PERIOP 101 LATEST EOC EXAM TEST QUESTIONS AND
ANSWERS SURE A+
Indemnity Payment - ✔✔Payment made on behalf of the policy holder
✔✔Liability - ✔✔A legal responsibility
✔✔Negligence - ✔✔An act or failure to act that deviates from the standard of care
✔✔Nursing Malpractice - ✔✔A nurse's negligence or any intentional act that causes
physical, financial, emotional, psychosocial, and/or cognitive damage to the person in
the nurse's care
✔✔Respondeat Superior - ✔✔An employer is legally responsible for the nurse
employee only when:
o The nurse acts within the scope of practice
o Any allegations brought against the nurse occurred during the nurse's employment
o The nurse's actions were within the employer's best interests.
✔✔Tort - ✔✔A breach of duty to another person as outlined by law
✔✔What are the four elements of malpractice? - ✔✔• Duty
• Breach of duty
• The breach of duty caused an injury
• The injury was harmful to the patient
✔✔Elements of Informed Consent - ✔✔• Must be obtained by the licensed professional
who is performing the procedure
• The patient must give consent voluntarily with the full understanding of all implications
• Must include
o Diagnosis
o Proposed treatment
o Treatment alternatives
o Consequences of accepting or declining the proposed treatment
✔✔Five Rights of Delegation - ✔✔Right task
Right circumstance
Right person
Right communication and direction
Right supervision and evaluation
✔✔Four types of patient privacy health care providers and personnel have an ethical
and legal responsibility to always maintain - ✔✔• Medical information
• Physical exposure
• Personal privacy
,• Electronic privacy
✔✔Eight factors to consider before determining what anesthetic to use for a particular
patient - ✔✔• Patient's age
• Length & type of surgery
• Patient & surgeon preferences
• Patient's co-existing diseases
• Patient's mental & psychological status
• Patient's previous experiences with anesthesia
• Plans & protocols for postoperative pain management
• Position of the patient during surgery
✔✔The American Society of Anesthesiologist's NPO Guidelines - ✔✔• Clear liquids -
stop 2 hours before surgery
• Breast milk - stop 4 hours before surgery
• Infant formula - stop 6 hours before surgery
• Light meal (toast & a clear liquid) - stop 6 hours before surgery
• Fried foods, fatty foods, meat - stop 8 hours before surgery
✔✔Circulator RN duties during Induction of anesthesia and assisting anesthesia
professional with Cricoid Pressure - ✔✔• Cricoid pressure application is not released
until the endotracheal (ET) tube cuff is inflated, tube placement is confirmed, and
anesthesia provider has given a verbal confirmation to the nurse that the cricoid
pressure can be released.
• If intubation or ventilation of the patient becomes difficult, the perioperative nurse
should retrieve additional airway equipment and supplies.
✔✔General anesthesia - ✔✔• A drug-induced reversible state of unconsciousness
• Results in amnesia, analgesia, and loss of responsiveness, decreased stress
response, and loss of skeletal muscle reflexes to a varying degree
✔✔Regional anesthesia - ✔✔• An injection of local anesthetics near nerve fibers that
causes reversible loss of sensation over an area of the body
• Examples include spinal, epidural, and peripheral nerve blocks.
✔✔Monitored anesthesia care (MAC) - ✔✔An anesthesia provider monitors the patient,
administers sedatives and other agents as needed, and provides medical services as
required.
✔✔Moderate sedation - ✔✔• The administration of sedative, analgesic, and/or anxiolytic
agents by a physician or by a nurse under physician supervision
• Depending on state laws and hospital policies, an RN may administer moderate
sedation.
✔✔Local anesthesia - ✔✔• The infiltration or topical administration of agents to
anesthetize a part of the body
,• The perioperative nurse provides patient monitoring and supportive care.
✔✔Phases of general anesthesia - ✔✔• Phase I: Induction
o IV medications and inhalational agents are administered by the anesthesia provider.
• Phase II: Maintenance
o Medications and inhalational agents are administered to keep the patient
anesthetized.
• Phase III: Emergence o At the end of the procedure, the anesthetic agents are
discontinued or reversed to allow the patient to wake up.
✔✔Anesthesia Reversal agents: Muscle relaxants: - ✔✔1. neostigmine
2. edrophonium.
Note: There is no reversal agent for succinylcholine
✔✔Anesthesia Reversal agents: Sugammadex: - ✔✔reversal agent for rocuronium,
vecuronium, and pancuronium
✔✔Anesthesia Reversal agents: Benzodiazepines: Midazolam - ✔✔Flumazenil
✔✔Anesthesia Reversal agents: Narcotics: Fentanyl: - ✔✔Naloxone
✔✔Patients at Increased Risk for Hypothermia - ✔✔• Older adults
• Infants and children
• Women
• Patients with lower-than-normal body weight
✔✔Medical Conditions Associated with Increased Risk for Hypothermia - ✔✔•
Hypothyroidism
• Hypoglycemia
• Burns
• Trauma
• Hypotension
• Congestive heart failure
• Cardiac vessel disease
✔✔Signs of Malignant Hyperthermia (MH) - ✔✔• ΜΗ is triggered by inhalation
anesthetic gases and succinylcholine
• Increased end-tidal carbon dioxide is the most specific sign of MH.
• Other signs include skeletal muscle rigidity, ventricular dysrhythmia, skin mottling, and
hyperthermia.
✔✔Medical professionals who can provide anesthesia services are: - ✔✔•
Anesthesiologists
, • Certified registered nurse anesthetists (CRNAs)
• Anesthesiologist assistants (AAs)
✔✔Surgical Safety Checklist Includes: - ✔✔• Μοbility
• Preexisting health conditions
• Planned duration of the procedure.
• Type of anesthesia
✔✔The Preoperative Nurse Visit Should Include: - ✔✔• Introduce yourself and ask your
patient how they would like to be addressed.
• Confirm your patient's identity with two patient identifier
• If your patient discusses suicidal thoughts during the preoperative visit, report this
immediately by following your facility's policy and procedure.
• Use the same scale for pain assessment throughout all patient care areas.
• Consider all elements of patient care needs prior to surgery.
• Consider how the required surgical position may impact a current condition that the
patient contends with.
✔✔A Medication Assessment Should Include: - ✔✔• Prescription medications
• Herbal preparations:
o may accentuate the toxicity of anesthetics.
o interfere with drug metabolism or clearance.
o might affect bleeding times.
• Recreational/street drugs
*It is also important to ask if the patient is using any recreational/street drugs. Close
observation must be maintained for symptoms of withdrawal, especially during and after
long procedures.
• Drugs, alcohol, and smoking can alter lab values or system assessment. A chemically
dependent patient who is recovering may have concerns about medication he or she is
given.
• Patient risk factors due to alcoholism include:
- Lowered immunity
- Prolonged bleeding times
- Increased stress response
- Cardiac complications
✔✔Physiological Effects of Cannabis Include: - ✔✔- Tachycardia
- atherosclerosis
- Airway edema
- chronic bronchitis
- Increased appetite
- hyperemesis
- Paranoia
- BIS elevation
- unknown tolerance to analgesics
- Potential increase in pain
ANSWERS SURE A+
Indemnity Payment - ✔✔Payment made on behalf of the policy holder
✔✔Liability - ✔✔A legal responsibility
✔✔Negligence - ✔✔An act or failure to act that deviates from the standard of care
✔✔Nursing Malpractice - ✔✔A nurse's negligence or any intentional act that causes
physical, financial, emotional, psychosocial, and/or cognitive damage to the person in
the nurse's care
✔✔Respondeat Superior - ✔✔An employer is legally responsible for the nurse
employee only when:
o The nurse acts within the scope of practice
o Any allegations brought against the nurse occurred during the nurse's employment
o The nurse's actions were within the employer's best interests.
✔✔Tort - ✔✔A breach of duty to another person as outlined by law
✔✔What are the four elements of malpractice? - ✔✔• Duty
• Breach of duty
• The breach of duty caused an injury
• The injury was harmful to the patient
✔✔Elements of Informed Consent - ✔✔• Must be obtained by the licensed professional
who is performing the procedure
• The patient must give consent voluntarily with the full understanding of all implications
• Must include
o Diagnosis
o Proposed treatment
o Treatment alternatives
o Consequences of accepting or declining the proposed treatment
✔✔Five Rights of Delegation - ✔✔Right task
Right circumstance
Right person
Right communication and direction
Right supervision and evaluation
✔✔Four types of patient privacy health care providers and personnel have an ethical
and legal responsibility to always maintain - ✔✔• Medical information
• Physical exposure
• Personal privacy
,• Electronic privacy
✔✔Eight factors to consider before determining what anesthetic to use for a particular
patient - ✔✔• Patient's age
• Length & type of surgery
• Patient & surgeon preferences
• Patient's co-existing diseases
• Patient's mental & psychological status
• Patient's previous experiences with anesthesia
• Plans & protocols for postoperative pain management
• Position of the patient during surgery
✔✔The American Society of Anesthesiologist's NPO Guidelines - ✔✔• Clear liquids -
stop 2 hours before surgery
• Breast milk - stop 4 hours before surgery
• Infant formula - stop 6 hours before surgery
• Light meal (toast & a clear liquid) - stop 6 hours before surgery
• Fried foods, fatty foods, meat - stop 8 hours before surgery
✔✔Circulator RN duties during Induction of anesthesia and assisting anesthesia
professional with Cricoid Pressure - ✔✔• Cricoid pressure application is not released
until the endotracheal (ET) tube cuff is inflated, tube placement is confirmed, and
anesthesia provider has given a verbal confirmation to the nurse that the cricoid
pressure can be released.
• If intubation or ventilation of the patient becomes difficult, the perioperative nurse
should retrieve additional airway equipment and supplies.
✔✔General anesthesia - ✔✔• A drug-induced reversible state of unconsciousness
• Results in amnesia, analgesia, and loss of responsiveness, decreased stress
response, and loss of skeletal muscle reflexes to a varying degree
✔✔Regional anesthesia - ✔✔• An injection of local anesthetics near nerve fibers that
causes reversible loss of sensation over an area of the body
• Examples include spinal, epidural, and peripheral nerve blocks.
✔✔Monitored anesthesia care (MAC) - ✔✔An anesthesia provider monitors the patient,
administers sedatives and other agents as needed, and provides medical services as
required.
✔✔Moderate sedation - ✔✔• The administration of sedative, analgesic, and/or anxiolytic
agents by a physician or by a nurse under physician supervision
• Depending on state laws and hospital policies, an RN may administer moderate
sedation.
✔✔Local anesthesia - ✔✔• The infiltration or topical administration of agents to
anesthetize a part of the body
,• The perioperative nurse provides patient monitoring and supportive care.
✔✔Phases of general anesthesia - ✔✔• Phase I: Induction
o IV medications and inhalational agents are administered by the anesthesia provider.
• Phase II: Maintenance
o Medications and inhalational agents are administered to keep the patient
anesthetized.
• Phase III: Emergence o At the end of the procedure, the anesthetic agents are
discontinued or reversed to allow the patient to wake up.
✔✔Anesthesia Reversal agents: Muscle relaxants: - ✔✔1. neostigmine
2. edrophonium.
Note: There is no reversal agent for succinylcholine
✔✔Anesthesia Reversal agents: Sugammadex: - ✔✔reversal agent for rocuronium,
vecuronium, and pancuronium
✔✔Anesthesia Reversal agents: Benzodiazepines: Midazolam - ✔✔Flumazenil
✔✔Anesthesia Reversal agents: Narcotics: Fentanyl: - ✔✔Naloxone
✔✔Patients at Increased Risk for Hypothermia - ✔✔• Older adults
• Infants and children
• Women
• Patients with lower-than-normal body weight
✔✔Medical Conditions Associated with Increased Risk for Hypothermia - ✔✔•
Hypothyroidism
• Hypoglycemia
• Burns
• Trauma
• Hypotension
• Congestive heart failure
• Cardiac vessel disease
✔✔Signs of Malignant Hyperthermia (MH) - ✔✔• ΜΗ is triggered by inhalation
anesthetic gases and succinylcholine
• Increased end-tidal carbon dioxide is the most specific sign of MH.
• Other signs include skeletal muscle rigidity, ventricular dysrhythmia, skin mottling, and
hyperthermia.
✔✔Medical professionals who can provide anesthesia services are: - ✔✔•
Anesthesiologists
, • Certified registered nurse anesthetists (CRNAs)
• Anesthesiologist assistants (AAs)
✔✔Surgical Safety Checklist Includes: - ✔✔• Μοbility
• Preexisting health conditions
• Planned duration of the procedure.
• Type of anesthesia
✔✔The Preoperative Nurse Visit Should Include: - ✔✔• Introduce yourself and ask your
patient how they would like to be addressed.
• Confirm your patient's identity with two patient identifier
• If your patient discusses suicidal thoughts during the preoperative visit, report this
immediately by following your facility's policy and procedure.
• Use the same scale for pain assessment throughout all patient care areas.
• Consider all elements of patient care needs prior to surgery.
• Consider how the required surgical position may impact a current condition that the
patient contends with.
✔✔A Medication Assessment Should Include: - ✔✔• Prescription medications
• Herbal preparations:
o may accentuate the toxicity of anesthetics.
o interfere with drug metabolism or clearance.
o might affect bleeding times.
• Recreational/street drugs
*It is also important to ask if the patient is using any recreational/street drugs. Close
observation must be maintained for symptoms of withdrawal, especially during and after
long procedures.
• Drugs, alcohol, and smoking can alter lab values or system assessment. A chemically
dependent patient who is recovering may have concerns about medication he or she is
given.
• Patient risk factors due to alcoholism include:
- Lowered immunity
- Prolonged bleeding times
- Increased stress response
- Cardiac complications
✔✔Physiological Effects of Cannabis Include: - ✔✔- Tachycardia
- atherosclerosis
- Airway edema
- chronic bronchitis
- Increased appetite
- hyperemesis
- Paranoia
- BIS elevation
- unknown tolerance to analgesics
- Potential increase in pain
