Periop 101 Final Exam/ Test Bank

Periop 101 Final Exam/ Test Bank Every member of the healthcare team has a role to play in cost containment. Which of the following is an example of how the perioperative RN can participate in cost containment in the OR? a) Ask the surgeon to use a less expensive implant b) Begin cleaning the OR for the next case before the patient leaves the room c) Open all supplies listed on preference card, including "available" supplies d) Verify with surgeon before opening suture Ans- d An RN who attends continuing nursing education and has verified skills, knowledge, and attitudes about perioperative nursing is demonstrating accountability in his/her: a) Certification requirements for professional achievement in perioperative nursing b) Collaboration among team members c) Professional growth and maintenance of competency d) Verification of nursing knowledge Ans- c Which of the following statements is TRUE concerning use of the AORN Guidelines for Perioperative Practice? a) Both medical and nursing licensing boards require health care institutions to comply with the AORN guidelines b) The AORN Guidelines legally supersede departmental and institutional policies c) The AORN Guidelines reflect scientific evidence of how nurses actually practice in perioperative settings d) Work setting and situation variations may determine the extent to which AORN Guidelines can be applied Ans- d What legal standard does the professional nurse need to meet when providing care? a) Reasonably prudent care b) certification standard c) Reasonably responsible standard d) There is no legal standard Ans- a a professional practice model includes personal accountability and ethical decision making. Which of the following is not part of personal accountability? a) Responsibility to self, patients, and peers b) Make decisions and accept consequences when necessary c) Accept performance input from direct and upper level management only d) Maintain professional engagement Ans- c What would be the MOST important information for a nurse in Preadmission Testing (PAT) to collect on an insulin dependent diabetic patient? a. How long the patient has been diabetic b. If there is someone to deive them home c. The last time the patient ate or drank d. The type of insulin that patient takes Ans- d After transferring a male pt into the Phase I PACU, the perioperative RN could reasonably expect the PACU RN to FIRST a. Administere med to the pt for nausea and vomiting b. Ask the pt if he has any pain c. Assess the pt's airway and respirations d. Care for this pt and 2 other pts as assigned Ans- c During a handover report to the PACU RN, the perioperative RN may use a communication method identified by the acronym "SBAR". What does SBAR stand for? a. Safety, Background, Actions, Recovery expectations b. Situation, Background, Assessment, Recommendation Ans- b A 40 yr old male pt is awake and alert in the PACU after a right shoulder surgery. What is the best measure to assess the pt's pain? a. Disucss the pt's pain with the anesthesiologist b. Observe facial expressions c. Ask the pt to rate pain from 1-10 d. Monitor vital sign changes Ans- c A 47 yr old male is admitted to the Pre-op area for an inguinal hernia repair. What does the nurse include in the intake assessment? a. Pain b. Cognitive ability of the pt c. Cultural considerations d. All of the above Ans- d During the preoperative interview, the perioperative nurse should ask pt's about their use of a. alcohol b. herbal preparations c. recreational drugs d. tobacco products e. all of the above Ans- e The preoperative interview is the final assessment of the pt. This nurse-pt interaction enables the nurse to a. identify any additional pt care needs prior to surgery b. determine the length of the procedure and needed supplies c. introduce the pt to the surgical team d. provide info necessary for d/c Ans- a Which assessment finding is common among elderly pts? a. An increase in oxygen saturation b. Decrease in vision including color and depth perception c. Increased perception of pain d. An easy adjustment to a change in their environment Ans- b During the preoperative interview, the RN should ask the pt about use of any herbal preparations and/or botanicals. Why is this a critical component of the assessment? a. These products can affect bleeding times b. An alteration of medication metabolism can ensue c. Anesthetic toxicity can occur d. All of the above Ans- d It is important to discuss the pt's spiritual needs during the pre-op assessment. What elements of different faiths should the periop nurse be aware of in the event of a pt's intraoperative death? a. Islamic beliefs include that one designated person should wash the body of the deceased b. The team should prepare for an organ donation for the deceased of any religious belief c. The RN circulator should immediately contact a local mortuary d. Cremation is preferred by memebers of the Jewish faith Ans- a factors that may affect postoperative pain are: select all that apply a. The surgical site b. The nature and intended purpose of the surgery c. The pt's fears regarding anesthesia or surgery d. The level of anxiety of the pt's family members Ans- a, b, c Which of the following best illustrates the purpose of perioperative pt and family education? a. To reduce the pt's anxiety b. To increase pt and family adherence to the plan of care c. To increase the pt's and fam's satisfaction with the quality of care d. To support legal, ethical, and regulatory mandates Ans- c Which of the following practices violates a pt's ethical right to self-determination or removes his or her ability to make informed choices? a. Automatically suspending an intraoperative DNR decision b. Including family in the education process c. Performing emergency surgery without informed consent d. Providing info about the scientific evidence for planned care Ans- a A 43 yr old female scheduled for a lap choly, the periop RN should provide preop education to her and her family, incuding a. Detailed info about the surgical procedure, including risks and benefits b. Obtaining informed consent from her and suspending any DNR orders c. Verification of financial records d. Wound care and pain management Ans- d Periop teaching encompasses the 3 elements of info, psychological support, and skills training. What most accurately describes the level of skills training? a. Information describing elements of postoperative recovery b. Coping mechanisms provided for fear and anxiety c. The explanation of the periop process d. Description of intraoperative pt care activities Ans- a A surgical mask should cover both mouth, nose and should be a. Allowed to hang around the neck between procedures b. Changed after 2 hours of use c. Removed and discarded after every case d. Tied snugly with strings crossed Ans- c The ventilation system in the restricted area of the OR should have an air exchange rate of at least _________ air exchanges per hour a. 5 b. 20 c. 10 c. 15 Ans- b Documentation should be accurate, concise, and complete, providing information for future reference in addition to a. Ensuring the quality of pt care b. Serving as evidence in a court of law c. Reconstructing the pt's healthcare experience d. All of the above Ans- d Who is responsible for ensuring that the daily operations of the surgical suite meet accrediting and regulatory agency requirements? a. Administrative support staff b. Biomedical staff c. Environmental support staff d. Surgical team Ans- a Regulatory agencies require documentation for equipment and staff education. Which of the following are types of records that the healthcare facility is required to maintain? a. Sterilization logs b. Equipment maintenance records c. Chemical sterilant records d. All of the above Ans- d What is the best method for keeping instruments clean on the sterile field? a. Soak instruments in a basin of normal saline b. Wipe instruments with a sponge moistened with sterile water c. Spray instruments with an enzymatic detergent d. Wipe instruments with a sponge moistened with sterile water and flush lumens with sterile water Ans- d Select the appropriate Spaulding Classification System category for each item listed: a. Blood pressure cuff b. Laryngoscope blade c. Ortho implants 1. critical 2. non- critical 3. semi critical Ans- a. 2, b. 3, c. 1 or BP non crit, blade semi, implants critical What is the first step in reprocessing surgical instruments after they have been used in a procedure? a. Cleaning b. Decotamination c. Disinfection d. Transport to the sterilizer Ans- a Biological monitoring a. Is utilized to document the sterility of an item b. Indicates that the intended physical conditions in the sterilizer were met c. Can be read immediately after the sterilization cycle is complete d. Should never be used in IUSS Ans- b Decontamination of instruments should begin after the completion of all invasive porcedures to prevent the formation of biofilm. Which of the following statements is correct? a. Decontamination of instruments occurs at the time of use of the instruments b. Decontamination begins when instruments are treated with an approved chemical application or covered with a moistened towel c. Decontamination of lumened instruments begins with flushing the lumen with sterile saline d. Instruments with multiple parts are not disassembled if they were not used during the surgery Ans- b What are the principle elements required for an infection to occur? a. A method of transmission, a source or reservoir, a susceptible host b. A susceptible host, middle age pt, skin integrity c. A susceptible organism, a warm, moist environment, a method of transmission d. Limited air flow in the OR, a source or reservoir, compromised sterile technique Ans- a Which is the best method for preventing blood borne pathogen exposure? a. Allowing for proper air exchange to occur between cases b. Inspecting all sharps to ensure they are intact after use c. Using PPE and handwashing d. Wearing non sterile gloves at all times when in the surgical suite Ans- c You are circulating on a lap appendectomy. Upon entering the abdomen, the surgeon encounters purulent inflammation and asks for a culture. What is the wound class for this case? a. Class I: Clean b. Class II: Clean contaminated c. Class III: Contaminated d. Class IV: Dirty infected Ans- d Which of the following is a disease that is transmitted via the airborne route? a. C Diff b. Flu c. Measles d. Shingles, localized Ans- c When transporting a pt who is on contact precautions, the transporter a. Always wears PPE b. Wears PPE for a restless or intubated pt c. Wears PPE if they are uncertain if they will need to touch the pt d. Wears PPE only when touching the bedrails Ans- b What are the types of transmission based precautions? a. contact, droplet, airborne b. direct contact, enteric, standard c. indirect contact, direct contact, standard contact d. MRSA, VRE, C Diff Ans- a Vaccine preventable disease against which health care providers should be immunized include: (select all that apply) a. hep B b. seasonal flu c. tuberculosis d. varicella Ans- a, b,