AORN Periop 101 Exam A __________ is a designated area on the sterile field where the scrub person and the surgeon place all sharp instruments. - ✔A. Neutral zone 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. ✔Delayed wound healing 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 - ✔B. Corticosteroids may potentially delay wound healing C. People with diabetes have a higher risk for infection due to the increase in glucose levels D. Smoking as been documented to increase the probability of nonunion at a fracture site 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? - ✔C. Chlorhexidine gluconate 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. - ✔B. Request additional personnel to assist with patient transfer C. Use a friction-reducing transfer sheet. D. Use a slider or roller board E. Use the draw sheet to lift the patient slightly to allow the skin to realign with the skeletal structures A psychosocial assessment may include the patient's: Select all that apply - ✔A. Cultural beliefs and practices B. Expressed level of anxiety or stress C. Spiritual or religious beliefs D. Understanding of the surgical procedure A surgical hand scrub includes the following steps: Select all that apply: - ✔A. Clean the sublingual areas of both hands using a disposable nail cleaner B. Dispense an approved antimicrobial scrub agent onto wet arms and forearms D. Wash all four sides of each finger, hand, and arm and repeat on the opposite side
E. Wash your hands and forearms with soap and running water 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. - ✔- All mattress and pad surfaces on the OR bed are to be cleaned - Kick buckets haps are inspected and cleaned if soiled - The area of the floor cleaned should include all areas that are visible soiled 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. - ✔- Evidence based literature support cleaning the entire floor after each surgical procedure - Extend the perimeter of the floor area being mopped to include all areas that are visibly soiled 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? - ✔D. Class IV (Dirty/Infected) According to the CDC, which wound classification should be documented for the patient who underwent a laparoscopic appendectomy with the diagnosis of perforated appendicitis? - ✔D. Dirty (Class IV) After initial administration, which statement below the proper order of the 4 stages of general anesthesia affecting the patient? - ✔A. Administration, excitement, intrasurgery, respiratory failure 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 - ✔B. Change the gown and gloves of the contaminated team members C. Break down the entire back table and re-establish a sterile field All of the following are important examples of activities that are mad possible with preoperative nursing documentation EXCEPT? - ✔D. Ability to freely distribute information regarding surgical procedure and diagnosis to patient's family and employer All of the following are important examples of activities that re made possible with preoperative nursing EXCEPT: - ✔B. Ability to freely distribute information regarding surgical procedure and iqsgnosis to patient's family and employer postoperatively All of the following organization provide guidance related to tissue banking EXCEPT: ✔D. American National Standards Institute (ANSI)
All of the following statements indicate an understanding of the recommended attire for the circulating nurse during and invasive procedure EXCEPT: - ✔C. Jewelry should on the outside of surgical attire to be constantly monitored An area of painful skin that is abraded, blistered, or had shallow craters would be classified as which stage of ulcer? - ✔B. Stage II An immediate latex allergic response has 3 stages. Which of the following states is matched with the appropriate symptoms? - ✔C. Can progress to a sudden drop in blood pressure, increased heart rate and potential circulatory collapse An important difference between minimally invasive (MIS) and open surgical procedures is that MIS: - ✔A. Can be performed through smaller incisions. At the end of an orthopedic case, all of the following instrument care guidelines should be followed EXCEPT? - ✔B. Place heavy instruments in top of smaller instruments to promote cleaning Barriers to effective patient and family education in perioperative settings include: select all that apply - ✔A. Anxiety about an uncertain outcome B. Discomfort or pain C. Fear of the unknown D. Limited time for assessment and teaching Based on your knowledge of the Universal Protocol, Which of the following are acceptable ways to identify your patient? SELECT ALL THAT APPLY. - ✔- Ask the patient to state his or her date of birth. - Ask the patient to state his or her full name Based on your understanding of chemical safety issues, identify the best strategy to reduce the risk associated with ignition of prep solution vapor. - ✔A. Allow the prep to dry before draping to allow vapors to dissipate Bases on your knowledge of universal protocol, which of the following are acceptable methods to correctly identify your patient. Select all that apply. - ✔B. Aks the patient to state his or her date of birth C. Ask the patient to state his or her full name By using a high radio frequency electrical current, surgeons routinely use electrosurgery to _________ the tissue. - ✔C. Cut and coagulate Critical thinking considerations when positioning a surgical patient include all of the following EXCEPT: - ✔A. Assessing patient position once at the beginning of the procedure.
Documentation of intraoperative surgical specimens includes which of the following: Select all that apply - ✔- Identification of the specimens in the intra-operative record and the pathology requisition - No abbreviations - Notation of markers or tags such as clips or sutures, with a statement of what they represent Documentation of intraoperative surgical specimens includes which of the following? Select all that apply. - ✔A. Identification of the specimen in the intraoperative record and the pathology requisition B. No Abbreviations C. Notation of markers or tags such as clips or sutures, with a statement of what they represent Documentations of intraoperative surgical specimens include which of the following? Select all that apply. - ✔A. Indication of the specimen in the intraoperative record and the pathology requisition B. NO abbreviations C. Notation of markers or tags such as slices or sutures with a statement of what they represent. 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 - ✔A. Assessing the patient's level of consciousness B. Assessing the patients pain level C. Maintaining a patent airway D. Monitoring blood pressure, heart rate and oxygen saturation During an inguinal hernia repair the surgeon asks for a self-retaining retractor. Which of the following retractors would be most appropriate to chose? - ✔D. Weitlaner During the physiologic portion of the perioperative assessment, which systems should be assessed more carefully in elderly and pediatric patients? Select all that apply. - ✔A. Cardiovascular C. Renal D. Respiratory During which phase of wound healing does contraction occur? - ✔C. Proliferation 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. - ✔A. Patients previous abdominal surgery. B. History of DVT. C. Voiding in the prep area prior to going to the OR.
Endoscopic instrumentation maintenance may be enhanced by all of the following EXCEPT: - ✔C. Irrigating channels with normal saline at the end of each case How can the preoperative nurse directly contribute to financial efficiency in the OR? Select all that apply. - ✔B. Manage the length of cases by having all needed supplies ready C. Participate in product evaluation and waste reduction activities D. Reducing turnover time E. Working to attain on-time starts Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply. - ✔- The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges - Traffic should be controlled to limit access to those trained in the handling of sterile supplies - Sterile supplies are able to be stored in a manner that allows adequate air circulation Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply. - ✔A. The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges B. Outside shipping containers are segregated from items on shelves C. Traffic should be controlled to limit access to those trained in the handling of sterile supplies D. Sterile supplies are able to be stored in a manner that allows adequate air circulation Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply. - ✔A. The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges C. Traffic should be controlled to limit access to those trained in handling of sterile supplies D. Sterile supplies are able to bet stored in a manner that allows adequate air circulation. 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 Identify the general guidelines for identifying and labeling specimens. Select all that apply - ✔A. Ask the surgeon to identify the specimen B. Complete the laboratory or pathology requisition C. Label the outside of the specimen container with the patients name, identification number, description and source of the specimen and surgeon If the preoperative team is unable to extinguish the fire in the OR, recommendations include: - ✔C. Evacuating the patient and the preoperative team following the organization fire plan
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: - ✔C. Situation, Background, Assessment, Recommendation Important skills affecting the clinical setting include which of the following? - ✔D. Problem solving and situational awareness Important values affecting the clinical setting include which of the following? - ✔C. Fair and equitable care In addition to giving Dantrolene, which of the following treatment options for malignant hyperthermia should the nurse anticipate and prepare for? - ✔B. Provide 100% oxygen, used iced saline to cool patient. In preparing for a regulatory survey, your quality consultant questions you about the restricted zone in your OR suite. The following statements are true: - ✔A. Air flow in the OR rooms should be cleaned by HEPA filters. C. Mask are required when open sterile supplies are present. E. Temperature is maintained between 68 and 75 degree F. In which order do the body's defense mechanisms take place during healing? - ✔1. Stop the blood loss 2. Clean up pathogens and debris in the wound 3. Seal the wound against infection 4. Regenerate the natural epidermal covering 5. Repair the deeper tissue damage. In which type of healing does the wound remain open and allowed to heal on its own without additional surgery? - ✔B. Granulation Indirect expenses include which of the following: Select all that apply. - ✔B. Utilities C. Support services E. Administrative personnel Interventions to help prevent a surgical site infection (SSI) in the patient undergoing a laparoscopic appendectomy include: Select all that apply - ✔A. Performing the surgical skin prep beginning at the planned incision site and moving out towards the periphery in all directions C. Confirming that antibiotics are administered as ordered before the start of the case 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 - ✔A. Applying cricoid pressure during intubation if necessary
B. Double checking blood if administered D. Obtaining warming blankets and emergency equipment as necessary E. Assessing the patient throughout the operative procedure 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. - ✔A. Applying cricoid pressure if necessary B. Double checking blood if administered D Obtaining warming blankets and emergency equipment as necessary E. Assessing the patient throughout the operative procedure Intrinsic and extrinsic factors that may lead to development of preoperative pressure ulcer include: Select all that apply. - ✔A. Duration of the procedure B. Exaggerated positions C. Circulatory disorders D. Malnutrition Intrinsic and extrinsic factors that may lead to development of preoperative pressure ulcer include: Select all that apply. - ✔A. Duration of the procedure B. Exaggerated positions C. Circulatory disorders D. Malnutrition Match the thermal hemostasis device with the correct action - ✔- Laser: an intense and concentrated beam of light that coagulates and cuts at the same time while minimizing tissue destruction - Electrosurgery: The electrosurgical unit ESU is used to apply electrical current through the patient's tissue to cute and/or coagulate the tissue - Argon Beam: a device that uses ionized gas and electrical current. Only facility approved EPA registered disinfectants should be used to clean your facility. For which organisms must an approved disinfectant pass potency test against? - ✔B. Pseudomonas aeruginosa C. Salmonella choleraesuis D. Staphylococcus aureus Over-oressurizaiton of a tourniquet cull may cause: - ✔B. Compression injuries to blood vessels Performance of the "time out" for patient safety includes verbal team agreement on which of the following items: Select all that apply. - ✔A. Patient identification using two patient identifiers B. Site of the procedure, including right-left distinction D. Procedure to be performed
Place the four basic steps of fire safety in the correct order: - ✔RACE: Rescue patients and staff members in immediate danger Notify the fire department Confine the fire. Shut the doors Evacuate according to the facility plan Potential sources of fuel for surgical fires include: - ✔A. Draping materials Preliminary room preparation is performed before the first case of the day. All of the following are activities included in the preparation EXCEPT: - ✔Damp dust with a lintfree cloth moistened with 70% isopropyl alcohol Preoperative documentation should include: Select all that apply - ✔A. Administration of ordered medications C. Performance of the universal protocol for preventing wrong site, wrong procedure, wrong person surgery D. Skin assessment Preoperative documentation should include: Select all that apply: - ✔A. Administration of ordered preoperative medication C. Performance of the Universal Protocol for preventing wrong site, wrong procedure, wrong person surgery D. Skin assessment Preoperative fluid management is important because excessive amounts of fluid could lead to which of the following conditions? Select all that apply. - ✔B. Hypervolemia C. Hyponatremia 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. - ✔A. Bipolar surgery should be used whenever possible B. The active electrode and dispersive electrode are close together but as far away from the IED as possible. D. The patient should be monitored closely for signs of complications and IED malfunction Proper OR attire for restricted area includes: Select all that apply. - ✔B. Shoe coverings required for all team members during c-section deliveries C. Two piece scrub suit with top tucked into the pants and secured at the waist D. Warm up jacket snapped with cuffs down to wrists. Proper OR attire for restricted areas include: Select all that apply. - ✔- Two piece scrub suit with top tucked into pants and secured at waist.
- Warm up jacket snapped with cuffs down to wrists shoe coverings required for all team members during c-section Proper OR attire for restricted areas includes: Select all that apply - ✔C. Two-piece scrub suit with top tucked into the pants and secured at the waist D. Warm-up jacket snapped, with cuffs down to wrists Put the following steps in order when opening a wrapped sterile package: - ✔1. Open the farthest wrapper flap 2. Open side flaps 3. Open the nearest wrapper flap Recommended sponge count procedures include all of the following EXCEPT? - ✔B. Counting silently so it doesn't distract other personnel. Safety precaution when handling and caring for powered instruments include: Select all that apply. - ✔A. Handling powered instrument to the surgeon with the safety mechanism on B. Having irrigation ready to use the drill or saw D. Using the instrument with the blade guard or drill guard in place Safety precautions when handling and caring for powered instruments include. Select all that apply. - ✔A. Handling the powered instrument to the surgeon with the safety mechanism on B. Having irrigation ready to use with the drill or saw D. Using the instrument with the blade guard in place Terminal cleaning is performed on a daily basis after scheduled cases are completed. This process includes cleaning of the following: Select all that apply. - ✔- Anesthesia carts and equipment - Ceilings and walls - Mopping or wet vacuuming floors - OR beds, and positioning devices The Aldrete scale, used to determine readiness for discharge, measures all of the following EXCEPT: - ✔A. Circulation C. Patient mobility D. Pulse oximetry E. respiratory status 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. - ✔- A safe, clean environment should be reestablished after each surgical procedure.
- Contaminated disposable items should be handled safely accordingly to state and federal regulations - Personnel should take precautionary measures to limit transmission of microorganisms when performing environmental cleaning and disinfection activities. The best intervention to prevent intraoperative pressure ulcer development on the patient's heels would be to: - ✔A. Elevate (offload) heels off the bed The choice of anesthesia is influenced by all of the following EXCEPT: - ✔A. Length of surgery C. Past experience with anesthesia D. Surgical procedure 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. - ✔- Age - ASA physical status classification - Length of surgery - Past experience with anesthesia - Surgical procedure The culture of a clinical setting if affected by which of the following skills. Select all that apply. - ✔A. Collaborations B. Conflict resolution C. Decision making The dispersive electrode should: - ✔C. Be placed as close to the operative site as possible The first step in the sterilization process of surgical instruments that have been used in case is: - ✔A. Cleaning The following information is important in the management of forensic specimens. Select all that apply. - ✔A. Forensic specimens include but are not limited to hair, fibers, debris, body fluids and foreign bodies B. Forensic specimens require special handling when the surgeon is using metal instruments C. Hospitals need to have policies to give guidance to the preoperative nurse about the management of forensic specimens The following steps can be used to reduce personnel exposure to specimen fixatives such as formalin. Select all that apply. - ✔A. Avoid splashing while pouring C. When pouring wear gloves and a mask. D. Use absorbent material and then triple rinse with water any area or surface where accidental formalin spillage occurs.
E. Store fixatives securely so they are inaccessible to persons unfamiliar with their use. The goals of patient and family education include all of the following EXCEPT: - ✔A. Achieve long-lasting improvements in patient health status B. Improve patient satisfaction C. Provide information/knowledge to the patient and and family The goals of the surgical skin prep are to: Select all that apply. - ✔A. Inhibit rapid rebound growth of microorganisms B. Reduce the risk of postoperative site infection C. Remove soil and transient microorganisms and to reduce the number of resident microorganisms The Joint Commission Universal Protocol consists of: Select all that apply - ✔A. Preoperative verification B. Surgical site marking C. Time Out The Joint Commission Universal Protocol consists of: Select all that apply. - ✔A. Preoperative verification B. Surgical site marking C. Time Out The most important reason for maintaining endoscopic instruments at an optimal level of suction that - ✔A. Insulation defects can cause unseen burns The open assisted gloving technique should be used: Select all that apply. - ✔B. Everytime gloves are changed during a case C. When close assisted gloving is not possible. D. When the surgeon requests this specific technique The perioperative team implements aseptic technique practices to meet all of the following primary goals except: - ✔A. Improve patient satisfaction The preoperative nurse should avoid placing the dispersive electrode on the following areas. Match the area with the rational listed below: - ✔A. Scar tissue: May act as insulation B. Tattoo sites: contain metallic elements that could attract current C. Implanted prosthesis: Contain metal which could attract current and impede return current flow D. Hairy sites: Inhibits the flow of electrical current The preoperative nurse's documentation of the skin prep procedure should include: Select all that apply. - ✔A. The body area prepped B. Name of the person performing the prep
C. Preoperative assessment of the skin at the operative site. D. Skin prep agent used. The preoperative nurse's role in preparing and administering medications includes: ✔B. Assessing the patient's medication allergies and use of herbal or dietary supplements C. Documenting and reading back the surgeon's oral orders before preparing medications D. Verifying the administration of the correct medication, dose and route The preoperative nurse's role in preparing and administering medications includes: Select all that apply - ✔B. Assessing the patients medications allergies and use of herbal or dietary supplements. C. Documenting and reading back the surgeon's oral orders before preparing the medications D. Verifying the administration of the correct medication, dose, and route. The preoperative nurse's role in the patient and family education should include: Select all that apply - ✔A. Explaining what the patient will experience C. Providing emotional support to enhance coping D. Teaching specific skills that the patient will need to perform postoperatively The preoperative team implements aseptic technique practices to meet all of the following primary goals EXCEPT? - ✔A. Improve patient satisfaction The principle elements required for an infection to occur are: Select all that apply. - ✔A. A method of transmission B. A source or reservoir C. A susceptible host with a portal of entry to receive an infection The purpose of conducting postoperative phone calls within 24-48 horns for outpatient procedures is: Select all that apply. - ✔A. Ask about patient satisfaction with care D. Direct future hospital performance activities E. Note any surgical complications 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: - ✔B. Fumes trapped underneath the drapes and could ignite 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: - ✔Fumes trapped underneath the drapes could ignite
The types of questions that a novice perioperative nurse might NOT ask her preceptor about an upcoming cardiovascular surgery include which of the following? - ✔A. How does the conduction system of the heart work? 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. - ✔- Provide 100% oxygen - Stop administration of trigging agents - Stop surgery all together if possible - Used iced saline to cool patient To follow AORN Guidelines for positioning the patient, the preoperative nurse should ✔use additional precautions as appropriate based on unique patient considerations To follow the AORN Guidelines for positioning the patient , the perioperative nurse should: - ✔D. Use additional precautions as appropriate based on unique considerations 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 - ✔A. Ensure that the audible alarm can be heard if it is activated B. If expecting fluids, encase the footswitch in an impervious cover C. Never pour fluids on the generator or foot switch To place a patient safely in TRENDELENBURG position, which of the following practices is indicated? - ✔B. Position knees over the break in the procedure bed to allow for knee flexion. To prevent or minimize electrosurgical injuries to patients the preoperative nurse should Select all that apply. - ✔A. Assure that the prep solutions have dried and vapors evaporated before the device is used B. Confirm each requested power setting orally with the surgeon C. Inspect each circuit component if the surgeon repeatedly requests high power settings D. Inspect the electrosurgical unit before each use to verify the electrical integrity. Two types of regional anesthesia include spinal and epidural blocks. Which of the following reflect complications of an epidural block? - ✔hypotension, high spinal paralysis, spinal headache Types of powered cutting instruments include: Select all that apply. - ✔A. Bone Reamers B. Ultrasonic dissectors C. Saws D. Tissue shavers
Types of powered cutting instruments include: Select all that apply. - ✔A. Bone Reamers C. Saw D. Tissue shavers What are the 3 main factors to consider when assessing the patient for allergies? - ✔C. Prior reaction, heredity, type of reaction What are the 3 main factors to consider when assessing the patient for allergies? ✔Prior reaction, hereditary, type of reaction What are the perioperative nurses responsibilities for the informed consent process? Select all that apply. - ✔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. D. Ensure that the surgeon has discussed the proposed intervention and the risks involved with the patient and the patient has signed the consent. What are the perioperative nurses responsibilities for the informed consent process? Select all that apply. - ✔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 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. What are the requirements for hospital disinfectants? Select all that apply. - ✔A. Labeled as an EPA registered germicide B. Meets the required indications of use C. Has passed the potency test against 3 representative microorganisms What are the three methods used to accomplish hemostasis? - ✔A. Mechanical, chemical and thermal What factors increase the risk for skin injury? Select all that apply. - ✔- Diabetes - Prolonged length of surgery - Unusual positions or positioning devices What interventions can the preoperative nurse preform to protect elderly patients? Select all that apply - ✔A. Employ deep vein thrombosis prophylactic devices B. Position the patient for effective air exchange D. Use warming devices to maintain normothermia What is the best drape to use for an umbilical hernia repair? - ✔B. Laparotomy
What is the correct definition of incisional biopsy? - ✔D. A small portion of tissue is incised and sent for examination. What is the most appropriate needle point for performing a vascular anastomosis? - ✔C. Taper Point What precautions should be taken when microbibrillar collagen is used as a hemostatic agent intrapoperatively? - ✔C. Avoid using it with an autologous blood salvage unit What responsibilities do OR staff members have in maintaining a safe OR environment? Select all that apply. - ✔A. Adhering to facility policies related to safety B. Consistently applying OR specific safety practices D. Monitor, identify and report safety hazards. What responsibilities do OR staff members have in maintaining a safe OR environment? Select all that apply. - ✔A. Adhering to facility policies related to safety B. Consistently applying OR specific safety practices D. Monitor, identify and report safety hazards. What special care procedures are required for microsurgical instruments? Select all that apply - ✔B. Keep stainless and titanium instruments separated C. Use a non-birous sponge wipes to clean the instruments recommended D. Use tip covers or protective sleeves when instruments are not used. What steps should be followed in correctly draping the sterile field? Select all that apply. - ✔A. Drape from sterile to unsterile 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 When a "Time Out" discrepancy occurs, the nurse's priority action should be to: - ✔A. Call the patient's family to make them aware of the situation. B. Document the "Time Out" discrepancy C. Notify the manager or administrator D. Stop the procedure from beginning until the discrepancy is resolved When a preoperative nurse is assigned to monitor the patient receiving moderate sedation the following are recommendations for this role. Select all that apply. - ✔ACLS certification - Competency in the use of monitoring and emergency resuscitative equipment and drugs - Access to and ability to administer appropriate reversal medications
When applying the concept of surgical conscience which of the following statement should be considered? Select all that apply. - ✔A. It involves mental discipline & the ability to speak out B. It is essential to the delivery of optimal care and prevent harm. D. Surgical conscience allows for no compromise in the principles of aseptic technique. When assessing your patients tolerance for the planned surgical position which factors are important to consider? Select all that apply. - ✔- BMI - Nutritional status - Physical limitations - Pre-exisiting conditions When documenting medications, which of the following elements should be included? Select all that apply - ✔- Drug name, concentration, route of administration, dose and time it was administered - Verbal orders When documenting medications, which of the following elements should be included? Select all that apply. - ✔B. Drug name, concentrations, route of administration, dose and time it was administered. D. Verbal orders When faced with an electrical power outage in the OR it is most important for the preoperative RN to remember that: - ✔C. The nurse is responsible for knowing, understanding and complying with the facilities emergency electrical outage pace When making the preoperative assessment the nurse should take the factors into consideration? Select all that apply. - ✔A. Mobility C. Planned duration of the procedure D. Preexisting health conditions E. Type of anesthesia When making the preoperative assessment, the nurse should take the following into considerations. Select all that apply - ✔A. Mobility C. Planned duration of the procedure D. Preexisiting healthy conditions E. Type of anesthesia When performing a plastic surgery skin closure, which choice of suture size would be most appropriate? - ✔C. 5-0 When selecting surgical drapes the following are desirable characteristics. Select all that apply. - ✔A. Antistatic and allergenic B. Barrier to restrict passage of microorganisms C. Resistance to tearing, punctures, or abrasions
D. Dull or non-glaring material When setting up insufflation equipment for an abdominal endoscopic procedure the preoperative nurse should: Select all that apply. - ✔A. Have a backup tank available C. Verify that the CO2 pressure and supply alarms are on and functioning When setting up the insufflator for a robotic hysterectomy procedure, the perioperative nurse should do all of the following except: - ✔D. Set the initial insufflators pressure to 12mmHg When the tourniquet has been used for a surgical procedure the circulating nurse should document the following: Select all that apply. - ✔B. Limp Occlusion Pressure (LOP) and cup pressure C. Location of tourniquet and time of inflation and deflation D. Skin protective measures and preoperative and post-operative skin assessments 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? - ✔C. Discard the medication and replace with an unopened container Which AORN guideline most directly pertains to interim cleaning in the perioperative environment? - ✔A. A safe, clean environment should be reestablished after each surgical procedure. Which elements are required to create an environment where the culture of safety is embraced? Select all that apply. - ✔A. A sense of trust among all team members B. Development of a proactive approach instead of a reactive approach D. Sincere commitment to affirming safety as the first priority E. Verification of receipt of all information at all levels of the organization Which is the following a disadvantage of using skin clips? - ✔C. They often cause more scarring than other skin closure methods Which item blow is typically subjected to non-biologic testing? - ✔C. Bullet from a crime scene Which nerves are most frequently injured as a result of improper positioning of the patients arms? Select all that apply. - ✔- brachial plexus - ulnar Which nursing diagnosis is a PRIORITY for the patient who is being positioned for a posterior lumbar laminectomy? Select all that apply. - ✔A. Impaired gas exchange D. Risk for preoperative positioning injury
Which of the following activities should be performed during post procedure cleaning of an OR? - ✔A. Clean the floor, moving the OR bed to clean underneath Which of the following are advantages of disposable drapes? Select all that apply. - ✔A. Disposable drapes are lint free. D. Using disposable drapes can minimize strike-through because of their moisture repellent quality. Which of the following are examples of regional anesthesia methods? Select all that apply. - ✔B. Epidural blocks C. Eye (Retrobulbar) blocks D. Spinal blocks E. Upper extremity blocks Which of the following are examples of the Guidelines - A sterile field should be maintained and monitored constantly. Select all that apply. - ✔B. If a delay occurs after a sterile field is set up, it may be covered with sterile drapes until the delay is resolved. 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 D. The sterile field should be prepared as close as possible to the time of use. Which of the following are preoperative systemic factors that negatively affect wound healing? Select all that apply. - ✔A. Diabetes C. Protein deficiency D. Smoking E. Steroid use Which of the following are qualities of skin adhesive products? Select all that apply. ✔B. They can be used in place of sutures. D. They are primarily used on facial, extremity, and torso wounds. Which of the following attributes of the nursing process reflect the use of critical thinking skills? Select all that apply. - ✔- Requires evaluation and reflection - Requires seeking additional information - Results in a decision Which of the following best describes capacitive coupling? - ✔C. The transfer of electrical current form the active electrode though intact insulation to adjacent conductive items such as tissue to trocars Which of the following components should be included in documentation of intraoperative patient position? Select all that apply. - ✔A. Identification of specific positioning devices used B. Names of personnel assisting with positioning
C. Placement of arms D. Position that the patient is placed in for the procedure Which of the following components should be included in documenting the placement of a surgical drain? - ✔B. Location of the drain Which of the following environmental sanitation practices is used to limit the transmission of microorganisms? - ✔D. Use PPE when handling body fluid spills Which of the following environmental sanitation practices is used to limit transmission of microorganisms? - ✔D. Use personal protective equipment when handling body fluid spills Which of the following examples is included on the "Joint Commission" list of DO-NOTUSE abbreviations, Acronyms and Symbols? - ✔A. MS Which of the following is a finding of recent research studies on the value of certification? - ✔C. Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse. Which of the following is a method for preventing blood-borne pathogen exposure? ✔A. Changing gloves during regular intervals during a procedure Which of the following is a strategy to reduce medication errors? - ✔D. Using only computerized physician order entry for medication management Which of the following is an example of synthetic absorbable material? - ✔D. Vicryl Which of the following is NOT a characteristic that promotes a culture of safety within a healthcare organization? - ✔C. Prompt disciplinary action when errors occur. Which of the following is NOT an example of an ethical dilemma that preoperative nurses may encounter? - ✔C. Family disagreement about a below knee amputation of an 19 year old who has already given consent Which of the following is the best definition of sterile technique? Sterile technique is: ✔D. Implemeted during surgical procedures to prevent microbial contamination Which of the following is the best way to conduct a Time Out? - ✔D. The Time Out takes place once the patient is prepped and draped and involves the entire team Which of the following latex sensitivity categories match the description provided? - ✔C. Irritant contact dermatitis: non allergic skin reaction usually aggravated by glove power and chemical agents added to raw latex
Which of the following methods listed below may prevent mishap, event, or fire from occurring when handling electrosurgical equipment? Select all that apply. - ✔A. Allow enough time for alcohol based skin preparations to completely dry. B. Do not use in an oxygen-enriched environment, such as the trachea when oxygen is being "blown over" the patient. D. Visually check the integrity and insulation of all cords and coagulation instruments before use. Which of the following nursing tools does not reflect critical thinking and clinical reasoning? - ✔A. A single procedure list used for all patients scheduled for that procedure. Which of the following physiological effects is most likely to result from positioning a patient in lithotomy position? - ✔A. Circulatory and respiratory compromise due to pressure on the abdomen Which of the following practices help to prevent contamination in the surgical suite? Select all that apply - ✔B. All horizontal surfaces should be damp dusted before the first scheduled procedure of the day. C. hands should be washed with soap and water for at least 15 seconds D. Surgical suites should be cleaned after each surgical procedure with a lint free or microfiber cloth moistened with detergent for disinfectant and water. Which of the following practices is recommended for damp dusting in the OR? Damp dusting should: - ✔D. Begin with higher surfaces and finish with lower surfaces Which of the following practices is recommended for handling of natural absorbable suture? - ✔C. Open the package carefully over a small basin to prevent splashing of the packaging solution Which of the following practices is recommended to reduce the patient's risk of intraoperative skin injury - ✔D. Protect sensitive areas of the skin with appropriate padding Which of the following practices is recommended when transferring from gurney to the OR bed? Select all that apply. - ✔A. Ensure that wheels are locked on both the OR bed and gurney prior to beginning transfer. D. Secure lines and catheters prior to the move and dislodging. Which of the following practices should be used to implement the Joint Commissions Universal Protocol for Preventing wrong site, wrong procedure, wrong person surgery? ✔C. Using the time-out procedure before beginning the procedure
Which of the following practices violates a patient's ethical right to self-determination? ✔A. Automatic intrapoperative suspension of a don-not-resusucitate decision Which of the following procedures reflects best practice for transferring a medication vial to the sterile field? - ✔D. Use a sterile transfer device Which of the following questions would you expect to hear in a preoperative interview? Select all that apply. - ✔A. Could you tell me about any past surgeries B. Has your surgeon reviewed the surgical procedure with you? Do you have any questions? C. What medications do you take on a regular basis Which of the following recommendation for enhancing the future of nursing included in the 21011 Institute of Medicine report? Select all that apply. - ✔A. Nurses should engage in life long learning C. Nurses should achieve higher levels of education D. Academic institutions should improve their systems to provide academic progression Which of the following reflects examples of a preceptor's role working with a new preoperative RN. - ✔Limiting support to a fixed period of time. Asking questions, and supporting growth and development Which of the following sensory assessment findings is common among elderly patients? - ✔A. Decreased color and depth perception Which of the following statement about regional anesthesia is correct? - ✔B. Continuous never stimulation help insure proper needle placement during peripheral nerve blocks Which of the following statement is true concerning the use of the AORN Guideline for Preoperative Practices? - ✔D. Work setting and situations variations may determine the extent to which the AORN Guidelines can be applied Which of the following statements about counts is correct? Select all that apply. - ✔A. All preoperative personnel involved in a surgical procedure are responsible for the accuracy of sponge counts 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. C. All sponges must remain in the OR room until the sponge count is complete. E. Two people, one of them whom is the RN circulator, must preform the sponge count WHICH OF THE FOLLOWING STATEMENTS ABOUT DRAINS ARE CORRECT? SELECT ALL THAT APPLY. - ✔B. Drains expedite healing by removing blood, serosanguinous fluid and purulent material C. Drains function by passive (gravity) or active means (suction)
D. Hand-off report to the PACU nurse should include; the type location and patency of the drain Which of the following statements about gloving is true? - ✔B. The gown should be fastened in the back before donning gloves Which of the following statements about proper attire of surgical team members are true? Select all that apply. - ✔C. Sterile gowns should resist fluid strike-through D. The scrub top must be secured at the waist or tucked into the pants Which of the following statements about regional anesthesia is correct? - ✔B. Continuous nerve stimulation helps ensure proper needle placement during peripheral nerve blocks. Which of the following statements about the gowning procedure are correct? - ✔D. Step back from the table into an unobstructed area to let the gown unfold Which of the following statements about the immediate use steam sterilization is the recommended practice? - ✔D. Instruments may be immediate use steam sterilized only when there is insufficient time tot process by the preferred wrapped or container method. Which of the following statements concerning mentors and preceptors are correct? Select all that apply - ✔A. Both model professional nursing behaviors B. Mentors guide nurses through global professional activities C. Preceptors guide nurses through defined clinical activities Which of the following statements correctly describes recommendations for preoperative patient skin antisepsis? - ✔D. Prep should start at the site of the incision and move outwards. Which of the following statements is generally true about the coping styles of pediatric patients between the ages of 3 and 6 years? - ✔A. This age group interprets term literally Which of the following statements is TRUE concerning use of the AORN guidelines for Preoperative Practice? - ✔Work setting and situation variations may determine the extent to which the AORN guidelines can be applied Which of the following statements reflect the concept of critical thinking? Select all that apply. - ✔C. Informed practice D. Holistic thinking E. Unbiased thinking F. Reasoned application of a step by step process
Which of the following strategies are recommended to reduce the occurrence of retained surgical items? Select all that apply - ✔- Avoid distractions during the counting process. - Count items including radiopaque soft goods, sharps and other miscellaneous items and instruments. - Use a standardized approach each time a count is conducted. Which of the following strategies should be considered for implementing successful infection control? - ✔B. Washing your hands prior to greeting the patient in the preoperative room Which of these practices is recommended during decontamination of used instruments? Select all that apply. - ✔B. Open box locks and disassemble instruments with multiple parts D. Use an enzymatic detergent on heavily soiled instruments E. Wear PPE Which of these practices is recommended during decontamination of used instruments? Select all that apply. - ✔B. Open box locks and dissemble instruments with multiple parts D. Use enzymatic detergent on heavily soiled instruments E. Wear PPE Which PNDS outcome is the most important when draping the surgical patient? - ✔A. The patient is free from signs and symptoms of infection Which PNDS outcome is the most important when draping the surgical patient? - ✔A. The patient is free from signs and symptoms of infection Which process should be performed before construction begins, after demolition, and at the end of an OR construction project? - ✔A. Air sampling 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? - ✔C. Situational Which type of needle point should you expect to be needed for suturing viable tissue such as the liver? - ✔A. Blunt 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. - ✔B. Metallic taste C. Numbness of the lips D. Tinnitus E. Visual Disturbances
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? - ✔A. Alert the team that the drape is contaminated and replace with a sterile drape You are assigned to relieve a surgical technologist for lunch. You will need: - ✔A. A sterile gown and gloves opened on a table (other than the main instrument table) for closed gloving. 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: - ✔C. Contaminated 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 - ✔A. One of the surgical lights are dim D. There are no specimen containers available 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. - ✔- Hair is contained in a facility approved bouffant head covering - Scrub top is secured by tucking it into her pants - Putting on a long sleeved warm-up jacket to prepare for her circulating role 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? - ✔C. Using soap and water to perform surgical skin prep 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: - ✔A. Assessing the patients NPO status NPO status, weight, medication, and allergies. Your manager has asked you to provide an in-service to team members regarding hand hygiene. Important information for you to include is: - ✔D. Skin is a major source of contamination in the surgical environment