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Medications
Aseptic Technique
SSIP
WHO Surgical Checklist
Miscellaneous
100
What is the ideal time to deliver the preop antibiotic to prevent postop infections? a) 1 to 2 hours before the incision b) 30 minutes to 1 hour before the incision c) 1 to 2 hours after the incision.
What is - b) 30 minutes to 1 hour before the incision
100
Acccording to the Association for Professionals in Infection Control & Epidemiology and AORN, the primary source of AIRBORNE bacteria is healthcare personnel. The 'take home message' to the Perioperative caregivers would be what?
What is:** keep conversations in the presence of a sterile to a minimum to reduce the spread of droplets. Air contains microorganisms on airborn particles, such as respiratory droplets. **Make certain masks fit properly. **Have anesthesia wear masks while in the presence of the sterile field.
100
Several pre-existing factors increase a surgical patient's risk for SSIs. List 5.
What is 1) Diabetes 2) Obesity 3) Nicotine use 4) Malnutrition 5) Use of immunosuppresive medications 6) Extremes in Age 7) Existing infection 8) Ischemia secondary to vascular disease or irradiation 9) Glucose control 10) Hair removal 11) Preop infection 12) Surgical scrub 13) Pt. skin prep 14) Surgeon skill 15) Asepsis 16) Operative time 17) Ventilation 18) Traffic control 19)Environmental Surfaces 20) Sterilization of Equipment
100
What was piloted in 8 cities around the world and proven to dramatically decrease complications and death by more than one-third?
What is: the World Health Organization (WHO) Surgical Safety Checklist?
100
A safe work practice control technique used to ensure that the surgeon and the scrub person do not touch the same sharp instrument at the same time? What is this area called?
What is the neutral zone?
200
Which of the following isn't an adverse reaction to hemostatic agents? a) Intravascular thrombosis if introduced into the vascular space. b) Increased risk of wound infection due to blood residue at the site. c) It may cause pressure in confined spaces d) Reduce capillary bleeding & assist in blood clotting when applied directly on an area.
What is - d) Reduce capillary bleeding & assist in blood clotting when applied directly on an area.
200
In referring to the storage & handling of sterile packages, AORN recommends using event-related sterility. What is the definition of 'event-related"?
What is - conditions present for the term of 'shelf life' depends on the quality of the wrapper material, the storage conditions, the conditions during transport, and the amount of handling?
200
List 4 preventive factors that can be used to prevent Surgical Site Infections?
What is 1) Controlling hypothermia 2) Appropriate hair removal 3) Administering preop, procedure-specific antibiotics within an appropriate timeframe 4) Monitoring for controlled postop blood glucose
200
Name 4 of the 6 items that the circulator needs to confirm with the patient before induction of anesthesia.
What is: 1) Pt. name 2) Pt. date of birth 3) Surgical site 4) Surgical procedure to be performed 5) Consent 6) The site/side/level has been marked
200
List at least 3 KEY pieces of information you can easily find on the SHARQ form for presurgery to OR.
What is 1) H & P status 2) Past Medical History 3) Brief assessment by systems 4) Pregnancy test 5) Labs completed 6) Recent labs ordered 7) Vital Signs
300
What anesthesia agents and muscle relaxant triggers MH? a) Nitrous Oxide & Narcan b) Sevoflurane & Succinycholine c) Desfluane & Barbituates d) Diprivan & Succinycholine
What is - b) Sevoflurane & Succinycholine
300
Doors to the operating or procedure rooms should be closed except during movement of pts, personnel, supplies, & equipment. The air pressure within each O.R. should be greater than in the semi-restricted area. The air in the OR should be maintained under positive pressure with a minimum of what?
What is - a minumum of 15 air exchanges per hour?
300
There is a strong correlation between hyperglycemia & an increased risk of SSIs. In addition to creating a comfortable host environment for bacteria by providing excess glucose, elevated glucose levels ( __???____mg/dL or higher ) will decrease leukocyte phagocytosis & depress antibody response to staphylococcus toxin. a. 200 b. 300 c. 400 d. 250
What is - 250?
300
Before Induction of Anesthesia what does the anesthesia provider confirm with the team? ( 5 checks)
What is: 1) Anesthesia safety check has been completed. 2) Pt. Allergies 3) Anticipated airway or aspiration difficulty 4) Required equipment/assistance available 5) Active warming in place.
300
What product is contraindicated for use on the head and neck area?
What is chlorhexidene gluconate? (CHG)
400
Which statements best describe Nitrous Oxide? a) Non toxic & nonirritation b) Can cause nausea and vomiting c) Flammable and should not be used during upper airway procedures. d) Does not trigger MH. e) All of the above
What is - e) All of the above
400
AORN states that all personnel entering the semi-restricted areas of the surgical suite should confine or remove all jewelry & watches. They clearly state 'rings should be removed from hands'. What is their rationale for this?
What is -**"Rings may harbor organisms & canot be removed during hand washing. Higher bacterial counts have been noted when jewelry is worn." AORN also states **"Studies show that wearing rings may result in colonization of the hands with pathogens such as gram-negative & gram positive pathogens."
400
Which of the following are SCIP goals in relation to prophylactic antibiotic administration? a) Administering within one hour of surgical incision allows for adequate levels of the antibiotic in the tissue during surgery. b) An exception to this rule is when vancomycin or fluoroquinolones (Cipro, Levaquin, Norfloxacin) are ordered, which can be administered two hours prior to incision. c) Must be infused a minimum of 10 minutes PRIOR to inflating the tourniquet. d) All of the above.
What is - d) All of the above
400
Before the skin incision list 4 of the 6 items that the Surgeon will ask of the team?
What is - 1) Introductions [if needed] 2) Pt. name 3) Procedure 4) Confirm position 5) Confirm site is marked and is visible 6) Pt. Allergies
400
What are anatomical locations of pressure points and potential pressure ulcers? Name 6.
What is-1) occiput 2) elbow 3) sacrum 4) heels 5.) scapula 6) ischium 7) malleolus 8) trochanter 9) knee 10) iliac crest
500
What is the main advantage of Peripheral Nerve Blocks? a) Relaxation b) Blocks muscle contractions c) Post-op Pain Control d) Surgical Pain Control
What is - c) Post-op Pain Control
500
AORN does not support home laundering of surgical attire. If staff do launder their attire at home, AORN states, "steps should be taken to minimize contaminates to the home environment; therefore, laundering practices similar to regulations & professional standards for commercial laundries are recommended." State 5 of these standards:
What is:1) Use an automatic washer & hot air dryer 2) use water temperature of 110 to 123 degrees F to facilitate microbial kill 3) use chlorine bleach 4) use detergent according to manufacturers instructions 5) launder surgical attire in a separate load with no other items 6) use the highest drying setting possible 7) attire should be protected during transfer & storage.
500
As of fiscal year 2009 CMS (Center for Medicare & Medicaid) will no longer pay for HAC (Hospital Acquired Conditions) that could reasonably have been prevented through the application of evidence-based guidelines. There are 10 categories of conditions selected for this nonpayment. Name 5 of the 10 categories.
What is- 1) Foreign Object Retained After Surgery 2) Air Embolism 3) Blood Incompatibility 4) Stage III & IV Pressure Ulcers 5) Falls & Trauma - includes burns 6) Manifestations of Poor Glycemic Control 7) Catheter-Associated Urinary Tract Infection 8) Vascular Catheter-Associated Infection 9) Surgical Site Infection after CABG, Bariatric Surgery, Orthopedic Procedures 10) DVT/PE after Total Knee and Hip Replacements
500
Before the pt. leaves the room the Circulator needs to check complete 8 items. List 5 of the 8.
What is: 1) Record the procedure name 2) Wound Classification 3) # of specimens & correctly labeled 4) Special instructions for pathologist 5) Verify correct counts 6) Equipment issues? 7) Key concerns for recovery? 8) Anything we could have done better?
500
When performing a sponge and instrument count, name the 5 conditions in which a xray is required at SCHS -Bend?
What is - 1) BMI > 45 2) Multiple major procedures 3) Multiple instrument sets [4 or more] 4) Multiple staff changes [more than 2 teams] 5) Multiple surgeons [3 or more]