AORN PERIOP 101 FINAL EXAM LATEST ALL 1OO QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS)/AGRADE
First forms of anesthesia: - ANSWER: Nitrous Oxide and ether
Who may provide anesthesia care? (4 answers) - ANSWER: Anesthesiologist, CRNA,
Anesthesiologist assistant, perioperative nurse
Factors to consider when determining what anesthetic to use for a particular patient:
(8 answers) - ANSWER: -pt/surgeon preference
-Surgical procedure
-Physical Status
-Age
-Postoperative recovery time
-Length of surgery
-Position of pt
-Pt previous experience with anesthesia
General Anesthesia - ANSWER: a reversible state of unconsciousness, consisting of
amnesia, analgesia, and muscle relaxation
Regional Anesthesia - ANSWER: a reversible loss of sensation, which is achieved by
injecting a local anesthetic to block the nerve fibers from transmitting impulses.
Local Anesthesia - ANSWER: functions like regional anesthesia but usually applies to
a smaller area or a single body part such as a finger or a toe.
Monitored Anesthesia Care (MAC) - ANSWER: consists of intravenous medications
and concurrent local infiltration of tissue at the surgical site
What are the Four STAGES of Anesthesia? - ANSWER: • Stage I: Initial Administration
- The first stage is the actual administering of the anesthetic drugs. There are only a
few seconds in between the initial administering of the drug and unconsciousness.
• Stage II: Excitement - In Stage II the patient is now unconscious. Also known as
"excitement", is the time from loss of consciousness to the loss of eyelid reflex.
Involuntary movements may occur at this time.
• Stage III: Intrasurgery - This is the time of surgical anesthesia. The patient has rapid
eye movement and breathing may be labored until the muscles completely relax. It is
time to start the surgery.
• Stage IV: Possibility of respiratory failure - During this last stage of anesthesia, the
patient might need help. If too much anesthesia has been given, this stage is
characterized by respiratory failure, leading to circulatory failure. Without breathing
apparatus and heart support, the patient can die.
,What are the three PHASES of anesthesia? - ANSWER: • Induction - This phase begins
with the administration of anesthesia and lasts until the surgical incision is made.
• Maintenance - This phase begins with the surgical incision and lasts until near
completion of the procedure (Stage 3).
• Emergence - This phase starts as the patient begins to awaken and ends upon
exiting the operating room
IV regional anesthesia (Beir Block) is most often used for: - ANSWER: Upper
extremity nerve blockade
A common side effect to monitor after spinal anesthesia is: - ANSWER: hypotension
due to vasodilation
What is the most consistent physiological indication of Malignant Hyperthermia? -
ANSWER: Increased end tidal CO2
What drug is given for Malignant Hyperthermia? - ANSWER: Dantrolene
*Also, stop triggering agents, give 100% oxygen, cool pt
During Monitored Anesthesia Care (MAC), the Pt is monitored for what 3 risks? -
ANSWER: • Extravasation of intravenous medication
• A reduction of arterial oxygen saturation
• Breathing difficulty
During a peripheral nerve block, why must there be continuous nerve stimulation in
the area to be anesthetized? - ANSWER: To ensure proper needle placement
Special considerations for Pt undergoing endoscopic or minimally invasive surgery
include: (4 answers) - ANSWER: -Previous incisions (may alter the trocar insertion
technique)
-History of DVT
-Consent to include possibility of open procedure
-Voiding prior to surgery (empty bladder helps to avoid puncture during trocar
placement & decrease need for catheterization)
Fluid management in Minimally Invasive Surgery involves risk of: (2 answers) -
ANSWER: -Hypothermia
-Fluid overload
*Hyponatremia could accompany hypervolemia
How can we reduce risk of systemic hemodynamic changes while maintaining intra-
abdominal pressure during laparoscopic surgery? - ANSWER: Keep pressure under 12
mm/hg in adult Pt
, What is the single most important factor in minimizing micro organism transfer? -
ANSWER: Hand Hygiene!
How long should hands be washed for? - ANSWER: 15 seconds
*Hand washing for 15 seconds has been shown to reduce soil, spores, and
microorganism counts on the hands.
Standard Precautions - ANSWER: Precautions used for care of all patients regardless
of their diagnosis or presumed infectious status.
List endogenous sources of pathogens that may cause surgical site infections (3
answers) - ANSWER: -Personnel
-OR environment
-Tool/Instruments/supplies brought to sterile field
*Exogenous would be aerobes (live in air)
When should OR be "Damp Dusted"? - ANSWER: Before the first procedure of the
day
*All horizontal surfaces should be wiped with a clean, lint-free cloth moistened with
hospital approved disinfectant; Begin with high surfaces and work down
What is the most effective floor cleaning method in the surgical suite? - ANSWER:
Wet Vacuuming ( flood floor half room at a time with detergent - disinfectant
solution, water left to sit for five minutes and vacuumed)
What 3 bacteria must any germicide that is labeled as a hospital disinfectant have
potency against? - ANSWER: Pseudomonas aeruginosa
Staphylococcus aureus
Salmonella choleraesuis
True or False
Recommended practice says that after each surgical/ invasive procedure, the floor
should be mopped in a perimeter of 3-4 ft around the OR table - ANSWER: False
*The floors of the operating room should be cleaned and disinfected after each
surgical or invasive procedure if soiled or potentially soiled. This frequently means
cleaning a perimeter area around the OR table and extending as necessary. Move OR
bed to check for items or soiled areas under table.
Terminal Cleaning - ANSWER: More thorough cleaning that takes place at the end of
the days schedule
AND CORRECT ANSWERS (VERIFIED ANSWERS)/AGRADE
First forms of anesthesia: - ANSWER: Nitrous Oxide and ether
Who may provide anesthesia care? (4 answers) - ANSWER: Anesthesiologist, CRNA,
Anesthesiologist assistant, perioperative nurse
Factors to consider when determining what anesthetic to use for a particular patient:
(8 answers) - ANSWER: -pt/surgeon preference
-Surgical procedure
-Physical Status
-Age
-Postoperative recovery time
-Length of surgery
-Position of pt
-Pt previous experience with anesthesia
General Anesthesia - ANSWER: a reversible state of unconsciousness, consisting of
amnesia, analgesia, and muscle relaxation
Regional Anesthesia - ANSWER: a reversible loss of sensation, which is achieved by
injecting a local anesthetic to block the nerve fibers from transmitting impulses.
Local Anesthesia - ANSWER: functions like regional anesthesia but usually applies to
a smaller area or a single body part such as a finger or a toe.
Monitored Anesthesia Care (MAC) - ANSWER: consists of intravenous medications
and concurrent local infiltration of tissue at the surgical site
What are the Four STAGES of Anesthesia? - ANSWER: • Stage I: Initial Administration
- The first stage is the actual administering of the anesthetic drugs. There are only a
few seconds in between the initial administering of the drug and unconsciousness.
• Stage II: Excitement - In Stage II the patient is now unconscious. Also known as
"excitement", is the time from loss of consciousness to the loss of eyelid reflex.
Involuntary movements may occur at this time.
• Stage III: Intrasurgery - This is the time of surgical anesthesia. The patient has rapid
eye movement and breathing may be labored until the muscles completely relax. It is
time to start the surgery.
• Stage IV: Possibility of respiratory failure - During this last stage of anesthesia, the
patient might need help. If too much anesthesia has been given, this stage is
characterized by respiratory failure, leading to circulatory failure. Without breathing
apparatus and heart support, the patient can die.
,What are the three PHASES of anesthesia? - ANSWER: • Induction - This phase begins
with the administration of anesthesia and lasts until the surgical incision is made.
• Maintenance - This phase begins with the surgical incision and lasts until near
completion of the procedure (Stage 3).
• Emergence - This phase starts as the patient begins to awaken and ends upon
exiting the operating room
IV regional anesthesia (Beir Block) is most often used for: - ANSWER: Upper
extremity nerve blockade
A common side effect to monitor after spinal anesthesia is: - ANSWER: hypotension
due to vasodilation
What is the most consistent physiological indication of Malignant Hyperthermia? -
ANSWER: Increased end tidal CO2
What drug is given for Malignant Hyperthermia? - ANSWER: Dantrolene
*Also, stop triggering agents, give 100% oxygen, cool pt
During Monitored Anesthesia Care (MAC), the Pt is monitored for what 3 risks? -
ANSWER: • Extravasation of intravenous medication
• A reduction of arterial oxygen saturation
• Breathing difficulty
During a peripheral nerve block, why must there be continuous nerve stimulation in
the area to be anesthetized? - ANSWER: To ensure proper needle placement
Special considerations for Pt undergoing endoscopic or minimally invasive surgery
include: (4 answers) - ANSWER: -Previous incisions (may alter the trocar insertion
technique)
-History of DVT
-Consent to include possibility of open procedure
-Voiding prior to surgery (empty bladder helps to avoid puncture during trocar
placement & decrease need for catheterization)
Fluid management in Minimally Invasive Surgery involves risk of: (2 answers) -
ANSWER: -Hypothermia
-Fluid overload
*Hyponatremia could accompany hypervolemia
How can we reduce risk of systemic hemodynamic changes while maintaining intra-
abdominal pressure during laparoscopic surgery? - ANSWER: Keep pressure under 12
mm/hg in adult Pt
, What is the single most important factor in minimizing micro organism transfer? -
ANSWER: Hand Hygiene!
How long should hands be washed for? - ANSWER: 15 seconds
*Hand washing for 15 seconds has been shown to reduce soil, spores, and
microorganism counts on the hands.
Standard Precautions - ANSWER: Precautions used for care of all patients regardless
of their diagnosis or presumed infectious status.
List endogenous sources of pathogens that may cause surgical site infections (3
answers) - ANSWER: -Personnel
-OR environment
-Tool/Instruments/supplies brought to sterile field
*Exogenous would be aerobes (live in air)
When should OR be "Damp Dusted"? - ANSWER: Before the first procedure of the
day
*All horizontal surfaces should be wiped with a clean, lint-free cloth moistened with
hospital approved disinfectant; Begin with high surfaces and work down
What is the most effective floor cleaning method in the surgical suite? - ANSWER:
Wet Vacuuming ( flood floor half room at a time with detergent - disinfectant
solution, water left to sit for five minutes and vacuumed)
What 3 bacteria must any germicide that is labeled as a hospital disinfectant have
potency against? - ANSWER: Pseudomonas aeruginosa
Staphylococcus aureus
Salmonella choleraesuis
True or False
Recommended practice says that after each surgical/ invasive procedure, the floor
should be mopped in a perimeter of 3-4 ft around the OR table - ANSWER: False
*The floors of the operating room should be cleaned and disinfected after each
surgical or invasive procedure if soiled or potentially soiled. This frequently means
cleaning a perimeter area around the OR table and extending as necessary. Move OR
bed to check for items or soiled areas under table.
Terminal Cleaning - ANSWER: More thorough cleaning that takes place at the end of
the days schedule