CNOR Practice Exam Prep by CCI 2023 latest, Exams of Advanced Education

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CNOR Practice Exam Prep by CCI 2023 latest

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Which patient population is more sensitive to dosage errors A. Male patients 25- 40 B. Bariatric patients C. A patient with a history of polypharmacy D. Pediatric patients - D. Pediatric patients The National Patient Safety Goals directed at improving staff communication review the need for A. ensuring important test results are communicated to the right person on time B. transferring patients to the correct next level of care C. completing perioperative charting prior to transfer to the postanesthesia care unit D. Conducting a daily huddle on the unit - A, ensuring important test results are communicated to the right person on time Which of the following is a potential contraindication to the use of a pneumatic tourniquet? A. Pt has undergone prev joint replacement surgery B. Pt is older than 80 years old C. Pt has sickle cell anemia D. Pt's operative extremity has been shaved - C. Sickle cell anemia Which of the following is part of the surgical check list A. When the pt last ate food or drank fluids B. whether any special equipment, devices or implants will be needed C. Whom the surgeon should talk to after surgery D. What pharmacy the patient uses - B. Whether any special equipment, devices or implants will be needed A pt taking ginger preoperatively is at risk for surgical complications that include bleeding, hypotension and A. hypoglycemia B. Bradycardia C. hypokalemia D. liver dysfunction - B. Bradycardia A patient is on long term acetyl salicylic acid therapy. Preoperatively, the pt should be counselled to discontinue taking the medication _________ prior to surgery A. 1 week B. 2 weeks

C. 3 weeks D. 4 weeks - B. 2 weeks A pt-specific risk factor for venous thromboembolism (VTE) is A. a prev hx of stroke B. duration of surgery C. intraoperative position D. use of a pneumatic tourniquet - A. previous history of stroke Actively warming surgical patients with forced air to prevent hypothermia should begin A. as soon as the patient enters the OR or procedure room B. In the recovery room C. in the preoperative holding area D. just before the surgeon makes the incision - C. in the preoperative holding area Which of the following indicators demonstrates a patient who is at increased risk of developing a pressure ulcer during a surgical procedure A. Aged 50 or older B. Hx of recent gallbladder surgery C. Female D. Poor preoperative nutritional status - D. Poor preoperative nutritional status Based on data collected during the patient assessment, the perioperative RN A. identifies an outcome B. Formulates a nursing diagnosis C. develops a plan of care D. performs nursing interventions - B. formulates a nursing diagnosis Liquid peracetic acid low-temperature sterilant is used for devices that meet all of the following criteria except: A. Device must be approved for this process B. Device must be heat sensitive C. Device must be aerated D. Device must be immersed - C. Device must be aerated During surgery the patients respirations become increasingly shallow, and the pupils become smaller and smaller until they are pinpoint. How should this situation be managed? A. The patient should be extubated and bagged with 100% oxygen B. This is normal and is not cause for alarm C. The anesthetic should be discontinued, and a narcotic antagonist such as naloxone (Narcan) should be administered D. Oxygen should be increased while anesthetic is decreased - C. The anesthetic should be discontinued, and a narcotic antagonist such as naloxone (Narcan) should be administered

St. johns Wort Valerian What are the three tenets that radiation safety is based on - Time, distance and sheilding A patients life threatening injuries prevent required hair removal before transfer to the OR. The best course of action for the perioperative nurse to follow is to A. Leave the hair at the incision site and prep the patient B. use a razor and 3" cloth tape to remove the hair C. moisten the area to be prepped and use a disposable clipper D. use a depilatory cream on the surgical site - C. moisten the area to be prepped and use a disposable clipper When prescribed, intermittent pneumatic compression devices should be applied and functioning A. after the administration of regional or gen anesthesia B. before the admin of regional or gen anesthesia C. before the patient arrives in the operating or procedure room D. after the patient arrives in the operating or procedure room - B. before the admin of regional or gen anesthesia In planning for the transfer of an 18 pound child to the gurney after bilateral myringotomies with insertion of ear tubes, the perioperative nurse plans for which of the following patient transfer aides A. A lateral transfer device, one caregiver, and the anesthesia professional B. A lateral transfer device, two caregivers, and the anesthesia professional C. A lateral transfer device, three caregivers, and the anesthesia professional D. A mechanical list device, three caregivers and the anesthesia professional - A. A lateral transfer device, one caregiver, and the anesthesia professional ( any patient under 52 pounds) Lead shielding used to minimize the patients exposure to ionizing radiation should be placed A. between the patient and the source of radiation, but not within the path of the beam that originates from the x-ray tube B. between the patient and the source of radiation and within the path of the beam that originates from the x-ray tube C. between the patient and the image intensifier of the fluoroscopic unit, but not within the path of the beam that originates from the x-ray tube D. between the patient and the image intensifier side of the fluoroscopic unit, and within the path of the beam that originates from the x-ray tube. - A. between the patient and the source of radiation, but not within the path of the beam that originates from the x-ray tube

An 18 year old pt is hesitant to remove her acrylic tongue piercing before and ex-lap for a possible ruptured ovarian cyst. The most appropriate verbal response for the perioperative RN to provide is A. You can always get another piercing if the opening for this one closes B. If the piercing is dislodged while the breathing tube is put in, it could block your airway or be pushed into your lung C. It is our policy that all jewelry be removed prior to surgery D. Your tongue could be burned if your jewelry serves as an alternate ground for the electrocautery - B. If the piercing is dislodged while the breathing tube is put in, it could block your airway or be pushed into your lung Which of the following statements reflects a female paitents accurate understanding of her scheduled total abdominal hysterectomy A. I'm having all my female parts removed B. I'm having a TAH C. I'm having my uterus removed D. I'm having my uterus removed through my vagina - C. I'm having my uterus removed The plan of care for an obese patient in the supine position may include A. using 2 chest supports that extend from the clavicle to the iliac crest B. placing an axillary roll under the patients dependent thorax C. elevating the head 25 degrees D. the use of foam heal padding - C. elevating the head 25 degrees Assessing the surgical patients psychosocial state allows the RN to contribute to the plan of care by A. suggesting modifications to the patients position B. communicating effectively with other members of the team C. ensuring the requisite supplies and equipment are readily available D. Providing explanation, comfort and emotional support - D. Providing explanation, comfort and emotional support A pt scheduled for a bronchoscopy states he has had a persistent cough with blood-tinged sputum, night sweats and a loss of appetite with significant weight loss over the past three months. Which action should be taken A. Leave the portable HEPA filter unit "on" while the patient is intubated to supplement normal room air exchanges. B. Schedule the patient for the first procedure of the day, when the infection prevention specialist is available C. Provide the patient with N-95 fit tested respirator to wear during transport D. Notify environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles - D. Notify environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles

C. 20% lipid emulsion D. 25% hetastarch - C. 20% lipid emulsion Placing the patient on the OR bed in the supine position with arms extended on armboards at greater that 90 degrees may cause injury to the A. Axillary Nerve B. Brachial Nerve C. Median Nerve D. Radial Nerve - B. Brachial Nerve The correct time to label containers designated for medications or solutions is A. When setting up the sterile field but before the medications are delivered to the field B. When there are more than two medications being used on the sterile field C. At the time the medication is delivered to the sterile field D. Just before using the medication on the patient - C. At the time the medication is delivered to the sterile field A periop nurse is preparing to perform a skin prep for a patient scheduled for a right breast biopsy with needle localization. When the nurse removes the patients gown, she discovers a wire inserted into the left breast. What is the appropriate action A. Leave the wire in place and prep the left breast B. Remove the wire and prep the right breast C. Call the radiologist and tell him of the error D. Postpone prepping until the discrepancy is resolved - D. Postpone prepping until the discrepancy is resolved Potential harm from the use of povidone-iodine antiseptics include A. deafness B. thyroid dysfunction C. neurotoxicity D. allergic response to iodine - B. thyroid dysfunction A specific directive, written by a physician, about end of life decisions is a/an A. DNR order B. AND order C. Advance Directive D. Required reconsideration - B. AND order When performing preop patient skin antisepsis, the RN should A. Perform a surgical hand scrub and wear a sterile gown B. Perform a surgical hand scrub and wear short sleeved scrub attire C. Perform hand hygiene and wear a sterile gown D. perform hand hygiene and wear long sleeved scrub attire - D. perform hand hygiene and wear long sleeved scrub attire

Patients placed in the steep trendelenberg position may be at risk for A. increased tidal volume B. decreased tidal volume C. decreased intracranial pressure D. increased stroke volume - B. decreased tidal volume due to the pressure of abdominal contents against the diaphragm What type of extinguisher should be used in an electrical fire - Halon because it will not leave a residue on the equipment When risk for exposure to blood and body fluids exists, the following types of PPE should be worn - gloves, surgical masks, fluid resistant gown, eye protection What airflow pressures and total air exchanges per hour is the most appropriate for sterile storage areas - positive airflow pressure with a min of 4 total air exchanges per hour What incision should be used for a C-Section of a baby in breech position? A. Kerr B. Kronig C. Low transverse D. Classic uterine incision - B. Kronig What is a Kronig incision - An 8cm vertical incision made in the lower uterine segment after the bladder is separated and retracted away A Sterile field has been prepared for a vaginal hyst. The surgeon has been called away for an emergency C-Section, delaying the scheduled case by at least 1 hour. the appropriate method for maintaining the sterile field for a delayed case is to A. Tape the door closed B. Cover the sterile field with a sterile drape and leave the room C. Cover the sterile field with a sterile drape and remain in the room D. Wait for an hour and the tear down the back table - C. Cover the sterile field with a sterile drape and remain in the room A pt has lost 750mL of blood intraop. Vitals are WNL. Which of the following interventions sould the nurse anticipate. A. Send a blood specimen for a stat type and cross B. Set up autologous blood transfusion unit C. Send an order for 2 units of O-neg D. Obtain additional crystalloids - D. Obtain additional crystalloids

malignant hyperthermia is a life threatening condition triggered by - medications used in anesthesia; inhaled anesthetics, succinylcholine Symptoms of MH - hypercarbia, tachypnea, tachycardia, metabolic and resp acidosis, cardiac dysrhythmias, and temp elevation What is an early indication of MH - rigidity of the jaw, identified during intubation What is the treatment for MH - Dantrolene 2.5mg/KG What is the one medication used as a preoperative anxiolytic? - Midazolam Hetastarch - A substitute for blood plasma and has oxygen carrying capabilities What are the three primary methods of hand hygiene? - Washing with soap and water performing surgical hand scrub using surgical hand rubs What is the ONLY way to prevent the transfer of Clostridium difficile? - Hand washing with Soap and Water How long is the Surgical hand scrub with a brush - Three to five minutes Wound classification parameters: Clean - Wound is not infected or inflammed The procedure was free from entry into the resp, alimentary or genitourinary tract Was the wound primarily closed or drained with closed drainage Wound classification: Was the respiratory, alimentary, or genitourinary tract entered under controlled conditions without: Evidence of infection or contamination or major break in technique ie spillage - Clean Contaminated II Wound Classification: Is the wound Fresh, open or accidental; or is there gross (ie visible) spillage from the GI tract; or is there acute non purulent inflammation present? Was there a major break in sterile tech during the procedure - Class III Contaminated Wound Classification: Is the wound An old wound with retained, devitalized tissue (gangrene, necrosis) or a wound with existing clinical infection (purulence), or a perforated viscera - Class IV Dirty infected

What wound class would a lap appy be - Contaminated hemostatic agent, Absorbable gelatin should not be used on what part of the body - in small closed spaces, such as the spinal canal The three primary phases of wound healing are - inflammatory proliferative remodeling Primary intention wound healing is - wounds are created with aseptic tech and then are closed as soon as possible with suture, staples, tape or adhesives Secondary intention wound healing is - for wounds with tissue loss and the inability to proximate edges. Wounds are typically left open so the can heal from the inside out Delayed primary closure or third intention wound healing is - wounds that require debridement first and then later require primary or secondary closure Supine position with head up is - Reverse Trendelenberg Which of the following is a common root cause of sentinel events A. Failure to use written communication tools B. Breakdown in communication C. Absence of or failure to follow policies and procedures D. Fear of reprisal for speaking up - B. Breakdown in communication When communicating patient information to other team members, perioperative RNs should A. speak loudly and slowly B. Avoid using body language C. use the read-back method D. provide the information in writing - C. use the read-back method What is the greatest value of a standardized process for transferring patient information A. Improves accuracy, reliability, and quality of info B. shortens the time it takes to transfer info from one caregiver to another C. Ensures that the same information is transferred for every patient D. Ensures that the transfer process adheres to facility policy - A. Improves accuracy, reliability, and quality of info Structure and processes for transfer of patient information should be developed by whom? - a multidisciplinary team comprising caregivers who participated in the transfer of pt info During a hand off between scrubs before a change in personnel using the SBAR, the information under Situation includes pertinent procedural information, name of the procedure and

B. Reviewing with transport the process for confirming the correct pt's identity. C. Ensuring that the OR charge calls the unit before transport of the patient D. Posting the surgical schedule at the nurses station on the med-surg unit - B. Reviewing with transport the process for confirming the correct pt's identity. The importance of educating patients and family members about prevention of wound infections post-op is part of the A. National patient safety Goals B. Surgical Care Improvement Project C. AORN D. Centers for Disease Control and Prevention - A. National patient safety Goals Documentation of transfer of care communication should be A. done by each member of the peri-op team participating in the handover B. presented in SBAR format to ensure the consistency of hand-over documentation C. Approved by all personnel involved in the hand over D. done using a standardized documentation format - D. done using a standardized documentation form Policies and procedures related to transfer of patient information should be A. reviewed annually B. Available in the practice setting C. written by a registered nurse D. Written using SBAR format - B. Available in the practice setting The peri-op pts transition phase 1 to phase II level of care is based on A. length of time the pt has been in phase I B. the nurses assessment of the pt C. The pts blood pressure measurement D. the pts oxygen saturation - B. the nurses assessment of the pt The goal to "improve the effectiveness of communication among caregivers" is proposed by A. Centers for Medicare and Medicaid Services B. the Occupational Safety and Health Administration C. the United States Department of Health and Human Services D. The Joint Commission's National Patient Safety Goals - D. The Joint Commission's National Patient Safety Goals Discharge education should include adverse effects of opioid pain medications, including constipation, vomiting, and A. respiratory depression B. hypotension C. hypertension D. diarrhea - A. respiratory depression

The goal of performing a follow-up telephone call within 48-72 hours of the pts discharge is to A. monitor the pts heart rhythm B. confirm pts understanding of and compliance with instructions C. finalize paperwork for submission to the pts ins provider D. schedule follow-up appts. - B. confirm pts understanding of and compliance with instructions Which teaching method has been shown to improve communication and teamwork A. Role-playing B. Case Studies C. Online modules D. Simulation - D. Simulation What can compromise the accuracy of the nurses transfer of pt care A. Interruptions B. Pt acuity C. Pt diagnosis D. Paper charting - A. Interruptions What items can be sterilized with Saturated Steam - stainless steel, glass, towels. Power, Ortho and neuro instruments What areas of the OR require POSITIVE AIRFLOW? - Sterilizer loading and unloading, prep and packaging, textile packaging room, clean/sterile storage Ethylene oxide (EO) sterilization is - low-temperature sterilization used for moisture and heat sensitive items What molecules that Ethylene oxide kills are - proteins and DNA Why does Ethylene oxide need to be aerated in a mechanical aerator? - To remove (EO) at the end of a cycle because it is a carcinogen. What does Ozone sterilization use for sterilization? - oxygen and water what is a low-temp steriliant that should be used for devices that are heat sensitive, can be immersed, needs to be used immediately after sterilization. - Peracetic acid liquid Class I (CI) - process indicator show whether the item has been exposed to the sterilization processed and should be placed EXTERNALLY ie Tape Class II (CI) - specialty indicator. tests for the presence of air in the sterilizer chamber

A. Diagnostic Peritoneal Lavage B. CT Scan C. Chest X-Ray D. Focused Assessment with Sonography in Trauma (FAST) - B. CT Scan A disaster prepardness plan including the use of a command center, triage center, staffing plan, documentation and communication should be held at least A. every three months B. Twice a year C. Yearly D. every 2 years - B. Twice a year Management of a patient infected with anthrax includes using __________ precautions A. droplet B. standard C. airborne D. contact - B. standard What component if the fire triangle does prepping solution represent A. Oxidizer B. Liquid ignition C. Fuel D. ignition source - C. Fuel Penetrating trauma is the result of _________ blast injuries common in explosions. A. initial B. tertiary C. primary C. secondary - C. secondary The best way to preserve potential evidence in a trauma victims hands is to A. place hands in plastic bags and tie at elbow B. wash hands and keep rinsed fluid in a sterile specimen container C. cover hands with paper bags and tape at wrists D. have law enforcement conduct examination - C. cover hands with paper bags and tape at wrists A 12 year old child with a history of asthma is emerging from general anesthesia following a tonsillectomy. Upon extubation the child begins wheezing, which rapidly progresses to stridor. The peri-op nurse can anticipate assisting the anesthesia professional with which of the following actions first? A. Suctioning the airway B. Setting up an aerosol mask with 2.5% racemic epi C. Administering Solu-Medrol 2mg/kg IV

D. reintubating the child - A. Suctioning the airway A patient is undergoing a procedure to remove vocal cord polyps using a carbon dioxide laser. During the procedure, the ET tube ignites. Which of the following actions should be undertaken first A. call for assistance B. Remove the ETT C. Pour saline into the patients airway D. turn off the CO2 laser - B. Remove the ETT A facility has a shortage of surgical techs and is considering allowing radiology techs to serve in the scrub role for interventional radiology procedures. What is the first step in determining the feasibility of this new role A. Consult the states standards of practice for radiology techs. B. Determine if the radiology technicians educational program includes training on surgical scrub details C. Ask the peri-op nurse educator to develop an orientation plan D. Develop a job description for the new role. - A. Consult the states standards of practice for radiology techs. Which of the following products should be used for disinfecting environmental surfaces in the peri-op setting A. Liquid chemical sterilants B. Hospital grade Environmental Protection Agency registered disinfectants C. High level disinfectants D. Commercial grade bleach - B. Hospital grade Environmental Protection Agency registered disinfectants The appropriate method for cleaning an OR after a procedure includes A. disinfecting the back table and mayo stand while the pt emerges from anesthesia to cute down on turnover time B. Starting at the center of the room and working toward the perimeter C. Starting at the top and working toward the bottom D. Flooding horizontal surfaces with alcohol - C. Starting at the top and working toward the bottom Which of the following actions are appropriate for a health care industry rep who is present in the OR during a procedure A. Providing technical support B. Assisting with positioning C. Opening sterile supplies on to the back table D. Scrubbing to assist the surgical team - A. Providing technical support

A ____ is an environment where actions are analyzed to determine accountability and reparations are enacted when appropriate A. Just Culture B. culture of Accountability C. Culture of communications D. Learning culture - A. Just Culture Collecting and evaluating information to assess current processes are known as A. research utilization B. change implementation C. EBP D. quality improvement - C. EBP The Joint Commission has provided guidance on _______ processes to address unexpected occurrences that have resulted or may result in pt injury or death A. root cause analysis B. sentinel event C. error identification D. process analysis - B. sentinel event The "standards of professional peri-op professional practice" identifies key behaviors of a professional that include maintaining competency and current knowledge on the peri-op specialty and A. pursuit of lifelong learning B. an understanding of legislative matters C. a commitment to precepting D. an ability to identify pt outcomes - A. pursuit of lifelong learning The purpose of the ______ is that it contains statements related to ethical obligations, duties, standards, and a nurses commitment to society. A. Guidelines for peri-op practice B. Standards of Peri-op nursing C. The Future of Nursing: Leading change, advancing health D. Code of Ethics for Nurses with Interpretive Statements - D. Code of Ethics for Nurses with Interpretive Statements What professional nursing behavior is evidenced by mutual trust, recognition, and respect among all members of the health care team in a shared decision-making process? A. Conflict resolution B. Just culture C. Collaboration D. Advocacy - C. Collaboration

Which standard of peri-op nursing is represented by completing an individualized orientation based on identified learning needs and seeking experiences to maintain skills and competency? A. Quality of practice B. Professional practice evaluation C. Education D. Evaluation - C. Education What type of research involves evaluating the link among pt characteristics, nursing care delivery, and the results of that care A. Process B. Outcomes C. Implementation D. Results - B. Outcomes What trait of professionalism is used to describe telling the truth and keeping promises A. Honesty B. Veracity C. Fidelity D. Excellence - C. Fidelity The center for Transforming Healthcare is part of _____, which is dedicated to encouraging cultures of safety for patients and personnel A. The World Health Organization B. The Joint Commission C. CDC D. Institute of Medicine - B. The Joint Commission