CNOR AORN online test
a principle concept that the perioperative RN should be aware of during the cleaning of instruments is that after an operative or invasive procedure - all instruments are to be taken to the decontamination area and placed in a non-perforated instrument tray before decontamination to allow all surfaces to be exposed when processed in an automated cleaner. - All instruments opened for the procedure are to be taken to the decontamination area and placed in a perforated or mesh bottom instrument tray to allow all surfaces to be exposed when processed in an automated cleaner - all sharp instruments should be placed in a separate paper/peel-pack pouch inside the instrument tray when processed. - All shar instruments should be placed in a separate tray within a larger tray when processed.
...- all instruments are to be taken to the decontamination area and placed in a non-perforated instrument tray before decontamination to allow all surfaces to be exposed when processed in an automated cleaner.
22. recent studies have identified that a _________has been linked to an increase in pt care errors and worker injuries (eg, needle-stick injuries, musculoskeletal injuries)? 4 hr shift 8 hr shift 10 hr shift 12 hr shift
12 hr shift
the perioperative RN should ensure that the pt's intermittent pneumatic compression device remains "on" for a minimum of how many hrs per day during the intraoperative and immediate postoperative period? - 6 hrs - 8 hrs - 12 hrs - 18 hrs
18 hrs
23. perioperative team members should maintain short, natural fingernails; fingernail tips should be no longer than 2 mm (0.08") 6mm (0.25") 1.25mm (0.5") 2.5mm (1")
2 mm (0.08")
if a state law does not specify a time frame for a physician to authenticate a verbal order, the federal mandate requires the physician to authenticate the verbal order within___hrs 12 24 36 48
48
to provide optimal pt care for a pt scheduled fro moderate sedation/analgesia, the RN manager should assign one perioperative RN to circulate and - a certified RN anesthetist to manage the pt receiving moderate sedation. - A second RN to manage the pt receiving moderate sedation - a surgical technologist to scrub - an anesthesiologist to provide monitored anesthesia care to the pt
A second RN to manage the pt receiving moderate sedation
if surgical smoke is not evacuated out of the pneumoperitoneum during minimally invasive surgery, the pt is at risk for - delayed wound healing hypothermia, and deep vein thrombosis due to unrelieved abdominal pressure - cancer cells spreading into the retroperitoneal space - infection due to smoke absorption by the white blood cells. - Absorption and excretion of smoke by-products and carboxyhemoglobinemia.
Absorption and excretion of smoke by-products and carboxyhemoglobinemia.
the bowie-dick test is used for which of the following? - determining the correct temperature reached in a low-temperature hydrogen peroxide gas plasma sterilizer. - Detecting air leaks, ineffective air removal, and non-condensable gases in the chamber of a dynamic air-removal steam sterilizer - determining the penetration of the sterilizing agent in immediate use of steam sterilizer. - Determining the proper functioning of an ethylene oxide sterilizer.
Detecting air leaks, ineffective air removal, and non-condensable gases in the chamber of a dynamic air-removal steam sterilizer
the final count should not be considered complete until all sponges used in closing the wound - are documented in the medical record - have been placed in waste containers - have been removed from the OR or procedure room. - Have been removed from the wound and returned to the scrub person.
Have been removed from the wound and returned to the scrub person.
when the retractable magnetic resonance imaging (MRI) scanner is in use in a hybrid OR, the OR is considered to be MRI zone I II III IV
IV
for what procedures should scrubbed team members double glove (ie, wear one glove over another)? - all operative and other invasive procedures - all operative and invasive procedures as identified by an interdisciplinary team of Rns, infection preventions, and surgeons at each health care facility. - Invasive procedures with the potential for exposure to blood, body fluids, and other potentially infectious materials - invasive procedures during which powered surgical tools will be used.
Invasive procedures with the potential for exposure to blood, body fluids, and other potentially infectious materials
isolation technique should be implemented to reduce the potential for - microorganism in the bowel to transfer into the abdominal cavity during bowel surgery and microorganism in the chest cavity to transfer into the ambient air of the OR. - Microorganisms in the bowel to transfer into the abdominal cavity during bowel surgery and the potential spread of cancer cells to other regions of the body during resection of metastatic tumors. - Microorganisms in the bowel to transfer into the abdominal cavity during bowel surgery.
Microorganisms in the bowel to transfer into the abdominal cavity during bowel surgery and the potential spread of cancer cells to other regions of the body during resection of metastatic tumors.
how can the perioperative RN implement complementary care interventions to the extremely anxious pt in the preoperative area? -Administer oxygen by nasal cannula at 2L/minute and instruct the pt to take slow, deep breaths. - closely monitor the pt's vital signs. - Obtain disposable headphones for the pt and help the pt select music - request an order from the anesthesia professional for IV midazolam to administer to the pt.
Obtain disposable headphones for the pt and help the pt select music
when positioning the pt in reverse Trendelenburg for a computer-assisted procedure, the perioperative RN should be aware that this position. - increase cardiac output and can result in misalignment of the apt's extremities - increase venous return and can result in misalignment of the pt's extremities - reduce cardiac output and decrease peripheral and pulmonary resistance. - Reduce venous return and cardiac output and increase peripheral and pulmonary resistance.
Reduce venous return and cardiac output and increase peripheral and pulmonary resistance.
a 50-yr-old woman is awake and alert in the postanesthesia care unit after left knee arthroplasty. What is the best measure that the perioperative RN should use to assess the pt's pain intensity? - discussion of the pt's pain with a close family member - facial expression, behaviors, and ability to achieve functional goals for each day after surgery. - Self-report on a standardized pain scale - vital sign changes.
Self-report on a standardized pain scale
what do the AORN guidelines recommend for sterilization of implantable medical devices? - immediate use steam sterilize the implant device for 10 minutes in a steam sterilizer with a biological monitoring device and then use immediately - immediate use stem sterilize the implant for 3 minutes with a biological monitoring device and then use immediately - release the implant before the results of the biological monitoring device are known, then report the results to the surgeon as soon as the result is available. - Sterilize then quarantine the implantable device and await the outcome of biological monitoring to display a negative result.
Sterilize then quarantine the implantable device and await the outcome of biological monitoring to display a negative result.
which of the following measures should be taken to prevent accidental activation or misdirection of laser beans? - all learn members in proximity to the leaser user should be able to activate the laser via the foot control device. - The laser should be placed in the "stand by" mode when it is not in sue and the procedure is still occurring. - The laser foot control should be placed out of immediate reach of the laser user to prevent it from accidentally firing - the laser RN should be able to attend to other matters while the laser is in active use and being monitored by the laser user.
The laser should be placed in the "stand by" mode when it is not in sue and the procedure is still occurring.
with what organization must facilities that procure, process, and/or preserve autologous tissue and facilities that store tissue for potential transfer to a different facility register as tissue banks? - centers for disease control and prevention - centers for Medicare & Medicaid services - US Food and Drug Administration - the Joint Commission
US Food and Drug Administration
the HVAC, surgical attire, and traffic pattern requirements of the surgical suite are designed to be more stringent as personnel move from. - restricted to semi-restricted areas. - Restricted to unrestricted areas. - Semi Restricted to unrestricted areas. - Unrestricted to restricted areas.
Unrestricted to restricted areas.
19. to prepare for a brain biopsy to rule out Creutzfeldt-Jakob disease, the perioperative RN should - ask the OR charge RN to assign an additional scrub person to help with the procedure - notify the pt of all of the special precautions that are being taken to ensure the staff member's safety - open the standard reusable brain biopsy tray with all of the extra instruments that may be needed. - Use a disposable brain biopsy set, linens, drapes, and equipment
Use a disposable brain biopsy set, linens, drapes, and equipment
what statement related to medication management in an ASC is TRUE? - a pharmacist may be contracted by the health care organization to provide consultative services on site or by telepharmacy. - An rn or pharmacist may be contracted by the health care organization to provide pharmaceutical services. - Pharmaceutical services must be provided by a pharmacist who is on site at the ASC. - Physicians and pharmacists are the only licensed professional who may provide pharmaceutical services at an ASC
a pharmacist may be contracted by the health care organization to provide consultative services on site or by telepharmacy.
33. when providing care for a pt who is suspended to be infected or colonized with rubeola or varicella zoster, the perioperative RN should follow what type of precautions in addition to standard precautions? - airborne precautions - contact precautions - droplet precautions = no other precautions are necessary
airborne precautions
what laboratory value can assist the perioperative RN determining a surgical pt's nutritional status for effective wound healing? -albumin -electrolyte panel -hemoglobin -potassium
albumin
surgical pts at risk for venous thromboembolism include - all surgical pts - elderly perioperative pts - obese pts - pts taking oral contraceptives
all surgical pts
to decrease the potential for _____ during spinal surgery, the perioperative RN should ensure that the cardiac monitoring leads and neuromuscular monitoring cords are as far as possible from the electrosurgical handpiece cord - antenna coupling - capacitive coupling - direct coupling - insulation failure
antenna coupling
where should a wand (ie, capture device) of the smoke evacuation system be positioned at the surgical field? - as close as possible within 2" of the source of the smoke - near the source of central wall suction - 6 to 12" from the source of the smoke - 1 foot from the source of the smoke to capture any diffuse smoke
as close as possible within 2" of the source of the smoke
which biological indicator should be used to test ethylene oxide sterilizer efficacy? - aspergillus spp - bacillus atrophaeus - c difficile - geobacillus stearothermophilus
bacillus atrophaeus
Mohs surgery involves excision lesions layer by layer for surgeries involving treatment for - basal cell and squamous cell carcinomas - endometrial carcinoma - large cell carcinoma - mesothelioma
basal cell and squamous cell carcinomas
when should leak testing of a flexible endoscope be performed? - after manual cleaning and before it is placed into cleaning solution - after manual cleaning and being placed into cleaning solution and before drying - at the point of use during precleaning - before manual cleaning and before it is placed into cleaning
before manual cleaning and before it is placed into cleaning.
if a pt experiences a cardiac arrest in a hybrid OR when the magnetic resonance imaging (MRI) scanner is in use, the first action the perioperative rn should do to assist the team is - begin basic cardiopulmonary resuscitation and retract the MRI scanner back into the holding bay - call for help, bring in the code cart and resuscitate the pt. - Remind the team that the MRI scanner is in use and follow the facility protocol - turn off the MRI scanner by pushing the quench button
begin basic cardiopulmonary resuscitation and retract the MRI scanner back into the holding bay
what should the water temperature be for hand hygiene? - 60 F (15.6C) or lower - between 60 F and 100 F (15.6c to 37.8C) - between 70 F and 80F (21.1C and 26.7C) - 80F (26.7C) or higher
between 70 F and 80F (21.1C and 26.7C)
what type of indicator should be used to monitor sterilizer efficacy? - biological indicator - chemical indicator - class 5 chemical integrating indicator - physical monitor
biological indicator
which of the following chemical indicator tests detects air leaks, ineffective air removal, and presence of non-condensable gases in a dynamic air removal steam sterilizer? - bacillus atrophaeus (biological indicator) - bowie-dick test (class 2 chemical indicator) - class 5 ( integrating indicator) - geobacillus stearothermophilus (biological indicator)
bowie-dick test (class 2 chemical indicator)
a 25-yr-old man is scheduled for surgery to place a venous access port to be used for administration of his chemotherapy medication. During the preoperative assessment, the perioperative RN review the recent arterial blood gases report. The results are pH 7.2, PaCO2 50, and HCO3 26. what is the perioperative RN's most likely action regarding the test results? - administer additional pain medications that were ordered preoperatively and ask the physicians for an order for supplemental oxygen - call the code arrest team - closely monitor the vital signs for changes and notify the physician of abnormal findings - encourage the pt to take deep breaths, contact the physicians, and request ab oxygen from the anesthesia professional
call the code arrest team
The neurosurgeon's preference sheet indicates he will remove hair at the surgical site. What is the recommended method for hair removal? clippers depilatory cream razor straight-edged barber's razor
clippers
a pt who is experiencing severe pain, a lack of sensation, swelling, vascular compromise, and restricted movement in the extremity after the use of a pneumatic tourniquet is most likely exhibiting the clinical manifestations of - bacterial overgrowth syndrome - compartment syndrome - pressure ulcer development. - Toxic antenor segment syndrome.
compartment syndrome
a perioperative RN assesses an adult female pt who is scheduled for a breast biopsy and local anesthesia. She learns that the pt has a past history of myocardial infarction. What should the perioperative RN do? - cancel the surgery - consult with the surgeon to determine the plan of care. - Notify the supervisor - postpone the surgery and request a cardiology consultation.
consult with the surgeon to determine the plan of care.
32. where should the hand washing station be placed in a single-room endoscopy processing area? - clean work area - decontamination area - center of the room - outside the entrance to the room
decontamination area
the occupational risk of the hepatitis B virus (HBV) is - dependent on the level of exposure to blood and the type of hepatitis B antigens. - Dependent on the virulence of the bacteria - not a risk factor for infection for the pt - slightly increased since the widespread adoption of the HBV immunizations
dependent on the level of exposure to blood and the type of hepatitis B antigens.
which of the following is an example of a recommended quality improvement activity to monitor and improve the prevention of sharps injuries? - developing processes to measure rates of percutaneous injuries and near misses - providing ongoing feedback to perioperative team members about improvement in the prevention of retained items - purchasing new safety straps secure pt's on the OR bed - using hand hygiene data to determine whether an individual organization is within benchmark goals
developing processes to measure rates of percutaneous injuries and near misses
what is the most common safety issue that should be addressed preoperatively when caring for any pt with an existing implantation electronic device(eg, pacemaker, internal cardiac defibrillator, ventricular assist device)? - electromagnetic interference - inadvertent device activation - inadvertent device failure - monopolar surgery equipment interference.
electromagnetic interference
which of the low-temperature sterilization methods is an alkylating agent that disrupts proteins and DNA and is lethal to microbes? - ethylene oxide - low-temperature gas plasma sterilization - low-temperature hydrogen peroxide vapor sterilization - steam sterilization.
ethylene oxide
the sterility of an item is -dependent on multidisciplinary team decisions - event-related and dependent on whether the integrity of the item has been maintained - dependent on hospital protocol and community standards. - Time-limited, event-related, and dependent on whether the integrity of the item has been maintained
event-related and dependent on whether the integrity of the item has been maintained
how often should surgical gloves are worn during invasive surgical procedures be changed during the procedure? - every 60 to 90 minutes - every 90 to 150 minutes - surgical gloves only require changing if a known or suspected break-in technique occurs or a tear in the glove is identified - there is no recommended time for changing gloves
every 90 to 150 minutes
how often should surgical gloves are worn during invasive surgical procedures be changed during the procedure? - every 60 to 90 minutes - every 90 to 150 minutes - surgical gloves only require changing if a known or suspected break-in technique occurs or a tear in the glove is identified. - There is no recommended time for changing gloves.
every 90 to 150 minutes
a pt is in the postanesthesia care unit after surgery involving an open reduction internal fixation of a fractured right femur. The perioperative RN observes the following signs: the pt is experiencing respiratory distress as demonstrated by tachypnea, his heart rate is 160, the pt appears anxious an agitated, and there are petechiae present on the pt's chest. The pt in most likely exhibiting signs of - an ineffective response to pain medications - elevation myocardial infarction - compartment syndrome - fat embolism syndrome.
fat embolism syndrome.
as the scrub person passes and autologous vein graft to the surgeon, the graft inadvertently drops onto the OR floor. What should the perioperative RN do? - follow a predetermined process according to the hospital policy related to when an autologous tissue is dropped - inform the surgeon that according to the collective evidence, a dropped vein graft is considered highly contaminated and should not be replanted - notify the OR charge RN - prepare to sterilize the autologous vein graft using a low-temperature sterilization method
follow a predetermined process according to the hospital policy related to when an autologous tissue is dropped
an ambulatory surgery center (ASC) does not have a radiology department at the facility. When surgical count discrepancies occur, what actions should be taken 1st by the perioperative rn? - arrange for the pt to be x-rayed for the missing item at the closest hospital - document the results of the surgical count - follow the ASC's standardized process to locate the missing item - inform the pt's family or caregiver that the procedure is taking longer than expected due to the missing item
follow the ASC's standardized process to locate the missing item
mr. hones is a 68-yr-old obese man with a history of prostate cancer and cardiac disease. He is scheduled for a lengthy orthopedic knee procedure. It is important that during the preoperative assessment the perioperative RN recognized that mr. Jones is at - greater potential for risk for venous thromboembolism (VTE) formation - no greater potential for risk for VTE formation - lower potential for risk for VTE formation - moderate potential for risk for VTE formation
greater potential for risk for venous thromboembolism (VTE) formation
the timing of the administration of a preoperative prophylactic antibiotic ordered for a pt whose plan of care includes the use of a pneumatic tourniquet should be based on the -anesthesia professional orders - anticipated length of pt's postoperative recovery from planned surgical procedure -average length of time to perform the surgical procedures - health care organization's policy and procedure.
health care organization's policy and procedure.
unauthorized access to a pt's health information is in violation of the ____ - american recovery and reinvestment act of 2009 - budget control act of 2011 - health insurance portability and accountability act of 1996 - safe medical devices act of 1990
health insurance portability and accountability act of 1996
a solution of 2% glutaraldehyde is categorized as which of the following type of disinfectant? critical level high level intermediate level low level
high level
a root cause analysis is conducted after it is discovered that a laparotomy sponge was left in a patient's abdomen after a surgical procedure. In response to this event, which of the following actions would be consistent with conducting a root cause analysis? - apologize and disclose the error to the patient - identify and analyze each step of the surgical count process that is in place at the facility. - Identify the involved perioperative learn members and initiate disciplinary actions - report the event to the designated hospital accreditation organization
identify and analyze each step of the surgical count process that is in place at the facility.
the perioperative RN maintains rapport with the pt during the procedure being performed under moderate sedation/analgesia to verify the level of consciousness. This practice represent which phase of the nursing process? assessments evaluation implementation planning
implementation
according to the 2012 consensus statement and call to action endorsed by 20 organization, what was identified as the number-one priority to reduce percutaneous injuries? - advocating for increased sharps safety legislation - improving sharps safety in surgical settings - reducing the number of sharps in surgical settings - providing sharps safety education to all health care
improving sharps safety in surgical settings
evidence suggests that the most common causes of sentinel events are communication failure and - failure to provide a handover communication - incomplete or missing pt information - use of abbreviations - use of acronyms
incomplete or missing pt information
during surgery, a surgeon is assistant comments," sounds from the electrosurgical unit always give me a headache. Can you turn off the sound?" the perioperative RN's response to this request should be - ask the supervisor to come into the OR and explain the policy - inform the surgeon's assistant that she can replace the electrosurgical unit with another similar device that does not have the activation sound - inform the surgeon's assistant that the activation sound of the ESU is a pt safety device and it should be audible. - Turn down the volume of the ESU because the sound is annoying to everyone on the OR team, not just the surgeon's assistant.
inform the surgeon's assistant that the activation sound of the ESU is a pt safety device and it should be audible.
perioperative Rns can demonstrate environmental responsibility in the perioperative setting by advocating for the facility to - install motion-activated water fixtures at the scrub sinks and hand washing stations - purchase scrub attire dispensers - recycle single-use sterile supplies - use disposable paper towel dispensers.
install motion-activated water fixtures at the scrub sinks and hand washing stations
47-yr-old man who was struck by a car 2 days ago has returned to surgery for the removal of the therapeutic abdominal packing left inside the wound from the previous surgery. What should the perioperative RN do after the packing material is removed from the wound? - isolate the packing material and not include it in the counts for the removal procedure. - Isolate the packing material to a defined area on the back table - reconcile the surgical count and include the packing material in the count. - Send the packing material to the pathology lab.
isolate the packing material and not include it in the counts for the removal procedure.
at a minimum, what type of personal protective equipment should perioperative team members wear when performing manual high-level disinfection? - mask and eye protection - mask, eye protection, and chemical resistant gloves - maks, moisture-repellent gown, and gloves - PVC gloves and moisture-repellant gown
mask, eye protection and chemical resistant gloves
mr. S is a 24-yr-old pt with a diagnosis of diabetic ketoacidosis from the emergency department (ED). In the transfer-of-care report, you learn that his blood glucose on arrival was 780 mg/dL. He has been started on an insulin drip, and the ED RN gives you the arterial blood gases(ABG) report. What do mr. S's ABG values indicate? PH 7.22, PaCO2 25, HCO3 12 - metabolic acidosis with respiratory compensation - metabolic alkalosis with respiratory compensation - respiratory acidosis with metabolic compensation
metabolic acidosis with respiratory compensation
during the surgical count before closure of the peritoneum, the scrub person and the RN circulator are unable to locate a laparotomy sponge. What should the surgeon do? - contact the radiology department scheduler to obtain a stat x-ray for instrument and sponge verification - inform the charge RN - methodically explore the wound before closing - re-open all bagged and discarded sponges and recount them
methodically explore the wound before closing
what is an effective medium in which to store an avulsed tooth when immediate replantation is not possible? - Carbonate water - hydrogen peroxide - milk - water
milk
what is the purpose of maintaining asepsis in the surgical environment? - ensuring no breaks in sterile technique - guaranteeing that pathogens do not harm the pt - minimizing contamination of the surgical wound - minimizing wound contamination and reducing the pt's risk for surgical site infection
minimizing wound contamination and reducing the pt's risk for surgical site infection
a pt is scheduled to return to surgery for replantation of his cranial born flap that has been stored in a designated tissue freezer in the OR. As part of the preoperative preparation for this procedure, the perioperative RN should first verify the - location of the pt's cranial bone flap in the freezer and remove it from the freezer to begin the thawing procedure as outlined in the hospital policy - name of the surgeon performing the procedure - processing, labeling, storage, and cultures for this pt are satisfactory before retrieving the cranial bone flap from the designated storage area - scheduled time of the replantation procedure
name of the surgeon performing the procedure
an rn circulator hears an anesthesia professional ask an unlicensed assistive person (UAP) to push IV. What should the perioperative rn immediately do? - help the UAP administer the IV push medication - notify the charge rn that the UAP is performing a task that is not within his job description - offer assistance to the anesthesia professional so that the anesthesia professional can administer the medication himself - tell the UAP to stop and the perioperative rn should administer the medication for the anesthesia professional.
offer assistance to the anesthesia professional so that the anesthesia professional can administer the medication himself
identify the correct protocol for assisted gowning and gloving - ask the RN circulator to first gown and glove and then assist the incoming team member - open the gown and gloves on the back table and have the scrub RN gown and glove the incoming team member - open the sterile gown and gloves on the back table and have the incoming team member gown and glove himself or herself - using aseptic technique, open the sterile gown and gloves on a separate surface.
open the gown and gloves on the back table and have the scrub RN gown and glove the incoming team member
the role of the health care industry representative includes all of the following except - opening sterile implants and instructing the surgeon and the assistants how to implant the medical devices - providing one-on-one instruction for the perioperative team related to the medical device. - Providing technical support according to the health care organization's policies and local, state, and federal regulations - teaching in-service programs to the perioperative team related to the medical device
opening sterile implants and instructing the surgeon and the assistants how to implant the medical devices
17. what nursing activity can a perioperative RN delegate to an unlicensed assistive person? - assessment of the pt's skin - evaluation of nursing care - organization of supplies - planning the pt's care
organization of supplies
research indicates the nurses who can relate the pt diagnosis to the planned intervention are more - assignment oriented - attentive to detail - outcome focused - task oriented
outcome focused
25. a perioperative RN's documentation for postoperative pt, "the pt is free from pain or numbness associated with surgical positioning," is an example of a nursing assessment diagnosis intervention outcome statement
outcome statement
What is the leading and most costly occupational health problem in the united states? - headache - needlesticks and sharps injury resulting in exposures to transmissible diseases - overexertion leading to back strains sand sprain - overwork leading to fatigue
overexertion leading to back strains sand sprain
when the OR suite is empty for a period of time, the use of an HVAC setback system to reduce the number of air exchanges per hr is cost-effective and may be used if the - humidity level is maintained within a range of 40% to 60% - negative-pressure relationship of the OR to the adjacent area is maintained - positive-pressure relationship of the OR to the adjacent area is maintained - temperature is maintained within a range of 72F to 78F (22C to 26C)
positive-pressure relationship of the OR to the adjacent area is maintained
which of the following approaches would be most effective to ensure that the perioperative lean abl to take appropriate actions when a pt experiences a malignant hyperthermia (MH) crisis? - delegate all responsibility for the recognition and treatment of MH in the OR setting to the anesthesia personnel present - prepare an MH protocol for the OR that outlines the role of the perioperative RN, verify clinical competency in the protocol, and review this protocol periodically with the OR staff - require that all perioperative Rns attend an emergency in-service program pertaining to the risk of general anesthesia and MH - require that selected perioperative team members read professional journal articles relate to MH, and present a brief unit in-service review on the topic.
prepare an MH protocol for the OR that outlines the role of the perioperative RN, verify clinical competency in the protocol, and review this protocol periodically with the OR staff
24. a primary concern for an RN preparing a premature infant for surgery is to initiate measure to - ensure that all supplies are assembled before the pt arrives - ensure that the anesthesia professional is standing by - maintain proper body alignment - prevent loss of body heat
prevent loss of body heat
what type of radiation might perioperative team members be exposed to? - primary and leakage - primary -primary, leakage, and scatter - scatter
primary, leakage, and scatter
in addition to the pt's identity, which of the following should be confirmed to help decrease the risk for wrong site surgery? allergies medication history previous responses to general anesthesia procedure and site
procedure and site
evidence-based practice questions are typically formatted as PICO questions. What does PICO stand for? - pt, intervention, comparison, outcome - pt, investigation, comparison, outlier - population, intervention, counter-intervention, outlier - problem, investigation, counter-intervention, outcome
pt, intervention, comparison, outcome
the evidence supports performing medication reconciliation during all phases of pt care to - decrease the amount of medication a pt is required to receive - educate the pt about medication interactions - increase medication practices compliance by the pt - reduce medication errors
reduce medication errors
evidence supports perioperative RN's implementing aromatherapy as a complementary care intervention to -decrease the pt's heart rate -decrease the pt's pain level - increase the pt's level of consciousness - relieve the pt's anxiety
relieve the pt's anxiety
following and appendectomy, a blistered area noted on the pt's left thigh where the electrosurgical grounding pad as placed. In addition to documenting the finding, what should the perioperative RN do? - apply a thin coating of antibiotic ointment to the affected area - check the hypothermia unit for any signs of malfunction - check the perioperative assessment for documentation of any allergies - remove the electrosurgical unit (ESU) from service and save the active and dispersive electrode devices, including the ESU pad package.
remove the electrosurgical unit (ESU) from service and save the active and dispersive electrode devices, including the ESU pad package.
the scrub RN setting up for an emergency cesarean delivery examines the laparotomy sponges on the back table and notes that no radiopaque detectable strip is visible. What is the appropriate response to this situation? -make note of the missing strips on the operative record and proceed with the sponge count -proceed with the count but have the RN circulator obtain a second package -proceed with the sponge count to avoid delaying the start of the emergency procedure - remove the laparotomy sponges from the OR and obtain a new package for the setup
remove the laparotomy sponges from the OR and obtain a new package for the setup
After a vaginal hysterectomy, a healthy 47-yr-old woman is in the postanesthesia care unit. Her body mass index is 22. her arterial blood gas test results are pH 7.52, PaCO2 28, HCO3 24. the patient's condition is metabolic acidosis metabolic alkalosis respiratory acidosis respiratory alkalosis
respiratory alkalosis
Mr. w is a 52-yr-old man in the emergency department complaining of shortness of breath and tingling fingers. His breathing is shallow and rapid. He denies that he has diabetes, and his blood sugar is within normal limits. There are no electrocardiogram changes. He has no significant respiratory or cardiac history. He takes several anti-anxiety medications. He says he has had anxiety attacks in the past. While Mr. w is being worked up for chest pain, a blood specimen is drawn for testing arterial blood gasses (ABG). What do mr. w's ABG values indicate? pH 7.48, PaCO2 28, HCO3 22 metabolic acidosis metabolic alkalosis respiratory acidosis respiratory alkalosis
respiratory alkalosis
the perioperative rn should be recognized that the most common complication for a pt with multiple traumatic injuries is fluid and electrolyte imbalance hemorrhage infection shock
shock
30. according to the AORN guidelines, a sterile field - should be covered when there are no staff monitoring an empty procedure room that has been set up with sterile supplies for a procedure that has been delayed. - should never covered because there is no practical way to remove the cover without contaminating the sterile setup - may be covered in manner that allows the covering drape to be removed without bringing the part of the covering drape that falls below the sterile field above the sterile field - may be covered by two persons in sterile attire using sterile technique, to ensure there is no contamination of the cover.
should never covered because there is no practical way to remove the cover without contaminating the sterile setup
ropivacaine is an aminoamide local anesthetic that has a -fast onset and long duration of action. fast onset and short duration of action - slow onset and long duration of action - slow onset and short duration on action.
slow onset and long duration of action
18. a surveyor comments to the perioperative director that one team member is not following the AORN guidelines related to surgical attire. Which team member is he referring to? - RN circulator who is wearing a long-sleeved scrub shirt while performing preoperative skin antisepsis for a surgical pt in the OR - sterile processing team member who is wearing a short-sleeved scrub top while preparing and packaging items in the clean assembly area of the sterile processing department - scrubbed RN who is wearing protective eyewear during an orthopedic trauma procedure surgeon who is wearing a hood as a head cover, goggles, and a surgical mask
sterile processing team member who is wearing a short-sleeved scrub top while preparing and packaging items in the clean assembly area of the sterile processing department
a nurse manager is interviewing and experienced perioperative RN and is interested in how the RN makes pt care decisions. Select from the following a statement that could help the nurse manager elicit information about the RN's critical thinking skills for pt care. - tell me about a time when you were successful in learning about and using a complicated piece of medical equipment safely. - Tell me how precious colleagues in the work setting would describe your skills and abilities - tell me about a difficult work conversation and your actions related to this conversation - tell me about a clinical situation where you anticipated a problem with a pt and your actions related to the problem
tell me about a clinical situation where you anticipated a problem with a pt and your actions related to the problem
prior to growing a resident who just completed his surgical hand scrub, the scrub RN notices that the new resident is still wearing his ring and watch. What should the scrub RN do? - gown the new resident and use the closed assisted gloving method - instruct the new resident to gown and glove himself at the small table - remind the new resident about the importance of following the sterile technique - tell the new resident to remove his ring and watch, re-scrub his hands and then return to the OR for assistance with gowning and gloving
tell the new resident to remove his ring and watch, re-scrub his hands and then return to the OR for assistance with gowning and gloving
the perioperative rn should select a pneumatic tourniquet cuff - based on the pt's age and blood pressure - by considering the average length of the planned surgical procedure - after the pt is under anesthesia and positioned on the OR bed and the surgeon is in the OR - that is long enough so that bladder of the tourniquet overlaps sufficiently on the limb.
that is long enough so that bladder of the tourniquet overlaps sufficiently on the limb.
A pt is on a stretcher in the perioperative ready area. When he arrived at the facility's surgery admission desk that morning, he appeared disheveled and incoherent. Laboratory blood tests indicated a high level of cocaine in his system. The anesthesia professional was at the pt's side discussing the need to postpone the surgery with the surgeon when the pt became belligerent and forcefully grabbed the anesthesia professional's neck. The pt was placed into restraints. In this situation, why were restraints necessary? - the pt was incoherent - the pt posed a threat to himself - the pt posed a threat to the anesthesia professional - the pt was using illegal drugs before his surgery
the pt posed a threat to the anesthesia professional
when loaned instruments will be used in a surgical procedure, who assumes the responsibility of ensuring that the items are sterile? - the industry representative - the loaning hospital - the loaning hospital only if the items are sent in a sterile, closed, plastic wrap - the receiving hospital
the receiving hospital
well-constructed physician order sets should include all of the following except - a recent review date - acceptable abbreviations - trailing zeroes in medication dosages - standardized names and terms
trailing zeroes in medication dosages
when opening a basin to add to the sterile field, the perioperative RN notes water droplets on the inside of the basin. The basin is considered - sterile, since condensation occurred after sterilization - sterile, since the wrap material is absorbent and water-impermeable - unsterile and contaminated - unsterile, unless wrapped in water-impermeable film.
unsterile and contaminated
the risks for alternate site injuries that can occur due to insulation failure of the endoscopic equipment and/or the phenomenon of capacitive coupling can be decreased by - irrigating the area with electrolyte solutions - performing preoperative and postoperative skin assessments - placing the active electrode in a plastic holder when it is not in use - using active electrode monitoring
using active electrode monitoring
positioning a pt undergoing abdominal myomectomy procedures in a 10-degree reverse Trendelenburg position may reduce the risk for -cardiac arrhythmias - pressure injury - respiratory insufficiency - venous air embolism
venous air embolism
if exposure to blood or other potentially infectious materials is anticipated, team members at the sterile field should - change gloves every 30- 60 minutes - change gowns and gloves after 60 minutes - wear two pairs of gloves while draping and remove the top gloves after draping - wear two pairs of surgical gloves, one over the other
wear two pairs of surgical gloves, one over the other
