CNOR ONLINE PRACTICE EXAM 2024 | ALL QUESTIONS AND CORRECT ANSWERS WITH RATIONALES, Exams of Management of Health Service

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CNOR ONLINE PRACTICE EXAM 2024 | ALL

QUESTIONS AND CORRECT ANSWERS

WITH RATIONALES | ALREADY GRADED A+

| LATEST VERSION (JUST RELEASED)

When safely placing an adult pt in the prone position for surgery, a minimum of ___ people are required ------CORRECT ANSWER--------------- 4 Rational: a minimum of 4 and up to 6 people are needed when placing a pt in the prone position to maintain body alignment A pt who receives a score of 3 using the Glasgow coma scale for eye opening is able to open his/her eyes - -----CORRECT ANSWER--------------- in response to verbal stimuli Rational: a score of 3 on the eye opening portion of the scale signifies a response to speech Which of the following procedures is considered a class 3 wound? ------ CORRECT ANSWER---------------exploratory laparotomy with repair of ruptured diverticulum Rational: clean contaminated classification applies to procedures that enter the alimentary, genitourinary & respiratory tracts under controlled circumstances. A ruptured diverticulum is uncontrolled, contains spilled fecal material & would be classified as contaminated ( class 3) When a laser is in use during a procedure, the area around the surgical site that poses potential injury is known as ------CORRECT ANSWER--------------

• Nominal hazard zone

Rational: nominal hazard zone is a specifically identified area, usually within the surgical suite, that requires the implementation of certain safety measures, lasers do have the potential to penetrate through clear windows. The nominal zone once identified should have safety control measures instituted The ___ lithotomy position is most often associated with compartment syndrome ------CORRECT ANSWER---------------high Rational: flexing the thighs toward the abdomen & suspending the calves vertically compromise circulation, which leads to swelling and pressure on the blood vessels & nerves in the lower leg Which of the following situations would be categorized as a reportable sentinel event? ------CORRECT ANSWER---------------a pt with a gunshot wound that results in preoperative death Rational:events resulting in unanticipated pt death or permanent loss of function caused by an assault are reportable While a nurse is charting in an electronic pt chart, a colleague who is NOT assigned to the pt walks up and begins to read some of the chart. What should the nurse do? ------CORRECT ANSWER---------------tell the colleague that the pt chart is private & move from view Rational: every pt has a right to privacy related to health care information. Information should not be misused or shared with those outside the immediate care providers It is important for the perioperative nurse to communicate a pt new onset atrial fibrillation because of an increased risk of ------CORRECT ANSWER-- -------------stroke caused by embolus Rational: a fib causes small emboli to form in the atria, which may be dislodged and travel to the brain, causing new stroke

A nurse assists the anesthesiologist with placement of a spinal anesthetic. The nurse notices the physicians sterile gloves brush againstteh OR table. Which of the following actions demonstrates professional conduct by the nurse? ------CORRECT ANSWER---------------inform the md of the break in sterile technique & provide new sterile gloves Rational: pt safety should be maintained through effective communication of a break in sterile technique. It's the nurse's responsibility to speak up and protect the pt The RN circulator documents on the pt record what was counted, ____, and by whom, and if the counts were correct or incorrect ------CORRECT ANSWER---------------how many counts were performed Rationale: an RN is responsible for completing the counts and documenting them. Facility policy should be followed and recommended to include how many counts were performed. Those individuals counting are responsible for the accuracy of the counts It is important for nurses to use ___ when documenting nursing practice for the perioperative pt ------CORRECT ANSWER---------------nursing terminology R/the use of nursing terminologies ofr documentation provides an efficient, consistent way to communicate nursing knowledge. Nurses will be better able to track, report, and improve the outcomes of nursing care National standards for securityand privacy of health data are set in the ------ CORRECT ANSWER---------------HIPPA

When talking with the pt during teaching, using an open, relaxed sitting position is a form of ____ communication. ------CORRECT ANSWER--------- ------nonverbal The rationale for using a local anesthetic with adding epinephrine is to ------ CORRECT ANSWER---------------slow the rate of absorption of the local anesthetic by promoting vasoconstriction R/ epi causes vasoconstriction which lets the local anesthetic work longer because of decreased blood flow During a cataract extraction, which of the following medications is used as a prophylactic to reduce inflammation? ------CORRECT ANSWER------------- --dexamethasone While a nurse is walking in the hallway to the preop area, he notices his neighbor on one of the surgical stretchers waiting for an anesthesia interview. What is the nurse's most appropriate action? ------CORRECT ANSWER---------------not stopping or acknowledging the neighbor R/ privacy & confidentiality of all pt information must be protected. HIPAA prevents the health care provider from sharing any pt information with any one not directly associated with pt care Techniques used to enhance effective communication with pt who have impaired communication due to stroke include decreasing environmental stimuli, presenting one idea at a time, treating the pt as an adult and ------ CORRECT ANSWER---------------asking simple questions R/ asking simple questions allows pt who have experienced a stroke to answer with simple responses like yes and no. open ended questions may be frustrating and difficult

Including the pt family/caregivers in the perioperative plan of care has been found to ------CORRECT ANSWER---------------reduce pt & family anxiety Key component of quality end of life care is communication with the pt and caregiver that demonstrates empathy ------CORRECT ANSWER--------------- and active listening R/ pt who are in the palliative phase of care are silent, which allows time for reflection. Active listening by nurse means being attentive to what is said, observing nonverbal communication, and not onterrupting The most effective processing for transferring information related to perioperative nursing care include which of the following? ------CORRECT ANSWER---------------face to face report and checklist R/ the process for transferring pt information should include verbal components together with written components in a standardized documentation format that assists with continuity of patient care. If possible this interaction should occur using face to face format. When the OR circulator is relieved for lunch during a total hip replacement, the ensuing hand off communication should include the procedures progress, the family update, the implant status, and the ------CORRECT ANSWER---------------count status R/ count status is important topic to discuss during lunch relief hand off. Counts may affect the status of pt care and safety, preoperative teaching, to follow procedures and anesthesiologist lunch breaks do NOT affect the safety of the currently undergoing an operative procedure The most reliable indicator of a pt level of pain is ------CORRECT ANSWER---------------what the pt verbalizes

R/ the most reliable indicator of pain is the pt self-report. The response to pain may differ from situatin and from pt to pt During pt hand offs, providing the postanesthesia care unit (PACU) nurse with the amount and type of local anesthetic used for a regional field block is an example of which component of SBAR communication? ------ CORRECT ANSWER---------------Assessment R/ the method of pain management is part of assessment portion of SBAR communication between the perioperative and PACU nurses. The purpose of reconciling a pt medications prior ro discharge from an ambulatory surgery center is to ------CORRECT ANSWER--------------- prevent duplication of postoperative prescriptions with current medications R/ reconciliation of medications can prevent prescribing errors. The updated list should be shared with the primary care physician upon discharge from the facility if a surgeon performs a procedure without a valid informed consent, he is at risk for legal action related to a/an ------CORRECT ANSWER--------------- battery R/ the intentional touching of the pt or performing a procedure on a pt who has not given consent to the procedure is a form of battery. Assault criminalizes the threat of harm to an individual utilization and documentation of the nursing process when transferring care of the perioperative pt demonstrates ------CORRECT ANSWER--------------- use of critical thinking skills wound classification scores are used to determine a pt risk of postoperative complication from infection. The wound classification scores were

developed by the ------CORRECT ANSWER---------------centers for disease control and prevention ( CDC) R/wound classification scores developed by the CDC predict the pt risk of infection related to the surgical procedure. Risk is assessed based on the amount of contamination present during surgery. Classification categories include: clean, clean-contaminated, contaminated, and infected Spanish only speaking pt is undergoing an appendectomy. The perioperative nurse understands that the most appropriate way to assist in obtaining informed consent is to ------CORRECT ANSWER--------------- obtain an interpreter in the postop phase, information that shoul be included during hand off includes: estimated blood loss, surgeon's orders for drains, diet, medication and ------CORRECT ANSWER---------------surgical site dressings R/ surgical site dressings need to be included in postop transfer of care information, enabling the postop nurse to assess dressing and observe for any alterations in drainage and wound care. initial assessment of the pt upon arrival to the PACU begins with ------ CORRECT ANSWER---------------determination of airway patency R/ initial postop assessment of the pt begins with immediate determination of patency of airway pt at the highest risk for postop respiratory complications are pt who ------ CORRECT ANSWER---------------smoke a complementary therapy that could be utilized during the perioperative period to help reduce anxiety is ------CORRECT ANSWER---------------music therapy

monitoring the amount of fluid used during a hysteroscopy is important in preventing which of the following complications? ------CORRECT ANSWER---------------Hyponatremia R/ Extravasation of hysteroscopy fluid can lead to hyponatremia an example of a regulatory agency with the authority to fine a health care facility for not meeting laws established to protect the public is the ------ CORRECT ANSWER---------------Centers for Medicare & Medicaid services (CMS) as part of the nursing process, a postop follow up phone all should be made 24 to 48 hours after discharge. During the call the nurse is able to assess the achievement of ------CORRECT ANSWER---------------expected outcomes collection of postop data for evaluation may be collected through direct pt interview, pt evaluation response form ------CORRECT ANSWER--------------

• and interdisciplinary conference of caregivers R/ postop evaluation programs require an interdisciplinary and collaborative approach to be successful. Input from the pt and all team members who participate in the pt care process should be included> a potential complication of epidural anesthesia caused by a/an ____ is complete paralysis requiring intubation and systemic support until the block is resolved ------CORRECT ANSWER---------------subarachnoid injection R/ Subarachnoid injection caused by the initial needle or an epidural catheter that moves and punctures the subarachnoid space may result in total paralysis. Injection of medications should be done with a test dose1st followed by injections of up to 5 mL at a time to ensure proper placement

the most accurate method for verifying the effectiveness of a steam sterilizer is a ------CORRECT ANSWER---------------biologic indicator which of the following should be considered regarding the integrity of packing materials? ------CORRECT ANSWER---------------storage areas should have air temperature below 75degrees Fahrenheit R/ temp below 75F & humidity between 30-70% are environmental conditions needed to help prevent the potential for contamination. Storage should be secured away from unrestricted conditions. Closed cupboards are preferable for storage. Items should be cooled prior to storage an EPA registered disinfectant labeled to kill tuberculosis is effective against ------CORRECT ANSWER---------------mycobacteria when transporting instruments after a procedure, the ____ require that the instruments are put in a closed container or closed cart ------CORRECT ANSWER---------------OSHA regulations a reusable flexible neuroendoscope has been used for a pt who is suspected of having Creutzfedt-Jakob Disease (CJD). The safest way to process this neuroendoscope post-procedure is to ------CORRECT ANSWER---------------dispose of the scope R/ Shorter steam sterilization cycles and low temp sterilization technique are not effective in inactivationg prions. When used on high risk tissue, reusable instruments that are not easy to clean and cannot tolerate extended steam sterilization cycles should be discarded after use

to adequately decontaminate a flexible endoscope after use, the 1st step that should be followed is to ------CORRECT ANSWER---------------preclean the exterior with cleaning product R/ precleaning at point of use should occur as soon as possible after the endoscope is removed from the pt. the exterior of the endoscope should be washed with an approved cleaning solution before transport to the decontamination area for leak testing and manual cleaning. Precleaning prevents drying of organic material and formation of biofilm the FDA began the voluntary ____ program to encourage physicians, nurses, pharmacists & other health care professionals to report adverse events and defects or problems with regulated drugs and devices ------ CORRECT ANSWER---------------Medwatch R/medwatch was developed to create a national standardized reporting format for devices that have the potential for creating harm the perioperative nurse sterilizes a yankaur suction tip that has been contaminated during the case. The temperature on the print out tape for the gravity displacement steam sterilizer read 272 F ( 135C). the nurse's next action is to ------CORRECT ANSWER---------------return the instrument to the sterile field in an aseptic fashion R/ parameters for temperature for immediate use sterilization in a gravity displacement steam sterilizer for metal items with lumens are 270 to 272 F (132-135 C) the purpose for placing a chemical indicator tape on the outside of a package is to signify that the package ------CORRECT ANSWER--------------

• an external chemical indicator should be checked to determine that the package has been exposed to a sterilant. R/The integrity of the package and expiration date, if applicable, also determined the sterility of the contents

packages prepared for sterilization should be labeled and writing should be on the ------CORRECT ANSWER---------------* Indicator tape R/ writing should be entered on the indicator tape, or affixed label of wrapped package, or on the " plastic side" of peel pouches. Package labels should be visible. Writing on the wrapper or the paper side of peeled pouches my compromise its barrier function. solutions used for manually cleaning flexible endoscopes should be discarded ------CORRECT ANSWER---------------after every use R/using a freshly prepared solution for each new cleaning process help prevent cross contamination, decreases the risk for bacterial growth in the solution, and ensures that the proper concentration of active ingredients are available for each cleaning for unwrapped, porous stainless steel item with lumens, the minimum exposure time at 270 F in a prevacuum cycle ------CORRECT ANSWER---- -----------is 4 minutes While completing the preoperative assessment, a nurse notices the pt R knee has been marked by the surgeon but the pt is scheduled for the L Knee arthroplasty. What is the best action for the nurse? ------CORRECT ANSWER---------------verify with the surgeon A pt age 7 is scheduled for a tonsillectomy and adenoidectomy at the ambulatory surgery center. During the preoperative telephone interview, the mother asks the preoperative nurse if her daughter will be able to take her favorite stuffed animal into the OR. Which of the following is the best response based on the child's developmental level ------CORRECT ANSWER---------------we will make sure the toy stays with your daughter until the anesthetic takes effect

The periperative registered nurse notes that the pt is taking garlic as a prophylactic cold remedy. This information is reported to which of the following health care providers? ------CORRECT ANSWER--------------- Anesthesia care provider, because garlic can prolong bleeding A pt who has just received a local anesthetic block is beginning to demonstrate decreased breathing rate & depth, tremors, and muscle twitching, the nurse should suspect a/an ------CORRECT ANSWER----------- ----toxic reaction to the local anesthesia the perioperative nurse can expect the would /ostomy/continence nurse to mark the site for the stoma for a colostomy at ------CORRECT ANSWER---- -----------rectus muscle During a local procedure, the nurse notices that the pt is exhibiting a sense of uneasiness, agitation, coughing & wheezing. The nrse should suspect a/an ------CORRECT ANSWER---------------allergic reaction to the local anesthesia the 3 tops risk factors associated w/ pt falls are medications, gait, and ------ CORRECT ANSWER---------------previous fall normal hematocrit for pt age 10 years ranges from ------CORRECT ANSWER--------------- 34 - 40% universal protocol is a process to keep pt safe in surgery. Verbal confirmation is performed at 3 points during the perioperative period. Which

of the following is identified as 1 of the 3 critical points? ------CORRECT ANSWER---------------sign in before induction of anesthesia a 12 year old boy is scheduled for srgery to repair a fracture to the knee involving the epiphyseal plate. The perioperative nurse recognizes the primary complication resulting from the injury is ------CORRECT ANSWER-- -------------impaired growth to the affected leg a pt suffers a cardiac arrest following the injection of bupivacaine 0.5% w/ epi 1:200,000 25 mL as a peripheral nerve block for L knee arthroscopy. The perioperative nurse can anticipate obtaining which of the following drugs for the anesthesia care provider? ------CORRECT ANSWER------------ ---20% lipid emulsion Which of the following is an assessment parameter monitored through the use of perioperative nurse process? ------CORRECT ANSWER--------------- documentation of potential needs preoperative pt assessment of the use of herbs is an important function of the perioperative nurse so that ------CORRECT ANSWER---------------the appropriate healthcare provider can be notified of potential risks to the surgical procedure which electrolyte is important to check preoperatively after bowel prep the day before? ------CORRECT ANSWER---------------Potassium AORN peripoperative nursing data set (PNDS) is the structured nursing vocabulary designed to describe nursing care in the perioperative setting.

At the core of the PNDS conceptual model is the ------CORRECT ANSWER---------------patient What Is Defined As The Standardized Process To Keep Patients Safe In Surgery? ------CORRECT ANSWER---------------Universal protocol The purpose of witnessing a surgical consent is to attest to which of the following? ------CORRECT ANSWER---------------the signature was voluntary and not coerced Which one of the following antibiotics can potentiate neuromuscular blocking agents? ------CORRECT ANSWER---------------piperacillin Universal protocol is ------CORRECT ANSWER---------------a standardized means for ensuring pt safety during surgery during the discharge medication reconciliation process, the postanesthesia care unit nurse educates the pt and family members to ------CORRECT ANSWER---------------use 1 pharmacy for filling all prescriptions and OTC medications a pt scheduled for an emergency hip arthroplasty has a preoperative prothrombin result of 12 seconds. The best action of the RN circulator is to ------CORRECT ANSWER---------------inform the surgical team and transport the patient to the OR suite

During the preoperative assessment, the pt states that "donor-directed" RBCs are available and should be sued if a blood transfusion is necessary. Which of the following is accurate about donor directed RBCs? ------ CORRECT ANSWER---------------donated blood is tested and processed by the blood bank What is the physiological change associated w/ the normal aging process in geriatric pt? ------CORRECT ANSWER---------------increased vascular resistance during the preoperative assessment, the perioperative nurse notes on the history & physical that the pt has an entrapped median nerve on the volar surface of the wrist secondary to her work as an IT specialist. The nurse will set up for which of the following procedures? ------CORRECT ANSWER---------------carpal tunnel repair which of the following pt is at increased risk of inadvertent hypothermia? --- ---CORRECT ANSWER---------------82 year old undergoing colectomy pt is admitted from a long term facility with a fractured hip. The pt has a " do not resuscitate" (DNR) order in his medical record. The perioperative nurse's next action is to ------CORRECT ANSWER---------------ensure that the pt, anesthesia care provider & surgeon have an opportunity to discuss options and answer questions It is the responsibility of the _____ to obtain informed consent for a proposed surgical procedure ------CORRECT ANSWER--------------- practitioner performing the procedure

a form of standardized language in the perioperative setting is reinforced by the use of which documentation format? ------CORRECT ANSWER----------- ----PNDS Pneumatic tourniquet inflation pressures are determined by ------CORRECT ANSWER---------------systolic BP, age of pt, & circumference of extremity placing sequential compression devices ( SCDs) on a pt legs preoperatively addresses which of the following risk factors for the development of deep vain thrombosis (DVT)? ------CORRECT ANSWER---- -----------venous stasis a pt is scheduled for a laparoscopic cholecystectomy at 1000. In response to a question related to NPO status, the pt states she had a sip of water with her usual dose of metoprolol/hydrochlorothiazide at 0700. The perioperative nurse's next response is to: ------CORRECT ANSWER---------- -----proceed with the case as scheduled bone wax should be immediately available for craniotomies conducted in the Fowler position because of this position's increased risk for: ------ CORRECT ANSWER---------------air embolus for a pt with a history of serum cholinesterase deficiency, which of the following anesthetic agents should be avoided? ------CORRECT ANSWER- --------------succinylcholin

the perioperative registered nurse is caring for a developmentally delayed male pt aged 46 years whose cognitive level is comparable to a child aged 9 years.Which of the following is the most appropriate pain assessment tool? ------CORRECT ANSWER---------------using a FACES pain rating scale Pt with a possible injury within the cranium should not be placed in a ____ position unless absolutely necessary ------CORRECT ANSWER--------------- Trendelenburg Which of the following is an example of education using the pt centered care approach? ------CORRECT ANSWER---------------call the dr if the blood on your dressing is bigger than a fifty cent piece greatest risk for transmitting the HIV virus is through exposure ------ CORRECT ANSWER---------------to infected blood or body fluids via a large bore hollow needle which of the following complementary therapies may provide relief for postoperative nausea & vomiting? ------CORRECT ANSWER--------------- peppermint aromatherapy the major benefit of using the Perioperative Nursing Data set (PNDS) is its - -----CORRECT ANSWER---------------ability to document pt care that is unique to perioperative nursing pt preoperative health assessment form indicates that he uses a continuous positive airway pressuse (CPCP) machine at night for sleep

apnea. The perioperative nurse knows to transfer this information to the postanesthesia care unit (PACU) nurse so that the pt can be monitored more closely for signs & symptoms of : ------CORRECT ANSWER------------- --hypoxia administration of the preoperative prophylactic antibiotic is the responsibility of ------CORRECT ANSWER---------------a designated perioperative health care provider compared to adults, infants are at increased risk for hypothermia due to ---- --CORRECT ANSWER---------------increased body surface area to weight ratio accountability for surgical counts is a professional responsibility that rests primarily on the ------CORRECT ANSWER---------------scrub person & RN circulator PNDS uses ____ domains to address the perioperative nursing process ---- --CORRECT ANSWER--------------- 4 the nurse should place a specimen in a container with ___ when sending to pathology for a frozen section ------CORRECT ANSWER--------------- Nothing specimens should be transferred from the sterile field to the appropriate container using ___ precautions ------CORRECT ANSWER--------------- standard

34 year old female pt with a diagnosis of breast cancer is scheduled for a R breast mastectomy. When performing the surgical skin prep, the nurse ------ CORRECT ANSWER---------------uses a no touch technique during prepping if the alimentary, respiratory & genitourinary tracts or oropharyngeal cavity are entered under controlled conditions without significant spillage or unusual contamination, the surgical wound is classified as which of the following? ------CORRECT ANSWER---------------clean contaminated wound Rational: correct wound classification should be completed after conclusion of the surgical procedures. Determination of any alteration related to spillage of contaminated contents must be considered when applying the wound classification. Any GI or GU tracts are considered clean contaminated unless alterations occur. During a subtotal thyroidectomy, both the R & L recurrent laryngeal nerves are ligated. The perioperative nurse can anticipate the need for which of the following interventions? ------CORRECT ANSWER---------------obtaining an emergency tracheotomy tray a pt with a fractured anterior fossa of the skull may have an alteration in which sense? ------CORRECT ANSWER---------------smell Rational: fractures of the anterior fossa of the skull may affect the olfactory nerve, which is responsible for the sense of smell the preferred incisional type for an exploratory laparotomy is ------ CORRECT ANSWER---------------midline vertical Rational: a midline vertical incision is preferred for an exploratory laparotomy because it enables fast entry into the abdomen and excellent

exposure to the abdominal contents and because it can be closed securely and rapidly A ____ is a major cause of death during & immediately following a surgical procedure that can result from blood pooling in low pressure areas ------ CORRECT ANSWER---------------pulmonary embolism Rational: PE can be caused by blood clots or other debris like fat. Debris blocks the pulmonary artery or one of the branches. A PE is most often caused by stasis of blood in deep veins during extended proceedures. in the absence of a sterile transfer device when dispensing medication to the sterile field, the best option is to ------CORRECT ANSWER--------------- have the RN circulator draw up the medication in syringe & transfer Rational: The best option is to use a sterile transfer device. If one is not available, the next best option is for the RN circulator to draw up the medication in a syringe and remove the needle prior to dispensing on the field most medication errors in pediatric care occur because this pt population varies dramatically in ------CORRECT ANSWER---------------weight Rational: pediatric medication administration is based on the pt weight. An accurate wt measurement upon admission in both pounds and kg is an essential part of preventing medication errors. determining whether re-anastomosis is possible after a low anterior resection of the sigmoid colon depends on ------CORRECT ANSWER-------- -------cancer free margin of the distal rectum Rational: the ability to reestablish continuity of the proximal sigmoid colon and the rectum is contingent on whether the distal rectal margin is cancer free and if there is sufficient length of the bowel to vreate a tension- free anastomosis

what is the American Society of Anesthesiologists (ASA) classification of a pt with severe hypertention? ------CORRECT ANSWER---------------ASA Class 3 Rational: Class 3 defined as pt having severe systemic disease that limits activity but does not completely incapacitate the pt. the chemical indicator inside a wrapped instrument tray has not changed to the appropriate color. The perioperative nurse should first ------CORRECT ANSWER---------------review the sterilizer print out Rational: the sterilizer print out should be checked 1st to determine whether cycle parameters have been met. Physical monitors can provide a rapid means of identification of sterilizer failure. Subsequent actions are based on whether the reason for the failure is due to operator or sterilizer causes using ___ after high level disinfection of flexible endoscopes may help dry the lumen to prevent microorganisms from multiplying ------CORRECT ANSWER--------------- 70 - 90% ethyl alcohol Rational: flushing w/70-90% ethyl or isopropyl alcohol should be determined by the interdisciplinary team at the organization. Flushing with alcohol may not be necessary if the flexible endoscope is dried properly pt is scheduled for burr holes to remove fluid accumulated secondary to blunt head trauma. The best option for a drain that removes cerebral spinal fluid while monitoring intracranial pressure is a ------CORRECT ANSWER--- ------------ventriculostomy Rational: A ventriculostomy provides the most accurate method of monitoring intracranial pressure while providing the ability to drain cerebrospinal fluid

mcburney's incision is used by surgeons when performin an open ------ CORRECT ANSWER---------------appendectomy Rational: this method involved pressing on the R lower quadrant below the umbilicus and medial to the anterior superior iliac spine. This is known as the McBurney's point the primary goal for moderate sedation/analgesia is for the pt to exhibit a depression level of consciousness while ------CORRECT ANSWER----------- ----being aroused with tactile stimulation Rational: goals of moderate sedation include independent maintenance of airway and appropriate response to physical and verbal stimulation. Although the pain threshold is elevated, all painfull sensation may NOT be eliminated shoes worn by perioperative team members within the surgical suite should have closed toes & backs, low heels, and non skid soles & must meet ___ requirements ------CORRECT ANSWER---------------OSHA pulse oximetry measures ------CORRECT ANSWER---------------saturated hemoglobin in arterial blood local anesthesia injected during an epidural is diffused by the ------ CORRECT ANSWER---------------rate of injection Rational: the concentration, volume, and rate of injection determine the spread and diffusion of medication during an epidural injection which of the following is an effective way to prevent hypothermia in the perioperative pt? ------CORRECT ANSWER---------------warm pt before induction of anesthesia

which perioperative team member (s) is/are responsible for prevention of retained surgical items? ------CORRECT ANSWER---------------all perioperative team memberst Rational: The entire surgical team should be reasonable for ensuring pt safety and prevention of retained surgical items. A system that includes a multidisciplinary approach based on team skill and intervention is the best way to prevent pt injury passive drains like a Penrose provide ------CORRECT ANSWER--------------

during the ___ stage of healing, granulation tissue can be felt as a firm ridge under the edges of the incision ------CORRECT ANSWER--------------- proliferative Rational: granulation tissue forms during the proliferative stage and resolves during the remodeling phase blood salvage for autotransfusion should not be done intraoperatively if there is presence of amniotic fluid, enteric organisms or ------CORRECT ANSWER---------------Avitene Rational: Avitene may not be removed when the cells are washed and could lead to disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). Avitene is a collagen used for hemostasis the recommended maximum cuff pressure limit for a pneumatic tourniquets applied to the lower leg is ------CORRECT ANSWER--------------- 250 - 300 Rational: Tourniquet pressure should not exceed the recommended maximum cuff pressure limits of 250-300mmHg for the lower leg.

in the event of an incorrect count during closing procedures, what is the 1st thing the nurse should do? ------CORRECT ANSWER--------------- immediately inform the surgeon Rational: the surgeon should be informed immediately to allow him to search the wound area while temporarily suspending the closure. In some cases, the surgeon may continue to close based on the pt health status. which of the following is a sign of a blood transfusion reaction in the anesthetizing pt? ------CORRECT ANSWER---------------temperature change Rational: pt under anesthesia may demonstrate profound hypotension, change in temperature, the presence of blood in the urine or a skin rash during intraoperative use of a monopolar electrosurgery unit, the ------ CORRECT ANSWER---------------return electrode should be placed as close to the surgical site as possible Rational: the electrical current pathway goes from the generator through the pt to the return electrode & back to the generator. The shortest path decreases the risk of aberrant pathways that could cause the pt burns contaminated items should be transported to the decontamination area -----

• CORRECT ANSWER---------------in a closed container Rational: this minimizes the risk of staff exposure to blood-borne pathogens & other potentially infectious materials. Contaminated instruments should be separated from clean & sterile supplies before transport to the processing area Explanted medical devices that have caused serious injury to the pt must be reported to which of the following ------CORRECT ANSWER--------------- Device manufacturer Rational: implants that have caused serious injury

must be reported to the mfr. If the implant caused death, it must be reported to BOTH FDA & MFR during preoperative verification the nrse notes the pt has an implantable cardioverter-defibrillator (ICD). The nurse ensures the device is turned off prior to the planned procedure because the ___ can deprogram the device and cause it to trigger during the procedure. ------CORRECT ANSWER------ ---------wavelength Rational: unintended firing of an ICD can cause injury to the pt through an alternate current or potential injury to the caregiver during the procedure A/An ___ forcep is angled to prevent the users hand from occluding vision in a small space ------CORRECT ANSWER---------------bayonet Rational: bayonet forceps may be toothed or smooth and are angled like bayonet. This instrument is commonly used by ENT surgeons and in neurosurgery for a pt undergoing a L total knee replacement, appropriate marking of the surgical site includes which of the following? ------CORRECT ANSWER----- ----------initialing the surgical site on the L knee by the surgeon with pt input Rational: site should be marked by person performing the operative procedure with pt input if possible. communicating sudden changes in a pt status, such as decerebrate posturing is important because this may be a sign ------CORRECT ANSWER---------------of worsening and damage Rational: increased intracranial pressure (ICP) may present with decerebrate posturing, which may signal serious damage or disruption of motor fibers in the midbrain & brainstem