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AORN PERIOP 101 QUESTIONS AND VERIFIED ANSWERS
"Data collection is part of which phase in the nursing process - CORRECT ANSWER
Assessment" "Which of the following is considered a critical perioperative nursing diagnosis within the PNDS?
CORRECT ANSWER Risk for perioperative positioning injury"
"Competency statements - CORRECT ANSWER Direct a nurse's activity in the perioperative
arena; Provide a basic model to evaluate the quality of nursing practice; Ascertain a level of skills and abilities necessary to fulfill the professional role (All of the above)" "Defining nursing goals and intervention strategies is a part of which phase in the nursing process
- CORRECT ANSWER Outcome identification"
"The IOM report describes the importance of setting standards and expectations for patient
safety. Setting standards can_____ - CORRECT ANSWER Set expectations for the health
professionals; Establish consistency across individuals and organizations; Help set expectations of consumers and purchases."
"Which of the following AORN Position Statement on Correct site of surgery is true? - CORRECT
ANSWER The staff member should verbally verify the correct site with each member of the
surgical team" "Which of the following practices should be used ti implement the Joint Commission's Universal
Protocol for preventing Wrong Site, Wrong Procedure, Wrong Person Surgery? - CORRECT
ANSWER Using a time-out procedure before beginning the procedure"
"The purpose of the National Patient Safety Goals is to - CORRECT ANSWER Promote specific
improvements in patient safety; Highlight problematic areas in health care; Describe evidence and expert-based system-wide solutions to the problems"
"Match the type of budget with its description - CORRECT ANSWER Gross revenue- All monies
received by the facility for goods and services; Fixed expenses- Medical records and
administration; Net revenue- gross revenue minus expenses; Variable costs- Costs directly related to patient volume"
"Which of the following definitions are correct? - CORRECT ANSWER Liable means to bind or
to be responsible to or to be under obligation to; Negligence means the failure to exercise care that a prudent person would perform under the same circumstances."
"Professionalism in nursing means - CORRECT ANSWER Showing personal accountability in
understanding the Nurse Practice Act; Maintaining a current knowledge base; Participating in professional organizations."
"Which of the following statements are true about objective data? - CORRECT ANSWER Data
that is the information written in the patient's record and nursing notes; History, physical, and laboratory data are examples of objective data"
"Match the age groups with their ability for learning and understanding - CORRECT ANSWER
Birth to one month- The child is able to express only through crying; 1-12 months- The baby will smile, babble, and gurgle; One to three years- The baby is able to understand and respond to simple commands; Three to six years- The child is able to literally interpret terms." "Patients in which of the following age groups have the greatest blood volume per unit of body
weight? - CORRECT ANSWER Children"
"Which of the following factors make geriatric patients more sensitive to injury and cold? -
CORRECT ANSWER Decrease in subcutaneous fat"
"A child in which of the following age groups can be described as "likes to socialized and can
interpret terms"? - CORRECT ANSWER 3 to 6 years"
"The goal of patient and family education is to - CORRECT ANSWER Provide information to the
patient; Improve knowledge; Achieve long lasting changes in behavior; Take ownership of the patient's care; Improve the patient's outcome."
"A directive interview is - CORRECT ANSWER Structures with predetermined questions"
"Factors that may affect the amount of pain the patient will experience postoperatively are -
CORRECT ANSWER The surgical site;
The nature and intended purpose of the surgery; the patient's fears regarding anesthesia or surgery" "Which of the three elements required for an infection to occur is related to inanimate
environmental surfaces? - CORRECT ANSWER Source or Reservoir"
"One of the most effective ways to prevent disease transmission and control infections in health
care settings is - CORRECT ANSWER Hand Hygiene"
"Which factors determine the likelihood of transmission and persistence of multi drug resistant
organisms - CORRECT ANSWER Effectiveness of prevention methods;
Numbers of colonized patients; Vulnerability of the patients"
"Several types of infections may be acquired in the perioperative settting - CORRECT ANSWER
Surgical site infections- SSIs; Multidrug resistant organisms- MDROs; Central line associated blood stream nfections- CLABSIs; Catheter associated urinary tract infections- CAUTIs"
"The single most important factor in preventing the spread of infection is - CORRECT ANSWER
Hand Hygiene"
"Damp dusting of the OR as part of the preliminary room preparation should be done - CORRECT
ANSWER In the morning before bringing in any surgical supplies"
"Which methods are most effective for terminal cleaning floors in the OR - CORRECT ANSWER
Wet vacuum or single use mop" "Which of the following is correct regarding the disposal of contents from reusable suction
systems? - CORRECT ANSWER done according to federal, state, and local regulations"
"Correct statements about spray bottles - CORRECT ANSWER Spray bottles can aerosolize
potentially infectious materials; Spray bottles are not used to apply disinfectant" "The proper device for the disposal of blades, needles, stapling devices, pins, and cautery tips
should be - CORRECT ANSWER A sharps disposal container"
"Terminal cleaning must be done - CORRECT ANSWER Once during each 24 hour period"
"During post procedure cleaning - CORRECT ANSWER All kick buckets, hampers, and similar
receptacles must be inspected and disinfected as needed; Transport vehicles are to be considered contaminated after patient contact; All horizontal surfaces of tables and equipment, including the anesthesia machine, should be wiped down with a lint free cloth moistened with a hospital approved disinfectant."
"Identify the pathogens that can be commonly found in the OR environement - CORRECT
ANSWER Escherichia coli;
Methicilin resistant STaph aureus; Serratia marcescens."
"In which surgical wound category should a total abdominal hysterectomy be classified? -
CORRECT ANSWER Clean contaminated wound"
"Immediate use steam sterilization can be used - CORRECT ANSWER In urgent situations"
"A packing system for items undergoing sterilization should - CORRECT ANSWER Permit
aseptic delivery of contents to the sterile field" "Complete sterilization in ethylene oxide is dependent upon four primary variables: proper time,
gas concentration, temperature, and - CORRECT ANSWER Chamber humidity"
"Which of the following is true about ethylene oxide sterilization - CORRECT ANSWER EO
exposure is potentially carcinogenic and mutagenic to personnel and patients"
"Plastic incise drapes - CORRECT ANSWER May increase moisture and bacterial growth under
the drape; Are NOT recommended for use."
"Recommendations for draping include - CORRECT ANSWER -handling sterile drapes as little
as possible
- cuffing the drape material over the gloved hands
- holding the drapes in a controlled manner"
"Select the areas of the sterile gown that are considered sterile. - CORRECT ANSWER - 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." "Which of the following practices are NOT examples of the recommendation that "A sterile field
should be maintained and monitored constantly"? - CORRECT ANSWER A sterile field that has
been set up for more than 1 hour before the procedures begins should be broken down and a new set up prepared. If a delay occurs after a sterile field is set up, the personnel may leave the room as long as the room as been secured."
"When transferring medication and solutions to the sterile field the perioperative nurse should -
CORRECT ANSWER Avoid removing stoppers from vials.
Discard unused, opened irrigation or IV solutions at the end of the procedures. Dispense the entire contents to the container slowly. Use a sterile transfer device." "Accurate preoperative documentation of the patient admission is an integral part of the nursing
process. This includes - CORRECT ANSWER Patient identification;
Preoperative orders; Patient assessment."
"The primary purpose of documentation is to - CORRECT ANSWER Record the chronological
order of events during the nursing are of a patient." "When documenting the placement of a surgical drain, which of the following components
should be included? - CORRECT ANSWER Where the drain was placed on the patient."
"Which of the following is true about the use of abbreviations in perioperative documentation? -
CORRECT ANSWER They can put patients at risk for medication errors."
"When documenting, the perioperative nurse should - CORRECT ANSWER Document in a
timely manner; Use nursing diagnoses based on sound judgement; Use patient statements to verify the nurse's findings."
"The concept of a standard of care related to documentation - CORRECT ANSWER Requires
the nurse to document and act as a reasonably qualified nurse would in a similar situation"
"An individualized patient care plan that was initiated during the preoperative phase includes -
CORRECT ANSWER A cultural or religious preferences;
Emotional considerations; Psychosocial considerations"
"The primary reason for documenting sharp, sponge, and instrument counts is - CORRECT
ANSWER to prevent injury to the patient from a retained foreign object"
"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? - CORRECT ANSWER Upwards"
"What actions can the RN circulator take to assist the scrub personnel during gowning? -
CORRECT ANSWER Touch only the ties, Velcro, or snaps to secure the back of the gown at the
neck and the waist; Adjust the gown by grasping the bottom edge and pulling down to eliminate any blousing." "Because skin is a major source of contamination in the surgical environment, which of the
following statements is true? - CORRECT ANSWER Health care personnel who have cuts on
their hands should not provide direct patient care"
"You have just finished a surgical procedures and are removing your gown and gloves. -
CORRECT ANSWER 1. Pull the gown downward from the shoulders and off the arms.
- Fold the contaminated side of the gown to the inside, roll it up, and discard it.
- Remove and discard the gloves using a glove to glove and skin to skin technique.
- Wash hands with soap and water."
"When using chemical products, the perioperative nurse should - CORRECT ANSWER Use skin
prep solutions according to the manufacturer's recommendations; Ensure the prep solution does not pool on the drapes; Apply blotting towels before performing a skin prep; allow skin prep solutions to dry before draping" "sponge and instrument counts are performed according to facility policy and procedure.
Generally, the times during sx procedure that sponges are counted are: SATA - CORRECT
ANSWER a. at skin closure
c. before the procedure begins d. when new sponges are added to the field e. when wound closure begins"
"when a count discrepancy occurs, what should be the FIRST action by the RN circulator? -
CORRECT ANSWER c. inform the surgical team of the discrepancy"
"Which of the following is NOT included in basic monitoring of the patient for anesthesia? -
CORRECT ANSWER Arterial line"
"Which drug is used to reverse valium and midazolam? - CORRECT ANSWER Flumazenil"
"Which method is used to prevent aspiration during endotracheal intubation? - CORRECT
ANSWER Applying cricoid pressure"
"How can the perioperative nurs assist the anesthesia provider with placement of a spinal or
epidural block? - CORRECT ANSWER Calm the patient"
"During intravenous regional anesthesia (Bier Block), the tourniquet should be deflated slowly to
prevent which of the following from entering the circulation? - CORRECT ANSWER Bolus of
anesthetic"
"What is the most consistent indicator of MH during a surgical intervention? - CORRECT
ANSWER Unexplained increase in end tidal CO2"
"Depending on state laws and hospital policies, which of the following types of anesthesia can be
performed without a professional anesthesia provider? - CORRECT ANSWER Moderate
sedation" "Which assessment factor is important to include when screening patients for potential risk of
MH? - CORRECT ANSWER Family history of problems related to anesthesia"
"The perioperative nurse's role in preparing and administering medications includes - CORRECT
ANSWER Assessing the patient's medication allergies and use of herbal or dietary supplements;
Verifying the administration of the correct medication, dose, and route; Checking expiration date of medication"
"Identify the true statements from those given - CORRECT ANSWER Radiographic dyes are a
risk to patients allergic to iodine and shellfish; Radiographic dyes are instilled directly into an organ or duct with a catheter or tube; Miotic agents are used to reduce intraocular pressure." "In addition to hyponatremia, which of the following conditions can be a result of improper fluid
management? - CORRECT ANSWER b. Hypervolemia"
"During the medication administration phase of the medication use process, nursing assessment
should include which of the following factors? - CORRECT ANSWER Current medications,
including herbal; Medication allergies; Patient weight in pounds and kilograms" "What are the most common roles of the perioperative nurse in preparing medications and
solutions? - CORRECT ANSWER Preparing medications and solutions per the
physiciansrpeference card; Preparing and labeling medications and solutions; Document and verify by verbally reading back to the provider all verbal orders, per facility policy"
"Potential sources of fuel for surgical fires include - CORRECT ANSWER Draping materials"
"The nominal hazard zone for laser use is the - CORRECT ANSWER Space where direct,
scattered, or reflected laser radiation exceeds maximal permissible exposure"
"To follow the AORN guidelines for positioning the patient, the perioperative nurse should -
CORRECT ANSWER Use additional precautions as appropriate based on unique patient
considerations" "Which of the following physiological effects is most likely to results from positioning a patient in
the lithotomy position? - CORRECT ANSWER Circulatory and respiratory compromise due to
pressure on the abdomen" "The following safety measures should be considered when placing a patient in the lateral
position - CORRECT ANSWER The upper leg is straight and supported with pillows between
the legs; Lower arm on same plane as OR bed mattress, forearm and wrist in neutral position, palm up; The patient's dependent ear should be assessed to ensure that it is not folded."
"Documentation of the perioperative nursing care should include, but not be limited to -
CORRECT ANSWER Type of positioning devices used;
Names of persons positioning the patient"
"Which of the following patient factors should be considered int he perioperative assessment -
CORRECT ANSWER Age;
Nutritional status; Preexisting conditions"
"Which intraoperative factors should be considered during periop assessment? - CORRECT
ANSWER Type of anesthesia delivered;
Duration of the surgery; Position required" "The table is flexed 90 degrees for the _____ position, which is a variation of the _____ position.
CORRECT ANSWER Jack-knife (Kraske), prone"
"Which surgical position adversely affects the diaphragmatic movement? - CORRECT ANSWER
Trendelenburg position; Prone position; Lateral position"
"the use of the PNDS helps a periop nurse to - CORRECT ANSWER Plan the nursing
interventions;
Assess and develop the nursing diagnoses; Assess and evaluate the patient's status; Evaluate response to positioning"
"What response is the results of tissue layers moving on each other - CORRECT ANSWER
Shearing"
"chlorhexidine gluconate CHG is a antimicrobial skin prepping agent used - CORRECT ANSWER
For topical skin application only below the neck"
"What agents are effective in removing resident microorganisms - CORRECT ANSWER
chemical agents"
"Which of the following are desired characteristics of antimicrobial agents? - CORRECT
ANSWER Broad spectrum;
High log reduction capacity; Effective for long periods of time"
"Which of the following statements is correct regarding hair removal from a surgical patient? -
CORRECT ANSWER Hair should be removed from the surgical site only when the hair is so thick
that it will interfere with the procedure" "What does AORN's guideline for preop patient skin antisepsis recommend for prepping areas
with high microbial counts? - CORRECT ANSWER Prep them last"
"Which of the following should be avoided during hair removal - CORRECT ANSWER Nicking or
cutting the skin" "Which of the following observations are critical when doing skin antisepsis on pediatric patients?
- CORRECT ANSWER Take measures to prevent the loss of body heat" "Which actions should the perioperative nurse take in prepping an extremity when a tourniquete
is used - CORRECT ANSWER Start the prep at the incision site and extend both distally and
proximally to include the entire extremity; Use an assistive device to support the extremity during the prep; Use an impervious drape to protect the tourntiquet"
"Surgical tissue banking is - CORRECT ANSWER The retrieval, processing, preserving, and
storing of selected human tissue for later transplantation back into the patient or into another patient"
"Which pathology specimens require fresh preparation and the use of a sterile container? -
CORRECT ANSWER Breast tissue for hormonal assay;
Cerebral spinal fluid; Semen for infertility studies" "The patient, the surgeon, and the scrub person all interact with the circulator in the
management of specimens and each have special roles - CORRECT ANSWER Patient-
Concerned with diagnosis, speed of diagnosis, psychosocial concerns. Surgeon- communicates identifying characteristics to the scrub person and to the circulator. Scrub person- Ensure accurate identification of the specimen by having a sterile marking pen to write location and type of tissue. Circulator- Sensitive to the scrub person's needs and to actions that facilitate accurate specimen management" "Which of the following forensic specimens should be placed in a paper envelope, labeled, and
sealed? - CORRECT ANSWER Finger nails;
Carpet remnants"
"Songs counts are done for all the following reasons, EXCEPT - CORRECT ANSWER Because
state laws require specific count procedures" "Which of the following are reasons to avoid using radiopaque sponges for postoperative
dressings? - CORRECT ANSWER Possible invalidation of subsequent sponge counts if the
patient were returned to the OR with intact dressings; Radiopaque sponges may appear as a foreign body on postop x-rays"
"Which classification of hemostatic methods involves pressure or the use of ligating clips? -
CORRECT ANSWER Mechanical"
"What precaution should be taken when microfibrillar collagen is used as a hemostatic agent
intraoperatively? - CORRECT ANSWER Avoid using it with an autologous blood salvage unit"
"Which of the following drains allows for passive drainage of fluid from the body? - CORRECT
ANSWER Penrose;
T-tube"
"The benefits of a standardized count procedure include which of the following? - CORRECT
ANSWER Assists in achieving accuracy during the count procedure;
Assists in conducting efficient counts; Human error studies have shown that many errors results from deviation" "Which type of dressing is used to prevent drying of the wound and increase the proliferation of
epithelial cells? - CORRECT ANSWER Occlusive"
"Which of the following is true in handling hemostatic agents such as collagen or gelatin sponges?
- CORRECT ANSWER Must not be injected or allowed to enter large vessels, as extensive intravascular clotting may occur"
"Match the suture with its appropriate description - CORRECT ANSWER Surgical silk- Gives
good support during early ambulation and promotes rapid healing, used to close fascia when on infection is present. Virgin silk- Composed of natural fibers, used for ophthalmic surgery. Dermal silk- Strands are encased in a gelatin or protein substance; used for skin sutures. Surgical cotton- Weakest of the nonabsorbable material choices, gains strength when wet. Linen- Tensile strength is inferior to other nonabsorbables, used for GI surgery. Steel- Used in ortho; may also be used in the presence of infection."
"Match the suture with its appropriate example - CORRECT ANSWER Monofilament nylon-
Ethilon and Dermalon. Coated multifilament nylon- Surgilon. Uncoated polyester fiber- Mersilene and Dacron. Coated polyester fiber- Ticron, Ethibond, Teflon, Polydek, and Tevdek. Polybutester- Novafil. Polyethylene- Dermalene. Polypropylene- Prolene and Surgilene."
"Match the needle point with its appropriate description - CORRECT ANSWER Conventional
cutting point- Cutting edge on the inside curvature, creating a very small path that heals quickly. Reverse cutting point- Curved needles with cutting edges on the outer curvature. Side cutting point- These needles do not penetrate underlying tissues, but rather split tissue layers, used for ophthalmic surgery. Trocar point- Used to punch through tough tissues. Taper point- pushes the tissue aside when passing through.
"Identify the proper sequence of events in the body's defense mechanism - CORRECT
ANSWER Hemostasis- cleaning up the pathogens;wound sealing;regeneration of epidermal
covering;repairing deeper tissue damage"
"At what point in the healing process do most wound disruptions occur? - CORRECT ANSWER
Beginning of proliferative phase- Phase 2- 2 to 10 days"
"Match each type of wound with its appropriate example - CORRECT ANSWER Clean wounds-
Thyroidectomy. Clean contaminated wounds- Colon resection. Contaminated wounds- Open or fresh traumatic wounds. Dirty wounds- Ruptured appendix."
"Prolonged high dosages of steroids preoperatively delay______ - CORRECT ANSWER
collagen formation"
"The CDC's classification of Surgical Wounds system is intended to_______ - CORRECT
ANSWER monitor postoperative infections and suggest steps to take to reduce these infections"
"Factors that Negatively affect wound healing - CORRECT ANSWER -A surgical complication
-Failure to eliminate dead space when closing the incision -Implantation of orthopedic hardware -Surgical incisions in an area of high mobility"
"Match the Topical Hemostatic Method with the appropriate method of Action - CORRECT
ANSWER Passive- Provide barrier
Flowables- mechanically obstruct flow of blood Fibrin Sealants- Increase amount of fibrinogen at site Active- Enhanced clotting"
"Methods of producing hemostasis include which of the following? - CORRECT ANSWER
Administering blood; Applying pressure; Using electrocautery; Using topical hemostatic agents"
"The process of digestion of pathogens by neutrophils and macrophages is known as ______ -
CORRECT ANSWER phagocytosis"
"In what areas would you most likely find a perianesthesia nurse? - CORRECT ANSWER
Extended Care Unit; Postanesthesia Care Unit; Preadmission Testing Unit; Preoperative Holding" "During admission of a patient to Phase 1 of postanesthesia care, the perianesthesia nurse is
responsible for - CORRECT ANSWER -assessing the patient's level of consciousness
-assessing the patient's pain level -maintaining a patent airway -monitoring blood pressure, heart rate, and oxygen saturation" "What would be the most important information for a nurse in preadmission Testing (PAT) to
collect on a insulin dependent diabetic patient? - CORRECT ANSWER The type of insulin that
patient takes"
"Match the phase or unit or age group with the correct nurse patient ratio - CORRECT
ANSWER Extended Care Unit- 1:3/5;
Patients are under age 8: 1:2; Upon admission: 1:1; Patient recovering in CCU: 2:1"
"Which factors contributed to the creation of a specialized care unit for the surgical patient? -
CORRECT ANSWER -use of anesthetic gases
-use of specialized equipment -introduction of PACU standards" "In Phase II, patient education becomes a critical task. What aspects of post-discharge life should
the nurse be teaching the patient? - CORRECT ANSWER -how to empty drainage fluid
-coughing and deep breathing exercises -how to take the prescribed medications"
"What are the complications associated with laparoscopic surgery? - CORRECT ANSWER -
Wound infections -CO2 embolism"
"Identify some methods used to maintain a sterile camera head - CORRECT ANSWER -Put the
camera head in a sterile pouch
