Operating Room Procedures and Safety Guidelines, Exams of Nursing

Download Operating Room Procedures and Safety Guidelines and more Exams Nursing in PDF only on Docsity! 1 / 42 AORN PERIOP 101 FINAL EXAM LATEST ALL 168 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)/AGRADE 1. Using mechanical friction when prepping will NOT aid in A. Removal of resident bacteria B. Removal of dirt and oil C. The effectiveness of antimicrobials D. Removal of transient bacteria-CORRECT ANSWER- A. Removal of resident bacteria 2. Reduction in resident bacteria is aided by A. Use of a degreaser B. Use of antimicrobials C. Prepping clean to dirty D. Mechanical friction-CORRECT ANSWER- B. Use of antimicrobials 3. Prolonged contact of skin antisepsis agents due to pooling of the solutions can cause patient injuries that include 1. Chemical burns 2. Thermal burns 3. Injuries related to equipment malfunction-CORRECT ANSWER- A. 1 and 2 4. Which one of the following statements is TRUE? A. Povidone-iodine's mechanism of action is to disrupt the cell membrane B. Povidone-iodine is nonirritating to the skin C. Povidone-iodine cannot be used on mucous membranes D. Heating povidone-iodine may decrease its effectiveness-CORRECT ANSWER- D. Heating povi- done-iodine may decrease its effectiveness 2 / 42 5. Documentation of the preoperative skin prep includes all of the follow EXCEPT A. Hair removal B. Manufacturer of solutions used C. Allergies D. Name of the person who performed the prep-CORRECT ANSWER- B. Manufacturer of solutions used 6. When prepping an extremity, which one of the following is ALWAYS re- quired? A. Positioning the extremity to prevent prep solution from running toward the incision site B. Assistance in holding the limb C. Scrubbing nails with a brush before the formal prep D. Prepping so that the entire limb can be draped-CORRECT ANSWER- A. Positioning the extremity to prevent prep solution from running toward the incision site 7. Surgical wound infections can result in decreased . A. Hospitalization time B. Intraoperative time C. Income for hospitals D. Workload for perioperative nurses-CORRECT ANSWER- C. Income for hospitals 8. Preoperative skin preparation is accomplished by . A. Removing soil and transient microbes B. Reducing resident microbes C. Using antimicrobial agents that inhibit growth of microbes D. All of the above-CORRECT ANSWER- D. All of the above 9. According to AORN's guidelines for skin preparation of patients, hair at the operative site is . 5 / 42 C. It has been shown to be nontoxic and nonirritating D. Percutaneous absorption does not occur across mucous membranes-CORRECT ANSWER- - It provides rapid reduction in microbial counts of skin 18. Which statement is FALSE about eye, extremity, or vaginal preps? A. A 5% sterile ophtalmic prep solution is commercially available for eye preps B. The vagina should be prepped first as part of a vaginal prep C. When prepping an extremity, it should be positioned so that the incision site is the upper- most portion of the prep D. If fingers or toes are included in the surgical field (extremity prep), it may be necessary to scrub the nail with a brush and soap solution-CORRECT ANSWER- B. The vagina should be prepped first as part of a vaginal prep 19. Hand hygiene should be performed after which of the following? A. Touching the operating room bed controls B. Adjusting a patient's bed linens C. Eating D. Marking the surgical site E. All of the above-CORRECT ANSWER- E. All of the above 20. When should perioperative team members use an alcohol-based rub for hand hygiene? A. After hands have been exposed to blood or other bodily fluids B. After using the restroom C. When the hands are not visibly soiled D. When caring for patients with spore-forming organisms-CORRECT ANSWER- C. When the hands are not visibly soiled 21. What is the minimum length of time perioperative team members should spend performing hand hygiene by washing with soap and water? 6 / 42 A. 7 seconds B. 15 seconds C. 20 seconds D. 30 seconds-CORRECT ANSWER- B. 15 seconds 22. How much of an alcohol-based hand rub should be used when performing hand hygiene? A. A dime-sized amount B. A quarter-sized amount C. 10 drops D. The amount recommended by the manufacturer-CORRECT ANSWER- D. The amount recommend- ed by the manufacturer 23. Perioperative team members should maintain fingernails at a maximum of what length? A. 2 mm (0.08 inch) B. 6 mm (0.24 inch) C. 10 mm (0.4 inch) D. 12 mm (0.5 inch)-CORRECT ANSWER- A. 2 mm (0.08 inch) 24. Which of the following measures is helpful for maintaining healthy skin and minimizing the risk of hand dermatitis? A. Completely drying hands before putting on gloves B. Avoiding water hotter than 80° F (27° C) C. Using approved moisturizing products D. Using glove liners E. All of the above-CORRECT ANSWER- E. All of the above 25. Which of the following types of jewelry is acceptable for perioperative team members to wear in patient care areas? 7 / 42 A. One ring per hand B. Watch C. Loose bracelet D. Fitness monitor E. No jewelry is acceptable-CORRECT ANSWER- E. No jewelry is acceptable 26. Which of the following is a primary line of defense for protecting the patient from the transmission of pathogens during surgical procedures? A. Sterile gloves B. Sterile gowns C. Surgical hand antisepsis D. Surgical masks-CORRECT ANSWER- C. Surgical hand antisepsis 27. Which of the following parts of the surgical gown is considered sterile? A. The axillary region B. The back C. The cuff of the gown sleeve D. The front from the chest to the level of the sterile field E. The shoulders-CORRECT ANSWER- D. The front from the chest to the level of the sterile field 28. Which method of gloving should be used by team members during the initial gowning and gloving process for surgical procedures? A. Assisted gloving with gown cuffs at fingertips B. Assisted gloving with gown cuffs at wrists C. Open gloving D. Open assisted gloving E. Any of the above-CORRECT ANSWER- A. Assisted gloving with gown cuffs at fingertips 29. How often should surgical gloves be changed during an invasive surgical procedure? A. Every 60 to 90 minutes B. Every 90 to 150 minutes 10 / 42 to the side E. All of the above-CORRECT ANSWER- C. Place the opening of the laparotomy sheet directly over the surgical site 38. Which of the following is an important consideration when draping pa- tients for procedures on the eye? A. It is important to repel water B. The environment must be free of lint C. Cataract procedures are often performed without sedation D. Adequate air exchange for the patient must be maintained E. All of the above-CORRECT ANSWER- E. All of the above 39. The perioperative RN should follow which of these procedures when drap- ing equipment? A. Drape equipment that will be positioned over the sterile field B. Drape equipment that will be positioned immediately adjacent to the sterile field C. Drape large pieces of equipment as close to the time of use as possible D. Follow the manufacturer's instructions for use E. All of the above-CORRECT ANSWER- E. All of the above 40. Which of the following is an acceptable position for the hands and arms of a scrubbed person for maintaining the integrity of the sterile field? A. Straight down at the sides B. Above waist level C. Folded with hands in the axillary area D. Resting against another scrubbed person's back E. All of the above-CORRECT ANSWER- B. Above waist level 41. When should perioperative team members wear surgical attire and a sur- gical head covering? A. Any time they enter an operating room for any reason B. Only when they are directly involved with patient care 11 / 42 C. Only when they are part of the scrubbed team D. Only when they are transferring sterile items to the sterile field E. Only when they will remain in an operating room for more than 1 minute-CORRECT ANSWER- A. Any time they enter an operating room for any reason 42. Which of the following is the most important practice for minimizing the risk for infectious organism transmission? A. Keeping doors to the operating room closed B. Observing isolation precautions C. Performing hand hygiene and surgical hand antisepsis D. Properly preparing the sterile field E. Wearing a gown and gloves-CORRECT ANSWER- C. Performing hand hygiene and surgical hand antisepsis 43. Which of the following parts of a surgical gown are considered sterile? A. The back B. The neckline C. The shoulders D. The sleeves from the cuff to 2 inches above the elbow E. All of the above-CORRECT ANSWER- D. The sleeves from the cuff to 2 inches above the elbow 44. Which of the following statements about preparation of sterile fields is most accurate? A. Sterile fields for all procedures planned for the day should be prepared in the morning before patients arrive B. Sterile fields should be prepared in a dedicated sterile room and transport- ed to the operating rooms for use C. Perioperative team members should perform surgical hand antisepsis be- fore preparing a surgical sterile field D. Sterile fields for multiple patients can be prepared at the same time to improve efficiency- CORRECT ANSWER- C. Perioperative team members should perform surgical hand antisepsis before preparing a surgical sterile field 12 / 42 45. Which of the following areas of a properly draped sterile field is considered sterile? A. The bottom B. The sides C. The top D. Any area above the tallest scrubbed team member's waistline E. All of the above-CORRECT ANSWER- C. The top 46. Which of the following isolation technique procedures should be followed to prevent the spread of cancer cells from one area to another during resection of metastatic tumors? A. Changing surgical gloves when soiled B. Covering existing sterile drapes with new sterile drapes after the resection C. Discontinuing use of instruments after they were used for the tumor exci- sion D. Organizing the sterile field in a way that minimizes risk of exposure to cancerous cells E. All of the above-CORRECT ANSWER- E. All of the above 47. Which of the following practices should be followed when transferring sterile items to the sterile field? A. An unscrubbed team member should stand as close as possible to the sterile field when transferring items B. Only a scrubbed team member may transfer sterile items to the sterile field C. Open and transfer all sterile items needed for the procedure to the sterile field before the patient enters the room D. Present heavy or sharp sterile items directly to a scrubbed team member receiving the items onto the sterile field E. Toss sterile items onto the sterile field from a distance whenever possi- ble-CORRECT ANSWER- D. Present heavy or sharp sterile items directly to a scrubbed team member receiving the items onto the sterile field 48. What is the best practice to follow if a contaminated item is discovered in a set of sterilized instruments? A. Consider all opened instruments in the room to be contaminated B. Con- sider only the 15 / 42 knee arthroplasty. Which of the following is NOT a primary contraindication for pneumatic tourniquet use? A. Significant vascular disease, including recent bypass, history of deep venous thrombosis, or impaired peripheral circulation B. Sickle cell anemia and other forms of hemoglobinopathy C. History of pain or weakness in the bones or muscles of the extremities D. History of ulcerative colitis-CORRECT ANSWER- D. History of ulcerative colitis 57. Choose the FALSE statement about pneumatic tourniquet safety. A. Wider, contoured cuffs are generally safer than narrow cuffs because they require less pressure to achieve a near bloodless field B. Increased tourniquet time increases the risk of postoperative complica- tions C. Narrow cuffs are generally safer than wide, contoured cuffs because they require less pressure to achieve a near bloodless field D. Increased cuff pressure increases the risk of postoperative complications- -CORRECT ANSWER- C. Narrow cuffs are generally safer than wide, contoured cuffs because they require less pressure to achieve a near bloodless field 58. Choose the FALSE statement regarding intravenous regional anesthesia (Bier's block). A. After a procedure is over, the perioperative nurse should leave the cuff fully inflated for at least 60 minutes B. Intermittently deflating and reinflating the cuff for several cycles after the procedure is over may help minimize peak blood concentration of the local anesthetic and reduce the risk of a systemic toxic reaction C. Central nervous system abnormalities are usually the earliest warning signs of a systemic toxic reaction during intravenous regional anesthesia D. Before applying a pneumatic tourniquet, nurses should screen patients for sensitivities to local anesthetics and communicate with the anesthesia professional to confirm the plan for intravenous regional anesthesia-CORRECT ANSWER- A. After a procedure is over, the perioperative nurse should leave the cuff fully inflated for at least 60 minutes 16 / 42 59. Choose the extremity and nerve most frequently affected by pneumatic tourniquet- induced nerve damage. A. Lower limb, peroneal nerve B. Upper limb, radial nerve C. Upper limb, median nerve D. Upper limb, ulnar nerve-CORRECT ANSWER- B. Upper limb, radial nerve 60. A perioperative nurse is assessing patients for DVT risk factors prior to lower limb surgeries. Based on the following descriptions, which patient DOES NOT have risk factor(s) for DVT? A. A 35 year old patient on prolonged bed rest B. A 70 year old smoker with no history of significant medical problems C. An obese 45 year old who is otherwise healthy D. A 20 year old non-smoking athlete with a left anterior cruciate ligament tear-CORRECT ANSWER- D. A 20 year old non-smoking athlete with a left anterior cruciate ligament tear 61. The average estimated number of surgical fires every year in the United States is- CORRECT ANSWER- A. 20 to 30 B. 200 to 240 C. 700 to 1000 D. 2000 to 2500 E. 2500 to 2700-CORRECT ANSWER- B. 200 to 240 62. Choose the FALSE statement about perioperative fire prevention and man- agement plans. A. They should be developed by a multidisciplinary group of key stakeholders B. They should describe key content and frequency of fire safety education activities C. They should specify policies and procedures for fire prevention and re- sponse D. They generally are not needed unless required by a health care facility's insurance policy E. They should specify team member roles and responsibilities during fire prevention and response-CORRECT ANSWER- D. They generally are not needed unless required by a health care 17 / 42 facility's insurance policy 63. The three components of the fire triangle are oxidizing source, ignition source, and fuel source. A. True B. False-CORRECT ANSWER- A. True 64. The three overriding principles of operating room fire safety are A. Awareness, communication, teamwork B. Oxidizing source, heat source, fuel source C. Inspect, check, respond D. Prevent, extinguish, evacuate E. Source, extinguish, safety-CORRECT ANSWER- D. Prevent, extinguish, evacuate 65. Examples of ignition sources include A. Electrocautery units and active electrosurgical electrodes B. Fiber-optic light cords C. Lasers D. A and C E. A, B, and C-CORRECT ANSWER- E. A, B, and C 66. A fire risk assessment should be performed A. Only before procedures involving electrocautery, an electrosurgical unit, or a laser B. Only if requested by the surgeon or first assistant C. Before all operative procedures D. Only before surgical procedures above the xiphoid process and in the nasopharynx E. Only if the patient requires more than 30% supplemental oxygen-CORRECT ANSWER- C. Before all operative procedures 67. he flash point of flammable materials is , while the flash point of combustible materials is A. Less than 100° F, greater than 100° F 20 / 42 C. Water mist extinguisher D. Foam extinguisher E. A or C-CORRECT ANSWER- wrong 75. Patients and personnel must be evacuated because of an operating room fire. The proper order of steps to take is A. Alarm, confine/contain, rescue, evacuate B. Rescue, alarm, confine/contain, evacuate C. Rescue, evacuate, alarm, confine/contain D. Confine/contain, alarm, rescue, evacuate E. Alarm, rescue, evacuate, confine/contain-CORRECT ANSWER- B. Rescue, alarm, confine/contain, evacuate 76. If evacuated because of a fire, health care personnel should go A. To the front doors of the building B. Outside the building C. Behind at least two sets of fire doors D. To the nearest stairwell E. To the nearest safe location where they can resume caring for patients-CORRECT ANSWER- E. To the nearest safe location where they can resume caring for patients 77. A scrubbed perioperative registered nurse observes a fire start on a pa- tient in the operating room. After alerting the team, the nurse should immedi- ately A. Obtain and operate the nearest fire extinguisher by using the PASS tech- nique B. Pat the flames with a drape C. Smother the fire with a towel or pour nonflammable liquid on the fire D. Lift the patient and transport him or her out of the room E. Turn off the oxygen source-CORRECT ANSWER- C. Smother the fire with a towel or pour nonflam- mable liquid on the fire 78. Which practice is NOT recommended to prevent fires during surgeries at high-risk sites? 21 / 42 A. use an ignition source to enter gas-distended bowel B. pack the back of the throat with radiopaque sponges prior to tonsillectomy C. stop supplemental oxygen or nitrous oxide for one minute before using an ignition source D. place an adhesive incise drape between the surgical site and the oxygen source E. inflate endotracheal tubes with tinted solutions prior to tracheotomy-CORRECT ANSWER- A. use an ignition source to enter gas-distended bowel 79. Ifan airway fire occurs, perioperative team members should be prepared to help the anesthesia professional do which of the following A. disconnect and remove the anesthesia circuit and turn off the flow of oxygen B. remove the endotracheal tube from the airway, including any burned fragments C. pour saline or water into the airway D. examine and re-establish the airway E. assess the surgical field for secondary fire F. all of the above-CORRECT ANSWER- F. all of the above 80. All of the following are appropriate practices to manage oxidation sources in the operating room EXCEPT A. administer the lowest concentration of oxygen needed to maintain ade- quate oxygen saturation B. use a laryngeal mask or endotracheal tube if the patient needs more than 30% supplemental oxygen C. ensure that there are no leaks in the anesthesia circuit D. turn the warmer blower off when using a warming blanket with an attached head drape E. prevent oxygen from accumulating under drapes-CORRECT ANSWER- wrong 81. Which of the following is a potential oxidizer for fires in the operating room? A. Electrosurgical units B. Gauze C. Nasal cannulae 22 / 42 D. Nitrous oxide E. Solutions containing alcohol-CORRECT ANSWER- wrong 82. All of the following are safety precautions common to all energy-generat- ing devices EXCEPT A. Alcohol-soaked pads should not be allowed on the surgical field when energy- generating devices are used B. Foot pedals should be enclosed in a fluid resistant cover whenever there is potential for a fluid spill C. Oxygen delivery to the patient should be stopped or reduced to the lowest possible level when energy-generating devices are used around the head, face, or neck D. The RN circulator should activate the foot pedal at the direction of the surgeon using the hand piece E. The lowest power settings that will accomplish the desired task should be used-CORRECT ANSWER- D. The RN circulator should activate the foot pedal at the direction of the surgeon using the hand piece 83. When is it acceptable to disable the alarms on energy-generating devices? A. Alarms should never be disabled B. During the time out before the procedure C. When the device is on standby D. When they are creating a distraction for the practitioner performing the procedure E. When they are making the patient anxious-CORRECT ANSWER- A. Alarms should never be disabled 84. Which of the following is an accurate statement about dispersive pads used with monopolar electrosurgical units? A. Disposable pads can be removed and repositioned several times B. The pad should be cut to conform to the curves of the patient's body C. The pad should be placed as far from the surgical site as practical to minimize interference with the procedure 25 / 42 C. Intermediate-level disinfectant D. Sanitizer-CORRECT ANSWER- wrong 93. Terminal cleaning is typically the responsibility of the Environmental Ser- vices Team. A. True B. False-CORRECT ANSWER- A. True 94. Dust is not known to contain human skin and hair, pollens, and mold. A. True B. False-CORRECT ANSWER- B. False 95. Infections can potentially be acquired from which of the following sources? A. Contaminated environmental surfaces B. Contaminated hands C. Contaminated skin D. All of the above-CORRECT ANSWER- D. All of the above 96. Federal law requires that all sharps be placed in biohazard containers prior to disposal. A. True B. False-CORRECT ANSWER- A. True 97. Which of the following basic components of personal protective equip- ment should be worn by the perioperative nurse when likely contacting po- tentially infectious material? A. Gloves B. Gown, mask, and eye shields C. N-95 respirator D. All of the above-CORRECT ANSWER- wrong 98. Which federal agency regulates the Bloodborne Pathogens Standard? A. AORN B. CDC C. HHS D. OSHA-CORRECT ANSWER- D. OSHA 26 / 42 99. Which of the following are typical microorganisms found in the periopera- tive setting? A. ESBL-producing organisms B. Serratia C. Staphylococcus D. All of the above-CORRECT ANSWER- D. All of the above 100. Clostridium difficile is primarily transmitted via which of the following routes? A. Respiratory/inhalation B. IV Injection C. Fecal-oral D. None of the above-CORRECT ANSWER- C. Fecal-oral 101. Which of the following pathogens requires special attention for disinfec- tion of tsurfaces contaminated with brain, eye, or spinal cord tissue? A. CJD B. Clostridium difficile C. MRSA D. VRE-CORRECT ANSWER- A. CJD 102. Which of the following microorganisms are found routinely in water pipes in ceilings or during wall demolitions? A. MRSA B. VRE C. Aspergillus D. None of the Above-CORRECT ANSWER- C. Aspergillus 103. Floors should be mopped or wet-vacuumed with an EPA registered dis- infectant after all scheduled cases are completed. A. True B. False-CORRECT ANSWER- A. True 104. Liquid waste can be disposed in which of the following manners? 27 / 42 A. Adding a solidifying powder to the liquid B. Using a medical liquid waste disposal C. Pouring the liquid down a sanitary sewer D. All of the above-CORRECT ANSWER- D. All of the above 105. Disinfectants used in health care facilities do not require EPA registration. A. True B. False-CORRECT ANSWER- B. False 106. Damp-dusting should be performed using EPA registered disinfectant. A. True B. False-CORRECT ANSWER- A. True 107. Which of the following would be considered noncritical items? A. Blood pressure cuffs B. Foley catheters C. Needles D. All of the above-CORRECT ANSWER- A. Blood pressure cuffs 108. Ice machines are known vectors of infection transmission when not properly maintained and cleaned. A. True B. False-CORRECT ANSWER- A. True 109. A hierarchy of controls should be used to prevent sharps and injuries in health care settings. The CORRECT order of implementation, ranked from potentially most effective to least effective, is-CORRECT ANSWER- A. Hazard elimination, engineering controls, work practice controls, adminis- trative controls, PPE B. Hazard elimination, work practice controls, engineering controls, PPE, ad- ministrative controls C. Engineering controls, hazard elimination, administrative controls, work practice controls, PPE 30 / 42 117. Choose the FALSE statement about introducing safety engineered sharps devices in health care settings? A. Sharps products under consideration should primarily be evaluated by administrators who can compare them to benchmarking standards B. Sharps products under consideration by a facility should be evaluated by front-line users trained in correct use of the device C. Final product selections should be based on results of a one-page tester survey tool that is easy to complete and score and includes room for com- ments D. Safety engineered devices must be evaluated every year-CORRECT ANSWER- A. Sharps products under consideration should primarily be evaluated by administrators who can com- pare them to benchmarking standards 118. Bloodborne pathogen exposure control plans must conform to all of the following EXCEPT A. Be written and must follow federal, state, and local rules and regulations B. Establish and define work restrictions for health care workers who have transmissible bloodborne infections C. Specify processes for education, training, competency evaluation, evalua- tion of the efficacy and utility of sharps safety devices, and annual review of sharps safety issues D. Be posted in every room in which sharps are handled-CORRECT ANSWER- D. Be posted in every room in which sharps are handled 119. Double gloving is an example of using PPE to reduce the risk of sharps injuries. Based on available evidence about its effectiveness, double gloving should be practiced A. When the surgeon gives consent to do so B. During all surgical procedures C. When there is a written policy requiring the use of double gloves during surgery D. When the surgical patient is known to have a bloodborne pathogen infec- tion-CORRECT ANSWER- B. During all surgical procedures 120. Engineering controls help prevent sharps injuries. Which statement about safety 31 / 42 engineered devices is FALSE? A. Safety engineered devices include blunt-tip needles, single-use scalpels, retractable scalpels, and needles with sliding sheaths or needle guards B. Studies have not yet shown that safety engineered devices significantly reduce needlestick injuries, but they should be used anyway as a precaution C. Safety engineered devices should be used during surgery unless their use could negatively affect patient safety D. Blunt-tip needles are safety engineered devices designed to penetrate mus- cle and fascia, but not skin-CORRECT ANSWER- B. Studies have not yet shown that safety engineered devices significantly reduce needlestick injuries, but they should be used anyway as a precaution 121. Which statement about neutral zones is FALSE? A. A kidney basin is appropriate for a neutral zone B. The neutral zone should be designated during preoperative briefing C. When moving a sharp to the neutral zone, give verbal notice such as saying "sharp" D. Only one sharp and one hand at a time should be in the neutral zone E. The sharp should be positioned for easy retrieval by the surgeon-CORRECT ANSWER- A. A kidney basin is appropriate for a neutral zone 122. If a needle must be-recapped, the proper technique to use is A. Hold the cap with your fingers sideways and slide the needle into the cap with your other hand B. With the cap on a stable, flat surface, guide the needle into the cap while holding only the syringe attached to the needle, then tip up the syringe so the cap sits on the needle hub and secure the cap in place C. Hold the syringe vertically while sliding the cap over the needle D. Use both hands to center and push the cap onto the needle-CORRECT ANSWER- B. With the cap on a stable, flat surface, guide the needle into the cap while holding only the syringe attached to the needle, then tip up the syringe so the cap sits on the needle hub and secure the cap in place 123. Which of the following is NOT an appropriate way to prevent sharps injuries in the 32 / 42 OR? A. Communicating the location of sharps on the sterile field during personnel changes B. Removing suture needle from suture before tying C. Using double-gloved hands to retract tissue D. Cutting the exposed ends of sharp pins or Kwires, or covering them with a protective cap after they have passed through a patient's skin-CORRECT ANSWER- C. Using double-gloved hands to retract tissue 124. Needleless systems should be used when A. Withdrawing fluids from multi-use vials B. Withdrawing body fluids after establishing initial access C. Administering fluids or medications D. Withdrawing IV fluids E. A, B, and C F. B, C, and D G. A and D H. A, B, C, and D-CORRECT ANSWER- D. Withdrawing IV fluids 125. Select the FALSE statement about alternative wound closure. A. Tissue adhesive is comparable to suture in terms of infection rates, cost, and patient and user satisfaction B. Tissue adhesive enables faster wound closure than suture C. Tissue adhesive can be associated with higher rates of wound dehiscence than suture D. Other examples of alternative wound closure devices include tissue sta- plers and adhesive skin closure strips-CORRECT ANSWER- B. Tissue adhesive enables faster wound closure than suture 126. If a sharps injury occurs during a surgery, employers must A. Report the name of the injured worker and details of the exposure to OSHA B. Conduct source testing and risk assessment 35 / 42 B. Whenever possible to attenuate radiation C. If a patient or staff person requests it D. If an ionizing radiation dose to a patient is expected to exceed 20 rem-CORRECT ANSWER- B. Whenever possible to attenuate radiation 136. A 0.25 mm lead apron will reduce scattered x-rays by approximately A. 15% B. 25% C. 50% D. 95%-CORRECT ANSWER- D. 95% 137. Average cumulative radiation exposure has in the past several decades as a result of changes in medical applications of ionizing radiation A. Decreased B. Increased C. Remained about the same-CORRECT ANSWER- B. Increased 138. A person who works with radiation is required to be monitored if A. He or she asks to be B. His or her annual dose is likely to exceed 15 mrem C. He or she is likely to exceed 10% of the dose limit D. He or she is likely to exceed 50% of the dose limit-CORRECT ANSWER- C. He or she is likely to exceed 10% of the dose limit 139. For adults who work with radiation, the annual occupational whole body dose limit is A. 5 rems B. 15 rems C. 50 rems D. 500 rems-CORRECT ANSWER- wrong 140. For adults who work with radiation, the annual dose limit for the skin/ex- tremities is A. 5 rems 36 / 42 B. 15 rems C. 50 rems D. 500 rems-CORRECT ANSWER- C. 50 rems 141. For adults who work with radiation, the annual dose limit for the lens of the eye is A. 5 rems B. 15 rems C. 50 rems D. 500 rems-CORRECT ANSWER- B. 15 rems 142. For minors who work with radiation, the annual dose limit is A. 10% of adult dose limits B. 50% of adult dose limits C. 75% of adult dose limits D. 150% of adult dose limits-CORRECT ANSWER- A. 10% of adult dose limits 143. The dose limit for a fetus is A. 0.5 rem during the entire pregnancy B. 0.5 rem per month C. 5 rem during the entire pregnancy D. 5 rem per month-CORRECT ANSWER- A. 0.5 rem during the entire pregnancy 144. The linear-no-threshold model assumes that the stochastic effects of radiation A. Are inversely proportional to the dose B. Are directly proportional to the dose C. Occur only after a certain level of cumulative exposure D. Increase exponentially as exposure increases-CORRECT ANSWER- B. Are directly proportional to the dose 145. All of the statements about the proper use of dosimeters (badges) in the workplace are TRUE except for A. When one dosimeter is used, all personnel should wear it at the same place on the body 37 / 42 B. Badges should be exchanged for assessment and replaced at pre-deter- mined intervals C. Badges should not be taken home at the end of the workday D. The best place to leave a badge when not in use is on an apron-CORRECT ANSWER- D. The best place to leave a badge when not in use is on an apron 146. Badges worn by pregnant personnel should be worn at waist level and read every A. Week B. Month C. Three months D. Six months-CORRECT ANSWER- B. Month 147. If a health care worker who works with radiation becomes pregnant, she should A. Stop working with any form of radiation B. Promptly inform the radiation safety officer C. Wear a badge at waist level outside her apron D. Switch from a lead apron to a lead-free alternative for comfort-CORRECT ANSWER- B. Promptly inform the radiation safety officer 148. The most serious long-term effect of ionizing radiation exposure is A. Blindness B. Osteoporosis C. Cancer D. Skin injuries-CORRECT ANSWER- C. Cancer 149. To minimize patients' risk of adverse effects from radiation exposure, perioperative nurses should do all of the following except A. Keep extraneous body parts out of the primary radiation beam B. Place lead shielding between the radiation source and the patient C. Place lead shielding on the opposite side of the patient from the radiation source D. Check medical records before radiographic procedures to ensure patients do not have substantial amounts of residual radioactive material in their bodies-CORRECT ANSWER- C. Place 40 / 42 enlarged left cervical lymph node. Her prior exposure to ionizing radiation is minimal. The woman later determines that she was approximately 10 days pregnant when the radiographs were taken. This woman most likely has a A. Substantially increased risk of later developing cancer B. Very small increased risk of later developing cancer C. Substantially increased risk of spontaneous abortion D. Substantially increased risk of having a child with a hereditary defect, such as trisomy 21 (Down's syndrome)-CORRECT ANSWER- B. Very small increased risk of later developing cancer 158. When distance from the point source of radiation doubles, ionizing radi- ation exposure is approximately A. One quarter of the previous level B. One third of the previous level C. The same as before D. Twice the previous level-CORRECT ANSWER- Incorrect 159. In 1920, an organization that developed a standard curriculum of OR techniques was A. American Medical Association B. AORN C. Bellevue Hospital D. The National League of Nursing-CORRECT ANSWER- D. The National League of Nursing 160. Perioperative RNs primarily use checklists to ensure that A. Lawsuits from the patient and their family are avoided B. Surgical supplies are not wasted before or after surgery C. Team members begin shifts on schedule D. The plan of care is implemented correctly before, during, and after surgery- -CORRECT ANSWER- D. The plan of care is implemented correctly before, during, and after surgery 161. The TIME OUT should be performed by which member(s) of the perioper- ative team? 41 / 42 A. All perioperative team members B. RN circulator C. Scrub person D. Surgeon-CORRECT ANSWER- A. All perioperative team members 162. This perioperative RN coordinates the patient's care in the OR, prepares the OR, and assists the anesthesia professional if requested. A. PACU RN B. Pre-admission RN C. RN circulator D. RN first assistant-CORRECT ANSWER- C. RN circulator 163. Which of the following best describes the semirestricted area? A. Has work areas for processing and storing instruments B. Includes an operating room C. Permits wearing of street clothes D. Requires that all patients wear masks-CORRECT ANSWER- A. Has work areas for processing and storing instruments 164. What statements below are TRUE related to creating and maintaining a sterile field? A. A sterile field should be prepared as near as possible to the start time of the surgery B. Movement of personnel around the sterile field should be minimized C. The scrub person is a part of the sterile field D. All of the above E. A and B only-CORRECT ANSWER- D. All of the above 165. Approximately what percentage of serious medical errors are thought to be associated with miscommunication during patient hand-offs? A. < 1% B. 10% C. 50% 42 / 42 D. 80% E. 100%-CORRECT ANSWER- D. 80% 166. Examples of allied healthcare providers include A. Anesthesia technicians B. Surgical residents C. Surgical technologists D. All of the above E. A and C only-CORRECT ANSWER- E. A and C only 167. Patients who are "fast-tracked" from the OR to the PACU Phase II due to the administration of rapidonset, fast-emergence, general anesthetics may require an increased use of which prophylactic medications? A. Antiemetics B. Antihypertensives C. Pain medications D. All of the above E. A and C only-CORRECT ANSWER- E. A and C only 168. The PACU RN observes his patient is more alert and functional and no longer requires intensive nursing care. The PACU RN focuses on preparing the patient for self-care and care by support persons. Select this patient's phase in recovery. A. Phase I B. Phase II C. Phase III D. Phase IV E. Not possible to state based on this information-CORRECT ANSWER- B. Phase II