
562. B. Continuous never stimulation help insure proper needle placement during peripheral nerve blocks
563. What are the perioperative nurses responsibilities for the informed consent process? Select all that apply.
564. B. Act as a witness attesting to the authenticity of the patients signature, the voluntary nature of the patient’s consent, and answers patient questions about the plan for surgery
565. D. Ensure that the surgeon has discussed the proposed intervention and the risk involved with surgery with the patient and the patient has signed the consent.
566. Intrinsic and extrinsic factors that may lead to development of preoperative pressure ulcer include: Select all that apply.
567. A. Duration of the procedure
568. B. Exaggerated positions
569. C. Circulatory disorders
570. D. Malnutrition
571. The choice of anesthesia is influenced by all of the following EXCEPT:
572. A. Length of surgery
573. C. Past experience with anesthesia
574. D. Surgical procedure
575. Indirect expenses include which of the following: Select all that apply.
576. B. Utilities
577. C. Support services
578. E. Administrative personnel
579. What responsibilities do OR staff members have in maintaining a safe OR environment? Select all that apply.
580. A. Adhering to facility policies related to safety
581. B. Consistently applying OR specific safety practices
582. D. Monitor, identify and report safety hazards.
583. Which PNDS outcome is the most important when draping the surgical patient?
584. A. The patient is free from signs and symptoms of infection
585. All of the following are important examples of activities that re made possible with preoperative nursing EXCEPT:
586. B. Ability to freely distribute information regarding surgical procedure and iqsgnosis to patient’s family and employer postoperatively
587. Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply.
588. A. The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges
589. B. Outside shipping containers are segregated from items on shelves
590. C. Traffic should be controlled to limit access to those trained in the handling of sterile supplies
591. D. Sterile supplies are able to be stored in a manner that allows adequate air circulation
592. Intraoperative responsibilities of the nurse caring for a patient undergoing a procedure with general anesthesia may include which of the following? Select all that apply.
593. A. Applying cricoid pressure if necessary
594. B. Double checking blood if administered
595. D Obtaining warming blankets and emergency equipment as necessary
596. E. Assessing the patient throughout the operative procedure
597. In which type of healing does the wound remain open and allowed to heal on its own without additional surgery?
598. B. Granulation
599. You are circulating on a laparoscopic appendectomy. Upon entering the abdomen, the surgeon encounters non-purulent inflammation and ask for a culture. The procedure is completed using the laparoscope without need to open the abdomen, in completing your documentation of wound class the best choice would be:
600. C. Contaminated
601. Which item blow is typically subjected to non-biologic testing?
602. C. Bullet from a crime scene
603. Which of these practices is recommended during decontamination of used instruments? Select all that apply.
604. B. Open box locks and dissemble instruments with multiple parts
605. D. Use enzymatic detergent on heavily soiled instruments
606. E. Wear PPE
607. Which of the following environmental sanitation practices is used to limit the transmission of microorganisms?
608. D. Use PPE when handling body fluid spills
609. What is the most appropriate needle point for performing a vascular anastomosis?
610. C. Taper Point
611. According to the CDC, which wound classification should be documented for the patient who underwent a laparoscopic appendectomy with the diagnosis of perforated appendicitis?
612. D. Dirty (Class IV)
613. Your are the circulating RN for a patient having an operative hysteroscopy. Actions you should take to achieve correct fluid management for the patient includes all of the following EXCEPT:
614. A. Assessing the patients NPO status NPO status, weight, medication, and allergies.
615. When making the preoperative assessment the nurse should take the factors into consideration? Select all that apply.
616. A. Mobility
617. C. Planned duration of the procedure
618. D. Preexisting health conditions
619. E. Type of anesthesia
620. When selecting surgical drapes the following are desirable characteristics. Select all that apply.
621. A. Antistatic and allergenic
622. B. Barrier to restrict passage of microorganisms
623. C. Resistance to tearing, punctures, or abrasions
624. D. Dull or non-glaring material
625. Which of the following are preoperative systemic factors that negatively affect wound healing? Select all that apply.
626. A. Diabetes
627. C. Protein deficiency
628. D. Smoking
629. E. Steroid use
630. Documentations of intraoperative surgical specimens include which of the following? Select all that apply.
631. A. Indication of the specimen in the intraoperative record and the pathology requisition
632. B. NO abbreviations
633. C. Notation of markers or tags such as slices or sutures with a statement of what they represent.
634. All of the following are important examples of activities that are mad possible with preoperative nursing documentation EXCEPT?
635. D. Ability to freely distribute information regarding surgical procedure and diagnosis to patient’s family and employer
636. Which of these practices is recommended during decontamination of used instruments? Select all that apply.
637. B. Open box locks and disassemble instruments with multiple parts
638. D. Use an enzymatic detergent on heavily soiled instruments
639. E. Wear PPE
640. To prevent or minimize electrosurgical injuries to patients the preoperative nurse should Select all that apply.
641. A. Assure that the prep solutions have dried and vapors evaporated before the device is used
642. B. Confirm each requested power setting orally with the surgeon
643. C. Inspect each circuit component if the surgeon repeatedly requests high power settings
644. D. Inspect the electrosurgical unit before each use to verify the electrical integrity.
645. Which of the following are examples of the Guidelines – A sterile field should be maintained and monitored constantly. Select all that apply.
646. B. If a delay occurs after a sterile field is set up, it may be covered with sterile drapes until the delay is resolved.
647. C. If a delay occurs after a sterile field is set up, personnel my leave the room as long as someone remains in the room to maintain continuous visual observation of the sterile field
648. D. The sterile field should be prepared as close as possible to the time of use.
649. Safety precautions when handling and caring for powered instruments include. Select all that apply.
650. A. Handling the powered instrument to the surgeon with the safety mechanism on
651. B. Having irrigation ready to use with the drill or saw
652. D. Using the instrument with the blade guard in place
653. What are the requirements for hospital disinfectants? Select all that apply.
654. A. Labeled as an EPA registered germicide
655. B. Meets the required indications of use
656. C. Has passed the potency test against 3 representative microorganisms
657. The preoperative nurse’s role in preparing and administering medications includes: Select all that apply
658. B. Assessing the patients medications allergies and use of herbal or dietary supplements.
659. C. Documenting and reading back the surgeon’s oral orders before preparing the medications
660. D. Verifying the administration of the correct medication, dose, and route.
661. The open assisted gloving technique should be used: Select all that apply.
662. B. Everytime gloves are changed during a case
663. C. When close assisted gloving is not possible.
664. D. When the surgeon requests this specific technique
665. Proper OR attire for restricted area includes: Select all that apply.
666. B. Shoe coverings required for all team members during c-section deliveries
667. C. Two piece scrub suit with top tucked into the pants and secured at the waist
668. D. Warm up jacket snapped with cuffs down to wrists.
669. When the tourniquet has been used for a surgical procedure the circulating nurse should document the following: Select all that apply.
670. B. Limp Occlusion Pressure (LOP) and cup pressure
671. C. Location of tourniquet and time of inflation and deflation
672. D. Skin protective measures and preoperative and post-operative skin assessments
673. Bases on your knowledge of universal protocol, which of the following are acceptable methods to correctly identify your patient. Select all that apply.
674. B. Aks the patient to state his or her date of birth
675. C. Ask the patient to state his or her full name
676. Which of the following is the best way to conduct a Time Out?
677. D. The Time Out takes place once the patient is prepped and draped and involves the entire team
678. What precautions should be taken when microbibrillar collagen is used as a hemostatic agent intrapoperatively?
679. C. Avoid using it with an autologous blood salvage unit
680. Only facility approved EPA registered disinfectants should be used to clean your facility. For which organisms must an approved disinfectant pass potency test against?
681. B. Pseudomonas aeruginosa
682. C. Salmonella choleraesuis
683. D. Staphylococcus aureus
684. Which of the following activities should be performed during post procedure cleaning of an OR?
685. A. Clean the floor, moving the OR bed to clean underneath
686. Which of the following is a finding of recent research studies on the value of certification?
687. C. Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse.
688. Which of the following are examples of regional anesthesia methods? Select all that apply.
689. B. Epidural blocks
690. C. Eye (Retrobulbar) blocks
691. D. Spinal blocks
692. E. Upper extremity blocks
693. The culture of a clinical setting if affected by which of the following skills. Select all that apply.
694. A. Collaborations
695. B. Conflict resolution
696. C. Decision making
697. Critical thinking considerations when positioning a surgical patient include all of the following EXCEPT:
698. A. Assessing patient position once at the beginning of the procedure.
699. Potential sources of fuel for surgical fires include:
700. A. Draping materials
701. During the physiologic portion of the perioperative assessment, which systems should be assessed more carefully in elderly and pediatric patients? Select all that apply.
702. A. Cardiovascular
703. C. Renal
704. D. Respiratory
705. Which of the following statements is generally true about the coping styles of pediatric patients between the ages of 3 and 6 years?
706. A. This age group interprets term literally
707. The perioperative team implements aseptic technique practices to meet all of the following primary goals except:
708. A. Improve patient satisfaction
709. Which of the following strategies are recommended to reduce the occurrence of retained surgical items? Select all that apply
710. Avoid distractions during the counting process.
711. Count items including radiopaque soft goods, sharps and other miscellaneous items and instruments.
712. Use a standardized approach each time a count is conducted.
713. Based on your knowledge of the Universal Protocol, Which of the following are acceptable ways to identify your patient? SELECT ALL THAT APPLY.
714. Ask the patient to state his or her date of birth.
715. Ask the patient to state his or her full name
716. Which nerves are most frequently injured as a result of improper positioning of the patients arms? Select all that apply.
717. brachial plexus
718. ulnar
719. The surgeon’s preference for the preoperative skin prep includes the application of an alcohol and chlorhexidine gluconate (CHG) solution. The primary reason for allowing this prep to dry prior to draping is because:
720. Fumes trapped underneath the drapes could ignite
721. What factors increase the risk for skin injury? Select all that apply.
722. Diabetes
723. Prolonged length of surgery
724. Unusual positions or positioning devices
725. Documentation of intraoperative surgical specimens includes which of the following: Select all that apply
726. Identification of the specimens in the intra-operative record and the pathology requisition
727. No abbreviations
728. Notation of markers or tags such as clips or sutures, with a statement of what they represent
729. The choice of anesthetic is determined after patient evaluation by and anesthesia professional. Some factors that may impact this decision include which of the following? Select all that apply.
730. Age
731. ASA physical status classification
732. Length of surgery
733. Past experience with anesthesia
734. Surgical procedure
735. Timely administration of Dantrolene or Ryanodex is a critical measure in resolving a malignant hyperthermia crisis. Which of the following are also corrective measures that should be implemented? Select all that apply.
736. Provide 100% oxygen
737. Stop administration of trigging agents
738. Stop surgery all together if possible
739. Used iced saline to cool patient
740. Which of the following reflects examples of a preceptor’s role working with a new preoperative RN.
741. Limiting support to a fixed period of time. Asking questions, and supporting growth and development
742. The AORN guideline for Environmental Cleaning gives director to preoperative staff on cleaning and disinfection in the surgical environment. Which recommendations in that guideline address interim cleaning? Select all that apply.
743. A safe, clean environment should be reestablished after each surgical procedure.
744. Contaminated disposable items should be handled safely accordingly to state and federal regulations
745. Personnel should take precautionary measures to limit transmission of microorganisms when performing environmental cleaning and disinfection activities.
746. When a preoperative nurse is assigned to monitor the patient receiving moderate sedation the following are recommendations for this role. Select all that apply.
747. ACLS certification
748. Competency in the use of monitoring and emergency resuscitative equipment and drugs
749. Access to and ability to administer appropriate reversal medications
750. Terminal cleaning is performed on a daily basis after scheduled cases are completed. This process includes cleaning of the following: Select all that apply.
751. Anesthesia carts and equipment
752. Ceilings and walls
753. Mopping or wet vacuuming floors
754. OR beds, and positioning devices
755. According to AORN Guideline on Environmental Cleaning a safe clean environment should be reestablished after each surgical procedure. Facility approved EPA registered disinfectants are used to accomplish which of the following activities? Select all that apply.
756. All mattress and pad surfaces on the OR bed are to be cleaned
757. Kick buckets haps are inspected and cleaned if soiled
758. The area of the floor cleaned should include all areas that are visible soiled
759. Preliminary room preparation is performed before the first case of the day. All of the following are activities included in the preparation EXCEPT:
760. Damp dust with a lint-free cloth moistened with 70% isopropyl alcohol
761. Which of the following attributes of the nursing process reflect the use of critical thinking skills? Select all that apply.
762. Requires evaluation and reflection
763. Requires seeking additional information
764. Results in a decision
765. When assessing your patients tolerance for the planned surgical position which factors are important to consider? Select all that apply.
766. BMI
767. Nutritional status
768. Physical limitations
769. Pre-exisiting conditions
770. According to the AORN Guideline on Environmental Cleaning, which of the following are strategies for effective between procedure cleaning in the surgical environment? Select all that apply.
771. Evidence based literature support cleaning the entire floor after each surgical procedure
772. Extend the perimeter of the floor area being mopped to include all areas that are visibly soiled
773. You are second scrubbing today with another nurse. As you are both changing in the locker room, you notice the following aspects of her surgical attire. Which aspects of her surgical attire are acceptable? Select all that apply.
774. Hair is contained in a facility approved bouffant head covering
775. Scrub top is secured by tucking it into her pants
776. Putting on a long sleeved warm-up jacket to prepare for her circulating role
777. A 72 year old man is scheduled for a procedure to repair his right hip fracture. He has a history of smoking and diabetes, and is currently taking prednisone for his rheumatoid arthritis. Based on this history, your would be concerned about which of the following.
778. Delayed wound healing
779. Two types of regional anesthesia include spinal and epidural blocks. Which of the following reflect complications of an epidural block?
780. hypotension, high spinal paralysis, spinal headache
781. What are the 3 main factors to consider when assessing the patient for allergies?
782. Prior reaction, hereditary, type of reaction
783. To follow AORN Guidelines for positioning the patient, the preoperative nurse should
784. use additional precautions as appropriate based on unique patient considerations
785. Which of the following statements is TRUE concerning use of the AORN guidelines for Preoperative Practice?
786. Work setting and situation variations may determine the extent to which the AORN guidelines can be applied
787. Proper OR attire for restricted areas include: Select all that apply.
788. Two piece scrub suit with top tucked into pants and secured at waist.
789. Warm up jacket snapped with cuffs down to wrists
     shoe coverings required for all team members during c-section
790. When documenting medications, which of the following elements should be included? Select all that apply
791. Drug name, concentration, route of administration, dose and time it was administered
792. Verbal orders
793. Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply.
794. The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges
795. Traffic should be controlled to limit access to those trained in the handling of sterile supplies
796. Sterile supplies are able to be stored in a manner that allows adequate air circulation

16[Date]AORN Periop 101 Final Exam Questions andAnswers (2022/2023) Using mechanical friction when prepping will NOT aid inA. Removal of resident bacteriaB.Removal of dirt and oilC.The effectiveness of antimicrobialsD.Removal of transient bacteria Correct Ans – A. Removal ofresident bacteriaReduction in resident bacteria is aided by:A. Use of a degreaser B. Use of antimicrobialsC. Prepping clean to dirtyD. Mechanical friction Correct Ans – B. Use of antimicrobialsProlonged contact of skin antisepsis agents due to pooling of the solutions can cause patient injuries that include:1.Chemical burns2.Thermal burns3.Injuries related to equipment malfunction Correct Ans – A. 1 and2Which one of the following statements is TRUE?A. Povidone-iodine’s mechanism of action is to disrupt the cell membrane B. Povidone-iodine is nonirritating to the skinC. Povidone-iodine cannot be used on mucous membranesD. Heating povidone-iodine may decrease its effectiveness Correct Ans-D. Heating povidone-iodine may decrease its effectivenessDocumentation of the preoperative skin prep includes all of the follow EXCEPT:A.Hair removalB.Manufacturer of solutions usedC. AllergiesD. Name of the person who performed the prep Correct Ans – B.Manufacturer of solutions usedWhen prepping an extremity, which one of the following is ALWAYS required?A. Positioning the extremity to prevent prep solution from running toward the incision siteB.Assistance in holding the limbC.Scrubbing nails with a brush before the formal prepD.Prepping so that the entire limb can be draped Correct Ans -A. Positioning the extremity to prevent prep solution from running toward the incision site1
16Surgical wound infections can result in decreased . A. Hospitalization timeB. Intraoperative time C. Income for hospitalsD. Workload for perioperative nurses Correct Ans – C. Income forhospitalsPreoperative skin preparation is accomplished by . A. Removing soil and transient microbesB. Reducing resident microbesC. Using antimicrobial agents that inhibit growth of microbes D. All of the above Correct Ans – D. All of the aboveAccording to AORN’s guidelines for skin preparation of patients, hair at theoperative site is .A. Allowed to remain unless it interferes with the surgical procedures B. Always removed with a depilatoryC. Removed at least two hours before surgeryD. Dry shaved as opposed to wet shaved Correct Ans – A. Allowedto remain unless it interferes with the surgical proceduresThe concept of prepping from clean to dirty means . A. Cleaning all stomas or open wounds firstB.Beginning at the incision site and using circular strokes toward theperipheryC.Prep solution is changed after cleaning contaminated areasD.Surgical scrub solutions used first and then surgical paint Correct Ans-B. Beginning at the incision site and using circular strokes toward theperipheryCommon resident bacteria include all EXCEPT:A. Staphylococcus epiermidis B. Staphylococcus aureusC. Diphtheroid bacillusD. Pseudomonas aeruginosa Correct Ans – wrongWhich one of the following statements about the skin prep is FALSE? A. Povidone-iodine should not be allowed to dryB.Manufacturers’ guidelines should be followedC.Skin prep is performed after the patient has been positionedD.The name of the person performing the prep should be documentedCorrect Ans – A. Povidone-iodine should not be allowed to dryObjectives of the surgical prep include all EXCEPT:
16A.Removal of dirt, skin oil, and microbes from the skin
16B.Sterilization of skinC.Reduction of bacterial countD.Prevention of regrowth of microbes for several hours Correct Ans- B. Sterilization of skinThe generally recognized length of time required for contact of antimicrobialagents to be effective isA. 1 to 3minutes B. 2 to5 minutes C. 3to 5 minutesD. According to manufacturers’ directions Correct Ans – D.According to manufacturers’ directionsThe principles of preoperative skin preparation include all of the following EXCEPT:A. Prep from clean to dirty B. Use aseptic technique C. Prep stomas firstD. Prevent pooling Correct Ans – C. Prep stomas firstWhich one of the following topical antimicrobial agents is neurotoxic? A. Povidone-iodineB.AlcoholC.PCMX (parachlorometaxylenol)D.Chlorhexidine gluconate Correct Ans – D. ChlorhexidinegluconateWhich statement is TRUE about iodophor with alcohol? A. It provides rapid reduction in microbial counts of skinB. Persistence or residual activity is excellentC. It has been shown to be nontoxic and nonirritatingD. Percutaneous absorption does not occur across mucous membranesCorrect Ans – wrongWhich statement is FALSE about eye, extremity, or vaginal preps?A.A 5% sterile ophtalmic prep solution is commercially available for eyeprepsB.The vagina should be prepped first as part of a vaginal prepC.When prepping an extremity, it should be positioned so that the incisionsite is the upper-most portion of the prepD.If fingers or toes are included in the surgical field (extremity prep), it may be necessary to scrub the nail with a brush and soap solution Correct Ans – B. The vagina should be prepped first as part of a vaginal prepHand hygiene should be performed after which of the following? A. Touching the operating room bed controls
16B. Adjusting a patient’s bed linens C. EatingD. Marking the surgical siteE. All of the above Correct Ans – E. All of the aboveWhen should perioperative team members use an alcohol-based rub for hand hygiene?A. After hands have been exposed to blood or other bodily fluids B. After using the restroomC. When the hands are not visibly soiledD. When caring for patients with spore-forming organisms Correct Ans-C. When the hands are not visibly soiledWhat is the minimum length of time perioperative team members should spend performing hand hygiene by washing with soap and water?A. 7 seconds B. 15 secondsC. 20 secondsD. 30 seconds Correct Ans – B. 15 secondsHow much of an alcohol-based hand rub should be used when performing hand hygiene?A. A dime-sized amount B. A quarter-sized amountC. 10 dropsD. The amount recommended by the manufacturer Correct Ans -D. The amount recommended by the manufacturerPerioperative team members should maintain fingernails at a maximum ofwhat length?A. 2 mm (0.08inch) B. 6 mm(0.24 inch) C. 10mm (0.4 inch)D. 12 mm (0.5 inch) Correct Ans – A. 2 mm (0.08 inch)Which of the following measures is helpful for maintaining healthy skin and minimizing the risk of hand dermatitis?A. Completely drying hands before putting on glovesB. Avoiding water hotter than 80° F (27° C)C. Using approved moisturizing productsD. Using glove linersE. All of the above Correct Ans – E. All of the aboveWhich of the following types of jewelry is acceptable for perioperative teammembers to wear in patient care areas?A.One ring per hand
16B.WatchC.Loose bracelet D. Fitness monitorE. No jewelry is acceptable Correct Ans – E. No jewelry is acceptableWhich of the following is a primary line of defense for protecting the patientfrom the transmission of pathogens during surgical procedures?A. Sterile glovesB. Sterile gownsC. Surgical hand antisepsisD. Surgical masks Correct Ans – C. Surgical hand antisepsisWhich of the following parts of the surgical gown is considered sterile? A. The axillary regionB.The backC.The cuf f of the gown sleeveD.The front from the chest to the level of the sterile fieldE.The shoulders Correct Ans – D. The front from the chest to the level of the sterile fieldWhich method of gloving should be used by team members during the initialgowning and gloving process for surgical procedures?A. Assisted gloving with gown cuffs at fingertips B. Assisted gloving with gown cuffs at wristsC.Open glovingD.Open assisted glovingE.Any of the above Correct Ans – A. Assisted gloving with gowncuffs at fingertipsHow often should surgical gloves be changed during an invasive surgical procedure?A. Every 60 to 90 minutes B. Every 90 to 150 minutesC. Surgical gloves only require changing if a known or suspected break in technique occurs or a tear is identified in the gloveD. There is no recommended time for changing gloves Correct Ans -wrongWhich of the following is the preferred method for assessing hand hygiene in the perioperative setting?A.Direct observationB.Measurement of product usageC. Automated monitoringD. Self-reporting Correct Ans – wrong

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16Approximately what percentage of surgical patients develop a surgical site infection during hospitalization?A.1%B.5%C. 10%D. 15%E. 20% Correct Ans – B. 5%Which of the following terms is used to refer to seepage of fluid through a sterile material with subsequent bacterial penetration?A. Breakthrough B. Pierce throughC. Punch throughD. Strikethrough Correct Ans – D. StrikethroughWhich of the following type of drape is designed to be tubular? A. Fenestrated drapeB. Flat sheet C. StockinetteD. Towel Correct Ans – C. StockinetteWhich of the following is recommended when opening a sterile field in the perioperative setting?A.All sterile fields for all patients should be opened in a designated centralsterile area and transported to the OR for useB.Cables and tubing should be secured with non-perforating devicesC.Drapes should be shaken after opening and before placement to removedustD.When draping a patient, the RN should drape the peripheral areas first and move inward toward the surgical site Correct Ans – B. Cablesand tubing should be secured with non-perforating devicesWhich surfaces of the sterile drape are considered sterile?A. Top onlyB. Top and bottom but not sidesC. Top and sides but not bottomD. Top, bottom, and sidesE. Bottom and sides Correct Ans – A. Top onlyDrapes are considered contaminated under which of the following conditions?A.A hole is discoveredB.The drape drops below waist levelC. The drape is placed incorrectlyD. There is some doubt about the drape’s sterilityE. All of the above Correct Ans – E. All of the above
16The perioperative RN should do which of the following when draping a patient for a laparotomy?A.Stand on the opposite side of the OR bed when handing sterile towels tothe surgeonB.Secure sterile towels with pointed, penetrating clipsC.Place the opening of the laparotomy sheet directly over the surgical siteD. Unfold the drapes toward the bottom and top of the patient before unfolding to the sideE. All of the above Correct Ans – C. Place the opening of thelaparotomy sheet directly over the surgical siteWhich of the following is an important consideration when draping patients for procedures on the eye?A.It is important to repel waterB.The environment must be free of lintC.Cataract procedures are often performed without sedation D. Adequate air exchange for the patient must be maintainedE. All of the above Correct Ans – E. All of the aboveThe perioperative RN should follow which of these procedures when draping equipment?A.Drape equipment that will be positioned over the sterile fieldB.Drape equipment that will be positioned immediately adjacent to thesterile fieldC.Drape large pieces of equipment as close to the time of use as possibleD. Follow the manufacturer’s instructions for useE. All of the above Correct Ans – E. All of the aboveWhich of the following is an acceptable position for the hands and arms of a scrubbed person for maintaining the integrity of the sterile field?A. Straight down at the sidesB. Above waist levelC.Folded with hands in the axillary areaD.Resting against another scrubbed person’s backE.All of the above Correct Ans – B. Above waist levelWhen should perioperative team members wear surgical attire and a surgicalhead covering?A. Any time they enter an operating room for any reasonB. Only when they are directly involved with patient careC. Only when they are part of the scrubbed teamD. Only when they are transferring sterile items to the sterile fieldE. Only when they will remain in an operating room for more than 1 minuteCorrect Ans – A. Any time they enter an operating room for any reason
16Which of the following is the most important practice for minimizing the risk for infectious organism transmission?A. Keeping doors to the operating room closedB. Observing isolation precautionsC. Performing hand hygiene and surgical hand antisepsis D. Properly preparing the sterile fieldE. Wearing a gown and gloves Correct Ans -C. Performing handhygiene and surgical hand antisepsisWhich of the following parts of a surgical gown are considered sterile?A. The backB. The neckline C. The shouldersD. The sleeves from the cuf f to 2 inches above the elbowE. All of the above Correct Ans – D. The sleeves from the cuf f to 2 inches above the elbowWhich of the following statements about preparation of sterile fields is most accurate?A.Sterile fields for all procedures planned for the day should be prepared inthe morning before patients arriveB.Sterile fields should be prepared in a dedicated sterile room andtransported to the operating rooms for useC.Perioperative team members should perform surgical hand antisepsisbefore preparing a surgical sterile fieldD.Sterile fields for multiple patients can be prepared at the same time to improve efficiency Correct Ans – C. Perioperative team membersshould perform surgical hand antisepsis before preparing a surgical sterilefieldWhich of the following areas of a properly draped sterile field is considered sterile?A. The bottom B. The sides C. The topD. Any area above the tallest scrubbed team member’s waistlineE. All of the above Correct Ans – C. The topWhich of the following isolation technique procedures should be followed to prevent the spread of cancer cells from one area to another during resectionof metastatic tumors?A.Changing surgical gloves when soiledB.Covering existing sterile drapes with new sterile drapes after the resectionC. Discontinuing use of instruments after they were used for the tumor excision
16D. Organizing the sterile field in a way that minimizes risk of exposure to cancerous cellsE. All of the above Correct Ans – E. All of the aboveWhich of the following practices should be followed when transferring sterile items to the sterile field?A.An unscrubbed team member should stand as close as possible to thesterile field when transferring itemsB.Only a scrubbed team member may transfer sterile items to the sterilefieldC.Open and transfer all sterile items needed for the procedure to the sterilefield before the patient enters the roomD.Present heavy or sharp sterile items directly to a scrubbed team memberreceiving the items onto the sterile fieldE.Toss sterile items onto the sterile field from a distance whenever possibleCorrect Ans – D. Present heavy or sharp sterile items directly to a scrubbed team member receiving the items onto the sterile fieldWhat is the best practice to follow if a contaminated item is discovered in a set of sterilized instruments?A. Consider all opened instruments in the room to be contaminated B. Consider only the involved item to be contaminatedC. Consider the entire set to be contaminatedD. Consider the involved item and any other item within 4 inches of the involved item to be contaminated Correct Ans – C. Consider theentire set to be contaminatedWhich of the following statements regarding the use of a unidirectional ultra clean air delivery system is most accurate?A. Heater-cooler devices should be positioned inside the air curtain B. Scrubbed team members should stand outside the air curtainC. The sterile instrument table should be positioned inside the air curtain D. The surgical site should be positioned outside the air curtainE. Unscrubbed team members should remain inside the air curtain as much as possible Correct Ans – wrongWhich of the following practices should scrubbed team members follow to maintain the integrity of the sterile field?A. Avoid folding the arms with hands in the axillary area B. Keep hands and arms above the waist level at all timesC.Maintain distance between themselves and other scrubbed teammembers when changing positionD.Remain face to face or back to back with other scrubbed team memberswhen changing positionE.All of the above Correct Ans – E. All of the above
16The use of a pneumatic tourniquet during extremity surgery: A. Is a noncontroversial practiceB.Requires effective communication and collaboration between nurses,anesthesia personnel, and the surgeonC.Is safe for all patients as long as tourniquet time does not exceed 30minutesD.All of the above Correct Ans – B. Requires effective communication and collaboration between nurses, anesthesia personnel, andthe surgeonPhysiologic effects of exsanguination and pneumatic tourniquet inflation during surgery typically include all of the following EXCEPT:A. Increase in central venous pressure B. Increased heart rateC. Increased core body temperatureD. Decreased core body temperature Correct Ans – D. Decreasedcore body temperatureWhich of the following is NOT a common physiologic effect ofpneumatic tourniquet deflation following a period of inflation during surgery?A.HypotensionB.Decreased heart rateC.Increased core body temperatureD.Decreased core body temperature Correct Ans – C. Increasedcore body temperatureThe acid-base effects of pneumatic tourniquet deflation following a period of inflation are characterized by:A. Elevated PaCO2 with respiratory acidosis and metabolic alkalosis B. Elevated PaCO2 with respiratory acidosis and metabolic acidosis C. Decreased PaCO2 with respiratory alkalosis and metabolic acidosisD. Decreased PaCO2 with respiratory alkalosis and metabolic alkalosis Correct Ans – B. Elevated PaCO2 with respiratory acidosis and metabolicacidosisA type of tissue in the extremities that is highly susceptible to ischemia is: A. Skeletal muscleB. NervesC. BoneD. Skin Correct Ans – A. Skeletal muscleA perioperative nurse is performing a preoperative assessment of a patient scheduled for total knee arthroplasty. Which of the following is NOT a primary contraindication for pneumatic tourniquet use?A.Significant vascular disease, including recent bypass, history of deepvenous thrombosis, or impaired peripheral circulation
16B.Sickle cell anemia and other forms of hemoglobinopathyC.History of pain or weakness in the bones or muscles of the extremitiesD.History of ulcerative colitis Correct Ans – D. History of ulcerativecolitisChoose the FALSE statement about pneumatic tourniquet safety.A.Wider, contoured cuffs are generally safer than narrow cuffs because theyrequire less pressure to achieve a near bloodless fieldB.Increased tourniquet time increases the risk of postoperativecomplicationsC.Narrow cuffs are generally safer than wide, contoured cuffs because theyrequire less pressure to achieve a near bloodless fieldD.Increased cuf f pressure increases the risk of postoperative complicationsCorrect Ans – C. Narrow cuffs are generally safer than wide, contoured cuffs because they require less pressure to achieve a near bloodless fieldChoose the FALSE statement regarding intravenous regional anesthesia (Bier’s block).A.After a procedure is over, the perioperative nurse should leave the cufffully inflated for at least 60 minutesB.Intermittently deflating and reinflating the cuf f for several cycles after the procedure is over may help minimize peak blood concentration of the local anesthetic and reduce the risk of a systemic toxic reactionC.Central nervous system abnormalities are usually the earliest warning signs of a systemic toxic reaction during intravenous regional anesthesia D. Before applying a pneumatic tourniquet, nurses should screen patients for sensitivities to local anesthetics and communicate with the anesthesia professional to confirm the plan for intravenous regional anesthesia Correct Ans – A. After a procedure is over, the perioperative nurse should leave the cuf f fully inflated for at least 60 minutesChoose the extremity and nerve most frequently affected by pneumatictourniquet-induced nerve damage.A. Lower limb, peroneal nerve B. Upper limb, radial nerve C. Upper limb, median nerveD. Upper limb, ulnar nerve Correct Ans – B. Upper limb, radial nerveA perioperative nurse is assessing patients for DVT risk factors prior to lowerlimb surgeries. Based on the following descriptions, which patient DOES NOThave risk factor(s) for DVT?A.A 35 year old patient on prolonged bed restB.A 70 year old smoker with no history of significant medical problemsC. An obese 45 year old who is otherwise healthy
16D. A 20 year old non-smoking athlete with a left anterior cruciate ligament tear Correct Ans – D. A 20 year old non-smoking athlete with a leftanterior cruciate ligament tearThe average estimated number of surgical fires every year in the United States is:A. 20 to 30 B. 200 to 240C. 700 to 1000 D. 2000 to 2500E. 2500 to 2700 Correct Ans – B. 200 to 240Choose the FALSE statement about perioperative fire prevention and management plans.A.They should be developed by a multidisciplinary group of keystakeholdersB.They should describe key content and frequency of fire safety educationactivitiesC.They should specify policies and procedures for fire prevention andresponseD.They generally are not needed unless required by a health care facility’sinsurance policyE.They should specify team member roles and responsibilities during fireprevention and response Correct Ans – D. They generally are notneeded unless required by a health care facility’s insurance policyThe three components of the fire triangle are oxidizing source, ignition source, and fuel source.A.TrueB.False Correct Ans – A. TrueThe three overriding principles of operating room fire safety are: A. Awareness, communication, teamworkB. Oxidizing source, heat source, fuel source C. Inspect, check, respondD. Prevent, extinguish, evacuateE. Source, extinguish, safety Correct Ans – D. Prevent, extinguish, evacuateExamples of ignition sources include:A. Electrocautery units and active electrosurgical electrodes B. Fiber-optic light cordsC. Lasers D. A and CE. A, B, and C Correct Ans – E. A, B, and C
16A fire risk assessment should be performed:A.Only before procedures involving electrocautery, an electrosurgical unit,or a laserB.Only if requested by the surgeon or first assistantC. Before all operative proceduresD. Only before surgical procedures above the xiphoid process and in the nasopharynxE. Only if the patient requires more than 30% supplemental oxygenCorrect Ans – C. Before all operative procedureshe flash point of flammable materials is , while the flash point of combustible materials is :A. Less than 100° F, greater than 100° FB. Greater than 100° F, less than 100° F C. Equal to 100° F, greater than 100° F D. Less than 120° F, greater than 120° FE. Greater than 120° F, less than 120° F Correct Ans – A. Less than100° F, greater than 100° FOxidizing sources in the operating room include:A.OxygenB.Nitrous oxide C. Carbon dioxideD. A and BE. A, B, and C Correct Ans – D. A and BFuel sources in the operating room include:A. Gauze sponges B. Floor glueC. Ceiling tile D. ScrubsE. Surgical instruments Correct Ans – A. Gauze spongesPerioperative registered nurses and scrub personnel have primary control over which component of the fire triangle during an operating or other invasive procedure?A. Oxidizing sourcesB. Fuel sourcesC. Ignition sources D. A and BE. A and C Correct Ans – B. Fuel sourcesChoose the FALSE statement about fire risks in the operating room.A.Patients with their heads draped are at increased risk of fire becausesupplemental oxygen can accumulate under drapes
16B.Substances that would not ignite in room or medical air can do so in an oxygen-enriched environment, which may occur in the operating roomC.Evaporated gases from flammable prep solutions can ignite, especially ifthey are allowed to accumulate under drapesD.Bowel surgeries are associated with the highest risk of surgical firesE. A piece of equipment that is smoking unexpectedly represents animmediate fire risk Correct Ans – D. Bowel surgeries are associatedwith the highest risk of surgical firesFire blankets should NOT be used in the operating room because they: A. Are made of wool, which can catch fire in an oxygen-enriched environmentB. Can cause wound contamination or move instruments at the surgical site C. Can trap fire next to or under a patientD. All of the aboveE. B and C Correct Ans – D. All of the aboveWhich of the following fire safety practices should be implemented when alaser is used during surgery?A.Keep wet towels and saline on the sterile fieldB.Place moist sterile towels, sponges, and drapes around the surgical siteC. Use standard endotracheal tubes for upper airway procedures involvinglaserD.allow fumes from flammable solutions to dissipate before activating thelaserE.A and B onlyF.A, B, and C only G. A, B, and D onlyH. A and D onlyI. C and D only Correct Ans – wrongWhich type of fire extinguisher is most appropriate to extinguish a fire on or in a patient?A.Carbon dioxide extinguisherB.Ammonium phosphate or other dry powder extinguisher C. Water mist extinguisherD. Foam extinguisherE. A or C Correct Ans – wrongPatients and personnel must be evacuated because of an operating roomfire. The proper order of steps to take is:A.Alarm, confine/contain, rescue, evacuateB. Rescue, alarm, confine/contain, evacuateC. Rescue, evacuate, alarm, confine/containD. Confine/contain, alarm, rescue, evacuate
16Rescue, alarm, confine/contain, evacuateIf evacuated because of a fire, health care personnel should go: A. To the front doors of the buildingB.Outside the buildingC.Behind at least two sets of fire doorsD. To the nearest stairwellE. To the nearest safe location where they can resume caring for patientsCorrect Ans – E. To the nearest safe location where they can resume caring for patientsA scrubbed perioperative registered nurse observes a fire start on a patient in the operating room. After alerting the team, the nurse should immediately:A. Obtain and operate the nearest fire extinguisher by using the PASS techniqueB. Pat the flames with a drapeC. Smother the fire with a towel or pour nonflammable liquid on the fire D. Lift the patient and transport him or her out of the roomE. Turn of f the oxygen source Correct Ans – C. Smother the fire with a towel or pour nonflammable liquid on the fireWhich practice is NOT recommended to prevent fires during surgeries athigh-risk sites?A.use an ignition source to enter gas-distended bowelB.pack the back of the throat with radiopaque sponges prior totonsillectomyC.stop supplemental oxygen or nitrous oxide for one minute before using anignition sourceD.place an adhesive incise drape between the surgical site and the oxygen sourceE.inflate endotracheal tubes with tinted solutions prior to tracheotomyCorrect Ans – A. use an ignition source to enter gas-distended bowelIfan airway fire occurs, perioperative team members should be prepared to help the anesthesia professional do which of the following:A.disconnect and remove the anesthesia circuit and turn of f the flow of oxygenB.remove the endotracheal tube from the airway, including any burnedfragmentsC.pour saline or water into the airway D. examine and re-establish the airwayE. assess the surgical field for secondary fireF. all of the aboveCorrect Ans – F. all of the aboveE. Alarm, rescue, evacuate, confine/contain Correct Ans – B.
16All of the following are appropriate practices to manage oxidation sources in the operating room EXCEPT:A.administer the lowest concentration of oxygen needed to maintainadequate oxygen saturationB.use a laryngeal mask or endotracheal tube if the patient needs more than30% supplemental oxygenC.ensure that there are no leaks in the anesthesia circuitD.turn the warmer blower of f when using a warming blanket with an attached head drapeE.prevent oxygen from accumulating under drapes Correct Ans -wrongWhich of the following is a potential oxidizer for fires in the operating room? A. Electrosurgical unitsB. GauzeC. Nasal cannulaeD. Nitrous oxideE. Solutions containing alcohol Correct Ans – wrongAll of the following are safety precautions common to all energy-generating devices EXCEPT:A.Alcohol-soaked pads should not be allowed on the surgical field whenenergy-generating devices are usedB.Foot pedals should be enclosed in a fluid resistant cover whenever thereis potential for a fluid spillC.Oxygen delivery to the patient should be stopped or reduced to the lowest possible level when energy-generating devices are used around thehead, face, or neckD.The RN circulator should activate the foot pedal at the direction of the surgeon using the hand pieceE.The lowest power settings that will accomplish the desired task should beused Correct Ans – D. The RN circulator should activate the foot pedal at the direction of the surgeon using the hand pieceWhen is it acceptable to disable the alarms on energy-generating devices? A. Alarms should never be disabledB. During the time out before the procedure C. When the device is on standbyD. When they are creating a distraction for the practitioner performing the procedureE. When they are making the patient anxious Correct Ans -A. Alarms should never be disabledWhich of the following is an accurate statement about dispersive pads used with monopolar electrosurgical units?A.Disposable pads can be removed and repositioned several times
16B.The pad should be cut to conform to the curves of the patient’s bodyC. The pad should be placed as far from the surgical site as practical tominimize interference with the procedureD. The pad should be placed distal to a tourniquet whenever possibleE. There should be no metal objects between the pad and the surgical siteCorrect Ans – E. There should be no metal objects between the pad andthe surgical siteWhich of the following tissue types is the best conductor of electricity? A. BoneB. Fat C. HairD. MuscleE. Scar tissue Correct Ans – D. MuscleWhich of the following statements is most accurate about the interaction ofenergy-generating devices and implanted electronic devices such as pacemakers?A.A magnet should always be placed on an implanted device during the procedureB.Different models of the same type of device from the same manufacturerrespond the same way when exposed to energy-generating devicesC.Most modern implanted electronic devices are constructed with shieldingto protect them from energy discharges and do not require any special precautionsD.Standard protocols should be established for management of implantedelectronic devicesE.The team managing the implanted device should be consulted to developa plan of care Correct Ans – E. The team managing the implanted device should be consulted to develop a plan of careWhich of the following systems should be used to minimize the risk for injury during minimally invasive surgery?A. Active electrode shielding systems B. Conductive trocar systemsC. Hybrid trocar systemsD. All of the aboveE. A and B only Correct Ans – E. A and B onlyWhich of the following is true about eye protection in areas where lasers are in use?A.All lasers require the same type of eye protectionB.Eye protection is required for everyone in the hazard zoneC.Looking away while the laser is in use is sufficient protection in mostcases
16D.Patients under general anesthesia with eyes taped shut do not requireeye protectionE.Prescription glasses provide sufficient protection for most lasers Correct Ans – B. Eye protection is required for everyone in the hazardzoneWhich of the following people is responsible for verifying that protective equipment for lasers is available and properly maintained?A. Biomedical engineerB. Laser operatorC. Laser safety officer D. Laser safety specialistE. Laser user Correct Ans – C. Laser safety officerWhich of the following is a risk unique to argon-enhancing coagulation systems?A. Alternate site injuries B. Antenna couplingC.FireD.Gas embolizationE.Retinal damage Correct Ans – D. Gas embolizationAlcohol should be used for cleaning and disinfection of large blood spills. A. TrueB. False Correct Ans – B. FalseWhich of the following disinfectants is required for general disinfection ofnon-critical items?A. High-level disinfectant B. Low-leveldisinfectantC. Intermediate-level disinfectantD. Sanitizer Correct Ans – wrongTerminal cleaning is typically the responsibility of the Environmental Services Team.A.TrueB.False Correct Ans – A. TrueDust is not known to contain human skin and hair, pollens, and mold. A. TrueB. False Correct Ans – B. FalseInfections can potentially be acquired from which of the following sources? A. Contaminated environmental surfacesB. Contaminated handsC. Contaminated skin
16D. All of the above Correct Ans – D. All of the aboveFederal law requires that all sharps be placed in biohazard containers prior to disposal.A.TrueB.False Correct Ans – A. TrueWhich of the following basic components of personal protective equipment should be worn by the perioperative nurse when likely contacting potentially infectious material?A.GlovesB.Gown, mask, and eye shieldsC. N-95 respiratorD. All of the above Correct Ans – wrongWhich federal agency regulates the Bloodborne Pathogens Standard? A. AORNB. CDCC. HHSD. OSHA Correct Ans – D. OSHAWhich of the following are typical microorganisms found in the perioperative setting?A. ESBL-producing organisms B. SerratiaC. StaphylococcusD. All of the above Correct Ans – D. All of the aboveClostridium difficile is primarily transmitted via which of the following routes?A. Respiratory/inhalationB. IV InjectionC. Fecal-oralD. None of the above Correct Ans – C. Fecal-oralWhich of the following pathogens requires special attention for disinfection of tsurfaces contaminated with brain, eye, or spinal cord tissue?A.CJDB.Clostridium difficileC. MRSAD. VRECorrect Ans-A. CJDWhich of the following microorganisms are found routinely in water pipes in ceilings or during wall demolitions?A. MRSAB. VREC. Aspergillus
16D. None of the Above Correct Ans – C. AspergillusFloors should be mopped or wet-vacuumed with an EPA registered disinfectant after all scheduled cases are completed.A.TrueB.False Correct Ans – A. TrueLiquid waste can be disposed in which of the following manners? A. Adding a solidifying powder to the liquidB.Using a medical liquid waste disposalC.Pouring the liquid down a sanitary sewerD.All of the above Correct Ans – D. All of the aboveDisinfectants used in health care facilities do not require EPA registration.A. TrueB. False Correct Ans – B. FalseDamp-dusting should be performed using EPA registered disinfectant.A. TrueB. False Correct Ans – A. TrueWhich of the following would be considered noncritical items? A. Blood pressure cuffsB. Foley cathetersC. NeedlesD. All of the above Correct Ans – A. Blood pressure cuffsIce machines are known vectors of infection transmission when not properly maintained and cleaned.A.TrueB.False Correct Ans – A. TrueA hierarchy of controls should be used to prevent sharps and injuries in health care settings. The CORRECT order of implementation, ranked from potentially most effective to least effective, is:A.Hazard elimination, engineering controls, work practice controls,administrative controls, PPEB.Hazard elimination, work practice controls, engineering controls, PPE, administrative controlsC.Engineering controls, hazard elimination, administrative controls, workpractice controls, PPED.Hazard elimination, engineering controls, PPE, work practice controls, administrative controlsE.PPE, work practice controls, administrative controls, engineering controls, hazard elimination Correct Ans – A. Hazard elimination, engineeringcontrols, work practice controls, administrative controls, PPE
16Cases of bloodborne pathogen transmission from sharps injuries are primarily the result of , although more than 20 other pathogens havebeen implicated.A. HBV, HCV, and HIVB. HBA, HBV, and HIVC. HAV, HBV, and HCVD. HBA, HBV, and HAV Correct Ans – A. HBV, HCV, and HIVSharps injuries in the OR are especially hazardous because surgical procedures often involve substantial amounts of blood and other possibly infectious body fluids. The most common cause of sharps injuries in the OR is , followed by :A. Scalpels, bone cuttersB. Scalpels, syringesC. Sharp suture needles, scalpelsD. Hypodermic syringes, sharp suture needles Correct Ans -C.Sharp suture needles, scalpelsAll of the following are examples of hazard elimination for sharps safety EXCEPT:A. Using electrosurgery instead of a scalpel when making a surgical incisionB. Requiring at-risk health care workers to participate in annual trainings onsharps safetyC. Ensuring that the facility only uses needleless IV systemsD. Eliminating the use of injectable needles when feasible and clinically appropriate Correct Ans – B. Requiring at-risk health care workersto participate in annual trainings on sharps safetyExamples of appropriate administrative controls to prevent sharps injuries include all of the following EXCEPT:A.Developing and updating sharps policies and proceduresB.Incorporating sharps safety prevention into a new or existing committeestructureC.Allowing only doctors to handle sharpsD.Educating and training employees on the proper handling and disposal ofsharps and safety engineered devices Correct Ans – C. Allowing only doctors to handle sharpsAll are UNSAFE practices in the OR EXCEPT which of the following?A.Passing sharps hand-to-hand between team members during orthopedic surgeryB.Waiting until after surgery to say something if you observe unsafe sharpshandlingC.Carefully recapping contaminated needles using a scooping technique
D. Disposing of sharps in an unlabeled bag Correct Ans- C.Carefully recapping contaminated needles using a scooping technique16Which of the following is NOT an appropriate work practice control to preventsharps injuries in the OR?A.Use of a neutral or safe zone when passing sharps between team membersB.Grasping and manipulating needles and scalpel blades with instruments orsuture packs instead of fingersC.Wearing a colored pair of gloves outside a standard pair during surgery D. During microscopic surgeries, placing the sharp in the surgeon’s hand andhaving the surgeon place the sharp in the designated neutral zone to return it to the scrub personE. Grasping a needle with a blunt instrument when suturing Correct Ans-C. Wearing a colored pair of gloves outside a standard pair during surgeryWhich of the following is NOT an appropriate response to a sharps injury inthe workplace?A.Immediately wash the area with soap and water and seek medicaltreatmentB.Report the injury to your supervisor as soon as possibleC.Report the injury to your supervisor only if the wound becomes infectedD. Discuss with your supervisor the risk of infection based on the infectionstatus of the patient and the presence of blood and other body fluids at time of injury Correct Ans – C. Report the injury to your supervisor only ifthe wound becomes infectedChoose the FALSE statement about introducing safety engineered sharps devices in health care settings?A.Sharps products under consideration should primarily be evaluated byadministrators who can compare them to benchmarking standardsB.Sharps products under consideration by a facility should be evaluated byfront-line users trained in correct use of the deviceC.Final product selections should be based on results of a one-page testersurvey tool that is easy to complete and score and includes room for commentsD.Safety engineered devices must be evaluated every year Correct Ans-A. Sharps products under consideration should primarily be evaluated byadministrators who can compare them to benchmarking standardsBloodborne pathogen exposure control plans must conform to all of the following EXCEPT:A. Be written and must follow federal, state, and local rules and regulationsB. Establish and define work restrictions for health care workers who have transmissible bloodborne infections
16C. Specify processes for education, training, competency evaluation, evaluation of the efficacy and utility of sharps safety devices, and annual review of sharps safety issuesD. Be posted in every room in which sharps are handled Correct Ans- D. Be posted in every room in which sharps are handledDouble gloving is an example of using PPE to reduce the risk of sharps injuries. Based on available evidence about its effectiveness, double gloving should be practiced:A. When the surgeon gives consent to do so B. During all surgical proceduresC. When there is a written policy requiring the use of double gloves during surgeryD. When the surgical patient is known to have a bloodborne pathogeninfection Correct Ans – B. During all surgical proceduresEngineering controls help prevent sharps injuries. Which statement about safety engineered devices is FALSE?A.Safety engineered devices include blunt-tip needles, single-use scalpels,retractable scalpels, and needles with sliding sheaths or needle guardsB.Studies have not yet shown that safety engineered devices significantly reduce needlestick injuries, but they should be used anyway as a precautionC. Safety engineered devices should be used during surgery unless their usecould negatively affect patient safetyD. Blunt-tip needles are safety engineered devices designed to penetrate muscle and fascia, but not skin Correct Ans – B. Studies have notyet shown that safety engineered devices significantly reduce needlestick injuries, but they should be used anyway as a precautionWhich statement about neutral zones is FALSE? A. A kidney basin is appropriate for a neutral zoneB. The neutral zone should be designated during preoperative briefing C. When moving a sharp to the neutral zone, give verbal notice such assaying “sharp”D. Only one sharp and one hand at a time should be in the neutral zoneE. The sharp should be positioned for easy retrieval by the surgeonCorrect Ans – A. A kidney basin is appropriate for a neutral zoneIf a needle must be-recapped, the proper technique to use is:A.Hold the cap with your fingers sideways and slide the needle into the capwith your other handB.With the cap on a stable, flat surface, guide the needle into the cap while holding only the syringe attached to the needle, then tip up the syringe so the cap sits on the needle hub and secure the cap in placeC.Hold the syringe vertically while sliding the cap over the needle
D. Use both hands to center and push the cAns-B. With the cap on a stable, flat surface, guide the needle into the cap while holding only the syringe attac16Which of the following is NOT an appropriate way to prevent sharps injuries in the OR?A.Communicating the location of sharps on the sterile field during personnelchangesB.Removing suture needle from suture before tyingC. Using double-gloved hands to retract tissueD. Cutting the exposed ends of sharp pins or Kwires, or covering them with aprotective cap after they have passed through a patient’s skin Correct Ans – C. Using double-gloved hands to retract tissueNeedleless systems should be used when:A.Withdrawing fluids from multi-use vialsB.Withdrawing body fluids after establishing initial accessC. Administering fluids or medicationsD. Withdrawing IV fluidsE. A, B, and CF. B, C, and D G. A and DH. A, B, C, and D Correct Ans – D. Withdrawing IV fluidsSelect the FALSE statement about alternative wound closure.A.Tissue adhesive is comparable to suture in terms of infection rates, cost,and patient and user satisfactionB.Tissue adhesive enables faster wound closure than sutureC.Tissue adhesive can be associated with higher rates of wound dehiscence than sutureD.Other examples of alternative wound closure devices include tissue staplers and adhesive skin closure strips Correct Ans – B. Tissueadhesive enables faster wound closure than sutureIf a sharps injury occurs during a surgery, employers must:A. Report the name of the injured worker and details of the exposure to OSHA B. Conduct source testing and risk assessmentC. Take responsibility for post-exposure prophylaxis D. B and CE. A and B Correct Ans – D. B and CSelect the FALSE statement. To reduce the risk of injuries to staf f and patients during invasive procedures, the scrub person should:A.Stack used non-sharp instruments on top of contaminated reusable sharpsfor transport to the decontamination area
16B.Use needle-counting devices to contain and isolate sharps on the sterileback tableC.Place used needles in a disposable, puncture resistant needle counter thatis appropriately labeled or color-coded and leak-proof on the sides and bottomD.Make sure sharps are not removed from the OR until the final count reconciliation is done and the patient has been removed from the roomCorrect Ans – A. Stack used non-sharp instruments on top of contaminated reusable sharps for transport to the decontamination areaSharps disposal containers in the perioperative area outside the sterile field should be:A.Kept on a table behind other equipmentB.Replaced as soon as they begin to overflowC.Open containers as long as they are labeled with a biohazard symbol D. Leak-proof, puncture-resistant, and closeable Correct Ans – D.Leak-proof, puncture-resistant, and closeableIonizing radiation is useful for diagnostic radiology because: A. It can harm cellsB. It is of low frequency C. It can penetrate tissueD. It is absorbed by lead Correct Ans – C. It can penetrate tissueChoose the TRUE statement.A.Only pregnant women are at risk from ionizing radiation exposureB.The risks of adverse effects from ionizing radiation exposure decreasewith increasing doseC.Anyone exposed to ionizing radiation can have adverse effectsD. There is a minimum (safe) threshold for exposure to ionizing radiation Correct Ans – C. Anyone exposed to ionizing radiation can have adverseeffectsThe primary occupational source of ionizing radiation exposure in health care facilities is:A.CarelessnessB.Incorrect positioning of equipmentC. ScatterD. Lack of following radiation protocols Correct Ans – C. ScatterThe three fundamental principles of radiation safety are:A. Regulations, protocols, and consistencyB.Measure, protect, and reportC.Aprons, dosimeters, and leaded wallsD.Time, distance, and shielding Correct Ans – D. Time, distance, and shielding
16Ionizing radiation doses should be:A. Monitored only if the radiation worker is a minor or is older than 50 years. B. Administered at the highest level necessary, regardless of a patients’ exposure history.C. Kept as low as reasonably achievable.D. Monitored only if the radiation worker is pregnant Correct Ans -C. Kept as low as reasonably achievable.In health care settings, the primary occupational source of radiation exposure is:A.LasersB.Direct beam radiationC. MRI scannersD. Scatter Correct Ans – D. ScatterLead shielding should be used:A. Only at the discretion of a surgeon or radiologist B. Whenever possible to attenuate radiationC. If a patient or staf f person requests itD. If an ionizing radiation dose to a patient is expected to exceed 20 remCorrect Ans – B. Whenever possible to attenuate radiationA 0.25 mm lead apron will reduce scattered x-rays by approximately: A. 15%B. 25%C. 50%D. 95% Correct Ans – D. 95%Average cumulative radiation exposure has in the past several decadesas a result of changes in medical applications of ionizing radiation:A. DecreasedB. IncreasedC. Remained about the same Correct Ans – B. IncreasedA person who works with radiation is required to be monitored if:A. He or she asks to beB. His or her annual dose is likely to exceed 15 mrem C. He or she is likely to exceed 10% of the dose limitD. He or she is likely to exceed 50% of the dose limit Correct Ans -C. He or she is likely to exceed 10% of the dose limitFor adults who work with radiation, the annual occupational whole body dose limit is:A. 5 rems B. 15 rems
16C. 50 remsD. 500 rems Correct Ans – wrongFor adults who work with radiation, the annual dose limit for the skin/extremities is:A. 5 rems B. 15 remsC. 50 remsD. 500 rems Correct Ans – C. 50 remsFor adults who work with radiation, the annual dose limit for the lens of the eye is:A. 5 rems B. 15 remsC. 50 remsD. 500 rems Correct Ans – B. 15 remsFor minors who work with radiation, the annual dose limit is:A. 10% of adult dose limitsB. 50% of adult dose limits C. 75% of adult dose limitsD. 150% of adult dose limits Correct Ans – A. 10% of adult doselimitsThe dose limit for a fetus is:A. 0.5 rem during the entire pregnancy B. 0.5 rem per monthC. 5 rem during the entire pregnancyD. 5 rem per month Correct Ans -A. 0.5 rem during the entirepregnancyThe linear-no-threshold model assumes that the stochastic effects of radiation:A. Are inversely proportional to the doseB. Are directly proportional to the doseC. Occur only after a certain level of cumulative exposureD. Increase exponentially as exposure increases Correct Ans – B.Are directly proportional to the doseAll of the statements about the proper use of dosimeters (badges) in the workplace are TRUE except for:A.When one dosimeter is used, all personnel should wear it at the sameplace on the bodyB.Badges should be exchanged for assessment and replaced at pre-determined intervals
16C.Badges should not be taken home at the end of the workday
16D.The best place to leave a badge when not in use is on an apron Correct Ans – D. The best place to leave a badge when not in use is onan apronBadges worn by pregnant personnel should be worn at waist level and read every:A. Week B. MonthC. Three monthsD. Six months Correct Ans – B. MonthIf a health care worker who works with radiation becomes pregnant, she should:A.Stop working with any form of radiationB.Promptly inform the radiation safety officer C. Wear a badge at waist level outside her apronD. Switch from a lead apron to a lead-free alternative for comfortCorrect Ans – B. Promptly inform the radiation safety officerThe most serious long-term effect of ionizing radiation exposure is: A. BlindnessB. Osteoporosis C. CancerD. Skin injuries Correct Ans – C. CancerTo minimize patients’ risk of adverse effects from radiation exposure, perioperative nurses should do all of the following except:A. Keep extraneous body parts out of the primary radiation beam B. Place lead shielding between the radiation source and the patientC. Place lead shielding on the opposite side of the patient from the radiation sourceD. Check medical records before radiographic procedures to ensure patientsdo not have substantial amounts of residual radioactive material in their bodies Correct Ans – C. Place lead shielding on the opposite side ofthe patient from the radiation sourceRadiation dose limits for members of the public are rem per year andless than rem in any hour.A. 0.1, 0.002B. 1, 0.02C. 5, 1D. 10, 20 Correct Ans – A. 0.1, 0.002Select the TRUE statement about appropriate handling of shielding garments.A.Protective garments should be discarded annually
16B.Leaded eyewear is not indicated unless personnel are within 6 inches ofthe primary beamC.Protective garments can be evaluated for damage by lining them up and scanning them on a CT tableD.RFIDs contribute to radioactivity and should not be used in equipment protecting against radioactivity Correct Ans – C. Protective garments can be evaluated for damage by lining them up and scanning themon a CT tableAccording to the 2013 American College of Radiology guidelines on MR safety:A. All clinical and research MR sites should maintain MR safety policies.B. An MR medical director should be designated to ensure that safety guidelines are established and updatedC. The MRI suite should be a zero tolerance zone where adverse events,MR safety incidents, or near accidents are promptly reported to the MRmedical directorD. All of the above Correct Ans – D. All of the aboveSelect the behavior or practice that does not conform with the radiation safety principles of time, distance, and shielding.A.Wear a lead-free (lead alternative) garment to protect against direct beam exposureB.Stand on the image detector side of the fluoroscopy system, away fromthe tubeC.Shield the upper legs when standing near the radiation beamD.Stand facing the radiation source or wear a wrap-around apron Correct Ans – A. Wear a lead-free (lead alternative) garment to protect against direct beam exposureWhich is not an appropriate way to decrease exposure to ionizing radiation from patients?A.Shield syringes containing radioactive microspheres (eg, seeds, microbeads)B.Follow universal precautions when patients are treated with I-131 forthyroid cancerC.When patients have undergone diagnostic nuclear medicine studies,handle their body fluids and tissues the same way as for any invasive procedureD.Label sentinel lymph node biopsy specimens as radioactive in accordancewith facility policies Correct Ans – B. Follow universal precautions when patients are treated with I-131 for thyroid cancerWhich cell type or tissue is least sensitive to the effects of ionizing radiation?A. NeuronsB.Bone marrow
16C.GonadsD.Embryonic cells Correct Ans – IncorrectAccording to American College of Radiology guidelines on magnetic resonance (MR) safety:A.patients and non-MR staf f should be allowed to travel freely through ZoneIIB.patients and non-MR staf f should have unrestricted access to Zone IIIC.non-MR staf f should have access to Zone II as long as they are wearing a dosimeterD.access to Zones III and IV should be severely restricted because of therisk of injury or death from magnetic interactions with ferromagnetic materials Correct Ans – D. access to Zones III and IV should be severely restricted because of the risk of injury or death from magnetic interactions with ferromagnetic materialsA woman undergoes standard thoracic radiographs (x-rays) for a chronic cough and enlarged left cervical lymph node. Her prior exposure to ionizing radiation is minimal. The woman later determines that she was approximately 10 days pregnant when the radiographs were taken. This woman most likely has a:A. Substantially increased risk of later developing cancerB. Very small increased risk of later developing cancer C. Substantially increased risk of spontaneous abortionD. Substantially increased risk of having a child with a hereditary defect, such as trisomy 21 (Down’s syndrome) Correct Ans – B. Very smallincreased risk of later developing cancerWhen distance from the point source of radiation doubles, ionizing radiation exposure is approximately:A. One quarter of the previous levelB. One third of the previous level C. The same as beforeD. Twice the previous level Correct Ans – IncorrectIn 1920, an organization that developed a standard curriculum of OR techniques wasA. American Medical Association B. AORNC. Bellevue HospitalD. The National League of Nursing Correct Ans – D. The NationalLeague of NursingPerioperative RNs primarily use checklists to ensure that: A. Lawsuits from the patient and their family are avoided B. Surgical supplies are not wasted before or after surgery
16C. Team members begin shifts on scheduleD. The plan of care is implemented correctly before, during, and after surgery Correct Ans – D. The plan of care is implemented correctlybefore, during, and after surgeryThe TIME OUT should be performed by which member(s) of the perioperative team?A. All perioperative team membersB. RN circulatorC. Scrub personD. Surgeon Correct Ans – A. All perioperative team membersThis perioperative RN coordinates the patient’s care in the OR, prepares the OR, and assists the anesthesia professional if requested.A.PACU RNB.Pre-admission RNC. RN circulatorD. RN first assistant Correct Ans – C. RN circulatorWhich of the following best describes the semirestricted area? A. Has work areas for processing and storing instrumentsB.Includes an operating roomC.Permits wearing of street clothesD.Requires that all patients wear masks Correct Ans – A. Has workareas for processing and storing instrumentsWhat statements below are TRUE related to creating and maintaining a sterile field?A.A sterile field should be prepared as near as possible to the start time ofthe surgeryB.Movement of personnel around the sterile field should be minimizedC. The scrub person is a part of the sterile fieldD. All of the aboveE. A and B only Correct Ans – D. All of the aboveApproximately what percentage of serious medical errors are thought to be associated with miscommunication during patient hand-offs?A. < 1%B. 10%C. 50%D. 80%E. 100% Correct Ans – D. 80%Examples of allied healthcare providers include: A. Anesthesia techniciansB. Surgical residents
16C. Surgical technologistsD. All of the aboveE. A and C only Correct Ans – E. A and C onlyPatients who are “fast-tracked” from the OR to the PACU Phase II due to the administration of rapidonset, fast-emergence, general anesthetics may require an increased use of which prophylactic medications?A.AntiemeticsB.AntihypertensivesC. Pain medications D. All of the aboveE. A and C only Correct Ans – E. A and C onlyThe PACU RN observes his patient is more alert and functional and no longerrequires intensive nursing care. The PACU RN focuses on preparing the patient for self-care and care by support persons. Select this patient’s phase in recovery.A. Phase I B. Phase II C. Phase IIID. Phase IVE. Not possible to state based on this information Correct Ans – B.Phase II