AORN Periop 101 Final Exam Study Guide 2024

AORN Periop 101 Final Exam Study Guide 1. A critical perioperative nursing diagnosis within the PNDS is: - ✔What is risk for perioperative positioning injury?

1.This type of needle point is what you would expect to be needed for suturing friable tissue such as the liver. - ✔What is a Blunt needle point?

2 Characteristics included in the elements of a culture of safety within a healthcare organization: - ✔a. Commitment to safety as the first priority in providing care* b. Trust among healthcare team members* 2.These particular wound closing items are available in a wide variety of instrument sizes. - ✔What are disposable stapler sets?

3.Give one example from TJC list of Do-Not-Use Abbreviations, Acronyms, and Symbols. - ✔What is cc?

4.Following an excisional breast biopsy, the circulating nurse would anticipate the need to have available this type of drain - ✔What is a Jackson-Pratt?

5.The surgical wound classification for a total abdominal hysterectomy. - ✔What is Clean contaminated?

6.This position can cause physiological effects of circulatory and respiratory compromise due to pressure on the abdomen. - ✔What is Lithotomy Position?

7.To protect sensitive areas of the skin with appropriate padding is a recommended practice for this: - ✔What is to reduce the patient's risk of intraoperative skin injury.

8.An environmental sanitation practice that is required to limit the transmission of microorganisms to personnel when handling body fluid spills - ✔What is personal protective equipment?

9.It is recommended to inspect the active electrode for insulation defects to prevent this from occurring during MIS - ✔What is capacitive coupling?

10. According to AORN RP for positioning the patient, the perioperative nurse should: What is... a. Use a consistent method of procedure-specific position for each patient b. Rely on the surgeon's and anesthesia provider's assessments to guide positioning c. use additional precautions as appropriate based on unique patient considerations

d. Depend on the patient's natural defense mechanisms to indicate the need for positioning alterations - ✔c. use additional precautions as appropriate based on unique patient considerations 11.The disadvantage of using this type of wound closure is because they often cause more scarring than other skin closure methods. - ✔What is skin clips?

12.An automatic intraoperative suspension of a do-not-resuscitate decision violates a patient's ethical right to... - ✔What is Self-determination?

13. This type of human factor error is responsible when a perioperative nurse is trying to attend to several tasks at once - ✔What is situational-based error?

14.Restricting pathogenic organisms from the patient, environment, equipment, and supplies is the definition of.... - ✔What is aseptic technique?

16.Patient and caregiver education for continuing post-op care at home is the primary focus of this Phase of post anesthesia care. - ✔What is Phase II? 17.According to the Institute of medicine recommendations for improving patient safety, this organization has the greatest potential impact to make changes on improving pt safety - ✔What are Healthcare organizations?

18. This statement about gloving technique is true What is... a. When gloving another person, always glove the left hand first. b. The scrub gown should be fastened in the back before donning gloves c. Open glove technique is used for initial donning of the sterile gown and gloves. d. Closed glove technique is used to glove the surgeon or assistant. - ✔b. The scrub gown should be fastened in the back before donning gloves 19. Draping material is this source in the fire triangle? (fuel, ignition, oxidizer) - ✔What is fuel source?

20. The safest way to pass a cutting instrument to a surgeon is: - ✔What is place it in a designated neutral zone with a verbal cue 21. To place a patient safely in this particular position the knees are over the break in the procedure bed to allow for knee flexion. - ✔What is Trendelenberg?

22. A packaging system for items undergoing sterilization should possess this characteristic: What is....

1. Made of only disposable materials 2. to permit aseptic delivery of contents to the sterile field

3. Maintain sterility of the items for a specified length of time.

4. Compatible with all sterilization processes - ✔2. to permit aseptic delivery of contents to the sterile field 23. Silicone catheters should be stocked on this particular cart in the surgical suite. ✔What is a Latex-safe cart?

24. Open this package carefully over a small basin to prevent splashing of the packaging solution. - ✔What is handling natural absorbable sutures (plain, chromic) 25. An example of administrative controls to assure safe use of lasers, is the appointment of a person in this role: - ✔What is a laser safety officer?

26. This statement about the perioperative nurse's role in bioethical decision making is most justifiable. The perioperative nurse should... WHAT IS... a. Try to avoid involvement in ethical dilemmas unless they are personally engaged in a situation. b. Refer all ethical dilemmas to the institution's ethics committee to decide the best course of action. c. act according to the terms of agreement establishing the nature of the relationship between the pt and the nurse d. Defer to surgeons judgment when there is disagreement about the right course of action. - ✔c. act according to the terms of agreement establishing the nature of the relationship between the pt and the nurse 27. A precaution that should be taken when using this hemostatic agent intraoperatively is to avoid using it with an autologous blood salvage unit (cell saver). - ✔What is microfibrillar collagen 28. A designation of 4-0 on a suture package indicates this about the suture material. ✔What is the diameter?

29. A recommended means of promoting the safety of personnel in the surgical suite is: What is.... a. Routine screening of patients for HIV and hepatitis C b. Providing access to MSDS (material safety data sheets) for hazardous agents in that environment c. Double-glove for every procedure d. Leaving the room when x-rays are being used, even if scrubbed. - ✔b. Providing access to MSDS (material safety data sheets) for hazardous agents in that environment 30. This type of healing the wound remains open - ✔What is Granulation?

31. An abstract concept that has been developing since Socrates. - ✔What is Critical thinking?

32. This item is placed as close to the operative site as possible - ✔What is the dispersive electrode?

33. This is desired patient outcome most closely related to the use of local anesthesia for a procedure: What is.... a. The pt is the recipient of competent and ethical care within legal standards of practice. b. The pt is normothermic at the conclusion of the procedure c. The patient reports adequate pain control throughout the perioperative process d. The pt's respiratory function is consistent with preoperative baseline levels. - ✔c. The patient reports adequate pain control throughout the perioperative process 34. Antibiotics are most commonly administered during the intraoperative phase through this route - ✔What is Irrigation solution?

35. Recent research studies on the value of certification found that: WHAT is.... a. Non-certified nurse managers saw little value in certification related to professional growth. b. The most frequent reason for achieving certification is the expectation of higher salary and career advancement c. Most facilities do not offer any incentives for achieving certification. d. Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse. - ✔d. Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse.

36. The recommended practice for flash sterilization is the item should be processed with this: - ✔What is a routine process monitoring device (chemical indicator, integrator).

37. When documenting the placement of surgical drains, it should include: - ✔What is location of drain?

38. The action that the perioperative nurse should take if the pt states he/she is allergic to shellfish and breaks out in hives when ingested. - ✔What is Alert surgeon for the need for appropriate selection of skin prep solution?

39. Principles of care for forceps during a procedure should include this: WHAT IS... a. Stand them upright along the sides of the instrument tray so that handles are easily grasped when needed b. Move them from the mayo stand to the back table if the surgeon says that they are not working properly. c. frequently inspect tips and wipe clean of blood or tissue as needed d. Organize them on the may stand or back table by placing one inside another. - ✔c. frequently inspect tips and wipe clean of blood or tissue as needed

41. There are 3 process monitors in the sterilization process; this particular monitor indicates that the intended physical conditions in the sterilizer were met. - ✔What is biological monitoring?

42. This is the most reliable early indication of malignant hyperthermia - ✔What is unexplained increase in end-tidal CO2?

43. This statement concerning the use of AORN Recommended Practices is true: a. RPs supersede departmental and institutional policies b. Work setting and situation variations may determine the extent to which the RPs can be applied c. RPs are based on scientific evidence of how nurses actually practice in perioperative settings d. Licensed and accredited institutions are required to comply with the RPs - ✔b. Work setting and situation variations may determine the extent to which the RPs can be applied 44. Lock the wheels of the stretcher and the OR bed is a recommendation when: ✔What is transferring pt from OR bed to gurney?

45. Begin this task with higher surfaces and finish with the lowest levels - ✔What is recommended for damp dusting in the OR? 46. Name one step that should be used to follow TJC universal protocol for preventing wrong site, wrong procedure, and wrong person surgery. - ✔What is using a time-out before beginning the procedure?

47. This can be performed through smaller incisions - ✔What is the Difference between MIS and open surgical procedures?

48. After this is procured by the surgeon, the scrub person should keep it moist with saline and in a sterile basin until it can be passed to the circulating nurse. - ✔What is a surgical specimen?

49. Documentation of the serial number in the medical record and on the pathology requisition when an apparent defect or failure occurs. - ✔What is proper handling of explants 51. AORN RP states, this should be matched to the type of laser, optical density, and wavelength - ✔What is appropriate eyewear during laser surgery?

52. Use a sterile transfer device - ✔What is recommended for transferring medication from a multi-use vial to the sterile field?

53. Family history of problems related to anesthesia; and pts previous experience with anesthesia - ✔What are assessment factors when screening pts for potential risk of malignant hyperthermia?

54. The space where direct, scattered, or reflected laser radiation exceeds maximal permissible exposure - ✔What is the nominal hazard zone for laser use?

55. First step in the sterilization process of surgical instruments that have been used in a procedure - ✔What is decontamination?

56. This is affected by pt and staff beliefs, staff attitudes, and individual and collective values - ✔What is the culture of a clinical setting?

57. Decreased color and depth perception - ✔What are sensory assessment findings common among elderly patients?

58. Principle of asepsis that is most directly related to the concept of surgical conscience - ✔What is consider items of doubtful sterility contaminated?

59. Most important reason for maintaining endoscopic instruments at optimal level of function - ✔What are insulation defects that can cause unseen thermal burns?

60. What type of thinking is required to deliver safe patient care based on the statement "safe care requires teamwork and care tailored to the individual patient?" - ✔What is critical thinking?

62. According to Dewey and Glaser this statement about critical thinking is incorrect. a. Logical inquiry and thoughtful reasoning b. Active, persistent and careful consideration of the evidence supporting a decision c. Passive acceptance of an unreflective jump to conclusion required in the OR. d. Skill in applying the methods of logical inquiry and reasoning - ✔Passive acceptance of an unreflective jump to conclusion required in the OR. 63. During this phase of wound healing contraction occurs - ✔What is proliferation phase?

64. Placing the light in standby mode when not in use - ✔What are guidelines for safe use of an endoscopic light source?

65. What is a kocher? - ✔an example of an occluding clamp 66. The surgical team member responsible for preparing the surgical specimen to be sent to the lab - ✔Who is the circulating nurse?

67. Exposure to this sterilization method is potentially carcinogenic and mutagenic to personnel and patients. - ✔What is EO 68. The AORN RP that most directly pertains to this phase of cleaning in the Periop environment states that a safe, clean environment should be reestablished after each surgical procedure. - ✔What is interim cleaning?

69. Placing it in a sterile plastic container is the proper handling of this item when removed from a patient for forensic evidence. - ✔What is a bullet?

70. During which phase of Cleaning includes the entire floor, moving the OR bed to clean 3-4 feet around it - ✔What is the activity performed during post-procedure cleaning of the OR? 71. Clinical nurse progression from Novice to Expert requires enhancement of this, and the development and refinement of this is affected by Clinical narratives, simulation, questioning; Partnering with proficient nurses; and the nurse's level of knowledge and experience - ✔What is critical thinking skills?

72. When performing a skin prep on a patient scheduled for a bunionectomy what steps should be included? - ✔a. Prop the foot to allow ample access to all surfaces during the prep b. use an impervious drape to protect the tourniquet c. start at the incision site, include toes and move up the leg.

73. Name the perioperative nurse's role in pt and family education? - ✔a. Explain what the patient will experience b. Provide emotional support to enhance coping c. Teaching specific skills that the pt will need to perform post-op 74. Why should the perioperative nurse ask about a patient's use of herbal preparations, alcohol, tobacco products, and recreational drugs during the perioperative interview. ✔a. Herbal supplements may affect the metabolism of drugs administered b. Recreational drug use may affect choice of preoperative sedation c. Smoking may affect circulatory and respiratory system assessment results 75. List 4 team members who wear sterile gowns and gloves. - ✔a. Scrub person b. Surgical assistant c. Surgeon d. Medical student/resident/PA/NP 76. Name 3 risks to patients and staff members associated with laser use: - ✔a. Eye injury b. Fire hazards c. Inhalation of laser plume -

77. Name 4 types of powered cutting instruments used in surgery - ✔a. Bone reamers b. Dissectors c. Saws d. Tissue shavers 78. Name 2 ways that health care workers are most likely to become sensitized to latex - ✔a. Airborne contact b. Cutaneous contact 79. During admission of a patient to Phase 1 in PACU, what is the Perianesthesia nurse responsible for? - ✔a. Assessing patient's level of consciousness b. Assessing the patient's pain level c. Assessing the surgical dressing d. Maintaining a patent airway e. Monitoring BP, HR, and O2 saturation 80. Name 4 types of biopsies that require specialized methods of preparation and preservation to preserve the cells - ✔a. Bone marrowb. Musclec. Nerved. Testicular81. List 4 items necessary included in Preoperative documentation - ✔a. Administration of ordered preoperative medicationsb. Oral verification by the pt of the procedure to be performedc. Patient allergies to medications and materials used in the surgical suited. Patient identification, using oral verification and patient records82. List Clinical manifestation of a true allergic response to latex - ✔a. Contact urticarialb. Periorbital edema and itchingc. Wheezing83. List 4 components that should be included in documentation of intraoperative patient position. - ✔a. Names of personnel assisting with positioningb. Placement of armsc. Position that pt is placed in for procedured. Use of specific positioning devices84. AORN guidelines for a "time-out" specify that all surgical team members must agree on the following 3 things - ✔a. Name of ptb. Procedure to be performedc. Site of procedure-

85. 4 Barriers to effective pt and family education in the perioperative setting. - ✔a.

Anxiety about an uncertain outcomeb. Discomfort or painc. Fear of unknownd. Short period of time for assessment and teaching88. List Recommended Practices for sponge count procedures - ✔a. Count all sponges at the beginning of the caseb. Separate sponges as they are countedc. Simultaneous counting by two people, including an RN circulatord. Count out loud e. Document all counts 89. List 2 ways that the Perioperative nurse assists with general anesthesia induction ✔a. Apply cricoid pressure if needed during intubationb. Remain at the pts side to offer reassurance and promote safety90. List 3 steps that should be followed to remove of the gown and gloves at the end of the procedure - ✔a. Grasp gown at shoulders and pull downward, turning sleeves inside outb. Remove gown firstc. Use a glove-to-glove and skin-to-skin technique to remove gloves91. List 5 actions that should be included in the perioperative nursing care of a pt with a suspected latex allergy. - ✔a. Assess pts cross-sensitivities and previous reactions to latexb. Indicate latex precaution on door signs for every room pt occupiesc. Use latex-free supplies for IVs, hair covering, dressing materials, etc.d. Verify surgeon is aware of the allergye. Schedule pt as first case of the day if possible 92. List 5 steps that should be followed in correctly draping the sterile field - ✔a. Drape from sterile to unsterile areasb. Drape from operative site outwardc. Form a cuff with the drape and place gloved hands under the cuffd. Handle each drape as little as possiblee. If draping without assistance, walk around the OR bed to drape the other side93. State 4 reasons why perioperative pt and family education is important - ✔a.

Conveying genuine caring for the pts well-beingb. Increasing pt and family adherence to the plan of carec. Increasing pts and family satisfaction with quality of cared. Legal, ethical, and regulatory mandates-

95. 4 things the perioperative nurse should do when setting up the insufflation equipment for an abdominal endoscopic procedure - ✔a. Have a back up tank availableb. Verify that CO2 pressure and supply alarms are on and functioningc. Position the insufflator at pts heart level or above d. Verify that the tank valve is open 96. Name 2 methods or items that accomplish hemostasis by occluding a severed blood vessel, and causing platelets to clump together - ✔a. Ligaturesb. Pledget97. Name 4 ways to prevent or minimize ESU injuries to the pt - ✔a. Assure that prep solutions have dried and vapors evaporated before the device is usedb. Confirm each requested power setting change orally with the surgeonc. Inspect each circuit component if the surgeon repeatedly requests higher power settingsd. Inspect the ESU unit before use to verify electrical integrity 98. List 3 things the perioperative nurse should do when a Bier Block is used during a procedure - ✔a. Check the calibration of the tourniquet before applying itb. Monitor the length of time the tourniquet is inflatedc. Deflate the tourniquet slowly d. Inflate the proximal cuff first 99. Name 2 unique identifiers to ensure proper handling of surgical specimens verified by the perioperative nurse before the pt enters the OR. - ✔a. Pts medical record numberb. Spelling of pts name100. A psychosocial assessment of your pt should include: - ✔a. Cultural beliefs and practicesb. Expectations of perioperative carec. Spiritual or religious beliefsd. Understanding of the surgical procedure101. The Perioperative nurse's documents of the skin prep procedure should include ✔a. Body area preppedb. Name of person performing prepc. Preoperative assessment of skin at the operative sited. Skin prep agente. Type and extent of hair removal if ordered102. What special care procedures are required for microsurgical instruments - ✔a.

Keep stainless steel and titanium instruments separatedb. Use a non-fibrous sponge wipe to clean the instrument tip if recommendedc. Use tip covers or protective sleeves when instruments are not being used-

103. Name factors regarding the proper attire of surgical team member - ✔a. Sterile gowns should resist fluid strike-throughb. Head covering should be donned before pulling on the scrub topc. Scrub top must be secured at the waist or tucked into the pantsd. Shoe covers are optional e. Masks are changed after each patient 104. What phases of the nursing process that the perioperative nurse practices during the preoperative phase of the surgical experience? - ✔a. Assessmentb. Identification of desired outcomec. Nursing diagnosisd. Planning105. Name 4 practices you should follow during the surgical scrub procedure - ✔a.

Fingernails should be cleaned under running waterb. Stand slightly back from the sink and lean over to prevent splashing scrub suitc. Forearms scrubbed 2" above the elbow d. Hands held higher than the elbows to scrub and rinse 106. What are practices from AORN RP V that states "a sterile field should be maintained and monitored constantly." - ✔a. The sterile field should be constantly monitoredb. The sterile field should be prepared as close as possible to the time of usec. The sterile field may be covered with a sterile drape107. What are 3 Safety precautions when handling and caring for powered instrument ✔a. Hand the powered instrument to the surgeon with the safety mechanism onb. Have irrigation ready to use with the drill or sawc. Use the instrument with the blade or drill guard in place108. A patient is unable to transfer independently to the procedure bed. To achieve the PNDS outcomes related to safe patient transfer, which measures may be used to prevent shearing injury? - ✔a. Request additional personnel to assist with pt transferb. Use a friction-reducing transfer sheetc. Use a slider or roller boardd. Use the draw sheet to lift the pt slightly to allow the skin to realign with skeletal structure109. What Practices are recommended during decontamination of used instruments ✔a. Open box locks and disassemble instrument with multiple partsb. Use enzymatic detergent on heavily soiled instrumentsc. Wear PPE-

110. What is the Perioperative nurses role in preparing and administering meds - ✔a.

Assess pts medication allergies and use of herbal or dietary supplementsb. Verify the administration of the correct med, dose, and routec. Writing down and reading back the surgeons oral orders before preparing medicationd. Verify expiration date 111. The OR management team has responsibility for safety in the surgical suite which includes: - ✔a. Establishing policies related to electrical, fire, radiation, pt management safetyb. Monitoring adherence to safety policies and practicesc. Providing education to staff members regarding safety policies and proceduresd. Reporting safety hazards and violations to appropriate authorities112. The OR staff members are responsible for maintaining a safe OR environment which include: - ✔a. Adhering to facility policies related to safetyb. Consistently applying OR-specific safety practicesc. Reporting safety hazards and violations to appropriate authorities113. The EPA registered germicides labeled as hospital disinfectants must demonstrate effectiveness against these 3 microorganisms: - ✔a. Pseudomonas aeruginosab. Salmonella cholera suisc. Staphylococus aureusa. Anxiety about an uncertain outcome b. Discomfort or pain c. Fear of unknown d. Short period of time for assessment and teaching - ✔a. Diabetesb. Protein deficiencyc. Smokingd. Steroid useEvaluation of pt outcomes, Nursing plan of care, Occurrence of any unusual events, and Periop nurses legal signature are components that should be included in this ✔perioperative nursing documentation.

Skin prep agent contraindicated for use during reconstruction of the external ear. ✔What is CHG? The most important consideration when selecting these materials is to prevent risk of contaminating patients with endogenous and exogenous microorganisms; and risk of exposing healthcare workers to patient's blood and body fluids - ✔What are draping materials?

The purposes of the surgical hand scrub - ✔a. Reduce risk of microbial contaminationb. Remove soil and debris-

c. Suppress growth of microorganisms-