Deck 30: Workplace Issues and Staff Safety

Question 1

Select the appropriate nursing action that supports hands-free instrument passing and sharps safety.

A) Create a neutral hands-free area between the scrub person and surgeon with a basin or magnetic mat.
B) Use a hands-free area for sharps and all small clamps or sponges.
C) Announce the transfer of the sharp or clamp as soon as possible after it is placed.
D) During the hand-off report,ask the relief scrub person if he/she will want to use the hands-free technique for passing sharps.

Answer 1

A
A magnetic pad or basin may be used to create the neutral zone;if a basin is used,it should be placed on the field and not held by the scrub person.Dedicate the neutral zone to sharps only;these include suture and hypodermic needles,scalpels,and other sharp instruments.Place only one sharp at a time in the neutral zone.Announce the transfer of a sharp before placing it in the neutral zone (such as "knife down").Include identification of the neutral zone during hand-off communications to relief scrub persons.

Question 2

Healthcare professionals should employ strategies to reduce their risk of allergic reaction to latex in the perioperative environment.Select a best practice for minimizing the risk of latex allergy development in nonallergic patients,and the risk of reaction in sensitive or allergic patients.

A) Use powder-free gloves that have low levels of protein and chemical allergens.
B) Use sterile oil-based hand creams before donning gloves if latex gloves must be worn.
C) Use nonlatex gloves for activities not likely to involve contact with infectious materials.
D) Wear an OR hat without an elastic band and do not wear rubber tennis shoes.

Answer 2

A
Use powder-free gloves that are low in protein and chemical allergens.Use nonlatex gloves for activities that are not likely to involve contact with infectious materials.Do not use oil-based hand creams or lotions when wearing latex gloves,which can cause glove deterioration.

Question 3

Select the guideline that complements the design of the culture of safety model.

A) Take advantage of a personal injury event to educate yourself about future prevention strategies.
B) Comply with those policies that fit your current practice.
C) Incorporate safe practices into your daily work when handling sharps.
D) Observe local,state,and federal regulations as they fit your current practice.

Answer 3

C
You can take significant measures toward ensuring your personal safety and avoiding injuries from sharps if you do the following:Adopt and incorporate safe habits into daily work activities when preparing and using sharp devices.Observe local,state,and federal (OSHA)regulations.Comply with methods to protect yourself from disease transmission (e.g.,get the hepatitis B vaccination).Participate in education about bloodborne pathogens,and follow recommended infection prevention practices.Know the location in your department of the exposure control plan.Finally,follow the exposure control policy if injured,including immediate reporting of the incident and commencement of exposure response procedures.

Question 4

Where are the sources of radiation exposure in an operating room setting?

A) Ionizing sources (e.g.,ultrasound machines) and nonionizing sources (e.g.,MRI scanners)
B) Nonattenuated fluorescent lights and portable x-ray machines without lead guards
C) Radioactive seed implants not contained in a lead container and nonionizing lasers
D) Nonionizing sources (e.g.,lasers) and ionizing sources (e.g.,x-ray machines and C-arms)

Question 5

The lifting equation provides a mathematical equation to determine the recommended weight limit (RWL)and lifting index (LI)for selected two-handed manual lifting tasks.Essentially,what is the recommended maximum weight limit for one person in a patient handling task? What is the best option when the weight limit exceeds the recommendation?

A) 25 lb;bend from the knees,not the waist
B) 32 lb;use good body mechanics
C) 37 lb;wear a support belt
D) 35 lb;use assistive lift devices

Question 6

Perioperative personnel historically have relied on numerous types of precautions to protect themselves and others from bloodborne pathogens and other infectious diseases.Select the statement that best differentiates between Universal and Standard Precautions.

A) Universal Precautions and Standard Precautions are the same;however,Standard Precautions require more hand hygiene and prevention of sharps injuries.
B) Many similarities and differences exist between Universal and Standard Precautions.
C) Standard Precautions apply to blood;all body fluids,secretions,and excretions (except sweat),regardless of whether they contain visible blood;mucous membranes;and nonintact skin.
D) Universal Precautions is the same as Blood and Body Fluid Precautions.

Question 7

Select the true statement that best explains the OSHA exposure control plan.

A) OSHA has developed the Hierarchy of Controls model,which protects the workplace from lawsuits stemming from worker injury from sharps and blood exposure.
B) The OSHA exposure control plan is similar to HIPAA in that it protects the workplace from being exposed when a worker injury occurs that could harm the facility's reputation.
C) The OSHA exposure control plan is designed to provide guidelines to control risks and protect workers from sharps injury and bloodborne pathogens.
D) The OSHA exposure control plan is a materials management strategy to explore replacements for sharps and other healthcare devices that can cause sharps injury and blood exposure.

Question 8

Contact with infected patients or infectious material places healthcare workers at risk for occupational-acquired infection.Many diseases and infections can be prevented through immunizations and vaccines.What group of communicable diseases are healthcare workers at risk for acquiring or transmitting?

A) Tuberculosis,hepatitis A,meningococcal disease,and typhoid fever
B) Tetanus and diphtheria
C) Hepatitis B,influenza,measles,mumps,rubella,varicella,and pertussis
D) Hepatitis C

Question 9

Latex allergy develops from exposure to natural rubber latex and plant cytosol,used extensively to manufacture medical gloves and other devices,as well as numerous consumer products.Allergic reactions to latex range from skin disease to asthma and anaphylaxis that can result in chronic illness,disability,career loss,hardship,and death.What types of signs and symptoms would be indicative of an allergic contact dermatitis response to contact with natural rubber latex?

A) Pruritus,edema,erythema,and vesicles that develop 6 to 48 hours after exposure
B) Dry,reddened,itchy skin with hives and peeling patches
C) Cracked hands,nausea,vomiting,and perioral numbness and tingling
D) Generalized urticaria,wheezing,dyspnea,and tachycardia

Question 10

Teamwork is a major component of OR efficiency,quality of care,and patient safety.The Joint Commission has reported breakdowns in communication as a leading cause of adverse events and errors.A study on teamwork in the operating room,in 2008,measured such domains as difficulty speaking up,conflict resolution,nurse-physician collaboration,feeling supported by others,asking questions,and heeding nurse input.On analysis,the researchers found:

A) teamwork climate variability was greater within hospital OR levels than between hospitals
B) surgeons and anesthesiologists were more satisfied with physician-nurse collaboration than were nurses
C) OR nurses and CRNAs gave high ratings of the teamwork climate given by physicians
D) there were discrepant attitudes about collaboration between the nurses and nurse anesthetists (CRNAs)

Question 11

Select the true statement that best describes a key component of the culture of safety in regards to blood exposure.

A) A goal of the culture of safety is to reduce the risk of blood exposure and sharps injuries to staff.
B) The culture of safety is a model for ensuring The Joint Commission survey expectations are met.
C) The culture of safety is mandated by regulatory agencies to structure environmental rounds.
D) The exposure control plan was designed to provide the framework for the culture of safety.

Question 12

A sharps-safe area on the sterile field between the scrub person and the surgeon-where sharps can be transferred to the surgeon from the scrub person and returned to the scrub person after use-is referred to as the:

A) sharps zone.
B) hands-free zone.
C) neutral zone.
D) safety zone.

Question 13

Which of the following may be a consequence of high-dose or full-body radiation?

A) Radiation poisoning,heart disease,stroke,and death
B) Nausea,vomiting,diarrhea,and weakness
C) Cancer and mental retardation in children of mothers exposed during pregnancy
D) All of the options are possible consequences of high-dose or full-body radiation

Question 14

What vaccine should healthcare workers receive if they are caring for immunocompromised patients?

A) Live attenuated influenza vaccine (LAIV)
B) Inactivated influenza vaccine
C) Immunoglobulin
D) Bordetella vaccine

Question 15

Charlene Majors is an anesthesia provider with an allergy to latex.When she is at work,she always carries an epinephrine autoinjector and a beta-agonist inhaler.What type of latex allergy does Charlene have?

A) Allergic contact dermatitis
B) Irritant contact dermatitis
C) Type I IgE-mediated hypersensitivity reaction
D) Combined-effect latex allergy

Question 16

Wet floors are a common hazard causing slips,trips,and falls (STFs).Select a prevention strategy that is a best practice for preventing STFs from spills on wet floors.

A) Transport liquids in covered containers with lids in place.
B) Place bright yellow low-profile pop-up signs in areas where STFs are most likely to occur.
C) Position highly visible yellow absorptive pads in areas where STFs are most likely to occur.
D) Use a dripless,brush-free gel solution for surgical patient skin preps.

Question 17

What one factor describes the high incidence of musculoskeletal disorders among surgical technologists and perioperative nurses?

A) Pulling a large,heavy piece of equipment rather than pushing it
B) The cumulative effect of repeated patient handling events
C) The growing high obesity rate and heavier patients and care providers
D) The cumulative effect of pushing,pulling,and carrying heavy instrument sets and rolling carts

Question 18

What is the purpose of a Material Safety Data Sheet (MSDS)?

A) To recommend exposure limits of all chemicals in the workplace over a working lifetime
B) To inform all employees of the presence,characteristics,handling,and risks of chemicals in the workplace
C) To provide a structured design for inservices and skill stations on hazardous chemical safety
D) To promote the development of manuals and log books for The Joint Commission survey

Question 19

A STF hazard is present when the scrub person stands on a lift,or foot stool,to reach an acceptable height for ergonomic comfort with the sterile field.Whether the scrub person uses one stool,stacked stools,or a "runway" of stools,the danger exists that a fall could occur.What classification of cause and prevention factor does this situation represent?

A) Proper footwear
B) Unobstructed pathways
C) Uneven floor surface
D) Lighting

Question 20

Linda Gardner is highly allergic to latex and the anesthesia provider plans to give Linda prophylactic medications before anesthesia.What medications might be administered to Linda in the preoperative holding area?

A) Epinephrine and an H2-blocker
B) Vasopressin and atropine
C) Prednisone and a beta-agonist inhaler
D) Dimethylxanthine

Question 21

AORN has developed a list of risk reduction strategies that the perioperative nurse and surgical technologist can use to protect themselves from exposure injuries during surgery.Which safe sharp handling practices reflect true statements that are appropriate intraoperative nursing actions for the scrub person?

A) Wearing a double layer of gloves
B) Keeping track of,and accounting for,all sharp items throughout the procedure
C) Using blunt suture needles
D) Counting sharps only twice during the procedure to restrict handling and contact
E) Giving verbal notification when passing a sharp device
F)Passing sharp items using neutral/hands-free techniques instead of passing hand to hand

Question 22

Exposure to bloodborne pathogens occurs during all phases of the perioperative process.Observing safety precautions during all phases of surgery,from setup to cleanup,reduces the number of injuries and exposures for all OR personnel.For the prevention of sharps injuries in the preprocedure and postprocedure phases,which risk reduction strategies reflect appropriate nursing actions?

A) Use standardized sterile field setups throughout the surgical services department.
B) Organize the Mayo stand with all sharps visible and pointed toward the setup person.
C) Transport reusable sharps in a safe,closed container to the decontamination cleanup area.
D) Safely grasp the sharp tip with gloved fingers when disposing in sharps container.
E) Do not place hands or fingers into a container to dispose of a device.f.Inspect the sharps container for overfilling before discarding disposable sharps in it.

Question 23

Number the corrective actions in the appropriate order in which they should occur in the event of a staff person receiving a needlestick injury.
a.Identify the source patient.
b.Undergo immediate testing;ensure confidentiality for HIV,HBV,and HCV infections.
c.Alert the supervisor of the injury.
d.Document the exposure in detail,for the staff member's records as well as for the employer.
e.Wash wound with soap and water;flush mucous membranes.
_f.Immediately report to employee health,the emergency department (ED),or the designated facility.

Question 24

Waste anesthetic gases are small amounts of gases that may leak either from the patient's anesthetic breathing circuit into the OR air while anesthesia is being administered or from exhalation of the patient during recovery.Both mechanisms of exposure create risks for OR personnel.Select the appropriate risk reduction strategy that protects the environment and perioperative worker from exposure to ambient waste anesthetic gas.

A) Check the anesthetic delivery system for irregularities or breaks.
B) Turn off the room or local ventilation system.
C) Ensure that the scavenging system is properly connected to the gas outlet.
D) Ensure proper facemask fit before delivering anesthesia gas.
E) Turn the breathing system off before turning off the gas.f.Use high-flow gas delivery for more rapid induction.