Question 1

In most situations, the surgical suite is maintained as a positive pressure room. What is the pattern of air circulation for this type of room?

Accepted Answer

A positive pressure room is one in which the flow of air moves out of the room, preventing outside air from entering. This is important in the operating room, as it prevents outside air, which may contain pathogens, from entering the room and possibly infecting the patient. Conversely, a negative pressure room is used with infectious patients as a form of isolation to keep them from infecting others.

Question 2

Which of the following tasks can the registered nurse delegate to a certified nursing assistant to do?

Accepted Answer

The registered nurse can delegate the task of assisting the patient with preoperative skin preparation by showering with antimicrobial soap. This is a task that a certified nursing assistant can perform and that will save the perioperative nurse time for other assessments and evaluations. The registered nurse cannot delegate patient teaching or critical assessments to unlicensed assistive personnel.

Question 3

The nurse is aware that their hospital has a policy that allows nursing aides to remove intravenous lines while on the surgical unit. The nurse delegates this task to the aide and the intravenous catheter is removed incorrectly. Who is responsible for this mistake?

Accepted Answer

In this situation, the nurse is responsible for the aide's actions, because they supervised the procedure. Tasks delegated to unlicensed personnel are ultimately the responsibility of the nurse. Although the hospital may have a policy allowing unlicensed personnel to perform certain tasks, this cannot override the state's nurse practice act.

Question 4

What is the purpose of bumper guards found on the walls of the surgical area?

Accepted Answer

The purpose of bumper guards are to protect the walls from damage if beds or equipment run into them. When moving patients and transporting materials through the hallways in the perioperative area, turning corners and moving around items may cause equipment to run into the walls. Bumper guards keep the walls from being damaged so that they can be cleaned and sanitized. Walls that have holes may not stay clean and can collect microorganisms that can cause illness.

Question 5

How are floors within operating suites designed to protect nurses and staff during surgical procedures?

Accepted Answer

The floors within surgical suites have non-slip surfaces to reduce the incidence of falls. These floors are typically non-porous and easy to clean so that they do not harbor bacteria. The operating suite is designed to be maintained at a level of cleanliness that allows it to become as close to sterile as possible. Providing flooring that is clean and not slippery will reduce microorganisms as well as prevent injuries related to falling.

Question 6

While assisting in a surgical procedure, a perioperative nurse pours saline into a sterile bowl. She inadvertently drops the bottle on the floor, spilling liquid beneath the instrument table. What is the most appropriate response in this situation?

Accepted Answer

The nurse should dry the wet floor as much as possible without contaminating themself and notify staff of the damp area. Spills that occur in the operating room during the procedure should be cleaned as quickly as possible to avoid incurring any injuries related to slips or falls. Once the procedure is finished, the housekeeping department may come and thoroughly clean the floor with the rest of the room.

Question 7

According to the AORN, which of the following items is not considered regulated medical waste?

Accepted Answer

Patient clothing is not considered regulated medical waste. The exception to this may be if the patient arrives for care with clothes that are saturated with blood or body fluids. Animal waste, blood products, body fluids and sharps are all items that can potentially transmit infectious disease. These items should be contained for proper disposal.

Question 8

Which of the following practices is necessary in order to protect surgical staff from overexposure to radiation?

Accepted Answer

To protect surgical staff from overexposure to radiation, staff should wear lead gloves and aprons when assisting patients who are receiving x-rays. Garments made from lead protect the body from exposure and should be stored properly, without folding the materials. While it is important for surgeons to understand radiation safety and perform testing, all employees who may come in contact with radiation should demonstrate knowledge of safety procedures.

Question 9

All of the following items should be included as part of a latex allergy cart to reduce the exposure to latex for a sensitive patient EXCEPT:

Accepted Answer

Bed sheets are not necessarily part of a latex allergy cart for patients with this specific condition. Latex products contribute to an allergy when particles are in the air, and bed sheets may collect allergen particles, but are not necessarily created with latex. However, some types of underpads that are placed on beds to absorb liquids may contain latex and latex-free alternatives should be provided on the cart.

Question 10

During surgery, a patient receives two units of packed cells, but the surgeon states that they will need more. How should the nurse handle this situation?

Accepted Answer

The nurse should prepare the blood warmer to warm the additional units of blood before the transfusion. Blood should be warmed before administration, particularly in situations when more blood is necessary and must be administered quickly. Giving blood that has been stored and is cold may cause hypothermia for the patient and could lead to cardiac arrhythmias.

Question 11

Which of the following types of insufflators should be considered when creating a pneumoperitoneum for a laparoscopic procedure?

Accepted Answer

An important consideration for creating a pneumoperitoneum is to use an insufflator that alarms when too much CO2 has been administered. Excessive CO2 can result in hypercarbia if the carbon dioxide enters the bloodstream. Additionally, excessive pressure in the abdominal cavity can create pressure on the diaphragm and cause respiratory compromise. An appropriate insufflator during this type of procedure is one that tells the surgical team when too much gas has been instilled.

Question 12

What actions must the nurse consider when working near surgical smoke that occurs during laser use?

Accepted Answer

When working around surgical smoke, the surgical team should use a suction valve to remove smoke while maintaining the pneumoperitoneum. This typically is necessary during laparoscopic procedures in which an insufflator is also being used. A suction valve, when used at low pressure, can remove the plume of smoke generated from a laser quickly enough that it does not diminish the pneumoperitoneum.

Question 13

What is purpose of using the cell saver during a surgical procedure?

Accepted Answer

The cell saver works to wash the patient's blood and return red blood cells for autotransfusion. If a patient needs more blood during surgery, suctioned blood and fluids can be washed in the cell saver and returned to the patient. This type of system is useful for surgical procedures where an extensive amount of blood is needed or if the patient does not want to use donor transfusions.

Question 14

Which of the following actions must the nurse consider when working with a pneumatic tourniquet cuff?

Accepted Answer

When using a cuff from a pneumatic tourniquet, the surgeon should verify the position of the cuff before use; the nurse should also document the location, time of inflation, and time of deflation of the cuff. These measures are essential to ensure patient safety while using the cuff, as significant damage can occur with improper use. By documenting the use of the cuff, as well as verification for use by the surgeon, the nurse protects both themself and the patient.

Question 15

When preparing to move a patient from the operating table onto a transport gurney, which types of body mechanics are essential to prevent injury to the patient and team members?

Accepted Answer

When moving a patient, the nurse should communicate plans for movement between team members and use the legs to bear much of the weight. Communicating plans for moving a patient provides better coordination so that everyone is aware of their role. Using the legs to bear the weight puts less strain on the back and reduces the risk of injury to the nurse.

Question 16

When preparing to assist a patient with walking for the first time after surgery, which of the following is not a factor to be considered when planning to provide help?

Accepted Answer

When preparing to help a patient walk, the amount of time needed is not necessarily a factor to be considered when planning to provide help. The nurse should exercise patience with the person who is getting up for the first time, as being too eager or trying to move too quickly can result in falls or injuries. The size of the room is important to determine if the patient has enough room to move around chairs or obstacles; the weight of the patient and use of assistive devices are necessary to determine how many people are needed for help.

Question 17

A patient has been diagnosed with an infectious disease during the postoperative period of recovery and needs to stay in an isolation room. Which of the following nursing interventions are appropriate for working in this situation?

Accepted Answer

The nurse should maintain ample amounts of towels and linens within the room for the patient. Patients in isolation still need to perform daily activities and undergo the healing process just like those who do not have infectious diseases. Maintaining linens and supplies in the room for the patient reduces the need for frequent trips outside the room to gather more items and return, thus reducing the risk of infectious microorganisms leaving the room.

Question 18

What is the rationale for milking the tubing of a chest tube drainage system?

Accepted Answer

The rationale for milking the tubing of the chest tube drainage system is to remove excess clots or debris. At times, clots may collect in the tubing, which can impede drainage flow. This may be noted by observing decreased amounts of drainage coming from the chest tube or by visually noting an occlusion. Milking the chest tube is done very gently and according to hospital policy.

Question 19

When preparing to apply oxygen via nasal cannula to a patient for low saturations, what is the order of connecting the components from the oxygen source in the wall to the patient?

Accepted Answer

Oxygen is connected from the wall source to the patient via the flow meter, connector, humidifier, and tubing, in that order. The flow meter is connected to the oxygen source, and controls how much oxygen is delivered to the patient. This is connected to a humidifier, which adds moisture to the oxygen to prevent drying. The oxygen is then delivered to the patient through the tubing.

Question 20

How does an oral airway work?

Accepted Answer

An oral airway is used to hold the tongue out of the way to help the patient to breathe. If a patient is unconscious, their facial muscles may relax and the tongue may fall back and occlude the throat. Inserting an oral airway pulls the tongue forward, opening the airway and facilitating better respiratory effort.

Quiz 7: Management