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During preoperative verification the nurse notes the patient 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. A. wavelength B. audible length C. electrical component D. volume CORRECT ANSWERS: A. wavelength Which of the following actions demonstrates a key physical attribute of the RN circulator? A. quickly anticipating the needs of the team B. Using eye-hand coordination C. Remaining calm D. Concentrating during long procedure CORRECT ANSWERS: B. Using eye-hand coordination A patient scheduled for an emergency hip arthroplasty has a preoperative prothrombin result of 12 seconds. The best action of the RN circulator is to: A. inform the surgical team and transport the patient to the OR suite B. inform the anesthesiologist C. cancel the case D. inform the surgeon CORRECT ANSWERS: A. inform the surgical team and transport the patient to the OR suite Specimens should be transferred from the sterile field to the appropriate container using precautions. A. droplet B. contact C. standard D. universal CORRECT ANSWERS: C. standard The perioperative nurse can expert the wound/ostomy/continence nurse to mark the site for the stoma for a colostomy at: A. the patient's belt line B. skin fold C. a crease in the abdomen D. the rectus muscle CORRECT ANSWERS: D. the rectus muscle What is the shelf life of red blood cells when refrigerated? A. 40 days B. 46 days C. 42 days
D. 44 days CORRECT ANSWERS: C. 42 days During a postoperative follow-up phone call, a patient recovering from a right lumpectomy states that she is experiencing numbness to the ring (fourth) and little (fifth) fingers of her right hand. The perioperative nurse suspects possible damage to the: A. median nerve B. radial nerve C. axillary nerve D. ulnar nerve CORRECT ANSWERS: D. ulnar nerve The time between traumatic injury and effective treatment that directly influences patient outcomes is referred to as the: A. hour of decision B. transitional hour C. golden hour D. trauma hour CORRECT ANSWERS: C. golden hour Most medication errors in pediatric care occur because this patient population varies dramatically in: A. height B. age C. allergic reactions D. weight CORRECT ANSWERS: D. weight Solutions used for manually cleaning flexible endoscopes should be discarded... A. after they become cloudy B. after there are visible particulates C. at the end of the shift D. after every use CORRECT ANSWERS: D. after every use The perioperative RN notes that the patient is taking garlic as a prophylactic cold remedy. This information is reported to which of the following health care providers? A. The anesthesia care provider, as the herb can prolong bleeding B. The Registered Nurse First Assistant (RNFA), as there will be less need for electrocautery C. The AM admit nurse, since it is not necessary to hang an IV prophylactic antibiotic D. CORRECT ANSWERS: A. The anesthesia care provider, as the herb can prolong bleeding During a local procedure, the nurse notices that the patient is exhibiting a sense of uneasiness, agitation, coughing, and wheezing. The nurse should suspect a/an: A. toxic reaction to the local anesthesia B. allergic reaction to the local anesthesia C. series of side effects to local anesthesia D. normal reaction to the local anesthesia CORRECT ANSWERS: B. allergic reaction to the local anesthesia
C. Perioperative nurses collaborate and consult with physicians to care for the patient throughout the perioperative phase, while surgical technicians supervise ancillary staff and care for patients throughout the perioperative phase. D. The scope of practice of the perioperative nurse includes educating patients and family members, while the scope of practice of the surgical technician is to educate staff. CORRECT ANSWERS: B. The scope of practice of the perioperative nurse is to care for patients throughout the continuum of the perioperative phase, while the scope of practice of the surgical technician is to prepare instruments and supplies and maintain aseptic technique of the surgical procedure. Initial assessment of the patient upon arrival of the postanesthesia care unit (PACU) begins with... A. assessing respiratory rate and rhythm B. noting oxygen saturation level C. auscultation of breath sounds D. determination of airway patency CORRECT ANSWERS: D. determination of airway patency For a patient with a history of serum cholinesterase deficiency, which of the following anesthetic agents should be avoided? A. Succinylcholine B. Atracurium C. Desflurane D. Nitrous Oxide CORRECT ANSWERS: A. Succinylcholine protected types of mobile hospital tents and containers are used in areas where nuclear, chemical, or biological terrorism threat exists. A. Environmentally B. Thermally C. Chemically D. Medically CORRECT ANSWERS: C. Chemically When delayed primary closure is required, the skin edges are closed how many days after? A. 4 to 6 days B. 3 to 5 days C. 1 to 3 days D. 2 to 4 days CORRECT ANSWERS: A. 4 to 6 days is an ideal complementary therapy to decrease patient anxiety during the intraoperative period, as there is no contact between the practitioner's hands and the patient. A. Massage B. Therapeutic touch C. Acupressure D. Reflexology CORRECT ANSWERS: B. Therapeutic touch Patients with a possible injuring within the cranium should not be placed in a position. A. Trendelenburg
B. Reverse Trendelenburg C. Prone D. Supine CORRECT ANSWERS: A. Trendelenburg A potential complication of epidural anesthesia caused by a/an is complete paralysis requiring intubation and systemic support until the block is resolved. A. knowledge deficit of the provider B. subarachnoid injection C. inadvertent dural puncture D. vascular injection CORRECT ANSWERS: B. subarachnoid injection When stocking medication in the perioperative suite, it is important to stock single-dose vials instead of multi-dose vials whenever possible because... A. the preference card is easier to maintain B. there is less risk of using a contaminated medication C. it is a cost-saving measure D. the pharmacy prefers single dose vials CORRECT ANSWERS: B. there is less risk of using a contaminated medication When transporting instruments after a procedure, the require that the instruments are put in a closed container of closed cart. A. OSHA regulations B. CDC Guidelines C. AORN Guidelines for Perioperative Practice D. TJC regulations CORRECT ANSWERS: A. OSHA regulations As part of the nursing process, a postoperative follow-up phone call should be made 24 to 48 hours after discharge. During the call the nurse is able to assess the achievement of... A. patient comfort B. expected outcomes C. patient satisfaction D. surgical success CORRECT ANSWERS: B. expected outcomes Techniques used to enhance effective communication with patients who have impaired communication due to stroke include decreasing environmental stimuli, presenting one idea at a time, treated the patient as an adult, and... A. assisting by trying to complete the statements B. asking simple questions C. avoiding physical contact D. using open-ended questions CORRECT ANSWERS: B. asking simple questions In the absence of a sterile transfer device when dispensing medication to the sterile field, the best option is to... A. have the scrub person draw up the medication in a syringe B. ask the educator for direction C. have the RN circulator draw up the medication in a syringe and transfer
D. getting hit with a baseball CORRECT ANSWERS: A. a seatbelt in a motor vehicle accident The FDA requires manufacturers to track implants throughout the chain of distribution from the purchaser to the... A. implanting physician B. explanting physicians C. patients D. materials managers CORRECT ANSWERS: C. patients Passive drains like a Penrose provide... A. continuous drainage B. drainage independent of the effect of gravity C. drainage based on pressure differential D. a path of resistance from inside a cavity to outside the body CORRECT ANSWERS: C. drainage based on pressure differential is the mnemonic used when performing a secondary assessment of a patient after all life-threatening issues have been treated. A. FGHI B. ABC C. FGH D. DEF CORRECT ANSWERS: A. FGHI (Full set of vitals, Give comfort measures, History and head-to-toe assessment, Inspect posterior surfaces) A patient 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... A. transducer-tipped catheter B. ventriculostomy C. VP shunt D. ventriculography CORRECT ANSWERS: B. ventruculostomy In the event of an incorrect count during closing procedures, what is the first thine the nurse should do? A. search the trash for missing items B. Look for the item after the case is over C. Repeat the entire count D. Immediately inform the surgeon CORRECT ANSWERS: D. Immediately inform the surgeon During intraoperative use of monopolar electrosurgery unit, the... A. patient requires no return electrode because it is monopolar B. return electrode should be placed as close to the surgical site as possible C. nurse cuts the return electrode to size according to the patient's weight D. sterile hand-piece cord is secured to the field with a hemostat CORRECT ANSWERS: B. return electrode should be places as close to the surgical site as possible
A patient suffers a cardiac arrest following the injection of Bupivacaine 0.5% with epinephrine 1:200,000 25mL a a peripheral nerve block for a left knee arthroscopy. The perioperative nurse can anticipate obtaining which of the following drugs for the anesthesia care provider? A. Flumazenil B. Dantrolene sodium C. 20% lipid emulsion D. Naloxone CORRECT ANSWERS: C. 20% lipid emulsion A involves removal of the entire breast along with axillary lymph nodes, the pectoral muscles, and all adjacent tissues. A. radical mastectomy B. simple mastectomy C. segmental mastectomy D. modified radical mastectomy CORRECT ANSWERS: A. Radical mastectomy For unwrapped, porous stainless steel items with lumens, the minimum exposure time at 270 degrees F in a prevacuum cycle is... A. 5 min B. 7 min C. 6 min D. 4 min CORRECT ANSWERS: D. 4 min The purpose of reconciling a patient's medications prior to discharge from an ambulatory surgery center is to... A. comply with Centers for Medicare & Medicaid Services (CMS) requirements for reimbursement B. satisfy American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) requirements for accreditation C. prevent duplication of postoperative prescriptions with current medications D. transfer responsibility for medication management from the primary care physician to the surgeon CORRECT ANSWERS: C. prevent duplication of postoperative prescriptions with current medications Communicating sudden changes in a patient's status, such as decerebrate posturing, is important because this may be a sign of... A. worsening and damage B. spinal cord injury C. an allergic reaction D. worsening spinal cord injury CORRECT ANSWERS: A. worsening and damage Pulse oximetry measure... A. unsaturated hemoglobin in venous blood B. saturated hemoglobin in venous blood C. saturated hemoglobin in arterial blood D. unsaturated hemoglobin in arterial blood CORRECT ANSWERS: C. saturated hemoglobin in arterial blood
A. act to ensure the impaired person receives assistance B. discuss the incident with several coworkers C. remain silent and keep the information to themselves D. wait to see if the incident occurs again before reporting it CORRECT ANSWERS: A. act to ensure the impaired person receives assistance A form of standardized language in the perioperative setting is reinforced by use of which documentation format? A. NIC B. PNDS C. NOC D. NANDA CORRECT ANSWERS: B. PNDS (Perioperative Nursing Data Set) The OR nurse is providing care for a local anesthetic procedure in the operating room. The surgeon has just injected a test dose of the local anesthetic. Which of the following is a toxic reaction and needs to be communicated to the surgeon? A. Visual disturbances B. Relaxation C. Hunger D. Normothermia CORRECT ANSWERS: A. Visual disturbances The philosophical basis for informed consent is the right of... A. self-determination B. privacy C. advance directive D. human dignity CORRECT ANSWERS: A. self-determination Which of the following complementary therapies may provide relief for postoperative nausea and vomiting? A. Garlic B. Peppermint aromatherapy C. Gingko D. Echinacea CORRECT ANSWERS: B. Peppermint aromatherapy The preferred incisional type for an exploratory laparotomy is... A. thoracoabdominal B. Pfannensteil C. midline vertical D. McBurney CORRECT ANSWERS: C. midline verical The perioperative RN is caring for a developmentally delayed male patient 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? A. Using a visual analog pain scale B. Asking the patient's caregivers how much pain they think the patient is experiencing
C. Asking the patient to describe his pain on a scale from 1 to 10, with 1 being no pain and 10 being the worse pain imaginable D. Using a FACES pain rating scale CORRECT ANSWERS: D. Using a FACES pain rating scale McBurney's incision is used by surgeons when performing an open... A. hysterectomy B. nephrectomy C. cholecystectomy D. appendectomy CORRECT ANSWERS: D. appendectomy The rationale for using a local anesthetic with added epinephrine is to... A. decrease the risk for hypertension by promoting vasodilation B. slow the rate of absorption of the local anesthetic by promoting vasoconstriction C. increase the flow of while blood cells to the surgical site to prevent infection by promoting vasodilation D. enhance the rate of absorption of the local anesthetic by promoting vasoconstriction CORRECT ANSWERS: B. Slow the rate of absorption of the local anesthetic by promoting vasoconstriction Compartemtn pressure of an extremity above mm Hg requires a fasciotomy. A. 20 mm Hg B. 15 mm Hg C. 30 mm Hg D. 5 mm Hg CORRECT ANSWERS: C. 30 mm Hg Which of the following describes appropriate role behavior of a health care industry representative in the surgical suite? A. The health care industry representative functions as a member of the scrubbed team B. The health care industry representative provides documentation that indicates its exclusion from HIPAA regulations C. The health care industry representative with specialized training performs calibration to adjust devices to the surgeon's specifications with facility approval. D. The health care industry representative wears professional business attire and photo identification in the perioperative areas CORRECT ANSWERS: C. The health care industry representative with specialized training performs calibration to adjust devices to the surgeon's specifications with facility approval. It is important for the perioperative nurse to communicate a patient's new onset atrial fibrillation because of an increased risk of... A. stroke caused by embolus B. chronic obstructive pulmonary disease (COPD) C. intraoperative hypertension D. hemorrhagic stroke CORRECT ANSWERS: A. stroke caused by embolus
Beneficence, one of several universal moral principles that guide ethical decision-making in nursing practice, is best defined as a duty to... A. seek balance between good and harmful acts B. provide equal care to all individuals C. give accurate information D. respect privileged information CORRECT ANSWERS: A. seek balance between good and harmful acts What is a physiologic change associated with the normal aging process in the geriatric patient? A. Increased testosterone levels B. Increased intestinal peristalsis C. Increased vascular resistance D. Increased renal blood flow CORRECT ANSWERS: C. Increased vascular resistance When safely placing an adult patient in the prone position for surgery, a minimum of people are required. A. five B. six C. four D. three CORRECT ANSWERS: C. four Standards published in the Guidelines for Perioperative Practice are... A. established by regulatory agencies B. enforceable by law C. voluntary D. part of the National Quality Forum (NQF) CORRECT ANSWERS: C. voluntary Signs of severe anaphylaxis are hypotension, , bronchospasm, and generalized erythema. A. anuria B. tachycardia C. hematuria D. bradycardia CORRECT ANSWERS: B. tachycardia A patient with a fractured anterior fossa of the skull may have an alteration in which sense? A. Sight B. Touch C. Smell D. Hearing CORRECT ANSWERS: C. Smell It is important for nurses to use when documenting nursing practice for the perioperative patient. A. medical terminology B. electronic health records C. nursing terminology
D. clinical information systems CORRECT ANSWERS: C. nursing terminology During the stage of healing, granulation tissue can be felt as a firm ridge under the edges of the incision. A. inflammatory B. remodeling C. reactive D. proliferative CORRECT ANSWERS: D. proliferative The surgical count procedure is a method of accounting for items during the surgical procedure. When is the final count performed? A. When the surgeon asks for a final count B. During the skin closure C. Immediately before the instrument count D. When there is a discrepancy CORRECT ANSWERS: B. During skin closure Electrical and laser equipment should pass inspection by the and be tagged with a dated preventative maintenance sticker. A. electrical engineering department B. biomedical engineering department C. laser safety officer D. department safety officer CORRECT ANSWERS: B. biomedical engineering department Which of the following situations would be categorized as a reportable sentinel event? A. a patient with a gunshot wound that results in a preoperative death B. Febrile reaction to a blood transfusion C. a patient with multiple contusions and a fractured jaw from an assault D. a patient with a fractured wrist as a result of a mechanical fall CORRECT ANSWERS: A. a patient with a gunshot wound that results in a preoperative death Atelectasis is characterized by... A. increased temperature, increased pulse, and increased respirations B. decreased temperature, increased pulse, and increased respirations C. increased temperature, increased pulse, and decreased respirations D. decreased temperature, decreased pulse, and decreased respirations CORRECT ANSWERS: A. increased temperature, increased pulse, and increased respirations Indications for use of Focused Assessment with Sonography in Trauma (FAST) include detection of... A. cardiac arrhythmias secondary to cardiac contusion B. suspected free fluid in the chest C. suspected perforated bowel D. suspected liver damage CORRECT ANSWERS: B. suspected free fluid in the chest A coup-contracoup brain injury is due to... A. energy/penetration
The most accurate method for verifying the effectiveness of a steam sterilizer is a... A. printed read-out of the sterilizer cycle B. biologic indicator C. Bowie-Dick test D. chemical indicator CORRECT ANSWERS: B. biological indicator Which of the following is a requirement for reprocessing a single-use device (SUD)? A. Meeting local regulations for disposal of biohazardous waste B. Using an in-house reprocessing facility C. Meeting OSHA requirements for regulation of medical devices D. Ensuring the device is FDA approved CORRECT ANSWERS: D. Ensuring the device is FDA approved All learners in the perioperative environment are adults. Which of the following describes a characteristic of adult learning (ie, andragogy)? A. Applying an extrinsic through process B. Using a problem-solving approach C. Using a trial-and-error approach D. Being task-oriented CORRECT ANSWERS: B. Using a problem-solving approach The major benefit of using the Perioperative Nursing Data Set (PNDS) is its... A. use of established North American Nursing Diagnosis Association International (NANDA) nursing diagnosis B. ability to document patient care that is unique to perioperative nursing C. foundation that is based on easily recognizable medical terminology D. exclusivity to hospital-based operative and invasive procedures CORRECT ANSWERS: B. ability to document patient care that is unique to perioperative nursing The chemical indicator inside a wrapped instrument tray has not changed to the appropriate color. The perioperative nurse should first... A. quarantine the contents of the load B. review the sterilization printout C. reprocess the load D. take the sterilizer out of service CORRECT ANSWERS: B. review the sterilization printout Blunt trauma to the chest usually results from a fall, blow, blast, deceleration injury, or . A. low-velocity object B. high-velocity object C. severe cough D. stab wound CORRECT ANSWERS: C. severe cough National standards for security and privacy of health data are set in the... A. AORN Standards and Recommended Practices B. Agency for Healthcare Research and Quality (AHRQ) C. Joint Commission (TJC) Standards
D. Health Insurance Portability and Accountability Act (HIPAA) CORRECT ANSWERS: D. Health Insurance Portability and Accountability Act (HIPAA) What is the American Society of Anesthesiologists (ASA) classification of a patient with severe hypertension? A. ASA Class III B. ASA Class IV C. ASA Class I D. ASA Class II CORRECT ANSWERS: A. ASA Class III Novice perioperative staff should seek a , a person who has experience and is respected for clinical competence, and pattern his or her behavior similarly. A. educator B. preceptor C. role model D. mentor CORRECT ANSWERS: C. role model To adequately decontaminate a flexible endoscope after use, the first step that should be followed is to... A. flush channels with compressed air B. preclean the exterior with cleaning product C. conduct a leak test D. flush channels with cleaning product CORRECT ANSWERS: B. preclean the exterior with cleaning product During a cataract extraction, which of the following medication is used as a prophylactic to reduce inflammation? A. Mannitol B. BSS C. Dexamethasome D. Cefazolin CORRECT ANSWERS: C. Dexamethasome The perioperative nurse brings a completed case's contaminated instruments to the decontamination area. he notes that the personal protective equipment (PPE) for workers in the area consists of gloves and shoe coverings. Which of the following is the correct response to this observation? A. "The correct PPE are being worn." B. "In addition to current PPE, workers should be wearing a fluid resistant gown with sleeves, masks, and eye protection." C. "In addition to current PPE, workers should be wearing a fluid-resistant gown with sleeves and masks." D. "In addition to current PPE, workers should be wearing a fluid-resistant gown with sleeves." CORRECT ANSWERS: B. "In addition to current PPE, workers should be wearing a fluid resistant gown with sleeves, masks, and eye protection."
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 reads 272 degrees F (135 degrees C). The nurse's next action is to... A. return the instrument to the sterile field in an aseptic fashion. B. resterilize the instrument as the temperature reached was too low. C. resterilize the instrument as the temperature reached was too high. D. report a malfunctioning steam sterilizer to the biomedical department CORRECT ANSWERS: A. return the instrument to the sterile field in an aseptic fashion A 12-year-old boy is scheduled for surgery to repair a fracture to the knee involving the epiphyseal plate. the perioperative nurse recognizes the primary complication resulting from this injury is... A. infection B. osteoporosis C. avascular necrosis D. impaired growth to the affected leg CORRECT ANSWERS: D. impaired growth to the affected leg Preparation and familiarity with surgical procedures and a specific surgeon's preferences are fundamental principles of... A. a surgical conscience B. evidence-based practice C. a culture of safety D. teamwork CORRECT ANSWERS: D. teamwork Patients at the highest risk for postoperative respiratory complication are patients who... A. smoke B. have COPD C. have asthma D. are obese CORRECT ANSWERS: A. smoke A patient is at risk for burns from an improperly placed grounding pad when the is altered. A. resistance B. power C. current D. voltage CORRECT ANSWERS: C. current Shoes worn by perioperative team members within the surgical suite should have closed toes and backs, low heels, and non-skid soles and must meet requirements. A. TJC B. CDC C. OSHA D. AORN CORRECT ANSWERS: C. OSHA
If a surgeon performs a procedure without a valid informed consent, he/she is at risk for legal action related to a/an... A. invasion of privacy B. battery C. assault D. HIPAA violation CORRECT ANSWERS: B. Battery A patient is admitted from a long-term care facility with a fractured hip. The patient has a "Do Not Resuscitate (DNR)" order in his medical record. The perioperative nurse's next action is to... A. call the long-term care facility and tell the director that the order must be rescinded before the patient can have surgery B. ensure that the patient, anesthesia care provider, and surgeon have an opportunity to discuss options and answer questions. C. automatically suspend the DNR order CORRECT ANSWERS: B. ensure that the patient, anesthesia care provider, and surgeon have an opportunity to discuss options and answer questions A key component of quality end-of-life care is communication with the patient and caregiver that demonstrates empathy and... A. nonverbal communication B. interviewing skills C. active listening D. direct communication CORRECT ANSWERS: C. active listening A 34-year-old female patient with a diagnosis of breast cancer is scheduled for a right breast mastectomy. When performing the surgical skin prep, the nurse... A. uses a "no-touch" technique during prepping B. uses a fenestrated drape to isolate the site before performing the skin prep C. uses only iodophor-based scrub and paint D. thoroughly scrubs the breast to provide the best asepsis CORRECT ANSWERS: A. uses a "no-touch" technique during prepping Which of the following is an example of education using the patient-centered care approach? A. "Call the doctor if there is more than 30 mL of blood on your dressing." B. "Call the doctor if there is more than 30 cc of bloody discharge on the ABD." C. "Call the doctor if there is excessive drainage from your wound." D. "Call the doctor if the blood on your dressing is bigger than a fifty cent piece." CORRECT ANSWERS: D. "Call the doctor if the blood on your dressing is bigger than a fifty cent piece." To prevent risk of SSI, AORN Guidelines recommend fingernails should be short and free of chipped nail polish. It has been demonstrated that nail polish chipping occurs on the day after application. A. eighth B. fourth C. third D. seventh CORRECT ANSWERS: B. fourth
