AORN PeriOP 101 Exam Answered Questions Graded A+

When applying the concept of surgical conscience which of the following statement should be considered? Select all that apply. – ANSWER 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. In preparing for a regulatory survey, your quality consultant questions you about the restricted zone in your OR suite. The following statements are true: - ANSWER 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. You are assigned to relieve a surgical technologist for lunch. You will need: - ANSWER A. A sterile gown and gloves opened on a table (other than the main instrument table) for closed gloving. The Joint Commission Universal Protocol consists of: Select all that apply. – ANSWER A. Preoperative verification B. Surgical site marking C. Time Out Which of the following procedures reflects best practice for transferring a medication vial to the sterile field? – ANSWER Use a sterile transfer device Recommended sponge count procedures include all of the following EXCEPT? – ANSWER Counting silently so it doesn't distract other personnel. What is the best drape to use for an umbilical hernia repair? – ANSWER Laparotomy Which of the following statements correctly describes recommendations for preoperative patient skin antisepsis? – ANSWER D. Prep should start at the site of the incision and move outwards. The following steps can be used to reduce personnel exposure to specimen fixatives such as formalin. Select all that apply. – ANSWER 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. After initial administration, which statement below the proper order of the 4 stages of general anesthesia affecting the patient? – ANSWER A. Administration, excitement, intrasurgery, respiratory failure What responsibilities do OR staff members have in maintaining a safe OR environment? Select all that apply. – ANSWER A. Adhering to facility policies related to safety B. Consistently applying OR specific safety practices D. Monitor, identify and report safety hazards. An important difference between minimally invasive (MIS) and open surgical procedures is that MIS: - ANSWER A. Can be performed through smaller incisions. The first step in the sterilization process of surgical instruments that have been used in case is: - ANSWER A. Cleaning The preoperative team implements aseptic technique practices to meet all of the following primary goals EXCEPT? – ANSWER A. Improve patient satisfaction When a "Time Out" discrepancy occurs, the nurse's priority action should be to: - ANSWER 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 Which of the following statements about the immediate use steam sterilization is the recommended practice? – ANSWER D. Instruments may be immediate use steam sterilized only when there is insufficient time to process by the preferred wrapped or container method. What are the perioperative nurses responsibilities for the informed consent process? Select all that apply. – ANSWER 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. A __________ is a designated area on the sterile field where the scrub person and the surgeon place all sharp instruments. – ANSWER A. Neutral zone Which of the following is the best definition of sterile technique? Sterile technique is: - ANSWER D. Implemeted during surgical procedures to prevent microbial contamination When setting up insufflation equipment for an abdominal endoscopic procedure the preoperative nurse should: Select all that apply. - ANSWER A. Have a backup tank available C. Verify that the CO2 pressure and supply alarms are on and functioning 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? - ANSWER C. Situational Put the following steps in order when opening a wrapped sterile package: - ANSWER 1. Open the farthest wrapper flap 2. Open side flaps 3. Open the nearest wrapper flap 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? – ANSWER D. Class IV (Dirty/Infected) Which of the following practices help to prevent contamination in the surgical suite? Select all that apply – ANSWER 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 statements about counts is correct? Select all that apply. – ANSWER 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 Latex Allergic Response Stages (matching) – ANSWER Stage I: Contact uticaria at the site of exposure. Symptoms could include: swelling, redness, itching and/or burning. Stage II: The allergic reaction spreads. Symptoms include: edema, itching around the eyes, acute rhinitis, nasal itching, sneezing, SOB Stage III: Can progress to a sudden drop in blood pressure, increased heart rate and potential circulatory collapse 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: - ANSWER Fumes trapped underneath the drapes and could ignite Which elements are required to create an environment where the culture of safety is embraced? – ANSWER Sincere commitment to affirming safety as the first priority Which of the following practices violates a patient's ethical right to self-determination? – ANSWER Automatic intrapoperative suspension of a don-not-resusucitate decision Which of the following statements about the gowning procedure are correct? - ANSWER Step back from the table into an unobstructed area to let the gown unfold A psychosocial assessment may include the patient's: Select all that apply – ANSWER A. Cultural beliefs and practices B. Expressed level of anxiety or stress C. Spiritual or religious beliefs D. Understanding of the surgical procedure Proper OR attire for restricted areas includes: Select all that apply - ANSWER 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 How can the preoperative nurse directly contribute to financial efficiency in the OR? – ANSWER Asking surgeon before opening supplies 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? – ANSWER Break down the entire back table and re-establish a sterile field 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: - ANSWER C. Situation, Background, Assessment, Recommendation The dispersive electrode should: - ANSWER C. Be placed as close to the operative site as possible Latex Sensitivity Categories (matching) – ANSWER 1.Irritant contact dermatitis: non allergic skin reaction usually aggravated by glove power and chemical agents added to raw latex 2. Immediate: occurs within 5 to 30 minutes or 10-12 hours 3. Delayed: occurs 24 to 72 hours If the preoperative team is unable to extinguish the fire in the OR, recommendations include: - ANSWER Evacuating the patient and the preoperative team following the organization fire plan Which of the following environmental sanitation practices is used to limit transmission of microorganisms? – ANSWER Use personal protective equipment when handling body fluid spills Which type of needle point should you expect to be needed for suturing viable tissue such as the liver? – ANSWER Blunt 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? - ANSWER Use the draw sheet to lift the patient slightly to allow the skin to realign with the skeletal structures In which order do the body's defense mechanisms take place during healing? – ANSWER 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. An area of painful skin that is abraded, blistered, or had shallow craters would be classified as which stage of ulcer? – ANSWER Stage II 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 – ANSWER 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 When making the preoperative assessment, the nurse should take the following into considerations. Select all that apply – ANSWER A. Mobility C. Planned duration of the procedure D. Preexisiting healthy conditions E. Type of anesthesia Performance of the "time out" for patient safety includes verbal team agreement on which of the following items: Select all that apply. - ANSWER A. Patient identification using two patient identifiers B. Site of the procedure, including right-left distinction D. Procedure to be performed The principle elements required for an infection to occur are: Select all that apply. – ANSWER A. A method of transmission B. A source or reservoir C. A susceptible host with a portal of entry to receive an infection 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? – ANSWER A. Alert the team that the drape is contaminated and replace with a sterile drape The purpose of conducting postoperative phone calls within 24-48 horns for outpatient procedures is: Select all that apply. – ANSWER A. Ask about patient satisfaction with care D. Direct future hospital performance activities E. Note any surgical complications The goals of patient and family education include all of the following EXCEPT: - ANSWER A. Achieve long-lasting improvements in patient health status B. Improve patient satisfaction C. Provide information/knowledge to the patient and and family What are the three methods used to accomplish hemostasis? – ANSWER A. Mechanical, chemical and thermal Which of the following statement is true concerning the use of the AORN Guideline for Preoperative Practices? – ANSWER D. Work setting and situations variations may determine the extent to which the AORN Guidelines can be applied Which of the following statements about gloving is true? – ANSWER B. The gown should be fastened in the back before donning gloves All of the following statements indicate an understanding of the recommended attire for the circulating nurse during and invasive procedure EXCEPT: - ANSWER C. Jewelry should on the outside of surgical attire to be constantly monitored The preoperative nurse's role in the patient and family education should include: Select all that apply – ANSWER 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 Interventions to help prevent a surgical site infection (SSI) in the patient undergoing a laparoscopic appendectomy include: Select all that apply - ANSWER 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 Which of the following components should be included in documenting the placement of a surgical drain? – ANSWER B. Location of the drain Which of the following practices is recommended to reduce the patient's risk of intraoperative skin injury – ANSWER D. Protect sensitive areas of the skin with appropriate padding Which of the following is an example of synthetic absorbable material? - ANSWER Vicryl Which of the following physiological effects is most likely to result from positioning a patient in lithotomy position? – ANSWER A. Circulatory and respiratory compromise due to pressure on the abdomen 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? – ANSWER C. Discard the medication and replace with an unopened container Which AORN guideline most directly pertains to interim cleaning in the perioperative environment? – ANSWER A. A safe, clean environment should be reestablished after each surgical procedure. The Joint Commission Universal Protocol consists of: Select all that apply - ANSWER A. Preoperative verification B. Surgical site marking C. Time Out Preoperative documentation should include: Select all that apply - ANSWER A. Administration of ordered medications C. Performance of the universal protocol for preventing wrong site, wrong procedure, wrong person surgery