Chapters 14 and 21: Skin Preps and Draping

Question 1

Using mechanical friction when prepping will NOT aid in \_\_\_\_\_.
A. Removal of resident bacteria 
B. Removal of dirt and oil 
C. The effectiveness of antimicrobials 
D. Removal of transient bacteria

Answer 1

A. Removal of resident bacteria

Question 2

Reduction in resident bacteria is aided by:
A. Use of a degreaser 
B. Use of antimicrobials 
C. Prepping clean to dirty 
D. Mechanical friction

Answer 2

B. Use of antimicrobials

Question 3

Prolonged contact of skin antisepsis agents due to pooling of the solutions can cause patient injuries that include:

1. Chemical burns
2. Thermal burns
3. Injuries related to equipment malfunction

A. 1 and 2
B. 1 and 3
C. 1, 2, and 3

Answer 3

B. 1 and 3

Chemical burns and injuries related to equipment.

Question 4

Which one of the following statements is TRUE?
A. Povidone-iodine’s mechanism of action is to disrupt the cell membrane
B. Povidone-iodine is nonirritating to the skin
C. Povidone-iodine cannot be used on mucous membranes
D. Heating povidone-iodine may decrease its effectiveness

Answer 4

D. Heating povidone-iodine may decrease its effectiveness

Question 5

Documentation of the preoperative skin prep includes all of the follow EXCEPT:
A. Hair removal
B. Manufacturer of solutions used
C. Allergies
D. Name of the person who performed the prep

Answer 5

B. Manufacturer of solutions used

Question 6

When prepping an extremity, which one of the following is ALWAYS required?
A. Positioning the extremity to prevent prep solution from running toward the incision site
B. Assistance in holding the limb
C. Scrubbing nails with a brush before the formal prep
D. Prepping so that the entire limb can be draped

Answer 6

A. Positioning the extremity to prevent prep solution from running toward the incision site

Question 7

7. Surgical wound infections can result in decreased \_\_\_\_\_.
A. Hospitalization time 
B. Intraoperative time 
C. Income for hospitals 
D. Workload for perioperative nurses

Answer 7

C. Income for hospitals

Question 8

Preoperative skin preparation is accomplished by _____.
A. Removing soil and transient microbes
B. Reducing resident microbes
C. Using antimicrobial agents that inhibit growth of microbes
D. All of the above

Answer 8

D. All of the above

Removing soil and transient microbes, reducing resident microbes, and using antimicrobial agents that inhibit growth of microbes

Question 9

According to AORN’s guidelines for skin preparation of patients, hair at the operative site is _____.
A. Allowed to remain unless it interferes with the surgical procedures
B. Always removed with a depilatory
C. Removed at least two hours before surgery
D. Dry shaved as opposed to wet shaved

Answer 9

A. Allowed to remain unless it interferes with the surgical procedures

Question 10

The concept of prepping from clean to dirty means _____.
A. Cleaning all stomas or open wounds first
B. Beginning at the incision site and using circular strokes toward the periphery
C. Prep solution is changed after cleaning contaminated areas
D. Surgical scrub solutions used first and then surgical paint

Answer 10

B. Beginning at the incision site and using circular strokes toward the periphery

Question 11

Which one of the following statements about the skin prep is FALSE?
A. Povidone-iodine should not be allowed to dry
B. Manufacturers’ guidelines should be followed
C. Skin prep is performed after the patient has been positioned
D. The name of the person performing the prep should be documented

Answer 11

A. Povidone-iodine should not be allowed to dry

Question 12

Objectives of the surgical prep include all EXCEPT:
A. Removal of dirt, skin oil, and microbes from the skin
B. Sterilization of skin
C. Reduction of bacterial count
D. Prevention of regrowth of microbes for several hours

Answer 12

B. Sterilization of skin

Question 13

The generally recognized length of time required for contact of antimicrobial agents to be effective is
A. 1 to 3 minutes
B. 2 to 5 minutes
C. 3 to 5 minutes
D. According to manufacturers’ directions

Answer 13

D. According to manufacturers’ directions

Question 14

The principles of preoperative skin preparation include all of the following EXCEPT:
A. Prep from clean to dirty 
B. Use aseptic technique 
C. Prep stomas first 
D. Prevent pooling

Answer 14

C. Prep stomas first

Question 15

Which one of the following topical antimicrobial agents is neurotoxic?
A. Povidone-iodine 
B. Alcohol 
C. PCMX (parachlorometaxylenol) 
D. Chlorhexidine gluconate

Answer 15

D. Chlorhexidine gluconate

Question 16

Which statement is TRUE about iodophor with alcohol?
A. It provides rapid reduction in microbial counts of skin
B. Persistence or residual activity is excellent
C. It has been shown to be nontoxic and nonirritating
D. Percutaneous absorption does not occur across mucous membranes

Answer 16

A. It provides rapid reduction in microbial counts of skin

Question 17

Which of the following could compromise the physical barrier function of a sterile surgical drape and increase the risk of surgical site infections?
A. Blood pooling on the drape
B. Water wicking through the drape
C. Excessive pressure or stretching during a procedure
D. All of the above

Answer 17

D. All of the above

Blood pooling on the drape, water wicking through the drape and excessive pressure or stretching during a procedure

Question 18

When draping equipment:
A. fully cover Mayo stands after they are introduced to the sterile field
B. cover only the part of the equipment that is positioned next to the sterile field
C. control the drapes to prevent them from moving and touching unsterile surfaces before or during an invasive procedure
D. none of the above

Answer 18

C. control the drapes to prevent them from moving and touching unsterile surfaces before or during an invasive procedure

Question 19

20. When draping for a laparotomy, which of the following is NOT an accepted practice?
    A. Use sterile towels to outline the prepared surgical site
    B. Place the fenestration directly above the prepped surgical site
    C. Drape from the edges of the table toward the surgical site
    D. Protect the sterile gloves of scrubbed team members by keeping them under the cuff of the folded laparotomy sheet

Answer 19

C. Drape from the edges of the table toward the surgical site

When performing laparoscopic surgery, prep large enough in the event the case converted to open surgery

Question 20

The circulating nurse observes the laparotomy drape fall below the waist level of the scrub person. What is the best action for the nurse to take?

Answer 20

The drape should be discarded if it is contaminated in any way

Question 21

Describe the procedure for the removal of contaminated drapes after the surgical procedure has concluded:

Answer 21

While holding the dressing in place, the scrub person with the assistance from the nonsterile circulator will remove towel clips first then drapes. Drapes should be rolled inside out toward the foot of the OR bed

Question 22

Why should a surgical prep start at the site of incision and move outward?

Answer 22

It directs any contaminants away from the critical area

Question 23

The perioperative nurse’s documentation of the skin prep procedure should include preoperative assessment of the skin at the operative site. Why is this important?

Answer 23

Translucent, fragile skin will not tolerate abrasive scrubbing or harsh chemicals. It is important to note any skin lesions at the operative site. If physical condition of the site is compromised discuss with surgeon. Also be sure of any allergies to prepping agents.

Question 24

List some protective measures you would use on a surgical patient to avoid prolonged contact with skin antiseptics.

Answer 24

Put pads down to collect prep excess and remove after prepping