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AORN PERIOP 101 FINAL REAL EXAM
LATEST UPDATE Q&A 2023
All the following professionals are qualified to provide anesthesia to a patient EXCEPT: a) anesthesiologist b) CRNA c) anesthesiology assistant d) operating surgeon - correct answer-d) operating surgeon Of the following, which is not used to secure airway: a) ET tube b) LMA c) nasal cannula d) oral airway - correct answer-c) nasal cannula The perioperative team should know the location of equipment stored in the OR and in the department. Equipment that the anesthesia provider may request includes: a) video laryngoscopy devices b) fiberoptic bronchoscopes c) suction tips and devices d) all of the above - correct answer-d) all of the above General Anesthesia - correct answer-a drug-induced reversible state of unconsciousness, it includes amnesia, analgesia, loss of responsiveness, decreased stress response, and loss of skeletal muscle reflexes to varying degree
Regional Anesthesia - correct answer-an injection of local anesthetics near nerve fibers to cause reversible loss of sensation over an area of the body, common examples include spinal, epidural, and peripheral nerve blocks Monitored Anesthesia Care (MAC) - correct answer-when an anesthesia provider monitors the patient, administers sedatives and other agents as needed, and provides medical services as needed Moderate Sedation - correct answer-the administration of sedative, analgesic, and/or anxiolytic agents by a physician or under physician supervision. Depending on state laws and hospital policies, a perioperative nurse may be able to administer this type of anesthesia Local Anesthesia - correct answer-The infiltration or topical administration of agents to anesthetize a part of the body. It is typically used for minor procedures, does not involve an anesthesia provider, and does not involve sedation. A perioperative nurse monitors the patient and provides supportive care if needed. The phases of general anesthesia, in order, are: a) induction, maintenance, emergence b) emergence, maintenance, induction c) maintenance, emergence, induction d) induction, emergence, maintenance - correct answer-a) induction, maintenance, emergence Propofol - correct answer-IV induction agent etomidate - correct answer-IV induction agent methohexitol - correct answer-IV induction agent
edrophonium - correct answer-reversal for muscle relaxant (except succinylcholine) sugammadex - correct answer-reversal agent for rocuronium, vecuronium, and pancuronium flumazenil - correct answer-reversal agent for benzos (midazolam) naloxone - correct answer-reversal agent for narcotics (fentanyl) which of the following type of airway maintenance usually requires muscle relazants? a) spontaneous respiration b) mask ventilation c) laryngeal mask airway d) endotracheal intubation - correct answer-d) endotracheal intubation When should cricoid pressure be released? a) if the patient coughs b) when the patient loses consciousness c) if the anesthesia provider cannot see the vocal cords d) after the cuff of the ET tube is inflated and the position is confirmed - correct answer-d) after the cuff of the ET tube is inflated and the position is confirmed lidocaine - correct answer-local anesthetic bupivacaine - correct answer-local anesthetic
ropivacaine - correct answer-local anesthetic tetracaine - correct answer-for long-acting spinal anesthesia epinephrine (anesthesia) - correct answer-added to increase density and duration of a regional block bicarbonate (anesthesia) - correct answer-sometimes added to reduce the acidity of the local anesthetic and speed the onset of the block Spinal Anesthesia - correct answer-the subarachnoid space is entered and local anesthetic is injected directly into the spinal canal, pt sitting or lateral Epidural Anesthesia - correct answer-the anesthesia care provider finds the space between the ligamentum flavum and dura, this space is identified by a loss of resistance as the needle is advanced, a single dose of anesthetic can be injected, or a catheter can be placed IV regional anesthesia (Bier Block) - correct answer-used for procedures on hand, wrist, or forearm (double tourniquet method) Local Anesthetic System Toxicity (LAST) - correct answer-can occur if unsafe amount of local anesthetic enters bloodstream, can occur slowly as med is absorbed over time, or quickly if accidentally injected into blood vessel CAN PROGRESS TO SEIZURES AND CARDIAC OR RESP ARREST Symptoms of LAST - correct answer--ringing in ears
- tingling lips
- metallic taste in mouth
- dizziness
a) circulating water garments b) cotton blankets c) forced-air warming devices d) increased ambient room temperature e) surgical drapes d) warmed IV fluids - correct answer-a) circulating water garments c) forced-air warming devices d) increased ambient room temperature f) warmed IV fluids Which of the following would be an appropriate action for the perioperative nurse when assisting with anesthesia? a) administer the muscle relaxant reversal agent if needed? b) apply cricoid pressure if needed during intubation c) document anesthetic agents used, dose, route, and time d) extubate the patient - correct answer-b) apply cricoid pressure if needed during intubation Which of the following is NOT included in basic monitoring of the patient for anesthesia? a) pulse oximetry b) ECG c) arterial line d) blood pressure - correct answer-c) arterial line Which drug is used to reverse valium and midazolam? a) neostigmine b) pancuronium
c) flumazenil d) succinylcholine - correct answer-c) flumazenil Which method is used to prevent aspiration during endotracheal intubation? a) applying cricoid pressure b) inserting a nasal/oral airway c) laryngoscopy d) invasive techniques - correct answer-a) applying cricoid pressure How can the perioperative nurse assist the anesthesia provider with placement of a spinal or epidural block? a) inject local anesthetic b) thread the catheter through the needle c) calm the patient d) identify landmarks for insertion of the needle - correct answer-c) calm the patient During IV regional anesthesia the tourniquet should be deflated slowly to prevent which of the following from entering the bloodstream? a) bacteria b) lymphatic fluids c) thrombus d) bolus of anestheitc - correct answer-d) bolus of anesthetic Depending on state laws and hospital policies, which of the following can be performed without a professional anesthesia provider? a) general anesthesia b) regional anesthesia
semi-rigid endoscope - correct answer-includes a deflectable-tip video laparoscope that will allow movement through the tip to allow a complete view from a variety of different angles operative endoscope - correct answer-channeled scopes that provide the ability to irrigate, suction, insert, and connect a variety of accessories capacitive coupling - correct answer-transfer of electrical current from the active electrode through intact insulation to adjacent conductive items (tissue, trocars) Based on your knowledge of laparoscopic surgery, identify the potential complications related to it: a) pneumonia b) hypoxemia c) hypercarbia d) cardiac dysrhythmia e) hypocarbia f) CO2 embolism - correct answer-b) hypoxemia c) hypercarbia d) cardiac dysrhythmia f) CO2 embolism Which are the major components of medical video imaging? a) electrosurgical unit b) fiber-optic light cable c) verres needle d) camera control unit - correct answer-b) fiber-optic light cable d) camera control unit
Based on your knowledge of cameras in endoscopic surgery, identify the tasks that should be completed while setting up the camera before surgery a) inspect the camera head for smudges or debris b) clean the camera head using sterile water c) plug the camera into the CCU and turn on the unit d) complete white balancing of the camera - correct answer-a) inspect the camera head for smudges and debris c) plug the camera into the CCU and turn on the unit d) complete white balancing of the camera Metal Halide Light Source - correct answer-emits continuous blue light, cheaper but less bright than xenon light source Xenon light source - correct answer-emit pulsing high intensity white light, expensive but brigher Pneumoperitoneum - correct answer-air or gas introduced into the body cavity as a distention medium (ex. carbon dioxide, nitrous oxide, helium) Verres needle (blunt tipped trocar) - correct answer-used to deliver CO2 into the peritoneal cavity, creates working space Laparoscopic instruments with small, blunt tips are used for: a) cutting tissue b) dissecting tissue c) grasping tissue d) moving tissue from one place to other - correct answer-b) dissecting tissue
Identify some methods to maintain a sterile camera head a) put the camera head in a sterile pouch b) gas-sterilize the camera head c) cold soak the camera head for 20 min in glutamate d) wipe the camera head and cord with alcohol and arrange on sterile field - correct answer-a) put the camera head in a sterile pouch b) gas-sterilize the camera head Which pieces of equipment are used during laparoscopic surgery? a) CO2 insufflator b) ESU c) smoke evacuator d) fiberoptic headlight e) traction apparatus - correct answer-a) CO2 insufflator b) ESU c) smoke evacuator What actions can the scrub person take to help prevent incidental thermal burns a) inspect laparoscopic instrumentation for excessive wear or obvious breaks and replace when necessary b) clean all instruments with sterile water c) watch the surgery carefullt d) replace instruments that have damaged insulation - correct answer-a) inspect laparoscopic instrumentation for excessive wear or obvious breaks and replace when necessary d) replace instruments that have damaged insulation
Identify one characteristic difference between laparoscopic instruments and those used in open procedures: a) all laparoscopic scissors are "take apart" b) laparoscopic instruments have long, thin shafts to accommodate trocar cannulas c) one cannot dissect tissue with laparoscopic instruments d) all laparoscopic instruments are disposable - correct answer-b) laparoscopic instruments have long, thin shafts to accommodate trocar cannulas What region of the patients abdomen is traditionally used to establish pneumoperitoneum for MIS? a) periumbilical b) supraumbilical c) subumbilical d) umbilical - correct answer-a) periumbilical What is an important safety consideration when using a light source? a) leave the light cord on the sterile field at all times b) place the light cord in standby mode whenever it is not in use c) coil the light cord tightly to keep its fibers in shape d) replace light cords only when more than 50% of the fibers are broken - correct answer-b) place the light source in standby mode whenever it is not in use CO2 is the gas used for abdominal insufflation because it: a) is not readily absorbed by the body b) is inexpensive c) suppresses combustion d) is rapidly eliminated from the body - correct answer-b) is inexpensive c) suppressed combustion
Any germicide that is labeled as a hospital disinfectant has passed the potency test for activity against , , and. - correct answer-Pseudomonas aeruginosa staphylococcus aureus salmonella choleraesuis Tuberculocidals are a special class of disinfectants. In order to be labeled 'tuberculocidal', products need to have demonstrated potency against: a) Pseudomonas b) Staphylococcus c) Mycobacteria d) Salmonella - correct answer-C Post Procedure Clean - correct answer-purpose is to break cycle of contamination from pt to environment to staff to subsequent patient Terminal Clean - correct answer-a more thorough cleaning and disinfection of periop environment decreases the number of pathogens and amount of dust and debris created during the day, done at end of day Identify the best practices to follow when performing environmental sanitation a) when cleaning spills of blood or any other potentially infectious material, use gloves and any other PPE appropriate to the task b) visibly soiled OR equipment, furniture, and floors should be cleaned with a hospital-grade germicide c) infectious waste should be segregated from noninfectious waste in the general waste stream d) color coded or labeled bags should be used to facilitate separation of the various wastes - correct answer-a
b c d HIV - correct answer-only survives in blood and body fluids that contain white blood cells, fragile and easily destroyed outside the body Creutzfeldt-Jakob disease - correct answer-a rare but progressive fatal disease caused by prions MRSA - correct answer-one of the hardiest bacteria and most difficult to treat VRE (vancomycin-resistant enterococcus) - correct answer-usually spread by the hands of caregivers or patients and contaminated equipment or environmental surfaces Select the correct statements about spray bottles a) spray bottles can aerosolize potentially infectious materials b) spray bottles are occasionally used to apply disinfectant c) spray bottles are not used to apply disinfectant d) spray bottles are an easy way to clean the environment - correct answer-a c Hemostasis - correct answer-1) the stoppage of bleeding or hemorrhage
- the stoppage of blood flow through a blood vessel or body part
- the stagnation of blood Mechanical Hemostasis - correct answer-achieved by occluding severed vessels until platelet formation occurs
abdominal surgery, peritoneal cavity or skin wound T Tube - correct answer-inserted into biliary tract to allow for drainage of bile, left for 10 days or more to develop tract through which bile can drain after removing tube Suction Drain - correct answer-to drain accumulated blood and fluid from operative site JP drain - correct answer-Used to drain fluid or blood after abdominal, urologic, thoracic, and head and neck procedures abdominal or breast surgery Hemovac - correct answer-orthopedic Chest Tube - correct answer-conduit for drainage of air, blood, and other fluid from intrapleural or mediastinal space, and reestablishment of negative pressure in intrapleural space Occlusive dressing - correct answer-prevent drying of wound, increase proliferation of epithelial cells bioclusive, dermicell, duoderm hydrocolloids, opsite, dermagel, tagaderm, vasoline gauze, xeroform Gauze dressing - correct answer-protect wound, absorb fluid (impregnated: vaseline, xeroform) (nonimpregnated: adaptic, telfa, nu-gauze, 4x4, ABD) Hydrogel dressing - correct answer-hydrate and soothe tissue (tegagel, nu-gel, vigilon, karaya, collonplast) Pressure dressing - correct answer-minimize intracellular fluid, eliminate dead space, distribute pressure evenly
fluffed gauze, non-radiopaque and gauze covered pads Biological dressing - correct answer-control infection in denuded area, prevent loss of serum, decrease pain allograft of human skin, xenograft of porcine skin, added antimicrobial or chemotherapeutic ointments (silver) silvadene, scarlet red Rigid support dressing - correct answer-immobilize cast, splint Sponge counts are done for all the following reasons EXCEPT a) account for used sponges b) prevent injury by retained foreign object c) bc state law requires specific count procedure - correct answer-C Reasons to avoid using radiopaque sponges in dressing - correct answer-1) possible invalidation of subsequent count if returns to OR with dressing
- may appear as foreign body on post op x ray Cardiac Agents - correct answer-used to reduce mammary artery spasm, test patency and integrity of graft, and sustain radial artery dilatation Otic Agents - correct answer-anesthetize, stop or slow bleeding, irrigate, anti-infective
