ASPAN Standard's
Expert opinion suggest vital sign are taken at what minimal frequency in Phase I PACU?
A. 10 minutes
B. 25 minutes
C. 20 minutes
D. 15 minutes
D- Expert opinion recommend vital signs are taken in Phase I PACU at a minimum of 15 minutes and as clinical condition require
To prove negligence of a healthcare provider, three elements must be established and include an established relationship, the duty established by profession and ________.
A. An informed consent signed by the patient
B. A violation of that duty that results in injury
C. Invasion of the patient's privacy
D. An expert witness to testify
B- The healthcare provider must have a relationship with the patient in terms of assigned to care for the patient.
You are performing preoperative teaching on a patient scheduled for left total knee arthroplasty. To prevent surgical site infection, the patient should avoid the following?
A. Eating protein rich foods
B. Cleansing with chlorhexidine wipes
C. Shaving near the site of surgical incision
D. Close contact with a family member who is immunocompromised
C- Shaving near the incision prior to surgery can cause cuts and micro abrasions that can allow bacteria to enter the skin and cause a surgical site infection
Which of the following is NOT one of the three domains of high reliability in health care organizations?
A. A leadership team committed to zero harm
B. A fully functional culture of blame
C. The use robust process improvement methods
D. Focus on near misses to improve processes
B- A high reliability organization focuses on patient safety and the prevention of errors
According to the Occupational Safety and Health Administration Bloodborne Pathogens (OSHA BBP) standard, institutional plans to reduce employee needlestick injuries must include input from:
A. Employee responsible for direct patient care
B. Registered clinical pharmacist and pharmacy technicians
C. Nurse managers
D. Employee Health Directors
A- The Occupational Safety and Health Administration requires that institutions obtain input from non-managerial staff actively participating in patient care when developing plans for a safe workplace
The competent perianesthesia nurse engages in all of the following EXCEPT:
A. Regularly participates in a professional development activities
B. Demonstrate teamwork, collaboration and effective communication
C. Collaborates with the health care team to ensure optimal care
D. Avoids conflict to minimize unit disruption
D- The other answers are all indications od a competent perianesthesia nurse
When a patient is unable to make decisions for their healthcare, the following guiding principles are in effect to honor the patient's wishes, EXCEPT:
A. Advanced directives
B. Living will or durable power of attorney for health care decisions
C. Physician orders for life-sustaining treatments
D. Last will and testament
D-The Patient Self-Determination Act was established in 1990 and addressed patient rights on a national level.
You are teaching a patient and family member to care for a surgical drain postoperatively. Which strategy is most effective for preventing a surgical site infection?
A. Measure and record daily drain output
B. Consume a carbohydrate-rich diet to facilitate wound healing
C. Take pain medications as prescribed
D. Perform hand hygiene before and after emptying the surgical drain
D- Hand hygiene remains the most important strategy for preventing surgical site infection.
When administering procedural sedation, which of the following is NOT true?
A. Suction is available at the bedside with Yankauer
B. Only opioid reversal agents are needed in the event of over-sedation
C. IV access and a full nursing assessment must be completed prior to administration of sedative
D. The patient is placed on a cardiac monitor with capnography and pulse oximeter
B- In addition to reversal agents for opioids,the unit where a patient is receiving procedural sedation should also have access to reversal agents for potential benzodiazepine overdose
The perianesthesia nurse reviews the Joint Commission (TJC) National Patient Safety Goals, acknowledging that:
A. The goals are only set applicable in the hospital setting
B. TJC revises the goals only when new safety issues arise
C. The goals are updated annually
D. TJC does not require adherence to the goals
C- TJC Patient Safety goals are updated annually and available specific to the facility type
According to ASPAN Practice Recommendation regarding equipment availability, which piece is considered an "as needed basis"piece of equipment?
A. Cardiac monitor
B. Airways
C. Suction
D. End-tidal CO2
D- While End-tidal CO2 demonstrates valuable information into the adequacy of ventilation, it is not considered necessary at every bedside, however, it is equipment that should be in the department and readily available as needed
Elements of informed consent include risks and benefits of treatment, alternative treatments and:
A. Alternate surgeon
B. Alternative hospitals
C. Consequences of alternative treatment
D. Consequences of no treatment
D- Elements of informed consent include risks and benefits of the treatment, alternative treatments, and consequences of no treatment.
Best practice recommendations for preoperative antibiotics include:
A. Initiation within 1 hour prior to incision time
B. All preoperative antibiotics should be given at least 3 hours after incision
C. Oral antibiotics prior to colon surgery should begin 1 week preoperatively
D. Cesarean patients receive their antibiotics after the cord is clamped
A-The goal of preoperative antibiotics is to have adequate serum and tissue levels of the agent prior to potential exposure to pathogenic mayerials durng surgery.
ASPAN is highly committed to a culture of safety in all perianesthesia practice settings. ASPAN's core value for patient safety include, but not limited to accountability, leadership, workplace safety and:
A. Patient and family engagement
B. Provide detailed information related to chemical products used in the units
C. A general preoperative safety checklist
D. Provide detailed information related to housekeeping
A- A culture of safety is defined as an environment whereby sharing and implementation of knowledge and shared beliefs promote safety in the practice setting
Patient safety is primarily defined as:
A. The highest priority of perianesthesia practice
B. An updated resource for evidence-based policies and procedures
C. Having a surgical team that is collaborative
D. Sustaining no injury from near-miss event
A- Patient safety is not only the core of standard practice of perianesthesia nurses but it is considered the highest priority
Following the ASPAN guidelines, which of the following Phase I patient requires 1:1 nursing care?
A. Conscious 9 year old pediatric patient
B. Patient requiring an oral airway
C. Unconscious stable patient
D. Pediatric patient less that 9 years old with family or health care provider
B- The patient requiring an airway of any sort and airway management need to be dealt with by the RN
While caring for a 30 year old person with advanced metastatic cancer, the perianesthesia nurse fonds a DNAR order in the chart. The nurse recognizes the need to contact the surgeon for a (an):
A. DNAR suspension order and intervention plan
B. Order revision and clarification of family decision
C. Plan to amend the order
D. New plan of care
A- Acting as an advocate for the patient, the perianesthesia nurse seeks to provide care that is respectful to the patient's wishes.
The Joint Commission (TJC) has many requirements for helping provide a safe culture for patients, staff and visitors. The National Patient Safety Goals are yearly goals announced by TJC. An example of an NPSG goal involves:
A. Improving the accuracy of patient identification
B. Restricting visitors in certain areas
C. Identifying certain populations for skin tear risks
D. Allowing for proper storage of items under the sink
A- TJC- issues NPSG to improve patient safety
An assessment tools used for trends in patient sedation levels are essential for the promotion of patient safety during opioid treatment of postoperative pain. The following sedation scale was found to be a reliable tool for assessing unwanted sedation in the adult patient in the PACU:
A. Pasero Opioid-Induced Sedation Scale
B. Richmond Agitation and Sedation Scale
C. Aldrete Scoring System
D. Sedation Agitation Scale
A- According to practice experts from APSAN, the Pasero Opioid-Induced Sedation Scale was rated as the superior scale for opioid management and sedation in the PACU
Emergency readiness requires consistent response plans for staff to follow when addressing all of the following emergencies EXCEPT:
A. Medical emergencies
B. Severe weather
C. Fire and evacuation plans
D. Equipment failure
D- Emergency readiness includes preparation of consistent response plans for medical emergencies, foe and evacuation plans, bomb threat, infant abduction, severe weather and violent intruder
According to the practice recommendation regarding obstructive sleep apnea (OSA) in the adult patient, a patient with know sleep apnea or suspected OSA should be monitored in Phase II PACU:
A. Until discharge criteria has been met and the patient's companion is present
B. Until Spo2 is stable on 2L oxygen
C. An average of 3 hours longer than non OSA patients
D. For 20 minutes following administration of an oral opioid
C- According to the ASPAN, patients with diagnosed or suspected OSA can anticipate additional observation on average of 3 hours beyond the time that patient without OSA would be monitored prior to discharge home
In the preanesthesia area, the perianesthesia nurse must be aware of of signs and symptoms of abuse. These include all of the following EXCEPT:
A. Disheveled appearance
B. Unexplained bruising
C. Maintaining eye contact while being interviewed
D. Inconsistent reporting of injuries
C- Patients who are in abusive situations often avoid eye contact.
A burn victim is admitted to Phase I after split-thickness skin graft for burns over 20% of the total body surface area. Appropriate care would include:
A. Isolation precautions and donning of sterile gloves
B. Donning sterile gloves prior to physical assessment
C. Contact isolation, including gown, mask and gloves
D. Airborne precautions, including N95 mask, gown and gloves
C- Appropriate infection prevention while providing care to a burn patient begins with thorough hand hygiene and isolation precations, which include wearing sterile gown
In the Phase I PACU, the nurse changes alarm parameters and disables alarm signals for the clinical monitoring system. The nurse makes the changes because:
A. Loud and frequent alarm signals wake up the patient
B. Policies address changing alarm parameters or disabling of alarm signals
C. Nursing staff change alarm parameters and disable alarm signals without orders
D. Nursing staff are authorized to make changes in alarm parameters or signals
B- Clinical alarm systems are intended to alert caregivers of potential patient problems, but if they are not effectively managed, they can compromised patient safety
Pre Procedure verification includes:
A. Patient name and fasting status
B. Patient name, procedure site and type of procedure
C. Pre Procedure time, surgeon name and anesthesia care provider name
D. Patient age, name and procedure
B- Hospitals are expected to ensure that procedures are performed for the correct patient and that that is the correct procedure at the correct site