Healthstream Module quizzes Pp 1 questions and answers.docx

  Hallways leading to the OR and the sterile processing areas are designated as ........ areas of the perioperative environment? - Correct Answers: Semi-restricted The airflow in an OR has a(n) ...... pressure relationship to the adjacent OR hallway? - Correct Answers: Positive Which of the following areas in a perioperative environment is considered a restricted area? - Correct Answers: Operating Room Which team member establishes the sterile field and passes instruments to the surgeon? - Correct Answers: scrub person What is the primary medication to treat a patient experiencing a malignant hyperthermia (MH) crisis? - Correct Answers: Dantrolene sodium Which of the following is NOT a fire prevention practice during surgery? 1. place the electrosurgical pencil in a holster when not in use. 2. have fluids for irrigation immediately available on the sterile field. 3. include a discussion of the fire risk assessment during the preop briefing. 4. verify the patient's position during the time out. - Correct Answers: 4. Verify the patient's position during the time out. What is considered an ignition source that may cause a fire to ignite during surgery? - Correct Answers: electrosurgery and laser. Which intervention should be implemented immediately when a fire occurs in a patient's airway? - Correct Answers: remove the endotracheal tube and any segments of the burned tube that remain in the airway. An anesthesia professional states, "this patient is experiencing local anesthetic systemic toxicity." The periop RN should be prepared to assist with the administration of? - Correct Answers: 20% lipid emulsion therapy. what is recognized as a primary means to prevent health-care associated infections? - Correct Answers: Hand hygiene What cleaning is conducted between each procedure? - Correct Answers: Turnover what action is considered to be the single most important action that can prevent the spread of infection? - Correct Answers: hand hygiene In the periop setting, what surface is always considered contaminated? - Correct Answers: Floor In the morning, before the start of the first procedure of the day, what should be done to remove dust and debris? - Correct Answers: damp dusting What is the term to describe the amount of time designated by the manufacturer that a cleaning agent must remain wet on the surface to achieve disinfection? - Correct Answers: contact time What is the common term for the directions provided by a manufacture on how to accurately use their product? - Correct Answers: IFU Terminal cleaning is performed after an environmental contamination event like flood. Which of the following additional measures is taken when there is a pest infestation? 1. containing biological waste. 2. removing food waste. 3. cleaning common eating areas. 4. all above. - Correct Answers: all of the above. What is the best method to use to complete turnover cleaning? - Correct Answers: Standardized - this includes perimeter, divide in half, and zone methods of cleaning. What is the removal of pathogenic and other microorganisms from surfaces by using chemical or physical means? - Correct Answers: Disinfection What is a systematic inquiry used to generate new knowledge? - Correct Answers: research Which of the following is an example of direct expense in the perioperative department? l payment for legal services 2. salary of finance manager 3. utility bills 4. wages of full-time employees who use timecards to track hours. - Correct Answers: 4. wages of fulltime employees You and another team member just finished a procedure. You hear your team member make snide comments about the patient in the cafe. You notice people who are not healthcare workers listening in. What type of behavior has your team member exhibited? - Correct Answers: breach of privacy Which organization writes the standards of perioperative nursing? - Correct Answers: The AORN Which term means "the duty to do no harm?" - Correct Answers: nonmaleficence what is the structured language used by perioperative RNs to document nursing care. - Correct Answers: PNDS (periop nursing data set) Which organization determines the scope of practice for RNs in each state? - Correct Answers: State board of nursing Which documents does a facility create based on governmental regulations, accrediting agency regulations, and AORN guidelines? - Correct Answers: Policy and procedures what is the definition of respondeat superior? - Correct Answers: An employer's responsibility for the RN when the RN acts within the scope of nursing practice. Not obtaining consent from a patient before surgery is an example of what? - Correct Answers: Assault and battery What describes the mode of transmission in the chain of infection? - Correct Answers: the route from the portal of exit. Drug diversion is a result of a facility's .... - Correct Answers: lack of narcotic safety. What outlines sharps safety for the healthcare provider? - Correct Answers: Bloodborne pathogen standard Your patient is scheduled for a bronchoscopy in the OR. They are diagnosed with flu and are on droplet precautions. what type of respiratory precaution should the RN make during the procedure? - Correct Answers: Wear a N95 The CDC has issued a statement regarding PAPRs in the OR. What is the recommendation? - Correct Answers: PAPRs are not recommended for use during surgical procedure. When caring for a patient on airborne precautions, what location is the respirator removed? - Correct Answers: outside of the AIIR Which level of the hierarchy of control addresses changing the way people work? - Correct Answers: administrative What is included in OSHA's bloodborne pathogen standard? - Correct Answers: use PPE for any anticipated blood/ body fluid exposure. Why is an employee screened for certain diseases that have an associated vaccination? - Correct Answers: The disease is preventable. Which of the following is NOT an emergency warning sign of SARS-CoV-2? 1. pressure/ persistent chest pain 2. paly, grey, blue colored lips, skin, nailbeds 3. new confusion 4. sore throat - Correct Answers: 4. sore throat What law mandates that a hospital must report all incidents resulting from defective equipment or user error that contribute to a patients death or serious injury? - Correct Answers: Safe medical device act of 1990 Protective eyewear worn during laser surgery is... - Correct Answers: Specific to the laser, wavelength, and it's optical capacity After source elimination and substitution, what is the next highest level of control to decrease patient and team member exposure to surgical smoke? - Correct Answers: Engineering- surgical smoke evacuation Where should the dispersive pad for the electrosurgical unit be placed on the patient? - Correct Answers: Close the surgical site over a large well perfused muscle What can increase the risk of fire during surgery when using ESU pencil? - Correct Answers: Pencil laying on the drapes close to surgeons hand Which of the following is ionizing radiation therapy? Home microwave X-ray Infrared heat lamp Laser - Correct Answers: X-ray Which of the following is non ionizing radiation therapy? Brachytherapy Laser X-ray CT - Correct Answers: Laser Occupational exposure to radiation can be reduced by following what principles? - Correct Answers: Time, distance, shielding What resource should be available to the surgical team when questions arise on how to safely use surgical equipment. - Correct Answers: The manufacture IFU A patient who is experiencing severe pain, lack of sensation, edema, vascular compromise, and restricted movement in the extremity after the use of pneumatic tourniquet is most likely exhibiting symptoms of what? - Correct Answers: Compartment syndrome What type of alloy finish on an instrument eliminates glare and is often used during laser surgery? 1. reflective 2. plastic 3. mirror 4. ebony - Correct Answers: Ebony What is the preferred sterile solution to use on the sterile filed to remove debris from instruments? - Correct Answers: water What is the characteristic of robotic instruments that is defined as an instrument with a specific number of uses? - Correct Answers: reposable What is not an endoscope classification? 1. semi-rigid 2. semi-flexible 3. flexible 4. rigid - Correct Answers: semi flexible what is the description of the Kocher clamp? - Correct Answers: toothed tip to hold tough tissue What are the four major categories of instruments? - Correct Answers: cutters, clamps, retractors, other The weight of an instrument tray should not exceed? - Correct Answers: 25 lbs Which of the following statements is correct regarding powered surgical instruments? 1. they are interchangeable 2. powered by air, electricity, or battery 3. are immersible 4. power sources are interchangeable with various power drills - Correct Answers: powered by air, electricity, or battery It is important to know what an instrument looks like and what it is called... 1. for the count process 2. to save OR time 3. to understand what is being said 4. all of the above - Correct Answers: all of the above an ergonomic consideration for instrument use would include the ...... of the instrument. - Correct Answers: weight What would be appropriate action for the periop RN when assist with anesthesia? - Correct Answers: apply cricoid pressure if needed during intubation Which of the following is not included in basic monitoring of the patient for anesthesia? 1. arterial line 2. pulse oximetry 3. blood pressure 4. ECG - Correct Answers: arterial line What drug is used to reverse valium and midazolam? - Correct Answers: flumazenil What method is used to prevent aspiration during endotracheal intubation? - Correct Answers: applying cricoid pressure How can the periop RN assist the anesthesia provider with placement of a spinal or epidural block? - Correct Answers: calm the patient What complication can arise with tourniquet deflation at the end of the Bier Block procedure? - Correct Answers: bolus of anesthetic What is the most consistent indicator of malignant hyperthermia during a surgical intervention? - Correct Answers: increased end-tidal CO2 What are signs of the patient experiencing LAST? 1. ringing in the ears 2. dizziness 3. tingling sensation around lips 4. all of the above - Correct Answers: all of the above What assessment factor is important to include when screening patients for potential risk of malignant hyperthermia? - Correct Answers: family history of problems related to anesthesia The RN caring for the patient receiving moderate sedation/ analgesia should 1. turn up the monitor alarms when prepping 2. be competent in the use of emergency resuscitation procedures 3. call an anesthesia provider to administer reversal meds 4. all of the above - Correct Answers: be competent in the use of emergency resuscitation procedures Your patient is scheduled for bariatric gastric bypass, has a body mass index of 55, and is type 1 diabetic. What ASA classification should you anticipate? - Correct Answers: ASA 3 You are the RN assigned to circulate on an organ recovery procedure on a patient who is brain dead. What ASA should you anticipate? - Correct Answers: ASA 6 The.... is a post anesthesia scoring system to establish postoperative discharge criteria? - Correct Answers: Aldrete scale During which phase of the care does the perianesthesia RN focus on preparing the patient for care at home? - Correct Answers: Phase II The purpose of the ASA physical status classification system is to... - Correct Answers: evaluate the surgical risk to the patient. The initial assessment of the patient entering Phase I includes the following except 1. drainage 2. airway 3. circulation 4. pain - Correct Answers: 4. pain Initial PCU placement may include either phase I or phase II. Which of the following helps determine placement for the patient directly out of surgery? 1. comorbid conditions 2. insurance coverable 3. weight 4. physician preference - Correct Answers: 1. comorbid conditions Patients may bypass Phase I and be transferred directly to phase II depending on all of the following except 1. vital signs 2. type of anesthesia 3. surgeon preference 4. pain - Correct Answers: 3. surgeon preference the ASPA standards have delineated levels of care for PACU nursing. According to the standards, what is the most important staffing consideration in all of the departments? - Correct Answers: patient acuity Geobacillus stearothermophilus is a biological indicator used for... 1. ethylene oxide sterilizers 2. liquid peracetic acid sterilizers 3. dry heat sterilizers 4. all of the above - Correct Answers: 2. liquid peracetic acid sterilizers what is the first step of instrument processing? 1. decontaminator cycle on washer-sterilizer 2. chemical disinfection 3. soaking 4. cleaning - Correct Answers: 4. cleaning What type of monitor is an external strip or tape? 1. physical 2. ultrasonic 3. chemical 4. biological - Correct Answers: 3. chemical which of the following is not done when assembling an instrument tray? 1. instruments are damp when placed in a container or wrapped. 2. instruments are opened when being placed on the stringer. 3. instruments are placed with heavier instruments on the bottom. 4. instruments are counted as they are placed in a tray. - Correct Answers: 1. instruments are damp when placed in a container or wrapped What should be used for instrument cleaning at the point of use? - Correct Answers: sterile water Which statement about cleaning and decontamination of contaminated surgical instruments is false? 1. SPD personnel should wear fluid resistant gown in the decon areas 2. all instruments should be submerged in a hot water solution. 3. The IFUs outline necessary steps for cleaning 4. blood removal on instruments in more difficulty with hot water. - Correct Answers: 2. all instruments should be submerged in hot water solutions What describes bioburden - Correct Answers: the amount of microbial contamination on an instrument surface Which chemical sterilization method used a toxic substance that requires aeration? 1. hydrogen peroxide 2. dry heat 3. ethylene oxide 4. peracetic acid - Correct Answers: 2. ethylene oxide instrument assembly stipulates that... 1. sharp and delicate items should be inserted into a peel pack 2. instruments need to be dry when assembled 3. cupped instruments are placed up on the set 4. instruments are closed when place don the stringer - Correct Answers: 2. instruments need to be dry when assembled When the IFU for a surgical device, sterilizer, or packaging system conflict follow the .... IFUs. - Correct Answers: device manufacturer's An organization with a culture of safety ... 1. focuses on errors 2. changes care delivery as a result of an error 3. encourages health care providers to report another providers near miss 4. all of the above - Correct Answers: 2. changes care delivery as a result of an error AORN advocates for patient and worker safety through the Guidelines for Perioperative Practice and ... 1. position statements 2. tool kits 3. mission, vision, and value statements 4. all of the above - Correct Answers: 4. all of the above The 2010 Future of nursing report outlined four key messages. Which of the statements below is not one of them? 1. The US health care redesign should empower nurses. 2. Data collection is necessary and adequate. 3. Nurses should practice to the full extent. 4. Nurses should strive for higher levels of education. - Correct Answers: 2. Data collection is necessary and adequate The surgical Safety checklist was an initiative of 1. CDC 2. TJC 3. WHO 4. AORN - Correct Answers: WHO Which of the following publishes regulatory requirements to which facilities and health care workers must adhere? 1. centers for Medicare and Medicaid services 2. TJC 3. AORN 4. all of the above - Correct Answers: 1. CMS Surgical site marking is a regulatory requirement. Which of the following is true about site marking? 1. site marking processes are determine by the operating provider 2. site marking is done immediately prior to the incision 3. the patient should be identified prior to site marking 4. the patient should not be involved in site marking - Correct Answers: 3. the patient should be identified prior to site marking organizational elements of a culture of safety include 1. an environment that emphasized individual recriminations 2. consistent and safe delivery of services 3. a commitment of resources that focus on accidents 4. teams and disciplines that operate in silos. - Correct Answers: 2. consistent and safe delivery of services In November 1999 the IOM published a report To Err Is Human: Building a Safer Health System and reported 1. the prevent errors, a safer system needs to be designed. 2. when an error occurs the system needs to be examined 3. standardization of processes 4. all of the above - Correct Answers: 4. all of the above What is not a skill-based behavior error - Correct Answers: nurse fails to respond to a device alarm A situational factor error can occur because of - Correct Answers: a lack of attention This is the technique used to prevent the transfer of organisms and cells from one site to another. It is best practice to use this technique during bowel surgery cases involving malignancy. 1. investigative 2. intervention 3. isolation 4. impervious - Correct Answers: 3. isolation technique When should the sterile field be prepared? - Correct Answers: as close to the time of surgery as possible. Which statement is true about transferring sterile fluids onto a sterile field? 1. using a transfer device can reduce the potential for contamination. 2. since the original fluid container has a label, the fluid does not need to be labeled on the sterile field. 3. it is best to pour fluids into a container placed in the center of the field 4. transfer saline 30 minutes before the case - Correct Answers: 1. using a transfer device can reduce the potential for contamination When scrubbed team members move in and around the sterile field, they should do this to prevent contamination? - Correct Answers: move back to back or face to face What should perioperative team members do when a break in sterile technique is discovered? - Correct Answers: speak up The definition of ..... is when mositure soaks through drapes, gowns, packages and renders the item contaminated. 1. strikeout 2. strikeover 3. strikeup 4. strikethrough - Correct Answers: 4. strikethrough What is an essential activity performed to prevent the spread of nasal and oropharyngeal secretions? - Correct Answers: masking only... items should come into contact with the sterile field. - Correct Answers: sterile Before opening a packaged item, the item is inspected for... - Correct Answers: package integrity when opening a rigid container, the lid is moved this way to prevent contamination. - Correct Answers: opened up, away from the container toward yourself. who is responsible for positioning the patient - Correct Answers: the entire surgical team which position is a modification of the prone position? - Correct Answers: jack-knife in the supine position, a wedge-shaped positioning device is placed under the right lumbar region for a pregnant patient undergoing a non-obstetric surgery to help prevent... 1. hypotension 2. pressure injury 3. hypertension 4. uterine contractions - Correct Answers: 1. hypotension To position a patient who is obese in the supine position, you should 1. use padded arm guards to contain the arms at the sides 2. place the safety strap below the knees 3. rotate the head to an extreme left lateral alignment 4. lower the head 25 degrees - Correct Answers: 1. use padded arm guards to contain the arms at the sides when the patient is in the supine position with the arms at the sides, where should you tuck the draw sheet? - Correct Answers: under the patient approximately how many inches above the patient's knees should the safety strap be applied in the supine position? - Correct Answers: 2 inches Raising the patient's legs into the lithotomy position shifts blood from the legs into the central circulation and ... 1. decreases cardiac and venous return 2. decreases pressure on the diaphragm 3. increases cardiac output and venous return 4. increases perfusion to the legs - Correct Answers: 3. increases cardiac output and venous return what occurs when layers of material, such as extra sheets or blankets are placed over the OR mattress or padding? - Correct Answers: negativity which of the following is a pressure injury risk assessment tool designed for surgical patients? 1. Braden Q scale 2. Munro pressure ulcer risk assessment scale 3. Braden scale 4. STOP-band questionnaire - Correct Answers: 2. Munro pressure ulcer risk assessment scale to protect the ulnar nerve in the supine position, how should the nurse place a patient's palms on a padded arm board during positioning? - Correct Answers: palm side up Which of the following is true regarding general skin antiseptic application 1. dilute skin prep solutions when requested by the physician. 2. begin prepping the patient while patient positioning is being done 3. prep as small an area as possible 4. prep in a back and forth motion when using CHG-based antiseptic. - Correct Answers: 4. prep in back and forth motion when using CHG-based antiseptic which of the following is not a patient risk factor for SSI? 1. diabetes 2. increased age 3. patient's knowledge of the condition 4. tobacco use - Correct Answers: 3. patient's knowledge of the condition what statement is true concerns iodine skin antiseptics? 1. iodine is found in thyroid hormones, amino acids, and other body substances. 2. those with shellfish allergy will have an iodine based skin prep reaction 3. research confirms a connection between shellfish allergies and iodine based contrast media 4. iodine is the chemical agent responsible for iodine-based skin prep reactions. - Correct Answers: 1. iodine is found in thyroid hormones, amino acids, and other body substances what is the prep time of an alcohol based CHG product on dry skin? 1. 30 seconds 2. 45 seconds 3. 60 seconds 4. 90 seconds - Correct Answers: 30 seconds which measure should be included as part of an extremity prep? 1. prep the leg circumferentially from the tourniquet to the knee 2. cover the distal edge of the tourniquet with a impervious drape to prevent patient injury 3. prep only the anterior portion of the leg for knee surgery 4. apply the tourniquet after the skin prep has been completed - Correct Answers: 2. cover the distal edge of the tourniquet with a impervious drape to prevent patient injury hair this is removed from the head for a cranial procedure ... - Correct Answers: is the property of the patient what should be documented after the surgical prep 1. person performing the prep 2. skin antiseptic product used 3. skin condition at the surgical site 4. all of the above - Correct Answers: 4. all of the above which of the following is true regarding an abdominoperineal prep 1. a single prep kit is used for both the abdomen and vaginal preps 2. the bladder is emptied after the vaginal prep is completed 3. the patient's abdomen is always prepped first, followed by the vaginal prep - Correct Answers: 2. the bladder is emptied after the vaginal prep is completed the goal of surgical skin antisepsis? - Correct Answers: to reduce the risk of the patient developing an SSI which measure helps decrease the risk of fire caused by skin antiseptics? 1. dilute skin prep to reduce flammable content 2. allow materials saturated with skin antiseptic to remain under the patient 3. prevent flammable skin antiseptics from pooling/ soaking into linens of the patient's hair 4. begin the procedure before the skin prep has dried - Correct Answers: 3. prevent flammable skin antiseptics from pooling or soaking into linens or the patient's hair select one principle of surgical draping 1. drape the area from the periphery to the incision site 2. handle the drapes as little as possible 3. adjust drapes at the sterile field when positioned incorrectly 4. the top surface to 4 inches below the edge are sterile - Correct Answers: 2. handle drapes as little as possible you are scrubbed in at the sterile field for umbilical hernia repair and will be using cloth towels to square off the incision. It is best to secure the towel with.. - Correct Answers: non-perforating clamp what type of sterile surgical drape would you expect to use for a laparoscopic- assisted vaginal hysterectomy? - Correct Answers: leggings what type of drape would you expect to use on an umbilical hernia repair? - Correct Answers: laparotomy drape as a scrubbed team member, how can you protect your gloves hands when passing a drape to the anesthesia professional who will clip it to the IV pole? - Correct Answers: cuff the interior portion of the sterile drape over your sterile glove. when inserting a central venous catheter, what sterile drape is recommended for use? - Correct Answers: full body sterile drape which of the following items are part of the sterile field and require a drape cover? 1. anesthesia cart 2. IV poles 3. instrument table 4. electrosurgical unit - Correct Answers: 3. instrument table what type of sterile surgical drape would you use for a cholecystectomy? - Correct Answers: abdominal drape when are sterile drapes placed on the patient for surgery? - Correct Answers: after the preop skin antisepsis has been performed after an abdominal surgery is completed, who typically is tasked with removing the surgical drapes? - Correct Answers: scrubbed team member Which type of endoscope allows he surgeon to perform surgery by placing instruments into the channels of the endoscope? 1. rigid 2. flexible 3. operative 4. diagnostic - Correct Answers: 3. operative what action should the RN circulator take to decrease the risk for injury from heated fiberoptic light cable? 1. instruct the scrub to always disconnect the light cable after use. 2. connect the light cable loosely into the light box 3. place the light source in stand-by mode when not being used. 4. instruct the scrub person to wrap the light cable in a dry sterile towel - Correct Answers: 3. place the light source in stand-by mode when not being used During surgery, the scrub person notices a defect in the insulation coating of one of the instruments. What should they do? 1. cover the defect with clear dressing 2. continue to pass the instrument to the surgeon 3. use a scanner to see if the defect affects the function of the instrument 4. ask the circulator to get a replacement instrument - Correct Answers: 4. ask the circulator to get a replacement instrument what type of instrument does the surgeon use for laparoscopic surgery to create one or more orifices in the patient's body to access the operative site? 1. stapler 2. endoscope 3. scissors 4 trocar - Correct Answers: 4. trocar what is the purpose of filling the peritoneal cavity with carbon dioxide gas before performing a laparoscopy? 1. to increase cardiac output 2. to reduce the risk of a surgical site infection 3. to help maintain normothermia 4. to create a working space to help visualize the surgical site - Correct Answers: 4. to create a working space to help visualize the surgical site. insufflation of gas during endoscopic surgery increases intra-abdominal pressure and open blood vessels may allow gas to enter the circulatory system. This places a patient at risk for.... - Correct Answers: gas embolism During surgery, the scrub person can remove gross soil and decrease the formation of biofilm on an endoscope by wiping the outside of the instrument and flushing channels with... - Correct Answers: sterile water which type of irrigation fluid is typically used for endoscopic procedures using monopolar ESU 1. nonelectrolyte fluids 2. rigners lactate 3. normal saline 4. electrolyte fluids - Correct Answers: 1. nonelectrolyte fluids which component of the robotic system is a part of the sterile field? 1. vision cart 2. patient cart 3. camera control unit (CCU) 4. surgeon console - Correct Answers: 2. patient cart a no-fly zone in a hybrid OR designates an area... 1. for the anesthesia professional only 2. in which imaging equipment can be used safely during surgery 3. where no equipment is allowed 4. where no one is allowed to stand - Correct Answers: 2. in which imaging equipment can be used safely during surgery Which of the following is a negative consequence of a specimen error? 1. diagnosis accuracy 2. shorter length of hospitalization 3. potential litigation 4. timely treatment - Correct Answers: 3. potential litigation to decrease the possibility of specimen compromise, the scrub person should... 1. keep the specimen in a sterile basin under the mayo stand. 2. label the rim of the specimen container and cover the container with a water-soaked sponge 3. keep the specimen dry in a counted sponge 4. cover and level the specimen - Correct Answers: 4. cover and label the specimen When transferring the specimen off the sterile field, the scrub should... 1. pour sterile water into the specimen container 2. use the transfer instrument for the closing count 3. wear two masks to avoid breathing the preservative 4. confirm with the RN circulator that the container is large enough for the specimen - Correct Answers: 4. confirm with the RN circulator that the container is large enough for the specimen What is a negative outcome of specimen mismanagement that can have a direct impact on any member of the surgical team. 1. community distrust 2. additional procedure 3. exposure to blood and other potentially infectious material 4. increased morbidity/ mortality - Correct Answers: 3. exposure to blood and other potentially infectious material It is necessary for specimen containers to be 1. leak proof 2. puncture resistant 3. large enough to contain the specimen and preservative 4. all of the above - Correct Answers: 4. all of the above what patient harm may occur due to specimen management error? 1. community distrust 2. exposure to blood/ body fluids 3. extended length of stay 4. appropriate treatment - Correct Answers: extended length of stay how are bullets handled during a procedure 1. grasped with a metal instrument with protective rubber shods and placed in a nonmetal basin. 2. grasped with a metal instrument and placed in a metal basin 3. grasped with a metal instrument with protective shods and placed into metal basin 4. grasped with metal instrument with protective shods and placed in lap sponge. - Correct Answers: 1. grasped with a metal instrument with protective rubber shods and placed into a nonmetal basin. why would a patient's medical device be removed? 1. discomfort 2. manufacturer recall 3. infection 4. all of the above - Correct Answers: 4. all of the above what is the appropriate procedure for returning an implant to the manufacture? - Correct Answers: follow the manufacturer's instructions if the facility policy does not describe the steps for handling an infectious specimen, who should you call? - Correct Answers: pathology department Which sterile team member typically administers medication to the patient at or near the incision site during the procedure? - Correct Answers: surgeon a periop RN is preparing a heparin flush. Before administration the RN should double-check the medication dosage with any of the following members except... 1. unlicensed team member 2. RN 3. MD 4. anesthesia - Correct Answers: 1. unlicensed team member a medication that is accepted onto the sterile and is not in its original container should be labeled with medication name, date, time, and the 1. strength and dilution if used 2. scrub's initials 3. surgeons initials 4. patient name - Correct Answers: 1. strength and dilution which med neutralizes the effect of heparin 1. protamine 2. vitamin K 3. propranolol 4. bacitracin - Correct Answers: 1. protamine when epinephrine is added to local anesthetic its action includes 1. antimicrobial activity 2. prolonging the rate of absorption of the local anesthetic 3. bronchial dilation 4. increased bleeding at the wound bed - Correct Answers: 2. prolonged absorption rate a medication used in vascular surgery to prevent blood clot formation is 1. heparin 2. hetastarch 3. papaverine 4. protamine sulfate - Correct Answers: 1. heparin the last opportunity to detect a med error before it reaches the patient occurs prior to which phase 1. administering 2. dispensing 3. procuring 4. transcribing - Correct Answers: 1. administering after receiving a verbal order from the surgeon who is scrubbed, the RN should first 1. acquire the med 2. implement the order 3. ask surgeon to sign order 4. read back the order - Correct Answers: 4. read back which IV med is indicated to decreased ICP 1. mannitol 2. mag sulfate 3. methergine 4. nafcillin - Correct Answers: 1. mannitol an RN who dispended an antibiotic irrigation solution to the scrub at the field should keep the empty med vials and delivery devices in the OR until... - Correct Answers: the procedure has been completed what is the principle enzyme in hemostasis and catalyst to convert fibrinogen to fibrin in the coagulation cascade? 1. thrombin 2. amylase 3. lipase 4. protease - Correct Answers: 1. thrombin Traditional methods of surgical hemostasis include mechanical, thermal based energy sources, and ... - Correct Answers: chemical agents using suture to close a wound is a .... method to achieve surgical hemostasis. 1. pharmaceutical 2. thermal based energy 3. chemical 4. mechanical - Correct Answers: 4. mechanical Thrombin is considered a ...... agent because it biologically participates in the coagulation cascade. 1. pharmaceutical 2. passive 3. active 4. chemical - Correct Answers: 3. active which type of drain allows for free flow of fluids from the wound using gravity only. 1. closed drainage system 2. negative pressure therapy unit 3. Penrose drain 4. chest drainage system - Correct Answers: 3. Penrose drain which medication reverses heparin - Correct Answers: protamine who should conduct a surgical count with an scrub person? - Correct Answers: circulating RN during the closing count, a lap sponge is missing. what is the first action the RN circulator should take? 1. look in the trash 2. call the manager 3. ask the scrub person to look for the lap sponge under the drapes 4. notify to the team of the missing item - Correct Answers: 4. notify the team of the missing item the periop RN should anticipate using what type of drain for a trauma patient with multiple rib fractures? 1. Penrose 2. chest tube/ chest drainage system 3. hemovac 4. JP - Correct Answers: 2. chest tube/ chest drainage system surgical sponges differ from dressing sponges in that surgical sponges are.. 1. smaller than dressing sponge 2. radiopaque 3. manufactured using specific textile 4. always packaged in groups of give - Correct Answers: 2. radiopaque During surgery the surgeon verbally orders a medication they want to administer. What should the RN do first to decrease risk of communication error? 1. verify the order is correct for situation 2. document the order 3. administer the medication immediately 4. read back the order - Correct Answers: 4. read back the order management of potential loss of patient care data should be part of: 1. intra to post op handover information 2. PNDS vocabulary 3. the patient consent form 4. EHR downtime protocols - Correct Answers: 4. EHR downtime protocols Whish US law guarantees the privacy of individuals receiving health care services and the confidentially of their health information? - Correct Answers: HIPPA Which statement about standing orders/ reprinted orders is true? 1. surgeons should review their standing orders for accuracy. 2. standing orders do not need to be documented 3. standing orders should not be used in the OR 4. standing orders always expire after 6 months - Correct Answers: 1. surgeons should review them for accuracy. what is recommended if a correction is required on a paper health care record? 1. do not make corrections on a paper record 2. cover the existing content using black ink and add the correction. 3. always use red ink 4. follow facility policy and procedure - Correct Answers: 4. follow facility policies and procedures a benefit of including the perioperative nursing data set in a documentation format is that it... 1. provides evidence based guidelines 2. describes patient care using standardized and unambiguous terms 3. addresses only the intra op phase of care 4. determines patient specific outcomes - Correct Answers: 2. describes patient care using standardized and unambiguous terms which of the following is not a risk reduction strategy 1. maintained confidentiality 2. using standardized documentation 3. discussing your assignment with your manager 4. limiting documentation to a major episode in the patient's care - Correct Answers: 4. limiting documentation to a major episode in patient care A patient's neighbor calls looking for information and asks who their friend is doing. what is the nurses best response? 1. how did you get this number 2. I cannot give you any information 3. she is doing fine and will be out of surgery soon 4. please call back and talk with PACU RN - Correct Answers: 2. I cannot give you any information lawsuits may be derived from failure to: 1. follow standards of care 2. assess and monitor the patient 3. document accurately 4. all of the above - Correct Answers: all of the above which of the following statements is true? 1. if an electronic medical is amended, the original is deleted. 2. documentation cannot be used to analyze regulatory compliance. 3. documentation can be used to align service with reimbursement 4. for efficiency, each health care system should have its own unique structed vocabulary - Correct Answers: 3. documentation can be used to align service with reimbursement A goal of patient and family centered care is to 1. make the patient aware of their reliance on medical personnel 2. improve the patients knowledge regarding their care 3. achieve short term behavioral changes 4. focus on one point person for all communication - Correct Answers: 2. improve patient knowledge regarding their care For patient and family centered care to succeed, which of the following must occur? 1. physician-provided patient education 2. decreased likelihood of medical errors 3. improvement in the nurse patient relationship 4. active patient engagement in the education process - Correct Answers: 4. active patient engagement in the education process identify a goal of ERAS 1. reduce patient stress response 2. limit activity for 48 hours 3. muscle strengthen exercise 2 days prior to surgery 4. opioids prescribed every 4 hours for 48 hours - Correct Answers: 1. reduce patient's stress response ...... are the conditions where people are born, where they grow up, where they work, and where they live. - Correct Answers: Social determinants of health What is one way the RN circulator can support a family member in the waiting room during surgery. 1. wait to have the surgeon talk to them after 2. avoid making a phone call because you are busy 3. have lunch during the procedure with the family member 4. phone call the family member - Correct Answers: 4. phone call to the family member what is an example of health equity 1. offering noon appointment to day workers 2. requires people to talk public transport for a check up 3. providing resources to one patient population 4. providing low-cost health services to those living in low-income housing. - Correct Answers: 4. providing low-cost health services to those living in low-income housing. What is a SDOH resource that can enhance population health outcomes? 1. unsanitary housing conditions 2. fast food 3. intermittent internet service 4. public safety - Correct Answers: 4. public safety what is a hallmark of an accountable care organization? 1. decrease in errors 2. physician controlled care 3. increased costs 4. duplication of services - Correct Answers: 1. decrease in errors Teach back is a particularly valuable tool for perioperative nurses when providing 1. information about surgical treatment options 2. preoperative teaching 3. information for informed consent 4. periop discharge instructions - Correct Answers: 4. periop discharge instructions what is one hallmark of patient centered care 1. decisions are made and shared with the patient and family 2. physical comfort and emotional wellbeing are priorities 3. new information is delivered withing 48 hours 4. families have specific visiting hours. - Correct Answers: 2. physical comfort and emotional wellbeing are priorities Which area is considered a sterile area of a surgical gown? 1. cuff of the gown 2. front 3. axilla 4. back of gown - Correct Answers: 2. front of gown how often should surgical gloves be changed during surgery? 1. 60-90 min 2. 50-60 min 3. 90-150 min 4. 20-45 min - Correct Answers: 3. 90-150 minutes how should a surgical hand rub be applied? 1. apply solution liberally on hands up to axilla 2. apply solution vigorously from fingers to mid forearms 3. apply solution and rub to both arms then hands 4. according to the IFU - Correct Answers: 4. according to IFUs what is an example of a glove perforation indicator system? 1. black ink appears on the glove 2. wearer's dominant hand is gloved a different color 3. smaller glove worn under top glove 4. inner glove is a different color from outer - Correct Answers: 4. inner glove is a different color from the outer glove for initial gloving after you have donned a sterile gown, what self-gloving technique should you use? 1. closed 2. controlled 3. open assisted 4. open - Correct Answers: 1. closed gloving you are helping a team member don a sterile gown and gloves. assist the team member by: 1. handing the sterile gloves to them to self glove 2. help expose the members hands before being gloved 3. release the gown and step away once their arms are inside 4. face the inside of the gown towards yourself - Correct Answers: 3. release the gown and step away once their arms are inside You are assigned to scrub on a case you know will be high risk for blood and fluid exposure. which class gown should you wear? - Correct Answers: level 4 which of the following should be worn on the hands during antisepsis 1. bracelet 2. ring 3. watch 4. none of the above - Correct Answers: 4. none of the above what action should be taken first to remove a gown and gloves after completion of the case. - Correct Answers: with gloved hands, pull the gown away from your body and break the ties, roll it into a bundle touching only the outside of the gown If your sterile glove becomes contaminated during surgery what action should you take first? 1. remove your gown and gloves, perform hand antisepsis 2. cover the contaminated glove with a sterile glove 3. remove both gloves yourself and don sterile ones 4. ask a non-scrubbed member to remove the contaminated gloves. - Correct Answers: 4. ask a non-scrubbed member to remove the contaminated gloves. Which of the following features is common to delayed primary healing? 1. scar formation and contracture may require scare revision 2. the wound is cleaned, debrided, and packed for eventual skin approximation. 3. delayed healing may result in weaker tissue approximation and herniation 4. there is no wound edge separation and minimal post op swelling. - Correct Answers: 2. the wound is cleaned, debrided, and packed for eventual skin approximation. Wound healing is influenced by numerous intrinsic and extrinsic factors. which of the following would place stress on a fresh post op wound? 1. vomiting, coughing, edema 2. age and pre-existing conditions 3. malnutrition and obesity 4. immune system response, respiratory and circulatory status - Correct Answers: 1. vomiting, coughing, edema Which is an example of a biologic wound debridement? 1. surgical removal of devitalized tissue 2. forceful irrigation 3. enzymatic agent application 4. sterile maggot application - Correct Answers: 4. sterile maggot application what is the main reason for the sue of negative pressure wound therapy? 1. to accelerate granulation tissue formation 2. to dilute the bacterial load with water 3. to reduce edematous bacterial load and initiate wound contracture and healing 4. to increase oxygenation to the tissue - Correct Answers: 3. to reduce edematous bacterial load and initiate wound contracture and healing what is a disadvantage of a drain? 1. provides an entry for pathogenic microorganisms 2. affords an escape for serum and blood 3. allows for intestinal secretion and bile escape 4. removes air from the surgical site - Correct Answers: 1. provides an entry for pathogenic microorganisms Which of the following options describes a Class II surgical wound? 1. the respiratory, gastrointestinal tract, or genitourinary tract is entered under controlled circumstances. 2. there is visible gastrointestinal spillage or inflammation present 3. the wound is infected, or perforated organ space is present 4. it is the result of a non-penetrating trauma - Correct Answers: 1. the respiratory, gastrointestinal tract, or genitourinary tract is entered under controlled circumstances. which of the following materials are used int eh composition of non-absorbable sutures? 1. cotton 2. metal 3. linen 4. all of the above - Correct Answers: 4. all of the above a stitch that is separate and tied independently of the other stiches is called... 1. running stitch 2. pure-string stitch 3. retention stitch 4. interrupted stitch - Correct Answers: 4. interrupted stitch in addition to sutures, the skin can be closed by using... 1. staples 2. adhesive 3. wound strips 4. all of the above - Correct Answers: 4. all of the above Coefficient of friction is an element of which suture material characteristic? 1. needle configuration 2. handling 3. physical 4. tissue-retraction - Correct Answers: 2. handling Which of the following is not a key element of ERAS? 1. return to regular diet and activities on the day of surgery 2. minimal fasting prior to surgery 3. opioid only pain relief 4. patient and family education - Correct Answers: 3. opioid only pain relief The nursing alliance for quality care (NAQC) emphasizes patient centered care that includes patient engagement. Which of the following is one of the nine assumptions of patient engagement? 1. nurses must form an active partnership with their patient, the support system, and the providers. 2. circumstances surrounding the need for health care interventions do not include the patient's level of engagement. 3. cultural, racial, ethnic diversity cannot be considered when providers make decisions for the patient. 4. physicians must make decisions about the patients care. - Correct Answers: 1. nurses must form an active partnership with their patient, the support system, and the providers. An element that is no part of the surgical checklist pre-procedure check in is... 1. confirmation of surgical site marking 2. introduction of team members 3. presence of the consent and H&P 4. confirmation of the procedure and site. - Correct Answers: 2. introduction of team members Which element would be part of a nursing focused assessment for the integumentary system? 1. dyspnea 2. turgor 3. fall risk 4. hypoxia - Correct Answers: 2. turgor Which of the following contains the elements of economic stability and built environment? 1. Patient bill of rights 2. the joint commission requirements for H&P 3. ERAS 4. social determinants of health (SDOH) - Correct Answers: 4. social determinants of health (SDOH) What can patients do to lessen preoperative anxiety? 1. listen to music 2. practice aromatherapy 3. perform meditation 4. all of the above - Correct Answers: 4. all of the above Which of the following drugs is not an anticoagulant? 1. Fragmin 2. lovenox 3. heparin 4. Tylenol - Correct Answers: 4. Tylenol When should anticoagulants be discontinued prior to surgery? 1. 12 hours 2. 36 hours 3. 24 hours 4. 48 hours - Correct Answers: 4. 48 hours THC is metabolized through the liver. Which of the following is not a route of elimination? 1. feces 2. sweat 3. bile 4. urine - Correct Answers: 2. sweat What is an important element when assessing your patient's pain? 1. checking the pain across two pain scales 2. always using the same scale with the same patient 3. always having the patient read the pain scale 4. asking the family member what level the patient's pain level is - Correct Answers: 2. always using the same scale with the same patient