Select all that apply:
What factors influence the choice of anesthetic?
a. Age
b. Postoperative recovery time
c. Length of surgery
d. Position of pt
e. Pt’s previous experiences with anesthesia
f. Physiological status
g. Pt/surgeon preference
h. Surgical procedure
What is all of the above
100
The nurse's preoperative interview should include questions to help determine tolerance to the planned operative position. Which of the following assessments should be included (select all that apply):
A. skin condition
B. amount of bodily hair
C. weight
D. occupation
E. pre-existing conditions
What is A, C, D
100
These bacteria are adherent and resistant to removal. _____ organisms are the flora below the skin surface in hair follicles and sweat glands. _______ organisms usually attach loosely to the skin’s surface and are acquired by direct contact.
What is Resident organisms, Transient organisms
100
What are the advantages of using surgical staples to close a wound.
What is Provide a rapid method to ligate, anastomose, and approximate tissue. Healing is accelerated with minimal tissue trauma. Result produces and even surface and leak-proof closure
100
Radiation safety involves what?
What is nonessential personnel should leave the room or maintain a safe distance behind a lead screen while x-rays are being taken
-all personnel should wear protective devices (lead)
-pregnant women should avoid or limit exposure
-film badges that measure radiation exposure may be used for those staff members who have prolonged or frequent exposure
-education should be provided
200
Match:
a. General
b. Regional
c. Local
__ a reversible state of unconsciousness, consisting of amnesia, analgesia, and muscle relaxation
__ a reversible loss of sensation, which is achieved by injecting a local anesthetic to block the nerve fibers from transmitting impulses
__ functions like regional anesthesia but usually applies to a smaller area or a single body part such as a finger or a toe
What is A, B, C
200
For a kidney procedure, the patient is most likely to be positioned:
A. supine
B. modified fowler's
C. lithotomy
D. lateral recumbent
What is D
200
Preparation for the surgical hand scrub include:
a. The table should not be used as the main instrument table
b. Lather hands and forearms to 2 inches above the elbow, rinse hands and arms keeping the fingers pointed upward, so that the water drips off at the elbow.
c. wash hands and forearms with soap and running water before beginning the surgical scrub.
d. use back and forth motion to scrub all four sides of each finger, including the web spaces.
e. all of the above
What is e all of the above
200
Put the bodies defense mechanisms in order.
a. Clean up pathogens and debris in the wound
b. Repair deeper tissue damage
c. Seal the wound against infections
d. Stop the blood loss/ hemostasis
e. Regenerate the natural epidermal covering
What is d, a,c,e,b
200
When applying a pneumatic tourniquet, one must?
What is elevate extremity
-apply at least two layers of limb protective sleeve around extremity at the most proximal point
-grasp cuff with two hands, pull, and secure to extremity
-attach tubing and ensure that the tubing does not and will not get kinked
300
Also called the critical volume hypothesis, this theory proposes that there is a relationship between the lipid solubility of the anesthetic and the anesthetic potency.
a. Protein Receptors theory
b. Meyer-Overton theory
c. Endogenous Endorphins theory
d. Oliver Wendell Holmes theory
What is b. Meyer-Overton theory
300
To avoid brachial plexus compression in the supine position, arms should be positioned
A. less than 45 degrees
B. less than 90 degrees
C. always tucked at the patient's side
D. hanging freely alongside the bed
What is B
300
Which of the following are true in how the circulator can assist the scrub person in gowning?
a. reach inside the gown and pull the seam to bring the gown over the scrub persons shoulders.
b. adjust the gown by pulling the bottom edge and pulling down to eliminate bunching
c. tie the back of the gown and assist with holding the tag as the scrub person turns
d. can pick up a dropped tie tag from the gown and hand it back to the scrub for them to tie
e. all of the above
What is a, b, and c
300
What is the difference between primary union wound healing and delayed primary closure (first intention vs third intention)?
What is a. Primary union is the preferred method of wound healing. Occurs when necessary conditions are met like clean incision with wound edges approximated. It heals with minimal separation or scaring. Example is a surgical incision.
b. Delayed primary closure is a repair of contaminated, dirty, and infected traumatic wounds with excessive tissue loss and high risk of infection. The wound can be kept open to monitor infection. Will have a scar. Example is compartment syndrome or burns.
300
The universal protocol wants to prevent
What is wrong site, wrong procedure, wrong person
400
Select all that apply based on your knowledge of the stages and phases of anesthesia:
Judy is a patient about to undergo surgery. She was administered anesthesia a few minutes back and is beginning to feel the side effects. What stage and phase of anesthesia is she in?
a. Stage II
b. Stage III
c. Stage I
d. Phase: Induction
e. Phase: Maintenance
What is a. Stage II,c. Stage I, d.Phase: Induction
400
A patient is scheduled for a pelvic procedure in the Trendelenburg position. It is important for the nurse to (select all that apply):
A. apply shoulder braces to avoid damage to the brachial plexus
B. avoid shoulder braces to prevent damage to the brachial plexus
C. return the patient quickly to the supine position to avoid circulatory depression
D. return the patient slowly to the supine position to avoid circulatory depression
What is B,D
400
______ gloving is used to perform sterile procedures such as bladder catheterization or insertion of an I.V. cut down.
What is open gloving
400
What wound classification is being described?....Traumatic wound or spillage of infected material. Open or fresh traumatic wound less then 4 hours. Major break in sterile technique occurred. Gross spillage of the GI tract. An example is a penetrating wound.
What is class 3 contaminated
400
When marking a site for surgery, it must it include?
What is using a marker that is visible after the skin is prepped and draped
-having the surgeon mark the site with their initials prior to entering the OR suite and with patient’s participation
-using an additional mechanism for identifying site exempt from marking according to facility policy and The Joint Commission guidelines (ex. ID band with procedure written on it)
-a parent or guardian should be involved in the marking of minors, unconscious, and/or mentally incompetent adults
500
Which of the following common peri-operative positions presents a risk for a potential air emboli due to pressure on head and neck?
A. Trendelenburg
B. reverse Trendelenburg
C. modified Fowler's
D. Kraske
What is C
500
Which of the following statements are false:
a. open gloving is used at the beginning of each case, where as closed gloving is used for subsequent gloving.
b. closed gloving should not be used when changing one or both gloves because once the hand has passed through the cuff it is contaminated.
c. in closed gloving the hands are remain inside the gown sleeves not touching the cuff’s edge.
d. In open gloving the hands are all the way through the gown sleeves and through the cuff.
What is A
500
Name five factors that can affect wound healing?
What is Nutrition, Medications, Age, Pre-op skin prep, Stress, preexisting infection, length of the surgery, location of the wound, complications, smoking
500
What to do if there is a Time Out discrepancy?
What is procedure should not begin until the patient verification and missing information are completed and agreed upon by all team members
-if the disagreement is not resolved, follow the local facility policy and notify the manager or administrator
-all issues resolved should be documented in the medical record