Which of the following is not applicable to the RN working in PACU

Can provide regional anesthesia

2. When is it appropriate for the perioperative nurse to release cricoid pressure?

C. When the ET tube cuff is inflated

Chain of custody for forensic evidence must do all the following except

Store evidence in your locker until it can be handed over to law

Which statement was included in OSHA BLOODBORNE PATHOGENS STANDARD

Wash hands after touching blood, body fluids, or other infectious materials

Why is water temperature an important consideration when cleaning instruments?

Cool water prevents blood coagulation

Which is a traffic rule scrub persons should observe?

Change positions with a scrubbed person face to face, back to back

One action to promote safe gas insufflation

Check the alarms are on and audible

When is damp dusting performed

Beginning with the highest surfaces and moving to lowest

Which example describes a situational based error?

Juggling several patient care activities

Of the following which is NOT an example of patient centered care

Health care decisions provided to PT and family

Disposable dispersive pads are

Stamped with an expiration date that should be verified prior to use

For sterile field medications

Medication is verified by scrub tech and nurse

Which of the following describes revenue?

An organizations earnings made by services rendered

The ET OR LARYNGEAL MASK ARE REMOVED

When the patient can maintain their airway

Extravasation can lead to

Intraandominal compartment syndrome

Which statement is incorrect about hazardous chemical agents in the periop setting?

Eyewash station within 20 seconds of use and storage locations

What is the temp and humidity in the OR?

68-75 F temp 20-60 percent humidity

. The ET tube or laryngeal mask airway is removed

when the patient is able to maintain their airway.

Skin antisepsis products can be flammmable. Which of the following is NOT recommended.

Warming the product prior to application

What is a benefit of robotic surgery?

Instruments have more flexibility than the human wrist

Which of the following social determinants of health relates to high lead levels in water affecting pediatric health

An environment free of life threatening toxins

One of the physiological effects of the trendelenburg position

Increased intraoccular pressure

Which option best describes an interrupted stitch?

A single stitch tied independently

Which of the following options concerning MIS that is performed by robot is not correct

The robotic arms are part of the surgeons console

When opening a blue wrap item, the nurse should

Inspect the wrap integrity for holes and tears

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Questions 91

Answers

1
Specimen management errors can result in
Increased community trust
Lower incidence of morbidity
Potential litigation
Faster diagnostic results
2
Which is not a radiation safety measure?
Time
Exposure
Distance
Shielding
3
Which of the following is not applicable to the RN working in PACU
Relies on facilities quick response team for unit emergencies
Holds a certification in advanced cardiac support
Is competent in age specific care
Can provide regional anesthesia
4
5 domains of social determinants of health. Which one is related to the economy?
A neighborhood and built environment
Social and community context
Health and health care
Economic stability
5
2. When is it appropriate for the perioperative nurse to release cricoid pressure?
When the ET tube stylet is removed I
C. When the ET tube cuff is inflated
A. As the anesthesia provider starts to intubate the patient
B. After the trachea is occluded
6
Chain of custody for forensic evidence must do all the following except
Detail wh collected the specimen and how it was handled
Have documentation when evidence is released to law officer
Adhere to regulatory requirements
Store evidence in your locker until it can be handed over to law
7
When is the bladder drained when doing a vaginal prep
After the vaginal prep
It’s ok to prep abd and vagina at the same time if you have help
Prep the abdomen first
Three or more prep kits are necessary
8
Which statement was included in OSHA BLOODBORNE PATHOGENS STANDARD
Education on occupational exposure should be provided q2 years
Wash hands after touching blood, body fluids, or other infectious materials
Food is permissible in restricted and semi restricted areas
Semi and restricted area nurses should apply lip balm to avoid cracked lips
9
Why is water temperature an important consideration when cleaning instruments?
Cool water prevents blood coagulation
Hot water makes blood removal easier
Cool water makes it harder to remove soil from instrument crevices
Hot water is preferred by all cleaning solution manufacturers
10
Which is a traffic rule scrub persons should observe?
Cross arms and put hands in acillary
Change positions with a scrubbed person face to face, back to back
Turn back to sterile field to get an instrument
Maintain a distance from the sterile field
11
One action to promote safe gas insufflation
Flush insufflation tubing with Normal saline
Check the alarms are on and audible
Maintain the pneumoperitonium at the highest level possible
Remove the filter from the tubing
12
Which of the following results from medication errors?
Increase in health care cost
Increased patient confidence
Decreased threats to patient safety
Decrease chance of human factor mistakes
13
When is damp dusting performed
When the OR suite has been empty for 24 hours
Before every surgical procedure
Beginning with the highest surfaces and moving to lowest
Using a cloth moistened with alcohol
14
Which example describes a situational based error?
Does not adjust a medication dosage for a peds patient
Does not properly conduct a patient assessment
Misinterprets a lab result
Juggling several patient care activities
15
Of the following which is NOT an example of patient centered care
Alliance between health care practictioners, patients and their support
Health care decisions provided to PT and family
Focus on communication with all involved in pt care, support system and pt.
Patient and family participation in care
16
The pre operative to intraoperative hand over documentation would not include
A diagnostic test result
Family contact information
Specimen documentation
NPO status
17
Which of the following legal terms describes the actions of a reasonable and prudent professional in same scenario
Tort
Liability
Standard of care
Respondent superior
18
Disposable dispersive pads are
Multi use
Stamped with an expiration date that should be verified prior to use
Cut to fit the patient
Opened and stuck to ESU handle
19
For sterile field medications
The time the med is retrieved from storage is noted
Medication is verified by scrub tech and nurse
Rubber stopper is removed prior to placing on field
If there is only one med, it doesn’t have to be labeled
20
Which of the following is associated with increased risk for hypothermia
Elderly patients
Hypertension
Higher than normal body weight
Hyperthyroidism
21
Which of the following describes revenue?
An organizations earnings made by services rendered
Cost related to services provided
Costs related to employee salaries and hospital equipment
Part time such as vacation, orientation and holidays
22
The ET OR LARYNGEAL MASK ARE REMOVED
After an IV injection of sugammadex
When the patient can maintain their airway
When the patient is fully awake
After the narcotic reversal is administered.
23
Extravasation can lead to
Hyponatremia
Hypervolemia
Intraandominal compartment syndrome
Pulmonary complications
24
Which statement is incorrect about hazardous chemical agents in the periop setting?
Formaldehyde is carcinogenic
All hazardous agents should be handled according to manufacture IFU
Agents include anesthetic gases and cleaning agents
Eyewash station within 20 seconds of use and storage locations
25
What is an example of clean contaminated wound
Total knee arthroplasty
An Incision and drainage
Laparotomy with spillage
A total abdominal hysterectomy
26
What is the temp and humidity in the OR?
68-75 F temp 20-60 percent humidity
65- 78 humidity temperature 20-60 degrees
Humidity 30-60 percent Room temp 72 F
66-76 F with humidity 20-60 percent
27
1.Which of the following is associated with increased risk for perioperative hypothermia?
The Female sex
Hyperthyroidism
B. Higher than normal body weight
Males
28
Which of the following is the correct product for cleaning in the OR?
A high level disinfectant
Alcohol
A liquid chemical sterilant
An EPA registered product
29
Choose the term that describes the amt of virus that is found in an individuals blood
Viral transmission
Viral load
Viral replication
Viral shedding
30
. The ET tube or laryngeal mask airway is removed
after an IV injection of Sugammadex
when the patient is fully awake
when the patient is able to maintain their airway.
after the narcotic reversal agent is administered.
31
Which of the following is considered a drape?
Reusable cloth towel
Disposable cloth towel
Impervious towel
Skin prep towel
32
Which statement is an accurate desc of negative pressure wound therapy?
Increases bacterial load
Promotes wound contracture
Encourages edema
Applies constant, positive wound pressure
33
Skin antisepsis products can be flammmable. Which of the following is NOT recommended.
Allowing the skin antiseptic to dry completely prior to draping
Using towels to absorb solution accumulation during application
Warming the product prior to application
Clipping hair at the surgical site before prep application
34
What is a benefit of robotic surgery?
Instruments have more flexibility than the human wrist
Heavier robotic arms can impede precise instrument movements
Instrument changes are slowed by the robotic release
Technology cannot prevent instrument movements during procedure
35
A mechanical method for achieving Hemostasis includes the use of
Electro surgical devices
Thrombin
Sutures, staples, clips
Vasopressors
36
Which of the following social determinants of health relates to high lead levels in water affecting pediatric health
Public safety
An environment free of life threatening toxins
Healthy food availability
Access to health services
37
When is it appropriate to release cricoid pressure?
After the trachea is occluded
When anesthesia starts intubation
When the stylet is removed
When the ET CUFF IS INFLATED
38
One of the physiological effects of the trendelenburg position
Venous pooling in the lower extremities
Evenly distributed lug ventilation
Increased cardiac output
Increased intraoccular pressure
39
Which of the following is not a sign or symptom of an allergic reaction?
Hypertension
Nausea
Tachycardia
Strider
40
Most postoperative complications occur within
12 hours
48 hours
8 hours
24 hours
41
Which option best describes an interrupted stitch?
A suture that encircles the wound
A heavy suture that reinforces the primary suture line
A single stitch tied independently
A suture placed in the epidermal layer
42
Consideration for the patient in prone position include
5-10 degree reverse trendelinburg to decrease orbital swelling
All of the above
Keeping the patient in Prone position shortest time possible
Using positioning devices or beds to allow chest and abdominal expansion
43
A potential complication of gas insufflation is
Increased blood flow to kidneys
Decreased diaphragmatic pressure
Increased cardiac output
Hypercarbia
44
Which gown would you use when there will be a lot of blood
Two
One
Three
Four
45
Patient and family education
Increases patient length of stay
Improves patient outcome
Should begin following the surgery
Hinders the development of life changing behaviors
46
Knowing instrument names help with
Increasing time in the OR
The count process
Predicting the next step of the operation
None of the above
47
Fall prevention measures in the OR
Placing safety strap 3inches above the knee
Unlocking the stretcher prior to
Leave pt unattended to get supples
Never leave patient unattended
48
Which of the following options concerning MIS that is performed by robot is not correct
The operating surgeon has control of robotic instruments, camera and scope
The video cart contains equipment such as monitor and camera
Robotic instruments are similar to laparoscopic instruments
The robotic arms are part of the surgeons console
49
Which element in the chain of infection describes a microorganisms route after exciting an infectious reservoir?
Portal of entry
Susceptible host
Infectious agent
A mode of transmission
50
When opening a blue wrap item, the nurse should
Open the top flap toward your body
Open the last flap towards the scrub person
Inspect the wrap integrity for holes and tears
Allow side flaps to hang loose
51
Instrument sets must not weigh more than
20 lb
30 lb
50 lb
25 lb
52
What action should be taken when transferring a specimen off the sterile field?
Immersing the specimen into preservative until further instructions
Wait til end of surgery to place specimen in container
Depositing the specimen into the smallest container
Confirming test to be performed with the surgeon
53
Which of the following interventions can help manage a gas embolism?
Continue has insifflation
Place the patient in trendelenburg and on left side
Place the patient in reverse trendelenberg on right side
Continue anesthesia and hyperventilate the patient with 100•\• O2
54
From the options below which describes a portal of entry for an infectious agent?
An individual receiving healthcare
Mucous membranes
Dirty surfaces and equipment
Aerosols
55
Which of the following is Not an appropriate action for specimen handling on the sterile field?
Ensuring that the specimen stays dry until it is transferred off back table
Labeling the covered or contained specimen
Handling the specimen as little as possible
Covering the specimen or placing it in a sterile specimen container
56
The specimen transport container should
Protect the integrity of the specimen
Be stored in the operating room until it goes to pathology
Have a biohazard sticker for fresh or frozen
Display pt’s info for ease of specimen handover
57
Choose the correct statement about general skin antisepsis application measures
Dilute prep solution
Begin the prep as the pt is being positioned
Apply antiseptic to area larger than the intended incisional site
Allow positioning equipment to absorb excess skin prep
58
Which of the following is NOT part of universal protocol?
Site marking
Pre-procedure verification
Time out
Clipping the surgical site
59
Instruments are inspected at multiple points of use. Which is a preventative measure?
A point of use instrument lubrication
Use of misaligned instruments for grabbing tissue
Use of a cracked instrument during an emergency
Scheduled inspection of instruments
60
Fast tracking
Requires 1:1 ratio
Does not require a nursing handoff
Does not include patient and family education
Bypasses phase one and goes directly to phase 2
61
Which of the following is NOT a type of a closed drainage system
Hemovac
T-Tube
Negative wound therapy
Chest tube
62
Which statement related to biological indicator (BI) is True?
Two BI test vials are placed in the sterilizer together
An unprocessed BI is positive after incubation
Any BI Type can be used for any sterilization method
A sterilizer quality test is performed at least every 6 months
63
An area of painful skin that is abraded, blistered, or has shallow craters would be what stage?
Stage 3
Stage 2
Stage 4
Stage 1
64
The RN should ask the patient about use of any herbal preparations and botanical products. Why is this critical?
All of the above
These products can affect bleeding times
Liver toxicity can be potentates
Anesthetic effects can be prolonged
65
Which gowning and gloving action would a scrub tech perform
Gloving another team member only when Hands are exposed, the cuff at wrist
Wearing double gloves that are extra loose to avoid numbness
Changing gloves every 90-150 minutes
Drying arms and hands by waving them around
66
Which of the following is NOT a laser safety precaution?
The laser is tested prior to use.
The laser is kept in the active mode until the procedure is over
Appropriate wavelength eyeware placed at entry to OR
Windows are covered prior to Laser use
67
Which is not a key component of ERAS?
Multimodal analgesia
Pt fasting for 12 hours proper to surgery
Return to normal diet on the day of surgery
Patient and family education
68
The definition of health disparity is
All of the above
Equal distribution of healthcare resources across the populations
Adherence to SOC for every individual
A higher burden of disease for some populations
69
Which of the following is true regarding surgical count
RN Circulator is solely responsible for the count
All counted items stay in the surgical suite until all counts are completed
Count should be acessable on the count sheet only
Count starts with items thrown in kick bucket
70
1999 report, To err is Human, started a culture shift. Which is NOT AN ELEMENT of SYSTEMS error study?
Individual blame
Communication tools
Standardized process
Standardized check list
71
Health care professionals protect patients confidentiality and privacy? Which of the following is False.
Discussion about a patient in public setting is Inappropriate
HIPA ACT determines what may or may not be done with information PTs
Team members should protect patients privacy at all times
It’s ok to use personal devices to capture info and photos of PTs
72
Which option describes a critical step the scrub tech takes prior to laparoscopic procedures
Identifies laparoscopic instruments
Determines length of trocars.
Measures the width of laparoscopic instruments
Checks surface of instruments for tears and cracks
73
ERAS protocols typically begin
Prior to scheduled surgery
On the day of surgery
Intraoperatively
Postoperatively
74
4. The most specific early indicator of a malignant hyperthermia crisis is
Increase CO2 above 45
Dark urine
Temperature greater than 102
Arrhythmias
75
Which of the following is the best option for a nurse giving medication
Prepare medication for patients one at a time
Use multi dose vial
Get medications for multiple patients at one time
When given a choice draw up meds instead of using a prefilled syringe
76
LAST is a patient medical emergency that occurs when
The local anesthetic blood threshold is exceeded
The airway is occluded
An unintended hypothermic event occurs
A sedative bolts is injected intravenously
77
Which method is not an effective method of correct instrument care?
Transport instruments in a closed cart to decontam
Wipe debris from instruments with sterile saline
Organize instruments on sterile field
Choose instruments for use according to their design
78
An accountable care organization is
Voluntary, coordinated effort across health care specialities
Provides education for facility medical and nursing
Mandated
Education based for surgical candidates
79
A brachial plexus injury is most likely to occur
When the arms are extended less than 90 degrees
When shoulder braces are used
When the head and neck are in a neutral position
When the patient is in a lateral position with an acillary roll
80
Which of the following is a safety measure for use of energy devices?
Use non-conductive trocar system
Use the highest setting possible
Inspecting insulation of endoscopic instruments after the procedure only
Having the person using the energy device operate the foot pedal
81
When a count discrepancy occurs
RN Circulator immediately calls radiology
The surgeon continues closing
Surgical assistant breaks scrub to help circulator
A recount of that item is conducted after missing item is found
82
Preoperative assessment is a critical nursing element when considering positioning. What increases pts risk
Age
Preexisting medical condition
Body mass index
All of the above
83
An example of an open or passive drain is
Jackson Pratt
Penrose
Hemovac
Chest tube
84
Risk factors for a patient that uses/abuses alcohol
Normal cardiac function
Shortened bleeding times
Strengthened immune system
Exaggerated physiological stress response
85
A mono polar electrosurgery intervention for a pt with an IED IS
Place dispersive pad as close to IED AS POSSIBLE
Inactivation of IED whenever possible
Verification of IED and leads are between the ESU pencil and the IED
Use ESU at highest power for faster application
86
A consideration for instrument set creation would not include:
Tray weight
Scheduling conflicts
Type of surgery
Patient population
87
Failure to follow instructions for healthcare product or device
May result in the hospitals accrediting body issuing citations
Ensures correct device storage
Prevents patient injury
Adheres to equipments warranty
88
A culture of safety focuses on
Organizational care delivery
Patient safety regulatory requirements
Medical staff goals
Individual healthcare provider
89
Which of the following statements regarding surgical attire is correct
Masks are required in semi-restricted area
Personnel don a head covering prior entering the restricted area
Beard covers are required surgical attire only in the restricted area
Personnel remove all hand jewelry before performing hand hygiene
90
Surgical fires can occur on or in the patient. A laser or ESU device belong to which element of fire triangle
Chemical
Ignition
Oxidant
Fuel
91
Which of the following statements is regarding hand hygiene is INCORRECT?
Personal hand lotion should be used to maintain skin integrity
Fingernails should be kept short and clean
Hand hygiene is the single most effective infection prevention
Personnel should follow policy and procedure regarding use of nail polish

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