CNOR

What is one antibiotic given preoperatively that can potentiate anesthesia neuromuscular blocking agents? A. Clindamycin B. Cefazolin C. Vancomycin D. Ciprofloxacin

A. Clindamycin

Symptoms of neurogenic shock resulting from spinal anesthesia may include all of the following EXCEPT: A. Fever B. Cool and clammy skin C. Tachycardia D. Hypotension

A. Fever

Hypotension is common in the first 24 hours after a severe burn for which of the following reasons? A. Fluid shifts from the intravascular space to the interstitial tissues. B. Blisters containing fluid form on the skin. C. Fluid shifts from the interstitial tissues to the intravascular space. D. The patient who is badly burned may be unable to drink enough fluids to keep up with fluid loss.

A. Fluid shifts form the intravascular space to the interstitial tissues.

The following skin changes in older adults increases the risk of developing pressure ulcers: A. Hypodermis thins B. Sweat glands decrease C. Epidermal-dermal junction flattens D. Langerhans cells decrease in number

A. Hypodermis thins

Your preoperative patient is to undergo a scleral buckling procedure. You understand that this procedure involves: A. Implantation of a silicone wedge intrasclerally or episclerally. B. Placement of a donor cornea after the patient's damaged cornea has been removed. C. Excision of the cornea. D. Replacement of the lens of the eye.

A. Implantation of a silicone wedge intrasclerally or episclerally.

You have identified your patient and reviewed his chart. As you are ready to take him to the OR he says "I forgot to tell them I'm allergic to eggs." Your communication should include all of the following EXCEPT: A. Notify the operating room manager because this allergy was not discovered and communicated through normal channels. B. Notify anesthesia so they consider this allergy when giving medications. C. Notify the surgeon so he has complete knowledge of patient allergies. D. Have the perioperative nurse add it to the patient's EMR so all appropriate staff (the floor nurses, pharmacy and food services, etc.) get the notice.

A. Notify the operating room manager because this allergy was not discovered and communicated through normal channels.

Which of the following instruments will hold the tissue without slipping? A. Rat tooth forceps B. Adson tissue forceps C. Allis intestinal tissue forceps D. Babock intestinal tissue forceps

A. Rat tooth forceps

After the patient is positioned correctly, the perioperative nurse should reassess for compromise of the patient's body systems. Which systems are involved? A. Respiratory, circulatory, neurological, musculoskeletal, and integumentary. B. Respiratory, circulatory, neurological, alimentary, and musculoskeletal. C. Respiratory, circulatory, alimentary, neurological, and integumentary. D. Respiratory, alimentary, neurological, endocrine, and integumentary.

A. Respiratory, circulatory, neurological, musculoskeletal, and integumentary.

Your patient is undergoing abdominal surgery when he suddenly begins to bleed heavily. His heart rate increases and his blood pressure starts to drop. What type of fluid should you prepare to administer for fluid resuscitation of this patient? A. Ringer's solution B. Normal saline with potassium added C. Dextrose in water D. NaCl 0.45%

A. Ringer's solution

A family member has just been told that his loved one did not survive surgery. The family member is angry and hostile and is standing before you with his fists clenched. Which of the following nonverbal methods might convey a sense of calmness to this person? A. Standing a foot away from the person with your arms held down at your sides. B. Standing with your arms crossed in front of you. C. Standing several feet away from the person. D. Sitting with your head bowed, looking downward at the floor.

A. Standing a foot away from the person with your amrs held down at your sides.

After high-level disinfection soaking is completed, rinsing with what solution is recommended? A. Sterile distilled water B. Tap water C. Lactated ringer's solution D. 0.9% NaCl

A. Sterile distilled water

You are caring for a patient who is on a heparin drip to treat a pulmonary embolism. The patient begins to bleed from his nose, his IV site, and from previous puncture sites. What is the FIRST step you take to control the patient's bleeding? A. Stop the heparin drip and notify the physician immediately. B. Apply pressure dressings to the bleeding sites and apply direct pressure to the patient's nose. C. Increase the patient's IV rate to compensate for the bleeding. D. Insert a nasal tampon.

A. Stop the heparin drip and notify they physician immediately.

Surgical complications and poor surgical outcomes are often related to all of these factors EXCEPT: A. Surgical checklists B. Staffing issues C. Emergencies D. Multiple surgeons

A. Surgical checklists

Which of the following findings indicates that a patient who has had conscious sedation is NOT ready for discharge? A. The patient's gag reflex is not intact. B. The patient complains of 4/10 pain on a numeric scale. C. The patient's respirations are 20 per minute, regular and unlabored. D. The patient is drowsy but rouses easily to voice.

A. The patient's gag reflex is not intact.

You are the scrub nurse. While passing a sharp suture to the surgeon, you accidentally catch your glove, and it tears. How should you proceed? A. Pass the suture to the surgeon. Extend your gloved, contaminated hand to the circulating nurse for removal, and put on a new sterile glove, using the closed glove method. B. Discard the contaminated suture and step away from the sterile field. Extend your gloved, contaminated hand to the circulating nurse for removal, and put on a new sterile glove, using the open glove method. C. Discard the contaminated suture and step away from the table. Ask the circulating nurse to scrub in. D. Discard the contaminated suture and pass a new sterile suture to the surgeon. Step away from the sterile field, extend your gloved, contaminated hand to the circulating nurse, and put on a new glove, using the open glove method.

B

A patient, Mrs. Anna Jones, has arrived in the holding area. You are the circulator on duty. You should identify the patient by: A. Reading the patient's name off the paper label at the end of the bed, and comparing it to the patient's identification bracelet and chart. B. Asking the patient to give her name and one other identifier, such as birthday, and comparing this information to the patient's identification bracelet and chart. C. Asking the patient, "Are you Anna Jones?" and comparing the answer to her identification bracelet and chart. D. Reading the name and age on the patient's identification bracelet and chart.

B.

If the fire alarm goes off while your patient is undergoing surgery, what do you do? A. Leave the room and go get the instructions regarding your patient. B. Proceed as planned with caring for your patient until your manager sends instructions to do something different. C. Grab an Ambu bag, and work with the surgeon to close and protect the wound in preparation to evacuate. D. Call your manager and ask for instructions regarding caring for your patient.

B.

Which of the following events constitutes a "never event" for which the Centers for Medicare and Medicaid (CMS) will never reimburse health care providers? A. 42-year-old patient with colorectal care experiences postsurgical complications and, during an extended ICU stay, develops stage II pressure ulcers. B. An 18-month-old child falls out of the hospital crib and suffers an intracranial bleed requiring emergency surgical intervention after climbing over the crib rails. C. A 32-year-old type 1 diabetic is admitted for DKA and experiences poor control of blood sugar during his hospital stay. D. A 23-year-old primigravida experiences an amniotic fluid embolism during childbirth and expires despite resuscitative measures.

B. ("never events": air embolism; blood incompatibilities resulting from incompatible blood or blood products; catheter-associated urinary tract infections; death or serious disability which results from a fall while in care; death or disability which results from hypoglycemia with the onset occurring while the patient was in care at the health care facility; any stage III or IV pressure ulcers which occur after admission to the health care facility)

When dropping sterile instruments from sterile packs onto the sterile tray, how much distance must the packs be held at by the nurse? A. 2 inches B. 3 inches C. 4 inches D. 5 inches

B. 3 inches

What is the normal range of ejection fraction for an adult? A. 40-50% B. 60-70% C. 80-90% D. 90-100%

B. 60-70%

Cleanliness and decontamination are the first and most important steps in disinfection. All of the following actions contribute to clean/disinfected instruments EXCEPT: A. Using an enzyme presoak/prerinse B. Ethylene oxide sterilization C. Washing the instruments D. Wiping organic matter off instruments during a procedure

B. Ethylene oxide sterilization

When using a bag mask to provide oxygen, it is important to do all of the following EXCEPT: A. Cover the nose and mouth with the mask, ensuring that the mask fits snugly against the face. B. Give 15 chest compressions after every 2 breaths. C. Watch for bilateral rise and fall of the chest to ascertain that air is entering the lungs. D. Squeeze the bag to its full volume with the hand that is not holding the mask.

B. Give 15 chest compressions after every 2 breaths.

Which of the following is caused by preformed anti-donor antibodies? A. Acute rejection B. Hyperactue rejection C. Chronic rejection D. Non-adherence rejection

B. Hyperacute rejection

This drug, a short-acting intravenous anesthetic, may cause hallucinations when given in large doses: A. Halothane B. Ketamine C. Etomidate D. Desflurane

B. Ketamine

A patient who is undergoing a laparoscopic procedure suddenly begins showing signs of cardiovascular collapse, including tachycardia, dysrhythmia, and cyanosis, and it is determined the patient has experienced gas embolism. Immediate treatment of gas embolism in this scenario should include all of the following EXCEPT: A. Pass a central venous pressure catheter and aspirated blood from the right atrium. B. Place the patient in the Sims position. C. Hyperventilate the patient with 100% oxygen. D. Elevate the patient's right side.

B. Place the patient in the Sims position.

What purpose does the application of cricoid pressure hold during intubation? A. Prevention of irritation or trauma to the airway during intubation to minimize potential for inflammation and scarring. B. Prevent regurgitation of stomach contents during intubation. C. Displacement of thyroid tissue which may interfere with a smooth intubation. D. Displace the esophagus to allow the ventilation tube to pass more easily through the airway.

B. Prevent regurgitation of stomach contents during intubation.

Metochlopramide may be given as a preoperative medication in order to: A. Relieve apprehension B. Reduce risk of aspiration C. Relieve discomfort D. To control secretions

B. Reduce risk of aspiration

All of the following symptoms indicate a toxic reaction to a local anesthetic EXCEPT: A. Nausea and vomiting B. Tachycardia C. Hypotension D. Tingling of the fingers and toes (paresthesia)

B. Tachycardia (symptoms of LAST: hypotension, vasodilation, bradycardia, myocardial depression, dizziness, nausea and vomiting, paresthesias, seizures)

Brachytherapy for prostate cancer involves which of the following? A. Interstitial needle therapy on tumors B. Titanium radioisotope-containing cylinders which are implanted around tumor tissue. C. Argon laser therapy to coagulate lesions. D. Holmium laser therapy to ablate soft tissues.

B. Titanium radioisotope-containing cylinders which are implanted around tumor tissue.

The anesthesia provider has elected to administer preanesthetic sedation to a five-year-old girl scheduled to undergo tonsillectomy who clings to her mother and cries each time a member of the perioperative enters the room. The primary reason for administering preanesthetic sedation in this scenario is: A. The administration of preanesthetic sedation is standard for all children ages five and under. B. To prevent crying of the patient. C. As an adjunct to anesthesia. D. To help the child feel relaxed prior to entering the operative area.

B. To prevent crying of the patient. (crying in a child who is about to undergo surgery can be detrimental due to the respiratory status of the child; can increase mucus in the respiratory tract)

During x-ray studies of the hips and femur, x-ray shielding should be applied: A. To protect the thyroid B. To protect the ovaries and testes C. To protect the other leg D. No shielding is necessary

B. To protect the ovaries and testes

If a pinprick to the palmar side of the pinky finger is perceived as dull, this would indicate a possible injury to the ______________ nerve. A. Radial B. Ulnar C. Medial D. Palmar

B. Ulnar

Virchow's Triad refers to what? A. Venous stasis, vessel wall damage, and normal coagulability. B. Venous stasis, vessel wall damage, and hypercoagulability. C. Venous patency, intact vessel wall, and hypercoagulability. D. Venous patency, vessel wall damage, and hypercoagulability.

B. Venous stasis, vessel wall damage, and hypercoagulability.

Health care workers exposed to glutaraldehyde may experience all of the following symptoms EXCEPT: A. Dermatitis/itchy irritated skin B. Viral conjunctivitis C. Mucous membrane irritation D. Pulmonary/asthma symptoms

B. Viral conjunctivitis

When preparing the operating room for a geriatric patient who will be undergoing surgery, which of the following actions can the perioperative nurse take to BEST ensure the patient does not experience hypothermia as a result of environmental factors? A. Obtain a warming lamp to be placed at the OR beside. B. Warm intravenous fluids prior to administration. C. Place warmed bags of IV fluids against the patient's trunk. D. Set the OR temperature to 77 degrees.

B. Warm intravenous fluids prior to administration.

The manager of the operating suite communicates to each of the OR teams that a fire has been discovered within the operating suite and all patients and surgical employees are required to evacuate the area immediately. Which of the following scenarios demonstrates effective communication that aids in the evacuation process? A. The surgeon removes the sponges which were in the patient's abdomen and places them in a plastic bag for later count prior to temporarily closing the patient's surgical wound. B. The circulating nurse announces to the OR team that someone needs to be responsible for unplugging all of the electrical equipment prior to leaving the OR. C. The anesthesia provider asks the circulating nurse to provide ventilation for the patient using an Ambu bag while he removes that patient from the mechanical ventilator. D. The surgical scrub takes responsibility for all the instruments, wrapping them in sterile packaging and slipping them into his pocket as they transport the patient out of the OR.

C.

Your patient is suspected of having Creutzfeldt-Jakob disease (CJD). Based on this suspicion, you know that all instruments used (that cannot be discarded) during surgery on this patient must be: A. Sterilized using dry heat for 30 minutes at 71 degrees Celsius (180 degrees F) after soaking in bleach or sodium hypochlorite for 1 hour at room temp. B. Aerated for 12 hours following 100% ethylene oxide (EO) concentration after soaking in bleach or sodium hypochlorite for 1 hour at room temp. C. Steam sterilized for 60 minutes at 132 degrees C (272 degrees F) in a steam sterilizer after soaking in bleach or sodium hypochlorite for 1 hour at room temp. D. Soaked for two hours in a 2% glutaraldehyde solution after soaking in bleach or sodium hypochlorite for 1 hour at room temp.

C.

Name a short-acting, rapid-onset and recovery muscle relaxant. Then name a long-acting muscle relaxant. A. Rocuronium (Zemuron); Succinylcholine (Anectine) B. Vecuronium (Norcuron); Atracurium (Tracrium) C. Succinylcholine (Anectine); Pancuronium (Pavulon) D. Midazolam (Versed); Mivacurium (Mivacron)

C. (Succinylcholine and mivacurium are short-acting; atracurium, vecuronium, and rocuronium are intermediate-acting; pancuronium is long-acting

Breastfeeding infants must not breastfeed or receive breast milk for: A. 8 hours before surgery B. 6 hours before surgery C. 4 hours before surgery D. 2 hours before surgery

C. 4 hours before surgery

What is the definition of gossypiboma? A. Return of consciousness, sensation, and reflexes after general anesthesia. B. Loss of memory C. A retained foreign object made of woven textiles. D. A retained metal instrument.

C. A retained foreign object made of woven textiles.

The risk management program of any perioperative environment should be comprised of the four essential elements of: A. Management, prevention, correction, and documentation. B. Administration, prevention, improvement, and documentation. C. Administration, prevention, correction, and documentation . D. Administration, prevention, examination, correction.

C. Administration, prevention, correction, and documentation.

Included in the hand-off report is information regarding the patient's basic demographics. This information is contributed by which member of the perioperative team? A. First assistant B. Surgeon C. Anesthesia provider D. Circulating nurse

C. Anesthesia provider

What types of sponges come in counts of five? A. Tonsil sponges, raytex sponges, peanuts, and kitners. B. Lap pads, cottonoids, tonsil sponges, and kitners. C. Lap pads, tonsil sponges, peanuts, and kitners. D. Lap pads, tonsil sponges, cottonoids, and peanuts.

C. Lap pads, tonsil sponges, peanuts, and kitners.

Comfort measures provided to patients during the preoperative period include all of the following EXCEPT: A. Privacy B. Warm blankets C. Light snacks D. Family/support persons if the patient wants them to visit

C. Light snacks

Pasteurization is a high-level disinfectant method. Which of the following is also TRUE about pasteurization? A. Pasteurization is used for delicate metal instruments. B. Pasteurization employs warm water to kill microorganisms. C. Pasteurization kills bacteria, not endospores. D. Pasteurization kills viruses, including HIV.

C. Pasteurization kills bacteria, not endospores. (Used to disinfect reusable respiratory devices and anesthesia breathing circuits, not metal instruments. It utilizes hot water and chlorine detergents.)

A preanesthesia evaluation and assessment may not be required for: A. Minor surgical procedures B. Patients with recent history of anesthesia C. Patients receiving local anesthesia D. Outpatient surgical procedures

C. Patients receiving local anesthesia.

Which one of the following surgical skin-preparation agents acts by oxidation? A. Isopropyl alcohol B. Chlorhexadine C. Povidone-Iodine D. Hexidine

C. Povidone-Iodine

Patients are classified as morbidly obese when they have a BMI that exceeds 25 to greater than 30/kg/m^2 or weigh more than 100lbs over their recommended weight. Morbidly obesity predisposes an individual to several conditions which make surgical procedures more difficult and include all of the following EXCEPT: A. Inefficient respiratory muscles which reduces ventilation capability B. A compromised airway which makes intubation more difficult. C. Pressure ulcers D. Increased demand on the heart

C. Pressure ulcers

What type of plan should a healthcare facility have to address a breakdown in the medical gas system? A. Fire safety plan B. Patient safety plan C. Utility failure plan D. Hazardous materials plan

C. Utility failure plan

Ideal characteristics of a housekeeping/disinfectant cleaning agent include all of the following EXCEPT: A. can be easily rinsed off. B. virtually odorless C. already mixed to proper concentration. D. biodegradable

C. already mixed to proper concentration.

You are performing preoperative teaching. You instruct a patient who is having an elective reversal of his colostomy to avoid eating or drinking after midnight before the day of surgery. He asks you why it is important that he not eat or drink. How should you answer him? A. Eating before surgery may cause constipation following surgery. B. Eating before surgery may lead to nausea and vomiting when you are given pain medication after surgery. C. Eating before surgery may increase the risk that you vomit due to anxiety. D. Eating before surgery increases the risk of aspiration, or stomach contents coming up into the back of your throat, where they may be inhaled into your lungs.

D.

You, the circulator, together with the scrub nurse, are preparing the OR for a pediatric patient aged 13 months who weighs 22 pounds (10kg). At what temperature should the operating room be for this patient? A. 85 degrees F B. 68 degrees F C. 70 degrees F D. 73 degrees F

D. 73 degrees F

Which of the following may be removed from the OR during a procedure? A. Broken instruments B. Paper waste C. soiled linen D. A suture attached to a frozen section sent to the pathologist

D. A suture attached to a frozen section sent to the pathologist

What is the MOST common manifestation of anaphylaxis in the anesthetized patient? A. Rash B. Hypertension C. Hyperthermia D. Circulatory collapse

D. Circulatory collapse

Removing visible body fluids or blood from devices or instruments while they are still in the operating room is an example of: A. Washing B. Sterilization C. Aseptic technique D. Decontamination

D. Decontamination

Your patient is in the midst of a complicated resection of the colon when the anesthesiologist reports a sudden onset of cardiac dysrhythmia, increased temperature and muscle rigidity. Your most appropriate FIRST response is to: A. Initiate ice lavage B. Infuse 2 liters of normal saline via pressure infuser. C. Call for the malignant hyperthermia cart and start giving dantrolene. D. Discontinue use of inhalation anesthetics.

D. Discontinue use of inhalation anesthetics.

The MOST effective means of preventing the spread of infection is: A. Wearing gloves during procedures requiring their use. B. Wearing a mask when you have cold symptoms. C. Wearing a gown to prevent the transfer of microorganisms from your clotting. D. Hand washing before and after each contact with a patient.

D. Hand washing before and after each contact with a patient.

You are providing pre-op teaching to a young teenage girl who is about to have a central venous catheter placed for chemotherapy. She tells you she is worried that her friends will notice the catheter under her clothing. Choose the BEST response. A. No one will notice. Don't worry about it. B. You should be more worried about your cancer than the catheter. C. You should not be so worried about what other kids will think. D. I understand that you are worried about others seeing the catheter. Let's talk about dressing strategies you can use to hid the catheter.

D. I understand that you are worried about others seeing the catheter. Let's talk about dressing strategies you can use to his the catheter.

Your 21-year-old male patient has just undergone a partial splenectomy to stage his recently diagnosed Hodgkin's disease. He is still semi-conscious in the PACU. His parents are at the beside and ask you what was found during the patient's surgery. How should you BEST respond? A. You will need to talk to the surgeon if you have any questions. B. My nursing supervisor can tell you, but I am not allowed. C. He has stage 4 cancer, and it's very serious. D. I'm sorry, but because your son is legally an adult, I must have his permission to give you any information about his diagnosis.

D. I'm sorry, but because your son is legally an adult, I must have his permission to give you any information about his diagnosis.

When a biopsy specimen is sent to the pathologist immediately from the OR, what is crucial for the pathologist to know? A. If the patient has received any antibiotics B. If the patient has any allergies C. If the patient is a minor D. If the patient is awake

D. If the patient is awake.

Which of the following statements is true related to an operating room alarm system? A. It should only be used when a fire is detected. B. It should alert only the personnel inside the operating room. C. It should only be used when a patient suffers cardiac arrest. D. It should prompt a set of rehearsed actions from operation room staff.

D. It should prompt a set of rehearsed actions from operating room staff.

When a blanket removed from your patient lands on the OR floor, can it be used again on the patient? A. No, the blanket is wrinkled and cold; get a new one for the patient. B. Yes, the floor gets mopped after every case. C. Yes, if the blanket was immediately picked up off the floor. D. No, the floor is considered contaminated, and a new blanket should be obtained to put on the patient.

D. No, the floor is considered contaminated, and a new blanket should be obtained to put on the patient.

The purpose of wearing a surgical gown is to: A. Maintain warmth in the cool operating room environment. B. Keep some germs from being exposed to patients. C. Protect the wearer in case fire breaks out. D. Prevent contamination between the scrubbed person and the sterile field.

D. Prevent contamination between the scrubbed person and the sterile field.

When planning for the use of an intraoperative CT contrast study for a patient who is schedule to undergo a surgical procedure, a preoperative history which contains information about all of the following substances EXCEPT WHAT should be obtained, as allergy to these substances may play a role in sensitivity to the CT contrast? A. Egg B. Milk C. Shellfish D. Ragweed

D. Ragweed

What is antisepsis in a surgical unit? A. Use of sterile instruments B. Use of no hand touch C. Absence of infectious organism D. Removal of transient micro-organisms from the skin

D. Removal of transient micro-organisms from the skin

An intraoperative irrigation of bacitracin solution may be used to decrease colonization with bacteria, but should be avoided in patients who have a history of which of the following? A. Blood dyscrasias B. Liver failure C. Allergy to neomycin D. Renal failure

D. Renal failure (bacitracin has toxic renal effect)

Reasons to count sponges, sharps, and instruments include all of the following EXCEPT: A. Items left in a patient's body cause harm and the need for additional surgery. B. Items lost in trash or linen may cause harm to other personnel. C. Items lost from inventory result in high, replacement costs. D. Staff must be accountable for instruments.

D. Staff must be accountable for instruments.

Your diabetic patient is scheduled for a below-the-knee amputation of his right leg. The patient states, "I'm really going to miss having two legs." What nursing diagnosis might be appropriate in this situation? A. Fear B. Anxiety C. Anticipatory grieving D. Ineffective coping

C. Anticipatory grieving

When should radiopaque soft goods be counted to prevent the retention of surgical items, according to the Association of perioperative Registered Nurses (AORN)? A. Before surgery begins and twice at closing wound; when new items are added; and at permanent relief of staff. B. When the surgical procedure has been completed; when new items are added; and when staff is permanently relieved. C. When the surgeon enters the body cavity. D. Every thirty minutes from the beginning of surgery until closure of the surgical wound.

A

An earthquake rocks the area and causes injuries and damage to buildings. Each facility has a disaster plan to follow. The following actions would all be included in a disaster plan EXCEPT: A. Activate the evacuation plan even if the building appears safe. B. A command center will be set up, and disaster protocol will be activated, including communication. C. Triage protocol will be used to prioritize and care for patients. D. Each department will have a telephone list to call off-duty employees to work.

A. Activate the evacuation plan even if the building appears safe.

An intraoperative nursing assessment and care plan to prevent complications includes all of the following patient information EXCEPT: A. Anxiety and nutritional status. B. Oxygenation needs C. Cardiovascular function D. Allergies and medications given

A. Anxiety and nutritional status.

Your patient is having a skin lesion removed from her face. You explain to the patient that the surgeon will incise around the lesion oriented to the: A. Langer's lines B. Laugh lines C. Wrinkles D. Frown lines

A. Langer's lines (Langer's lines are the natural lines of the skin)

When you check your diabetic patient's chart, what information do you want to know about blood sugar? A. Last blood sugar test results and time; last dose and time of diabetic meds B. Time of last blood sugar test; time of last diabetic meds given C. Last blood sugar test time; last dose of diabetic meds D. Last blood sugar test results and time; last dose of diabetic meds given

A. Last blood sugar test results and time; last dose and time of diabetic meds

If an intracranial mass is suspected as the cause of increase intracranial pressure (ICP), which of the following would be contraindicated? A. Lumbar puncture B. Burr hole C. Administration of non-osmotic diuretic D. IV transfusion of hypertonic mannitol

A. Lumbar puncture (sudden decrease in pressure from LP could cause brain herniation)

The position that places the eyes most at risk for injury is: A. Prone B. Reverse trendelenburg C. Supine D. Left lateral decubitus

A. Prone

All of the following are common microorganisms in an OR environment EXCEPT: A. Tuberculosis B. Staphylococci C. Escherichia coli D. Pseudomonas

A. Tuberculosis

Why do most surgeons prefer to use carbon dioxide (CO2) to create a pneumoperitoneum for laparoscopic abdominal surgery? A. CO2 supports combustion. B. CO2 contributes to normothermia for the patient. C. CO2 is a normal metabolic end product. D. There is no risk of gas embolism when CO2 is used.

C. CO2 is a normal metabolic end product.

The perioperative nurse is providing postoperative instructions to the family of a three-year-old boy who underwent exploratory laparotomy to remove swallowed magnets. Not all of the magnets were located during the surgery. Which of the following instructions should the nurse give to the patient's parents to help PREVENT further complication from the retained magnets? A. Ensure adequate daily fluid intake. B. Avoid wearing belts that have a metal buckle. C. Examine the stool to look for the presence of passed magnets. D. Administer laxatives daily until all the retained magnets have passed.

B. Avoid wearing belts that have a metal buckle. (should avoid anything with metal buttons/snaps, zippers, studs, etc.)

Microbial communities that are tightly attached to surfaces and cannot be easily removed are known as: A. Endospores B. Biofilms C. Colonies D. Bioburden

B. Biofilms

A patient in the PACU says to you. "I'm feeling so sick." How should you respond to elicit more information from the patient? A. "You'll feel better soon. It is likely the anesthetic that is making you feel that way." B. "Can you tell me more about how you are feeling?" C. "What do you think is wrong?" D. I'll get you some pain medication right away."

B. Can you tell me more about how you are feeling?

Possible complications related to patient placement in the lateral kidney position include: A. Tissue ischemia to the sacrum. B. Compromise of pulmonary function in the dependent lung. C. Extreme abduction of the hips. D. Pressure injury to the breasts/chest.

B. Compromise of pulmonary function in the dependent lung.

The narrowest part of a child's airway is the: A. vocal cords B. cricoid cartilage C. mouth opening D. bronchioles

B. Cricoid cartilage

You are providing preoperative teaching to a patient who is to undergo uvulopalatopharyngoplasty (UPPP). Your teaching regarding his airway should include all the following information EXCEPT: A. A call light and a message board will be provided so that the patient may communicate with staff. B. The patient's solid food supper order for postoperative day is predetermined. C. The heat of the bed will be elevated to decrease postoperative swelling. D. Oxygen will be provided by a mask to the face, or over the tracheal stoma if trach is performed until swelling subsides.

B. The patient's solid food supper order for postoperative day is predetermined.

A cardiac arrest occurs in the operating room on a Wednesday at approximately 1300. Which of the following OR personnel is responsible for maintaining sterility of the surgical site and packing it with sterile saline-soaked sponges? A. The first assistant B. The scrub person C. The circulating nurse D. The surgeon

B. The scrub person

The manager of the OR is preparing to schedule the staff for the OR for the next week's surgical cases. When assigning the OR personnel to their surgical roles, the nurse manager of the OR takes into consideration the fact that: A. The certified perioperative nurse (CNOR) may function as a registered nurse first assist (RNFA). B. The surgical technologist is capable of working in sterile processing. C. The RNFA may simultaneously fill the role of RNFA and scrub nurse. D. The AORN has developed staffing templates which must be adhered to.

B. The surgical technologist is capable of working in sterile processing.

Crying is contraindicated for pediatric patients in the preoperative period for all of the following reasons EXCEPT: A. Crying increases mucus production. B. Crying may increase stress of the parents. C. Crying indicates laryngospasm. D. Crying increases edema in nasal and throat tissues.

C. Crying indicated laryngospasm.

With Perioperative Nursing Data Set (PNDS) coding, the letter X stands for: A. Outcome B. Intervention C. Diagnosis D. Domain

C. Diagnosis

Safe use of a pneumatic tourniquet involves: A. Avoiding deflation of the tourniquet at all costs until the procedure has been completed. B. Not exceeding two hours of use on upper extremity. C. Ensuring the ends overlap by at least three inches but no more than six inches. D. Not exceeding one hour of use on a lower extremity.

C. Ensuring the ends overlap by at least three inches but no more than six inches. (tourniquet use should not exceed one hour on an upper extremity and one and a half hours on a lower extremity)

How should you store flexible endoscopes with detachable parts to prevent contamination and promote drying? A. Use a dryer to dry the scope thoroughly, then place it by itself on a cart. B. Stack the endoscopes together, one on top of the other. C. Hang the endoscope in a vertical position. D. Lay the endoscope by itself on a cart.

C. Hang the endoscope in a vertical position.

A trauma patient has suffered massive blood loss and has had multiple blood transfusions. The surgeon notices symptoms of disseminated intravascular coagulation (DIC). What are those symptoms? A. Thrombophlebitis, air embolism, and abnormal clotting B. Hemorrhage, bruising, and deep vein thrombosis C. Hemorrhage, oozing from puncture sites, and ischemia of vital organs D. Hemorrhage, air embolism, and deep vein thrombosis

C. Hemorrhage, oozing from puncture sites, and ischemia of vital organs.

Which of the following vaccines is a requirement for all health care workers? A. Tuberculosis B. Hepatitis A C. Hepatitis B D. Hepatitis C

C. Hepatitis B

Which of the following blood tests measures the ability of the patient's blood to clot by assessing the factors V, VII, X, and fibrinogen? A. PTT B. Serum vitamin K C. PT D. Platelets

C. PT

What are three methods of surgical instrument/equipment sterilization? A. Steam, pasteurization, hydrogen peroxide B. Formaldehyde, hydrogen peroxide plasma, ethyl alcohol C. Steam, ethylene oxide, hydrogen peroxide plasma D. Steam, quaternary ammonium, ozone gas

C. Steam, ethylene oxide, hydrogen peroxide plasma

Drawbacks to the use of quaternary ammonium compounds include all of the following EXCEPT: A. They are unable to kill all viruses. B. They are inactivated in the presence of organic soil. C. They are irritating to the skin. D. They can be absorbed by cotton and other fabrics.

C. They are irritating to the skin.

On arrival to the post-anesthesia care unit, you obtain your pediatric patient's temperature to determine the effectiveness of warming procedures used in the OR to maintain the patient's temperature. Which part of the nursing process does your action represent? A. Implementation B. Planning C. Assessment D. Evaluation

D. Evaluation

You are caring for a 2-year-old child who is awaiting surgery for a traumatic injury to the leg. You are assessing pain. Which of the following pain-rating scales would be BEST suited for a child of this age? A. Verbal Rating Scale B. FACES Scale C. Word Descriptor Scale D. FLACC Scale

D. FLACC Scale (Face, Legs, Activity, Cry, Consolability scale; use to assess pain in children 2 months- 7 years.

Which of the following is used to occlude blood vessels? A. Anesthesia forceps B. Biopsy forceps C. Magill forceps D. Kelly's forceps

D. Kelly's forceps

When communicating with a patient who has a visual impairment/blindness: A. Gently touching the patient's arm before introducing oneself can help provide comfort. B. Speak slowly and clearly in an elevated pleasant tone to ensure a friendly mood is aptly communicated. C. Protect the patient from potential distress from unexpected sounds by ensuring that the environment is kept quiet. D. The speaker should address the patient by name then introduce himself.

D. The speaker should address the patient by name then introduce himself.

Patients' dentures are removed prior to entering the OR for all of the following reasons EXCEPT: A. To prevent them from getting lost if removed in the OR. B. To prevent them from obstructing respiration. C. To prevent them from getting damaged during the intubation process. D. To overcome the problem of leakage of gases between the mask and the sunken cheeks of the endentulous patient.

D. To overcome the problem of leakage of gases between the mask and the sunken cheeks of the endentulous patient.

Which of the following is a common symptom of hyperkalemia? A. Fever B. Itching C. Muscle rigidity D. Weakness/fatigue

D. Weakness/fatigue (weakness, muscle fatigue, abnormal heart rhythms, chest pain, nausea)