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AORN Periop 101 Module Questions
A child in which of the following age groups would be described as "likes to socialize and interpret terms"? A. 1 month- 12 months B. 1-3 years old C. 3-6 years old D. 6-12 years old - ✔C A packing system for items undergoing sterilization should: A. be compatible with all sterilization processes B. be made of only disposable materials C. maintain sterility of the items for a specified length of time D. permit aseptic delivery of contents to the sterile field - ✔D 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, B, D After the surgical hand scrub, the scrub person should keep the fingers pointed in which direction to allow water to drip off away from the attire? A. Downwards B. Upwards C. Straight D. Curled towards the palm - ✔B 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, B, D 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 - ✔B
AORN guidelines for the time out recommend that all team members verbally verify their agreement on the following: SATA a. the name of the surgeon b. the name of the pt. c. the site of the procedure including R/L distinction d. the procedure to be performed - ✔B, C, D AORN recommends that the following factors be considered when selecting drape products: SATA A. amount of irrigation fluid that is anticipated B. anticipated blood loss C. duration of procedure D. potential for linting E. surgeon preference - ✔A, B, C, E At what point in the healing process do most wound disruptions occur? A. beginning of proliferative phase (2-10 days) B. End of proliferative phase (10-22 days) C. Beginning of maturation phase (21 days - 6 weeks) D. End of maturation phase (6 weeks-2 years) - ✔A Based on knowledge you have gained about ethics and ethical decision making, identify the situations where a decision would be made on ethical grounds A. Using new technology B. Implementing or suspending the DNR order on a patient C. After the patient gives consent to surgery: refusing to proceed until all involved personnel discuss the situation D. Participating in human experiments that are conducted at your facility E. Strongly supporting organ donation even though the family disagrees - ✔A, B, D, E Based on the knowledge you have gained about legal and risk management issues, identify ways to enhance one's professional practice. A. documentation of orientation program B. documentation of clinical competency C. documentation of employee performance evaluations D. knowledge of the nursing practice act in your state E. documentation of continuing education activities F. revision of all departmental policies and procedures - ✔A, B, D, E based on what you have learned about various sources of information, identify the ways in which the periop nurse can improve professionally? - ✔The different ways in which a perioperative nurse can improve professionally are: AORN continuing education conferences, attending chapter meetings, reading AORN Journals, and visiting AORN websites.
D. dispersive electrode, fiber, generator, and key - ✔A Correct surgical attire for the restricted areas include: SATA A. Facility identification on a lanyard B. Head covering that covers all hair C. Long sleeved jacket with the sleeves pushed up D. Scrub top tucked into scrub pants and a warm up jacket E. A lab coat when leaving the department - ✔B & D Data collection is part of which phase in the nursing process? - ✔Assessment Defining nursing goals and intervention strategies is a part of which phase in the nursing process? - ✔Outcome Identification Documentation of the perioperative nursing care should include, but not be limited to: SATA A. Type of positioning devices used B. Name of the operating surgeon C. Names of persons positioning the patient D. Preoperative outcome evaluation - ✔A & C Draping the patient involves... A. covering the patient with the sterile barrier B. covering the patient and the surrounding areas with a sterile barrier C. covering the patient and the surrounding areas with sterile materials to create and maintain a barrier between nonsterile and sterile areas D. covering the patient, the surrounding areas, and the instruments with a sterile barrier
- ✔C Droplet precautions include all of the following except: A. Donning PPE B. Consulting with the risk manager C. Placing a mask on the patient during transport D. Placing the patient in a single patient room E. using an isolation room for the patient - ✔B. During laparoscopic surgery, periop RNs can reduce the chances of capacitive-coupling injuries by: A. using a combination of insulated and noninsulated instruments B. using coagulation waveform and a high setting C. using metal and plastic cannulas together D. using the lowest power setting and low voltage cutting waveform - ✔D
During the preoperative interview, why should the perioperative nurse ask patients about their use of herbal preparations, alcohol, tobacco products, and recreational drugs? SATA 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, C, D During what phase of wound healing does contraction occur? - ✔Proliferation Effective methods for preventing SSIs include: A. effective environmental cleaning procedures B. performance of sterile technique C. use of surgical attire and other barriers D. all of the above - ✔D Elements required to create a culture of safety include: SATA A. sense of trust among team members B. sincere commitment to affirming safety as the first priority C. development and support of a proactive approach rather than a reactive, blaming approach D. development of a reporting mechanism for grievances and complaints. E. dissemination of receipt of information to all levels of staff - ✔A, B, C, E Identify the correct draping considerations SATA A. Drape from a sterile area to an unsterile area by draping the nearest first B. Start draping from the periphery to the operating site C. Ensure that surgical drapes are applied after prepping solutions have dried D. After a drape is placed, it can be moved if necessary E. When draping the opposite side, the scrubbed person should walk around the OR bed to drape - ✔A, C, E Identify the proper sequence of events in the body's defense mechanism for wound healing - ✔Hemostasis Cleaning up the pathogens wound sealing regeneration of epidermal covering repairing deeper tissue damage If the surgeon continuously asks for higher power settings, what is the first action the periop RN should take? A. Get another ESU unit immediately B. Check the circuitry for possible disruption C. Switch to a bipolar generator and electrode
A. anesthetic complication risks B. gas emboli risks C. postop infections D. postop surgical complications - ✔A, C, D Individual staff members play the biggest role in maintaining a safe OR environment. Staff members are required to: SATA A. Monitor, identify, and report safety hazards B. set appropriate electrical and fire safety hazards C. understand and comply with the emergency power outage plan D. Practice sound, basic, and OR specific electrical and fire safety. - ✔A, C, D Key business metrics over which you can have control to affect the bottom line are: SATA a. length of procedures b. on time starts c. physician satisfaction d. turnover time e. volume of procedures - ✔A, B, D, E Many medical errors occur due to three types of human errors. Which of the following statements are true? SATA A. a nurse programs a new electrosurgery unit incorrectly is a skill based error B. a nurse misinterprets test results is a knowledge based error C. juggling multiple activities is a knowledge based error D. a nurse fails to provide indicated prophylactics is a knowledge based error E. physical stamina due to occupational musculoskeletal injuries is a situational factor - ✔A, B, D, E Match the terms given below with their definitions:
- Surgical conscience
- Sterile
- Sterile Technique A. the use of specific actions and activities to prevent contamination and sterility of identified areas during operative or other invasive areas during operative and other invasive procedures B. Allows for no compromise in the principles of sterile technique C. the absence of all living microorganisms - ✔ 1 - B 2 - C 3 - A match the three types of transmission based precautions with the correct examples of precautions that should be implemented for them: a. contact b. droplet
c. airborne
- donning PPE and patient placement
- donning PPE and env cleaning
- donning PPE and wearing a surgical mask with a respirator level of N95 or higher - ✔1=b 2=a 3=c Mechanical issues and problems that can cause skin injury include: SATA A. Placing heavy objects on the patient B. Placing an electrosurgical unit hand piece on the patient C. Dragging the patient's body across the sheets D. Improperly applying sequential compression stockings E. Allowing prep solution to pool under the patient - ✔A, C, D non-research parts of evidence ratings include the following: SATA a. summaries of the evidence b. organizational experience c. consensus on appraisal scores d. community standards e. clinician experience and expert opinion f. consumer preferences - ✔Everything except C Nurse to patient ratio for Extended Care Unit - ✔1:3/ Nurse to patient ratio for patient recovering in the CCU - ✔2: Nurse to patient ratio for patients under age 8 - ✔1: Nurse to patient ratio upon PACU admission - ✔1: Nursing documentation for the pneumatic tourniquet use includes: SATA A. identification/serial number and model of the specific tourniquet B. location of the cuff C. name of the company who manufactured the cuff D. skin and tissue integrity under the cuff before the use of the pneumatic tourniquet E. skin temperature F. Time of inflation and deflation - ✔A, B, D, F one - three years ability for learning and understanding - ✔baby is able to understand and respond to simple commands one month - twelve months ability for learning and understanding - ✔baby will smile, babble, and gurgle
A. draping materials B. fiberoptic cables C. lasers D. nitrous oxide - ✔A Professional nurses seek to support and encourage peers by... - ✔Through precepting, mentoring, and role modeling, and providing feedback, the professional nurse is a daily example of excellence in the perioperative setting Professional organizations and societies, as well as individual organizations can proactively create a culture that supports patient safety through which of the following mechanisms? SATA A. set processes rather than standards B. convene and communicate with members about safety C. incorporate attention to safety into training programs D. collaborate across disciplines - ✔B, C, D prolonged high dosages of steroids preoperatively delay _______ A. hemoglobin formations B. bile production C. insulin production D. collagen formation - ✔D Radiation exposure safety controls include: SATA A. nonessential personnel should leave the room B. Pregnant health care workers should avoid or limit exposure C. OR nurses all should be trained to operate x-ray machines D. Lead protective aprons, gloves, and thyroid collars should be worn - ✔A, B, D Recommendations for draping include: A. handling sterile drapes as little as possible B. Cuffing the drape material over the gloved hands C. Holding the drapes in a controlled manner D. All of the above - ✔D Risks to patients and staff members associated with laser use include: SATA A. eye injury B. fire hazards C. inhalation of laser plume D. radiation hazards - ✔A, B, C Safety measures to prevent complications or injury due to the use of a pneumatic tourniquet includes: SATA A. Apply three layers of padding around the extremity at the most proximal point B. Keep fluids from pooling under the cuff
C. only minimal effective pressure should be used to create a bloodless field D. there should be a complete preoperative patient assessment E. The cuff should fit properly on the patient F. the inflation time should be monitored - ✔B, C, D, E, F Select the areas of the sterile gown that are considered sterile. SATA
- The back of the gown from the nape of the neck to the level of the elbows.
- Gown sleeves from two inches above the elbow to the cuff, circumferential.
- The front of the gown from the chest to the level of the sterile field.
- The part of the sleeve cuff that is covered by the sterile glove. - ✔B & C Select the correct statements about spray bottles SATA A. Spray bottles can aerosolize potentially infectious materials B. Spray bottles are occasionally used to apply disinfectant C. Spray bottles are not used to apply disinfectant D. Spray bottles are an easy way to clean the environmet - ✔A & C Select the statements below that are correct: A. During open assisted gloving, the team members's gown sleeve is pulled down so that the gown cuff is at fingertip level B. Closed assisted gloving should be used to glove team members during the initial gowning and gloving C. Once the scrubbed team member's hands pass through the cuff, the cuffs are considered contaminated D. Scrubbed team members should wear two pairs of surgical gloves - ✔B, C, D Shelf life is related to: SATA A. exposure to external events B. methods of sterilization C. type of packaging material used D. number of personnel who may have handled the package E. time from initial sterilization - ✔A, C, D Some of the ways by which professional nurses can protect themselves from legal action include maintaining; A. Documentation of performance appraisals B. Documentation of administrative competencies C. Documentation of continuing education D. Knowledge of state nurse practice act - ✔A, C, D sponge and instrument counts are performed according to facility policy and procedure. Generally, the times during surgical procedure that sponges are counted are: SATA a. at skin closure b. before the procedure begins c. when new sponges are added to the field d. when wound closure begins
B. To kill microorganisms C. To reduce the resident microbial count to a minimum D. To inhibit rapid rebound growth of microorganisms E. To remove soil, debris, and transient microorganisms - ✔C, D, E The surgical hand scrub controls resident microorganisms by: A. the mechanical action of scrubbing B. the chemical action of microbial agents used C. the temperature of the water combined with chemical action D. none of the above - ✔B The table is flexed 90 degrees for the __________ position, which is a variation of the __________ position A. lateral, prone B. Jack-knife, prone C. Trendelenburg, supine D. Jack-knife, supine - ✔B The term local exhaust ventilation (LEV) is used to describe the process of evacuation smoke from the surgical site. Which of the following are considered LEV? 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, B, E The use of the PNDS helps a perioperative nurse to: SATA A. plan the nursing interventions B. assess and develop the nursing diagnoses C. assess and evaluate the patient's status D. evaluate responses to positioning E. determine medical diagnoses - ✔A, B, C, D three- six years ability for learning and understanding - ✔the child is able to literally interpret terms to follow the AORN guidelines for positioning the patient, the perioperative nurse should: A. depend on the patient's natural defense mechanisms to indicate the need for positioning alterations B. rely on the surgeon's and anesthesia professional's assessment to guide positioning C. use a consistent method of procedure-specific positioning for each patient D. use additional precautions as appropriate based on unique patient considerations - ✔D
To reduce the possibility of an injury or burn, which of the following most accurately describes where the periop nurse should place the dispersive electrode? A. as far from the operating 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 True or False: it is important for perioperative nurses to practice within the context of professional standards and to maintain current knowledge of nursing practice? - ✔True True or False: AORN guidelines can replace departmental and institutional policies? - ✔False What action below is the best course to take when is hair is found in an instrument tray on the back table? A. Using a sterile clamp, the scrub person should remove hair and pass it off to the circulator B. the scrub person should pass off the entire instrument tray and request a replacement C. the entire sterile field should be broken down and reestablished D. The scrub person should pass off the instrument tray and change gown and gloves. - ✔C What agents are effective in removing resident microorganisms? A. Mechanical agents B. Chemical agents C. Biochemical agents D. Hydrostatic agents - ✔B What biting instrument is used for cutting tough tissue or bone? A. rongeur B. rasp C. osteotome D. curette - ✔A What does AORN Guideline for Preoperative Patient Skin Antisepsis recommend for prepping areas with high microbial counts? A. Prep them first B. Prep them last C. Prep them during the procedure D. Prep them whenever necessary - ✔B What interventions can perioperative nurses do to protect elderly patients? SATA A. employ DVT prophylactic devices
What wound class...
- Procedure does involve the resp, alimentary, or GU tract, entered under controlled conditions - ✔Wound class 2: clean-contaminated What wound class...
- Procedure does not involve the resp, alimentary, or GU tract and no infection/inflammation is present - ✔Wound class 1: clean when a count discrepancy occurs, what should be the FIRST action by the RN circulator? a. call for anterior and lateral x-ray b. inform the nurse supervisor c. inform the surgical team of the discrepancy d. instruct the scrub person to search for the missing item - ✔C When medication is administered from the sterile field, the RN should immediately and clearly label it with... SATA A. concentration and amount B. date prepared C. expiration date when used within 24hr D. expiration time if less than 24hr E. initials of the RN preparing the medication - ✔A,B,D,E When selecting drapes to create a sterile field for the patient, which of the following drape qualities are most essential to maintaining the sterile field? A. barrier protection B. cost/benefit ratio C. limitation of environmental impact D. flexibility and flammability - ✔A 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 content of the container slowly D. Replace caps on opened medication to maintain sterility E. Use a sterile transfer device - ✔A, B, C, E 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
When using chemical products, the perioperative nurse should: SATA A. Use skin prep solutions according to the manufacturer's recommendations B. Never remove the skin prep solutions C. Ensure the prep solution does not pool on the drapes D. Apply blotting towels before performing a skin prep E. Allow skin prep solutions to dry before draping - ✔A, C, D, E When using the forum for public commenting on clinical guidelines and offering a suggested change in the comment field, it is very important that you: SATA a. suggest alternate phrasing b. cite evidence to support your change c. provide rationale for your suggestion d. call the consult line to clarify the content with the guideline author - ✔A, B, & C: suggest alternate phrasing, cite evidence to support your change, provide rationale for your suggestion When working with electrical equipment, the periop nurse must: SATA A. Ensure that the active electrocautery is switched on before starting the procedure B. ensure that warming therapy devices are used at appropriate settings C. ensure that users are educated in the safe use of electrical equipment D. never place the hose of a patient warmer directly under the patient's blankets E. ensure that laser electrodes are discharged after each use - ✔B, C, D Where should the scrub person's sterile gown be opened? A. as far away from the instrument tray as possible B. in the back corner of the instrument table C. on a separate Mayo stand D. on top of the gloves for the scrub person - ✔C Which actions can the RN circulator take to assist the scrub personnel during gowning? SATA A. Touch only the ties, Velcro, or snaps to secure the back of the gone at the neck and the waist B. Don the sterile gloves before fastening the gown to prevent contamination from the gown flaps C. Grasp the ties 4-6 inches from the tag and pull D. Adjust the gown by grasping the bottom edge and pulling down to eliminate any blousing - ✔A & D Which actions should the periop nurse take in prepping an extremity when a tourniquet is used? SATA A. Drape the tourniquet with a cloth towel to keep solution from going under the tourniquet B. start prepping at the level of the tourniquet C. Start the prep at the incision site and extend both distally and proximally to include the entire extremity
Which of the concepts below are appropriate for the care of forceps during the procedure? A. cleaning the tips of blood or tissue frequently B. handing them off the sterile field to the circulating RN if the surgeon say they aren't working correctly C. organizing them on the back table by nesting them D. Standing them upright along the sides of the instrument tray so the handles are easily grasped - ✔A & B Which of the elements required for an infection to occur is related to inanimate environmental surfaces? A. method of transmission b. susceptible host c. source of reservoir - ✔c. source of reservior 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. 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 - ✔C Which of the following actions should be included in the perioperative nursing care of a patient with suspected latex allergy? SATA A. Assess the patient's cross sensitivities and previous reactions to latex B. Indicate latex precautions on door signs for every room the patient occupies C. Schedule the patient as the last procedure of the day if possible D. Use latex free supplies for IVs, hair covering, and dressing materials E. Verify that the surgeon is aware of the allergy - ✔A, B, D, E Which of the following are desired characteristics of antimicrobial agents? SATA A. Broad spectrum B. High log reduction capability C. Effective for long periods of time D. High toxicity E. Low toxicity - ✔A, B, C Which of the following are true about low temperature hydrogen peroxide gas plasma sterilization? SATA A. exhaust monitoring required B. items can be stored for future use C. no toxic residue is produced D. the sterilant is bactericidal, virucidal, and fungicidal E. It can be used for items that are heat sensitive - ✔B, C, D, E
Which of the following best describes sterile technique? Sterile technique is: A. applied when stocking supplies in the surgical suite B. carried out by non-scrubbed personnel by maintaining a distance of at least 6in from the sterile field C. employed during the terminal cleaning to assure a sterile environment D. implementing during surgical procedures to prevent microbial contamination - ✔D Which of the following factors increase the patient's risk for skin injury? SATA A. use of the wrong type of linen B. Unusual positions or positioning devices C. Use of electrical equipment D. Use of chemical agents E. Prolonged length of surgery - ✔B, C, D, E Which of the following factors make geriatric patients more sensitive to injury and cold? A. decreases in subcutaneous fat B. lung capacity decreases with age C. bilirubin and hemoglobin shift D. range of medication absorption is altered - ✔A Which of the following is a correct application of the AORN guidelines for perioperative practice for use of appropriate eyewear during laser use? A. Personnel should not use protective eyewear in common B. Protective eyewear is required only for certain types of lasers C. Regular corrective lenses, including contact lenses, are sufficient for most types of lasers D. The eyewear should be matched to the type of laser, optical density, and wavelength
- ✔D Which of the following is considered a critical perioperative nursing diagnosis within the PNDS? A. Impaired tissue integrity B. Pain C. Risk for fluid volume deficit D. Risk for perioperative positioning injury - ✔D Which of the following is true about ethylene oxide sterilization? A. EO exposure is potentially carcinogenic and mutagenic to personnel and patients B. It cannot be used for heat-sensitive items C. It is effective against prions D. Items processed by EO sterilization may be used immediately - ✔A Which of the following is true about iodophor paint and iodophor scrub? A. a paint has a detergent additive, a scrub does not B. a scrub has a detergent additive, a paint does not C. Iodophors have a low fungicidal and high bacterial kill rate
