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Wound Classification
Minimally Invasive Surgery
Anesthesia
Electrosurgery
Patient Positioning
100
How would a gunshot wound to the head be classified
What is a class III contaminated wound?
100
Which of the following is a cause of hypothermia during MIS procedure a. CO2 insufflation b. warm O.R.s c. warm solutions d. the use of forced-air warming devices
What is a. CO2 insufflation?
100
A state in which a patient has a minimally depressed level of consciousness, is able to maintain his/her airway, and can respond appropriately to verbal commands and physical stimulation is called: a. minimal sedation b. moderate sedation/analgesia c. deep sedation/analgesia e. general anesthesia
What is b. moderate sedation/analgesia?
100
The most frequently reported patient injury from use of the electrosurgical unit (ESU) is: a. burn at the site of the dispersive electrode b. an alternate site injury c. a capacitive coupling injury d. a patient airway fire
What is a. burn at the site of the dispersive electrode?
100
True or False. One caregiver should lift the legs to position an adult patient into the lithotomy position.
What is false?
200
How is a bronchoscopy with lung biopsy categorized
What is a class II clean-contaminated wound?
200
True or False. Limited visibility during MIS procedures can lead to undetected tissue burns and controlled bleeding.
What is true?
200
Prior to the administration of any medication, a RN should verify right medication, right route, right time, right dose, right documentation and right... a. authentication b. indication c. verification d. none of the above
What is b. indication?
200
Which practice is recommended to minimize the potential for ESU injuries? a. do not use a foot pedal when there is a potential for fluid spills b. have the ESU inspected & tested by bioengineering personnel before each use c. remove a damaged ESU from service immediately & report it to appropriate personnel d. use an extension cord if the power cord does not reach the electrical outlet
What is c. remove a damaged ESU from service immediately & report it to appropriate personnel?
200
The most frequent predictors of perioperative pressure ulcers have been found to include all of the following EXEPT: a. increase age of the patient b. diabetes c. vascular disease & vascular procedures d. thyroid disease
What is d. thyroid disease?
300
How should the perioperative RN classify an incision and drainage of a perirectal abscess with packing procedure?
What is a class IV dirty/infected wound?
300
All of the following patients are at higher risk during a laparoscopic procedure that requires general anesthesia, extreme positions, and creation of pneumoperitoneum EXCEPT: a. adolescents b. older adult with cardiac or pulmonary disease c. patients with increase intracranial pressure d. premature infants
What is a. adolescents?
300
The perioperative RN's discharge instructions for the patient & caregiver should include: a. written instructions b. verbal instructions c. verbalization by the patient & caregiver that they understand the discharge/homecare instructions d. all of the above
What is d. all of the above?
300
Dr. Jones is making repeated requests for Sara, the RN circulator, to increase the ESU power setting. He complains of ineffective coagulation. What should Sara do first? a. comply with the request & document the setting change b. inspect the dispersive electrode and the underlying skin c. report the malfunction to the appropriate bioengineering personnel d. replace the ESU & all accessories
What is b. inspect the dispersive electrode and the underlying skin?
300
True or False. Pillows, blankets & molded foam devices are less effective during long surgical procedures.
What is true?
400
How should the perioperative RN classify an adenoidectomy that goes smoothly with no complications
What is a class II clean-contaminated wound?
400
Which complications can result from mismanagement of distention fluids and irrigation fluids during MIS a. fluid emboli b. fluid extravasation c. hyponatremia d. hypothermia e. all of the above
What is e. all of the above?
400
Flumazenil otherwise known as Romazicon is an opioid antagonist or a benzodiazepine antagonist? It is a reversal for versed.
What is a benzodiazepine antagonist?
400
Which of the following practices is most likely to eliminate the risk of fire with the use of an ESU? a. disconnect the active electrode from the ESU between cases b. use only isotonic solutions in body cavities c. use only nonflammable skin prep agents d. use rubber catheters as insulating sheaths for active electrode tips
What is c. use of nonflammable skin prep agents?
400
All of the following are at a higher risk for vision loss EXCEPT: a. a patient positioned in prone position b. a patient positioned in lateral position c. a patient undergoing a lengthy procedure greater than or equal to 6.5 hours d. a patient who loses a substantial amount of blood (more than 44.7% of their estimated blood volume)
What is b. a patient positioned in lateral position?
500
A 22 year old female patient was hiking on Saturday and a foreign body embedded in her right forearm close to her wrist. The right forearm is edematous & warm to touch. While the patient is under general anesthesia, the surgeon cleans the wound, removes the foreign body & packs the wound. The surgery goes smoothly with no complications. The perioperative RN would classify the wound as:
What is a class IV dirty/infected wound?
500
After an MIS urologic procedure, the patient in the PACU states that he has abdominal pain, he is nauseous, and is feeling confused. His BP is 90/60. His urine output for the one hour that he has been in PACU is 15 ml. The patient's symptoms can be related to: a. cold irrigations used during the MIS procedure b. extravasation of distention fluids used during the urologic MIS procedure c. the patient's position during the MIS procedure
What is b. extravasation of distention fluids used during the urologic MIS procedure?
500
During the surgical procedure & after the administration of sedation and analgesia, the RN observes that the patient is restless. This can be a result of which of the following (more that one may apply): a. hypercapnia b. hypercalcemia c. hypertension d. hypoxia
What is a. hypercapnia and d. hypoxia?
500
Which of the following practices is recommended concerning the use of an ESU? a. do not administer oxygen to patients when ESU is being used b. during head & neck procedures, use the active electrode as far from the oxygen source as possible c. the ESU may be used without additional risk of patient injury if the patient needs oxygen d. when administering oxygen in a closed system, drapes should be tented to prevent buildup of oxygen under the drapes
What is b. during head & neck procedures, use the active electrode as far from the oxygen source as possible?
500
A full-thickness tissue loss with exposed tendon, bone, or muscle & with or without slough or eschar present is an example of which stage of pressure ulcer?
What is a stage IV pressure ulcer?