Download Perioperative Nursing: Patient Safety and Equipment Considerations and more Exams Public Health in PDF only on Docsity!
Which patient population is more sensitive to dosage errors A. Male patients 25- B. Bariatric patients C. A patient with a history of polypharmacy D. Pediatric patients - answer>>D. Pediatric patients
Which of the following is part of the surgical check list A. When the pt last ate food or drank fluids B. whether any special equipment, devices or implants will be needed C. Whom the surgeon should talk to after surgery D. What pharmacy the patient uses - answer>>B. Whether any special equipment, devices or implants will be needed
A pt taking ginger preoperatively is at risk for surgical complications that include bleeding, hypotension and A. hypoglycemia B. Bradycardia C. hypokalemia D. liver dysfunction - answer>>B. Bradycardia
The National Patient Safety Goals directed at improving staff communication review the need for A. ensuring important test results are communicated to the right person on time B. transferring patients to the correct next level of care C. completing perioperative charting prior to transfer to the postanesthesia care unit D. Conducting a daily huddle on the unit - answer>>A, ensuring important test results are communicated to the right person on time
Which of the following is a potential contraindication to the use of a pneumatic tourniquet? A. Pt has undergone prev joint replacement surgery B. Pt is older than 80 years old C. Pt has sickle cell anemia D. Pt's operative extremity has been shaved - answer>>C. Sickle cell anemia
A patient is on long term acetyl salicylic acid therapy. Preoperatively, the pt should be counselled to discontinue taking the medication _________ prior to surgery A. 1 week B. 2 weeks C. 3 weeks
Based on data collected during the patient assessment, the perioperative RN A. identifies an outcome B. Formulates a nursing diagnosis C. develops a plan of care D. performs nursing interventions - answer>>B. formulates a nursing diagnosis
Liquid peracetic acid low-temperature sterilant is used for devices that meet all of the following criteria except: A. Device must be approved for this process B. Device must be heat sensitive C. Device must be aerated D. Device must be immersed - answer>>C. Device must be aerated
During surgery the patients respirations become increasingly shallow, and the pupils become smaller and smaller until they are pinpoint. How should this situation be managed? A. The patient should be extubated and bagged with 100% oxygen B. This is normal and is not cause for alarm C. The anesthetic should be discontinued, and a narcotic antagonist such as naloxone (Narcan) should be administered D. Oxygen should be increased while anesthetic is decreased - answer>>C. The anesthetic should be discontinued, and a narcotic antagonist such as naloxone (Narcan) should be administered
NPO Guidelines: Food and fluids as desired - answer>>Up to 8 hours
NPO Guidelines Light meal (toast, clear liquids, infant formula, non human milk) - answer>>Up to 6 hours
NPO Guidelines Breast Milk - answer>>Up to 4 hours
NPO Guidelines Clear liquids only, NO solid food or foods with fat content - answer>>Up to 2 hours
NPO Guidelines No solids or liquids - answer>>During the 2 hours until surgical times
After a person with an airborne disease has been cared for in the OR, the OR should be closed and not cleaned until.. - answer>>99% of the airborne particles have been removed from the air (eg 15 air exchanges/hour for 28 minutes)
What Herbs may elevate Blood Pressure - answer>>Goldenseal Licorice
What Herbs may prolong the effects of anesthesia - answer>>Kava St. johns Wort Valerian
What are the three tenets that radiation safety is based on - answer>>Time, distance and sheilding
A patients life threatening injuries prevent required hair removal before transfer to the OR. The best course of action for the perioperative nurse to follow is to A. Leave the hair at the incision site and prep the patient B. use a razor and 3" cloth tape to remove the hair C. moisten the area to be prepped and use a disposable clipper D. use a depilatory cream on the surgical site - answer>>C. moisten the area to be prepped and use a disposable clipper
When prescribed, intermittent pneumatic compression devices should be applied and functioning A. after the administration of regional or gen anesthesia B. before the admin of regional or gen anesthesia C. before the patient arrives in the operating or procedure room
D. after the patient arrives in the operating or procedure room - answer>>B. before the admin of regional or gen anesthesia
In planning for the transfer of an 18 pound child to the gurney after bilateral myringotomies with insertion of ear tubes, the perioperative nurse plans for which of the following patient transfer aides A. A lateral transfer device, one caregiver, and the anesthesia professional B. A lateral transfer device, two caregivers, and the anesthesia professional C. A lateral transfer device, three caregivers, and the anesthesia professional D. A mechanical list device, three caregivers and the anesthesia professional - answer>>A. A lateral transfer device, one caregiver, and the anesthesia professional ( any patient under 52 pounds)
Lead shielding used to minimize the patients exposure to ionizing radiation should be placed A. between the patient and the source of radiation, but not within the path of the beam that originates from the x-ray tube B. between the patient and the source of radiation and within the path of the beam that originates from the x-ray tube C. between the patient and the image intensifier of the fluoroscopic unit, but not within the path of the beam that originates from the x-ray tube D. between the patient and the image intensifier side of the fluoroscopic unit, and within the path of the beam that originates from the x-ray tube. - answer>>A. between the patient and the source of radiation, but not within the path of the beam that originates from the x-ray tube
D. the use of foam heal padding - answer>>C. elevating the head 25 degrees
Assessing the surgical patients psychosocial state allows the RN to contribute to the plan of care by A. suggesting modifications to the patients position B. communicating effectively with other members of the team C. ensuring the requisite supplies and equipment are readily available D. Providing explanation, comfort and emotional support - answer>>D. Providing explanation, comfort and emotional support
A pt scheduled for a bronchoscopy states he has had a persistent cough with blood-tinged sputum, night sweats and a loss of appetite with significant weight loss over the past three months. Which action should be taken A. Leave the portable HEPA filter unit "on" while the patient is intubated to supplement normal room air exchanges. B. Schedule the patient for the first procedure of the day, when the infection prevention specialist is available C. Provide the patient with N-95 fit tested respirator to wear during transport D. Notify environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles - answer>>D. Notify environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles
A 28 y/o Hispanic male is scheduled for repair of an incarcerated inguinal hernia. He does not speak English. The consent form is only available in English. The best way for the nurse to ensure informed consent for this patient is to A. witness the pts signature on the consent form B. arrange for a medical interpreter C. allow a family member to interpret for the surgeon D. arrange for a Spanish speaking staff member to interpret for the surgeon. - answer>>B. arrange for a medical interpreter
If all members of the surgical team are present when the patients enters the room, can the sign in a time out process be performed? - answer>>yes
What are the three elements of the fire triangle - answer>>fuel, ignition, oxidizers
What is the "nominal hazard zone" in Laser safety - answer>>The space in which the level of direct, reflected, or scattered radiation used during normal laser operation exceeds the applicable max permissible exposure
How should a patient weighing more that 157 pounds be transferred to the OR bed - answer>>Mechanical lifting device by 3 caregivers plus anesthesia
When placing the patient in steep Trendelenberg, where should the patients knees be on the bed - answer>>over the distal break to allow for bending the knees and to secure the pt, and to protect from undue shear during the procedure
Placing the patient on the OR bed in the supine position with arms extended on armboards at greater that 90 degrees may cause injury to the A. Axillary Nerve B. Brachial Nerve C. Median Nerve D. Radial Nerve - answer>>B. Brachial Nerve
The correct time to label containers designated for medications or solutions is A. When setting up the sterile field but before the medications are delivered to the field B. When there are more than two medications being used on the sterile field C. At the time the medication is delivered to the sterile field D. Just before using the medication on the patient - answer>>C. At the time the medication is delivered to the sterile field
A periop nurse is preparing to perform a skin prep for a patient scheduled for a right breast biopsy with needle localization. When the nurse removes the patients gown, she discovers a wire inserted into the left breast. What is the appropriate action A. Leave the wire in place and prep the left breast B. Remove the wire and prep the right breast C. Call the radiologist and tell him of the error
D. Postpone prepping until the discrepancy is resolved - answer>>D. Postpone prepping until the discrepancy is resolved
Potential harm from the use of povidone-iodine antiseptics include A. deafness B. thyroid dysfunction C. neurotoxicity D. allergic response to iodine - answer>>B. thyroid dysfunction
A specific directive, written by a physician, about end of life decisions is a/an A. DNR order B. AND order C. Advance Directive D. Required reconsideration - answer>>B. AND order
When performing preop patient skin antisepsis, the RN should A. Perform a surgical hand scrub and wear a sterile gown B. Perform a surgical hand scrub and wear short sleeved scrub attire C. Perform hand hygiene and wear a sterile gown D. perform hand hygiene and wear long sleeved scrub attire - answer>>D. perform hand hygiene and wear long sleeved scrub attire
What is a Kronig incision - answer>>An 8cm vertical incision made in the lower uterine segment after the bladder is separated and retracted away
A Sterile field has been prepared for a vaginal hyst. The surgeon has been called away for an emergency C-Section, delaying the scheduled case by at least 1 hour. the appropriate method for maintaining the sterile field for a delayed case is to A. Tape the door closed B. Cover the sterile field with a sterile drape and leave the room C. Cover the sterile field with a sterile drape and remain in the room D. Wait for an hour and the tear down the back table - answer>>C. Cover the sterile field with a sterile drape and remain in the room
A pt has lost 750mL of blood intraop. Vitals are WNL. Which of the following interventions sould the nurse anticipate. A. Send a blood specimen for a stat type and cross B. Set up autologous blood transfusion unit C. Send an order for 2 units of O-neg D. Obtain additional crystalloids - answer>>D. Obtain additional crystalloids
The RN completing the final count for a knee arthroscopy discovers that an atraumatic needle is missing. After an exhaustive search, an X-Ray is ordered. The results are negative and the surgeon closes the wound. How does the RN document the incident
A. Document that the count was incorrect or unreconciled and describe the steps that were taken to rectify the count B. Document that the count was correct because the x-ray was negative C. Notify the supervisor and document what he or she instructs according to policy D. Inform the patient that a needle may have been left in the wound - answer>>A. Document that the count was incorrect or unreconciled and describe the steps that were taken to rectify the count
A pt is scheduled for a total knee. During time out the scrub discovers that the incorrect implant is on the back table. The correct implant is available, but unsterile. The surgeon would like to continue with the case. What is the best course of action. A. Notify the surgeon that the correct implant may be sterilized via the immediate-use steam sterilization method if biological and class V indicators are placed in the load B. Notify the surgeon that the correct implant may be sterilized via the ethylene oxide method if the aeration period is aborted C. Notify the surgeon that a root cause analysis will be initiated D. Cancel and reschedule the procedure - answer>>A. Notify the surgeon that the correct implant may be sterilized via the immediate-use steam sterilization method if biological and class V indicators are placed in the load
An 18 y/o pt is scheduled for surgery to have cochlear implants placed, The patient refuses to have the implants tracked even after the team has informed her of the possible implications of a recall or adverse event. What is the next course of action
Symptoms of MH - answer>>hypercarbia, tachypnea, tachycardia, metabolic and resp acidosis, cardiac dysrhythmias, and temp elevation
What is an early indication of MH - answer>>rigidity of the jaw, identified during intubation
What is the treatment for MH - answer>>Dantrolene 2.5mg/KG
What is the one medication used as a preoperative anxiolytic? - answer>>Midazolam
Hetastarch - answer>>A substitute for blood plasma and has oxygen carrying capabilities
What are the three primary methods of hand hygiene? - answer>>Washing with soap and water performing surgical hand scrub using surgical hand rubs
What is the ONLY way to prevent the transfer of Clostridium difficile? - answer>>Hand washing with Soap and Water
How long is the Surgical hand scrub with a brush - answer>>Three to five minutes
Wound classification parameters: Clean - answer>>Wound is not infected or inflammed The procedure was free from entry into the resp, alimentary or genitourinary tract Was the wound primarily closed or drained with closed drainage
Wound classification: Was the respiratory, alimentary, or genitourinary tract entered under controlled conditions without: Evidence of infection or contamination or major break in technique ie spillage - answer>>Clean Contaminated II
Wound Classification: Is the wound Fresh, open or accidental; or is there gross (ie visible) spillage from the GI tract; or is there acute non purulent inflammation present? Was there a major break in sterile tech during the procedure - answer>>Class III Contaminated
Wound Classification: Is the wound An old wound with retained, devitalized tissue (gangrene, necrosis) or a wound with existing clinical infection (purulence), or a perforated viscera - answer>>Class IV Dirty infected
