AORN PeriOP. Questions Bank. Practice Questions & Answers. 100% Accurate, graded A+

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AORN PeriOP. Questions Bank. Practice Questions & Answers. 100% Accurate, graded A+ All of the following professionals are qualified to provide anesthesia to a pt except: A. Anesthesiologist ... B. CRNA C. AA D. Surgeon - ✔✔Surgeon Of the following, which is not used to secure and manage a patient's airway? A. ET tube B. LMA (laryngeal Mask Airways) C. Nasal Cannula D. Oral airway - ✔✔Nasal Cannula The Periop team should know the location of equipment stored in the OR and in the department. Equipment that the anesthesia provider may request includes: A. Video laryngoscopy devices B. Fiberoptic bronchoscopes C. Suction tips and devices D. All - ✔✔All Which of the following tyupes of anesthesia require an anesthesia professional? A. General B. Local C. Moderate D. Monitored Anesthesia Care (MAC) - ✔✔General and MAC The phases of general anesthesia, in order, are: A. Induction, maintenance, emergence B. Emergence, maintenance, induction C. Maintenance, emergence, induction D. Induction, emergence, maintenance - ✔✔Induction, Maintenance, Emergence Induction - agents administered to put pt asleep Maintenance - provider continue to administer agents to keep pt anesthetized Emergence - at end of procedure, agents are discontinued or reversed Which of the following type of airway maintenance usually requires muscle relaxants? A. Spontaneous Respiration B. Mask Ventilation C. Laryngeal Mask Airway D. Endotracheal Intubation - ✔✔ET Intubation Mask ventilation - used during induction and emergence, mask attached to endo purple tubing placed to provide oxygen Laryngeal Mask Airway/Supraglottic airway device - sits around larynx, does not require relaxants and has lower incidents of coughing Fentanyl can be reversed with which of the following agents? A. Neostigmine B. Sugammadex C. Naloxone D. Flumazenil - ✔✔Naloxone Neostigmine - reversal agent for many relaxants (Note. there is no reversal agent for succinylcholine) Sugammadex - reversal agent for rocuronium, vecuronium and pancuronium Flumazenil - reversal agent for benzos like midazolam When should cricoid pressure be released? A. If the patient coughs B. When the patient loses consciousness C. If the anesthesia provider cannot see the vocal cords D. After the cuff on the ET tube is inflated and the position is confirmed - ✔✔D. Which type of anesthesia involves an injection in tot he space between the Ligamentum Flavum and the Dura? A. Epidural Anesthesia B. General Anesthesia C. Spinal Anesthesia D. Bier Block - ✔✔Epidural Block Locals: Lidocaine, bupivicaine and ropivacaine (epi increases density and duration of block, bicarb reduces acidity of block and increases speed of onset of the block Spinal: positioned sitting or lateral, can cause hypotension, respiratory compromise (if at high level in spine), and HA Bier Block/Regional Anesthesia: IV placed and double tourniquet placed, proximal inflated, if pain occurs, proximal is deflated and distal is inflated Sedation can be used with any of the following types of anesthesia except: A. Regional B. Monitored Anesthesia Care (MAC) C. General D. Local - ✔✔Local The most specific sign of a malignant hyperthermia crisis is: A. Increase in End Tidal CO2 B. Skin mottling C. Tachycardia D. Hypertension - ✔✔Increase in End Tidal CO2 Susceptib ility to MH is genetic Common/Initial Signs: Tachy/HTN but are not specific to MH Tachypnea more specific but can be masked if vented or muscle relaxants have been given Muscle rigidity, mottling, ventricular dysrhythmias, hyperthermia, myoglobinuria Tx: actively cooling pt, cold isotonic saline, dantrolene injections, dilute with sterile water Which of the following is associated with increased risk for perioperative hypothermia? A. Being Female B. Higher than normal body weight C. Hyperthyroidism D. HTN - ✔✔Being Female Those at highest risk: elderly, infants and children, women, those with lower body weights Co-Risks associated with hypothermia: hypothyroidism, hypoglycemia, burns, trauma, CFH, hypotension, previous organ transplants or cardiac surgery Identify the active warming devices: A. Circulating water garments B. Cotton Blankets C. Forced air warming devices D. Increased ambient room temperature E. Surgical Drapes F. Warmed IV fluids - ✔✔Passive Means: Cotton blankets, space blankets, plastic sheeting, surgical drapes Active Means: Circulating water garments, radiant warming, FAWDs, Increased ambient room temperature, warmed anesthetic gases, warmed IV and irrigation fluids Identify which drugs are muscle relaxants and which is an IV induction agent: Atracurium Etomidate Ketamine Pancuronium Propogol Succinylcholine Vecuronium - ✔✔Muscle Relaxants: Succinylcholine, atracurium, vecuronium, pancuronium Induction Agents: Etomidate, ketamine, propofol Which of the following would be an appropriate action for the perioperative nurse when assisting with anesthesia? A. Administer the muscle relaxant reversal agent if needed B. Apply cricoid pressure if needed during intubation C. Document anesthetic agents used, dose, route, and time D. Extubate the patient - ✔✔Apply cricoid Pressure Which of the following is not included in basic monitoring of the patient for anesthesia? A. Pulse ox B. EKG C. Arterial line D. Blood pressure - ✔✔Arterial line Which drug is used to reverse valium and midazolam? A. Neostigmine B. Pancuronium C. Flumazenil D. Succinylcholine - ✔✔flumazenil Which method is used to prevent aspiration during endotracheal intubation? A. Applying cricoid pressure B. Inserting a nasal oral airway C. Laryngoscopy D. Invasive techniques - ✔✔Applying cricoid pressure How can the perioperative nurse assist the anesthesia provider with placement of a spinal or epidural block? A. Inject local anesthetic B. Thread the catheter through the needle C. Calm the patient D. Identify landmarks for insertion of the needle - ✔✔Calm the patient During intravenous regional anesthesia (Bier Block), the tourniquet should be deflated slowly to prevent which of the following from entering the circulation? A. Bacteria B. Lymphatic fluids C. Thrombus D. Bolus of anesthetic - ✔✔Bolus of anesthetic What is the most consistent indicator of malignant hyperthermia during a surgical intervention? A. tachycardia B. Unexplained increase in end tidal CO2 C. Elevated temperature D. Sustained muscle contraction - ✔✔Unexplained increase in end tidal CO2 Depending on state laws and hospital policies, which of the following types of anesthesia can be performed without a professional anesthesia provider? A. General B. Regional C. Monitored Anesthesia Care (MAC) D. Moderate - ✔✔Moderate Which assessment factor is important to include when screening patients for potential risk of malignant hyperthermia ? A. family history related to anestheisa B Age C. Use of herbal and vitamin sypplements D. Use of over the counter medications - ✔✔Family history related to anesthesia The RN caring for the patient receiving moderate sedation/analgesia should: A. turn up the monitor alarms when prepping the patient B. be competent in the use of emergency resuscitation procedures C. call an anesthesia provider to administer reversal medications D. all of the above - ✔✔be competent in the use of emergency resuscitation procedures Based on your knowledge of laparoscopic surgery, identify the potential complications related to it? A. Pneumonia B. Hypoxemia C. Hypercarbia D. Cardiac dysrhythmia E. Hypocarbia F. CO2 embolism - ✔✔Hypoxemia, hypercarbia, cardiac dysrhythmia, CO2 embolism Other complications: hyper/hypotension, extraperitoneal insufflation, subcutaneous emphysema, instrumentation injuries, peritonitis, delayed hemorrhage, gastric reflux, Which are the major components of medical video imaging? A. Electrosurgical unit B. fiber optic light cable C. Verres needle D. Camera control unit - ✔✔fiber optic light cable and camera control unit Based on your knowledge of cameras in endoscopic surgery, identify the tasks that should be completed while setting up the camera before surgery. A. Inspect the camera head for smudges or debris B. Clean the camera head using sterile water C. Plug the camera into the CCU and turn on the unit D. Complete white balancing of the camera - ✔✔inspect the camera head for smudges, plug the camera into the CCI and turn on the unit, complete white balancing of the camera Camera should be cleaned with alcohol and cotton swabs Based on your knowledge of light sources used in laparscopic surgery, identify which light source would be used in a surgery where bright light is required. A. Metal Halide light source B. Xenon light source - ✔✔Xenon light source Light Emitting Diode(LED): immeidate full light inesnity with long energy life Metal Halide: emits continuous blue light and not as bright as LED or xenon Xenon: emits a pulsing high intensity white light Based on your knowledge of CO2 insufflators, identify the functions of the component slisted below: A. Alarms B. NG tube C. Two way disposable filter 1. to prevent contamination of the operation cavity 2. to indicate the level of CO2 3. to decompress the stomach - ✔✔Alarms --> 2 NG tube --> 3 Two filter --> 1 Laparscopic instruments with small blunt tips are used for: A. cutting tissue B. dissecting tissue C. grasping tissue D. moving tissue from one place to other - ✔✔dissecting tissue larger blunt tips or teeth with ratcheted handles used for grasping Identify the instruments that can be used in laparoscopic surgeries: A. Babcock forceps B. Mosquitoes forceps C. Needle holder forceps D. Dissector forceps - ✔✔babcocks, needle holders, dissectors Identify the additional assessments that should be made by the perioperative nurse before an endscopic surgery. A. history of thermal burns B. history of DVT C. consent for open surgery D. history of anaphylactic reactions E. history of previous incisions F. types of instruments used in surgery - ✔✔history of DVT and previous incisions, consent previous incisions may alter trocar insertion techniques CO2 insufflation increase intraperitoneal pressure which in turn decreases venous return, which increases chance of DVT Hypothermia: use warm fluids Compromised positioning Consent Voiding prior ot surgery: helps avoid puncturing bladder when trocar is placed What contrinutes to potential complications of minimally invasive surgery? A. positioning B. distention gases C. Irrigation fluids D. All of the above - ✔✔All of the above Which of the following statements about light source safety is incorrect? A. Connect the light cable to the scope before turning on the light source B. When not in use, the light source should be disconnected from the scope and placed on the drapes C. follow the manufacturer's instructions for use D. check the light bulb status/hrs before starting the case - ✔✔when not in use, the light source should be disconnected from the scope and placed on the drapes Which of the following statements about the CO2 insufflator is correct? A. be sure the alarm is off so as not to interfere with anesthesia alarms B. intra-bdominal CO2 pressures should be 15mmHg or higher C. positioning the insufflator at the level of the patient's heart or higher D. the insufflator tubing should have a one way valve - ✔✔position the insufflator at the level of the patients heart or higher Which region of the patient's abdomen is traditionally used to establish pneumoperitoneum for laparoscopic surgery? A. Periumbilical B. Supraumbilical C. Subumbilical D. Umbilical - ✔✔Periumbilical CO2 is the gas used for abdominal insufflation because: A. it is rapidly eliminated B. it increases combustion C. it is easily absorbed, causing serious adverse effects D. none of the above - ✔✔it is rapidly eliminated Advantages of minimally invasive surgery include: A. a longer recuperative period B. increased pain medication requirements C. a prolonged hospitalization D. an earlier return to normal activities - ✔✔an earlier return to normal activities What is the meaning of capacitive coupling? A. Electrical current transfer through intact insulation B. electrical current transfer through non intact insulation C. electrical current transfer through the insufflation line D. electrical current transfer with abdominal irrigation - ✔✔Through intact insulation It is the transfer of electrical current from the active electrode through intact insulation to adjacent conductive items (tissue, trocars) What is a responsibility of the scrub person ahead of a laparoscopic procedure? A. Assuming insulation cracks or breaks are discovered by sterilization techs B. Checking and tightening any screws on endoscopic instruments C. Cleaning bioburden off of instruments during case set up D. Using any endoscopic instrument set for all types of minimally invasive surgery - ✔✔Checking and tightening any screws on endoscopic instruments Which is a nursing consideration for the patient undergoing endoscopic surgery? A. Hyperthermia B. Automatic urinary bladder catheterization C. Positioning D. laparoscopic setup only - ✔✔Positioning Which of the following actions should not be interrupted? A. answering the room phone B. Providing a family update C. Opening additional instrument sets D. Docking and undocking the robot - ✔✔docking and undocking the robot Identify the activities that may be handled by the environmental services personel. A. Preliminary room preparation B. Damp dusting and mopping C. End of procedure cleaning D. Terminal cleaning - ✔✔End of procedure cleaning and terminal cleaning Environmental services resonisble for: Post-procedure cleaning, terminal cleaning, preoperative areas, postoperative areas, sterile processing Surgical personell: prelimary room prep and damp dusting Clean with: soft absorbent low lint cloths, wet vacuum, mop A hospial disinfectant haspassed te ptency test for activity against which 3 microorganisms? A. pseudonomas aeruginosa, staph aureus, salmonella B. pseudonomas aeruginosa, Ecoli, staph aureus C. Pseudonomas aeruginosa, clostridium, strep D. pseudonomas aeruginosa, strep, salmonella - ✔✔pseudonomas, staph, salmonella Tuberculocidals are a special class of disinfectants. In order to be labeled tuberculocidal products need t have demonstrated potency against: A. pseudonomas B. staphylococcus C. Mycobacteria D. salmonella - ✔✔Mycobacteria Mycobacteria have the highest level of resistance, therefore germicides are broad spectrum They do not interrupt or prevent the transmision of TB because TB is not acquired from environmental sufaces Vehicles transporting pts are not considered to be contaminated and hence do not need to be clean during end of procedure cleaning. A. True B. False - ✔✔False Floors, equipment, furniture, transport vehicles should all be cleaned Terminal cleaning of the OR room is performed a the end of each surgical procedure in order to render the environment safe for the patient following in that room and to prevent cross contamination. A. True B. False - ✔✔False End of procedure cleanin is performed at the end of each case while terminal cleaning of the environment is the more thorough cleaning that takes place at the end of the day's schedule Based on what you have learned about standard precautions, identify the best practices to be followed when performing environmental sanitation. A. when cleaning spills of blood or any other potentially infectious material, use gloves and any other PPE that is appropriate to the task B. Visibly soiled operating room equipment, furniture, and floors should be cleaned with a hospital grade germicide C. Infectious waste should be segregated from noninfectious waste in the general waste stream D. color coded or labeled bags should be used to facilitate separation of the various wastes - ✔✔All of the above Match the pathogens and their definitions A. HIV B. AIDS C. Creutzfeldt-Jakob disease D. Methicillin resistant staphylococcus aureus (MRSA0 E. Vancomycin resistant enterococci (VRE) 1. A rare but progressive fatal disease caused by prions 2. one of the hardiest bacteria and most difficult to treat. It has been cultured from dried clinical materials and found on gloves and surfaces C. Usually spread by the hands of the caregivers or patients and contaminated equipment or environmental surfaces Only survives in blood and body fluids that contain white blood cells, fragile and easily destroyed outside the body E. a state of immune dysfunction that results as the HIV infection progresses - ✔✔HIV to D AIDS to E Creutzfeldt Jakob disease to A MRSA to B VRE to C The single most important factor in preventing the spread of infection is: A. hand hygiene B. cleaning all horizontal surfaces C. patient's hygiene D. none of the above - ✔✔Hand hygiene Damp dusting of the OR as part of the preliminary rom preparation should be done: A. in the morning before bringing in any surgical supplies B. the nigh before scheduled surgery C. every time surgical supplies are brought into the room D. after the surgery - ✔✔in the morning befor [Show More]

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