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AORN PERIOP 101 FINAL EXAM QUESTIONS AND ANSWERS 100% CORRECT
"Nursing Malpractice - CORRECT ANSWER An intentional act or an act of omission causing
physical, financial, emotional, psychosocial, and/or cognitive damage to the person in the nurse's care. (There are two tiers: Primary ((related to bedside skills)) and Secondary ((revolve around shared responsibilities such Dx, surgery)))."
"Respondeat Superior - CORRECT ANSWER "Let the master answer" an employer is vicariously
liable for the behavior of an employee working within his or her scope of employment"
"Tort - CORRECT ANSWER A breach of duty to another person as outlined by law."
"Standard of Care - CORRECT ANSWER Actions of a reasonable and prudent professional in
the same or similar circumstance."
"5 Rights of Delegation - CORRECT ANSWER 1. Right task
- Right circumstance
- Right person
- Right direction/communication
- Right supervision/evaluation"
"US Regulatory Organizations at the State Level include (3 entities) - CORRECT ANSWER 1.
Public Health depts
- Licensing Boards
- Insurance commissioners"
"US Accreditation Agencies (4 entities) - CORRECT ANSWER 1. AAAHC (Ambulatory Health
Care)
- ACHC (Health Care)
- DNV GL
- TJC (The Joint Commission)"
"Professional Organizations to help guide practice (2 entities) - CORRECT ANSWER 1. ASCA
(Surgery Center Association)
- AORN (Association of periOperative Registered Nurses)"
"4 Elements of Safety Culture - CORRECT ANSWER 1. Consistent and safe delivery of services.
- Collaborative efforts among all teams and disciplines.
- Environment that places reporting of errors and near misses ahead of blaming and recrimination.
- Commitment of resources that focuses on safety."
"Types of Errors (3 types) - CORRECT ANSWER 1. Skill-based error (ex: incorrect ESU settings,
wrong button pushed, etc)
- Situational factor error (ex: under stress, etc)
- Knowledge-based performance error (ex: fails to respond to an alarm)"
"What type of culture changes care delivery as a result of an error? - CORRECT ANSWER
Culture of Safety"
"AORN advocates through Guidelines for Perioperative Practice and: (3 terms) - CORRECT
ANSWER 1. Position Statements
- Tool Kits
- Mission, Vision, and Values Statements"
"The Surgical Safety Checklist was an initiative of what organization? - CORRECT ANSWER
WHO (World Health Organization)"
"Which major entity publishes regulatory requirements? - CORRECT ANSWER Centers for
Medicare & Medicaid Services (CMMS)"
"Surgical sire marking is a regulatory requirement. What is true about marking? - CORRECT
ANSWER Patient should be identified prior to site marking."
"A situational factor can occur because of: - CORRECT ANSWER A lack of attention"
"What's the minimum number of air exchanges per hour in the OR? - CORRECT ANSWER 20"
"Timeout Criteria (Minimum of 4) - CORRECT ANSWER 1. Correct patient
- Correct site
- Correct patient position
- Correct procedure"
"the Association of periOperative Registered Nurses - CORRECT ANSWER which organization
writes the standards of perioperative nursing?"
"Nonmaleficence - CORRECT ANSWER means "the duty to do no harm""
"PNDS - CORRECT ANSWER is a structured language used by perioperative RNs to document
nursing care"
"State Board of Nursing - CORRECT ANSWER which organization determines the scope of
practice for RNs in each state?"
"Policies and Procedures - CORRECT ANSWER which document does a facility create based on
governmental regulations, accrediting agency regulations, and AORN Guidelines?"
"an employers responsibility for the RN when the RN acts within the scope of nursing practice -
CORRECT ANSWER definition of respondeat superior"
"not obtaining informed consent - CORRECT ANSWER example of assault and battery"
"changes care delivery as a result of an error - CORRECT ANSWER an organization with a
culture of safety"
"position statements, tool kits, mission/value/values statements - CORRECT ANSWER AORN
advocates for patient and worker safety through the Guidelines for Perioperative Practice and ___"
"WHO - CORRECT ANSWER the surgical safety checklist was an initiative of"
"the patient should be identified prior to the site marking - CORRECT ANSWER the surgical site
marking is a regulatory requirement. which of the following statements about surgical site marking is true?"
"a lack of attention - CORRECT ANSWER a situational factor error can occur because of"
"centers for medicare and medicaid services - CORRECT ANSWER which of the following
publishes regulatory requirements to which facilities and health care workers must adhere?"
"semirestricted - CORRECT ANSWER hallways leading to the OR and the sterile processing
areas are designated as _______ areas of the perioperative environment"
"positive - CORRECT ANSWER the airflow in an OR has a _________ pressure relationship to
the adjacent OR hallway"
"operating room - CORRECT ANSWER which of the following areas in a perioperative
environment is considered a restricted area?" "dantrolene sodium calcium chloride 10% and sodium bicarb 8.4% are medications that also should be available in the
MH care as well as refrigerated regular insulin - CORRECT ANSWER the primary medication to
treat a patient experiencing a malignant hyperthermia crisis"
"electrosurgery and laser - CORRECT ANSWER which of the following are considered ignition
sources that may cause a fire to ignite during surgery?" "remove the endotracheal tube and any segments of the burned tube that remain in the airway
CORRECT ANSWER which intervention should be implemented immediately when when a fire
occurs in a patients airway"
"20% lipid emulsion therapy - CORRECT ANSWER the RN should be prepared to assisted with
the administration of _____ when the patient is experiencing local anesthetic system toxicity"
"sterile water - CORRECT ANSWER which of the following should be used for instrument
cleaning at the point -of-use"
" - CORRECT ANSWER what statement about cleaning and decontamination of contaminated
surgical instruments and equipment is false?"
"biological material that forms a barrier on an instrument surface - CORRECT ANSWER
bioburden"
"ethylene oxide - CORRECT ANSWER what chemcial sterilization method uses a toxic
substance that requires aeration"
- CRNA's
- Anesthesia assistants
- Periop nurses"
"4 types anesthesia - CORRECT ANSWER General - loss of consciousness
Regional - loss of sensation Local - small area loss of sensation MAC - IV"
"Whose responsibility during MAC to monitor pt? - CORRECT ANSWER RN"
"What is often used for upper extremity nerve blocks? - CORRECT ANSWER IV regional
anesthetic/Bier block"
"Where is epidural anesthetic injected? - CORRECT ANSWER between ligamentum flavum and
dura (NOT spinal canal)" "What helps ensure proper needle placement during peripheral nerve block with regional
anesthesia? - CORRECT ANSWER continuous nerve stimulation"
"First sign of Malignant Hyperthermia - CORRECT ANSWER increased end-tidal CO2"
"What should be done for pt with MH crisis? - CORRECT ANSWER 1. Stop surgery & stop
triggering agents
- Give dantrolene
- Give 100% O
- Cool pt with iced saline" "Mentor or preceptor? "One who provides encouragement and acts as a guide and facilitator while modeling
professional nursing behaviors" - CORRECT ANSWER Mentor"
"What should intra-abd pressure be maintained under in an adult pt during CO2 insufflation for
endoscopic surgery? - CORRECT ANSWER 12 mm Hg"
"Single most important factor in minimizing microorganism transfer - CORRECT ANSWER
Hand hygiene"
"The most effective method for floor care in surgical suite - CORRECT ANSWER Wet
vacuuming"
"When should air sampling be done in OR? (3) - CORRECT ANSWER 1. Before construction
begins
- After demolition
- At end of project"
"examples of mechanical hemostasis (8) - CORRECT ANSWER 1. Manual pressure (sponges)
- Clamps
- Sutures
- Staples
- Clips
- Ligatures
- Pledgets
- Bone wax" "What type of hemostasis is achieved by occluding severed vessels until platelet formation occurs - CORRECT ANSWER Mechanical"
"Strand of material tied around blood vessel to occlude lumen and prevent bleeding - CORRECT
ANSWER Ligature"
"non-absorbable suture support used when there is possibility of sutures tearing through tissue -
CORRECT ANSWER Pledget"
"Who is involved in sponge counts? - CORRECT ANSWER ALL periop personnel"
"What types of surgery are JP suction drains frequently used in? - CORRECT ANSWER
Abdominal or breast"
"What should be labeled on a medication on or off sterile field (5) - CORRECT ANSWER 1. Med
name
- Concentration
- Initials of RN preparing
- Skin degreasers/tinctures/aerosols
- Prep solutions
- Body tissues/pt hair
- Intestinal gases"
"What questions should you ask when identifying a pt preop? (3) - CORRECT ANSWER Name
DOB
Planned procedure"
"What do you need to document for Time Out? (3) - CORRECT ANSWER 1. 2 Pt identifiers
checked
- Site/side
- Verification of procedure"
"What can increase pt risk for skin injury in OR? (6) - CORRECT ANSWER 1. Preexisting
metabolic conditions (DM)
- Unusual position
- ESU
- Length of surgery
- Reduced tissue perfusion
- Chemical agents"
"What can be done to reduce introp skin injuries? (5) - CORRECT ANSWER 1. Positioning
(protect areas)
- Use electric/thermal equip properly
- Manage electromagnetics
- Never place heavy objects or lean on pt
- Remove excess prep solution"
"What occurs when pt has irritant contact dermatitis latex sensitivity? - CORRECT ANSWER
non-allergic* skin rxn. Confined to area in contact with irritant"
"What occurs with Immediate Type I Hypersensitivity reaction to latex? - CORRECT ANSWER
(allergy) 5-30 min after exposure OR delayed onset of 10-12 hrs"
"What happens with delayed type IV hypersensitivity rxn to latex? - CORRECT ANSWER
Delayed *allergic rxn 24-72 hrs after contact"
"3 stages of latex rxn - CORRECT ANSWER I. Contact uticaria at site
II. Allergic rxn spreads III. (If allowed to progress) BP drop, increased HR, anaphylaxis"
"Factors that make elderly pt skin more sensitive to injury (4) - CORRECT ANSWER 1. Less
subcu fat
- Less skin elasticity
- Thin/wrinkling skin
- Atrophy of sweat glands (decreased temp change tolerance)"
"What should preop psychosocial assessment include? (4) - CORRECT ANSWER 1.
Expectations of periop care (including stress levels)
- Understanding of procedure
- Philosophical/religious beliefs
- cultural beliefs/practices"
"Who determines pt position in OR? - CORRECT ANSWER Surgeon"
"What main precaution should you take with pt in prone position? - CORRECT ANSWER Pad
eyes - avoid pressure"
"Goals of surgical skin prep (3) - CORRECT ANSWER 1. Remove soil/transient microorganisms
from skin
- Reduce resident microbes below pathogenic levels
- Inhibit rapid rebound growth of microbes"
"When can CHG prep be used/not used? - CORRECT ANSWER Use: for topical ONLY
NOT: above neck"
"Which type of prep has quickest reduction in microbe counts? - CORRECT ANSWER Alcohol"
"How far from incision site should prep area extend? - CORRECT ANSWER At least 6-8" past"
"What should be documented with skin prep? (6) - CORRECT ANSWER 1. Area prepped
- Type/extent of hair removal
- Who prepped
- Skin assessment at site
- Prep agent used
- Dry time"
"Type of surgical specimen:
Specimens obtained for studying cell biology - CORRECT ANSWER Cytology"
"Type of surgical specimen:
Specimens that do not require immediate processing by the pathologist - CORRECT ANSWER
Routine specimen" "Type of surgical specimen:
Specimens of tissue or fluid suspected of being infected - CORRECT ANSWER Culture"
"After how long should you change your surgical gloves? - CORRECT ANSWER 150 min (max)"
"1st step in sterilization process - CORRECT ANSWER Cleaning - removing gross
soil/moistening at point of use"
"2nd step in sterilization process - CORRECT ANSWER Decontamination"
"What conditions are important in storage area of sterile items? - CORRECT ANSWER
Cleanliness Temp Humidity Air exchange"
"Outcome of primary importance when draping surgical pt - CORRECT ANSWER Pt free from
s/s of infection"
"Desirable characteristics of surgical drapes (4) - CORRECT ANSWER Barrier to migration of
microbes Resistant to tears Antistatic/antiallergenic Nonglaring"
"Draping process - CORRECT ANSWER 1. cuff drapes over gloves
- Drape from operative site to periphery
- Drape from sterile to unsterile (near to far)
- Walk around to opposite side
- If incorrectly placed, discard by unscrubbed person"
"What type of air pressure should be in the restricted zone of OR? - CORRECT ANSWER
Positive pressure"
"How many air exchanges per hr in OR? - CORRECT ANSWER 20"
"What should temp in OR be? - CORRECT ANSWER 68-75 F"
"What does semi-restricted zone include? - CORRECT ANSWER Equipment/sterile supply
storage Sterile prcessing"
"Class I wound - CORRECT ANSWER Clean
Not infected or inflamed Result of blunt trauma"
"Class II Wound - CORRECT ANSWER Clean-contaminated
NO evidence of infection or contamination GI spill, inflamed gall bladder"
"Class III Wound - CORRECT ANSWER Contaminated
Non-purulent inflammation"
"Class IV wound - CORRECT ANSWER Dirty, infected
Retained devitalized tissue (gangrene, pus)"
"2 Types natural absorbable sutures - CORRECT ANSWER Surgical gut
Collagen" "Suture material of choice for plastic surgery
Recommended size? - CORRECT ANSWER Polypropylene
"Smooth needles with no cutting edges - CORRECT ANSWER Taper point needles"
"Type of needle used for biliary, fascia, GI, muscle, myocardium, nerve, peritoneum, pleura -
CORRECT ANSWER taper point needle"
"Needles with round blunt tip that will not cut tissue - CORRECT ANSWER Blunt point needles"
"Your patient is experiencing a Malignant Hyperthermia crisis. Which medications should be
readily available in the MH cart? - CORRECT ANSWER 1. Dantrolene Sodium (2.5 mg/kg while
infusing IV fluids)
- Calcium Chloride 10% (10 mg/kg)
- Sodium Bicarbonate 8.4% (maximum dose 50 mEq)
- Refrigerated regular insulin" "Local anesthetic systemic toxicity (LAST) is a life-threatening adverse event that may occur after the administration of local anesthetic drugs through a variety of routes. What medication should
be available? - CORRECT ANSWER 1. 20% lipid emulsion (Bolus: 1.5mL/kg over 1 min)
(Infusion: 0.25mL/kg/min over 30-60 min, may double rate as needed)
- Use benzodiazepines for seizure suppression (NO PROPOFOL)" "Data collection is necessary and adequate the 4 of them:
- nurses should strive for higher education -the us health care redesign should empower nurses
-nurses should practice to the full extent of their education - CORRECT ANSWER the 2010
Future of Nursing report outlined four key messages. which is not one of them?"
"consistent and safe delivery of services - CORRECT ANSWER organizational elements of a
culture of safety include" "to prevent errors - a safer system needs to be designed, when an error occurs - the system needs
to be examined, standardization of process - CORRECT ANSWER in 1999, the IOM /NAMI
published the landmark "to err is human: building a safer health system" and reported ___"
"the nurse fails to respond to a device alarm - CORRECT ANSWER which of the following is not
a skill-based behavior error"
"hand hygiene - CORRECT ANSWER which of the following is recognized as a primary means to
prevent health care associated infections?"
"liquid peracetic acid sterilizers - CORRECT ANSWER geobacillus stearothermophilus is a
biological indicator used for"
"cleaning - CORRECT ANSWER what is the first step of instrument processing?"
"chemical - CORRECT ANSWER what type of monitored is an externmal strip or tape?"
"instruments are damp when placed in a container or wrapped - CORRECT ANSWER which of
the following is not done when assembling an instrument tray?"
"What should RN monitor during MAC? (3) - CORRECT ANSWER 1. Extravasation of IV
- Reduction of arterial O2 sat
- Difficulty breathing"
"4 Stages of anesthesia - CORRECT ANSWER 1. Initial administration
- Excitement - unconscious to loss of eyelid reflex
- Intrasurgery
- Possibility of resp failure"
"3 Phases of Anesthesia - CORRECT ANSWER 1. Induction - admin until 1st incision
- Maintenance - incision to completion
- Emergence - from when pt awakens until pt exits OR" "Mentor or preceptor? "One who teaches, counsels, inspires, serves as a role model, and supports the growth and
development of the novice for a fixed and limited period" - CORRECT ANSWER Preceptor"
"Mentor or preceptor?
Guides nurse through a wide range of professional activities - CORRECT ANSWER Mentor"
"Mentor or preceptor?
Guides nurse through defined clinical activities - CORRECT ANSWER Preceptor"
"What type of hemostasis uses pharmacological or topical products? - CORRECT ANSWER
Chemical"
"Ex of thermal hemostasis (3) - CORRECT ANSWER Laser
Argon beam electrosurgery"
"Ex of chemical hemostasis methods - CORRECT ANSWER 1. Microfibrillar collagen
- Oxidized cellulose
- Collagen sponge
- Gelatin sponge
- Fibrin sealant
- Phenol solution
- Thrombin
- Styptics"
"What things should be documented when taking pt hx before surgery? (5) - CORRECT
ANSWER 1. Allergies/implants/prostheses/piercings
- D/c plans
