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PERIOP 101 FINAL EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS
(100% CORRECT ANSWERS) ALREADY GRADED A+
"An RN who attends continuing nursing education and has verified skills, knowledge, and attitudes about perioperative nursing is demonstrating accountability in his/her: a) Certification requirements for professional achievement in perioperative nursing b) Collaboration among team members c) Professional growth and maintenance of competency
d) Verification of nursing knowledge - CORRECT ANSWER c"
"Which of the following statements is TRUE concerning use of the AORN Guidelines for Perioperative Practice? a) Both medical and nursing licensing boards require health care institutions to comply with the AORN guidelines b) The AORN Guidelines legally supersede departmental and institutional policies c) The AORN Guidelines reflect scientific evidence of how nurses actually practice in perioperative settings d) Work setting and situation variations may determine the extent to which AORN Guidelines can
be applied - CORRECT ANSWER d"
"Which of the following is NOT an example of an ethical dilemma that perioperative nurses may encounter? a) Do-not-resuscitate (DNR) order for a surgical patient b) Family disagreement regardings possible organ donation c) Family disagreement about a below the knee amputation on an 18 year old who has already given consent
d) Human experimentation - CORRECT ANSWER c"
"Part of the AORN standards of Professional Practice mandate that nurses evaluate the quality of their nursing practice. Four ways to ensure professional practice related to the AORN practice include: maintaining competency, the use of evidence-based practice, certification, and: a) Mentoring student nurses b) Pursuit of lifelong learning c) Achieving a minimum of an associate's degree
d) Achievement of an advanced practice nurse degree - CORRECT ANSWER b"
"After transferring a male patient into the Phase I PACU, the perioperative RN could reasonably expect the PACU RN to FIRST: a) Administer medication to the patient for nausea and vomiting
b) Ask the patient is he has any pain c) Assess the patient's airway and respirations
d) Care for this patient and two other patients as assigned - CORRECT ANSWER c"
"During a handover report to the PACU RN, the perioperative RN may use a communication method identified by the acronym "SBAR." What does SBAR stand for? a) Safety, Background, Actions, Recovery expectations b) Situation, Background, Assessment, Recommendation c) Safety concerns, Background, Assessment, Responsibility
d) Surgeon, Background, Assessment, Recovery time - CORRECT ANSWER b"
"A 40-year-old male patient is awake and alert in the post anesthesia care unit after right shoulder surgery. What is the BEST measure to assess the patient's pain? a) Discuss the patient's pain with a close family member b) Observe facial expressions and behaviors c) Ask patient to describe his pain or use a standardized pain scale
d) Monitor vital sign changes - CORRECT ANSWER c"
"What would be the MOST important information for a nurse in Preadmission Testing (PAT) to collect on an insulin dependent diabetic patient? a) How long the patient has been diabetic b) If there is someone to drive them home c) The last time the patient ate or drank
d) The type of insulin the patient takes - CORRECT ANSWER d"
"You have just transferred your patient into the Phase I PACU. Which activities would you expect to observe FIRST? a) Administering medication for nausea and vomiting b) Asking patients if they have any pain c) Assessing patient airway and respirations
d) Caring for patients in 1:3 ratio - CORRECT ANSWER c"
"A hand-over communication report is given by the anesthesia professional and the _________________? a) Surgical resident b) Medical student c) OR nurse
d) Inpatient nurse - CORRECT ANSWER c"
d) Medication absorption is decreased - CORRECT ANSWER a"
"A preoperative nursing assessment should be conducted by a perioperative RN at what point? a) Prior to discharge b) Before the surgery c) In the surgeon's office
d) Before the surgical consent is signed - CORRECT ANSWER b"
"Factors that may affect postoperative pain are? Select all that apply. a) The surgical site b) The nature and intended purpose of the surgery c) The patient's fears regarding anesthesia or surgery
d) The level of anxiety of the patient's family members - CORRECT ANSWER a, b, c"
"Which of the following BEST illustrates the purpose of perioperative patient and family education? a) To convey genuine caring for the patient's well-being b) To increase patient and family adherence to the plan of care c) To increase the patient's and family's satisfaction with the quality of care
d) To support legal, ethical, and regulatory mandates - CORRECT ANSWER b"
"Obtaining informed consent is a two-step process of: a) Weighing the benefits and burdens of tx options b) Communicating information and documenting the decision c) Determining patient competency and authenticity of the signature
d) Communicating the plan of care and reaching a decision - CORRECT ANSWER b"
"How does the perioperative nurse test patient's level of understanding? a) By checking to see whether the patient feels knowledgable enough to sign the consent b) By asking questions about the procedure and evaluating the answer c) By offering reassurance
d) By returning at another time to test recall - CORRECT ANSWER b"
"A preoperative patient's do-not-resuscitate order is: a) Irrevocable and unchanged once established b) Not intended to be upheld in the perioperative environment c) Reconsidered to ensure that the risks and benefits of anesthesia and surgery are discussed before surgery
d) Not reinstated until the patient leaves the perioperative environment - CORRECT ANSWER
c" "Match the designated surgical area with the correct surgical zone: a) Perioperative patient care area b) Work area for processing instruments c) Individual OR suite with sterile supplies opened 1 - Restricted 2 - Semi-restrict 3 - Unrestricted *(Answer with and separate numbers w/commas)
*(Use numbers to correctly match w/"a, b, c" order) - CORRECT ANSWER 3, 2, 1"
"Clean supplied do NOT need to be separated from sterile supplies inside the surgical suite: a) True
b) False - CORRECT ANSWER b"
"The relative humidity in the OR suite should be maintained within a range of: a) 20-30% b) 20-60% c) 30-70%
d) 40-50% - CORRECT ANSWER b"
"A surgical mask should cover both mouth and nose, and should be: a) Allowed to hang around the neck between procedures b) Changed after two hours of use c) Removed and discarded after every case
d) Tied snugly with strings crossed - CORRECT ANSWER c"
"The ventilation system in the restricted area of the OR should have an air exchange rate of at least _____ air exchanged per hour. a) 5 b) 20 c) 10
d) 15 - CORRECT ANSWER b"
"The pathology laboratory and blood bank are usually situated in which of the following areas? a) Unrestricted area
a) Blood pressure cuff b) Laryngoscope blade c) Orthopedic implants 1 - Critical 2 - Non-critical 3 - Semi-critical *(Answer with and separate numbers w/commas)
*(Use numbers to correctly match w/"a, b, c" order) - CORRECT ANSWER 2, 3, 1"
"What is the FIRST step in reprocessing surgical instruments after they have been used in a procedure? a) Cleaning b) Decontamination c) Disinfection
d) Transport to the sterilizer - CORRECT ANSWER a"
"Biological monitoring: a) Is utilized to document the sterility of an item b) Indicates that the intended physical conditions in the sterilizer were met c) Can be read immediately after the sterilization cycle is complete
d) Should never be used in immediate use steam sterilizers (IUSS) - CORRECT ANSWER b"
"A ___________ does not permit a person to excuse an error but rather to admit and rectify one readily. a) Adherence to aseptic technique b) Practice of professional c) Surgical conscience
d) Just culture - CORRECT ANSWER c"
"Endoscopic instrumentation maintenance may be enhanced by the following EXCEPT a) Cleaning off external debris during the case b) Flushing channels with sterile water during surgery to remove gross soil c) Irrigating channels with normal saline at the end of each case
d) Testing scissors for sharpness prior to sterilization - CORRECT ANSWER c"
"According to AORN Recommended Practices, the shelf life of a sterile package kept in storage is: a) Time-related b) Event-related
c) Content-related
d) Sterilization-related - CORRECT ANSWER b"
"According to Spaulding's Classification System, to prepare items such as blood pressure cuffs for patient use the appropriate process is: a) Decontamination b) Low-level disinfection c) High-level disinfection
d) Sterilization - CORRECT ANSWER b"
"An integrator is a multiparameter indicator designed to measure which of the following parameters? a) Pressure, steam, and temperature b) Temperature, time, and presence of steam
c) Pressure and sterility - CORRECT ANSWER b"
"In which surgical wound category should a total abdominal hysterectomy be classified? a) Clean b) Clean contaminated c) Contaminated
d) Dirty - CORRECT ANSWER b"
"Immediate use steam sterilization can be used: a) For implants b) In urgent situations c) Under no circumstances
d) For all items - CORRECT ANSWER b"
"The AORN Surgical Wound Classification Decision Tree is helpful in determining: Select all that apply. a) If closed drainage is necessary b) If a major break in technique will affect the wound class c) What constitutes an old injury
d) Which wound class a surgery should be assigned - CORRECT ANSWER b, c, d"
"You are circulating on a laparoscopic appendectomy. Upon entering the abdomen, the surgeon encounters purulent inflammation and asks for a culture. The procedure using the laparoscope without need to open the abdomen. In completing your documentation of wound class, the best choice would be:
1 - B and C 2 - A and D 3 - A, B, and D 4 - A, B, C, and D
*Answer with the correct NUMBER only. - CORRECT ANSWER 3"
"Which of the three elements required for an infection to occur is related to inanimate environmental surfaces? a) Method of transmission b) Susceptible host
c) Source or reservoir - CORRECT ANSWER c"
"A patient is scheduled for reconstruction of her external ear following a dog bite injury. Which skin prep agent is indicated for use in this case? a) Aqueous iodophor b) CHG-alcohol c) CHG
d) Iodophor-alcohol - CORRECT ANSWER a"
"When performing surgical skin prep, the antiseptic agent should be applied for the length of the time designated by the a) AORN Guideline on Preoperative Patient Skin Antisepsis b) Available evidence-based research c) Manufacturer's instructions for use (IFU)
d) Recommendations from the facility's infection control dept. - CORRECT ANSWER c"
"The skin can be sterilized: a) Always b) Easily c) Never
d) None of the above - CORRECT ANSWER c"
"Chlorhexidine gluconate (CHG) is an antimicrobial skin prepping agent used: a) Above the neck b) For topical skin application only below the neck c) For vaginal or mucous membrane preps
d) In the brain or meninges - CORRECT ANSWER b"
"Which agents are effective in removing resident microorganisms? a) Mechanical agents b) Chemical agents c) Biochemical agents
d) Hydrostatic agents - CORRECT ANSWER b"
"Which of the following should be avoided during hair removal? a) Use of clippers b) Clipping of hair against the grain of growth c) Nicking or cutting of the skin
d) Removal of loose hair from prepped area - CORRECT ANSWER c"
"Which device should be used while carrying out an extremity prep? a) Cuff b) Tape c) Assistive prop
d) Clip - CORRECT ANSWER c"
"Identify the correct sequence for prepping: a) Dip the sponge into the antimicrobial solution, squeezing out any excess liquid b) Once the prepping is completed, discard the sponge into a trash container c) Perform hand hygiene d) Beginning at the site of the incision, use friction and scrub in a circular motion e) Don sterile gloves and prepare the prep set
*Use the letters separated w/commas to indicate correct order (first through last step) -
CORRECT ANSWER c, e, a, d, b"
"Iodophors with added detergent are referred to as "________," and those without added detergents are referred to as "________." a) Scrubs; paints b) Paints; scrubs c) Gels; film-forming
d) Scrubs; gels - CORRECT ANSWER a"
"Transient microorganisms live in the ______ layer of the skin. a) Epidermal
b) Elbows, the ileum, and the back of the heels c) Coccyx, back of the heels, and brachial plexus
d) Shoulder blades, the buttocks, and the clavicle - CORRECT ANSWER a"
"What response is the result of tissue layers moving on each other? a) Pressure ulcers b) Maceration c) Shearing
d) Friction - CORRECT ANSWER c"
"The minimum number of personnel that should be available to move an anesthetized patient from a supine-to-prone position is: a) Two b) Three c) Four
d) Five - CORRECT ANSWER c"
"What is included in the Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery? a) Briefing and time out b) Preoperative verification and handover report c) Preoperative verification, surgical site marking, and time out d) Surgical site marking and time out
e) Transfer de-briefing, site marking, and time out - CORRECT ANSWER c"
"During the surgical count before closure of the peritoneum, the scrub person and the RN circulator are unable to locate a laparotomy sponge. What is the FIRST thing the RN Circulator should do? a) Contact the radiology dept. scheduler to obtain a stat x-ray for instrument and sponge verification b) Inform the RN supervisor and ask for assistance c) Notify and receive verbal acknowledgment of the discrepancy from the surgeon
d) Re-open all bagged and discarded sponges, and recount them - CORRECT ANSWER c"
"According to the Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery, what is an acceptable method to identify a patient? a) Ask a patient his or her room number b) Confirm the patient's name by reviewing the surgical consent c) Ask the patient to state his/her full name and date of birth
d) Check the patient's armband for a hospital MRN and social security number - CORRECT
ANSWER c"
"Match the latex sensitivity categories with their correct description: a) Delayed Type IV Hypersensitivity b) Immediate Type I c) Irritant contact dermatitis 1 - Localized delayed allergic reaction occurring 24-72 hrs. after exposure 2 - Non-allergic skin reaction usually aggravated by glove powder and chemical agents added to raw latex 3 - Occurs within 5-30 min. after exposure. The onset may be delayed 10-12 hrs.
*Use numbers separated w/commas to match - CORRECT ANSWER 1, 3, 2"
"An immediate latex allergy response has three stages. Match the following stages with the appropriate symptoms: a) Can progress to a sudden drop in blood pressure, increased HR, and potential circulatory collapse b) Contact urticaria presenting as redness and swelling at the site of exposure c) Response spreads beyond the area of contact and can include itching around the eyes, shortness of breath, and acute rhinitis 1 - Stage I 2 - Stage II 3 - Stage III
*Use numbers separated w/commas to match - CORRECT ANSWER 3, 1, 2"
"What is the BEST way to conduct a Time Out? a) Perform the Time Out in the pre-procedure area if all team members are present. b) Perform the Time Out when the pt enters the room so that s/he may participate. c) The circulating RN leads the Time Out and documents it on the count board within the OR for all to agree
d) The Time Out occurs after the patient is prepped, draped, and involves the entire team -
CORRECT ANSWER d"
"When is NOT considered the best time to do a surgical count for sponges, sharps, and instruments?
"Which of the following practices should be used to implement the Joint Commission's Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery? a) Asking the patient to mark the correct surgical site with an "X" b) Asking the patient to verify the expected procedure in writing c) Using a time-out procedure before beginning the procedure
d) Using three unique patient identifiers - CORRECT ANSWER c"
"Which of the following "AORN Position Statement on Correct Site Surgery" statement is true? a) Family members should not be involved in identifying the correct site b) The surgical site should be marked with a washable marker c) The staff member should verbally verify the correct site with each member of the surgical team
d) Wrong-site surgery is most common in ophthalmologic procedures - CORRECT ANSWER c"
"Which of the following is not a characteristic that promotes a culture of safety within a health care organization? a) Commitment to safety as the first priority in providing care b) Dissemination of information to all levels of staff c) Prompt disciplinary action when errors occur
d) Trust among healthcare team members - CORRECT ANSWER c"
"Which type of human factor is responsible for an error that occurs when a perioperative nurse is trying to attend several tasks at once? a) Device user error b) Knowledge-based c) Situational
d) Skill-based - CORRECT ANSWER c"
"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 an inventory for the sterile processing dept. c) To provide an accurate item charge for the pt
d) To track instruments that might be needed for the next procedure - CORRECT ANSWER a"
"According to the AORN Guidelines, what is the correct documentation for this medication? a) M.S. 2.0 mg b) MS 2 mg c) Morphine sulfate 2 mg
d) Morphine sulfate 2.0 mg - CORRECT ANSWER c"
"A neighbor call the preoperative area and asks the perioperative RN, "How is my friend? I missed her at church and I heard she was in the hospital." What is the RN's appropriate response? a) "Here's her daughter's telephone number; she can give you more information." b) "She's doing well but I cannot give you any more information." c) "The patient has requested that we share her information only with her family."
d) "We are getting ready for surgery so you can talk with her in a few hours." - CORRECT
ANSWER c"
"Perioperative nursing care documentation must include a description of the patient care delivered and the patient response to that care. a) True
b) False - CORRECT ANSWER a"
"Which of the following examples is included on the Joint Commission's list of Do-Not-Use Abbreviations, Acronyms, and Symbols? a) MS b) mcg c) mL
d) unit - CORRECT ANSWER a"
"The regulatory agency responsible for surveying facilities' compliance with the Universal Protocol is: a) Institute of Medicine b) The Joint Commission c) National Quality Forum
d) Occupational Safety and Health Administration - CORRECT ANSWER b"
"When an electrosurgical unit (ESU) is used in surgery, proper documentation includes placement of the dispersive pad, identification of the ESU, and: a) The brand name of the ESU b) The setting used during the surgical procedure c) The brand name of the electrocautery pencil
d) The last date of the preventative maintenance - CORRECT ANSWER b"
"Which of the following types of anesthesia require an anesthesia professional? Select all that apply. a) General b) Local
"A 79-y/o patient undergoing laparoscopic cholecystectomy is being induced under general anesthesia. The anesthesiologist notices an unexplained tachycardia, tachypnea, and jaw tightness. The capnography shows an elevated end-tidal CO2. What is the immediate action the perioperative RN should take to treat this suspected MH? a) Call for the MH cart and Dantrolene b) Initiate cooling measures c) Administer sodium bicarb
d) Change the soda lime canister - CORRECT ANSWER a"
"A precise way of looking at general anesthesia is to divide it into 3 phases: a) Phase I: Initial Administration, Phase II: Maintenance, Phase III: Excitement b) Phase I: Initial Administration, Phase II: Maintenance, Phase III: Emergence c) Phase I: Induction, Phase II: Maintenance, Phase III: Emergence
d) Phase I: Induction, Phase II: Intrasurgery, Phase III: Excitement - CORRECT ANSWER c"
"During intubation, the patient has chest movement but no air exchange. The perioperative RN's first priority is to: a) Prepare for re-intubation b) Assure that suction is available for the anesthesia care provider c) Provide racemic epinephrine for the anesthesia care provider
d) Provide positive-pressure ventilation - CORRECT ANSWER b"
"In addition to giving Dantrolene, which of the following treatment options for MH should the RN anticipate and prepare? a) Cool pt, restart succinylcholine at lower doses b) Provide 100% oxygen, use iced saline to cool pt c) Replace potassium loss, continue w/safe anesthetic agents
d) Avoid pt shivering, contact blood bank for platelets - CORRECT ANSWER b"
"Which is NOT a local anesthetic drug used for regional anesthesia? a) Bupivacaine b) Lidocaine c) Fentanyl
d) Tetracaine - CORRECT ANSWER c"
"Which of the following drugs should be available to treat a Malignant Hyperthermia (MH) crisis? a) Diazepam (Valium) b) Meperidine (Demerol) c) Dantrolene (Dantrium)
d) Sodium Bicarbonate - CORRECT ANSWER c"
"_________ should not be placed on the sterile field until final counts are completed. a) Dressing sponges b) Closing stitches c) Irrigating fluid
d) Skin staples - CORRECT ANSWER a"
"While setting up for an emergency C-section before the patient enters the OR suite, the scrub RN notices that there are no radiopaque strips on the lap sponges. What should the scrub RN do? a) Ask the RN circulator to make a note of the missing strips on the perioperative record b) Hand off the lap sponges and ask the RN circulator to remove them from the OR suite c) Isolate the lap sponges on the sterile field by hiding them under towels
d) Proceed w/the sponge count to avoid delaying the start of the emergency procedure -
CORRECT ANSWER b"
"________________ hemostasis is achieved by occluding severed vessels until platelet formation occurs. a) Thermal b) Mechanical
c) Chemical - CORRECT ANSWER b"
"The perioperative RN discovers that a sponge is missing during the closing count for a left lung lobectomy. The RN's first action would be to: a) Repeat the count b) Notify the surgeon c) Notify the supervisor
d) Document the incident - CORRECT ANSWER b"
"The perioperative RN who is circulating for a breast lumpectomy should anticipate the need to add which suction drain to the sterile field? a) Nasogastric tube b) Jackson-Pratt c) Penrose drain
d) T-tube - CORRECT ANSWER b"
"These types of sponges prove blunt dissection as they absorb fluids: a) Neuro-patties b) Laparotomy sponges
