CNOR Practice Questions And Answers Comprehensive, Graded A+ 2023

CNOR Practice Questions When should assistive technology be used when transfering a patient? - When one team member is required to lift more than 35lbs of patient Time for surgeon to authenticate verbal orders (federal mandate, not hospital policy) - 48 hours Examples of clinical alarms - alarms on cardiac monitors anesthesia machines, ventilators (visual, auditory or both) Universal Protocol - prevent wrong site, wrong procedure, and wrong surgery 1. Preop/ procedure verification process 2. marking site 3. time out * part of assessment phase of Nursing Process National Patient Safety Goals Examples of full body patient transfer devices - air-assisted transfer mattresses (hovermats), full body slides, mechanical lifting equipment Examples of safety-engineered devices to prevent sharps injuries - blunt suture needles, safety scalpels, needless systems, alternate wound closures Contact time - specific length of time disinfectants can remain in contact w/ microorganisms to achieve disinfection For every time of equipment of supply used on or for patient, what document should always be followed? - IFU- manufacturer's instructions for use Adverse reactions to polymethymethacrylate (bone cement) - hypotension, cardiac arrest, CVA, pulmonary embolism, fat embolism, hypersensitivity, thrombophlebitis, death RN's action after hearing a verbal order from Dr - read back the order Symptoms of local anesthetic systemic toxicity - metallic taste, confusion, dizziness, numbness (initial phase) Indication for use of BSS (Endosol) (balanced salt solution) - keep eye moist during surgery Effective meds to reduce postop N/V - Droperidol, Ondansetron, Promethazine Maximum number of meds prep RN should compound in periop suite - Three What type of muscle cell is affected during MH? - Skeletal Examples of research evidence - RCTs, systematic reviews, quasi-experimental studies Standardized language that reflects period nursing practices? - Perioperative Nursing Data Set (PNDS) Examples of non-absorbable suture materials - cotton, milk, nylon sutures implant that reduces tremors, involuntary movements, gait problems for Parkinson's - Deep brain stimulator What is Unique Device Identification? - FDA requirement; every device has a number (also on package); for implantable life-supporting, sustaining devices Risk assessment for pressure injuries - Braden Scale, Munro Scale, Scott Triggers Tool Using prophylactic dressings applied to healthy skin that is at risk for pressure injury may reduce effects of - pressure, shear, friction Scatter radiation - reflected off patient, table, shielding, material (secondary radiation) risk to personnel in room Leakage Radiation - emanates from X-ray tube housing (secondary radiation) Remnant Radiation - exits patient & imparts image on film poses little threat to personnel The timing of the administration of a preoperative prophylactic antibiotic, when ordered for a patient whose plan of care includes the use of a pneumatic tourniquet, should be based on the - goal of achieving optimal tissue concentration & policy/ procedures of hospital Limb occlusion pressure is the pneumatic tourniquet pressure required to occlude ___________ blood flow in the limb. - arterial Before the pneumatic tourniquet is inflated, guidelines include the extremity may be exsanguinated by - using an elastic wrap elevating the limb The orthopedic surgeon and the anesthesia professional should determine the initial tourniquet inflation pressure by measuringthe patient's - limb occlusion pressure During application of a pneumatic tourniquet to an extremity, the perioperative RN should position the cuff tubing on or near the ___________ aspect of the extremity. - lateral A perioperative RN develops a plan of care for a patient whose surgery includes the use of a pneumatic tourniquet placed on her right lower extremity. Monitoring the patient's temperature throughout the perioperative period is considered what part of the nursing process for this patient? - intervention Maximum tourniquet cuff pressure for the thigh should not exceed - 350mmHg When the use of monopolar electrosurgery is anticipated, after the application of a pneumatic tourniquet, the perioperative RN should place a single-use dispersive electrode _____________ to the cuff. - proximal The employer must maintain the employee'sexposure record (ie, sharp incidents) for the duration of employment plus ___ years? - 30 years Using the Gown Liquid Barrier Performance Class rating, a surgical gown classified as a Barrier Level 4 should be worn when the anticipated level of exposure to fluids, splashes, or pressure on the gown is - high The perioperative RN should anticipate classifying a surgical wound when there is a controlled entry into the GI tract without spillage of gastric or bowel content as - Class II (Clean-contaminated) Bonewax is made of - beeswax, paraffin, and isopropyl palmitate. Which of the following is NOT a type of skeletal traction? - Cervical halo Gardner-Wells tongs ***Hip Spica cast*** Thomas splint balance suspension Key points related to the use of methyl methacrylate include the following EXCEPT A. It is a respiratory, eye, and skin irritant. B. It is a vasoconstrictor. C. It is used to secure prostheses in bone. D. Patients and staff can be allergic to it. - B- vasoconstrictor It is a vasodilator that causes hypotension Osteotomes, gouges, and chisels are what type of surgical instrument? - dissecting What injectable medication used in urologic surgery colorizes tissue and vessels? - indigo carmine Medications administered to decrease intracranial pressure may include all EXCEPT a. cefazolin. b. mannitol. c. propofol (Diprivan). d. thiopental (Pentothal). - cefazolin To control bleeding on the dura of the brain and spinal cord, the perioperative RN should anticipate the surgeon using - bipolar The standard means of vascular access for long-term renal dialysis is - AV fistula Which modification of the supine position should be made for the OB patient? - Insert a wedge under the patient's right pelvis orlumbar region Which of the following medications is used in ophthalmologic surgery to topically inhibit scar formation in glaucoma filtering procedures? a. Dexamethasone b. Mannitol c. Mitomycin d. Tobramycin - Mitomycin After a pneumoretinopexy to repair a tear in the retina near the macula, the patient should be positioned in the ____________ position. - prone (for several weeks) Which medication commonly used in otologic surgery is an anti-inflammatory/antibiotic? - cortisporin otic The perioperative RN should anticipate applying the preoperative skin antiseptic solution to what area in preparation for the patient's surgery scheduled as "left tympanomastoidectomy"? - behind the left ear A patient is in PACU after having surgery to remove a mass from his left lung. One chest tube was inserted connected to a sterile water seal, closed-chest drainage chamber. During the hand-over report, the perioperative RN reminds the PACU RN to immediately notify the surgeon or contact the rapid response team if a. drainage from the chest tube is greater than 25 mL/hour. b. gentle bubbling is observed in water-seal chamber when patient exhales. c. . patient has sudden onset or increase in intensity of dyspnea. d. b and c only - patient has sudden onset or increase in intensity of dyspnea. The perioperative RN is helping the perioperative team transfer a 10-year-old girl onto the stretcher after a tonsillectomy procedure. How should the patient be positioned on the stretcher for transport to the PACU? - Three-quarters prone with the head turned to the side, with arms and legs flexed A patient in is the PACU after surgery involving an open reduction internal fixation of a fractured right femur. The perioperative RN observes the following signs: the patient is experiencing respiratory distress as demonstrated by tachypnea, the patient's heart rate is 160, the patient appears anxious and agitated, and there are petechiae present on the patient's chest. The patient is most likely exhibiting signs of - fat embolism syndrome What is the minimum amount of urine output expected for a postoperative adult patient with an indwelling urinary catheter to ensure proper hydration and kidney function? - 30mL/ hour A healthy 40-year-old woman is transferred to the PACU after a total left knee replacement with no complications. During a transfer of care report, the perioperative RN describes the patient as having an indwelling urinary catheter in place, which is draining clear, yellow urine. The perioperative RN and PACU RN agree that the best time to remove the catheter is - as soon as possible, preferably within 24 hours after surgery A 50-year-old woman is awake and alert in the PACU after a left knee arthroplasty. What is the best measure below for the perioperative RN to assess the patient's pain intensity? - Self-report on a standardized pain scale Shoulder pain after a patient undergoes a laparoscopic cholecystectomy is most likely caused by - retained carbon dioxide in the peritoneal cavity. What nonpharmacological interventions may reduce pain and anxiety in the preoperative period for pediatric patients? - play therapy & music A perioperative RN's documentation for a postoperative patient, "the patient is free from pain or numbness associated with surgical positioning," is an example of a nursing - outcome statement The first choice of therapy to treat bronchospasm is - inhaled bronchodilators Which symptom would indicate a sub-optimal thyroid level in a patient taking levothyroxine? - chronic constipation "Risk for patient injury due to the use of electrosurgery" is an example of a perioperative RN documenting a nursing - diagnosis A perioperative RN collecting and analyzing patient data is executing which step of the nursing process? - Assessment "The patient's procedure is performed on the correct side, site, and level" is an example of a nursing - outcome