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NIFA Perioperative Quiz | 100% Correct
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Of the following choices, which would not be a consideration for choosing suture? A. Type of procedure B. The tissue being reapproximated C. Type of reapproximation D. Scrub person preference - โโD. Scrub person preference Alexanders 15th P Which of the following is not an event that would adversely affect the pulse ox reading? A. Hypothermia B. Hypertension C. Vasoconstriction D. Hypovolemia - โโB. Hypertension Alexanders 15th P Skin injuries related to shearing occur most commonly as a result of which of the following positions? A. Trendelenburg B. Prone C. Lateral D. Lithotomy - โโA. Trendelenburg Alexanders 15th P A basic anesthesia monitoring device that is used during general anesthesia to confirm successful endotracheal tube placement and determine the presence of gas exchange is the: A. Pulse oximetry device B. Stethoscope
C. Capnometer/end-tidal CO2 monitor D. Post-intubation arterial blood gas - โโC. Capnometer/ The immature blood-brain barrier and decreased protein binding in infants increase their sensitivity to which group of medications? A. anticholinergics, parasympathetics B. Antidysrhythmic agents C. Opioids and hypnotics D. Adrenerics - โโC. Opioids and hypnotics Alexander 15th p Proper care and handling of surgical specimens is imperative for correct diagnosis, treatment, and prognosis planning of the patient. Select the response that best reflects correct specimen care and handling. A. Label consecutive specimens B. Send all specimens to the lab together as one pickup, including the frozen sections C. Avoid placing specimens for frozen section in formalin D. Neutralize formalin/formaldehyde spills with glycerin and call the hazmat team. - โโC. Avoid placing specimens for frozen section in formalin Alexander 15th p From the following, choose the types of anesthesia that will allow patients to tolerate potentially uncomfortable procedures while maintaining their own airway and be easily aroused from light sleep. A. Moderate anesthesia care B. Local infiltraion C. Moderate sedation/analgesia D. Regional anesthesia - โโC. Moderate Sedation/analgesia Alexander 15th P Risk factors for postoperative nausea and vomiting should be assessed preoperatively. Which of the following is a risk factor for PONV?
Linda Gardner is highly allergic to latex and the anesthesia provider plans to give Linda prophylactic medications before anesthesia. What medications might be administered to Linda in the preoperative holding area? A. Epinepherine and an H2-blocker B. Vasopressin and atropine C. Prednisone and a beta-agonist inhaler D. Dimethylxanthine - โโC. Prednisone and a beta-agonist inhaler Alexander 15 p When a patient absorbs an unsafe amount of local anesthetic into the bloodstream, a catastrophic outcome is possible. Treatment for LAST includes the use of which of the following? A. Lipids B. LR bolus of 500cc C. NS Bolus of 500CC D. Diphenhydramine - โโA. Lipids Alexanders 15 p From the following, select an advantage polyester suture has over other nonabsorbable sutures. A. Greater tinsile strength B. Greater tissue reactivity C. Able to absorb tissue fluids D. decreased knot slippage - โโA. Greater tinsile strength Alexanders 15th p While tucking the arms at the sides of the patient in supine position offers comfort, safety, and easy access to the patient by the scrubbed team, improper positioning and securing of the arms can result in significant injury. Injury can be avoided by tucking the draw sheet ___________ the arm and under the ____________. A. Over, Body B. Under, Mattress C. Over, Mattress
D. Around, OR bedrail - โโA. Over, Body Alexanders 15th p In several studies, it was determined that the risk of contamination and subsequent infection to the wearer can be reduced by wearing two pairs of sterile surgical gloves, as opposed to wearing one pair. Select the correct statement that refers to double gloving in terms of a best practice. A. The American College of Surgeons endorses double gloving for all surgery and invasive procedures B. Wearing two glove layers permits re-gloving using the closed-glove technique for a contaminated glove. C. Wearing a glove liner between both layers of gloves may eliminate the risk of perforation to the inner glove, protecting the wearer from sharps injury. D. The AORN publication titled Recommended Practices for Prevention of Transmissible Infections in the Perioperative Practice Setting recommends the Double-Glove procedure during invasive procedures. - โโA. The American College of Surgeons endorses gloving for all surgery and invasive procedures. Alexanders 15th p An instrument that is used to occlude a vessel is know as: A. Hemostat B. Occluding clamp C. Kocher D. Forceps - โโA. Hemostat Alexanders 15th 201 ________ Precautions apply to blood, all body fluids, and excretions (except sweat), regardless of whether they contain visible blood, mucous membranes, and non-intact skin. A. Hospital B. Standard C. Isolation D. Contact - โโB. Standard Alexanders 15th p
A. Primary Intention B. Secondary intention C. Granulation and contraction D. Third Intention - โโD. Third Intention or Delayed primary closure Alexanders 15 p Which statement about surgical dressings is true? A.Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage. B. Surgical dressings cover the wound to maintain moisture to promote granulation C. Surgical dressings maintain tension on the suture line to prevent dehiscence D. Surgical dressings protect surrounding drapes, linens, and clothing from contamination. - โโA. Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage. Alexander 15th p Which of the following absorbable suture has the best tensile strength? A. Surgical gut B. Polypropylene C. Surgical silk D. Polydioxanone - โโD. Polydioxanone or PDS A type of suture to help eliminate tension on the primary suture line is known as: A. Retention B. Interrupted C. Subcuticular D. Buried - โโA. Retention Alex 15th p A common dysrythmia after surgery is:
A. SVT
B. Sinus Tachycardia C. Bradycardia D. Atrial Fibrillation - โโB. Sinus Tachycardia Alexanders 15th P 275 The new general surgery fellow placed the three trocar ports for the laparoscopic appendectomy. The procedure was completed without incident; however, on post op day 1, the patient demonstrated signs and symptoms of sepsis. What might have been the unusual occurrence that could ave resulted in patient sepsis? A. Unrecognized appendiceal rupture. B. Significant break in sterile technique C. Inadvertent trocar puncture through the bowel on insertion D. Recent H1N1 outbreak on the surgery unit at the hospital - โโC. Inadvertent trocar puncture through the bowel on insertion Once a count discrepancy is identified, an important step scrubbed team member should do to aid in resolving the discrepancy is which of the following: A. Allowing the circulator to search the sterile drapes and drape folds B. Continue closure of the incision C. Order intraoperative imaging D. Notify the charge RN - โโC. Order intraoperative imaging Alexanders 15th P A 19yo M received an IV peripheral nerve block for an ORIF of an ankle fracture. The anesthesia provider injected a distal dorsal vein of the pt's right foot with 2% lidocaine, after placing a single cuffed pneumatic tourniquet around the upper thigh. The surgeon noticed that the cuff seemed to be deflating and anticipated that the patient would initially complain of which of the following? A. Metallic taste in his mouth B. Seizures C. Dizziness
Which of the following suture choices would be the best suited for intestinal anastamosis based on the quantities of excellent handling capability, high tinsile strength that decreases after 1 yr, and is not a true nonabsorbable suture? A. Vicryl B. Prolene C. Monocryl D. Silk - โโD. Silk Alexanders 15th P The surgical hand scrub is designed to render the hands, nails, and arms: A. Surgically clean B. Aseptic C. Sterile D. Decontaminated - โโA. Surgically clean Alexanders 15th P 108 After prepping the face, neck, and upper chest for a radical neck dissection using an alcohol based prep stick, the protective towels around the site were removed. The RNFA applied the head drape and completed draping the patient. During the pre-incision surgical time-out, the fire risk score was determined to be high. When the surgeon noticed an area of the neck that did not look prepped, she asked for a new prep stick to complete the prep area, taking care not to moisten the head drape. After handing off the used prep stick she asked for the scalpel. What step was omitted in this process? A. The new prep area was not given time to dry B. The time-out should have been repeated with the surgoen scrubbed C. The patient should have been re-prepped and re-draped with all new drapes D. The scrub person should have given the surgeon a sterile towel to cover the unprepped area - โโA. The area was not given time to dry AORN Guidelines for Perioperative Practice 2019 Patient skin antisepsis, IVe. The instrument tips in laproscopic instruments are designed to produce the same tissue effects as a traditional instrument used for the open surgery. Instrument manufacturers have attempted to make
their products effecient by cobining functions. An appropriate combined function for a laproscopic instrument would be A. Ultrasound capability in a suturing forceps B. Electrosurgery conduction through the tips of a babcock grasper C. Blunt dissection with a smooth, rounded edge of the closed endoscopic scissors D. Suction and irrigation combined with an argon beam coagulation handpiece. - โโC. Blunt dissection with the smooth, rounded edge of the closed endoscopic scissors Alexanders 15th P 214 Suture permanently attached to the needle are referred to as A. Engineered crimp B. Controlled release C. Reverse cutting D. Swaged - โโD. Swaged Alexanders 15 P 191 The surgeon used the ESU in mono polar mode to cut and coagulate through the subcutaneous tissue on opening the abdomen during a bariatric bypass procedure. As she began to proceed through the muscle and fascia layer, she asked the circulating RN to increase the cut and coagulation modes on the ESU. What measure could the scrub person take to enhance energy delivery? A. Unwrap the ESU cord from around the tower damp handle B. Clean the charred tissue from the active electrode blade. C. Change the settings to blend mode D. Replace the active electrode blade with a coated blade. - โโB. Clean the charred tissue from the active electrode blade Alexanders 15th P 233 Which of the following is not a characteristic of silk suture? A. Soft B. Handling ability C. Knot security
emptied into the patient. The patient immediately experienced rapid onset of hypotension, bradycardia, and apnea. The resulting condition is called ____ and now must be managed with _____. A. Total subarachnoid syndrome, mechanical ventilation B. Hypotensive apnea episode, tracheostomy and humidified positive end-expiratory pressure C. Cardiogenic shock, ACLS protocol D. Total spinal anesthesia, general endotracheal anesthesia. - โโD. Total spinal anesthesia, general endotracheal anesthesia Care of the patient in surgery 15th P 145 When buried in tissue, silk loses its tinsile strength after what period of time? A. 6 months B. 1yr C. 90 days D. 2 qwwka - โโB. 1 Yr Alexanders 15th P 189 What is the appropriate action if the delayed after the room and instruments have been opened? A. Cover the instruments with a sterile drape. B. Cover the instruments with a sterile drape and have the scrub RN continually visually observe the room for breaches in sterility C. Do not cover open supplies and have the scrub RN continually visually observe the room for breaches in sterility D. Do not cover open supplies. Assign any OR personnel to observe the room for breaches in sterility. - โโA. Cover the instruments with a sterile drape AORN, Sterile technique, Maintaining a sterile Field, p 1039- 1041 Healthcare professionals should employ which strategy to reduce their risk of allergic reaction to latex in the preoperative environment? A. Use power-free gloves that have low levels of protein and chemical allergens B. Use sterile oil-based hand creams before donning gloves if latex gloves must be worn C. Use cotton under gloves if latex gloves must be worn
D. Wear an OR hat without elastic headband and do not wear rubber tennis shoes - โโA. Use power- free gloves that have low levels of protein and chemical allergens Alexanders 15th P 65 During you preoperative assessment, the patient reports a latex allergy and they always carry an epi pen adn a beta-agonist inhaler. What type of latex allergy does this patient have? A. Allergy contact dermatitis B. Irritant contact dermatitis C. True latex allergy D. Combined effect latex allergy - โโC. True latex allergy Alexanders 15th p Which member of the surgical team can be held liable in litigation for retained foreign bodies? A. The entire team B. The surgeon C. The scrub person D. The scrub person and the circulatior - โโA. The entire team AORN Perioperative Practice, Retained surgical items, 1. All perioperative team members are responsible for the prevention of RSI's Ketamine is a short activg induction and IV/IM maintenance agent that allows patients to maintain their airways. It is a suitable agent to use with small children and burn patients. Which of the following would be a concern with large doses of ketamine? A. Prolonged duration B. Thrombocytopenia C. Respiratory depression D. Myotonic movements - โโC. Respiratory depression Alexanders 15th p 138
