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1. Which of the following describes point-of-use cleaning of a surgical
instrument?
A. Prior to the procedure, the instrument is cleaned with a moist sponge
B. During the procedure, the instrument is cleaned with a moist sponge
after each use
C. After the procedure, the instrument is cleaned with a moist sponge in
the sterile processing area
D. Continually clean the instrument with a sponge moistened with
saline - Correct Answer: B. During the procedure, the instrument
is cleaned with a moist sponge after each use
One type of point-of-use cleaning of a surgical instrument is when the
instrument is cleaned with a sterile, water-soaked sponge after each use during
the procedure. Point-of-use cleaning also occurs when an instrument is
cleaned at the point of use immediately following the procedure. Saline should
not be used for point-of-care cleaning. Cleaning at the point of use prevents
bioburden from building up on the instrument and helps maintain the life of
the instrument.
,2. Venous air embolism is most likely to occur when the patient is in the
________ position.
A. Supine
B. Sitting
C. Lithotomy
D. Lateral - Correct Answer: B. Sitting
Venous air embolism can occur when air or gas is drawn into the circulation by
the veins above the level of the heart and is most likely to occur during
neurosurgery or open shoulder surgery in the sitting or semi-sitting position.
3. A subjective sign of the existence and intensity of postoperative pain is the
patient's:
A. Self-report
B. Change in blood pressure
C. Facial expression
D. Protective guarding behavior - Correct Answer: A. Self-report
A subjective sign is what the patient states. Objective signs include results from
physical assessment or observation.
4. A nursing diagnosis that considers a patient is at risk means the nursing
interventions:
A. Are directed at prevention
B. Will not affect the patient's outcome
, C. Should be performed only as needed
D. May put the patients at risk - Correct Answer: A. Are directed at
prevention
For perioperative patients, nursing diagnoses that consider a patient at risk for
an outcome mean the problem has not yet occurred, and the interventions are
directed at prevention.
5. Signs of a blood transfusion reaction include which of the following?
A. Hypotension, hemoglobinuria, hyperthermia
B. Weak pulse, hemoglobinuria, hypertension
C. Hypothermia, weak pulse, tachycardia
D. Hypothermia, hemoglobinuria, tachycardia - Correct Answer: A.
Hypotension, hemoglobinuria, hyperthermia
A blood transfusion reaction reflects vasomotor instability and is evidenced by
hypotension, hemoglobinuria, and hyperthermia. Many common signs are not
readily obvious when a patient is under anesthesia.
6. When performing time out, which of the following should be verified?
A. Laboratory studies
B. Instruments
C. Suture
D. Procedure - Correct Answer: D. Procedure
, Ensuring correct-site surgery requires affirmation of the following: correct
patient, position, site, procedures, equipment, images, and implants (if
required).
7. Pneumatic tourniquets should be deflated under the direction of:
A. The surgeon and the scrub person
B. The anesthesia professional and the circulating nurse
C. The circulating nurse and the surgeon
D. The surgeon and the anesthesia professional - Correct Answer: D.
The surgeon and the anesthesia professional
Hemodynamic changes may occur when the tourniquet is deflated. As the
tourniquet cuff deflates, the anesthetic agent may be released into the
circulatory system, causing systemic effects. Coordination among members of
the perioperative team under the direction of the surgeon and the anesthesia
professional can facilitate management of the patient's physiologic status
during this period of rapid change.
8. Which organization should be consulted about a perioperative RN's scope
of practice related to administration of medications for moderate sedation?
A. Association of periOperative Registered Nurses
B. The Joint Commission
C. State Board of Nursing
D. Centers for Medicare & Medicaid Services - Correct Answer: C.
State Board of Nursing