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AORN PERI-OP 101 FINAL EXAM QUESTIONS WITH VERIFIED CORRECT ANSWERS
"Whose responsibility during MAC to monitor pt? - CORRECT ANSWER RN"
"What should RN monitor during MAC? (3) - CORRECT ANSWER 1. Extravasation of IV
- Reduction of arterial O2 sat
- Difficulty breathing"
"4 Stages of anesthesia - CORRECT ANSWER 1. Initial administration
- Excitement - unconscious to loss of eyelid reflex
- Intrasurgery
- Possibility of resp failure" "What helps ensure proper needle placement during peripheral nerve block with regional
anesthesia? - CORRECT ANSWER continuous nerve stimulation"
"First sign of Malignant Hyperthermia - CORRECT ANSWER increased end-tidal CO2"
"What should be done for pt with MH crisis? - CORRECT ANSWER 1. Stop surgery & stop
triggering agents
- Give dantrolene
- Give 100% O
- Cool pt with iced saline"
"Single most important factor in minimizing microorganism transfer - CORRECT ANSWER
Hand hygiene"
"The most effective method for floor care in surgical suite - CORRECT ANSWER Wet
vacuuming"
"When should air sampling be done in OR? (3) - CORRECT ANSWER 1. Before construction
begins
- After demolition
- At end of project"
"examples of mechanical hemostasis (8) - CORRECT ANSWER 1. Manual pressure (sponges)
- Clamps
- Sutures
- Staples
- Clips
- Ligatures
- Pledgets
- Bone wax"
"Ex of chemical hemostasis methods - CORRECT ANSWER 1. Microfibrillar collagen
- Oxidized cellulose
- Collagen sponge
- Gelatin sponge
- Fibrin sealant
- Phenol solution
- Thrombin
- Styptics"
"Who is involved in sponge counts? - CORRECT ANSWER ALL periop personnel"
"What types of surgery are JP suction drains frequently used in? - CORRECT ANSWER
Abdominal or breast"
"What should be labeled on a medication on or off sterile field (5) - CORRECT ANSWER 1. Med
name
- Concentration
- Initials of RN preparing
- Expiration
- Date prepared"
"S&S of systemic toxicity from medications - CORRECT ANSWER Metallic taste
Tinnitus Lightheaded Vision disturbances Numb tongue/lips Confusion Tremors Shivering Siezures Tachy/HTN
"Who determines pt position in OR? - CORRECT ANSWER Surgeon"
"What main precaution should you take with pt in prone position? - CORRECT ANSWER Pad
eyes - avoid pressure"
"Goals of surgical skin prep (3) - CORRECT ANSWER 1. Remove soil/transient microorganisms
from skin
- Reduce resident microbes below pathogenic levels
- Inhibit rapid rebound growth of microbes"
"When can CHG prep be used/not used? - CORRECT ANSWER Use: for topical ONLY
NOT: above neck"
"What do direct expenses for hospital include? - CORRECT ANSWER Medical supplies
Personnel Purchases services"
"What do indirect expenses to hospital include? - CORRECT ANSWER Heating/cooling
Electricity Admin/support personnel (housekeeping)"
"Where should you avoid placing ESU dispersive electrode grounding pads? - CORRECT
ANSWER Bony prominences
Implanted prosthesis Hairy areas Tattooed areas Scar tissue"
"Term: Organisms on wet skin soak through & contaminating sterile gown - CORRECT
ANSWER Strike through"
"What gloving technique does initial donning of sterile gown/gloves use? - CORRECT ANSWER
Closed gloving"
"Fine gauge needle & syringe are used to aspirate the sample - CORRECT ANSWER Needle
aspiration"
"Small portion of tissue is incised and sent for examination - CORRECT ANSWER Incisional
biopsy"
"Outcome of primary importance when draping surgical pt - CORRECT ANSWER Pt free from
s/s of infection"
"Desirable characteristics of surgical drapes (4) - CORRECT ANSWER Barrier to migration of
microbes Resistant to tears Antistatic/antiallergenic Nonglaring"
"Draping process - CORRECT ANSWER 1. cuff drapes over gloves
- Drape from operative site to periphery
- Drape from sterile to unsterile (near to far)
- Walk around to opposite side
- If incorrectly placed, discard by unscrubbed person"
"What type of air pressure should be in the restricted zone of OR? - CORRECT ANSWER
Positive pressure"
"How many air exchanges per hr in OR? - CORRECT ANSWER 20"
"What should temp in OR be? - CORRECT ANSWER 68-75 F"
"What does semi-restricted zone include? - CORRECT ANSWER Equipment/sterile supply
storage Sterile prcessing"
"Class I wound - CORRECT ANSWER Clean
Not infected or inflamed Result of blunt trauma"
"Class II Wound - CORRECT ANSWER Clean-contaminated
NO evidence of infection or contamination GI spill, inflamed gall bladder"
"Class III Wound - CORRECT ANSWER Contaminated
Using antimicrobial agents that inhibit growth of microbes"
"Objectives of the surgical prep include all EXCEPT - CORRECT ANSWER Removal of dirt, skin
oil, and microbes from the skin Sterilization of skin Reduction of bacterial count Prevention of regrowth of microbes for several hours" "The generally recognized length of time required for contact of antimicrobial agents to be
effective is - CORRECT ANSWER According to manufacturers direction"
"The principle of preoperative skin prep include all of the following except - CORRECT
ANSWER Prep from clean to dirty
Use aseptic technique +++Prep stomas first Prevent pooling"
"Which of the following topical antimicrobial agents is neurotoxic - CORRECT ANSWER CHG"
"Which statement is TRUE about iodophor with alcohol? - CORRECT ANSWER It provides rapid
reduction in microbial counts of skin Persistence or residual activity is excellent Non toxic and nonirritating +++Percutaneous absorption does not occur across mucous membranes"
"When should peri-operative team members use an alcohol based rub for hand hygiene? -
CORRECT ANSWER After hands have been exposed to blood or other bodily fluids
After using the restroom +++When hands are not visibly soiled When caring for patients with spore-forming organisms" "What is the maximum length of time perioperative team members should spend performing
hand hygiene with soap and water? - CORRECT ANSWER 7, 15, 20, or 30 seconds Answer: 15
seconds"
"How much of an alcohol based hand rub should be used when performing hand hygiene -
CORRECT ANSWER The amount recommended by the manufacturer"
"Perioperative team members should maintain fingernails at a maximum of - CORRECT
ANSWER 2mm (0.8")"
"Which of the following measures is helpful for maintaining healthy skin and minimizing the risk
of hand dermatitis - CORRECT ANSWER Completely drying hands before putting on gloves
Avoiding water hotter than 80F Using approved moisturizing products Using glove liners All of the Above" "Which method of gloving should be used by team members during the initial gowning and
gloving process for surgical procedures - CORRECT ANSWER Assisted gloving with gown cuffs
at fingertips" "Approximately what percentage of surgical patients develop a surgical site infection during
hospitalization - CORRECT ANSWER 5%"
"Which of the following terms is used to refer to seepage of fluid through a sterile material with
subsequent bacterial penetration - CORRECT ANSWER Strike-through"
"Which of the following types of drape is to be tubular - CORRECT ANSWER Stockinette"
"Which of the following is recommended when opening a sterile field in the perioperative setting
- CORRECT ANSWER Cables and tubing should be secured with non-perforating devices"
"Which surface of the sterile field drapes are considered sterile - CORRECT ANSWER TOP
ONLY"
"The perioperative RN should follow which of these procedures when draping equipment -
CORRECT ANSWER Drape equipment that will be positioned over the sterile field
Drape equipment that will be positioned immediately adjacent to the sterile field Drape large pieces of equipment as close to the time of use as possible Follow the manufacturer's instructions for use All of the above"
Decreased heart rate +++Increased core body temp Decreased core body temp" "The acid base effect of penumatic tourniquet deflation ollowing a period of onfaltion are
characterized by - CORRECT ANSWER Elevated PaCO2 with resp acidosis and metabolic
alkalosis +++Elevated PaCO2 with resp acidosis and met. acidosis Decreased PaCO2 with resp alkalosis and met acidosis Decreased PaCO2 with resp alkalosis and met alkalsosis"
"A type of tissue in the extremites that is highly susceptible to ischemia is - CORRECT ANSWER
++Skeletal muscle Nerves Bone Skin" "A perioperative nurse is performing a preoperative assessment of a patient scheduled for total knee arthroplasty. Which of the following is NOT a primary contrindication for pneumatic
tourniquet use - CORRECT ANSWER Significant vascualr disease, including recent bypass,
history of deep venous thrombosis, or impaired peripheral circulation Sickle cell anemia and other forms of hemoglobinopathy History of pain or weakness in the bones of muscles of the extermities +++History of ulcerative colitis" "Choose the extremity and nerve most frequesntly affected by pneumitc tourniquet indced nerve
damage - CORRECT ANSWER Lower limb, peroneal nerve
++Upper limb, radial nerve Upper limb, median nerve Upper limb, ulnar nerve" "A perioperative nurse is assessing patients for DVT risk fators proir to lwoer limb surgeries. Based
on the following descriptions, which patient DOES NOT hve risk factors for DVT? - CORRECT
ANSWER A 35 year old patient on prolonged bed rest
A 70 year old smoker with no history of significant medical problems An obese 45 year old who is otherwise healthy A 20 year old non-smoking athlete with a left anterior cruciat ligament tear"
"The averge estimated number of surgical fires every year int he US is - CORRECT ANSWER 20
to 30 ++200 to 240 700 to 1000 2000 to 2500 2500 to 2700"
"Choose the FALSE statement about perioperative fire prevention and management plans -
CORRECT ANSWER They should be developed by a multidisciplinary group of key stakeholders
They should describe key content and frequency of fire safety education activities They should specify policies and procedures for fire prevention and response +++They generally are not needed unless required by a health care facility's insurance policy They should specify team members roles and responsibilities during the fire prevention and response" "The three components of the Fire Triangle are oxidizing source, ignition source, and fuel source
CORRECT ANSWER TRUE"
"Examples of ingtion sources include - CORRECT ANSWER Electrocautery units and active
electrosurgical electrodes Fiber optic light cords Lasers ALL OF THE ABOVE"
"A fire risk assessment should be performed - CORRECT ANSWER Only before procedures
involving electrocautery, an ectrosurgical unit, or a laser Only if requested by the surgeon of first assistant +++Before all operative procedures Only before surgical procedures above the xiphoid process and in the nasopharynx Only if the patient requires more than 30% supplemental oxygen"
"The flash point of flammable meterials is (), while the flash point of combustible materials is () -
CORRECT ANSWER <100F, >100F
=100F, >100F
<120F, >120F
>120F, <120F"
"Oxidizing sources in the operating room include - CORRECT ANSWER +++Oxygen
"Which type of fire extinguisher is most approraite to extignuish a fire on or in a patient -
CORRECT ANSWER +++Carbon dioxide extinguisher
Ammonium phosphate or other dry powder extinguisher Water mist extinguisher Foam extinguisher" "PAtients and personnel must be evacuated becuase of an operating room fire The proper order
of steps is - CORRECT ANSWER RACE Rescue Alarm Confine Evacuate"
"If evacuated becuase of a fire, health care personnel should go - CORRECT ANSWER To the
nearest safe location where they can resume caring for patients" "A scrubbed perioperative registerd nurse observes a fire start ojn a patient in the operating
room. After alerting the team, the nurse should immediately - CORRECT ANSWER Obtain and
operate the nearest fire extinguisher by using the PASS technique Pat the flames with a drape +++Smother the fire with a towel or pour flammable liquid on the fire Lift the patient and transport him or her out of the room Turn off the oxygen source"
"Which practice is NOT recommended to prevent fires during surfgeries at high risk sites -
CORRECT ANSWER +++Use an ignition source to enter gas-distended bowel
Pack the back of the throat with radiopaque sponges prior to tonsillectomy Stop supplemental oxygen or nitrous oxide for one minute before using an ignition source Plan an adhesive incise drape between the surgical site and the oxygen source Inflate endotracheal tubes with tinted solutions prior to tracheostomy" "If an airway fire occurs, perioperative team members should be prepared to help the anesthesia
professional to do which of the following? - CORRECT ANSWER Disconnect and remove the
anesthesia circuit and turn off the flow of oxygen Remove the endotrcheal tube from the airway, including any burned fragments Pour saline or water into the airway Examine and re-establish the airway Assess the surgical field for secondary fire ALL OF THE ABOVE" "All of the following are appropriate practice to manage oxidation sources to the operating room
EXCEPT - CORRECT ANSWER Administer the lowest concentration of oxygen needed to
maintain adequate oxygen Use a larygngeal mask or endotracheal tube if the patient needs more than 30% supplemental oxygen Ensure there are no leaks in the anesthesia circuit +++Turn the warmer blower off when using a warmer blanket with an attached head drape Prevent oxygen from accumulating under the drape"
"Which of the following is a potential oxidizer for fire in the operating room? - CORRECT
ANSWER Electrosurgical units
Gauze Nasal canula Nitrous oxide"
"All of the following are safety precautions common to all energy generating devices except -
CORRECT ANSWER Alcohol soaked pads should not be allowed on the surgical field when
energy generating devices are used Foot pedals should be enclosed in a fluid resitant cover whenever there is potential for a spill Oxygen delivery to the patient should be stopped or reduced to the lowest possible level when energy generating devices are used around the head face or neck +++The RN circulator should activate the foot pedal at the discretion of the surgeon using the hand piece The lowest power setting that will accomplish the task should be used"
“Who can provide anesthesia care? (4) - CORRECT ANSWER 1. Anesthesiologists
- CRNA's
- Anesthesia assistants
- Periop nurses"
"4 types anesthesia - CORRECT ANSWER General - loss of consciousness
Regional - loss of sensation Local - small area loss of sensation MAC - IV"
"3 Phases of Anesthesia - CORRECT ANSWER 1. Induction - admin until 1st incision
- Maintenance - incision to completion
- Emergence - from when pt awakens until pt exits OR"
"What is often used for upper extremity nerve blocks? - CORRECT ANSWER IV regional
anesthetic/Bier block"
"What is the first thing the RN should pay attention to in post anesthesia care? - CORRECT
ANSWER Airway"
"What is monitored with the Aldrete scale in PACU? (5) - CORRECT ANSWER 1. Mobility
- Resp
- Circulation
- LOC
- O2"
"What should be documented when giving meds in OR (5) - CORRECT ANSWER 1. Drug
- Concentration
- Route
- Dose
- Time"
"Potential sources of fuel for surgical fires (5) - CORRECT ANSWER 1. Linens/drapes
- Skin degreasers/tinctures/aerosols
- Prep solutions
- Body tissues/pt hair
- Intestinal gases"
"What questions should you ask when identifying a pt preop? (3) - CORRECT ANSWER Name
DOB
Planned procedure"
"What do you need to document for Time Out? (3) - CORRECT ANSWER 1. 2 Pt identifiers
checked
- Site/side
- Verification of procedure"
"What occurs when pt has irritant contact dermatitis latex sensitivity? - CORRECT ANSWER
non-allergic* skin rxn. Confined to area in contact with irritant"
"What occurs with Immediate Type I Hypersensitivity reaction to latex? - CORRECT ANSWER
(allergy) 5-30 min after exposure OR delayed onset of 10-12 hrs"
"What happens with delayed type IV hypersensitivity rxn to latex? - CORRECT ANSWER
Delayed *allergic rxn 24-72 hrs after contact"
"3 stages of latex rxn - CORRECT ANSWER I. Contact uticaria at site
II. Allergic rxn spreads III. (If allowed to progress) BP drop, increased HR, anaphylaxis"
"Factors that make elderly pt skin more sensitive to injury (4) - CORRECT ANSWER 1. Less
subcu fat
- Less skin elasticity
- Thin/wrinkling skin
- Atrophy of sweat glands (decreased temp change tolerance)"
"Which type of prep has quickest reduction in microbe counts? - CORRECT ANSWER Alcohol"
"How far from incision site should prep area extend? - CORRECT ANSWER At least 6-8" past"
"What should be documented with skin prep? (6) - CORRECT ANSWER 1. Area prepped
- Type/extent of hair removal
- Who prepped
- Skin assessment at site
- Prep agent used
- Dry time"
"An entire section of tissue is sent for examination - CORRECT ANSWER Excisional biopsy"
"Type of surgical specimen:
Will be microscopically studied by pathologist and may undergo histologic or cytologic analysis -
CORRECT ANSWER Biopsy"
"Type of surgical specimen: tissue is frozen and thinly sliced into sections to be examined under a microscope by the
pathologist - CORRECT ANSWER Frozen section"
"Type of surgical specimen:
Specimens obtained for studying cell biology - CORRECT ANSWER Cytology"
"Type of surgical specimen:
Specimens that do not require immediate processing by the pathologist - CORRECT ANSWER
Routine specimen" "Type of surgical specimen:
Specimens of tissue or fluid suspected of being infected - CORRECT ANSWER Culture"
"After how long should you change your surgical gloves? - CORRECT ANSWER 150 min (max)"
The name of the person performing the prep should be documented"
"Which statement is FALSE about eye, extremity, or vaginal prep? - CORRECT ANSWER A 5%
sterile opthalmic prep solution is commercially available for eye preps +++The vagina should be prepped first as part of the vag prep When prepping an extremity, it should be positioned so that the incision site is the upper-most portion of the prep If fingers or toes are included in the surgical field (extremity prep), it may be necessary to scrub the nail with a brush and soap solution"
"Hand hygiene should be performed after which of the following - CORRECT ANSWER
Touching the OR bed controls Adjusting a pt bed linens Marking the surgical site All of the above" "Which of the following types of jewelry is acceptable for perioperative team members to wear in
pt care areas - CORRECT ANSWER No jewelry is acceptable"
"Which of the following is a primary line of defense for protecting the patient from transmission
of pathogens during surgical procedures - CORRECT ANSWER Sterile gloves
Sterile gowns +++Surgical hand antisepsis Surgical masks"
"Which of the parts of the surgical gown is considered sterile - CORRECT ANSWER Front from
the chest to the sterile field"
"How often should surgical gloves be changed during an invasive surgical procedure - CORRECT
ANSWER Every 60 to 90 minutes
Every 90 to 150 minutes Surgical gloves only require chnaging if a known or suspected break occurs or tear identified There is no recommended time for changing gloves" "Which of the following is the preferred method for assessing hand hygiene in the perioperative
setting - CORRECT ANSWER Direct observation
Measurement of product usage Automated monitoring Self-reporting"
"Drapes are considered contaminated under which of the following conditions - CORRECT
ANSWER A hole is discovered
The drape drops below waist level
The drape is placed incorrectly There some doubt about the drapes sterility" "The perioperative RN should do which of the following when draping a patient for a laparotomy?
- CORRECT ANSWER Place the opening of the lap sheet directly over the surgical site"
"Which of the following is an important consideration when draping patients for procedures on
the eye - CORRECT ANSWER It is important to repel water
The environment must be free of lint Cataract procedures are often performed without sedation Adequate air exchange for the patient must be maintained"
"Which of the following statements about preoperation of sterile fields is most accurate -
CORRECT ANSWER Perioperative team members should perform surgical hand anitsepsis
before entering the sterile field"
"Which of the following areas of properly draped sterile field is considered sterile - CORRECT
ANSWER The TOP"
"Which of the following isolation technique procedures should be followed to prevent the spread
of cancer cells from one area to another during resection of metatstatis tumors - CORRECT
ANSWER Changing Surgical gloves when soiled
Covering existing sterile drapes with new sterile drapes after the resection Discontinuing use of instruments after they were used for the tumor excision Organizing sterile field in a way that minimizes risk of exposure to cancerous cells ALL OF THE ABOVE"
"The use of a pneumatic tourniquet during extremity surgery - CORRECT ANSWER It is a
noncontroversial process ++Requires effective communication and collaboration between nurses, anesthesia, and the surgeon Is safe for all patients as long as tourniquet time does not exceed 30 minutes" "Physiological effects of exsanguination and pneumatic tourniquet inflation during surgery
typically include all of the following EXCEPT - CORRECT ANSWER Increase in central venous
pressure Increased heart rate Increased core body temp +++Decreased core body temp"
