Zander Practice Exam Study Guide
ZANDER PRACTICE EXAM STUDY GUIDE NEWEST 2026/2027
ACTUAL EXAM COMPLETE 200 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
How should you treat a patient with a PH 7.13, CO2 80 and HCO3 30?
The patient needs to be ventilated or possibly receive reversal agents for sedatives
if the patient is overly sedated. - experiencing respiratory acidosis and needs to
breath faster to increase o2 and decrease the excess co2 they have in the body -
not blowing off co2 fast enough bc decreased respirations
The surgeon performed a biopsy during the bronchoscopy. The specimen is
appropriately prepared and transported to the lab. After the procedure the
cutting accessory and bronchoscope are processed. What level of processing is
recommended by the Spaulding Classification System?
the biopsy forceps are a critical item. The bronchoscope is semi-critical. The
Spaulding Classification System does not address how this combination should be
processed and so AORN recommends a multidisciplinary team decide and write
policy for the facility
The Spaulding Classification system does not address how to process semi-critical
items used in conjunction with critical items. Although flexible endoscopes are
categorized as semi-critical, the cutting accessory is critical. The accessory may
emerge from the distal end of the endoscope and contact the mucosal surface as
well. Thus, there are concerns about whether semi critical items should be
sterilized rather than high level disinfection. A multidisciplinary team that includes
infection prevention, endoscopy and peri-op RNs should conduct a risk
1|Page
, Zander Practice Exam Study Guide
assessment to determine whether items that secondarily enter sterile tissue or
the vascular system through a mucous membrane should be sterile.
Mr. K has come to the OR for a bowel resection. His preoperative lab work shows a
potassium of 2.9. What manifestations would you expect to find?
hypotension
manifestations =
signs and symptoms
ectopic beats, dysrhythmias, hypotension, muscle weakness, gastric distension
paralytic ileus and urinary retention are manifestations/signs/symptoms of what?
low potassium - hypokalemia
vomiting and diarrhea can cause
Vomiting and diarrhea are causes of hypotension, not symptoms.
muscle cramping is a symptom of what?
hypertension
what does crushing injuries do?
The major detrimental components released during crush injury are myoglobin
and potassium. Myoglobin can collect in the kidney faster than it can be
eliminated, causing injury to the renal tubular cells, leading to acute renal failure.
why do crushing injuries cause hyperkalemia?
2|Page
, Zander Practice Exam Study Guide
Due to the damage to the cellular membrane during a crush injury, sodium, water,
and calcium rush into the cell, causing swelling, while simultaneously potassium,
myoglobin, purines, and other toxins leak out of the cells and into the surrounding
tissue. All of this is maintained inside the compressed area.
The pneumonectomy patient is being positioned on the OR table. A beanbag
positioner is used. It is most important for the surgical team to...
Use padding at the head and feet to maintain spinal alignment.
A pillow or other head positioner is placed under the patient's head and lower
extremities to maintain good cervical and thoracic spinal alignment. The bottom
leg is flexed, and the top leg is straight. Padding at the lateral aspect of the bottom
knee and ankle also prevents pressure on the common peroneal nerve and distal
fibula.
what nerve is at risk during a pneumonectomy?
bc the patient would be side lying, at risk for pressure on peroneal nerve (lateral
knee)
When selecting products for use in the OR the following considerations are top
priority for the Product selection team.
Product selection should be based on a clinical trial. This evaluation should
include performance, effectiveness and efficiency but most of all patient safety.
Unexpectedly, the 16-year-old female is displaying a Wide Complex QRS on her
ECG immediately upon arrival in the OR. She is sweating and is becoming cyanotic.
She has a weak rapid pulse. The CRNA applies oxygen and opens the IV fluid to run
by gravity. The nurse expects anesthesia will give which of the following
medications first? Then what is the second treatment?
3|Page
, Zander Practice Exam Study Guide
Amiodarone first
syncrhonized cardioversion
Wide Complex QRS can be either VT or SVT. In an adolescent the observable
symptoms can be very similar. An adolescent or child may sometimes have a pulse
with VT. If clinicians are unsure it's always assumed to be VT and treated as such
first. Amiodarone followed by synchronized cardioversion is the treatment for VT
with a pulse. The cardioversion will also correct SVT. Decades ago Lidocaine was
given IV but this is an outdated treatment. The Berry and Kohn book still says to
use Lidocaine for VT in Ch. 31.
wide complex QRS can be what? how to treat?
VT - ventricular tachycardia
SVT - supraventricular tachycardia
1. amiodarone
2. synchronized cardioversion
During the laparoscopic cholecystectomy the perioperative nurse keeps the CO2
at less than 15 mmHg because increased CO2 pressures cause...
Respiratory compromise
Over pressurization can force CO2 to diffuse into the blood resulting in
Hypercarbia. End tidal CO2 monitoring is crucial.
Excess pressure also increases diaphragmatic pressure and reduced intrathoracic
space and thus tidal volume.
what law does retained surgical item fall under?
4|Page
ZANDER PRACTICE EXAM STUDY GUIDE NEWEST 2026/2027
ACTUAL EXAM COMPLETE 200 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
How should you treat a patient with a PH 7.13, CO2 80 and HCO3 30?
The patient needs to be ventilated or possibly receive reversal agents for sedatives
if the patient is overly sedated. - experiencing respiratory acidosis and needs to
breath faster to increase o2 and decrease the excess co2 they have in the body -
not blowing off co2 fast enough bc decreased respirations
The surgeon performed a biopsy during the bronchoscopy. The specimen is
appropriately prepared and transported to the lab. After the procedure the
cutting accessory and bronchoscope are processed. What level of processing is
recommended by the Spaulding Classification System?
the biopsy forceps are a critical item. The bronchoscope is semi-critical. The
Spaulding Classification System does not address how this combination should be
processed and so AORN recommends a multidisciplinary team decide and write
policy for the facility
The Spaulding Classification system does not address how to process semi-critical
items used in conjunction with critical items. Although flexible endoscopes are
categorized as semi-critical, the cutting accessory is critical. The accessory may
emerge from the distal end of the endoscope and contact the mucosal surface as
well. Thus, there are concerns about whether semi critical items should be
sterilized rather than high level disinfection. A multidisciplinary team that includes
infection prevention, endoscopy and peri-op RNs should conduct a risk
1|Page
, Zander Practice Exam Study Guide
assessment to determine whether items that secondarily enter sterile tissue or
the vascular system through a mucous membrane should be sterile.
Mr. K has come to the OR for a bowel resection. His preoperative lab work shows a
potassium of 2.9. What manifestations would you expect to find?
hypotension
manifestations =
signs and symptoms
ectopic beats, dysrhythmias, hypotension, muscle weakness, gastric distension
paralytic ileus and urinary retention are manifestations/signs/symptoms of what?
low potassium - hypokalemia
vomiting and diarrhea can cause
Vomiting and diarrhea are causes of hypotension, not symptoms.
muscle cramping is a symptom of what?
hypertension
what does crushing injuries do?
The major detrimental components released during crush injury are myoglobin
and potassium. Myoglobin can collect in the kidney faster than it can be
eliminated, causing injury to the renal tubular cells, leading to acute renal failure.
why do crushing injuries cause hyperkalemia?
2|Page
, Zander Practice Exam Study Guide
Due to the damage to the cellular membrane during a crush injury, sodium, water,
and calcium rush into the cell, causing swelling, while simultaneously potassium,
myoglobin, purines, and other toxins leak out of the cells and into the surrounding
tissue. All of this is maintained inside the compressed area.
The pneumonectomy patient is being positioned on the OR table. A beanbag
positioner is used. It is most important for the surgical team to...
Use padding at the head and feet to maintain spinal alignment.
A pillow or other head positioner is placed under the patient's head and lower
extremities to maintain good cervical and thoracic spinal alignment. The bottom
leg is flexed, and the top leg is straight. Padding at the lateral aspect of the bottom
knee and ankle also prevents pressure on the common peroneal nerve and distal
fibula.
what nerve is at risk during a pneumonectomy?
bc the patient would be side lying, at risk for pressure on peroneal nerve (lateral
knee)
When selecting products for use in the OR the following considerations are top
priority for the Product selection team.
Product selection should be based on a clinical trial. This evaluation should
include performance, effectiveness and efficiency but most of all patient safety.
Unexpectedly, the 16-year-old female is displaying a Wide Complex QRS on her
ECG immediately upon arrival in the OR. She is sweating and is becoming cyanotic.
She has a weak rapid pulse. The CRNA applies oxygen and opens the IV fluid to run
by gravity. The nurse expects anesthesia will give which of the following
medications first? Then what is the second treatment?
3|Page
, Zander Practice Exam Study Guide
Amiodarone first
syncrhonized cardioversion
Wide Complex QRS can be either VT or SVT. In an adolescent the observable
symptoms can be very similar. An adolescent or child may sometimes have a pulse
with VT. If clinicians are unsure it's always assumed to be VT and treated as such
first. Amiodarone followed by synchronized cardioversion is the treatment for VT
with a pulse. The cardioversion will also correct SVT. Decades ago Lidocaine was
given IV but this is an outdated treatment. The Berry and Kohn book still says to
use Lidocaine for VT in Ch. 31.
wide complex QRS can be what? how to treat?
VT - ventricular tachycardia
SVT - supraventricular tachycardia
1. amiodarone
2. synchronized cardioversion
During the laparoscopic cholecystectomy the perioperative nurse keeps the CO2
at less than 15 mmHg because increased CO2 pressures cause...
Respiratory compromise
Over pressurization can force CO2 to diffuse into the blood resulting in
Hypercarbia. End tidal CO2 monitoring is crucial.
Excess pressure also increases diaphragmatic pressure and reduced intrathoracic
space and thus tidal volume.
what law does retained surgical item fall under?
4|Page
