Periop Final

315. What are your chances of a Hepatitis C infection from a contaminated sharps injury? a. 1 in 30 b. 1 in 50 c. 1 in 75 d. 1 in 100

1 in 50

MH protocol

1. stop surgery if possible (if not, maintain with non-triggering agents) 2. Get cart and Dantrolene 3. Call for help 4. Hyperventilate with 100% O2 at 10L/min 5. administer Dantrolene at 2.5 mg/kg and repeat as needed 6. obtain ABGs 7. Cool patient if core temp higher than 39C

If 1. formalin is splashed into the eye(s), how long should someone slowly and gently rinse the eye(s)? a. 5-7 minutes b. 15-20 minutes c. 3-5 minutes d. 7-12 minutes

15-20 minutes

Clear liquids

2 hours

166. Approximately how many inches above the patent's knees should the safety strap be applied in the supine position? a. 2 inches b. 4 inches c. 6 inches d. 8 inches

2 inches

Minimum total air exchanges/hours

20

1. According to the CDC, for at lease how long should one wash hands? a. 10 seconds b. 15 seconds c. 20 seconds d. 25 seconds

20 seconds

1. An anesthesia professional states, "this patient is experiencing local anesthetic systemic toxicity." The RN should be prepared to assist with the administration of: a. Dantrolene sodium b. Protamine sulface c. Papaverine hydrochloride d. 20% lipid emulsion therapy

20% lipid emulsion therapy

Humidity in operating room should be

20-60%

82. A patient for measles has just exited the room. The OR has 20 air exchanges per hour. How many minutes does the OR need to remain unoccupied without an aerosolizing source to remove 99.9% of airborn particle contaminants? a. 28 minutes b. 21 minutes c. 18 minutes d. 14 minutes

21 minutes

1. The weight of an instrument tray should not exceed a. 15 pounds b. 20 pounds c. 25 pounds d. 30 pounds

25 pounds

Age at which physiologic functions begin to decline

30-44

Breast feeding

4 hours

78. What is the manufacturer's recommended contact time for bleach? a. 2 minutes b. 4 minutes c. 3 minutes d. 1 minute

4 minutes

35. When should anticoagulants be discontinued prior to surgery? a. 12 hours b. 48 hours c. 24 hours d. 36 hours

48 hours

How long does it take for a OR acquired pressure injury to appear?

48-72 hours

Formula feeding and light meals

6 hours

How warm should the water be in eye wash stations

60-100F

Temp in the OR

68-75F

Full meals

8 hours

1. How often should surgical gloves be changed during surgery? a. Every 60-90 minutes b. Every 50-60 minutes c. Every 20-45 minutes d. Every 90-150 minutes

90-150 minutes

1. Which statement about biological indicators (BIs) is FALSE? a. A BI is run with each sterilization load that contains one or more implants b. The BI used must be specific to the sterilization method c. A BI test for EO sterilization should be performed once a week d. In the event of a positive BI result, the sterilizer is not used until the cause of the BI failure has been determined

A BI test for EO sterilization should be performed once a week

ASA 5

A moribund patient who is not expected to survive without the operation

ASA Physical Status 5

A moribund patient who is not expected to survive without the operation

ASA 2

A patient with mild systemic disease

ASA Physical Status 2

A patient with mild systemic disease

ASA 3

A patient with severe systemic disease

ASA Physical Status 3

A patient with severe systemic disease

ASA 4

A patient with severe systemic disease that is a constant threat to life

ASA Physical Status 4

A patient with severe systemic disease that is a constant threat to life

Dilator

A surgical instrument used to enlarge an opening in an incremental manner

Retractor

A tool used to expose an area for surgical intervention

1. Which statements describe a breach of duty? Select all that apply a. The nursing care caused an injury b. The nursing care was not that of a reasonable and prudent nurse in a similar situation c. The nursing card did not follow the standard of care d. The nursing care caused measurable harm

A, B, C

213. Education is a critical component of Phase II patient care. Which of the following is included in the patient's education prior to discharge? Select all that apply a. How to empty the drain reservoir b. How to take the prescribed pain medication c. Coughing and deep breathing exercises d. When they may return to work

A, B, C

1. Which of the following descriptions below apply to the PACU RN? Select all that apply a. Has advanced knowledge concerning general regional, and local anesthesia b. Holds advanced cardiac life support (ACLS) and Pediatric Advanced Life Support (PALS) c. Has critical experience[LMDA1] , either from a critical care unit or the emergency department d. Should be competent regarding age specific, special needs, and complex cardiac and respiratory care of patients [LMDA1]

A, B, C, D

255. Inspection and testing evaluates an individual instrument for ____. Select all that apply a. Sharpness b. Integrity of cables and cords c. Alignment d. Cleanliness

A, B, C, D

1. Which of the following are responsibilities of State Boards of Nursing? Select all that apply a. Perform research on nursing practices b. Review and approve or accredit nursing education programs c. Act against the licenses of RN who have exhibited unsafe nursing practice d. Determine roles that and RN can fulfill in that state e. Write guidelines for nursing practice f. Issue licenses to practice nursing

A, B, C, D, E, F

18. Which of the following types of anesthesia must be administered by an anesthesia professional? a. Moderate sedation b. Monitored anesthesia care c. General anesthesia d. Local anesthesia

A, B, and C

41. A history and physical must be completed and documented before the patient's surgery, high-risk procedure, or any procedure that involves anesthesia. Why is it important that a relevant and complete assessment be performed? Select all that apply. a. Provide a patient-specific needs assessment b. Address a patient's condition c. Include a plan of care d. Include the cost of treatment

A, B, and C

1. Which of the following PPE is necessary for health care workers in the decontamination area? Select all that apply a. Eye protection or a full-face shield b. N95 respirator c. Fluid resistant shoe covers d. Utility gloves

A, C, D

1. The RN prepares the medications and solutions after receiving orders from: select all that apply. a. Advanced practice RNs b. Anesthesiologists c. First assistants d. Surgeons

ABD

1. Which of the following individuals handle medications in the operating suite? a. Anesthesia professional b. Scrub technician c. Nursing assistant d. Periop nurse

ABD

1. Thrombin is considered a/an _____ agent because it biological participates in the coagulation cascade a. Pharmaceutical b. Passive c. Active d. Chemical

Active

245. Which statement about cleaning and decontamination of contaminated surgical instruments and equipment is false: a. Blood removal on instruments is more difficult with hot water b. All instruments should be submerged in a hot water solution c. SPD personnel should wear a fluid-resistant gown in the decontamination area d. The manufacturer's IFU outlines the necessary steps for cleaning and decontamination

All instruments should be submerged in a hot water solution

33. Anxiety and stress cause unpleasant physiological reactions in patients before surgery. What can patients do to lessen their preoperative anxiety? a. Listen to music b. Practice aromatherapy c. Perform meditation d. All the above

All of above

1. Which of these indications help to determine that the conditions for sterility have been met? a. Expiration date b. Package integrity c. Chemical indicators d. All of the above

All of the above

147. What are key components of ERAS? Check all that apply a. Patient optimization prior to surgery b. Minimal fasting c. Multimodal analgesia d. Patient and family education e. all of the above

All of the above

73. Terminal cleaning is performed after an environmental contamination event such as flooding due to a natural disaster or building maintenance issue. Which of the following measures is taken when there is a pest infestation? a. Containing biological waste b. Removing food waste c. Cleaning common eating areas d. All of the measures are taken

All of the above

1. In November 1999, the Institute of Medicine (IOM), now the National Academy of Medicine (NAMI), published the landmark report to Err is Human: Building a safer Health System" and reported: a. To prevent errors a safter system needs to be designed b. When an error occurs, the system needs to be examined c. Standardization of process d. All of the above

All the above

136. AORN advocates for patient and worker safety through the Guidelines for Perioperative Practice and: a. Position statements b. Tool kits c. Mission, vision, and values statements d. All the above

All the above

37. What is an important element when assessing your patient's pain? a. Always having the patient read the pain scale b. Checking the patient's pain across two pain scales c. Asking the family member what level the patient's pain level is d. Always using the same scale with the same patient

Always using the same scale with the same patient

48. Of the following, which was the first to incorporate the nursing diagnosis as part of the nursing process? a. New York State Board of Nursing b. NANDA International c. North American Nursing Diagnosis Association d. American Nurses Association

American nurses association

1. Which of the following describes bioburden? a. A chemical interaction between blood and cleaning agents b. A physical barrier created by cleaning agents on an instrument surface c. Biological material that adheres to the surface of instruments and inhibits effective cleaning d. The amount of microbial contamination on an instrument surface

Amount of microbial contamination on an instrument surface

1. What is the correct definition for respondeat superior? a. A legal obligation or responsibility b. A breach of duty to another person as defined by law c. An action or the failure to act that deviates from the standard of care d. An employer's responsibility for the RN what the RN acts within the scope of nursing practice

An employer's responsibility for the RN wht the RN acts within the scope of nursing practice

128. After verifying the "8rights of medication administration" and before administering heparin and insulin, the RN should also verify the medication orders and dosages with: a. A non-licensed technician b. Another RN or other licensed person c. Patient d. Patient's spouse

Another RN or other licensed person

2. Which of the following is NOT included in basic monitoring of the patient for anesthesia? a. Blood pressure b. Pulse oximetry c. Arterial line d. Ecg

Arterial line

230. When should the sterile field be prepared? a. After induction of anesthesia b. As close to the time of surgery as possible c. While the OR is being cleaned d. One hour before the scheduled procedure

As close to surgery as possible

1. Which is an example of assault and battery? a. Requiring an RN to provide care to a patient who is HIV positive b. Not obtaining an informed consent from the patient before surgery c. Participating in a "near miss" in the OR d. Delegating a task to a person wo is not qualified to do it

B

148. Identify the purposes of ERAS: check all that apply a. Increase fasting time b. Optimize the patient's physiological function c. Improved nutritional status prior to surgery d. Increase the patient's surgical stress response

B and C

93. Which of the following statements about documentation are TRUE? a. RNs should use regionally appropriate terms to describe patient care b. Documentation incorporates the nursing process c. Patient data is collected throughout all phases of patient care d. Data is collected only on patient care milestones,.

B and C

43. Why is documentation of information essential to patient care? Select all that apply a. Supports submission of insurance bills b. Provides information for planning patient care c. Offers information in the event of a malpractice suit d. Allows for evaluation of care provided

B and D

55. Cannabis affects virtually all body systems. Which of the following describes an intraoperative-phase concern? a. Anxiety b. Unknown tolerance to anesthetic agents c. Unknown tolerance to analgesic medications d. Pain perception increase

B(?)

1. Which of the following are desirable traits of skin antiseptic products? select all that apply. a. Not tinted or colored b. Not inactivated by other chemicals or body fluids c. Non-irritating to the skin d. FDA Category 1 compliant

B, C, D

96. Which of the following are documentation standards? Select all that apply a. Use abbreviations customized for the situation b. Use standardized names and terms c. Eliminate trailing zeros in medication doses d. Request the surgeon review preprinted orders for accuracy

B, C, D

Noncritical Spaulding classifications:

BP cuff, stethoscope

1. You and another team member just finished a procedure. The patient had bed bug bites and you hear your team member make snide comments about the patient in the cafeteria. You notice people who are not health care providers listening to the conversation. What type of behavior has your colleague exhibited? a. Assault b. Veracity c. Breach of privacy d. Malpractice

Breach of privacy

Who administers HIPAA?

CMA

1. Which of the following published regulatory requirements to which facilities and health care workers must adhere? a. Centers for Medicare & Medicaid Services b. The Joint Commission c. Association of PeriOperative Registered Nurses d. All of the above

Centers for Medicare and Medicare services

135. An organization with a culture of safety: a. Focuses on errors b. Changes care delivery as a result of an error c. Encourages health care providers to report another providers near miss d. All of the above

Changes care delivery as a result of an error

1. What type of monitor is an external strip of tape? a. Biological b. Ultrasonic c. Chemical d. Physical

Chemical

1. Traditional methods of surgical hemostasis include mechanical methods, thermal-based energy sources, and a. Chemical agents (ie, pharmaceuticals b. Pressure dressings c. Lasers d. Monopolar electrosurgery

Chemical agents

109. The periop RN should anticipate using what type of drain for a trauma patient whose surgery includes treatment of multiple rib fractures? a. Chest tubes/chest drainage system b. Hemovac drain c. Penrose drain d. Jackson-pratt drain

Chest tubes/chest drainage system

Which of the following CI are placed on the outside of a package or container? a. Class 1: process indicator b. Class 2: specialty indicator c. Class 3: single-parameter indicator d. Class 4: multi-parameter indicator

Class 1

1. What is the first step in instrument processing? a. Soaking b. Chemical disinfection c. Cleaning

Cleaning

passive hemostatic agents

Collagen, cellulose, gelatin, polysaccharides

1. Initial PACU placement may include either Phase I or Phase II. Which of the following is one of the determining factors for unit placement for the patient directly out of surgery? a. Weight b. Physician preference c. Insurance coverage d. comorbid conditions

Comorbid conditions

52. Which of the following is completed during the sign-in phase, done in the OR before anesthesia induction? a. Verification of positioning considerations b. Confirmation of correct diagnostic images c. Discussion of equipment problems d. Confirmation of difficult airway or aspiration risk.

Confirmation of a difficult airway or aspiration risk

141. Organizational elements of a culture of safety include: a. A commitment of resources that focus on accidents b. Teams and disciplines that operate in silos c. Consistent and safe delivery of services d. An environment that emphasizes individual recriminations

Consistent and safe delivery of services

70. In the morning, before the start of the first procedure of the day, what should be done to remove dust and debris? a. Floor dusting b. Dry dusting c. Damp dusting d. Light dusting

Damp dusting

81. When performing terminal cleaning in the SPD, which area is cleaned last? a. Assembly b. Storage c. Decontamination d. Sterilization

Decontamination

1. What is a hallmark of an accountable care organization? a. Duplication of services b. Physician-controlled care c. Increased costs d. Decrease in errors

Decrease in errors

56. Which of the following is NOT a patient risk factor associated with alcoholism? a. Decreased immunity b. Decreased bleeding times c. Increased cardiac complications d. Increased stress response

Decreased bleeding times

What pressure injury is most common in OR

Deep tissue injuries

Third intention/delayed

Delayed wound closure due to considerable tissue loss, infection Wound is devascularized

1. The RN notices a partially full heparin vial and a syringe with solution in it on a shelf in the OR. a. Draw up the remaining heparin and use it for the next surgery b. Place the heparin vial on the anesthesia cart and discard the syringe c. Discard the heparin vial and syringe d. Leave the heparin vial and syringe on the shelf

Discard the heparin vial and syringe

76. ____ is the removal of pathogenic and other microorganisms from surfaces by using chemical or physical means. a. Washing b. Cleaning c. Disinfection d. Sterilization

Disinfection

92. Which of the following statements is TRUE? a. Documentation cannot be used to analyze regulatory compliance b. If an electronic record is amended, the original record is deleted c. Documentation can be used to align service with reimbursement d. For efficiency, each health care system should have its own, unique, structured

Documentation can be used to align service with reimbursement

Elements of malpractice

Duty, breach of duty, breach of duty caused injury, injury harmed patient

84. Management of potential loss of patient care data should be part of: a. EHR downtime protocols b. PNDS vocabulary c. The patient consent form d. Intraoperative to postoperative handover information

EHR downtime protocols

20. Which of the following types of airway maintenance usually requires muscle relaxants: a. Laryngeal mask airway b. Mask ventilation c. Endotracheal intubation d. Spontaneous respiration

ET intubation

What part of the body can CHG not be used on?

Ear

26. Which of the following is associated with increased risk for perioperative hypothermia? a. Hyperthyroidism b. Elderly patients c. Hypertension d. Higher than normal body weight

Elderly patients

1. Which of the following are considered ignition sources that may cause a fire to ignite during surgery? a. Alcohol-based preoperative skin antisepsis solutions b. Surgical drapes and sponges c. Electrosurgery and laser d. Nitrous oxide and oxygen

Electrosurgery and laser

161. Who is responsible for positioning the patient? a. Anesthesia professional b. Surgical support personnel c. RN d. Entire surgical team

Entire surgical team

1. Which chemical sterilization method uses a toxicv substance that requires aeration? a. Dry heat b. Hydrogen peroxide c. Peracetic acid d. Ethylene oxide

Ethylene oxide

97. What does the FACT acronym stand for? a. Fast, accurate, competent, timely b. Factual, accurate, complete, timely c. Factual, authentic, complete, targeted d. Fair, authentic, competent, true

Factual, accurate, complete, timely

38. Patients are responsible for providing only information that they want to share about themselves. a. True b. false

False

3. Which drug is used to reverse valium and midazolam? a. Pancuronium b. Succinylcholine c. Flumazenil d. Neostigmine

Flumazenil

87. What is recommended if a correction is required on a paper health care record? a. Always use red ink b. Cover the existing content using black ink and add the correction c. Do not make corrections on a paper health care record d. Follow your facilities policies for corrections

Follow your facilities policies for corrections

62. Insufflation of gas during endoscopic surger increases intra-abdominal pressure, and open blood vessels may allow the gas to enter the circulatory system. The places a patient at risk for: a. Gas embolism b. Myocardial infarction c. Venous thromboembolism d. Pleural effusion

Gas embolism

260. What is NOT included in the record of each sterilization cycle? a. Operator's identification b. General description of the sterilization load c. Physical, chemical, and biological indicator results d. Exposure parameters for the sterilization method

General description of the sterilization load

50. Most patients have concerns about surgery that outside of the technical aspects on which consent is based. Which option best describes trust issues? a. Not waking up from anesthesia b. Fear of the unknown c. Giving control to others d. Concerns about the postoperative phase

Giving control to others

1. How are bullets handled during a procedure a. Grasped with a metal instrument with protective rubber shods and placed in a metal basis b. Grasped with a metal instrument and placed in a metal basis c. Grasped with a metal instrument with protective rubber shods and placed in a non-metal basin d. Grasped with a metal instrument with protective rubber shods and placed in a laparotomy sponge

Grasped with a metal instrument with protective rubber shods and placed in a non-metal basin

68. This action is considered to be the single most important action that can prevent the spread of infection a. Terminal cleaning b. Hand hygiene c. Turnover cleaning d. Surgical attire

Hand hygiene

1. Medication used in vascular surgery to prevent blood clot formation is a. Heparin b. Hetastarch c. Protamine sulfate d. Papaverine

Heparin

1. In the supine position, a wedge-shaped positioning device is placed under the right lumbar region for a pregnant patient undergoing a non-obstetric surgery to help prevent a. Hypertension b. Uterine contractions c. Hypotension d. Pressure injury

Hypotension

72. What is the common term for the directions provided by a manufacturer on how to accurately use their product? a. BNP b. SCD c. IFU d. ACE

IFU

66. A "no-fly zone" in a hybrid OR designates an area: a. Where no one is allowed to stand b. In which imaging equipment can be used safely during surgery c. Where no equipment is allowed d. For the anesthesia professional only

Imaging equipment can be used safely during surgery

1. A goal of patient-and family-centered care is to: a. Make the patient aware of their reliance on medical personnel b. Improve the patient's knowledge regarding their care c. Focus on one point person for all communication d. Achieve short-term behavioral changes

Improve the patient's knowledge regarding their care

167. Raising the patient's leges into the lithotomy position shifts blood from the legs into the central circulation and a. Decreases pressure on the diaphragm b. Decreases cardiac and venous return c. Increases cardiac output and venous return d. Increases perfusion to the legs

Increases cardiac output and venous return

Traumatic

Injury caused by crushing or penetration

Sharp

Instrument with a pointed tip or cutting edge used to cut or dissect tissue

1. Which of the following is NOT done when assembling an instrument tray? a. Instruments are counted as they are placed in a tray b. Instruments are damp when placed in a container or wrapped c. Instruments are opened when being placed on a stringer d. Instruments are placed with heavier instruments on the bottom

Instruments are damp when placed in a container or wrapped

1. Instrument assembly stipulates that ____ a. Instruments are closed when placed on the stringer b. Cupped instruments are placed up in the instrument set c. Instruments need to be dry when assembled d. Sharp and delicate instruments are inserted into a peel pack

Instruments need to be dry when assembled

30. An element that is not part of the Surgical Checklist Pre-Procedure Check In is a. Confirmation of the surgical site marking(s) b. Confirmation of the procedure and procedure site c. Introduction of team members d. Presence of the consent(s) and history and physical

Introduction of team members

186. Hair that is removed from the head for a cranial procedure a. Is removed 24 hours prior to surgery b. Is bagged and disposed of c. Is the property of the patient d. Corresponds with the exact location of the prep area

Is property of the patient

229. Technique used to prevent the transfer of organisms and cells from one site to another. It is best practice to use this technique during bowel surgery and cases involving malignancy a. Intervention technique b. Impervious technique c. Investigation technique d. Isolation technique

Isolation technique

254. Which statement about completely submerging an instrument into the cleaning solution is TRUE? a. It increase the potential of contamination to the worker b. It increases the risk of splashes and sprays to the worker c. It reduces the need for instrument disassembly d. It reduces the risk of chemical and contaminant aerosolization

It reduces the risk of chemical and contaminant aerosolization

What position has the possibility of impaired gas exchange and increased airway pressure

Jack Knife

1. Which position is a modification of the prone position? a. Supine b. Trendelenburg c. Reverse Trendelenburg d. Jack-knife

Jack-knife

who creates national patient safety goals each year?

Joint Commission

1. A situational factor error can occur because: a. An assumption concerning a medication dosage b. A mistake in judgement c. Alarm fatigue d. A lack of attention

Lack of attention

1. What type of sterile drape would you expect to use for a laparoscopic-assisted vaginal hysterectomy? a. Split sheet b. Stockinette c. Leggings d. Head drape

Leggings

89. Which of the following is NOT a risk reduction strategy? a. Using standardized documentation b. Discussing your assignments with your manager c. Maintaining confidentiality d. Limiting documentation to a major episode in the patient's care

Limiting documentation to a major episode in the patient's care

1. Geobacillus stearothermophilus is a biological indicator used for _____ a. Ethylene oxide sterilizers b. Liquid peracetic acid sterilizers c. Dry heat sterilizers

Liquid per acetic acid sterilizers

79. Which statement best describes the handling of liquid waste? a. Liquid waste should be solidified before being discarded in red bag trash b. Liquid waste disposal is determined by each facility's policy and procedure c. Liquid waste should be discarded down a drain d. Liquid waste disposal is regulated by local, state, and federal agencies

Liquid waste disposal is regulated by local, state, and federal agencies

What position increases pressure on diaphragm, can cause nerve damage, and creates a shift in circulatory pressure when legs are lowered

Lithotomy

24. Sedation can be used with any of the following types of anesthesia EXCEPT: a. Regional b. Monitored c. General d. Local

Local

22. Which of the following neuraxial anesthesia procedures describes the spinal block? a. Local aesthetic is injected into a vein after tourniquet inflation b. Local anesthetic is injected into subarachnoid space c. Local anesthetic is injected into the space between the ligamentum flavum and dura

Local anesthetic is injected into subarachnoid space

34. Which of the following drugs is an anticoagulant? a. Retavase b. Pradaxa c. Lovenox d. Eliquis

Lovenox

1. Which IV medication is indicated for use to decrease intracranial pressure? a. Nafcillin b. Mannitol c. Methergine d. Magnesium sulfate

Mannitol

1. What is an essential activity performed to prevent the spread of nasal and oropharyngeal secretions? a. Draping b. Gloving c. Masking d. Gowning

Masking

103. Using suture to close a wound is a ____ method to achieve surgical hemostasis. a. Thermal-based energy b. Pharmaceutical c. Chemical d. Mechanical

Mechanical

Type 4 latex allergy

Minor irritation/inflammation. "Contact dermatitis". Occurs 24-72 hrs after exposure and persists several days. Worsens with repeated exposure.

When scrubbed team members move in and around the sterile field, they should do this to prevent contamination a. Place their hands in the axilla to relax their shoulders b. Move back to back or face to face when changing positions c. Change levels many times d. Turn their back on the field

Move back to back or face to face when changing positions

1. Which of the following is a pressure injury risk assessment tool designed for surgical patients? a. Braden scale b. STOP-Bang questionnaire c. Braden Q scale d. Munro Pressure Ulcer Risk Assessment Assessment scale

Munro

45. The ERAS program is initiated prior to surgery and typically includes a multimodal pain management plan. Another element of ERAS can incorporate a carbohydrate beverage up to 2 hours before surgery. Why is communication about he ERAS initiative important to the perioperative nurse? a. Allergy status b. NPO status c. Diagnostic test response d. Pain level

NPO status

Occurs when layers of material, such as extra sheets or blankets, are placed over the OR mattress or padding. a. Friction b. Negativity c. Shear d. Immersion

Negativity

64. Which type of irrigation fluid is typically used for endoscopic procedures using monopolar electrosurgery? a. Ringers lactate b. 0.9% sodium chloride c. Electrolyte fluids d. Nonelectrolyte fluids

Nonelectrolyte fluids

218. Which term means "the duty to do no harm?" a. Nonmaleficence b. Justice c. Fidelity d. Beneficence

Nonmaleficence

ASA 1

Normal healthy patient

ASA Physical Status 1

Normal healthy patient

108. During the closing count, a lap sponge is missing. What action should the RN circulator take FIRST? a. Look in the trash receptacles for the lap sponge b. Ask the scrub person to look for the lap sponge under the drapes c. Call the OR manager d. Notify the team the lap sponge is missing

Notify the team the lap sponge is missing

1. Which of the following is NOT a skill-based behavior error? a. The nurse forgets to retrieve a unit of blood when called to do a sponge count b. The nurse fails to respond to a device alarm c. The nurse hits the wrong button instead of the correct button beside it d. The nurse programs a new electrosurgical unit based on the machine she has used in the past.

Nurse fails to respond to a device alarm

29. The Nursing Alliance for Quality Care (NAQC) emphasizes patient-centered care that includes patient engagement. Which of the following is one of the nine assumptions of patient engagement? a. Circumstances surrounding the need for health care interventions do not influence the patient's level of engagement b. Nurses must form an active partnership with their patient, the patient's support system, and the patient's care providers c. Cultural, racial, and ethnic diversity cannot be considered when healcare providers make decisions for the patient. d. Physicians must make the decisions about the patient's care.

Nurses must form an active partnership with their patient, the patient's support system, and the patient's care providers

Critical Spaulding classifications

OR instruments

1. When opening a rigid container, the lid is moved this way to prevent contamination a. Opened up, away from the container and toward the scrub b. Opened out, away from the container and toward yourself c. Opened out, away from the container and toward the scrub d. Opened up, away from the container and toward yourself

Opened up, away from container and toward yourself

57. Which type of endoscope allows the surgeon to perform surgery by placing instruments of the endoscope? a. Operative b. Diagnostic c. Rigid d. Flexible

Operative

28. Which of the following is NOT a key element of ERAS (enhanced recovery after surgery)? a. Patient and family education b. Minimal fasting prior to surgery c. Return to regular diet and activities on the day of surgery d. Opioid-only pain relief

Opioid-only pain relief

Oxidizer example

Oxygen

1. The CDC has issued a statement regarding PAPRs in the OR. What is the recommendation: a. PAPRS are not recommended for use during surgical procedures b. PAPRS are recommended for use by circulators only c. PAPRS are recommended for use during surgical procedures d. PAPRS are recommended for use by scrub personnel only

PAPRS are not recommended for use during surgical procedures

1. _____ is a structured language used by perioperative RNs to document nursing care a. PNDS b. HIPAA c. NLC d. PICO

PNDS

1. The initial assessment of the patient entering Phase I consists of the following EXCEPT for a. Pain b. Airway c. Drainage d. Circulation

Pain

1. To protect the ulnar nerve in the supine position, how should the nurse place the patient's palms on a padded arm board during positioning? a. Palms fisted b. Palm-side up c. Palm-side down d. Palms secured in arm guards

Palm side down

65. Which component of robotic surgery system is a part of the sterile field? a. Surgeon console b. Patient cart c. Vision cart d. Camera control unit

Patient cart

1. Which type of drain allows for a free flow of fluids from the wound using gravity only? a. Chest drainage system b. Closed drainage system c. Negative pressure therapy unit d. Penrose drain

Penrose

94. A standardized language for periop nursing is the: a. Perioperative Nursing Documentation System b. Perioperative Nurse Data System c. Perioperative Nursing Data Set d. Perioperative Nurse Data Storage

Perioperative Nursing Data Set

204. During which phase of care does the perianesthesia nurse focus on preparing the patient for care at home? a. Phase I b. Phase II c. Phase III d. Phase IV

Phase III

160. What is one hallmark of patient-centered care? a. Families have specific visiting hours b. New information is delivered within 48 hours c. Physical comfort and emotional well-being are priorities d. Decisions are made and shared with the patient and family

Physical comfort and emotional well-being are priorities

58. What action should the RN circulator take to decrease the risk for injury from a heated fiberoptic light cable? a. Instruct the scrub person to wrap the light cable in a dry sterile towel b. Instruct the scrub person to always disconnect the light cable after use c. Place the light source in stand-by mode when it is not being used d. Connect the light cable loosely to the light box to allow cool air around the connection.

Place light source in stand-by mode when it is not being used

1. Which step precedes the others? a. Disinfection b. Point-of-use cleaning c. Transport d. Packaging

Point of use cleaning

1. The airflow in an OR has a(n) __ pressure relationship to the adjacent OR hallway. a. Adverse b. Positive c. Neutral d. Negative

Positive

1. Which of the following statements is correct regarding powered surgical instruments? a. Powered instruments are interchangeable b. Powered instruments are immersible c. Powered instruments are powered by air, electricity, or battery d. Power sources are interchangeable with various power drills

Powered instruments are powered by air, electricity, or battery

181. Which of the following is TRUE regarding general skin antiseptic application? a. Begin prepping the patient while patient positioning is being done b. Prep as small an area as possible c. Dilute skin preparation solutions when requested by physician d. Prep in a back and forth motion when using CHG-based antiseptic

Prep in a back and forth motion when using CHG-based antiseptic

198. Which statement is NOT true about skin antisepsis of the eye? a. Lashes and eyelid margins are cleaned with an antimicrobial skin disinfectant b. The eye prep includes the area from the brow to the cheek c. Prep solutions are diluted to prevent a chemical burn d. The eye is flushed with normal saline as the last step in the prep process

Prep solutions are diluted to prevent a chemical burn

1. Which measure helps decrease the risk of fire caused by skin antiseptics? a. Dilute the skin prep to reduce the flammable component b. Begin the procedure before the skin prep has dried c. Prevent flammable skin antiseptics from pooling or soaking into linens or the patient's hair d. Allow material saturated with skin antiseptic to dry before the patient is draped

Prevent flammable skin antiseptics from pooling or soaking into linens or the patient's hair

1. When epinephrine is added to a local anesthetic, its actions include: a. Increasing bleeding at the wound bed b. Bronchial dilation c. Antimicrobial activity d. Prolonging the rate of absorption of the local anesthetic

Prolonging the rate of absorption of the local anesthetic

1. Which medication neutralizes the effect of heparin? a. Bacitracin b. Propranolol c. Vitamin K d. Protamine

Protamine

209. The ASPAN standards have delineated levels of care for postanesthesia care. According to the standards, what is the most important staffing consideration in all perianesthesia departments? a. Surgery schedule b. Patient acuity c. Use of travelers d. Shift timing day, evenings, and nights

Pt acuity

1. Surgical sponges differ from dressing sponges in that surgical sponges are a. Manufactured using specific textiles b. Radiopaque c. Always packaged in groups of five d. Smaller than dressing sponges

Radiopaque

What is the standard that a professional nurse needs to meet when practicing?

Reasonable prudent nurse standard

1. Identify a goal of ERAS: a. Opioids prescribed every 4 hours for 48 hours b. Muscle strengthening exercise 2 days prior to surgery c. Reduce the patient's stress response d. Limit activity for 48 hours

Reduce the patient's stress response

178. Which intervention should be implemented immediately when a fire occurs in a patient's airway? a. Gather all supplies and equipment involved in the fire b. Complete an occurrence report c. Remove the endotracheal tube and any segments of the burned tube that remain in the airway d. Lower the flow of the breathing gases to the patient

Remove the endotracheal tube and any segments of the burned tube that remain in the airway

What should the RN do if a positive BI result is discovered?

Report immediately, sterilizer is not used

The Aldrete scale, used to determine readiness for discharge, measures what?

Respirations, activity, circulation, consciousness, O2 sat

Difference in PPE in the semi-restricted and restricted areas of the OR?

Restricted areas require MASK

1. Hallways leading to the OR and the sterile processing areas are designated as _____ areas of the perioperative environment a. Unrestricted b. Multipurpose c. Semi-restricted d. Restricted

Semi-restricted

Dissector

Sharp or blunt surgical tool used to separate tissues

Interrupted Stitch

Single sutures tied independently

32. Which of the following contains the elements of economic stability and built environment? a. The joint commission for the history and physical b. Enhanced recovery after surgery c. Patients' bill of rights d. Social determinants of health

Social determinants of health

Semicritical Spaulding classifications

Speculum, scope

1. The patient has a diagnosis of influenza and has been placed on droplet precautions. What type of respirator precautions should the RN take during the procedure? a. Wear a fit-tested N95 respirator b. Wear a standard surgical mask c. Wear a face shield d. Wear a surgical hood

Standard surgical mask

75. Which of the following is the best method to use to complete turnover cleaning? a. A zone cleaning method b. A perimeter method c. The divide-in-half method d. A standardized method

Standardized

220. Which organization determines the scope of practice for RNs in each state? a. AORN b. The Joint Commission c. State Board of Nursing d. ANA

State board of nursing

63. During surgery, the scrub person can remove gross soil and decrease the formation of biofilm on an endoscope by wiping the outside of the instrument and flushing the channels with: a. 70% alcohol b. 3% peroxide solution c. Sterile water d. Normal saline

Sterile water

What does a negative BI indicator mean?

Sterilization conditions were met

259. Which of the following statements about sterilization packages is TRUE a. Large items can be peel packed as long as it fits into the pouch b. Write information on the porous side of the peel pack c. It is important to allow for billowing or gaping of the sterilization wrap d. Sterilization wraps can be reusable, woven materials or single-use, nonwoven materials

Sterilization wraps can be reusable, woven materials or single-use, nonwoven materials

1. The definition of ____ is when moisture soaks through drapes, gowns and packages and renders the item contaminated. a. Strike through b. Strike up c. Strikeover d. Strikeout

Strike through

113. Which sterile team member typically administers medication to the patient at or near the incision site during the surgical procedure? a. Anesthesia professional b. RN circulator c. Scrub Tech d. Surgeon

Surgeon

86. Which statement about standing orders/preprinted orders is TRUE? a. Surgeons should review their standing orders/preprinted orders for accuracy b. Standing orders/preprinted orders always expire after 6 months c. Standing orders/preprinted orders should not be used in the OR d. Standing orders/preprinted orders do not need to be documented

Surgeons should review their standing orders/preprinted orders for accuracy

36. Virtually every body system is affected by Cannabis. Tetrahydrocannabinol (THC) is metabolized through the liver. Which of the following is NOT a route of elimination? a. Feces b. Urine c. Bile d. Sweat

Sweat

74. Your patient has airborne transmissible disease. Following this patient's surgical procedure your OR would need to reduce the airborne particle contaminants by remaining unoccupied for a specific period of time without an aerosolizing source. Which of the following is considered to be an airborne transmissible disease? a. Aspergillus b. C. difficle c. Tuberculosis d. Methicillin resistant staphylococcus aureus

TB

1. Which organizations writes the Standards of Perioperative Nursing? a. The Centers for Medicare and Medicaid Services b. The Joint Commission c. The Association of periOperative Registered Nurses d. State Board of Nursing

The Association of periOperative Registered Nurse

Type 1 latex allergy

The most severe allergic response to latex, worsens with each exposure. Symptoms include nausea, low blood pressure, respiratory distress. If latex is exposed to the blood, anaphylactic shock will occur. It is life-threatening.

323. Which of the following features is common to delayed primary closure: a. The wound is cleaned, debrided, and packed for eventual skin approximation b. Delayed healing may result in weak tissue approximation and herniation c. Scar formation and contracture may require scar revision d. There is no wound edge separation and minimal postoperative swelling

The wound is cleaned, debrided, and packed for eventual skin approximation

101. What is the principal enzyme in hemostasis and catalyst to convert fibrinogen to fibrin in the coagulation cascade? a. Lipase b. Thrombin c. Amylase d. Protease

Thrombin

77. What is meant by contact time? a. The time spent wiping the surface b. The time it takes to dry the surface c. The time a product takes to dry on a surface d. The time the product must stay wet on the surface

Time product must stay wet on surface

Tenets of radiation

Time, distance, shielding

1. Which material listed below is inert? a. Stainless steel b. Plated c. Titanium

Titanium

61. What is the purpose of filing the peritoneal cavity with carbon dioxide gas before performing a laparoscopy? a. To create a working space and help visualize the surgical site b. To help maintain normothermia c. To increase cardiac output d. To reduce the risk of a surgical site infection

To create a working space and help visualize surgical site

Trocar

Tool used to pierce layers of tissue. utilized for passage of gases, instruments, or tissue/organ removal

Grasper

Toothed or smooth instrument used to hold tissues

284. Which is a description of the Kocher clamp? a. Smooth tips for holding delicate tissue b. Small, short. Toothed tips to minimize tissue crushing c. Toothed tip to hold tough tissue d. None of the above

Toothed tip to hold tough tissue

40. A health history and physical is done to determine surgical risk. SDOH (social determinants of health) can guide the health care provider in a complete assessment. Which one of the following elements can impact an individual's availability for health access? a. Healthy food availability b. Transportation options c. Education opportunities d. Segregation

Transportation options

14. According to the ASA's NPO guidelines, infant formula, nonhuman milk, and a light meal such as toast and clear liquid may be consumed 6 hours before surgery. a. True b. False

True

23. LAST (local anesthetic systemic toxicity) occurs as a result of local medication injection directly into a blood vessel or from slow absorption. a. True b. False

True

95. Verbal orders should be used only when required by clinical necessity a. False b. True

True

31. The focused assessment collects data for a specific health issue and is continuous throughout all nurse-patient interactions. Which element would the nurse assess for the integumentary system? a. Turgor b. Fall risk c. Dyspnea d. Edema

Turgor

67. ___ cleaning is conducted in between surgical procedures a. Terminal b. Turnover c. Transient d. Transparent

Turnover

1. What is the dry time for skin antiseptic products when used in the hair? a. Up to 15 minutes b. Up to 30 minutes c. Up to 45 minutes d. Up to 60 minutes

Up to 60 minutes

164. To position a patient who is obese in the supine position, you should a. Rotate the head to an extreme left lateral alignment b. Use padded arm guards to contain the arms at the sides c. Lower the head 25 degrees d. Place the safety strap below the knees

Use padded arm guards to contain the arms at the sides

138. The surgical safety checklist was an initiative of: a. WHO b. AORN c. CDC d. TJC

WHO

Who wrote the surgical safety checklist?

WHO

27. Identify the active warming methods. Select all that apply a. Warmed IV fluids b. Circulating water garments c. Increased ambient room temperature d. Forced-air warming methods e. Surgical drapes f. Cotton blankets

Warmed IV fluids Circulating water garments Increased ambient room temps Forced-air warming methods

Primary dressing

Wound covering that comes into direct contact with the wound bed

secondary dressing

Wound dressing placed over the primary dressing that provides increased protection, cushioning, absorption, and/or occlusion.

Joint Commission released....

a comprehensive report on the future of nurses in the US healthcare system

Subcutical stitch

a suture line under the epidermis

199. For a CABG procedure with a saphenous vein harvest, the skin prep location is the chest and ____ a. Both legs b. The operative legs c. The abdomen, groin, both legs, and feet d. The groin and both legs

abdomen, groin, both legs, feet

1. What type of sterile surgical drape would you expect to use for a cholecystectomy? a. Leggings b. Extremity drape c. Abdominal drape d. Head drape

abdominal drape

1. Which of the following is NOT an emergency warning sign of SAR-CoV-2? a. New confusion b. Pale, grey, or blue-colored lips, nailbeds, or skin c. Pressure or persistent chest pain d. Ability to stay awake or awaken

ability to stay awake/awaken

1. An incomplete, inaccurate, or delayed diagnosis can have devastating consequences for the patient. What is a negative outcome of specimen mismanagement that can have a direct impact on any member of the surgical team? a. Increased morbidity and mortality b. Additional procedures c. Community distrust d. Exposure to blood and other potentially infectious materials

additional procedures

1. The last opportunity to detect a medication error before it reaches the patient occurs prior to which phase of the medication us process? a. Transcribing b. Procuring c. Administering d. Dispensing

adminstering

1. Which of the following materials are used in the composition of non-absorbable sutures? a. Cotton b. Metal c. Linen d. All of the above

all of the above

295. It is necessary for specimen containers to be a. Leak-proof b. Puncture resistant c. Large enough to contain the specimen and preservative d. All of the above

all of the above

8. What are signs the patient is experiencing local anesthetic systemic toxicity? a. Ringing in the ears b. Dizziness c. Tingling sensation around the lips d. All of the above

all of the above

1. Which of the following would be an appropriate action for the perioperative nurse when assisting with anesthesia? a. Document anesthetic agents used, dose, route, and time. b. Apply cricoid pressure if needed during intubation c. Administer the muscle relaxant reversal agent if needed. d. Extubate the patient

apply cricoid pressure if needed during intubation.

4. Which method is used to prevent aspiration during endotracheal intubation? a. Applying cricoid pressure b. Laryngoscopy c. Inserting a nasal/oral airway d. Invasive techniques

applying cricoid pressure

1. The RN telephones the patient to provide instructions on preoperative bathing before her carpal tunnel surgery the next day. What should the instructions include? a. Remove any hair at the surgical site b. Clean nails and remove any polish, gel or overlay c. Follow the soap/antiseptic manufacturer's instructions for use d. Bathe or shower with either soap or a skin antiseptic on the nigh before or the day of surgery e. Shampoo hair f. Do not apply locations, cosmetics or alcohol-based skin or hair products

b, c, d, e, f

17. Which of the following monitors assesses depth of anesthesia? a. Pulmonary artery catheter b. Bispectral index monitor c. Transesophageal echocardiography d. Central venous pressure

bispectral index monitor

1. Which of the following outlines sharps safety for the health care provider? a. Transmission-based precautions b. Standard of care c. Bloodborne pathogen standard d. Standard precautions

bloodborne pathogen standard

6. What complication can arise with tourniquet deflation at the end of a Bier Block Procedure? a. Lymphatic fluids b. Bacteria c. Thrombus d. Bolus of anesthetic

bolus of anesthetic

5. How can the perioperative nurse assist the anesthesia provider with placemen of a spinal or epidural block? a. Identify landmarks for insertion of the needle b. Thread the catheter through the needle c. Inject local anesthetic d. Calm the patient

calm the patient

1. Which of the following statements is FALSE regarding skin substitution wound management? Skin substitutes a. Stimulate wound healing b. Produce growth factors c. Can replace skin grafts as permanent wound closure d. Are a temporary wound treatment

can replace skin grafts as permanent wound closure

Signs of gas embolism

cardiac arrhythmia, hypoxemia, hypotension, decrease in ETCO2

First intention/primary wound healing mechanisms

clean, approximated incision is closed with suture

274. For initial gloving after you have donned a sterile gown, what self-gloving technique should you use? a. Closed gloving b. Open gloving c. Controlled gloving d. Open assisted gloving

closed gloving

293. When transferring the specimen off of the sterile field, the scrub should a. Use the transfer instrument for the closing count b. Pour sterile water into the specimen container c. Confirm, with the RN that the container is large enough for the specimen d. Wear two masks to avoid breathing in preservative fumes

confirm with the RN that the container is large enough

292. To decrease the possibility of specimen compromise, the scrub should a. Keep the specimen dry in a counted sponge b. Keep the specimen in a sterile basin under the mayo stand c. Cover and label the specimen d. Label the rim of the specimen container and cover the container with a water-soaked sponge

cover and label the specimen

1. The four major categories of instruments are a. General, orthopedic, plastic, GYN b. Hemostats, graspers, holders, forceps c. Cutters, clamps, retractors, other d. Army-navy, Deaver, self-retractors, senns

cutters, clamps, retractors, other

280. Which type of alloy finish on an instruments eliminates glare and is often used during laser surgery? a. Reflective b. Mirror c. Ebony d. Anodized

ebony

205. The purpose of the ASA Physical Status Classification System is a. To determine the anesthetic agent that will be used b. To evaluate the surgical risk to the patient c. To assist in predicting the length of stay needed in Phase I d. To predict length of time needed for recovery

evaluate surgical risk to patient

Ignition source exampe

example

1. What patient harm may occur due to a specimen management error? a. Appropriate treatment b. Community distrust c. Exposure to blood and body fluids d. Extended length of stay

extended length of stay

9. Which assessment factor is important to include when screening patients for potential risk of malignant hyperthermia? a. Patient's age b. Patient's use of over-the-counter medications c. Patients use of herbal and vitamin supplements d. Family history of problems related to anesthesia

family history of problems r/t anesthesia

1. The most frequently missed areas of the hand during hand hygiene are a. Fingertips and thumbs b. Back of hand and fingers c. Base of hand and wrists

fingertips and thumbs

Stage 4 pressure injury

full thickness skin and tissue loss

Stage 3 pressure injury

full thickness skin loss

1. Which option is NOT considered an element of stigmatization? a. Gender identity b. Race/ethnicity c. Health care access d. Gender

healthcare access

retention stitch

heavy suture reinforcing the primary line

7. What is the most consistent indicator of malignant hyperthermia during a surgical intervention? a. Elevated temperature b. Tachycardia c. Sustained muscle contraction d. Increased end tidal CO2

increased end tidal CO2

273. What is an example of a glove perforation indicator system? a. A smaller glove is worn under the top glove b. The wear's dominant hand is gloved in a different color c. Black ink appears on the glove when it is perforated d. The inner glove is a different color from the outer glove

inner glove is a different color from the outer glove

1. A stitch that is separate and tied independently of other stiches is called a(an) a. Running stich b. Purse-string stitch c. Interrupted stitch d. Retention stitch

interrupted stitch

1. What type of drape would you expect to use on an umbilical hernia repair? a. Head drape b. Stockinette c. Laparotomy drape d. Extremity drape

laparotomy drape

276. You are assigned to scrub for a surgical procedure with a high risk of blood and fluid exposure and a significant amount of fluid drainage and irrigation. Which ANSI/AAMI class of surgical gown should you wear? a. Level 1 b. Level 2 c. Level 3 d. Level 4

level 4

1. A common feature of the first intention/primary union wound healing mechanism is a. Need for antibiotic administration b. Minimal postoperative swelling c. Tissue loss d. Eventual approximation of skin edges

minimal postoperative swelling

15. Which of the following is NOT a duty of the perioperative nurse during surgery? a. Positioning forced-air warming equipment b. Monitory the patient according to the preoperative plan of care and making adjustments as needed c. Monitoring the patient's response to anesthesia d. Obtaining and checking blood products

monitoring pt response to anesthesia

Stage 1 pressure injury

non-blanchable erythema of intact skin

262. You will be using cloth towels to square off the incision area. It is best to secure the towels with a. Nothing; they will stay in place b. A perforating towel clamps c. Sterile adhesive tape d. A non-perforating clamp

non-perforating clamp

Atraumatic insturments

not causing damage or injury

12. The following professionals are qualified to provide anesthesia to a patient EXCEPT: a. Anesthesiologist assistant b. Certified registered nurse anesthetist c. Operating surgeon d. Anesthesiologist

operating surgeon

Stage 2 pressure injury

partial thickness skin loss with exposed dermis

1. If the facility policy and procedure does not describe steps for handling an infectious specimen, who would you call? a. Surgeon b. Pathology department c. Scrub person d. Physician assistant

pathology department

1. Which of the following is a negative consequence of a specimen error? a. Diagnosis accuracy b. Shorter length of hospitalization c. Timely treatment d. Potential litigation

potential litigation

1. Which is NOT a goal of preoperative patient skin antisepsis? a. Short application time b. Resident microbe reduction c. Soil and transient microorganism removal d. Rapid rebound of microbial growth

rapid rebound of microbial growth

1. What is a goal of surgical skin antisepsis? a. T allow for rapid regrowth of microbes b. To render the skin sterile c. To reduce the risk of the patient developing an SSI d. To slowly disrupt microbial life

reduce risk of SSI

1. This is a characteristic of robotic instruments and is defined as an instrument with a specific number of uses a. Ebonized b. Disposable c. Tempered d. Reposable

reposable

269. After an abdominal surgery is completed, who typically is tasked with removing the surgical drapes that are over the patient? a. RN b. Anesthesia professional c. Scrub d. Nursing assistant

scrub

Fuel example

surgical drapes

Purse string stitch

suture around a circular wound

1. Which of the following is TRUE regarding an abdominaoperineal prep? a. A single prep kit is used for both the abdomen and vaginal preps b. The bladder is emptied after the vaginal prep is completed c. The patient's abdomen is always prepped first, followed by the vaginal prep d. All the above

the bladder is emptied after the vaginal prep is completed

active hemostatic agents

thrombin products

Continuous/running stitch

uninterrupted suture line

324. Wound healing is influenced by numerous intrinsic and extrinsic factors. Which of the following could place stress on a fresh postoperative wound? a. Malnutrition and obesity b. Age and pre-existing conditions c. Immune systems response, respiratory, and circulatory status d. Vomiting coughing, edema

vomiting, coughing, edema

Second intention wound healing mechanism

wound heals by granulation, leading to wound contracture