AORN Final Study Guide
Which of the following publishes regulatory requirements to which facilities and health care workers must adhere? A. Centers for Medicare and Medicaid Services B. The Joint Commission C. Association of periOperative Registered Nurses D. All of the above
A. Centers for Medicare and Medicaid Services
The 2010 Future of Nursing report outlined four key messages. Which of the statements below is NOT one of them? A. Data collection is necessary and adequate B. Nurses should strive for higher levels of education C. Nurses should practice to full extent of their education D. The US health care redesign should empower nurses
A. Data collection is necessary and adequate
The Surgical Safety Checklist was an initiative of A. WHO B. AORN C. CDC D. TJC
A. WHO
which of the following statements about bringing personal items into the OR is FALSE?
A. personal items should not be brought into the OR
What of the following is NOT a skill-based behavior error? A. The nurse programs a new electrosurgical unit based on the machine she has used in the past B. The nurse fails to respond to a device alarm C. The nurse forgets to retrieve a unit a blood when called to do a sponge count D. The nurse hits the wrong button instead of the correct button beside it
B. The nurse fails to respond to a device alarm
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 provider's near miss D. All of the above
B. changes care delivery as a result of an error
A situational factor error can occur because of A. a mistake in judgement B. incorrect dosage calculation C. a lack of attention D. an assumption concerning a medication dosage
C. a lack of attention
AORN advocates for patient and worker safety through the Guidelines for Preoperative Practice and A. position statements B. tool kits C. Mission, Vision, and Values statements D. All of the above
D. All of the above
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 safer 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
D. All of the above
Surgical site marking is a regulatory requirement. Which of the following statements about surgical site marking is TRUE? A. Site marking processes are determined by the operating provider B. The patient should not be involved in site marking C. Site marking is done immediately prior to the incision D. The patient should be identified prior to site marking
D. The patient should be identified prior to site marking
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. an environment that emphasizes individual recriminations D. consistent and safe delivery or services
D. consistent and safe delivery or services
when a RN circulator opens a wrapped package to be used on the sterile field, which flap should be opened first?
NOT the flap farthest from the RN circulator it won't show me the right answer sorry
the AORN comprehensive surgical checklist is a collaborative effort between:
WHO and the Joint Commission
what are advantages of using a standardized nursing vocabulary such as the PNDS for documentation? a. help RNs to label and define nursing contributions to pt outcomes b. it is inconsistent c. allows nurses to communicate in code so the pt doesn't understand d. assists doctors in communicating with patient family
a. help RNs to label and define nursing contributions to pt outcomes
a goal of patient- and family-centered care is to: a. improve the pt's knowledge regarding their care b. focus on one point person for all communication c. make the pt aware of their reliance on medical personnel d. achieve short-term behavioral changes
a. improve the pt's knowledge regarding their care
which phase of the nursing process begins with an interview with the pt and their family? a. perioperative assessment b. outcome identification c. clinical documentation d. implementation
a. perioperative assessment
which is the PACU RN's primary responsibility? a. protect the pt's airway while continually assessing and monitoring the pt's hemodynamic status b. monitor the pt's LOC c. prevent health care-associated conditions such as pressure ulcer and venous thromboembolism d. assess the pt's pain level and administer pain meds as appropriat e
a. protect the pt's airway while continually assessing and monitoring the pt's hemodynamic status
identify a goal of ERAS a. reduce the patient's stress response b. muscle strengthening exercise 2 days prior to surgery c. limit activity for 48 hours d. opioids prescribed every 4 hours for 48 hours
a. reduce the patient's stress response
AORN Guideline Essentials are based on all of the following except: a. required practice for state nursing board license b. everyone is responsible for pt safety c. support the individual and periop team's goal in staying compliant and Joint Commission Survey Ready d. a standardized approach to educating and maintaining clinical skills
a. required practice for state nursing board license
who assists the surgeon in suturing, ligating, and other tasks during the procedure? a. scrub person b. first assistant c. RN circulator d. anesthesia assistant
a. scrub person
the PACU RN must possess all of the following skills EXCEPT: a. trained to work as a scrub person b. trained to react quickly to changes in respiratory status c. trained for the preop setting and for the PACU d. ACLS and PALS certification
a. trained to work as a scrub person
what action should be taken FIRST to remove a gown and gloves after the completion of a surgical procedure?
a. with gloved hands, pull the gown away from your body and break the ties, then roll it into a bundle touching only the outside of the gown
recommendations for surgical scrub agents include all of the following EXCEPT:
agent is slow acting
which member of the perioperative team are certified in ACLS and PALS? a. circulating RNs b. PACU RNs c. scrub persons d. all the above
b. PACU RNs
which of the following occurs in the preadmission testing unit? a. none of the above b. RN determines the need for lab, x-rays, or electrocardiogram tests c. pt changes into a gown d. RN establishes IV
b. RN determines the need for lab, x-rays, or electrocardiogram tests
which one of the areas listed below is considered a sterile area of the surgical gown? a. back of the gown b. front of the gown c. axilla d. cuff of the gown
b. front of the gown
which of the following items below is NOT a purpose of an ERAS protocol? a. optimize their physiological function b. increased communication amongst the care team c. facilitate recovery d. reduce the patient's surgical stress response
b. increased communication amongst the care team
teach-back is a particularly valuable tool for peroperative nurses when providing: a. intraoperative teaching b. perioperative discharge instructions c. information for informed consent d. assessment information obtained during the intake
b. perioperative discharge instructions
being dependable in all situations, taking responsibility for your actions, and making decisions using the BEST input available at the time are examples of what type of accountability? a. patient b. personal c. professional d. developmental
b. personal
what is one hallmark of patient-centered care? a. new information is delivered within 48 hours b. physical comfort and emotional well-being are priorities c. families have specific visiting hours d. decisions are made and shared with the patient and family
b. physical comfort and emotional well-being are priorities
what is an example of patient care analytics? a. a disclaimer b. research data c. financial data d. insurance coverage
b. research data
nursing diagnosis includes two CRITICAL problems specific to the care of perioperative patients. they are: a. risk for imbalanced fluid volume and body temp imbalance b. risk for infection and risk for positioning injury c. anxiety and deficient knowledge d. risk for postoperative nausea and vomiting
b. risk for infection and risk for positioning injury
___ are the conditions where people are born, where they grow up, where they work, and where they live a. health equity b. social determinants of health c. patient- and family-centered care d. social justice
b. social determinants of health
what can help lessen the risk of surgical site infection during skin prep? a. wearing a long sleeve jacket with large, loose-fitting sleeves b. use of a sterile sleeve in addition to a long sleeve jacket c. having multiple personnel assist in skin prep d. reaching over the prep area
b. use of a sterile sleeve in addition to a long sleeve jacket
how should badge holders be cleaned if they become soiled with potentially infectious material? a. they should be discarded b. with a low-level disinfectant c. cleaned with soap and water d. with a high-level disinfectant
b. with a low-level disinfectant
when should alcohol-based hand rube be used for general hand hygiene?
before performing a sterile task such as handling invasive medical devices or wrapped sterile packages
which of the following surgical hand scrub rinsing techniques is CORRECT?
begin with fingers, finish with elbows, keep hands higher than elbows
which of the following is a mode of transmission?
body fluid splatter
for pt- and family-centered care to succeed, which of the following must occur? a. decreased likelihood of medical errors b. improvement in the nurse-pt relationship c. active pt engagement in the education process d. physician-provided pt education
c. active pt engagement in the education process
what is the primary role of the RN circulator? a. documenting patient care b. creating and maintaining a safe environment c. being the patient's advocate d. performing ongoing pt assessment
c. being the patient's advocate
how often should sterile gloves be changes during a procedure? a. every 30 min b. every 45-60 min c. every 90-150 min d. they do not need to be changed during the procedure unless there is suspected contamination or a perforation
c. every 90-150 min
which QSEN competency recognizes the pt or designee as the source of control and full partner in providing compassionate, coordinated care based on respect for pt's preferences, values, and needs? a. teamwork and collaboration b. evidence-based practice c. patient-centered care d. safety
c. patient-centered care
what is one way the RN circulator can support a family member in the waiting room during their loved one's surgical procedures? a. have lunch during the procedure with the family while your assigned pt is in the OR b. ask the surgeon to talk to the family member after the procedure c. phone call to the family member d. avoid making a phone call because you are too busy
c. phone call to the family member
Mara wears their own t-shirt under their scrubs. during a procedure, blood spatter seeps through their surgical gown and stains the t-shirt. what should Mara do with the t-shirt?
c. remove the t-shirt as soon as possible and leave it at the facility for laundering
QSEN defines which competency as minimizing risk of harm to pts through both system effectiveness and individual performance: a. teamwork and collaboration b. evidence-based practice c. safety d. informatics
c. safety
all of the following are methods to break the chain of infection EXCEPT:
cleaning and disinfection of surfaces on an as needed basis (eg after a spill)
which statement is NOT correct when maintaining the sterile field?
contamination is considered minor and should not be addressed during the procedure
identify the nursing processes that are part of the intraoperative phase a. coordinate interventions b. document the care delivered c. evaluating nursing interventions d. all of the above
d. all of the above
identify the nursing processes that are part of the postoperative phase a. communicate the care given b. performing a patient assessment c. identify possible complications from the surgical procedure d. all of the above
d. all of the above
identify the nursing processes that are part of the preoperative phase a. developing a nursing diagnosis b. collecting data c. performing a pt assessment d. all of the above
d. all of the above
which of the following are ways in which perioperative RNs can improve professionally? a. attending AORN chapter meetings b. attending continued education conferences c. reading perioperative journals d. all of the above
d. all of the above
the purpose of the Joint Commission Universal Protocol is: a. correct person b. correct site c. correct procedure d. all the above
d. all the above
the rationale for precleaning prior to the surgical hand scrub is: a. to reduce the transmission of skin bacteria from the hands in the event of an unknown glove puncture during the surgical procedure b. inhibit bacteria growth under the glove c. allow for increased antimicrobial efficacy of the surgical scrub d. all the above
d. all the above
venous thromboembolism (VTE) prophylaxis is part of the preprocedure check-in. Why is communicating this information critical to the intraoperative team? a. pt positioning b. length of surgery c. use of sequential compression devices d. all the above
d. all the above
what information should be in the perioperative RN document? a. pt position and positioning devices b. skin prep and solution c. sponge, sharp, and instrument counts d. all the above
d. all the above
what information should be included in patient records? a. allergies b. surgical consent for procedure c. preoperative and postoperative skin condition d. all the above
d. all the above
which is a type of transmission-based precaution: a. airborne b. contact c. droplet d. all the above
d. all the above
which of the following are part of the preoperative assessment? a. advanced directive review b. discharge planning c. pain assessment d. all the above
d. all the above
which of the following statements about laundering at a health care accredited facility and about home laundering are TRUE? a. health care-accredited laundry facilities follow industry standards b. home laundering could expose the public to potentially infectious materials c. home laundering is not monitored for quality, consistency, or safety d. all the above
d. all the above
you are assigned to scrub for a surgical procedure and you know where there will be a high risk of blood and fluid exposure, as well as 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
d. level 4
State Practice Acts outline a nurse's legal scope of practice. which is CORRECT? a. state practice acts are the same for all states b. it is not the responsibility of the nurse's employer to know the regulation and licensing of nurses that work at their hospital c. a hospital's policies can override guidelines from a state's practice act d. maintaining state licensure is a requirement for employment as well as all speciality certification and credentialing
d. maintaining state licensure is a requirement for employment as well as all speciality certification and credentialing
all of the following are responsibilities of the RN circulator except: a. communicating information to other members of health care team and the pt's family b. performing ongoing pt assessment c. coordinating nursing care from other health care team members for each pt d. passing supplies and instruments to the surgeon and assistants
d. passing supplies and instruments to the surgeon and assistants
what is an example of health equity? a. requiring people to take public transportation for a check up b. providing resources to one pt population c. offering noon appts for people working during the day d. providing low-cost health services for those living in low income housing
d. providing low-cost health services for those living in low income housing
what is a SDOH resource that can enhance population health outcomes? a. unsanitary housing conditions b. fast foods c. intermittent internet services d. public safety
d. public safety
AORN's value of communication is defined as follows: a. supporting growth and excellence b. adovcating for pt and staff through exemplary practice in all phases of perioperative nursing c. honoring the contribution of all individuals d. respecting collaborative, open, and honest dialogue
d. respecting collaborative, open, and honest dialogue
gathering supplies and equipment for the surgical procedure; establishing and maintaining the sterile field; keeping an accurate count of sponges, sharps, and instruments; and monitoring sterile techniques are responsibilities of the ___ a. RN circulator b. perianesthesia RN c. first assistant d. scrub person
d. scrub person
SBAR refers to a. surgical-based assessment request b. situational-based, advanced recommendations c. skill-based assessments recommended d. situation, background, assessment, recommendation
d. situation, background, assessment, recommendation
the PACU RN receives a hand-over report from which member of the surgical team listed here? a. the surgeon b. the RN circulator c. the scrub person d. the anesthesia professional and the RN circulator
d. the anesthesia professional and the RN circulator
which of the following is NOT an option when a scrubbed team member needs to change a contaminated glove? a. have another team member assist in regloving b. use the open glove technique c. remove both gown and gloves, regown, and reglove d. use the closed glove technique
d. use the closed glove technique
the physical design of the surgical suite supports prevention of surgical site infection by all the following EXCEPT:
designation of the surgical suite as a semi-restricted zone
when does surgical site marking occur?
during the preprocedure surgical check-in phase
which of the following statements about hand lotions is incorrect?
hand lotions with petroleum as an ingredient are acceptable for use with surgical gloves
the debriefing process provides an opportunity to do all the following except:
identify individual mistakes and missteps
which instruction for drying the hands and arms after surgical hand antisepsis is CORRECT?
keep hands and elbows up and away from your body to prevent contact with the scrub attire
the overall goal of QSEN addresses the challenge of preparing future RNs with the _______ needed to continuously improve the quality and safety of the health care systems in which they work a. guidelines, professionalism, and knowledge b. education, attitudes, and professionals c. education, evaluation, and skill d. knowledge, skills, and attitudes
knowledge, skills, and attitudes
which piece of equipment is a small, wheeled table that holds instruments frequently used during surgical procedure?
mayo stand
identify the INCORRECT measure to reduce personnel exposure to specimen fixatives
never pour a volatile liquid under a flow hood
active (verbal) listening employs all of the following behaviors EXCEPT?
nodding in agreement
the more common areas missed during handwashing includes all of the following EXCEPT:
palms of hands
which statement about using electrosurgical equipment in the OR is TRUE?
place the foot switch in a location that minimizes the change of unintentional depression
which of the following is NOT one of the four components of the AORN Comprehensive Surgical Checklist?
postanesthesia check-out
what outlines the professional RN's legal scope of practice? a. practice acts b. evidence-based standards c. AORN guidelines d. departmental and institutional policies
practice acts
which function does NOT describe a requirement of the baccaleureate degree for the nursing profession?
prepares the nurse's practice as focused solely on illness, not prevention
when should the time-out occur?
prior to incision
in what zone would the following statement be true? sterile set-up should be far enough from the pt to prevent contamination from respiratory droplets?
restricted
this zone includes peripheral support areas, preoperative holding, sterile processing and decontamination areas, clean and sterile supply storage scrub sinks
semi-restricted zone
____ compression devices are used to prevent VTE during a surgical procedure
sequential
which attribute of effective communication accounts for the environment and/or setting?
situational understanding
what are the key elements that can lead to the occurrence of infection?
source, mode of transmission, susceptible host
which principle is CORRECT for drying your hands after a surgical hand scrub?
stand over the sterile mayo stand to avoid contaminating it during the drying process
what does the internal chemical indicator inside of sterile package or rigid container indicate?
the contents have been through the sterilization process
what should be done with unused, opened medications and solutions?
the contents should be discarded
which is TRUE regarding an alcohol-based hand rub?
the hands should be rubbed together until the product is completely dry?
what is the BEST reference for the appropriate use for a commercially based alcohol-based surgical hand scrub?
the manufacturer's IFU
why does the scrub person avoid touching the rim of a rigid container when removing sterile items from it?
the rim of the rigid container is not considered sterile
which statement below is NOT a best practice when moving around the sterile field?
to help direct scrubbed team members around a sterile field, place your hand on their back to direct them
why is positive air pressure used in the restricted zone?
to prevent contaminated air from other zones from entering the restricted zone
which statement about the sign-out phase is FALSE?
verifies the surgical site
which statements about volatile liquids and agents is TRUE?
volatile agents may be found in aerosol spray
forced-air warming warms the pt during surgery
with a warm-air generating machine attached to blankets
