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Which of the following statements are true about objective data? a. Data that consists of the patient's own feelings and perceptions. b. Age, religion, or culture are examples of objective data. c. Data that is the information written in the patient's record and nursing notes. d. History, physical, and laboratory data are examples of objective data. c. Data that is the information written in the patient's record and nursing notes. d. History, physical, and laboratory data are examples of objective data. Match the age groups with their ability for learning and understanding.
- Birth to one month
- 1-12 months
- 1-3 years
- 3-6 years a. The baby will smile, babble, and gurgle. b. The baby is able to understand and respond to simple commands. c. The child is able to literally interpret terms. d. The child is able to express only through crying.
- D
- A
- B
- C Patients in which of the following age-groups have the greatest blood volume per unit of body weight. a. children b. elderly adults c. middle adults d. young adults a. children During the preoperative interview, why should the perioperative nurse ask patients about their use of herbal preparations, alcohol, tobacco products, and recreational drugs? (select all that apply) a. herbal supplements may affect the metabolism of drugs administered b. patients who use alcohol heavily are unable to tolerate general anesthesia c. recreational drug use may affect the choice of preoperative sedation. d. smoking may affect circulatory and respiratory system assessment results.
a. herbal supplements may affect the metabolism of drugs administered c. recreational drug use may affect the choice of preoperative sedation d. smoking may affect circulatory and respiratory system assessment results. Which items below are included in a psychosocial assessment? (select all that apply) a. coping styles b. cultural beliefs and practices c. expectations of perioperative care d. sensory impairment e. spiritual or religious beliefs a. coping styles b. cultural beliefs and practices c. expectations of perioperative care e. spiritual or religious beliefs Which of the following statements is true? a. blood pressure remains constant with age. b. body temperature increases with increasing age. c. heart rate increases with increasing age d. lung capacity decreases with increasing age d. lung capacity decreases with increasing age Which of the following factors make geriatric patients more sensitive to injury and cold? a. decrease in subcutaneous fat b. lung capacity decreases with age c. bilirubin and hemoglobin shift d. rage of medication absorption is decreased a. decrease in subcutaneous fat Why is it important to assess the use of herbal supplements or recreational drugs before surgery? a. herbal preparations can decrease the toxicity of other drugs administered during anesthesia. b. herbal preparations can affect bleeding times. c. herbal preparations can interfere with drug metabolism. d. recreational drug use can result in withdrawal symptoms. e. recreational drug users may require higher doses of anesthetic medications. b. herbal preparations can affect bleeding times. c. herbal preparations can interfere with drug metabolism. d. recreational drug use can result in withdrawal symptoms. e. recreational drug users may require higher doses of anesthetic medications. What interventions can the perioperative nurse perform to protect elderly patients? a. employ deep vein thrombosis prophylactic devices. b. position the patient for effective air exchange. c. slide patient onto the OR bed without use of assistive device. d. use warming devices to maintain the normothermia. a. employ deep vein thrombosis prophylactic devices. c. slide patient onto the OR bed without use of assistive device. d. use warming devices to maintain the normothermia.
c. 1, 2, & 4 d. 1, 2, 3,& 4 d. 1, 2, 3, & 4 Based on the knowledge you have gained about documenting requirements, identify the true statements. a. You may be required to write out the physician's verbal orders for medications administered and have the physician sign the order. b. Hypersensitivity reactions should be documented. c. The manufacturer of implants should be documented. d. The manufacturer of the Foley catheter should be documented. e. Rationale for counts not performed should be documented. a. You may be required to write out the physician's verbal orders for medications administered and have the physician sign the order. b. Hypersensitivity reactions should be documented. c. The manufacturer of implants should be documented. e. Rationale for counts not performed should be documented. A fluid imbalance may occur rapidly due to fluid loss as a result of: a. fluid restrictions b. accurate measurement of irrigation fluids c. wound drainage d. nasogastric tubes e. inadequate fluid replacement a. fluid restrictions c. wound drainage d. nasogastric tubes e. inadequate fluid replacement Any tissue or fluid removed from the body is documented and identified. some of the items included in the documentation accompanying specimens are: a. site, location, type of dressing, loss of fluid b. type of specimen, date and time of collection, and hypersensitive reactions c. date and time of collection, site, surgeon's name and contact info c. date and time of collection, site, surgeon's name and contact info When documenting a dressing, the name of the person applying the dressing should be noted. a. true b. false b. false Based on the knowledge you have gained about using abbreviations, identify the true statements about abbreviations. a. Abbreviations are to be used by physicians only. b. Abbreviations can lead to medical errors. c. Abbreviations are difficult to read. d. Abbreviations might be wrongly interpreted. b. Abbreviations can lead to medical errors. c. Abbreviations are difficult to read. d. Abbreviations might be wrongly interpreted.
A successful lawsuit that an RN could be involved in: a. does not require patient injury b. only requires a nurse-patient relationship c. must show duty, breach, causation, and damages d. considers whether the patient has filed previous lawsuits c. must show duty, breach, causation, and damages Based on the knowledge you have gained about legal aspects of documentation and nursing practice, which elements must be proved for a negligence claim to be successful? a. Damages: actual injury to the patient b. Breach of duty: care provided was not within the standard of care c. Reasonableness: a nurse in the same circumstance would have done the same thing d. Duty: a nurse-patient relationship exists e. Causation: what the nurse did or did not do resulted in patient injury a. Damages: actual injury to the patient b. Breach of duty: care provided was not within the standard of care d. Duty: a nurse-patient relationship exists e. Causation: what the nurse did or did not do resulted in patient injury When documenting, always include your assessment of the situation, the actions you took, and the patient's response to them. a. True b. False a. True Charting by exception is a time saver and ________. a. is easy even if you don't understand what is expected of a nurse b. does not require assessment skills c. is based on the premise that the patient manifests normal response to most interventions d. does not require documentation during the shift or notes on changes in the patient's progress c. is based on the premise that the patient manifests normal response to most interventions Accurate preoperative documentation of the patient admission is an integral part of the nursing process. This includes: a. patient identification b. preoperative orders c. discharge referral d. patient assessment a. patient identification b. preoperative orders d. patient assessment The primary purpose of documentation is to: a. be prepared in case a court case is filed b. make sure everything is written down c. record the chronological order of events during the nursing care of a patient d. relate any conversations and discussion with the patient or family in detail
c. requires the nurse to document and act as a reasonably qualified nurse would in a similar situation d. is set in law and never changes c. requires the nurse to document and act as a reasonably qualified nurse would in a similar situation An individualized patient care plan that was initiated during the preoperative phase includes: a. cultural or religious preferences b. emotional considerations c. financial considerations d. psychosocial considerations a. cultural or religious preferences b. emotional considerations d. psychosocial considerations The primary reason for documenting sharp, sponge, and instrument counts is: a. to prevent injury to the patient from a retained foreign object b. to maintain inventory for the sterile processing department c. to provide an accurate item charge for the patient d. to track instruments that might be needed for the next procedure a. to prevent injury to the patient from a retained foreign object The use of powered air-purifying respirator (PAPR) is not recommended by the CDC because: a. the belt-mounted blower and tubing is designed to be worn on the inside of the gown. b. the device does not filter the wearer's exhaled air. c. the sterile field is protected by distance from the scrub team. d. none of the above. b. the device does not filter the wearer's exhaled air. Identify which of the following statements are correct. (select all that apply) a. Perioperative personnel should wear a clean surgical mask that prevents venting of oropharyngeal and/or nasopharyngeal droplet dispersal. b. According to the CDC, PAPRs are suitable respiratory protection in the presence of a sterile field. c. Surgical gloves should be changed every 75-120 minutes. d. Gown sizes and critical zone configurations are specified by the manufacturer on the product label. a. Perioperative personnel should wear a clean surgical mask that prevents venting of oropharyngeal and/or nasopharyngeal droplet dispersal. d. Gown sizes and critical zone configurations are specified by the manufacturer on the product label. Which of the following is incorrect? a. The sterile field should be prepared as close as possible to the time of use. b. A sterile field can be covered and moved to another room if there is a schedule change. c. Only sterile supplies and instruments should be used on a sterile field. d. If there is doubt about an item's sterility, it should be considered contaminated.
b. A sterile field can be covered and moved to another room if there is a schedule change. What is the ideal time to open an implant? a. When the scrub is setting up the back table. b. As close as possible to the time of implantation. c. While the cement is being mixed. d. Before anatomical reduction with the trial implants. b. As close as possible to the time of implantation. Which of the following statements are correct? (SATA) Medications and solutions should be transferred: a. via a sterile transfer device such as a sterile vial spike, filter straw, or plastic catheter. b. as fast as possible so the scrub is not away from the surgical field. c. into a receptacle that is placed at the back edge of the back table or held by a scrub team member. d. at the time that the back table is being set up. a. via a sterile transfer device such as a sterile vial spike, filter straw, or plastic catheter. c. into a receptacle that is placed at the back edge of the back table or held by a scrub team member. Regarding recommendation of continual monitoring of the sterile field. What is recommended in the event of a breach of sterile technique? a. Take corrective action immediately b. Consider any clamped instruments contaminated c. All perioperative personnel should monitor the sterile field for contamination d. All of the above d. All of the above At what times should a sterile field be covered? (SATA) a. For procedural delays b. When the patient is being repositioned c. When the evening crew is setting up tables for next day cases. d. A separate closure field that contains dressing sponges a. For procedural delays b. When the patient is being repositioned Which of the following statements are true? (SATA) a. Scrubbed personnel should stay as close to the sterile field as possible. b. Door openings decrease OR environmental contamination by allowing air to escape from the OR. c. Scrubbed team members can turn their back on the sterile field when getting instruments or equipment from the back table. d. The number of people and movement within the OR may contribute to OR environmental contamination. a. Scrubbed personnel should stay as close to the sterile field as possible. d. The number of people and movement within the OR may contribute to OR environmental contamination. A large amount of data is collected in the event of an SSI. From the following, select all that are discoverable by the infection preventionist and other members of an interdisciplinary team.
b. gown sleeves from two inches above the elbow to the cuff, circumferentially c. front of the gown from the chest to the level of the sterile field Which of the following are correct concerning the surgical gown and gloves? a. Surgical gloves should be changed after touching methyl methacrylate, optic eye pieces, and surgical helmet systems. b. The cuff of the sterile gown is considered contaminated once the hands pass through the cuff. c. Wear one pair of surgical gloves for short procedures. d. A & B e. All of the above. d. A & B In creating a sterile field, which of the following are recommended by AORN? (SATA) a. Cuff the drapes over your gloved hand to prevent contamination. b. Handle the drapes as needed to get the best coverage. c. Place drapes in sequence from the surgical site to peripheral areas. d. Place drapes on the patient and any furniture and equipment that will be in the sterile field. e. When placing drapes do not lean across unsterile areas. After placing the drape on the pt, reposition as needed to provide coverage. a. Cuff the drapes over your gloved hand to prevent contamination. c. Place drapes in sequence from the surgical site to peripheral areas. d. Place drapes on the patient and any furniture and equipment that will be in the sterile field. e. When placing drapes do not lean across unsterile areas. After placing the drape on the pt, reposition as needed to provide coverage. Breaks in sterile technique should be immediately corrected. Which of the following statements is correct? a. Instruments should be considered contaminated when found assembled or clamped closed and/or with organic material or other debris found on or in the instrument. b. When contaminated instruments are found within the instrument set, the contaminated instrument is removed, leaving the other instruments to be used throughout the surgery. c. It can be assumed that sterility or high-level disinfection was achieved if only one instrument was found with organic or other debris. d. All of the above. a. Instruments should be considered contaminated when found assembled or clamped closed and/or with organic material or other debris found on or in the instrument. Which of the following statements about covering a sterile field are correct? (SATA) a. Portions of the sterile field should be covered with the two-cuffed method. b. Covering portions of the sterile field that are not in active use may minimize potential air contamination of the field. c. The sterile field should be covered for instances that include procedural delays, for bowl or cancer surgery wound closures, or in the pre-incision timeframe. d. For fields that have been completely covered, the scrubbed person removes the top drape first by placing the hands within the cuff and lifting the drape up and away from the table.
b. Covering portions of the sterile field that are not in active use may minimize potential air contamination of the field. c. The sterile field should be covered for instances that include procedural delays, for bowl or cancer surgery wound closures, or in the pre-incision timeframe. When transferring medication and solutions to the sterile field, the perioperative nurse should adhere to which of the following recommendations? (SATA) a. Avoid removing stoppers from vials. b. Discard unused, opened irrigation or IV solutions at the end of the procedure. c. Dispense the entire contents of the container slowly. d. Replace caps on opened medications to maintain sterility. e. Use a sterile transfer device. a. Avoid removing stoppers from vials. b. Discard unused, opened irrigation or IV solutions at the end of the procedure. c. Dispense the entire contents of the container slowly. e. Use a sterile transfer device. Which of the following involves applying physical pressure to the wound to stop the blood flow? a. chemical method b. thermal method c. mechanical method d. both a & c c. mechanical method Match each "type of agent" for achieving hemostasis with its correct "description." Type:
- Hemostat
- Gelatin sponge
- Styptic
- Electrosurgical unit Description: a. produces a vasoconstriction effect b. causes coagulation by an electrical current c. clamps the vessel d. swells, forming a clot
- c
- d
- a
- b What are the cautions and contraindications when using bone wax? (SATA) a. Could cause a movable clot if placed near a vessel. b. Can act as a physical barrier that prevents bone union. c. Is contraindicated when rapid bone regeneration is desired. d. Can react with any metal hardware that is attached to the bone. b. Can act as a physical barrier that prevents bone union. c. Is contraindicated when rapid bone regeneration is desired. these types of sponges provide blunt dissection as they absorb fluids: a. neuro-patties
c. Avoid using it with an autologous blood salvage unit. d. Protamine sulfate should be available as a reversal agent. c. Avoid using it with an autologous blood salvage unit. Which of the following drains allows for passive drainage of fluid from the body? (SATA) a. Jackson-Pratt b. Penrose c. T-tube d. Hemovac b. Penrose c. T-tube The benefits of a standardized count procedure include which of the following? (SATA) a. Assists in achieving accuracy during the count procedure. b. Assists in conducting efficient counts. c. Human error studies have shown that many errors result from deviation. d. Provides a bonding situation among perioperative team members. a. Assists in achieving accuracy during the count procedure. b. Assists in conducting efficient counts. c. Human error studies have shown that many errors result from deviation. Which type of dressing is used to prevent drying of the wound and increase proliferation of the epithelial cells? a. gauze b. pressure c. rigid support d. occlusive d. occlusive Which of the following is true in handling hemostatic agents such as collagen or gelatin sponges? a. Should be moistened prior to use. b. Should not be left in the wound, since they are not absorbable. c. Are highly perishable and should be refrigerated prior to use. d. Must not be injected or allowed to enter large vessels, as extensive intravascular clotting may occur. d. Must not be injected or allowed to enter large vessels, as extensive intravascular clotting may occur. Based on the knowledge you have gained about ESUs and their usage, identify the statements below that are true about an ESU. (SATA) a. Electrosurgery is used to cut tissue. b. ESUs are a high radio-frequency electrical current. c. The active electrode is also referred to as "grounding pad." d. Bipolar current is most frequently used for electrosurgery. e. The dispersive electrode is also referred to as the "grounding pad." a. Electrosurgery is used to cut tissue. b. ESUs are a high radio-frequency electrical current. e. The dispersive electrode is also referred to as the "grounding pad." When using the ESU generator, the perioperative nurse should remember to: a. Never use the ESU in presence of alcohol-based antimicrobial prep agents until the
agents are dry and vapors have dissipated. b. Never allow fluids to be poured on the generator. c. Encase the foot switch in an insulated safety holster a. Never use the ESU in presence of alcohol-based antimicrobial prep agents until the agents are dry and vapors have dissipated. b. Never allow fluids to be poured on the generator. Based on the knowledge you have gained about the safety checks for ESUs, identify the correct safety checks. (SATA) a. When removing the plug from the outlet, pull the cord. b. The generator should be turned off after use. c. The ESU can be used in the presence of defatting agents. d. The generator and the foot switch should be protected from fluid spills. e. Power settings should be confirmed verbally between the perioperative nurse and the surgeon both before and during the procedure. f. When using multiple ESUs, the dispersive electrodes should not touch each other. b. The generator should be turned off after use. d. The generator and the foot switch should be protected from fluid spills. e. Power settings should be confirmed verbally between the perioperative nurse and the surgeon both before and during the procedure. f. When using multiple ESUs, the dispersive electrodes should not touch each other. Based on the knowledge you have gained about the active electrode, identify the correct statements. a. The active electrode should be connected in a stress-resistant receptacle of the ESU. b. The tip of the active electrode should never be cleaned during a procedure. c. When not in use, the electrode should be stores in a safety holster. d. Using an electrolyte solution may render the electrode less effective. e. When performing electrosurgery above the xiphoid process, administer the lowest practical level of oxygen to the patient. a. The active electrode should be connected in a stress-resistant receptacle of the ESU. c. When not in use, the electrode should be stores in a safety holster. d. Using an electrolyte solution may render the electrode less effective. e. When performing electrosurgery above the xiphoid process, administer the lowest practical level of oxygen to the patient. Based on the knowledge you have gained about dispersive electrodes, identify which statements about dispersive electrodes are true. a. Should not be used on bony prominences. b. Alternate pathway burns can occur because of improper placement. c. After repositioning, should be rechecked for skin adherence. d. Is applied as far from the operative site as possible. e. Condition of the skin should be documented after removing the electrode. a. Should not be used on bony prominences. b. Alternate pathway burns can occur because of improper placement. c. After repositioning, should be rechecked for skin adherence. e. Condition of the skin should be documented after removing the electrode. Based on the understanding you have gained about various types of electrosurgery, identify the correct statements.
b. dispersive electrode, fiber, and generator c. active electrode, dispersive electrode, generator, and scratch pad d. dispersive electrode, fiber, generator, and key a. active electrode, dispersive electrode, and generator To reduce the possibility of an injury or burn, which of the following most accurately describes where the perioperative RN should place the dispersive electrode? a. as far from the operative site as feasible b. directly on the operative site c. as close to the operative site as feasible d. anywhere it will be easy to access c. as close to the operative site as feasible Which statement best describes the path for bipolar surgical current? a. Current leaves the generator, is applied to tissue using a pencil device, is collected in the dispersive pad, and returns to the generator. b. Current leaves the generator, is applied to tissue using a pencil device, and returns to the generator. c. Current leaves the generator, is applied to tissue using a two-poled instrument, and returns to the generator. c. Current leaves the generator, is applied to tissue using a two-poled instrument, and returns to the generator. If the surgeon continuously asks for higher power settings, what is the first action that the perioperative RN should take? a. Get another ESU unit immediately. b. Check the circuitry for possible disruption. c. Switch to a bipolar generator and electrode. d. Change the active electrode and dispersive electrode. b. Check the circuitry for possible disruption. Alternate pathway burns can occur because of improper placement of the dispersive electrode. The dispersive electrode SHOULD NOT be applied on which of the following (SATA): a. hairy skin surfaces b. burn tissue c. well-perfused muscle d. bony prominences a. hairy skin surfaces b. burn tissue d. bony prominences When using argon-enhanced coagulation (AEC), there is a risk of: a. electrosurgical injuries b. carbon dioxide purge c. gas emboli d. decreased insufflator pressure c. gas emboli The term local exhaust ventilation (LEV) is used to describe the process of evacuating smoke from the surgical site. Which of the following are considered LEV? (SATA) a. Central suction system with 0.1 micrometer in-line filter
b. Central suction system with HEPA in-line filter c. High filtration surgical masks d. N95 respirators e. Smoke evacuator unit a. Central suction system with 0.1 micrometer in-line filter b. Central suction system with HEPA in-line filter e. Smoke evacuator unit Which precautions should be taken for a patient who has an implantable electronic device (IED)? SATA a. All team members should be informed about the IED. b. Insist that the surgeon use bipolar current instead of monopolar current. c. There should be intermittent EKG monitoring. d. The active and dispersive electrodes should be located as close together as possible a. All team members should be informed about the IED. d. The active and dispersive electrodes should be located as close together as possible According to the AORN Guideline for Safe Use of Energy-Generating Devices, which of the following are recommended components of documentation when using an ESU? (SATA) a. location of the dispersive electrode b. serial or biomedical device number c. ESU brand name d. Patient's skin condition before and after applying the dispersive pad a. location of the dispersive electrode b. serial or biomedical device number d. Patient's skin condition before and after applying the dispersive pad During laparoscopic surgery, perioperative RNs can reduce the changes of capacitive- coupling injuries by: a. using a combination of insulated and non-insulated instruments. b. using coagulation waveform and a high setting. c. using metal and plastic cannulas together. d. using the lowest power setting and the low-voltage cutting waveform. d. using the lowest power setting and the low-voltage cutting waveform. Sterile technique is defined as "comprises methods which are designed to exclude all microbes." True False False Sterile technique is the use of specific actions and activities to prevent contamination and maintain sterility of identified areas during operative or other invasive procedures. Surgical conscience demands the recognition of improper practices observed during surgery by: a. the surgeon. b. the anesthesiologist c. the perioperative nurse. d. any member of the health care team. d. any member of the health care team.
c. Prions appear to be resistant to most forms of sterilization used in health care settings. d. Prions appear to have a marked vulnerability towards moist heat. a. Prions are not bacteria or viruses but rather malformed proteins. b. Creutfeldt-Jakob disease is a degenerative neurologic disease that appears to be caused by prions. c. Prions appear to be resistant to most forms of sterilization used in health care settings. During the assembly process, instruments should be placed in a specifically designed container that restricts the penetration of the sterilizing agent and prevents the trapping of air. True/false False During assembly, instruments should be arranged in sets and placed in a tray with a mesh or perforated bottom or specifically designed container that permits the penetration of the sterilizing agent and prevents the trapping of air. Packaging systems should: a. permit sterilization to take place. b. maintain sterility for a limited period. c. be structured to provide for aseptic delivery of the contents onto the sterile field. d. be compatible with the sterilization process. e. be used according to the manufacturer's written instructions. a. permit sterilization to take place. c. be structured to provide for aseptic delivery of the contents onto the sterile field. d. be compatible with the sterilization process. e. be used according to the manufacturer's written instructions. After completion of the steam sterilization cycle, wrapped, sterilized items should be: a. placed on metal table until cooled b. used immediately. c. left untouched to cool for 30-60 minutes. d. left untouched to cool for 15-30 minutes. c. left untouched to cool for 30-60 minutes. Based on what you have learned about peracetic acid sterilization, identify the facts which are true regarding peracetic acid sterilization. SATA a. Is is a liquid chemical sterilization method. b. Is uses low temperature. c. Is it equal in efficacy to steam and ethylene oxide (EO) sterilization. d. It requires the use of a special unit designed for this type of sterilization. e. It can be used for all surgical items. a. Is is a liquid chemical sterilization method. b. Is uses low temperature. c. Is it equal in efficacy to steam and ethylene oxide (EO) sterilization. d. It requires the use of a special unit designed for this type of sterilization. Based on what you have learned about ethylene oxide sterilization, complete the following sentence. Complete sterilization in ethylene oxide is dependent upon four primary variables: proper time, humidity, temperature, and:
a. proper packaging b. aeration c. gas concentration d. pressure c. gas concentration Match implant to surgery type. Implants
- teflon and dacron patches
- stapedectomy prostheses
- synthetic mesh
- ventriculoatrial shunts
- scleral buckles/bands a. ENT b. general surgery c. neurosurgery d. ophthalmic surgery e. cardiac/vascular surgery
- e
- a
- b
- c
- d In which surgical wound category should a total abdominal hysterectomy be classified? a. clean b. clean contaminated c. contaminated d. dirty b. clean contaminated Match term with definition. a. disinfection b. decontamination c. sterilization d. high-level disinfection
- The use of physical or chemical means to remove, inactivate, or destroy bloodborne or other pathogens on a surface or item.
- The process of destroying all microorganisms on a substance by exposure to physical and chemical agents; the complete elimination of all forms of microorganisms.
- A process that destroys all microorganisms (vegetative forms of bacteria, all fungi, all viruses) with the exception of high numbers of bacterial spores.
- A chemical or physical process of destroying all pathogenic microorganisms, except spores, on inanimate objects. a. 4 b. 1 c. 2 d. 3
