Questions (Textbook 6th Edition)

Question 1

Chapter 1*

Answer 1

*

Question 2

1. The perioperative period begins when the patient

a. arrives in the holding area and ends in PACU.
b. arrives in the hospital and ends with discharge.
c. is informed of the need for surgery and ends with discharge from the hospital.
d. is informed of the need for surgery and ends when the patient achieves an optimal level of postsurgical function

Answer 2

D

Question 3

2. Which of the following is not a nursing focus during the preoperative period?

a. Patient teaching
b. Patient and family support
c. Getting informed consent from the patient
d. Preparation for the procedure

Answer 3

C

Question 4

3. Intraoperative phase begins when

a. the patient arrives at the hospital for surgery.
b. the patient is transferred to the operating room bed.
c. the anesthesia provider induces the patient.
d. the surgeon makes the initial incision.

Answer 4

B

Question 5

4. Initial nursing focus in the postoperative period focuses on

a. controlling postoperative pain.
b. supporting the patient’s physiologic systems.
c. preparing the patient for discharge.
d. making arrangements for the patient to return to normal activity.

Answer 5

B

Question 6

5. Why was the term “operating room nurse” changed to “perioperative nurse”?

a. AORN decided it sounded more contemporary.
b. To eliminate the “OR mystique” and encourage more nurses to join the specialty.
c. The responsibilities of nurses in this specialty have expanded to support and care for the surgical patient through the continuum of care.
d. Because PACU nurses wanted to be included.

Answer 6

C

Question 7

6. 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 health system

Answer 7

A

Question 8

7. Perioperative nurses provide patient care

a. to assist the surgeon and the anesthesia provider.
b. that focuses primarily on patient and family education and support.
c. within the framework of the nursing process: assessment, planning, intervention, and evaluation of patient outcomes. Ref 19
d. that is focused primarily on the patient’s surgical diagnosis.

Answer 8

C

Question 9

8. Nursing assessment of the surgical patient

a. may take place in a number of settings and timeframes.
b. may include a telephone call to the patient prior to surgery for teaching, support, and data gathering.
c. is usually initiated by someone other than the perioperative nurse.
d. takes place just prior to surgery and includes an interview, chart review, and a quick physical inspection of the patient.

Answer 9

A, B, C, D

Question 10

9. Typical nursing diagnoses for the surgical patient include

a. knowledge deficit and high risk for infection.
b. prevention of adverse outcomes and patient teaching.
c. high risk for infection and support of patient and family.
d. maintenance of normothermia and anatomical body alignment.

Answer 10

A

Question 11

10. The perioperative nurse 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 11

C

Question 12

11. The framework for the intervention stage of perioperative patient care is based on

a. the surgeon’s preferences related to the surgical procedure.
b. the patient’s medical diagnosis and comorbidities.
c. the needs of the healthcare team participating in the surgical procedure.
d. accepted standards of clinical practice and professional performance.

Answer 12

D

Question 13

12. The criteria upon which the final evaluation is made is the extent to which

a. the goals of the surgical procedure were met and the patient was transferred to the appropriate recovery area.
b. the desired patient outcomes have been achieved.
c. hospital policy and professional standards were upheld.
d. the patient and family express satisfaction with the entire surgical experience.

Answer 13

B

Question 14

13. The Perioperative Nursing Data Set (PNDS) is

a. standardized nursing vocabulary used to describe perioperative nursing practice.
b. a collection of recommended practices to guide patient care.
c. used by all electronic health record systems to standardize patient records.
d. a set of evaluation tools to determine the extent to which patient care has been successful.

Answer 14

A

Question 15

14. Perioperative nursing is

a. task oriented and designed to care effectively for surgical patients.
b. nursing science related to surgical patients.
c. patient oriented and focused on prevention, and uses knowledge, judgment, and skill.
d. a framework to evaluate patients’ responses to surgical and other invasive procedures.

Answer 15

C

Question 16

15. Which of the following is not a standard of perioperative care?

a. The patient is free from signs and symptoms of electrical injury.
b. The patient receives appropriately administered medications.
c. The patient’s wound perfusion is consistent with or improved from baseline levels.
d. The patient’s comorbidities are managed effectively during the operative or other invasive procedure.

Answer 16

D

Question 17

16. Which of the following facilitate(s) personal and professional growth?

a. Participating in research activities
b. Participating in professional organization activities
c. Mentoring and precepting other perioperative nurses
d. Pursuing certification

Answer 17

A, B, C, D

Question 18

17. Which of the following is a true statement about the registered nurse first assistant (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 18

B

Question 19

18. The transitioning of complex procedures from the traditional operating room to alternative settings is primarily the result of

a. reimbursement guidelines.
b. technological advances in anesthesia and surgical technique.
c. patient preference.
d. the nursing shortage.

Answer 19

B

Question 20

19. Who may function in the scrub role?

a. Perioperative registered nurse
b. Licensed vocational or licensed practice nurse
c. Surgical technologist
d. CRNA

Answer 20

A, B, C

Question 21

20. Who or what determines who may function as an assistant to the surgeon during the procedure?

a. Surgeon
b. Facility policy
c. State board of medicine
d. State board of nursing

Answer 21

A, B, C, D

Question 22

21. What is the primary focus of the perioperative nurse?

a. Managing the operating room environment
b. Patient safety and achieving the desired patient outcomes
c. Supervising the scrub person
d. Documenting intraoperative patient care

Answer 22

B

Question 23

22. Which of the following roles is not part of the sterile surgical team?

a. Perfusionist
b. RNFA
c. First assistant
d. Surgical technologist

Answer 23

A

Question 24

Chapter 2*

Answer 24

*

Question 25

1. Which of the following statements are true about standard hand-off protocols?
   They

a. determine which information must be communicated.
b. provide a framework for comprehensive and concise communication.
c. are mandated by TJC’s National Patient Safety Goals.
d. become part of the patient’s record.

Answer 25

B

Question 26

2. What resources does the perioperative nurse use to formulate nursing diagnoses?

a. AORN’s Perioperative Nursing Data Set (PNDS)
b. The nurse’s unique knowledge of the surgical procedure
c. The Joint Commission’s list of patient diagnoses for surgery
d. Patient assessment data Ref

Answer 26

A, B, D

Question 27

3. Assessment data come from which of the following sources?

a. Chart review
b. Observation
c. Communication with other healthcare providers
d. The patient and family

Answer 27

A, B, C, D

Question 28

4. Commonly targeted patient outcomes include:

a. The patient will be free of injury.
b. The patient’s skin integrity will be maintained.
c. The patient will be extubated before transfer to PACU.
d. The patient will be discharged from PACU within 4 hours.

Answer 28

A, B

Question 29

5. The dose and timing of prophylactic antibiotic administration are determined by

a. protocol that specifies the drug be given 1 hour before surgery.
b. the attending surgeon.
c. the anesthesia provider.
d. bactericidal tissue and serum level at the time of surgery.

Answer 29

D

Question 30

6. What is the exception to administering antibiotics 1 hour prior to the skin incision?
   a. Amoxicillin
   b. Keflex
   c. Vancomycin
   d. Fluoroquinolone

Answer 30

C, D

Question 31

7. Which of the following is true? Obese surgical patients

a. have an increased frequency of comorbidities.
b. are at higher risk for surgical-site infection. Ref 26-27
c. do not respond well to antibiotics.
d. are more fearful of surgery than nonobese patients.

Answer 31

A, B

Question 32

8. Which of the following are considered critical physiologic assessment data?

a. Previous surgery with complications
b. Laboratory data
c. Allergies
d. Readiness to learn

Answer 32

A, B, C

Question 33

9. Critical psychosocial assessment data include

a. knowledge of perioperative routines.
b. cultural beliefs.
c. spiritual beliefs.
d. understanding of the surgical procedure.

Answer 33

A, B, C, D

Question 34

10. The most common diagnoses in the preoperative period are

a. fear and anxiety.
b. knowledge deficit and hypothermia.
c. anxiety and knowledge deficit.
d. fear and sensory impairment.

Answer 34

C

Question 35

11. Which of the following best describes anxiety?

a. General discomfort related to alteration in body image
b. Uneasiness related to anesthesia and loss of control
c. Dread of something specific
d. General uneasiness with no specific etiology

Answer 35

D

Question 36

12. Which of the following are considered interventions to address anxiety and fear?

a. Attentive listening and reassurance
b. Giving information to the family instead of the patient
c. Soliciting the patient’s description of anxiety or fear
d. Telling the patient everything he or she needs to know

Answer 36

A, C

Question 37

13. A sentinel event or never event is

a. a preventable situation that results in death, permanent harm, or severe temporary harm.
b. an event that should never happen.
c. an event that requires intervention to sustain life.
d. an event that isn’t reported.

Answer 37

A

Question 38

14. Wrong-site surgery as defined by TJC includes

a. surgery on the wrong side.
b. surgery on the wrong patient.
c. the wrong surgical procedure.
d. surgery at the wrong level.

Answer 38

A, B, C, D

Question 39

15. Factors that have been identified as contributors to wrong-site surgery include:

a. use of unapproved abbreviations.
b. illegible handwriting.
c. inconsistent time-out process.
d. site markings removed during surgical prep.

Answer 39

A, B, C, D

Question 40

16. 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 40

C

Question 41

17. A priority for the perioperative nurse before bringing the patient into the operating room is

a. verification of the patient’s identity and surgical procedure. Ref 60
b. ensuring that the surgeon is in the room.
c. ensuring the scrub person has completed setting up the sterile field.
d. ensuring that family members are present in the waiting area.

Answer 41

A

Question 42

18. During the time-out, the team agrees on which of the following?

a. Procedure to be done
b. Correct site—site marking is validated
c. Patient identification
d. Initial counts have been completed

Answer 42

A, B, C

Question 43

19. For what reason do some facilities use a paper form to capture intraoperative information that will be documented in the patient’s record?

a. The information should be reviewed by another nurse before being officially entered into the record.
b. The nurse rarely gets to document the information in the record at the time that it occurs.
c. There should be a backup copy of all information that goes into the patient record.
d. Notes taken in real time help the nurse enter data accurately into the patient record.

Answer 43

B, D

Question 44

20. Which of the following statements about intervention times is true?

a. Most facilities have systems that automatically capture the times of important surgical events.
b. The time of an event that is documented in multiple places in the patient’s record must be consistent.
c. The surgeon is responsible for determining the event time that will be documented in the patient’s chart.
d. When an event time is documented in multiple places in the patient’s chart, the nursing documentation takes precedence if the times are not consistent.

Answer 44

B

Question 45

21. The focus of patient teaching prior to the day of surgery should focus on

a. the procedure, length of the procedure, and expected outcome of the procedure.
b. preoperative events including diagnostic testing and NPO requirement.
c. postoperative responsibilities related to rehabilitation.
d. preview of intraoperative events such as monitoring and anesthesia.

Answer 45

A, B, C, D

Question 46

22. Patient teaching must be tailored to the patient’s

a. age.
b. learning level.
c. culture.
d. readiness/willingness to learn.

Answer 46

A, B, C, D

Question 47

23. Health literacy is the patient’s

a. level of health and wellbeing.
b. highest level of education.
c. ability to assimilate information from printed literature.
d. capacity to obtain, process, and understand health information.

Answer 47

D

Question 48

24. Which factor(s) interfere(s) with learning in the elderly?

a. Elderly patients are more often frightened than anxious.
b. They have difficulty with written materials.
c. They do not need as much instruction because others will be caring for them.
d. Their short-term memory may be impaired.

Answer 48

D

Question 49

25. Which of the following statements is true?

a. Toddlers may feel that surgery is punishment for bad behavior.
b. School-age children have a short attention span.
c. Becoming familiar with items they will encounter in surgery gives pediatric patients a sense of control. Ref 86
d. Preschoolers will benefit from discussing the steps involved in the procedure.

Answer 49

C