Peri-Op 101 AORN Study Guide

A. Cultural beliefs and practices B. Expressed level of anxiety or stress C. Spiritual or religious beliefs D. Understanding of the surgical procedure

A psychosocial assessment may include the patient's: Select all that apply

C. The nurse is responsible for knowing, understanding and complying with the facilities emergency electrical outage pace

When faced with an electrical power outage in the OR it is most important for the preoperative RN to remember that:

A. Mobility C. Planned duration of the procedure D. Preexisiting healthy conditions E. Type of anesthesia

When making the preoperative assessment, the nurse should take the following into considerations. Select all that apply

A. Have a backup tank available C. Verify that the CO2 pressure and supply alarms are on and functioning

When setting up insufflation equipment for an abdominal endoscopic procedure the preoperative nurse should: Select all that apply

D. Set the initial insufflators pressure to 12mmHg

When setting up the insufflator for a robotic hysterectomy procedure, the perioperative nurse should do all of the following except:

A. The patient is free from signs and symptoms of infection

Which PNDS outcome is the most important when draping the surgical patient?

What are the 3 main factors to consider when assessing the patient for allergies?

C. Prior reaction, heredity, type of reaction

A. Elevate (offload) heels off the bed

The best intervention to prevent intraoperative pressure ulcer development on the patient's heels would be to:

A. Clean the sublingual areas of both hands using a disposable nail cleaner B. Dispense an approved antimicrobial scrub agent onto wet arms and forearms D. Wash all four sides of each finger, hand, and arm and repeat on the opposite side E. Wash your hands and forearms with soap and running water

A surgical hand scrub includes the following steps: Select all that apply

You are assigned to relieve a surgical technologist for lunch. You will need:

A. A sterile gown and gloves opened on a table (other than the main instrument table) for closed gloving.

What responsibilities do OR staff members have in maintaining a safe OR environment? Select all that apply.

A. Adhering to facility policies related to safety B. Consistently applying OR specific safety practices D. Monitor, identify and report safety hazards.

After initial administration, which statement below the proper order of the 4 stages of general anesthesia affecting the patient?

A. Administration, excitement, intrasurgery, respiratory failure

In preparing for a regulatory survey, your quality consultant questions you about the restricted zone in your OR suite. The following statements are true:

A. Air flow in the OR rooms should be cleaned by HEPA filters. C. Mask are required when open sterile supplies are present. E. Temperature is maintained between 68 and 75 degree F.

B. Corticosteroids may potentially delay wound healing C. People with diabetes have a higher risk for infection due to the increase in glucose levels D. Smoking as been documented to increase the probability of nonunion at a fracture site

A 72 year old man is scheduled for a procedure to repair his right hip fracture. He has a history of smoking and diabetes, and is currently taking prednisone for his rheumatoid arthritis. You are concerned about his wound healing post-operatively based on the following factors: Select all that apply

A. Neutral zone

A __________ is a designated area on the sterile field where the scrub person and the surgeon place all sharp instruments.

C. Chlorhexidine gluconate

A patient is scheduled for reconstruction of her external ear following a dog bite injury. Which of the following skin prep agents is contraindicated for use in this case?

B. Request additional personnel to assist with patient transfer C. Use a friction-reducing transfer sheet. D. Use a slider or roller board E. Use the draw sheet to lift the patient slightly to allow the skin to realign with the skeletal structures

A patient is unable to transfer independently to the procedure bed, to achieve the outcomes related to safe patient transfer, which measures may be used to prevent shearing injury? Select all that apply.

Which of the following methods listed below may prevent mishap, event, or fire from occurring when handling electrosurgical equipment? Select all that apply.

A. Allow enough time for alcohol based skin preparations to completely dry. B. Do not use in an oxygen-enriched environment, such as the trachea when oxygen is being "blown over" the patient. D. Visually check the integrity and insulation of all cords and coagulation instruments before use.

The following steps can be used to reduce personnel exposure to specimen fixatives such as formalin. Select all that apply.

A. Avoid splashing while pouring C. When pouring wear gloves and a mask. D. Use absorbent material and then triple rinse with water any area or surface where accidental formalin spillage occurs. E. Store fixatives securely so they are inaccessible to persons unfamiliar with their use.

When a "Time Out" discrepancy occurs, the nurse's priority action should be to:

A. Call the patient's family to make them aware of the situation. B. Document the "Time Out" discrepancy C. Notify the manager or administrator D. Stop the procedure from beginning until the discrepancy is resolved

An important difference between minimally invasive (MIS) and open surgical procedures is that MIS:

A. Can be performed through smaller incisions.

The first step in the sterilization process of surgical instruments that have been used in case is:

A. Cleaning

Intrinsic and extrinsic factors that may lead to development of preoperative pressure ulcer include: Select all that apply.

A. Duration of the procedure B. Exaggerated positions C. Circulatory disorders D. Malnutrition

Which of the following practices is recommended when transferring from gurney to the OR bed? Select all that apply.

A. Ensure that wheels are locked on both the OR bed and gurney prior to beginning transfer. D. Secure lines and catheters prior to the move and dislodging.

The preoperative team implements aseptic technique practices to meet all of the following primary goals EXCEPT?

A. Improve patient satisfaction

When applying the concept of surgical conscience which of the following statement should be considered? Select all that apply.

A. It involves mental discipline & the ability to speak out B. It is essential to the delivery of optimal care and prevent harm. D. Surgical conscience allows for no compromise in the principles of aseptic technique.

Which of the following examples is included on the "Joint Commission" list of DO-NOT-USE abbreviations, Acronyms and Symbols?

A. MS

The Joint Commission Universal Protocol consists of: Select all that apply.

A. Preoperative verification B. Surgical site marking C. Time Out

D. Class IV (Dirty/Infected)

According to the CDC, which surgical wound classification should be documented for the patient who underwent a laparoscopic appendectomy with the diagnosis of perforated appendicitis?

B. Change the gown and gloves of the contaminated team members C. Break down the entire back table and re-establish a sterile field

After setting up for a total joint procedure, a dirty instrument is discovered on the sterile back table while waiting for the patient to enter the OR. What actions should be taken to correct the contamination? Select all that apply

D. American National Standards Institute (ANSI)

All of the following organization provide guidance related to tissue banking EXCEPT:

B. Stage II

An area of painful skin that is abraded, blistered, or had shallow craters would be classified as which stage of ulcer?

C. Can progress to a sudden drop in blood pressure, increased heart rate and potential circulatory collapse

An immediate latex allergic response has 3 stages. Which of the following states is matched with the appropriate symptoms?

Recommended sponge count procedures include all of the following EXCEPT?

B. Counting silently so it doesn't distract other personnel.

What is the best drape to use for an umbilical hernia repair?

B. Laparotomy

While monitoring a patient undergoing local anesthesia, the nurse should be suspicious of systemic toxicity related to which of the following patient complaints? Select all that apply.

B. Metallic taste C. Numbness of the lips D. Tinnitus E. Visual Disturbances

To place a patient safely in TRENDELENBURG position, which of the following practices is indicated?

B. Position knees over the break in the procedure bed to allow for knee flexion.

In addition to giving Dantrolene, which of the following treatment options for malignant hyperthermia should the nurse anticipate and prepare for?

B. Provide 100% oxygen, used iced saline to cool patient.

A. Anxiety about an uncertain outcome B. Discomfort or pain C. Fear of the unknown D. Limited time for assessment and teaching

Barriers to effective patient and family education in perioperative settings include: select all that apply

By using a high radio frequency electrical current, surgeons routinely use electrosurgery to _________ the tissue.

C. Cut and coagulate

Which of the following statements reflect the concept of critical thinking? Select all that apply.

C. Informed practice D. Holistic thinking E. Unbiased thinking F. Reasoned application of a step by step process

Which of the following practices is recommended for handling of natural absorbable suture?

C. Open the package carefully over a small basin to prevent splashing of the packaging solution

What is the correct definition of incisional biopsy?

D. A small portion of tissue is incised and sent for examination.

Which of the following statements about the immediate use steam sterilization is the recommended practice?

D. Instruments may be immediate use steam sterilized only when there is insufficient time tot process by the preferred wrapped or container method.

Which of the following statements correctly describes recommendations for preoperative patient skin antisepsis?

D. Prep should start at the site of the incision and move outwards.

Which of the following procedures reflects best practice for transferring a medication vial to the sterile field?

D. Use a sterile transfer device

A. Assessing the patient's level of consciousness B. Assessing the patients pain level C. Maintaining a patent airway D. Monitoring blood pressure, heart rate and oxygen saturation

During admission of a patient to Phase 1 of post anesthesia care, the perianesthesis nurse is responsible for which of the following? Select all that apply

D. Weitlaner

During an inguinal hernia repair the surgeon asks for a self-retaining retractor. Which of the following retractors would be most appropriate to chose?

C. Proliferation

During which phase of wound healing does contraction occur?

A. Patients previous abdominal surgery. B. History of DVT. C. Voiding in the prep area prior to going to the OR.

During your preoperative assessment of a patient undergoing a laparoscopic cholecystectomy, which of the following considerations would be important to you as a preoperative nurse. Select all that apply.

B. Manage the length of cases by having all needed supplies ready C. Participate in product evaluation and waste reduction activities D. Reducing turnover time E. Working to attain on-time starts

How can the preoperative nurse directly contribute to financial efficiency in the OR? Select all that apply.

A. The condition of the storage area, that is, cleanliness, temperature, humidity, air exchanges C. Traffic should be controlled to limit access to those trained in handling of sterile supplies D. Sterile supplies are able to bet stored in a manner that allows adequate air circulation. E. When storing items on the top shelf of a supply cart one to consider the distance between the top of an item and the ceiling

Identify the conditions listed below that are important considerations in maintaining the sterility of an item. Select all that apply.

A. Ask the surgeon to identify the specimen B. Complete the laboratory or pathology requisition C. Label the outside of the specimen container with the patients name, identification number, description and source of the specimen and surgeon

Identify the general guidelines for identifying and labeling specimens. Select all that apply

C. Evacuating the patient and the preoperative team following the organization fire plan

If the preoperative team is unable to extinguish the fire in the OR, recommendations include:

C. Situation, Background, Assessment, Recommendation

If you have completed your case and must transport your patient to PACU. To give report to the PACU nurse, your facility requires the use of SBAR format, which includes:

D. Problem solving and situational awareness

Important skills affecting the clinical setting include which of the following?

C. Fair and equitable care

Important values affecting the clinical setting include which of the following?

1. Stop the blood loss 2. Clean up pathogens and debris in the wound 3. Seal the wound against infection 4. Regenerate the natural epidermal covering 5. Repair the deeper tissue damage.

In which order do the body's defense mechanisms take place during healing?

A. Applying cricoid pressure during intubation if necessary B. Double checking blood if administered D. Obtaining warming blankets and emergency equipment as necessary E. Assessing the patient throughout the operative procedure

Intraoperative responsibilities of the nurse caring for a patient undergoing a procedure with general anesthesia may include which of the following? Select all that apply

Laser: an intense and concentrated beam of light that coagulates and cuts at the same time while minimizing tissue destruction Electrosurgery: The electrosurgical unit ESU is used to apply electrical current through the patient's tissue to cute and/or coagulate the tissue Argon Beam: a device that uses ionized gas and electrical current.

Match the thermal hemostasis device with the correct action

A. Administration of ordered preoperative medication C. Performance of the Universal Protocol for preventing wrong site, wrong procedure, wrong person surgery D. Skin assessment

Preoperative documentation should include: Select all that apply

A. Bipolar surgery should be used whenever possible B. The active electrode and dispersive electrode are close together but as far away from the IED as possible. D. The patient should be monitored closely for signs of complications and IED malfunction

Preoperative safety concerns that should be considered when caring fro a patient with an implanted electrical device (IED) include which of the following? Select all that apply.

C. Two-piece scrub suit with top tucked into the pants and secured at the waist D. Warm-up jacket snapped, with cuffs down to wrists

Proper OR attire for restricted areas includes: Select all that apply

1. Open the nearest wrapper flap 2. Open side flaps 3. Open the farthest wrapper flap

Put the following steps in order when opening a wrapped sterile package

A. Handling powered instrument to the surgeon with the safety mechanism on B. Having irrigation ready to use the drill or saw D. Using the instrument with the blade guard or drill guard in place

Safety precaution when handling and caring for powered instruments include: Select all that apply.

A. Circulation C. Patient mobility D. Pulse oximetry E. respiratory status

The Aldrete scale, used to determine readiness for discharge, measures all of the following EXCEPT:

C. Be placed as close to the operative site as possible

The dispersive electrode should:

A. Forensic specimens include but are not limited to hair, fibers, debris, body fluids and foreign bodies B. Forensic specimens require special handling when the surgeon is using metal instruments C. Hospitals need to have policies to give guidance to the preoperative nurse about the management of forensic specimens

The following information is important in the management of forensic specimens. Select all that apply.

A. Scar tissue: May act as insulation B. Tattoo sites: contain metallic elements that could attract current C. Implanted prosthesis: Contain metal which could attract current and impede return current flow D. Hairy sites: Inhibits the flow of electrical current

The preoperative nurse should avoid placing the dispersive electrode on the following areas. Match the area with the rational listed below:

A. The body area prepped B. Name of the person performing the prep C. Preoperative assessment of the skin at the operative site. D. Skin prep agent used.

The preoperative nurse's documentation of the skin prep procedure should include: Select all that apply.

B. Fumes trapped underneath the drapes and could ignite

The surgeon's preference for the preoperative skin pre includes the application of an alcohol and chlorhexidine gluconate (CHG) solution. The primary reason for allowing this prep to dry prior to draping is because:

A. How does the conduction system of the heart work?

The types of questions that a novice perioperative nurse might NOT ask her preceptor about an upcoming cardiovascular surgery include which of the following?

A. Bone Reamers C. Saw D. Tissue shavers

Types of powered cutting instruments include: Select all that apply.

B. Act as a witness attesting to the authenticity of the patient's signature; the voluntary nature of the patient's consent, and that the patient is competent to give consent. D. Ensure that the surgeon has discussed the proposed intervention and the risks involved with the patient and the patient has signed the consent.

What are the perioperative nurses responsibilities for the informed consent process? Select all that apply.

A. Employ deep vein thrombosis prophylactic devices B. Position the patient for effective air exchange D. Use warming devices to maintain normothermia

What interventions can the preoperative nurse preform to protect elderly patients? Select all that apply

B. Drug name, concentrations, route of administration, dose and time it was administered. D. Verbal orders

When documenting medications, which of the following elements should be included? Select all that apply.

A. A sense of trust among all team members B. Development of a proactive approach instead of a reactive approach D. Sincere commitment to affirming safety as the first priority E. Verification of receipt of all information at all levels of the organization

Which elements are required to create an environment where the culture of safety is embraced? Select all that apply.

A. Disposable drapes are lint free. D. Using disposable drapes can minimize strike-through because of their moisture repellent quality.

Which of the following are advantages of disposable drapes? Select all that apply.

B. They can be used in place of sutures. D. They are primarily used on facial, extremity, and torso wounds.

Which of the following are qualities of skin adhesive products? Select all that apply.

A. Identification of specific positioning devices used B. Names of personnel assisting with positioning C. Placement of arms D. Position that the patient is placed in for the procedure

Which of the following components should be included in documentation of intraoperative patient position? Select all that apply.

D. Use personal protective equipment when handling body fluid spills

Which of the following environmental sanitation practices is used to limit transmission of microorganisms?

C. Prompt disciplinary action when errors occur.

Which of the following is NOT a characteristic that promotes a culture of safety within a healthcare organization?

C. Family disagreement about a below knee amputation of an 19 year old who has already given consent

Which of the following is NOT an example of an ethical dilemma that preoperative nurses may encounter?

A. Changing gloves during regular intervals during a procedure

Which of the following is a method for preventing blood-borne pathogen exposure?

D. Implemeted during surgical procedures to prevent microbial contamination

Which of the following is the best definition of sterile technique? Sterile technique is:

C. Irritant contact dermatitis: non allergic skin reaction usually aggravated by glove power and chemical agents added to raw latex

Which of the following latex sensitivity categories match the description provided?

A. A single procedure list used for all patients scheduled for that procedure.

Which of the following nursing tools does not reflect critical thinking and clinical reasoning?

B. All horizontal surfaces should be damp dusted before the first scheduled procedure of the day. C. hands should be washed with soap and water for at least 15 seconds D. Surgical suites should be cleaned after each surgical procedure with a lint free or microfiber cloth moistened with detergent for disinfectant and water.

Which of the following practices help to prevent contamination in the surgical suite? Select all that apply

A. Automatic intrapoperative suspension of a don-not-resusucitate decision

Which of the following practices violates a patient's ethical right to self-determination?

A. Nurses should engage in life long learning C. Nurses should achieve higher levels of education D. Academic institutions should improve their systems to provide academic progression

Which of the following recommendation for enhancing the future of nursing included in the 21011 Institute of Medicine report? Select all that apply.

A. All preoperative personnel involved in a surgical procedure are responsible for the accuracy of sponge counts B. All preoperative personnel involved in a. surgical procedure have a duty to remain aware of the location of sponges on the sterile field and in the wound. C. All sponges must remain in the OR room until the sponge count is complete. E. Two people, one of them whom is the RN circulator, must preform the sponge count

Which of the following statements about counts is correct? Select all that apply.

C. Sterile gowns should resist fluid strike-through D. The scrub top must be secured at the waist or tucked into the pants

Which of the following statements about proper attire of surgical team members are true? Select all that apply.

B. Continuous nerve stimulation helps ensure proper needle placement during peripheral nerve blocks.

Which of the following statements about regional anesthesia is correct?

D. Step back from the table into an unobstructed area to let the gown unfold

Which of the following statements about the gowning procedure are correct?

B. Washing your hands prior to greeting the patient in the pre-operative room

Which of the following strategies should be considered for implementing successful infection control?

A. Air sampling

Which process should be performed before construction begins, after demolition, and at the end of an OR construction project?

C. Situational

Which type of human factor is responsible for an error that occurs when a preoperative nurse is trying to attend to several tasks at once?

A. Blunt

Which type of needle point should you expect to be needed for suturing viable tissue such as the liver?

C. Using soap and water to perform surgical skin prep

You have been asked to give a presentation for your unit colleagues on preventing surgical site infections, which of the following discussion points is NOT recommended in AORN guidelines?

D. Skin is a major source of contamination in the surgical environment

Your manager has asked you to provide an in-service to team members regarding hand hygiene. Important information for you to include is: