CNOR Practice Exam Prep by CCI Questions with Answers 2024., Exams of Nursing

Download CNOR Practice Exam Prep by CCI Questions with Answers 2024. and more Exams Nursing in PDF only on Docsity! CNOR Practice Exam Prep by CCI Questions with Answers 2024. Which patient population is more sensitive to dosage errors A. Male patients 25-40 B. Bariatric patients C. A patient with a history of polypharmacy D. Pediatric patients ✔ D. Pediatric patients The National Patient Safety Goals directed at improving staff communication review the need for A. ensuring important test results are communicated to the right person on time B. transferring patients to the correct next level of care C. completing perioperative charting prior to transfer to the postanesthesia care unit D. Conducting a daily huddle on the unit ✔ A, ensuring important test results are communicated to the right person on time Which of the following is a potential contraindication to the use of a pneumatic tourniquet? A. Pt has undergone prev joint replacement surgery B. Pt is older than 80 years old C. Pt has sickle cell anemia D. Pt's operative extremity has been shaved ✔ C. Sickle cell anemia Which of the following is part of the surgical check list A. When the pt last ate food or drank fluids B. whether any special equipment, devices or implants will be needed C. Whom the surgeon should talk to after surgery D. What pharmacy the patient uses ✔ B. Whether any special equipment, devices or implants will be needed A pt taking ginger preoperatively is at risk for surgical complications that include bleeding, hypotension and A. hypoglycemia B. Bradycardia C. hypokalemia D. liver dysfunction ✔ B. Bradycardia A patient is on long term acetyl salicylic acid therapy. Preoperatively, the pt should be counselled to discontinue taking the medication _________ prior to surgery A. 1 week B. 2 weeks C. 3 weeks D. 4 weeks ✔ B. 2 weeks A pt-specific risk factor for venous thromboembolism (VTE) is A. a prev hx of stroke B. duration of surgery C. intraoperative position D. use of a pneumatic tourniquet ✔ A. previous history of stroke Actively warming surgical patients with forced air to prevent hypothermia should begin A. as soon as the patient enters the OR or procedure room B. In the recovery room C. in the preoperative holding area D. just before the surgeon makes the incision ✔ C. in the preoperative holding area Which of the following indicators demonstrates a patient who is at increased risk of developing a pressure ulcer during a surgical procedure A. Aged 50 or older B. Hx of recent gallbladder surgery C. Female D. Poor preoperative nutritional status ✔ D. Poor preoperative nutritional status Based on data collected during the patient assessment, the perioperative RN A. identifies an outcome B. Formulates a nursing diagnosis C. develops a plan of care D. performs nursing interventions ✔ B. formulates a nursing diagnosis Liquid peracetic acid low-temperature sterilant is used for devices that meet all of the following criteria except: A. Device must be approved for this process B. Device must be heat sensitive C. Device must be aerated D. Device must be immersed ✔ C. Device must be aerated During surgery the patients respirations become increasingly shallow, and the pupils become smaller and smaller until they are pinpoint. How should this situation be managed? A. The patient should be extubated and bagged with 100% oxygen ✔ A. A lateral transfer device, one caregiver, and the anesthesia professional ( any patient under 52 pounds) Lead shielding used to minimize the patients exposure to ionizing radiation should be placed A. between the patient and the source of radiation, but not within the path of the beam that originates from the x-ray tube B. between the patient and the source of radiation and within the path of the beam that originates from the x-ray tube C. between the patient and the image intensifier of the fluoroscopic unit, but not within the path of the beam that originates from the x-ray tube D. between the patient and the image intensifier side of the fluoroscopic unit, and within the path of the beam that originates from the x-ray tube. ✔ A. between the patient and the source of radiation, but not within the path of the beam that originates from the x-ray tube An 18 year old pt is hesitant to remove her acrylic tongue piercing before and ex-lap for a possible ruptured ovarian cyst. The most appropriate verbal response for the perioperative RN to provide is A. You can always get another piercing if the opening for this one closes B. If the piercing is dislodged while the breathing tube is put in, it could block your airway or be pushed into your lung C. It is our policy that all jewelry be removed prior to surgery D. Your tongue could be burned if your jewelry serves as an alternate ground for the electrocautery ✔ B. If the piercing is dislodged while the breathing tube is put in, it could block your airway or be pushed into your lung Which of the following statements reflects a female paitents accurate understanding of her scheduled total abdominal hysterectomy A. I'm having all my female parts removed B. I'm having a TAH C. I'm having my uterus removed D. I'm having my uterus removed through my vagina ✔ C. I'm having my uterus removed The plan of care for an obese patient in the supine position may include A. using 2 chest supports that extend from the clavicle to the iliac crest B. placing an axillary roll under the patients dependent thorax C. elevating the head 25 degrees D. the use of foam heal padding ✔ C. elevating the head 25 degrees Assessing the surgical patients psychosocial state allows the RN to contribute to the plan of care by A. suggesting modifications to the patients position B. communicating effectively with other members of the team C. ensuring the requisite supplies and equipment are readily available D. Providing explanation, comfort and emotional support ✔ D. Providing explanation, comfort and emotional support A pt scheduled for a bronchoscopy states he has had a persistent cough with blood- tinged sputum, night sweats and a loss of appetite with significant weight loss over the past three months. Which action should be taken A. Leave the portable HEPA filter unit "on" while the patient is intubated to supplement normal room air exchanges. B. Schedule the patient for the first procedure of the day, when the infection prevention specialist is available C. Provide the patient with N-95 fit tested respirator to wear during transport D. Notify environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles ✔ D. Notify environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles A 28 y/o Hispanic male is scheduled for repair of an incarcerated inguinal hernia. He does not speak English. The consent form is only available in English. The best way for the nurse to ensure informed consent for this patient is to A. witness the pts signature on the consent form B. arrange for a medical interpreter C. allow a family member to interpret for the surgeon D. arrange for a Spanish speaking staff member to interpret for the surgeon. ✔ B. arrange for a medical interpreter If all members of the surgical team are present when the patients enters the room, can the sign in a time out process be performed? ✔ yes What are the three elements of the fire triangle ✔ fuel, ignition, oxidizers What is the "nominal hazard zone" in Laser safety ✔ The space in which the level of direct, reflected, or scattered radiation used during normal laser operation exceeds the applicable max permissible exposure How should a patient weighing more that 157 pounds be transferred to the OR bed ✔ Mechanical lifting device by 3 caregivers plus anesthesia When placing the patient in steep Trendelenberg, where should the patients knees be on the bed ✔ over the distal break to allow for bending the knees and to secure the pt, and to protect from undue shear during the procedure When performing preoperative skin antisepsis, the perioperative RN should A. Shave the area to be prepped immediately before applying the antiseptic B. Apply the antiseptic in concentric circles moving from the outer perimeter toward the incision site. C. Clean the area to be prepped with 70% isopropyl alcohol before applying the antiseptic. D. Allow the antiseptic solution to dry for the full time recommended in the manufacturers instructions for use before the surgical drapes are applied ✔ D. Allow the antiseptic solution to dry for the full time recommended in the manufacturers instructions for use before the surgical drapes are applied A ________ must be used to remove waste anesthesia gases from the operating room A. Ventilation system B. anesthesia delivery system C. Scavenging system D. Air sampling system ✔ C. Scavenging system Local anesthetic systemic toxicity is treated by administering A. 10% lipid emulsion B. 15% hetastarch C. 20% lipid emulsion D. 25% hetastarch ✔ C. 20% lipid emulsion Placing the patient on the OR bed in the supine position with arms extended on armboards at greater that 90 degrees may cause injury to the A. Axillary Nerve B. Brachial Nerve C. Median Nerve D. Radial Nerve ✔ B. Brachial Nerve The correct time to label containers designated for medications or solutions is A. When setting up the sterile field but before the medications are delivered to the field B. When there are more than two medications being used on the sterile field C. At the time the medication is delivered to the sterile field D. Just before using the medication on the patient ✔ C. At the time the medication is delivered to the sterile field A periop nurse is preparing to perform a skin prep for a patient scheduled for a right breast biopsy with needle localization. When the nurse removes the patients gown, she discovers a wire inserted into the left breast. What is the appropriate action A. Leave the wire in place and prep the left breast B. Remove the wire and prep the right breast C. Call the radiologist and tell him of the error ✔ A. Notify the surgeon that the correct implant may be sterilized via the immediate- use steam sterilization method if biological and class V indicators are placed in the load An 18 y/o pt is scheduled for surgery to have cochlear implants placed, The patient refuses to have the implants tracked even after the team has informed her of the possible implications of a recall or adverse event. What is the next course of action A. Cancel the procedure and it rescheduled at a different facility B. Notify the surgeon and let them decide what to do C. Proceed with the surgery and document in the perioperative notes that the patient has refused to allow tracking of the medical device D. Report the incident to the US food and Drug admin ✔ C. Proceed with the surgery and document in the perioperative notes that the patient has refused to allow tracking of the medical device When should the scrub person transfer specimens from the sterile field to the RN A. At the end of the procedure B. When it's convenient for the scrub person C. ASAP D. Never, specimens should not be passed off the sterile field ✔ C. ASAP In the OR humidity should be maintained between ✔ 20%-60% In the OR temperature should be maintained between ✔ 68 and 75 What is a late sign of Malignant Hyperthermia? ✔ Increased Temperature malignant hyperthermia is a life threatening condition triggered by ✔ medications used in anesthesia; inhaled anesthetics, succinylcholine Symptoms of MH ✔ hypercarbia, tachypnea, tachycardia, metabolic and resp acidosis, cardiac dysrhythmias, and temp elevation What is an early indication of MH ✔ rigidity of the jaw, identified during intubation What is the treatment for MH ✔ Dantrolene 2.5mg/KG What is the one medication used as a preoperative anxiolytic? ✔ Midazolam Hetastarch ✔ A substitute for blood plasma and has oxygen carrying capabilities What are the three primary methods of hand hygiene? ✔ Washing with soap and water performing surgical hand scrub using surgical hand rubs What is the ONLY way to prevent the transfer of Clostridium difficile? ✔ Hand washing with Soap and Water How long is the Surgical hand scrub with a brush ✔ Three to five minutes Wound classification parameters: Clean ✔ Wound is not infected or inflammed The procedure was free from entry into the resp, alimentary or genitourinary tract Was the wound primarily closed or drained with closed drainage Wound classification: Was the respiratory, alimentary, or genitourinary tract entered under controlled conditions without: Evidence of infection or contamination or major break in technique ie spillage ✔ Clean Contaminated II Wound Classification: Is the wound Fresh, open or accidental; or is there gross (ie visible) spillage from the GI tract; or is there acute non purulent inflammation present? Was there a major break in sterile tech during the procedure ✔ Class III Contaminated Wound Classification: Is the wound An old wound with retained, devitalized tissue (gangrene, necrosis) or a wound with existing clinical infection (purulence), or a perforated viscera ✔ Class IV Dirty infected What wound class would a lap appy be ✔ Contaminated hemostatic agent, Absorbable gelatin should not be used on what part of the body ✔ in small closed spaces, such as the spinal canal The three primary phases of wound healing are ✔ inflammatory proliferative remodeling Primary intention wound healing is ✔ wounds are created with aseptic tech and then are closed as soon as possible with suture, staples, tape or adhesives Secondary intention wound healing is ✔ for wounds with tissue loss and the inability to proximate edges. Wounds are typically left open so the can heal from the inside out Delayed primary closure or third intention wound healing is ✔ wounds that require debridement first and then later require primary or secondary closure Supine position with head up is ✔ Reverse Trendelenberg Which of the following is a common root cause of sentinel events A. Failure to use written communication tools B. Breakdown in communication C. Absence of or failure to follow policies and procedures D. Fear of reprisal for speaking up ✔ B. Breakdown in communication When communicating patient information to other team members, perioperative RNs should A. speak loudly and slowly B. Avoid using body language C. use the read-back method D. provide the information in writing ✔ C. use the read-back method What is the greatest value of a standardized process for transferring patient information A. Improves accuracy, reliability, and quality of info B. shortens the time it takes to transfer info from one caregiver to another C. Ensures that the same information is transferred for every patient D. Ensures that the transfer process adheres to facility policy ✔ A. Improves accuracy, reliability, and quality of info Structure and processes for transfer of patient information should be developed by whom? ✔ a multidisciplinary team comprising caregivers who participated in the transfer of pt info The goal to "improve the effectiveness of communication among caregivers" is proposed by A. Centers for Medicare and Medicaid Services B. the Occupational Safety and Health Administration C. the United States Department of Health and Human Services D. The Joint Commission's National Patient Safety Goals ✔ D. The Joint Commission's National Patient Safety Goals Discharge education should include adverse effects of opioid pain medications, including constipation, vomiting, and A. respiratory depression B. hypotension C. hypertension D. diarrhea ✔ A. respiratory depression The goal of performing a follow-up telephone call within 48-72 hours of the pts discharge is to A. monitor the pts heart rhythm B. confirm pts understanding of and compliance with instructions C. finalize paperwork for submission to the pts ins provider D. schedule follow-up appts. ✔ B. confirm pts understanding of and compliance with instructions Which teaching method has been shown to improve communication and teamwork A. Role-playing B. Case Studies C. Online modules D. Simulation ✔ D. Simulation What can compromise the accuracy of the nurses transfer of pt care A. Interruptions B. Pt acuity C. Pt diagnosis D. Paper charting ✔ A. Interruptions What items can be sterilized with Saturated Steam ✔ stainless steel, glass, towels. Power, Ortho and neuro instruments What areas of the OR require POSITIVE AIRFLOW? ✔ Sterilizer loading and unloading, prep and packaging, textile packaging room, clean/sterile storage Ethylene oxide (EO) sterilization is ✔ low-temperature sterilization used for moisture and heat sensitive items What molecules that Ethylene oxide kills are ✔ proteins and DNA Why does Ethylene oxide need to be aerated in a mechanical aerator? ✔ To remove (EO) at the end of a cycle because it is a carcinogen. What does Ozone sterilization use for sterilization? ✔ oxygen and water what is a low-temp steriliant that should be used for devices that are heat sensitive, can be immersed, needs to be used immediately after sterilization. ✔ Peracetic acid liquid Class I (CI) ✔ process indicator show whether the item has been exposed to the sterilization processed and should be placed EXTERNALLY ie Tape Class II (CI) ✔ specialty indicator. tests for the presence of air in the sterilizer chamber Class III CI ✔ single parameter indicator. react to one of the critical process parameters ie. Time, pressure Class IV CI ✔ multiparameter indicator. are accurate than class III because they react to 2 or more of the critical process parameters Class V CI ✔ integrating indicators. react to all critical parameters of sterilization and should be placed internally. Multilayered trays may require more than 1 indicator Class VI CI ✔ emulating indicators. react to all the critical parameters of a specialized sterilization cycle What is a Bowie Dick test ✔ indicator II, run in an empty chamber at the beginning of each day. Test if all the air was removed in the chamber and whether residual air is present during the cycle Storage for sterilized instruments and supplies parameters. Temperature, total air exchanges per hour and humidity ✔ Temp not to exceed 75F (24C) 4 total air exchanges per hour humidity between 20%-60% but no higher than 70% Malignant Hyperthermia onset actions ✔ STOP inhalant anesthesia STOP surgery HYPERventilate with 100% O2 START Dantrolene COOL the patient (if greater than 102, once 100.4 stop cooling) The _______ is an algoriithm that guides EMS personnel through the following four decision points physiological parameters, anatomic parameters, mechanisms of injury, and other special considerations A. Triage Tree B. Medical Plan C. Decision Scheme D. Trauma Protocol ✔ C. Decision Scheme Massive Hemorrhage is treated by transfusion that is equal to replacing ______% of the patients estimated blood volume in three hours or less A. 15% B. 50% C. 25% D. 70% ✔ B. 50% Which of the following diagnostic procedures has the ability to be most specific when identifying a traumatic injury A. Diagnostic Peritoneal Lavage B. CT Scan C. Chest X-Ray D. Focused Assessment with Sonography in Trauma (FAST) ✔ B. CT Scan A disaster prepardness plan including the use of a command center, triage center, staffing plan, documentation and communication should be held at least A. every three months B. Twice a year C. Yearly D. every 2 years ✔ B. Twice a year Management of a patient infected with anthrax includes using __________ precautions A. droplet B. standard C. airborne A new plastic surgeon has just joined the staff of an ambulatory surgery center. The surgeon requests a line of suture that is not carried by the facility. how can the nurse best respond in providing rationale for use of the facilities current brand of suture A. Standardization of products is one way our surgeons can help us control costs B. We dont have enough shelf space in the suture room to accomodate more boxes C. We dont have a contract with that suture company D. The rest of our surgeons wont use that type of suture ✔ A. Standardization of products is one way our surgeons can help us control costs A split-thickness skin graft is obtained for autotransplantation to occur in one week at the same facility. The best way to preserve the graft is to A. place the tissue in balanced salt solution B. refrigerate the tissue in NS C. sterilize the skin using ethylene oxide (ETO) D. Sterilize the skin using steam sterilization ✔ B. refrigerate the tissue in NS A peri-op nurse is assigned to care for a pt with MRSA Which of the following cleaning practices can be anticipated to be required after the procedure A. Closing the room for 28 minutes to allow for an adequate air exchange B. Incinerating all disposable instruments C. incorporating enhanced environmental cleaning procedures D. incorporating routine environmental cleaning procedures. ✔ C. incorporating enhanced environmental cleaning procedures A multidisciplinary team is evaluating a new brand of irrigation fluid. The empty container is recyclable. Which of the following will be affected if this product is chosen. A. The environment B. Patient safety C. End-user satisfaction D. Group purchasing contract ✔ A. The environment A ____ is an environment where actions are analyzed to determine accountability and reparations are enacted when appropriate A. Just Culture B. culture of Accountability C. Culture of communications D. Learning culture ✔ A. Just Culture Collecting and evaluating information to assess current processes are known as A. research utilization B. change implementation C. EBP D. quality improvement ✔ C. EBP The Joint Commission has provided guidance on _______ processes to address unexpected occurrences that have resulted or may result in pt injury or death A. root cause analysis B. sentinel event C. error identification D. process analysis ✔ B. sentinel event The "standards of professional peri-op professional practice" identifies key behaviors of a professional that include maintaining competency and current knowledge on the peri- op specialty and A. pursuit of lifelong learning B. an understanding of legislative matters C. a commitment to precepting D. an ability to identify pt outcomes ✔ A. pursuit of lifelong learning The purpose of the ______ is that it contains statements related to ethical obligations, duties, standards, and a nurses commitment to society. A. Guidelines for peri-op practice B. Standards of Peri-op nursing C. The Future of Nursing: Leading change, advancing health D. Code of Ethics for Nurses with Interpretive Statements ✔ D. Code of Ethics for Nurses with Interpretive Statements What professional nursing behavior is evidenced by mutual trust, recognition, and respect among all members of the health care team in a shared decision-making process? A. Conflict resolution B. Just culture C. Collaboration D. Advocacy ✔ C. Collaboration Which standard of peri-op nursing is represented by completing an individualized orientation based on identified learning needs and seeking experiences to maintain skills and competency? A. Quality of practice B. Professional practice evaluation C. Education D. Evaluation ✔ C. Education What type of research involves evaluating the link among pt characteristics, nursing care delivery, and the results of that care A. Process B. Outcomes C. Implementation D. Results ✔ B. Outcomes What trait of professionalism is used to describe telling the truth and keeping promises A. Honesty B. Veracity C. Fidelity D. Excellence ✔ C. Fidelity The center for Transforming Healthcare is part of _____, which is dedicated to encouraging cultures of safety for patients and personnel A. The World Health Organization B. The Joint Commission C. CDC D. Institute of Medicine ✔ B. The Joint Commission