Situation –
In the OR, there are safety protocols that
should be
followed. The OR nurse should be well versed
with all
these to safeguard the safety and quality of
patient
delivery outcome.
51. Which
of the following should be given highest
priority
when receiving patient in the OR?
a. Assess
level of consciousness
b.
Verify patient identification and
informed
consent
c. Assess
vital signs
d. Check
for jewelry, gown, manicure, and
dentures
52.
Surgeries like I and D (incision and drainage) and
debridement
are relatively short procedures but
considered ‘dirty
cases’. When are these procedures best scheduled?
a.
Last case
b. In
between cases
c.
According to availability of
anaesthesiologist
d.
According to the surgeon’s preference
53. OR
nurses should be aware that maintaining the
client’s
safety is the overall goal of nursing care
during the
intraoperative phase. As the
circulating
nurse, you make certain that
throughout
the procedure…
a. the
surgeon greets his client before
induction
of anesthesia
b. the
surgeon and anesthesiologist are in
tandem
c.
strap made of strong non-abrasive
materials
are fastened securely around
the
joints of the knees and ankles and
around
the 2 hands around an arm
board.
d. Client
is monitored throughout the
surgery by
the assistant anesthesiologist
54. Another
nursing check that should not be missed
before the
induction of general anesthesia is:
a. check
for presence underwear
b. check
for presence dentures
c. check
patient’s ID
d.
check baseline vital signs
55. Some
lifetime habits and hobbies affect
postoperative
respiratory function. If your client
smokes 3
packs of cigarettes a day for the past
10 years,
you will anticipate increased risk for:
a.
perioperative anxiety and stress
b. delayed
coagulation time
c. delayed
wound healing
d.
postoperative respiratory infection
Situation:
Sterilization is the process of removing ALL
living
microorganism. To be free of ALL living
microorganism
is sterility.
56. There
are 3 general types of sterilization use in
the
hospital, which one is not included?
a. Steam
sterilization
b. Physical
sterilization
c. Chemical
sterilization
d.
Sterilization by boiling
57.
Autoclave or steam under pressure is the most
common
method of sterilization in the hospital.
The nurse
knows that the temperature and time
is set to
the optimum level to destroy not only
the
microorganism, but also the spores. Which
of the
following is the ideal setting of the
autoclave
machine?
a. 10,000
degree Celsius for 1 hour
b. 5,000
degree Celsius for 30 minutes
c. 37
degree Celsius for 15 minutes
d.
121 degree Celsius for 15 minutes
58. It is
important that before a nurse prepares the
material to
be sterilized, a chemical indicator
strip
should be placed above the package,
preferably,
Muslin sheet. What is the color of
the striped
produced after autoclaving?
a.
Black
b. Blue
c. Gray
d. Purple
59.
Chemical indicators communicate that:
a. The
items are sterile
b.
That the items had undergone
sterilization
process but not necessarily
sterile
c. The
items are disinfected
d. That the
items had undergone
disinfection
process but not necessarily disinfected
60. If a
nurse will sterilize a heat and moisture labile
instruments,
It is according to AORN
recommendation
to use which of the following
method of
sterilization?
a.
Ethylene oxide gas
b.
Autoclaving
c. Flash
sterilizer
d. Alcohol
immersion
Situation 5
– Nurses hold a variety of roles when
providing
care to a perioperative patient.
61. Which
of the following role would be the
responsibility
of the scrub nurse?
a. Assess
the readiness of the client prior
to surgery
b. Ensure
that the airway is adequate
c.
Account for the number of sponges,
needles,
supplies, used during the
surgical
procedure.
d. Evaluate
the type of anesthesia
appropriate
for the surgical client
62. As a
perioperative nurse, how can you best meet
the safety
need of the client after administering
preoperative
narcotic?
a.
Put side rails up and ask the client not
to
get out of bed
b. Send the
client to OR with the family
c. Allow
client to get up to go to the
comfort
room
d. Obtain
consent form
63. It is
the responsibility of the pre-op nurse to do
skin prep
for patients undergoing surgery. If hair
at the
operative site is not shaved, what should
be done to
make suturing easy and lessen
chance of
incision infection?
a. Draped
b. Pulled
c.
Clipped
d.
Shampooed
64. It is
also the nurse’s function to determine when
infection
is developing in the surgical incision.
The
perioperative nurse should observe for what
signs of
impending infection?
a.
Localized heat and redness
b.
Serosanguinous exudates and skin
blanching
c.
Separation of the incision
d. Blood
clots and scar tissue are visible
65. Which
of the following nursing interventions is
done when
examining the incision wound and
changing
the dressing?
a.
Observe the dressing and type and odor
of
drainage if any
b. Get
patient’s consent
c. Wash
hands
d. Request
the client to expose the incision
wound
Situation –
The preoperative nurse collaborates with the
client
significant others, and healthcare providers.
66. To
control environmental hazards in the OR, the
nurse
collaborates with the following
departments
EXCEPT:
a.
Biomedical division
b.
Infection control committee
c.
Chaplaincy services
d.
Pathology department
67. An air
crash occurred near the hospital leading
to a surge
of trauma patient. One of the last
patients
will need surgical amputation but there
are no
sterile surgical equipments. In this case,
which of
the following will the nurse expect?
a.
Equipments needed for surgery need not
be
sterilized if this is an emergency
necessitating
life saving measures
b.
Forwarding the trauma client to the
nearest
hospital that has available sterile
equipments
is appropriate
c. The
nurse will need to sterilize the item
before
using it to the client using the
regular
sterilization setting at 121
degree
Celsius in 15 minutes
d.
In such cases, flash sterlizer will be use
at
132 degree Celsius in 3 minutes
68. Tess,
the PACU nurse, discovered that Malou,
who weighs
110 lbs prior to surgery, is in severe
pain 3 hrs
after cholecystectomy. Upon checking
the chart,
Malou found out that she has an order
of Demerol
100 mg I.M. prn for pain. Tess should
verify the
order with:
a. Nurse
Supervisor
b.
Surgeon
c.
Anesthesiologist
d. Intern
on duty
69. Rosie,
57, who is diabetic is for debridement if
incision
wound. When the circulating nurse
checked the
present IV fluid, she found out that
there is no
insulin incorporated as ordered.
What should
the circulating nurse do?
a.
Double check the doctor’s order and
call
the attending MD
b.
Communicate with the ward nurse to
verify if
insulin was incorporated or not
c.
Communicate with the client to verify if
insulin was
incorporated
d.
Incorporate insulin as ordered.
70. The
documentation of all nursing activities
performed
is legally and professionally vital.
Which of
the following should NOT be included
in the
patient’s chart?
a. Presence
of prosthetoid devices such as
dentures,
artificial limbs hearing aid, etc.
b. Baseline
physical, emotional, and
psychosocial
data
c.
Arguments between nurses and
residents
regarding treatments
d. Observed
untoward signs and symptoms
and
interventions including contaminant
intervening
factors
Situation –
Team efforts is best demonstrated in the OR.
71. If you
are the nurse in charge for scheduling
surgical
cases, what important information do
you need to
ask the surgeon?
a. Who is
your internist
b.
Who is your assistant and
anaesthesiologist,
and what is your
preferred
time and type of surgery?
c. Who are
your anaesthesiologist,
internist,
and assistant
d. Who is
your anaesthesiologist
72. In the
OR, the nursing tandem for every surgery
is:
a.
Instrument technician and circulating
nurse
b. Nurse
anaesthetist, nurse assistant, and
instrument
technician
c. Scrub
nurse and nurse anaesthetist
d.
Scrub and circulating nurses
73. While
team effort is needed in the OR for
efficient
and quality patient care delivery, we
should
limit the number of people in the room
for
infection control. Who comprise this team?
a. Surgeon,
anaesthesiologist, scrub nurse,
radiologist,
orderly
b.
Surgeon, assistants, scrub nurse,
circulating
nurse, anaesthesiologist
c. Surgeon,
assistant surgeon,
anaesthesiologist,
scrub nurse,
pathologist
d. Surgeon,
assistant surgeon,
anaesthesiologist,
intern, scrub nurse
74. Who
usually act as an important part of the OR
personnel
by getting the wheelchair or stretcher,
and
pushing/pulling them towards the operating
room?
a.
Orderly/clerk
b. Nurse
Supervisor
c.
Circulating Nurse
d.
Anaesthesiologist
75. The
breakdown in teamwork is often times a
failure in:
a.
Electricity
b.
Inadequate supply
c. Leg work
d.
Communication
Situation:
Basic knowledge on Intravenous solutions is
necessary
for care of clients with problems with fluids
and
electrolytes.
76. A
client involved in a motor vehicle crash
presents to
the emergency department with
severe
internal bleeding. The client is severely
hypotensive
and unresponsive. The nurse
anticipates
which of the following intravenous
solutions
will most likely be prescribed to
increase
intravascular volume, replace
immediate
blood loss and increase blood
pressure?
a. 0.45%
sodium chloride
b. 0.33%
sodium chloride
c. Normal
saline solution
d.
Lactated ringer’s solution
77. The
physician orders the nurse to prepare an
isotonic
solution. Which of the following IV
solution
would the nurse expect the intern to
prescribe?
a.
5% dextrose in water
b. 0.45%
sodium chloride
c. 10%
dextrose in water
d. 5%
dextrose in 0.9% sodium chloride
78. The
nurse is making initial rounds on the nursing
unit to
assess the condition of assigned clients.
The nurse
notes that the client’s IV Site is cool,
pale and
swollen and the solution is not infusing.
The nurse
concludes that which of the following
complications
has been experienced by the
client?
a.
Infection
b.
Phlebitis
c.
Infiltration
d.
Thrombophelibitis
79. A nurse
reviews the client’s electrolyte
laboratory
report and notes that the potassium
level is
3.2 mEq/L. Which of the following would
the nurse
note on the electrocardiogram as a
result of
the laboratory value?
a.
U waves
b. Absend P
waves
c. Elevated
T waves
d. Elevated
ST segment
80. One
patient had a ‘runaway’ IV of 50% dextrose.
To prevent
temporary excess of insulin or
transient
hyperinsulin reaction what solution
you prepare
in anticipation of the doctor’s
34
order?
a. Any IV
solution available to KVO
b. Isotonic
solution
c.
Hypertonic solution
d.
Hypotonic solution
81. An
informed consent is required for:
a.
closed reduction of a fracture
b.
irrigation of the external ear canal
c.
insertion of intravenous catheter
d. urethral
catheterization
82. Which
of the following is not true with regards
to the
informed consent?
a. It
should describe different treatment
alternatives
b.
It should contain a thorough and
detailed
explanation of the procedure
to
be done
c. It
should describe the client’s diagnosis
d. It
should give an explanation of the
client’s
prognosis
83. You
know that the hallmark of nursing
accountability
is the:
a.
accurate documentation and reporting
b.
admitting your mistakes
c. filing
an incidence report
d.
reporting a medication error
84. A nurse
is assigned to care for a group of clients.
On review
of the client’s medical records, the
nurse
determines that which client is at risk for
excess
fluid volume?
a. The
client taking diuretics
b.
The client with renal failure
c. The
client with an ileostomy
d. The
client who requires gastrointestinal
suctioning
85. A nurse
is assigned to care for a group of clients.
On review
of the client’s medical records, the
nurse
determines that which client is at risk for
deficient
fluid volume?
a.
A client with colostomy
b. A client
with congestive heart failure
c. A client
with decreased kidney function
d. A client
receiving frequent wound
irrigation
Situation:
As a perioperative nurse, you are aware of the
correct
processing methods for preparing instruments
and other
devices for patient use to prevent infection.
86. As an
OR nurse, what are your foremost
considerations
for selecting chemical agents for
disinfection?
a.
Material compatibility and efficiency
b. Odor and
availability
c. Cost and
duration of disinfection process
d. Duration
of disinfection and efficiency
87. Before
you use a disinfected instrument it is
essential
that you:
a. Rinse
with tap water followed by alcohol
b. Wrap the
instrument with sterile water
c. Dry the
instrument thoroughly
d.
Rinse with sterile water
88. You
have a critical heat labile instrument to
sterilize
and are considering to use high level
disinfectant.
What should you do?
a. Cover
the soaking vessel to contain the
vapor
b. Double
the amount of high level
disinfectant
c. Test the
potency of the high level
disinfectant
d.
Prolong the exposure time according to
manufacturer’s
direction
89. To
achieve sterilization using disinfectants,
which of
the following is used?
a. Low
level disinfectants immersion in 24
hours
b.
Intermediate level disinfectants
immersion
in 12 hours
c. High
level disinfectants immersion in 1
hour
d.
High level disinfectant immersion in 10
hours
90.
Bronchoscope, Thermometer, Endoscope, ET
tube,
Cytoscope are all BEST sterilized using
which of
the following?
a.
Autoclaving at 121 degree Celsius in 15
minutes
b. Flash
sterilizer at 132 degree Celsius in 3
minutes
c. Ethylene
Oxide gas aeration for 20 hours
d.
2% Glutaraldehyde immersion for 10
hours
Situation:
The OR is divided into three zones to control
traffic
flow and contamination
91. What OR
attires are worn in the restricted area?
a. Scrub suit,
OR shoes, head cap
b.
Head cap, scrub suit, mask, OR shoes
c. Mask, OR
shoes, scrub suit
d. Cap,
mask, gloves, shoes
92. Nursing
intervention for a patient on low dose IV
insulin
therapy includes the following, EXCEPT:
a.
Elevation of serum ketones to monitor ketosis
b. Vital
signs including BP
c. Estimate
serum potassium
d.
Elevation of blood glucose levels
93. The
doctor ordered to incorporate 1000”u”
insulin to
the remaining on-going IV. The
strength is
500 /ml. How much should you
incorporate
into the IV solution?
a. 10 ml
b. 0.5 ml
c.
2 ml
d. 5 ml
94.
Multiple vial-dose-insulin when in use should be
a.
Kept at room temperature
b. Kept in
narcotic cabinet
c. Kept in
the refrigerator
d. Store in
the freezer
95.
Insulins using insulin syringe are given using how
many
degrees of needle insertion?
a. 45
b. 180
c.
90
d. 15
Situation:
Maintenance of sterility is an important
function a
nurse should perform in any OR setting.
96. Which
of the following is true with regards to
sterility?
a.
Sterility is time related, items are not
considered
sterile after a period of 30
days of
being not use.
b. for 9
months, sterile items are
considered
sterile as long as they are
covered
with sterile muslin cover and
stored in a
dust proof covers.
c.
Sterility is event related, not time
related
d. For 3
weeks, items double covered with
muslin are
considered sterile as long as
they have
undergone the sterilization
process
97. 2
organizations endorsed that sterility are
affected by
factors other than the time itself,
these are:
a. The PNA
and the PRC
b.
AORN and JCAHO
c. ORNAP
and MCNAP
d. MMDA and
DILG
98. All of
these factors affect the sterility of the OR
equipments,
these are the following except:
a. The
material used for packaging
b. The
handling of the materials as well as
its
transport
c. Storage
d.
The chemical or process used in
sterililzing
the material
99. When
you say sterile, it means:
a. The
material is clean
b. The material
as well as the equipments are sterilized and
had undergone
a rigorous sterilization process
c. There is
a black stripe on the paper indicator
d.
The material has no microorganism nor
spores
present that might cause an
infection
100. In
using liquid sterilizer versus autoclave
machine,
which of the following is true?
a.
Autoclave is better in sterilizing OR
supplies
versus liquid sterilizer
b.
They are both capable of sterilizing the
equipments,
however, it is necessary to
soak
supplies in the liquid sterilizer for
a
longer period of time
c. Sharps
are sterilized using autoclave and not cidex
d. If liquid sterilizer is used, rinsing
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