100 Question CNOR Practice Exam Questions with Answers 2024, Exams of Nursing

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100 Question CNOR Practice Exam

Questions with Answers 2024

Aseptic technique is also known as: A. Clean technique B. Sterile technique C. Sterilization D. Decontamination ✔ A. Clean technique Aseptic technique refers to clean methods of containing microbial contamination in the environment. The environment cannot be sterilized. An intrinsic factor that contributes to the development of a pressure injury is: A. Pressure B. Hypothermia C. Diabetes mellitus D. General anesthesia ✔ C. Diabetes mellitus An intrinsic factor is related to the health of the patient. Diabetes mellitus is an intrinsic factor that contributes to the development of a pressure injury. Which of the following helps determine a patient's discharge destination? A. Written discharge instructions from anesthesiology and medical staff B. Risk of postoperative complications C. Standardized pain scoring D. General condition and readiness for discharge ✔ B. Risk of postoperative complications The choice of discharge site is based on patient acuity, access to follow-up care, and the potential for postoperative complications. Central nervous system (CNS) signs and symptoms of local anesthetic systemic toxicity (LAST) include: A. Hypertension B. Numbness of lips and tongue C. Respiratory depression D. Elevated temperature ✔ B. Numbness of lips and tongue

CNS symptoms of LAST include circumoral and tongue numbness. All other options are not considered part of the CNS. Autologous bone grafts should be stored at a temperature of: A. 68F (20C) B. 32F (0C) C. -4F (-20C) D. -112F (-80C) ✔ C. -4F (-20C) Maintaining storage temperatures within recommended parameters of -4F (-20C) helps ensure that autografts are maintained in optimal conditions for successful replantation. When providing patient education for a child, it is important to understand which learning characteristics of children? A. Children are self-directed B. Children use intrinsic thought processes C. Children respond to use of activities that follow transitions of maturity. D. Children respond to a trial-and-error approach ✔ D. Children respond to a trial-and-error approach When teaching children, using a trial-and-error approach is effective. Child learners are task-oriented, use extrinsic thought processes, and value self-esteem. Which of the following actions would decrease radiation exposure during fluoroscopy procedures? A. Positioning the patient as close to the tube as possible B. Positioning the patient as far from the image intensifier as possible C. Positioning the patient as far from the monitor as possible D. Positioning the patient as close to the image intensifier as possible ✔ D. Positioning the patient as close to the image intensifier as possible The x-ray beams originate from the tube and are captured by the image intensifier. Multiple studies have demonstrated that positioning the patient closer to the image intensifier results in a significantly decreased dose of radiation. A perioperative nurse is assisting an anesthesia professional with a rapid-sequence induction by providing cricoid pressure using the Sellick maneuver. Which of the following is the most appropriate description of this technique? A. Exerting down-and-up pressure on the cricoid cartilage to compress the trachea

B. Palpating for the thyroid cartilage and exerting pressure on it with a dominant index finger and thumb to occlude the esophagus C. Applying pressure on the cricoid cartilage to occlude the esophagus D. Maintaining pressure on the thyroid cartilage until anesthesia verifies placement ✔ C. Applying pressure on the cricoid cartilage to occlude the esophagus The Sellick maneuver, more commonly known as cricoid pressure application, involves exerting downward pressure on the cricoid cartilage with the thumb and index finger of one hand to compress the esophagus. The Sellick maneuver is used to prevent potential aspiration during induction of anesthesia. A diagnostic procedure that replies on radio-frequency waves to reproduce cross- sectional images of the body without exposing the patient to ionizing radiation is: A. Ultrasonography B. Position emission tomography C. Computed tomography D. Magnetic resonance imaging ✔ D. Magnetic resonance imaging Magnetic resonance imaging stimulates disequilibrium in the nuclei of hydrogen atoms and the water of body cells. As nuclei return to their original state, they emit radiofrequency signals. Which of the following movements of a powered instrument is used to drill holes or to insert screws, wires, and pins? A. Reciprocating B. Oscillating C. Alternating D. Rotating ✔ D. Rotating Rotary movement is used to drill holes or to insert screws, wires, or pins. Reciprocating and oscillating movements are used to cut or remove bone. Alternating movement should not be sued. What is the most likely cause of a rapid decrease in blood pressure and heart rate for a patient being infused when 1.5% glycine is used for irrigation? A. Anaphylactic reaction B. Myocardial infarction C. TUR syndrome D. Pulmonary embolus ✔ C. TUR syndrome

The patient is most likely experiencing TUR syndrome associated excessive glycine absorption. Preoperative teaching is most effective when patients have a readiness to learn and the perioperative nurse teaches from ________ different levels. A. Two B. Three C. Four D. Five ✔ B. Three There are three different levels of preoperative teaching: information, psychosocial support, and skill training. Information should include explanations of procedure and what to expect throughout the phases of perioperative care. Psychosocial support includes encouraging the patient to share anxiety and supporting coping mechanisms. Skill training allows the patient to learn the skills required to function after the procedure and provides confidence and understanding. When caring for a patient with sickle cell anemia, the perioperative nurse should: A. Raise the temperature in the operating room to between 26.7C and 29.4C (80F and 85F). B. Have relaxing music playing in the operating room to avoid overstimulation C. Administer a liter of normal saline prior to surgery to ensure that the patient is well hydrated D. Allow a family member or friend to sit with the patient in the preoperative area and in the post anesthesia care unit. ✔ A. Raise the temperature in the operating room to between 26.7C and 29.4C (80F and 85F). The sickle cell patient must be kept warm to prevent hypothermia and meet increased demands for oxygen. A _______ type of fire extinguisher should be used in an operating or procedure room. A. Wet chemical B. Carbon dioxide C. Halogen D. Dry powder ✔ B. Carbon dioxide The National Fire Protection Association recommends using either a water mist or carbon dioxide extinguisher for extinguishing fires in the operating room. _______ requires purposeful, outcomes-directed thought and is driven by patient need.

A. Critical thinking B. Assessment C. Diagnosis D. Planning ✔ A. Critical thinking Scientific nursing interventions, critical thinking and clinical reasoning, and caring, comforting behaviors are at the heart of perioperative nursing. Critical thinking is a thoughtful process important in the performance of perioperative nursing care versus being part of the nursing process. A hemoglobin value considered to be within normal limits for an adult woman is: A. 10 g/dL to 14 g/dL B. 12 g/dL to 16 g/dL C. 14 g/dL to 18 g/dL D. 16 g/dL to 20 g/dL ✔ B. 12 g/dL to 16 g/dL Normal hemoglobin values are 12 g/dL to 16 g/dL for women and 14 g/dL to 18 g/dL for men. What technique is the safest to use when securing the arms at the patient's sides? A. Drawing a sheet under the arms, over the patient, and using non-penetrating clamps to secure it to the opposite side B. Drawing a sheet over the arm and then sliding it between the mattress and the bed C. Drawing a sheet over the arm and tucking it between the patient and the mattress D. Wrapping the patient's arm with padding and securing it to the body with a safety strap ✔ C. Drawing a sheet over the arm and tucking it between the patient and the mattress A safe and effective way to prevent nerve injury of the upper extremities is to secure the patient's arms by smoothly wrapping the draw sheet over the arm and then tucking it under the patient's body to prevent arm slippage during surgery. Which of the following intraoperative medication orders would prompt a perioperative nurse to have a urinary catheter readily available? A. Levetiracetam 1gm IV after incision B. Cefepime 2g/100mL IV infusion within 30 minutes of incision C. Ketorolac 20mg IV push before incision D. Mannitol 10% 10g/100mL after incision ✔ D. Mannitol 10% 10g/100mL after incision

Hypertonic mannitol is a nonosmotic diuretic that is often used during brain surgery to promote diuresis and therefore decrease intracranial pressure. Which of the following is defined as the process of teaching adults? A. Pedagogy B. Andragogy C. Cognition D. Orientation ✔ B. Andragogy Teaching and learning processes related to mature adults are known as andragogy. Personal protective equipment that must be worn when mixing and inserting methyl methacrylate bone cement includes: A. Head coverings B. Latex gloves C. Googles D. Shoe covers ✔ C. Googles Methyl methacrylate can penetrate many latex compounds. Methyl methacrylate fumes may irritate the eyes; therefore, eye protection must be worn when mixing and inserting methyl methacrylate bone cement. PPE is defined as any clothing or other equipment that protects a person from exposure to chemicals. PPE may include gloves, aprons, chemical splash goggles, and impervious clothing. Which of the following nursing actions would be best support a positive outcome for a nursing diagnosis of potential for alteration in skin integrity? A. Place a warming blanket on the OR bed prior to the patient coming into the operating room B. Obtain an appropriate positioning device that will aid in redistribution of pressure C. Place several layers of linen material on the OR bed D. Position the patient in a supine position with arms tucked at sides and palms facing down to protect the ulcer nerve ✔ B. Obtain an appropriate positioning device that will aid in redistribution of pressure Warming blankets and extra layers of material should not be placed under the patient. The goal is to use equipment that is designed to redistribute pressure and that decreases the risk for positioning injuries. Palms should face the patient when the arms are tucked. Which of the following describes point-of-use cleaning of a surgical instrument?

A. Prior to the procedure, the instrument is cleaned with a moist sponge B. During the procedure, the instrument is cleaned with a moist sponge after each use C. After the procedure, the instrument is cleaned with a moist sponge in the sterile processing area D. Continually clean the instrument with a sponge moistened with saline ✔ B. During the procedure, the instrument is cleaned with a moist sponge after each use One type of point-of-use cleaning of a surgical instrument is when the instrument is cleaned with a sterile, water-soaked sponge after each use during the procedure. Point- of-use cleaning also occurs when an instrument is cleaned at the point of use immediately following the procedure. Saline should not be used for point-of-care cleaning. Cleaning at the point of use prevents bioburden from building up on the instrument and helps maintain the life of the instrument. Venous air embolism is most likely to occur when the patient is in the ________ position. A. Supine B. Sitting C. Lithotomy D. Lateral ✔ B. Sitting Venous air embolism can occur when air or gas is drawn into the circulation by the veins above the level of the heart and is most likely to occur during neurosurgery or open shoulder surgery in the sitting or semi-sitting position. A subjective sign of the existence and intensity of postoperative pain is the patient's: A. Self-report B. Change in blood pressure C. Facial expression D. Protective guarding behavior ✔ A. Self-report A subjective sign is what the patient states. Objective signs include results from physical assessment or observation. A nursing diagnosis that considers a patient is at risk means the nursing interventions: A. Are directed at prevention B. Will not affect the patient's outcome C. Should be performed only as needed D. May put the patients at risk ✔ A. Are directed at prevention

For perioperative patients, nursing diagnoses that consider a patient at risk for an outcome mean the problem has not yet occurred, and the interventions are directed at prevention. Signs of a blood transfusion reaction include which of the following? A. Hypotension, hemoglobinuria, hyperthermia B. Weak pulse, hemoglobinuria, hypertension C. Hypothermia, weak pulse, tachycardia D. Hypothermia, hemoglobinuria, tachycardia ✔ A. Hypotension, hemoglobinuria, hyperthermia A blood transfusion reaction reflects vasomotor instability and is evidenced by hypotension, hemoglobinuria, and hyperthermia. Many common signs are not readily obvious when a patient is under anesthesia. When performing time out, which of the following should be verified? A. Laboratory studies B. Instruments C. Suture D. Procedure ✔ D. Procedure Ensuring correct-site surgery requires affirmation of the following: correct patient, position, site, procedures, equipment, images, and implants (if required). Pneumatic tourniquets should be deflated under the direction of: A. The surgeon and the scrub person B. The anesthesia professional and the circulating nurse C. The circulating nurse and the surgeon D. The surgeon and the anesthesia professional ✔ D. The surgeon and the anesthesia professional Hemodynamic changes may occur when the tourniquet is deflated. As the tourniquet cuff deflates, the anesthetic agent may be released into the circulatory system, causing systemic effects. Coordination among members of the perioperative team under the direction of the surgeon and the anesthesia professional can facilitate management of the patient's physiologic status during this period of rapid change. Which organization should be consulted about a perioperative RN's scope of practice related to administration of medications for moderate sedation? A. Association of periOperative Registered Nurses

B. The Joint Commission C. State Board of Nursing D. Centers for Medicare & Medicaid Services ✔ C. State Board of Nursing The professional registered nurse's scope of practice is defined by the individual state board of nursing. A perioperative nurse is monitoring a patient under local anesthesia during a hernia repair when the patient reports a strange taste in the mouth. What is the most appropriate response by the perioperative nurse? A. Reassure the patient that it is a common sensation and will resolve soon after surgery B. Check the patient's hemoglobin and hematocrit C. Ask the patient to confirm nothing by mouth status D. Call for help ✔ D. Call for help The patient's symptom may represent a local anesthetic systemic toxicity (LAST), which would require urgent treatment under the direction of a qualified health care provider such as an anesthesia professional or a code team. In addition to altered taste (eg, metallic taste), other symptoms of LAST are consistent with neurologic (eg, numbness, confusion, seizures) and/or cardiovascular collapse (eg, bradycardia/hypotension). A 47-year-old Spanish-speaking male presents with abdominal pain. He does not speak or understand English. How should the nurse communicate with the patient? A. Use a family member to interpret B. Use a trained medical interpreter C. Speak loudly and slowly to the patient D. Ask a bystander to interpret ✔ B. Use a trained medical interpreter Using a trained medical interpreter decreases errors and misunderstanding of the explanation of care. Using a family member may cause either the family member or patient to not be truthful to the care provider due to embarrassment. Using a bystander to interpret is a violation of HIPAA. Which of the following actions terminates the direct perioperative nurse-patient relationship? A. Evaluating the degree of attainment of expected outcomes B. Performing the postoperative assessment or follow-up telephone call C. Attending conferences with the patient's physician and/or other caregivers D. Suggesting comfort measures to help calm the patient

✔ B. Performing the postoperative assessment or follow-up telephone call The postoperative assessment or follow-up telephone call terminates the direct perioperative nurse-patient relationship. Operating room floors should be cleaned with: A. Dry mops B. Brooms C. Vacuums D. Damp or wet mops ✔ D. Damp or wet mops Wet and moist mopping produce fewer aerosols and are most effective in reducing organic soil in the environment. A coworker in the operating room asks to see the patient's chart for the nurse's next case, stating that the patient is her neighbor. The nurse should: A. State this would be a violation of the patient's privacy B. Hand over the patient's chart because they are neighbors C. Consult with the doctor about letting the coworker see the chart D. Ask their director to make the decision ✔ A. State this would be a violation of the patient's privacy The federal Health Insurance Portability and Accountability Act (HIPAA) granted patients significant rights in respect to how their health information is used. Only health care personnel involved in direct patient care should have access to patient information. Surgery of the liver requires incising the external covering referred to as: A. Glisson's capsule B. Gerota's fascia C. Porta hepatis D. Hepatic fascia ✔ A. Glisson's capsule The covering of the liver is made up of dense connective tissue called Glisson's capsule. Which of the following is the most appropriate recommendation for hair removal prior to surgery? A. A depilatory should be used in the operating room B. The patient should shave at home the night before surgery C. A wet shave should be done in the operating room

D. The patient's hair should be clipped in the preoperative area ✔ D. The patient's hair should be clipped in the preoperative area When necessary, hair at the surgical site should be removed in the area outside of the procedure room and in a manner that minimizes injury to the skin, such as by clipping or depilatory methods. Joey is a 4-year-old scheduled to have surgery. During preoperative teaching, the perioperative nurse knows that Joey's age-specific needs can best be met by: A. Allowing his parent or caregiver to explain what will happen B. Providing him privacy whenever possible C. Allowing him to handle the oxygen mask and ride in the wagon that will later take him to the OR D. Giving him a thorough explanation of everything that will happen ✔ C. Allowing him to handle the oxygen mask and ride in the wagon that will later take him to the OR The preschooler needs to explore and interact with his environment. Allowing him to familiarize himself ahead of time with some objects he may encounter can help ease anxiety. "Flammable" antiseptic solutions differ from "combustible" ones in that: A. Flammable solutions have a flash point above 101.5F B. Flammable solutions will not ignite C. Combustible solutions have a flash point above 100.0F D. Combustible solutions will not ignite ✔ C. Combustible solutions have a flash point above 100.0F The threshold between flammable and combustible solutions is the flash point of 100.0F, with flammable ones being below this temperature and combustible ones being above. All saturated flammable solutions should be removed prior to draping the patient. Fumes from volatile or combustible solutions may ignite without a direct connection to the source of ignition. Which of the following is the most important action by the circulating nurse to reduce specimen error? A. Seeking clarification from the surgeon about the specimen site and side B. Calling the laboratory to confirm the proper storage solution for the specimen C. Asking the scrub person to verify the specimen D. Paging the surgical assistant postoperatively to identify the specimen ✔ A. Seeking clarification from the surgeon about the specimen site and side

The surgeon is the person with the most accurate information about the site/side of the specimen, how the specimen should be handled (eg, specific storage solution), and what kinds of tests should be requested of the pathology department. Using the nursing process, nursing interventions lead to: A. Planning B. Implementation C. Assessment D. Outcome identification ✔ D. Outcome identification Outcome identification describes the desired patient condition that can be achieved through nursing interventions. Which of the following statements on wearing safety glasses is true? A. Eye protection must be worn if splashes, spray, or droplets of potentially hazardous materials can be reasonably anticipated B. Corrective lenses fulfill the personal protective equipment requirements for ocular safety C. Safety glasses enhance the visual field of the wearer D. Wearers of corrective lenses are not permitted to wear either contacts or eyeglasses with their safety glasses ✔ A. Eye protection must be worn if splashes, spray, or droplets of potentially hazardous materials can be reasonably anticipated Health care personnel must wear eye protection when splashes, spray, spatter, or droplets of blood or other potentially infectious materials can be reasonably anticipated. When delegating a task, the circulating nurse should: A.Verify the task is within the scope of practice of the designee B. Provide a minimum of instructions on how to complete the task C. Give feedback to the designee based on personal experiences D. Assume the designee has the skills to perform the task ✔ A.Verify the task is within the scope of practice of the designee When delegating tasks, the circulating nurse must verify that the person being assigned the task can perform them within their scope of practice. Clear instructions and appropriate feedback are vital to ensuring safe execution of the task being delegated. A medication that should be administered for treatment of local anesthetic systemic toxicity crisis is: A. Lidocaine

B. Epinephrine C. 20% Lipid emulsion D. Propofol ✔ C. 20% Lipid emulsion A medication that should be administered for treatment of local anesthetic systemic toxicity is 20% lipid emulsion. The lipid emulsion is used to draw the local anesthetic out of the bloodstream. Hospital policy should include the requirement of PPE for all personnel that are likely to come in contact with blood or infectious materials based on: A. OSHA regulations B. TJC standards C. AORN Guidelines D. CDC recommendations ✔ A. OSHA regulations OSHA regulations require the use of PPE for any person that may encounter blood or infectious materials. Hospital policy must comply with the OSHA regulations. When double gloving, personnel should wear: A. Gloves one size larger for the first layer B. Gloves one size smaller for the first layer C. Gloves that are the same size for both layers D. Hypoallergenic gloves for the outer layer ✔ A. Gloves one size larger for the first layer Using an inner glove that is one size larger allows for an air pocket that will prevent constriction when the outer glove is applied. If hypoallergenic gloves are worn, these should be donned as the first pair, with generic sterile gloves worn as the outside pair. When preparing the skin for head and neck surgery, the circulating nurse understands that: A. Chlorhexidine gluconate should not be used for facial preps because corneal damage can occur if the cleanser is accidentally introduced into the eye(s) B. Cotton applicators should not be used for cleaning the external ear canal because they can puncture the inner ear C. Facial skin surfaces should be cleansed within 1 to 2 inches of the hair line D. Shaving the eyebrows should be avoided unless medically ordered ✔ A. Chlorhexidine gluconate should not be used for facial preps because corneal damage can occur if the cleanser is accidentally introduced into the eye(s)

Facial preps can risk injury to the eyes and ears in particular. Chlorhexidine gluconate can cause corneal and inner ear damage if the agent enters these areas. Cotton applicators can be used (with caution). Eyebrows should not be shaved as they are likely to grow back incompletely and/or unevenly. The hair should not be included in the prep unless the area is part of the sterile field. Medication errors related to ______ may be prevented by the medication reconciliation process. A. Procuring and prescribing B. Transcribing and procuring C. Prescribing and monitoring D. Transcribing and prescribing ✔ D. Transcribing and prescribing The medication reconciliation process has been implemented to help prevent transcribing and prescribing errors. Deviation from a standardized procedure that is hospital policy suggests the need for: A. A root cause analysis B. A verbal warning C. An evaluation of the procedure or staff D. Better communication ✔ C. An evaluation of the procedure or staff Standardization of procedures helps help develop skill and efficiency. Policies and procedures based on standards and guidelines help to incorporate evidence-based practice into patient care. Deviation from those policies should lead to an evaluation of the processes and staff involved to discover if the process needs to be improved. A patient reports to the ambulatory surgery center for local anesthesia without sedation and claims that the surgeon gave him permission to drive himself home. The most appropriate action for the perioperative nurse is to: A. Cancel the surgery and reschedule when the patient has a ride B. Contact the social worker to assist in finding transportation for the patient C. Check for an order stating that the patient may drive himself home D. Allow the patient to leave when his postoperative Aldrete score is 10. ✔ C. Check for an order stating that the patient may drive himself home It may be permissible for the patient to drive himself home if the surgery was performed under local anesthesia without sedation and if there is a physician's order. Which of the following are methods of sterilization?

A. Chemical, mechanical, and biological B. Decontamination, disinfection, and pasteurization C. Thermal, chemical, and radiation D. Low-level disinfection, intermediate-level disinfection, and high-level disinfection ✔ C. Thermal, chemical, and radiation Sterilization processes are either physical (eg, steam), chemical (eg, ethylene oxide gas), or radiation (eg, x-ray). A 36-year-old male presents to the operating room for repair of a fractured right medial malleolus. He weighs 85 kg, does not smoke, and does not take any medications at home. Which of the following characteristics increases the patient's risk of developing venous thromboembolism (VTE)? A. His age B. His injury C. His weight D. His smoking status ✔ B. His injury Procedure-related VTE risk factors include ankle fracture. The patient is less than 40- years, does not smoke, and is not obese. During the preoperative assessment of an 82-year-old malnourished woman, the RN circulator determines that the patient is at an increased risk of: A. Postoperative hyperthermia B. Unplanned hypothermia C. Ineffective peripheral tissue perfusion D. Excess fluid volume ✔ B. Unplanned hypothermia The preoperative patient assessment should include factors that may contribute to unplanned hypothermia, including patient-related factors such as age (ie, above 65 years of age), sex (ie, female), low body-surface area or weight, and preexisting medical conditions (eg, malnourishment). Gelatin pads used for hemostatic absorb in: A. 7 to 10 days B. 10 to 20 days C. 20 to 40 days D. 60 to 90 days ✔ C. 20 to 40 days

Absorbable gelatin is treated to retard absorption, which allows the hemostatic agent to absorb 20 to 40 days after placement. The gelatin pad absorbs 40 times its weight and may be used wet or dry. A collection of blood in a body cavity or space caused by uncontrolled bleeding or oozing is called: A. Hematoma B. Pseudoaneurysm C. Varicosity D. Contusion ✔ A. Hematoma Hematomas form when there is uncontrolled bleeding or oozing into a body space or cavity. The hematoma may cause pain and require drainage. Policies and procedures for standardized transfer of care should reflect rules and recommendations from regulatory agencies and accreditation agencies as well as: A. A contingency plan should a patient's status change B. Verbal confirmation via read-back of cardiac monitoring and oxygen needs C. Use of a checklist to ensure all parameters for transfer of patient care have been met D. Approval of regulatory agencies for transfer of patient care processes, as documented in the institution's policies and procedures ✔ A. A contingency plan should a patient's status change Should a patient's status change, having a contingency plan in place has been shown to improve the effectiveness of the transfer of patient information in settings with high consequence for failure. A perioperative nurse is reviewing a patient's chart and notes that the patient will undergo a brain biopsy for symptoms of progressive dementia. Which of the following suspected pathogens would prompt the nurse to take additional actions during the perioperative period of this patient's care? A. Treponema pallidum bacteria B. Culex triaeniorhynchus virus C. Neuro-Cutaneous Leishmania protozoa D. Proteinaceous prion ✔ D. Proteinaceous prion Prions are proteinaceous infectious agents that are resistant to routine sterilization and disinfection practices. When a discrepancy is identified in the surgical count, the perioperative RN should:

A. Organize the sterile field B. Perform a methodical wound exploration C. Remain in the room until the item is found D. Call for assistance ✔ D. Call for assistance When a discrepancy is identified in the count, the perioperative RN should call for assistance. The scrub person should organize the sterile field. The surgeon and first assistant should perform a methodical wound exploration. The surgeon should remain in the room until the item is found or determined not to be in the patient. A health care industry representative should: A. Not participate in direct patient care B. Bring additional equipment that was not requested C. Check in with materials management D. Open requested implants ✔ A. Not participate in direct patient care Sales representatives should never participate in patient care and must not enter the sterile field. Only the requested equipment is brought in, and sales representatives must check in and out with the appropriate hospital staff. Which of the following demonstrates nursing professional development? A. Arriving to work on time every day B. Assisting with room turnover between cases C. Helping a coworker with his portfolio D. Achieving certification ✔ D. Achieving certification Certification is defined as documented verification of an individual's professional achievement of knowledge and skill in identified standards. The ANA supports certification as part of the individual nurse's professional development. The perioperative nurse identifies the patient's medical history in which phase of the nursing process? A. Assessment B. Diagnosis C. Planning D. Evaluation ✔ A. Assessment Assessment is the collection and analysis of relevant health data about the patient.

Most complications occur within the first ________ after surgery. A. 4 hours B. 12 hours C. 48 hours D. 72 hours ✔ C. 48 hours Most complications occur within the first 48 hours after surgery; therefore, a registered nurse should call to check on the patient's progress and to reiterate postoperative instructions the next day or, at most, within 2 days of discharge. The hand-over/hand-off report should be a standardized transfer of patient information from the current caregiver to the receiving caregiver. Strategies to avoid breakdown in hand-over communication include: A. Ensuring that the person reporting has had a rest break B. Documenting the unit personnel receiving the report C. Using a standardized documentation format such as SBAR (Situation, Background, Assessment, Recommendation) D. Asking the anesthesia professional to confirm accuracy of the hand-over report ✔ C. Using a standardized documentation format such as SBAR (Situation, Background, Assessment, Recommendation) A standardized format for passing on crucial patient information from the operative staff to the staff of the receiving unit (eg, PACU staff) facilitates communication. Communication breakdown is the root cause of many sentinel events according to The Joint Commission. For which of the following should an incident report be completed? A. Surgeon arriving late for scheduled surgery B. Equipment malfunctioning during procedure C. Sponge, sharps, and instrument counts correct D. Scrub person not relieved for lunch break ✔ B. Equipment malfunctioning during procedure Accidents or unusual occurrences involving a patient, employee, or property should be reported according to facility policy. Unusual situations requiring an incident report include falls, needlesticks, fire, theft, malfunctioning equipment, medication error or reaction, and retained surgical items. Preprocedure verification should include confirmation of the: A. Presence or absence of surgical complications B. Complete and signed history and physical by attending physician

C. Surgical count status D. Estimated blood loss ✔ B. Complete and signed history and physical by attending physician Transfer-of-patient information for the preoperative phase includes verification of correct patient, evidence of site marking, and required clinical documentation (eg, complete and signed history and physical by attending physician). When correcting a patient care entry in the electronic health record, the perioperative nurse should: A. Highlight the correction in a different color B. Double strike through the incorrect entry C. Add a rationale for the correction D. Enter corrected information at the end of the document ✔ C. Add a rationale for the correction Any correction to the patient health record should include providing the rationale for the correction above the inaccurate entry (if room is available) or adding it to the margin of the document. A superficial surgical site infection (SSI) is identified as: A. An infection of an organ/space that is routinely evident on x-ray film and that occurs within 30 days of surgery B. An infected burn wound that extends into the fascial and muscle layers C. Purulent drainage originating from proximate organs or compartments D. An infection with purulent incisional drainage involving only skin or incisional subcutaneous tissue that occurs within 30 days of the surgical procedure ✔ D. An infection with purulent incisional drainage involving only skin or incisional subcutaneous tissue that occurs within 30 days of the surgical procedure SSIs are defined according to specific criteria into three categories, including superficial incisional, deep incisional, and organ/space. The correct answer is defined as a superficial incisional infection. Which of the following is a measure of the Surgical Care Improvement Project (SCIP)? A. Performing strict hand hygiene protocols B. Administering prophylactic antibiotic within 1 hour of surgical incision C. Damp-dusting prior to the first case of the day D. Performing a surgical count prior to the start of surgery ✔ B. Administering prophylactic antibiotic within 1 hour of surgical incision Administering the prophylactic antibiotic within 1 hour of the surgical incision is the only option that is a SCIP measure.

Which of the following statements regarding radiation safety is true? A. All personnel in the operating room should wear wrap-around lead aprons when ionizing radiation is used B. When a C-arm is in use, radiation emanates from the top part of the C-arm that is over the patient C. Time, distance, and shielding are important components of radiation safety D. When only one x-ray badge is worn, the proper placement is underneath the lead apron and along the neck line ✔ C. Time, distance, and shielding are important components of radiation safety For all x-ray procedures, time, distance, and shielding affect dose levels sustained. At the end of the case, loaned instruments should be: A. Disassembled, cleaned, decontaminated, inspected, and returned to the lending facility B. Disassembled, cleaned, decontaminated, inspected, sterilized, and returned to the lending facility C. Disassembled, decontaminated, sterilized, inspected, reassembled, and returned to the lending facility D. Placed in a biohazard plastic container, sealed, labeled, and returned to the lending facility ✔ A. Disassembled, cleaned, decontaminated, inspected, and returned to the lending facility Loaned instruments should be disassembled, cleaned, decontaminated, and inspected before they are returned to the vendor or lending facility. The instruments do not have to be sterilized as they will have to undergo sterilization at the lending facility. Postoperative phone calls to the patient: A. Should be documented on the intraoperative record B. Should be made after the first week to accurately assess for complications C. Should not be part of a quality improvement initiative due to possible HIPAA violations D. Can be used to measure patient satisfaction ✔ D. Can be used to measure patient satisfaction Postoperative phone calls can be used to measure patient satisfaction, outcomes, and QI data. The relative humidity in a restricted area should be maintained within a range of: A. 15% to 60%

B. 15% to 70% C. 20% to 60% D. 20% to 70% ✔ C. 20% to 60% The relative humidity in a restricted area should be maintained within a range of 20% to 60%. What are the five rights of delegation? A. Right task, right circumstances, right practice, right communication and direction, and right supervision and evaluation B. Right task, right circumstances, right person, right communication and direction, and supervision and evidence C. Right task, right circumstances, right person, right communication and direction, and supervision and evaluation D. Right assignment, right circumstances, right person, right communication and direction, and right supervision and evaluation ✔ C. Right task, right circumstances, right person, right communication and direction, and supervision and evaluation The Five Rights of Delegation are the right task, right circumstances, right person, right communication and direction, and right supervision and evaluation. Perioperative nurses must continually be involved in the assessment, evaluation, and judgment needed for perioperative patient care. An oxygen-enriched environment is present when the oxygen concentration in the operating room is greater than: A. 21% B. 22% C. 26% D. 28% ✔ A. 21% An oxygen-enriched environment is present when the oxygen concentration is greater than 21% by volume. In an oxygen-enriched environment, the temperature and energy required for fuels to ignite is lower than that of ambient or medical environments. Which of the following forms of protection is not considered part of standard precautions? A. Gloves B. Eye protection C. Head covers D. Sharps safety

✔ C. Head covers Standard precautions include gloves, masks, eye protection, face shields, and sharps to avoid injury and contamination. Head covers are not impervious, are considered as part of the surgical attire, and are not part of standard precautions. Oxidized cellulose is a hemostatic agent that is absorbable but is contraindicated to be left in place after closure on: A. Bone B. Organs C. Vessels D. Ovaries ✔ A. Bone Oxidized cellulose left on bone inhibits regrowth and can interfere with healing. When a surgical item is left in the patient, which of the following is a potential result of ensuing litigation? A. The surgical team could be found guilty of assault and battery B. The surgical team could be found liable under the doctrine of respondent superior ("let the master answer") C. The facility could be found liable under the doctrine of corporate negligence D. The surgical team could be found liable under the doctrine of res ipsa loquitur ("the thing speaks for itself") ✔ D. The surgical team could be found liable under the doctrine of res ipsa loquitur ("the thing speaks for itself") Res ipsa loquitur ("the thing speaks for itself") is a doctrine likely to be involved in cases involving retained surgical items, to prove medical negligence and making the litigation nearly indefensible. Corrective measures that may be implemented based on a multidisciplinary risk assessment following a variance in the parameters of the heating, ventilating, and air conditioning (HVAC) system include: A. Taking no action B. Discarding all disposable surgical supplies C. Terminal cleaning of the entire perioperative area D. Inventorying all perioperative supplies ✔ A. Taking no action Based on the risk assessment, corrective measures may include rescheduling or redirecting procedures to areas of the surgical suite where the HVAC system is functioning within parameters, delaying elective procedures, limiting surgical procedures

to emergency procedures only, closing the affected OR(s), or taking no action. Discarding disposable surgical supplies, terminal cleaning of the perioperative area, and inventorying perioperative supplies are measures that may be taken to restore the surgical suite to full function after the HVAC system variance has been restored. Marking the surgical site for procedures that involve laterality: A. Should be performed after the patient is anesthetized and positioned in the OR B. Can use different methodology depending on surgeon preference C. Should use marking that is clear and unambiguous D. Can be performed by any member of the surgical team ✔ C. Should use marking that is clear and unambiguous Marking the surgical site must occur so that the intended site of incision or insertion is clear and unambiguous. Procedures that involve left/right distinction, multiple structures, or multiple levels (spinal surgery) require specific marking. Initials, a "yes," or a line at or near the incision site are all acceptable examples of unambiguous marking. The marking methodology should be consistently used throughout the facility. When using a medical interpreter to speak with a patient, the perioperative nurse should: A. Maintain eye contact with the interpreter B. Speak loudly to ensure understanding C. Talk directly to the patient D. Smile at the interpreter for reassurance ✔ C. Talk directly to the patient Speaking directly to the patient shows respect for the patient and allows the perioperative nurse to view body language and facial expression. The perioperative nurse should also speak slowly, use simple language, avoid raising their voice, and obtain verbal feedback to be certain the patient understands. Which of the following factors should be considered when selecting products for use in the operating room? A. Indirect costs and reimbursement potential B. Reimbursement potential and group purchasing organization contract pricing C. Direct costs and group purchasing organization contract pricing D. Direct costs, indirect costs, reimbursement potential, and group purchasing organization contract pricing ✔ D. Direct costs, indirect costs, reimbursement potential, and group purchasing organization contract pricing

The financial impact analysis should include cost of the product, replacement strategy, associated equipment, training, depreciation, reimbursement potential, and group purchasing organization (GPO) contract pricing. What is a desirable characteristic of antimicrobial skin cleansing agents? A. Broad spectrum B. Slow acting C. Abrasive D. Pathogen specific ✔ A. Broad spectrum The following are desirable characteristics of antimicrobial skin cleansing agents: broad spectrum, fast acting, effective, non-irritating and non-sensitizing, and prolonged action (ie, leaves an antimicrobial residue on the skin to temporarily prevent growth of microorganisms). When a parent is present during induction of a 6-month-old patient, the perioperative nurse explains the sequence of events and the atmosphere of the operating room. This is done to: A. Ensure cooperation of the child B. Decrease the parent's anxiety C. Comply with the surgical consent D. Minimize anesthesia distractions ✔ B. Decrease the parent's anxiety During induction, a parent will watch his or her child go from being animated to lethargic to anesthetized. This gives the appearance of helplessness or death and can be upsetting to parents. Walking parents through the process helps to manage their expectations and decrease their anxiety. Which type of indicator should be used to validate air removal in a sterilizer cycle? A. Class I B. Class II C. Class III D. Class IV ✔ B. Class II Class II chemical indicators are used as sterilizer test packs. They are used to test for air removal during the cycle. Shock resulting from anaphylaxis or sepsis is ________ shock. A. Hemorrhagic

B. Cardiogenic C. Vasogenic D. Neurogenic ✔ C. Vasogenic Anaphylaxis and sepsis from infection are the most common types of vasogenic shock. How many personnel are required to transfer an unconscious supine patient from the OR bed to a patient bed when a lifting frame or patient roller is used? A. Two B. Three C. Four D. Five ✔ C. Four A minimum of four people is required to safely move the patient when using a lifting frame or patient roller. Which action should be taken when moisture is noted on the outside of a wrapped instrument tray? A. Open the tray starting with the closest flap B. Leave the tray until it has cooled C. Open the tray and return for processing D. Consult with the surgeon ✔ C. Open the tray and return for processing Any sterile item that has any type of moisture on it is considered contaminated. The item(s) must be opened - to prevent others from mistakenly thinking the item is sterile - and sent back for reprocessing. When should discharge teaching begin? A. In the PACU B. During preoperative teaching C. On the day of discharge D. In the surgeon's office prior to surgery ✔ B. During preoperative teaching The patient needs to know preoperatively when to get assistance with discharge care if needed. Which of the following is true about chromic suture? A. It is used most often as a fine suture material for the eye