what ERAS element is associated w/ preop phase?

DC planning, education, and home med plan

When should the scrub label the container of normal saline for the sterile field?

Immediately after the solution is transferred to field

When is the ET or LMA able to be removed?

When the pt is conscious & maintaining their airway

Select one principle of surgical draping

Handle the drapes as little as possible

Which is true about surgical site marking

The patient should be identified prior to marking

After normal saline has been transferred to the field, what should be done with the empty container?

Keep solution container until procedure complete

An organization with a culture of safety....

encourages the team to report errors and near misses

signs and symptoms of LAST include:

perioral numbness, seizures, coma, resp arrest

Patients may bypass Phase I and be fast tracked to Phase II care depending on?

type of anesthesia the patient received

how long should skin antiseptic dry before draping?

According to the manufacturer's IFU

Which is a key element of PACU the hand-off process?

Allow completion of urgent tasks first before starting handoff

The specimen container should identify the:

pt name/MRN, specimen name/tissue type/laterality, date/time of collection

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Periop Cohort 6

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Questions 117

Answers

1
Which term means: negligence or an intentional act that causes physical, financial, emotional damage to the pt?
nonmaleficence
fidelity
beneficence
malpractice
2
How often should surgical gloves be changed during surgery?
Every 60-90 minutes
Only every 60 minutes
Every 60-150 minutes
They don't need to be changed
3
Errors in specimen management can result in which of the following?
treatment/procedure inaccuracies
all of the above
diagnosis errors
pt harm
4
what ERAS element is associated w/ preop phase?
early mobilization
avoiding tubes or drains
initial opioid meds
DC planning, education, and home med plan
5
There is a correlation between seafood allergies and iodine allergies (including povidine iodine prep)
True
False
6
Who is responsible for obtaining informed consent from a patient?
the patient's family memeber/ significat other
the admitting clerk
the lisenced praticitioner
the OR RN
7
When should the scrub label the container of normal saline for the sterile field?
Before solution is placed in the graduate for the field
Never, there's no need to label solutions
Any time before the surgery begins
Immediately after the solution is transferred to field
8
who is responsible for positioning the patient
circulator
anesthesia
scrub tech
entire surgical team
9
When should the surgeon or anesthesia professional discuss that the POC includes the use of pneumatic tourniquet?
during the preop briefing
immediately before the preop skin antisepsis is applied
after the pt is positioned for surgery
when the pt enters the OR
10
When is the ET or LMA able to be removed?
During the procedure
When the pt is unconscious
When the pt is conscious
When the pt is conscious & maintaining their airway
11
Select one principle of surgical draping
The top surface to 4 inches below the edge is considered sterile
Adjust the drapes at the sterile field when positioned incorrectly
Handle the drapes as little as possible
Drape the area from the periphery to the incision site
12
Select the categories of Anesthesia
Vascular
ENT
General
13
What type of fluid is used with bipolar instruments?
sterile water
5% mannitol
normal saline
14
If intubation/ ventilation of the pt becomes difficult, the periop nurse should retrieve additional airway equipment
True
False
15
Sterile cloth towels provide a barrier for microorganism passage from unsterile to sterile fields
True
False
16
I should pre-label specimen containers.
True
False
17
Who is NOT part of the sterile field in the OR?
first assist
surgeon
anesthesia
scrub
18
What is supine
Face down
Side lying
Flat on back
19
SDOH can guide the health care provider in a complete assessment. what can impact ability to access healthcare?
educational opportunities
transportation options
segregation
healthy food availability
20
Which is true about surgical site marking
The site marking process is determined by the individual provider
The patient should not be involved
The patient should be identified prior to marking
Site marking is done in the OR
21
what is the minimum amount of time to wash hands with soap and water when visibly soiled
15 seconds
10 seconds
1 minute
30 seconds
22
what process is used for verbal orders in the OR?
Read back process
Standardized process
yell out process
No process is needed
23
______ is an act that occurs when prescription medicines are obtained or used illegally.
Stealing Drugs
Selling Drugs
Smuggling Drugs
Drug Diversion
24
What must pts do to ensure accurate and appropriate healthcare?
all of the above
participate in treatment and care decisions
provide accurate info about themselves
provide info about their known conditions
25
when does turn-over cleaning happen?
between- case
at the end of the week
at the end of the day
at the beginning of each day
26
rigid containers ma require filters on the lid and the bottom of the container
False
True
27
After normal saline has been transferred to the field, what should be done with the empty container?
Use it as a sharps container
Send empty solution to pharmacy
Discard to trash
Keep solution container until procedure complete
28
which is NOT a form of mechanical hemostatic methods?
epinephrine
staples
clips
dressings
29
An organization with a culture of safety....
focuses on errors
focuses on discipline
encourages the team to report errors and near misses
focuses on the individual health care provider
30
Which area is considered a sterile area of a surgical gown?
Axilla
Cuff of the gown
Back of the gown
Front of the gown
31
why is the preop nurse assessment important?
the pt may have other physical limitations
they may remember another allergy
the nurse can anticipate positioning needs
all of the above
32
who has control in pt and family cenetered care?
medical team
physicians
case manager
pt and family
33
According to the chain of infection, the habitat in which the agent normally lives, grows, and multiplies is known as
causative organism
mode of transmission
the reservoir
portal of entry
34
Verbal orders should be used only when required by clinical necessity
False
True
35
You should protect the eyes for a patient in prone position
True
False
36
Any type of hand lotion is okay for staff to use in the hospital.
True
False
37
a common feature of primary intention wound healing is
delayed wound approximation
need for antibiotic administration
tissue loss
minimal wound trauma
38
signs and symptoms of LAST include:
perioral numbness, seizures, coma, resp arrest
perineal numbness, hyperactivity, cardiac arrest
a sense of impending doom
a sense of euphoria
39
Patients may bypass Phase I and be fast tracked to Phase II care depending on?
Patients’ preference
type of anesthesia the patient received
the surgeon’s preference
size of the incision
40
Drape from the surgical site to the periphery
True
False
41
how long should skin antiseptic dry before draping?
4 minutes
According to the manufacturer's IFU
1 minute
until it looks dry
42
what is the preferred solution used to wipe debris off of surgical instruments?
normal saline
betadine
hydrogen peroxide
sterile water
43
A break in skin that is tender and painful. May look like a blister
stage 1
stage 4
stage 3
stage 2
44
Which is a key element of PACU the hand-off process?
Generalize information
Hand-off as quickly as possible
Interruptions are expected and inevitable
Allow completion of urgent tasks first before starting handoff
45
data collection forms the baseline for periop care. what is a primary source for pt data?
sneaky link
patient
other healthcare workers
chart
46
Which of the following items does NOT need to be covered with a sterile drape?
ring stand
mayo stand
back table
anesthesia cart
47
the FDA category 1 rating for skin antisepsis includes?
fast acting
all of the above
persistent
broad spectrum
48
The specimen container should identify the:
pt name/specimen name
pt name/MRN, specimen name/tissue type/laterality, date/time of collection
pt name/DOB
pt name/MRN
49
what should perioperative team members do when a break in sterile technique is discovered
speak up
debrief
SBAR
check back
50
Which of the following is NOT included in the 5 Rights of Delegation?
right time
right task
right person
right supervision & evaluation
51
Which term means: an act or failure to act that deviates from the accepted standard of care?
liability
negligence
malpractice
tort
52
What intervention(s) should be done in the event of an OR fire?
remove ET tube
pour saline over the field
turn gas off
all of the above
53
The last opportunity to detect a medical error before it reaches the patient occurs prior to:
Procuring
Tanscribing
Administering
Dispensing
54
PPE does not need to be worn when transporting a pt with contact precautions, it is only necessary in the pts room.
False
True
55
What self-gloving technique should you used after putting on sterile gown?
Closed Gloving
Open Assisted Gloving
Controlled gloving
Open Gloving
56
What is NOT a part of SDOH?
community resources
how many instagram followers they have
access to healthcare
education
57
to prevent contamination when moving in and around the sterile feild, scrubbed personal should...
turn their back to the feild
put hands in arm pits while standing
move back to back or face to face
change levels many times
58
The proportion of clinically ill individuals with disease that is severe or fatal is known as
viral load
pathogenicity
Viral shedding
virulence
59
which of the following describes MAC?
Infiltration or topical admin of agents anesthesizing a part of the body
drug-induced reversible state of unconsciousness
An injection of local anesthetics near nerve fibers
monitoring pt, administering sedatives & providing medical services prn
60
how long is surgical consent good for?
3 months
24 hours
72 hours
6 months
61
The anesthesia provider is responsible for staying with the pt until the PACU RN accepts the pt?
True
False
62
which is NOT a goal of hemostasis?
decrease and control bleeding
increase length of surgical time
decrease infection risk
optimize the surgical field
63
which statement about completly submerging an instrument into cleaning solution is TRUE?
increases the potential of contamination to the worker
reduces the need for instrument disassembly
reduces the risk of chemical and contaminant aerosolization
increases the risk of splashes and sprays to the worker
64
what is the goal of surgical antisepsis?
to sterilize the skin
to reduce risk of pt developing SSI
to allow for rapid regrowth of microbes
to slowly disrupt microbial life
65
the max weight of an instrument tray should be:
20 lbs
25 lbs
35 lbs
30 lbs
66
I should keep the specimen moist with sterile water.
False
True
67
When are sterile drapes placed on the patient for surgery?
After preoperative skin antisepsis has been performed at the surgical site
After the incision is made
When the patient enters the OR
Before the patient is positioned for surgery
68
MAJOR s/sx of MH
increased agitation from your preceptor :(
increased end tidial CO2
saddened mood
decreased appetite
69
only sterile items should come into contact with the sterile feild
True
False
70
What is the reversal agent for Benzodiazepines?
Naloxone
Flumazenil
Neostigmine
Heparin
71
What is the top nursing priority for the surgical patient newly admitted to the PACU?
Head to toe assessment
getting a medical history
Medication
Airway
72
Hallways adjacent to the OR, sterile supply storage areas and sterile processing dept. are classified as what zone?
the fun zone
semi-restricted zone
unrestricted zone
restricted zone
73
When can cricoid pressure be released? (SATA)
When ET tube is inflated
The anesthesiologist has given verbal confirmation to release
all of the above
The tube placement is confirmed
74
What is the most commonly used gas for insufflation?
carbon dioxide CO2
air
helium
75
The no fly zone in an OR refers to limiting the # of personnel near the anesthesia professional
True
False
76
Which of the following are pt identifiers that you would use in the preoperative setting?
name & room number
name & D.O.B.
name, height
name, weight
77
what are the 4 main categories of instruments?
dissecting, clamp, retracting & grasp/ holding
clamp, retracting, insertion, application
cut, pressure, insertion, grasping/holding
suture, foley cath, central venous cath, rectal tubing
78
an items sterility is based on how long it is on the shelf
True
False
79
what is an accountable organization?
an organization that does your taxes
an organization that has tables that suck your blood
an organization where staff voluntarily joins together to give care
multiple organizations that you can count on your hand
80
Prefilled syringes eliminate the potential for errors.
True
False
81
What documentation is required for surgical prep?
all of the above
person performing prep
skin condition at surgical site
product used
82
How should a surgical hand rub be applied?
Rub both arms and then both hands
Apply liberally onto hands and up the axilla
Apply vigorously from fingers to mid forearms
According to IFU
83
what PPE is NOT required for CPD team members in the decontamination area?
utility gloves
eye protection or face shield
N95 respirator
mask
84
which step proceeds the others?
packaging
point of use treatment
transport
disinfection
85
which is NOT a surgical drain?
negative pressure wound therapy device
chest drain
Penrose open- drain
open gravity pool drain
86
Which of the following is an example of a culture of safety?
Discussing evets without fear of managerial reciprocation
Providing a meal ticket to patients
Being disruptive during time outs
not speaking up when noticing a patient safety issue
87
Organizational elements of safety include
resources that focuses on accidents
consistent delivery of safe services
an environment that focuses on discipline
team disciplines that operate in silos
88
What kind of communication should be used when dealing with specimens?
loud communication
closed loop communication
none of the above
it doesn't matter
89
Absorbable sutures are used with tissues that heal rapidly
False
True
90
Which of the following are ways to prevent complications of gas insufflation?
place the insufflator above the surgical cavity
turn alarms off to limit noise distraction
Set the flow rate to the surgeons preference only
91
Class I wound classification is also known as...
clean/contaminated
dirty, infected
clean
contaminated
92
When epinephrine is added to local anesthetic, its actions include
Prolonging Rate of Absorption of Local Anesthetic
Increase Bleeding
Antimicrobial Activity
Bronchial Dilation
93
What are two important interventions for MH treatment?
Assist pt into Lithotomy position
Provide preceptee with emotional support
Leave the Operating Room
Dantrolene & MHAUS Hotline
94
A chronic wound is classified as
an incision made into intact skin
injury caused by tissue loss
injury that could be either life-threatening or less serious
pressure-related injury
95
What are the proper cleaning methods? (SATA)
low to high
dirty to clean areas
bottom to top
Top to bottom
96
Which option is not considered an element of stigmatization?
Healthcare access
gender identity
race/ethnicity
Gender
97
Maintain the pressure of the pneumoperitoneum at a pressure less than
10mmHg
15mmHg
20mmHg
98
The State Board of Nursing...
disciplines licensees
all of the above
issues licenses
establishes standards
99
which statement if TRUE related to topical thrombin?
topical thrombin should NEVER be injected intravascularly
topical thrombin is a medication
is not biologically participate in the coagulation cascade
topical thrombin is only manufacturead by using animal sources
100
what is health equity?
difference in health between groups
customized distribution of resources
none of the above
everyone across populations receives the same resources
101
Most to least effective smoke control? 1. training/education; 2. not producing; 3. resp protection; 4. smoke evac
1, 3, 2, 4
2, 4, 1, 3
1, 2, 3, 4
4, 3, 2, 1
102
One benefit of using the zipper for wound closure is that
forces are distributed over a wide area away from wound edges
it has a faster closure time
it reduces risk of friction
it creates uniform incisional tension
103
A laser is an example of which part of the fire triangle?
the top
fuel
ignition
oxidizer
104
which category of instrumentation is used to describe hemostats?
grasp & holding
clamping & occluding
dissecting / cutting
retracting
105
according to the centers for disease control and prevention, for at least how long should one wash their hands?
15 seconds
20 seconds
10 seconds
25 seconds
106
Which medication reverses the effects of heparin?
Epinepherine
Protomine
Bupivcaine
Oxytocin
107
what information is NOT included in handoff between RN's?
anticoagulation prophaxlysis
allergies
patients educations background
operative side and site
108
how many inches above the knee should a safety strap be placed for a patient in supine
2 inches
10 inches
4 inches
1 inch
109
what pratice involves maintaining cleanliness and eliminating infectious pathogens from the environment?
sanitary technique
aspetic technique
sterile technique
clean technqiue
110
What is the purpose of the ASA Physical Status Classification System?
to evaluate the surgical risk to the patient
To determine the anesthetic agent that will be used
to predict length of time needed for recovery
to assist in predicting the length of stay needed in phase 1
111
occupational exposure to radiation can be reduced by following the principles of time, distance, and ____
shielding
exposure
sterile technique
contact
112
Which of the following is ok to be worn on the hands during surgical hand antisepsis?
Bracelet
Watch
Nothing should be worn
Ring
113
EBL can be estimated by inspecting all but the following...
suction canisters
drapes
blood in OR trash can
sponges
114
The use of specific actions and activities to prevent contamination and maintain sterility is
asepsis
sterile
sterile technique
sterile feild
115
when a pt receives education, what should happen?
the pt should ruminate with their thoughts
the pt should only receive info before the procedure
the pt should repeat the education back to the provider
the pt should be D/C'd immediately after
116
if the preop skin antisepsis solution contacts the dispersive pad, the RN circulator should
remove the dispersive pad and reapply to another location
remove the dispersive pad, clean the skin, apply new pad
allow the solution to dry completely before draping the pt
wipe up the solution from around the dispersive pad
117
when should the sterile feild be prepared
as close to the time of surgery as possible
one hour before the scheduled procedure
after induction of anesthesia
while the OR is being cleaned

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