Essentials of perioperative nursing textbook questions

Question 1

AORN’s Patient Focused model includes which of the following domains?
A. Patient safety, physiologic response, behavioral responses, the health system
B. Patient teaching, patient safety, behavioral responses, discharge planning
C. Patient safety, patient assessment, discharge planning, the health system
D. Patient assessment, plan of care, discharge planning, the healthy system

Answer 1

A. Patient safety, physiologic response, behavioral responses, the health system

Question 2

The perioperative nurses begins the patient’s care plan:
A. Prior to the procedure, based on information about the patient from the surgeon and other healthcare providers
B. In the holding area based on interview and assessment data
C. Prior to the procedure based on knowledge of the planned procedure, typical related nursing diagnoses, and resources required
D. When the patient enters the operating room and all attention is focused on supporting the patient

Answer 2

C. Prior to the procedure based on knowledge of the planned procedure, typical related nursing diagnoses, and resources required

Question 3

Which of the following is a true statement about the RNFA?
A. An RNFA is an advanced practice perioperative nurse, regardless of his or her academic level of preparation
B. the RNFA position is an expanded role in perioperative nursing
C. the RNFA practices under the license of the physician
D. The RNFA must have an advanced degree in nursing

Answer 3

B. the RNFA position is an expanded role in perioperative nursing

Question 4

The dose and timing of prophylactic antibiotic administration is determined by:
A. Protocol, which states the dosage and specifies that it be given 1 hour before surgery
B. The attending surgeon
C. the anesthesia provider
D. the optimal level of antibiotic in the patient’s serum and tissue at the time of surgery

Answer 4

D. the optimal level of antibiotic in the patient’s serum and tissue at the time of surgery

Question 5

Three protocols that TJC implements in an effort to prevent wrong site surgery are:
A. Site marking, time out, and better documentation
B. time out, better documentation and consent form
C. Pre procedure verification, site marking, and time out
D. Site marking, consent form and time out

Answer 5

C. Pre procedure verification, site marking, and time out

Question 6

Disinfection differs from sterilization in what way?
A. High level disinfection and sterilization are the same
B. Sterilization kills all spores; disinfection does not
C. High level disinfection kills vegetative bacteria; sterilization does not
D. Disinfection and sterilization both kill microorganisms, but only sterilization may be used for all medical devices

Answer 6

B. Sterilization kills all spores; disinfection does not

Question 7

Critical items:
A. contact sterile tissue and the vascular system
B. Must undergo high level disinfection
C. Do not penetrate mucous membranes
D. include thermometers, crutches and BP cuffs

Answer 7

A. contact sterile tissue and the vascular system

Question 8

For an item to be sterilized
A. It must be sequentially wrapped and placed upright in the sterilizer
B. Steam must penetrate the packaging completely and the intended parameters of moisture, temperature, and time must be met
C. It must be subjected to unsaturated steam for the appropriate amount of time and under the correct amount of pressure
D. The temperature must remain at 250 degrees Fahrenheit at atmospheric pressure for the proper amount of time

Answer 8

B. Steam must penetrate the packaging completely and the intended parameters of moisture, temperature, and time must be met

Question 9

Which statement is true about steam sterilization? SELECT ALL THAT APPLY
A. Moist heat under pressure is economical
B. Steam sterilization denatures and coagulates protein
C. steam sterilization occurs at atmospheric pressure
D. Steam sterilization is a function of time and temperature

Answer 9

A. Moist heat under pressure is economical
B. Steam sterilization denatures and coagulates protein
C. steam sterilization occurs at atmospheric pressure

Question 10

Which statement is true about autoclaves? SELECT ALL THAT APPLY
A. Air trapped in the chamber will interfere with sterilization
B. Sterilization begins only when the correct temperature has been reached
C. Cups and basins must be placed so that water will collect in them and form steam
D. Wrapped packages should be removed from the sterilizer immediately and allowed to cool for 2 hours

Answer 10

A. Air trapped in the chamber will interfere with sterilization
B. Sterilization begins only when the correct temperature has been reached

Question 11

How might trapping of air in a steam autoclave interfere with sterilization?
A. the presence of air forces the temperature above the target range
B. Air in the chamber prevents the sterilizer from reaching the target pressure
C. Air interferes with the humidity level in the chamber
D. Air pockets prevent steam from contacting all surfaces of an item, compromising the sterilization process

Answer 11

C. Air interferes with the humidity level in the chamber

Question 12

Which statement is true about steam sterilizers? SELECT ALL THAT APPLY
A. A Bowie-Dick test is done once each day in all gravity-displacement sterilizers
B. A prevacuum sterilizer is more efficient and preferred over a gravity-displacement sterilizer
C. Pre vacuum sterilizers are used for liquids
D. Pre vacuum sterilizers are less affected by incorrect arrangement of objects in the chamber

Answer 12

B. A prevacuum sterilizer is more efficient and preferred over a gravity-displacement sterilizer
D. Pre vacuum sterilizers are less affected by incorrect arrangement of objects in the chamber

Question 13

Which statement is true about IUSS? SELECT ALL THAT APPLY
A. IUSS is not intended for sterilizing sets of instruments
B. Items sterilized with IUSS cannot be stored or held for use on a future case
C. Drying time is the same in IUSS as with regular sterilization
D. In an emergency, items can be rinsed in the scrub sink and sterilized with IUSS

Answer 13

A. IUSS is not intended for sterilizing sets of instruments

B. Items sterilized with IUSS cannot be stored or held for use on a future case

Question 14

Which statement is true about IUSS? SELECT ALL THAT APPLY
A. IUSS is perfect for implants that arrive immediately before a procedure
B. IUSS is appropriate only in urgent clinical situations
C. IUSS is appropriate when there is only one specialty set of instruments
D. IUSS can only be done in a pre vacuum sterilizer

Answer 14

B. IUSS is appropriate only in urgent clinical situations

Question 15

Which statement is true about IUSS? SELECT ALL THAT APPLY
A. Only devices with manufacturer’s instructions for IUSS should be sterilized in this manner
B. there is a risk of contamination during transport following IUSS
C. Items for IUSS cannot be wrapped
D. A rigid container should be used for IUSS

Answer 15

A. Only devices with manufacturer’s instructions for IUSS should be sterilized in this manner
B. there is a risk of contamination during transport following IUSS

Question 16

What are some advantages of H2O2 sterilization? SELECT ALL THAT APPLY
A. Items to be sterilized can be wrapped in any material
B. There is a single cycle for all items
C. the process is an efficient alternative to EtO sterilization
D. cycle times are preset and the sterilizer is easy to operate

Answer 16

C. the process is an efficient alternative to EtO sterilization
D. cycle times are preset and the sterilizer is easy to operate

Question 17

The spore used to monitor H2O2 sterilization is:
A.  Bacillus atrophaeus
B.  Geobacillis atrophaeus
C.  Geobacillus stearothermophilus
D. Bacillus subtilis

Answer 17

C. Geobacillus stearothermophilus

Question 18

Which packaging materials can be used for H2O2 sterilization?  SELECT ALL THAT APPLY
A.  Muslin wrappers
B.  Tyvek pouches
C.  Polypropylene wraps
D.  Mylar pouches

Answer 18

B. Tyvek pouches
C. Polypropylene wraps
D. Mylar pouches

Question 19

Which statement is true about EtO sterilization? SELECT ALL THAT APPLY
A. EtO is a toxic gas that must be managed according to strict regulations
B. EtO is appropriate for items that cannot tolerate the temperature and moisture of steam sterilization
C. The essential parameters of EtO sterilization are gas concentration, temperature, humidity and exposure time
D. Aeration must be done for all loads sterilized using EtO

Answer 19

A. EtO is a toxic gas that must be managed according to strict regulations
B. EtO is appropriate for items that cannot tolerate the temperature and moisture of steam sterilization
C. The essential parameters of EtO sterilization are gas concentration, temperature, humidity and exposure time
D. Aeration must be done for all loads sterilized using EtO

Question 20

What are some advantages of EtO sterilization? SELECT ALL THAT APPLY
A. The process is rapid
B. the process is safe for items that cannot tolerate high heat and humidity
C. EtO is noncorrosive
D. EtO effectively penetrates large bundles and permeates all porous items

Answer 20

B. the process is safe for items that cannot tolerate high heat and humidity
C. EtO is noncorrosive
D. EtO effectively penetrates large bundles and permeates all porous items

Question 21

Which statement is true about liquid chemical processing? SELECT ALL THAT APPLY
A. It is a low temperature, nonterminal process
B. Items must be used immediately following processing; they cannot be packaged or stored for later use
C. Only one flexible endoscope can be processed at a time
D. Peracetic acid disrupts protein bonds and cell systems, causing immediate cell death

Answer 21

A. It is a low temperature, nonterminal process
B. Items must be used immediately following processing; they cannot be packaged or stored for later use
C. Only one flexible endoscope can be processed at a time
D. Peracetic acid disrupts protein bonds and cell systems, causing immediate cell death

Question 22

Which statement is true about sterilization monitoring? SELECT ALL THAT APPLY
A. physical monitors record activities within the sterilizer chamber
B. Chemical indicators exhibit a visual or physical change when sterilization has been achieved
C. A chemical indicator should be placed both on the inside and on the outside of each package
D. The nurse relies on the outside indicator to determine whether the contents of a sterilized package are sterile

Answer 22

A. physical monitors record activities within the sterilizer chamber
C. A chemical indicator should be placed both on the inside and on the outside of each package

Question 23

Which statement is true about biological indicators? SELECT ALL THAT APPLY
A. A biological indicator is the most accurate method of establishing that the conditions of sterilization have been met
B. A biological indicator contains a known quantity of highly resistant virus
C. A biological indicator must be incubated before it can be read
D. A biological indicator should be contained within a process challenge device (PCD) for cycles used for terminal sterilization

Answer 23

A. A biological indicator is the most accurate method of establishing that the conditions of sterilization have been met
C. A biological indicator must be incubated before it can be read
D. A biological indicator should be contained within a process challenge device (PCD) for cycles used for terminal sterilization

Question 24

Which statement is true about a “failed load?” SELECT ALL THAT APPLY
A. It should be reported immediately, the load quarantined, and the cause of the failure researched
B. failure can be caused by incorrect packaging, incorrect cycle, items incompatible with the process, or incorrect placement within the sterilizer
C. In any instance, all items from the failed load must be located and recalled for reprocessing
D. Items from a failed load that have already been used in or for a patient must be reported to TJC

Answer 24

A. It should be reported immediately, the load quarantined, and the cause of the failure researched
B. failure can be caused by incorrect packaging, incorrect cycle, items incompatible with the process, or incorrect placement within the sterilizer

Question 25

Which statement is true about biological monitors? SELECT ALL THAT APPLY
A. Rapid readout enzyme based biological indicators are available for steam and EtO sterilizers
B. Rapid readout monitors rely on fluorescence, which occurs when an enzyme present within the bacterial spore breaks down, to determine that the conditions for sterilization have been met
C. Rapid readouts show results within 30 minutes
D. A rapid readout can be used if an implant must be sterilized using IUSS

Answer 25

A. Rapid readout enzyme based biological indicators are available for steam and EtO sterilizers
B. Rapid readout monitors rely on fluorescence, which occurs when an enzyme present within the bacterial spore breaks down, to determine that the conditions for sterilization have been met
D. A rapid readout can be used if an implant must be sterilized using IUSS

Question 26

Documentation of sterilization should include:
A. A supervisors signature for every sterilizer load
B. Records indicating which sterilizer was used for which items
C. An indication that biological tests were run in every sterilizer twice a day
D. Bowie-Dick test results for gravity-displacement sterilizers

Answer 26

B. Records indicating which sterilizer was used for which items

Question 27

A biofilm: SELECT ALL THAT APPLY
A. consists of microorganisms living within a polysaccharide matrix that adheres to a surface
B. Prevents sterilants from contracting all surfaces of an instrument during the sterilization process
C. Prevents antibiotics from reaching cells
D. Is readily dissolved by disinfectants

Answer 27

A. consists of microorganisms living within a polysaccharide matrix that adheres to a surface
B. Prevents sterilants from contracting all surfaces of an instrument during the sterilization process
C. Prevents antibiotics from reaching cells

Question 28

Sterilization is required for:
A. All semicritical items
B. All instruments that contact mucous membranes
C. All instruments that penetrate mucous membranes
D. Anything used for an operative or invasive procedure

Answer 28

C. All instruments that penetrate mucous membranes

Question 29

The first and most important step in instrument decontamination is:
A.  Disinfecting with an enzyme soak
B.  Cleaning
C.  Decontamination
D.  Sterilization

Answer 29

D. Sterilization

Question 30

Which statement is true about manual cleaning? SELECT ALL THAT APPLY
A. it can be done in the OR or in SPD
B. all instruments should be soaked in water or an enzymatic detergent
C. Brushes, syringes and compressed air should be available
D. Instruments should first be washed in hot water

Answer 30

A. it can be done in the OR or in SPD

C. Brushes, syringes and compressed air should be available

Question 31

Which statement is true about ultrasonic cleaning? SELECT ALL THAT APPLY
A. Ultrasonic cleaning is used to flush all ports and articulations of robotic instruments
B. Ultrasonic cleaning removes tenacious debris through cavitation
C. Cavitation is the implosion of bubbles generated by sound waves
D. Ultrasonic cleaning is especially well suited to removing debris from box locks, serrations, lumens, crevices, and lensed and power instruments

Answer 31

B. Ultrasonic cleaning removes tenacious debris through cavitation
C. Cavitation is the implosion of bubbles generated by sound waves

Question 32

Which statement is true about ultrasonic cleaning? SELECT ALL THAT APPLY
A. Ultrasonic cleaning is a method of decontamination
B. It is especially useful for difficult to clean instruments
C. Instruments do not need to be free of gross soil before immersion in the ultrasonic cleaner
D. Instruments that rest on the bottom of the ultrasonic cleaner are subject to the strongest cavitation

Answer 32

B. It is especially useful for difficult to clean instruments

Question 33

Which statement is true about lubrication and inspection? SELECT ALL THAT APPLY
A. Oil based lubricants are most protective and extend instrument life
B. Water soluble lubricants permit penetration of sterilant
C. Items that are defective should be tagged before being placed in sets
D. Defective instruments can result in injury to the patient

Answer 33

B. Water soluble lubricants permit penetration of sterilant

D. Defective instruments can result in injury to the patient

Question 34

Which statement is true about woven fabrics? SELECT ALL THAT APPLY
A. They are lint free
B. they become superheated if not laundered between uses
C. they are compatible with all methods of sterilization
D. All woven materials require double wrapping to provide a tortuous path that provides a barrier to the migration of microorganisms

Answer 34

B. they become superheated if not laundered between uses

Question 35

Which statement is true about nonwoven wrappers? SELECT ALL THAT APPLY
A. They are virtually lint free, are tear resistant, and provide excellent barrier protection
B. They are disposable
C. they can display memory, creating a potential for contamination when packages are opened
D. They require double wrapping and longer sterilization times

Answer 35

A. They are virtually lint free, are tear resistant, and provide excellent barrier protection
B. They are disposable
C. they can display memory, creating a potential for contamination when packages are opened

Question 36

Which statement is true about pouches? SELECT ALL THAT APPLY
A. They can hold multiple small items in a sealed inner pouch contained within an outer pouch
B. The inner pouch should be positioned within the outer pouch so that the contents of the inner pouch are visible
C. Pouches should be stacked loosely on top of one another in the autoclave to provide maximum penetration of the sterilant
D. Pouches can be used to contain small items within instrument trays

Answer 36

A. They can hold multiple small items in a sealed inner pouch contained within an outer pouch
B. The inner pouch should be positioned within the outer pouch so that the contents of the inner pouch are visible

Question 37

Which statement is true about rigid containers? SELECT ALL THAT APPLY
A. There may be a valve system to permit entry and exit of sterilant
B. Rigid containers are durable and protect instruments from damage
C. They are lightweight; an empty container, weighs no more than 5 pounds
D. Cleaning before placing instruments inside a rigid container involves checking gaskets, valves or filters

Answer 37

A. There may be a valve system to permit entry and exit of sterilant
B. Rigid containers are durable and protect instruments from damage
D. Cleaning before placing instruments inside a rigid container involves checking gaskets, valves or filters

Question 38

Which statement is true about packaging for steam sterilization? SELECT ALL THAT APPLY
A. The combined weight of the tray and instrument cannot exceed 15 pounds
B. Pouches are used to contain small items within instrument sets
C. Pouches used within instrument sets should not be sealed
D. Basins and bowls should be positioned vertically to prevent pooling of water

Answer 38

D. Basins and bowls should be positioned vertically to prevent pooling of water

Question 39

Which statement is true about reusable textiles? SELECT ALL THAT APPLY
A. Textiles must be hydrated by laundering them before sterilization
B. Superheating is the result of the fabric temperature exceeding the temperature of the steam in the autoclave
C. Superheating enhances the barrier properties of textiles
D. Well maintained textiles will maintain their barrier qualities indefinitely

Answer 39

A. Textiles must be hydrated by laundering them before sterilization
B. Superheating is the result of the fabric temperature exceeding the temperature of the steam in the autoclave

Question 40

Which statement is true about packaging for low temperature sterilization? SELECT ALL THAT APPLY
A. Items must be thoroughly dried before being placed in the sterilizer
B. Cellulose wrappers cannot be used with H2O2 sterilizers
C. Paper and cloth cannot be used with H2O2 or EtO sterilizers
D. EtO in combination with water forms a toxic residue

Answer 40

A. Items must be thoroughly dried before being placed in the sterilizer
B. Cellulose wrappers cannot be used with H2O2 sterilizers
D. EtO in combination with water forms a toxic residue

Question 41

What are the parameters of steam sterilization?
A. Steam concentration, time, pressure
B. Relative humidity, time, temperature
C. Steam concentration, relative humidity, time
D. time, temperature

Answer 41

D. time, temperature

Question 42

Asepsis means:
A. the absence of organisms
B. Creating a sterile field
C. Scrubbing gowning and gloving
D. The prevention of infections

Answer 42

A. the absence of organisms

Question 43

What are the 3 components of OSHA's mandatory practice standard? SELECT ALL THAT APPLY
A. PPE
B. Proper hand washing
C. Preoperative patient prep
D. Proper management of sharps

Answer 43

A. PPE
B. Proper hand washing
D. Proper management of sharps

Question 44

Which of the following positions is most likely to affect circulation and oxygen-carbon dioxide exchange?
A.  Supine
B.  Sitting
C.  Trendelenburg
D. Reverse trendelenburg

Answer 44

C. Trendelenburg

Question 45

Which additional statement is true about coagulation? SELECT ALL THAT APPLY
A. It is self regulating; the process will stop on its own when bleeding stops
B. It is a slow process, and even small wounds need prompt attention
C. The clot becomes red as platelets, white blood cells, and red blood cells become entangled in the fibrin
D. Thromboplastic is released when tissues are injured and platelets break down

Answer 45

A. It is self regulating; the process will stop on its own when bleeding stops
C. The clot becomes red as platelets, white blood cells, and red blood cells become entangled in the fibrin
D. Thromboplastic is released when tissues are injured and platelets break down

Question 46

Which statement is true about coagulation? SELECT ALL THAT APPLY
A. As platelets from a platelet plug break down, thromboplastin is released into the blood
B. Coagulation is a complex process that begins with the interaction of prothrombin and thromboplastin
C. potassium ions are part of the coagulation process
D. fibrin is the basic structure of a clot

Answer 46

A. As platelets from a platelet plug break down, thromboplastin is released into the blood
B. Coagulation is a complex process that begins with the interaction of prothrombin and thromboplastin
D. fibrin is the basic structure of a clot

Question 47

Which statement is true about thrombin? SELECT ALL THAT APPLY
A. Thrombin is useful in controlling major artery bleeding
B. Thrombin is a hormone that combines with fibrin to form a clot
C. thrombin is for topical use only
D. Thrombin made from human plasma has fewer side effects than bovine thrombin

Answer 47

C. thrombin is for topical use only

D. Thrombin made from human plasma has fewer side effects than bovine thrombin

Question 48

Which statement is true about absorbable gelatin? SELECT ALL THAT APPLY
A. Absorbable gelatin is available in a compressed pad (Gelfoam), powder, or beads
B. Fibrin is deposited into the interstices of Gelfoam, which swells and promotes clot formation
C. Gelatin is sometimes used with thrombin or epinephrine
D. Gelfoam is soluble and is usually left in the wound

Answer 48

A. Absorbable gelatin is available in a compressed pad (Gelfoam), powder, or beads
B. Fibrin is deposited into the interstices of Gelfoam, which swells and promotes clot formation
C. Gelatin is sometimes used with thrombin or epinephrine

Question 49

Which statement is true? SELECT ALL THAT APPLY
A. Microfibrillar collagen is often used in crevices and sites of irregular contour
B. Styptics cause blood vessels to dilate
C. Hemostatic clamps must be replaced with a ligature or ligating clip for permanent hemostasis
D. Manual pressure is a form of temporary hemostasis

Answer 49

A. Microfibrillar collagen is often used in crevices and sites of irregular contour
C. Hemostatic clamps must be replaced with a ligature or ligating clip for permanent hemostasis
D. Manual pressure is a form of temporary hemostasis

Question 50

Which of the following might be contraindications for tourniquet use? SELECT ALL THAT APPLY
A. Hypertension
B. Open fracture
C. DVT
D. Sickle cell anemia

Answer 50

B. Open fracture
C. DVT
D. Sickle cell anemia

Question 51

Passivation is the process during instrument manufacture that:
A. Puts an ebony finish on the instrument to reduce glare
B. Protects the surface and minimizes corrosion
C. Hardens the metal and ensures that the instrument will retain its shape
D. Removes spots and stains from the instrument

Answer 51

B. Protects the surface and minimizes corrosion

Question 52

The overall design that is similar for all clamps include the following components:
A. Finger rings, a joint, a ratchet, and a distal tip or jaw
B. Finger rings, a screw joint, and serrated jaws
C. Finger rings, a ratchet and jaws with teeth
D. Finger rings, a box lock, and jaws that cannot damage tissue

Answer 52

A. Finger rings, a joint, a ratchet, and a distal tip or jaw

Question 53

Cystoscopes, hysteroscopes, and arthroscopes are examples of:
A. Jointed instruments
B. Rigid endoscopes
C. Flexible endoscopes
D. Powered endoscopes

Answer 53

B. Rigid endoscopes