AORN Periop 101 Questions with Complete solution

AORN Periop 101 Questions with Complete solution In addition to the surgeon, which surgical team members wear sterile gowns and gloves during the procedure? -Answer- Scrub Person AND Surgical assistant The pathology laboratory and blood bank are usually situated in which of the following areas? -Answer- Unrestricted area What phases of the nursing process does the periopeartive nurse practice during the preoperative phase of the surgical experience? -Answer- Assessment, Identification of desired outcome, Nursing diagnosis, Planning Data collection is part of which phase in the nursing process -Answer- Assessment Which of the following is considered a critical perioperative nursing diagnosis within the PNDS? -Answer- Risk for perioperative positioning injury Competency statements -Answer- Direct a nurse's activity in the perioperative arena; Provide a basic model to evaluate the quality of nursing practice; Ascertain a level of skills and abilities necessary to fulfill the professional role (All of the above) Defining nursing goals and intervention strategies is a part of which phase in the nursing process -Answer- Outcome identification Match each staff member with the appropriate responsibility -Answer- Scrub personMonitors aseptic technique; RN circulator- Creates and maintains a safe environment; Housekeeping- Cleans the furniture at the end of the OR day; Nurse anesthetistadministers anesthesia to the patient Creating cultures that supports patient safety through which of the following mechanisms? -Answer- Convene and communicate with members about safety; Incorporate attention to patient safety into training programs; Collaborate across disciplines. The IOM report describes the importance of setting standards and expectations for patient safety. Setting standards can_____ -Answer- Set expectations for the health professionals; Establish consistency across individuals and organizations; Help set expectations of consumers and purchases. Which of the following AORN Position Statement on Correct site of surgery is true? - Answer- The staff member should verbally verify the correct site with each member of the surgical team Maintaining a safe OR environment, staff members are required to -Answer- Monitor, identify, and reports safety hazards; Understand and comply with the emergency power outage plan; Practice sound, basic and OR specific electrical and fire safety. The elements required to create a cultures of safety include -Answer- A sense of trust among team members; A sincere commitment of affirming safety as the first priority; Development and support of a proactive approach rather than a reactive blaming approach; Dissemination of receipt of information to all levels of staff. Which of the following practices should be used ti implement the Joint Commission's Universal Protocol for preventing Wrong Site, Wrong Procedure, Wrong Person Surgery? -Answer- Using a time-out procedure before beginning the procedure The purpose of the National Patient Safety Goals is to -Answer- Promote specific improvements in patient safety; Highlight problematic areas in health care; Describe evidence and expert-based system-wide solutions to the problems AORN's Guidelines for Perioperative Practice provides -Answer- Information on administrative topics; Information that can be used to develop institution-specific policies; Scientific evidence for clinical practices. Which of the following are true about AORN's Guidelines for Perioperative Practice? - Answer- They are based on what nurses do in ideal situations; They may be fulfilled to varying degrees in different situations. Why is it important for perioperative nurses to have a basic understanding of business principles? -Answer- To enable them to plan safe and effective care that is also costeffective; To facilitate competition for patient volume; To manage and allocate resources wisely Match the type of budget with its description -Answer- Gross revenue- All monies received by the facility for goods and services; Fixed expenses- Medical records and administration; Net revenue- gross revenue minus expenses; Variable costs- Costs directly related to patient volume Which of the following definitions are correct? -Answer- Liable means to bind or to be responsible to or to be under obligation to; Negligence means the failure to exercise care that a prudent person would perform under the same circumstances. Professionalism in nursing means -Answer- Showing personal accountability in understanding the Nurse Practice Act; Maintaining a current knowledge base; Participating in professional organizations. Which of the following social media practices are important for the professional nurse to follow? -Answer- Acknowledge that anything you post on the internet is there forever; Do no speak on behalf of your employer unless you have been authorized to do so; Facebook mixes your personal and professional lives and requires careful attention. Benefits of evidence based practice include which of the following? -Answer- The professional perioperative nurse can base his or her practice on evidence; Provides point of care clinicians with tools that can assist in improving patient care, The evidence collected is rated for quality and strength. Which of the following statements reflects the findings from a research study of more than 11,000 nurses conducted in 2007 related to the importance of certification? - Answer- Enhances feelings of personal accomplishment; Validates specialized knowledge. For a professional nurse, personal accountability means -Answer- Willingness to take responsibility for one's actions; Being dependable in all situations; Making the best decisions with the input available; Willingness to bare consequences for one's actions Which of the following statements are true about objective data? -Answer- Data that is the information written in the patient's record and nursing notes; History, physical, and laboratory data are examples of objective data Match the age groups with their ability for learning and understanding -Answer- Birth to one month- The child is able to express only through crying; 1-12 months- The baby will smile, babble, and gurgle; One to three years- The baby is able to understand and respond to simple commands; Three to six years- The child is able to literally interpret terms. Patients in which of the following age groups have the greatest blood volume per unit of body weight? -Answer- Children During the preoperative interview, why should the perioperative nurse ask patients about their use of herbal preparations, alcohol, tobacco, and recreational drugs? - Answer- Herbal supplements may affect the metabolism of drugs administered; Recreational drug use may affect the choice of preoperative sedation; Smoking may affect circulatory and respiratory system assessment results. Which items are included in a psychosocial assessment? -Answer- Coping styles; cultural beliefs and practices; Expectations of perioperative care; Spiritual or religious beliefs Which of the following statements is true? -Answer- Lung capacity decreases with increasing age Which of the following factors make geriatric patients more sensitive to injury and cold? -Answer- Decrease in subcutaneous fat Why is it important to assess the use of herbal supplements or recreational drugs before surgery? -Answer- Herbal preparations can affect bleeding times; Herbal preparations can interfere with drug metabolism; Recreational drug use can result in withdrawal symptoms; Recreational drug users may require higher doses of anesthetic medications. What interventions can the perioperative nurse perform to protect elderly patients? - Answer- Employ DVT prophylactic devices; Position the patient for effective air exchange; Use warming devices to maintain the normothermia A child in which of the following age groups can be described as "likes to socialized and can interpret terms"? -Answer- 3 to 6 years The goal of patient and family education is to -Answer- Provide information to the patient; Improve knowledge; Achieve long lasting changes in behavior; Take ownership of the patient's care; Improve the patient's outcome. The importance of patient and family education is reflected by which of the following phrases? -Answer- Improvement in quality of care; Increase in patient satisfaction; Increase in patient compliance; Ethical and legal mandates for patient education Which of the following form part of patient's ongoing education needs as a patient? - Answer- Contact information for questions or concerns after surgery; Counseling on modified diet to be followed after surgery; List of foods that might interfere with prescribed mediation; Medications to be given and time intervals for taking. Factors that affect the patient's ability to learn include -Answer- Disability; Fear of dying; Pain; Self-esteem The perioperative nurse provides care to each patient undergoing a surgical intervention in a manner that preserves and protects -Answer- Patient autonomy, dignity, and human rights Patient and family education is a combination process involving -Answer- Influencing behavior; Producing changes in knowledge; Producing change in attitudes and skills Factors that may affect an adult patient's ability to learn include -Answer- Age; Attitude; Emotional state; Intellectual ability; Physical ability The perioperative nurse should use the directive interview technique over a nondirective interview technique when the information he or she needs -Answer- Consists of predetermined questions; Consists of questions in a predetermined order; Is to document the patient's health history A preoperative patient's DNR order is -Answer- Reconsidered to ensure that the risks and benefits of anesthesia and surgery are discussed before surgery Obtaining informed consent is a two step process of -Answer- Communicating information and documenting the decision How does the perioperative nurse test the patient's level of understanding? -Answer- By asking questions about the procedure and evaluating the answer A directive interview is -Answer- Structures with predetermined questions Factors that may affect the amount of pain the patient will experience postoperatively are -Answer- The surgical site; The nature and intended purpose of the surgery; the patient's fears regarding anesthesia or surgery Which of the three elements required for an infection to occur is related to inanimate environmental surfaces? -Answer- Source or Reservoir One of the most effective ways to prevent disease transmission and control infections in health care settings is -Answer- Hand Hygiene Match the three types of transmission based precautions with the correct examples of precautions that should be implemented -Answer- Contact- Donning PPE and environmental cleaning; Droplet- Donning PPE and patient placement Airborne- Donning PPE and waring a surgical mask with a respirator level of N95 or higher The OSHA Bloodborne Pathogen standard requires health care personnel to wear the following when splashes, spray, spatter, or droplets occur -Answer- Masks; Shoe coverings; Eye protection devices; Gloves Which factors determine the likelihood of transmission and persistence of multi drug resistant organisms -Answer- Effectiveness of prevention methods; Numbers of colonized patients; Vulnerability of the patients Several types of infections may be acquired in the perioperative settting -AnswerSurgical site infections- SSIs; Multidrug resistant organisms- MDROs; Central line associated blood stream nfections- CLABSIs; Catheter associated urinary tract infections- CAUTIs Effective methods for preventing SIs include -Answer- Effective environmental cleaning procedures; Performance of sterile technique; Use of surgical attire and other barriers (All of the above) Immunizations and testing for health care workers should include all of the following except -Answer- Shingles Match the correct wound elements with the wound classification -Answer- Class I Clean- Procedure does not involve the respiratory, alimentary, or genitourinary tract and no infection or inflammation is present. Class 2 Clean Contaminated- alimentary, or genitourinary tract is entered under controlled condition. Class 3 Contaminated- Gross spillage from GI tract occurs or unsterile instruments are used . Class 4 Dirty- A clinical infection exists or an internal organ perforation is present. Droplet precautions include all of the following except -Answer- Consulting with the risk manager The single most important factor in preventing the spread of infection is -Answer- Hand Hygiene Damp dusting of the OR as part of the preliminary room preparation should be done - Answer- In the morning before bringing in any surgical supplies Which methods are most effective for terminal cleaning floors in the OR -Answer- Wet vacuum or single use mop Which of the following is correct regarding the disposal of contents from reusable suction systems? -Answer- done according to federal, state, and local regulations Correct statements about spray bottles -Answer- Spray bottles can aerosolize potentially infectious materials; Spray bottles are not used to apply disinfectant The proper device for the disposal of blades, needles, stapling devices, pins, and cautery tips should be -Answer- A sharps disposal container The goals of performing post procedure cleaning of the OR/procedure room include the following -Answer- It renders the environment safe for the patient following in that room to prevent cross contamination; It breaks the cycle of contamination from the patient to the environment and from the environment to OR personnel and then to subsequent patients; It is the patient's right to have a clean and safe environment. Terminal cleaning must be done -Answer- Once during each 24 hour period During post procedure cleaning -Answer- All kick buckets, hampers, and similar receptacles must be inspected and disinfected as needed; Transport vehicles are to be considered contaminated after patient contact; All horizontal surfaces of tables and equipment, including the anesthesia machine, should be wiped down with a lint free cloth moistened with a hospital approved disinfectant. Identify the pathogens that can be commonly found in the OR environement -AnswerEscherichia coli; Methicilin resistant STaph aureus; Serratia marcescens. In which surgical wound category should a total abdominal hysterectomy be classified? -Answer- Clean contaminated wound Match terms -Answer- Disinfection- A chemical or physical process of destroying all pathogenic microorganisms, except spores, on inanimate objects. Decontamination- The use of physical or chemical means to remove, inactivate, or destroy bloodborne or other pathogens on a surface or item. Sterilization- The process of destroying all microorganisms on a substance by exposure to physical and chemical agents; the complete elimination of all forms of microorganisms. High level disinfection- A process that destroys all microorganisms with the exception of high numbers of bacterial spores. Immediate use steam sterilization can be used -Answer- In urgent situations A packing system for items undergoing sterilization should -Answer- Permit aseptic delivery of contents to the sterile field Complete sterilization in ethylene oxide is dependent upon four primary variables: proper time, gas concentration, temperature, and -Answer- Chamber humidity Which of the following is true about ethylene oxide sterilization -Answer- EO exposure is potentially carcinogenic and mutagenic to personnel and patients Which of the following is true about the use of peracetic acid on surgical items -AnswerItems must be immersible An integrator is a multiparameter indicator designed to measure which of the following parameters -Answer- Temperature, time, and presence of steam Which of the following are true about low temperature hydrogen peroxide gas plasma sterilization -Answer- Items can be stored for future use; No toxic residue is produced; The sterilant is bactericidal, viruicidal, and fungicidal; It can be used for items that are heat sensitive. Shelf life is related to -Answer- Exposure to external events; Type of packaging material used; Number of personnel who may have handled the package. Match the basic categories of surgical instrument with their uses -Answer- Graspers- To handle tissues and dressings. Retractors- To provide exposure of the operative site. Cutting instruments- To incise, cut, dissect, or separate tissue. Clamps- To hold join, or compress parts together. A mosquito is classified as a -Answer- Clamp When passing sharps during a procedure, the best way to protect yourself and surgeon is by using -Answer- A neutral zone Curved Mayo scissors are used for which of the following? -Answer- To cut heavy tissue What biting instrument is used for cutting tough tissue or bone? -Answer- A Rongeur while passing scissors, which of their parts should be visible to the surgeon? -AnswerTip Which of the concepts are appropriate for the care of forceps during a procedure? - Answer- Cleaning the tips of blood or tissue frequently. Handing them off the sterile field to the circulating RN if the surgeon says that they are not working properly. Atraumatic forceps are most often used in -Answer- Cardiovascular surgery the point of the forceps should be facing __________ when passing it to the surgeon? - Answer- Downward Which powered cutting instruments are used in orthopedic surgery? -Answer- Tissue shavers; Bone reamers. Plastic incise drapes -Answer- May increase moisture and bacterial growth under the drape; Are NOT recommended for use. Which of the following best describes sterile technique -Answer- Implemented during surgical procedures to prevent microbial contamination Match the terms given below with their definitions. -Answer- 1. Surgical conscienceAllows for no compromise in the principles of sterile technique 2. Sterile- The absence of all living microorganisms. 3. Sterile Technique- The use of specific actions and activities to prevent contamination and sterility of identified areas during operative or other invasive procedures. Recommendations for draping include -Answer- -handling sterile drapes as little as possible - cuffing the drape material over the gloved hands - holding the drapes in a controlled manner Select the areas of the sterile gown that are considered sterile. -Answer- - Gown sleeves from two inches above the elbow to the cuff, circumferential. - The front of the gown from the chest to the level of the sterile field. Select the statements below that are correct -Answer- closed assisted gloving should be used to glove team members during initial gowning and gloving; Once the scrubbed team member's hands pass through the cuff, the cuffs are considered contaminated; Scrubbed team members should wear two pairs of surgical gloves. In creating a sterile field, which of the following are recommended by AORN? -Answera. Cuff the drapes over your gloved hand to prevent contamination. c. Place drapes in sequence from the surgical site to peripheral areas. d. Place drapes on the patient and any furniture and equipment that will be in the sterile field. e. When placing drapes do not lean across unsterile areas. What action below is the best course to take when a hair is found in an instrument tray on the back table? -Answer- c. The entire sterile field should be broken down and a sterile field reestablished. Which of the following practices are NOT examples of the recommendation that "A sterile field should be maintained and monitored constantly"? -Answer- A sterile field that has been set up for more than 1 hour before the procedures begins should be broken down and a new set up prepared. If a delay occurs after a sterile field is set up, the personnel may leave the room as long as the room as been secured. When transferring medication and solutions to the sterile field the perioperative nurse should -Answer- Avoid removing stoppers from vials. Discard unused, opened irrigation or IV solutions at the end of the procedures. Dispense the entire contents to the container slowly. Use a sterile transfer device. Accurate preoperative documentation of the patient admission is an integral part of the nursing process. This includes -Answer- Patient identification; Preoperative orders; Patient assessment. The primary purpose of documentation is