CCI First Edition CNOR Exam Prep Chapters 1-9 Questions & Answers. 100% Accurate.

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CCI First Edition CNOR Exam Prep Chapters 1-9 Questions & Answers. 100% Accurate. 1. Which patient population is more sensitive to dosage errors? A. Male patients ages 25-40 B. Bariatric patien... ts C. A patient with a history of polypharmacy D. Pediatric patients - ✔✔D. Pediatric patients Rationale: Pediatric patients are at higher risk of medication errors related to dosing for body size. Patient weight should always be recorded in kilograms for medication dosage calculations. Other populations at high risk including geriatric patients and those patient with impaired body systems. 2. The goal of medication reconciliation is to: A. inform the patient of anesthetic medication administered intraoperatively. B. save the surgeon from having to look up medications later. C. promote safe patient outcomes related to medication administration D. save the floor nurse work when admitting the patient - ✔✔C. promote safe patient outcomes related to medication administration Rationale: Medication reconciliation is done to promote safe patient outcomes. It is a process of comparing the medications that a patient is currently using at home with medications that are ordered for him or her by the current health care provider. 3. A perioperative nurse is assessing a patient preoperatively for carpal tunnel surgery. Which of the following would be a possible contraindication to using a tourniquet on the operative side? A. the patient is wearing a wedding ring on the operative side B. The patient drank coffee with milk five hours ago C. the patient has a dialysis access device on the operative side D. the patient's dominant hand is the same as the operative side - ✔✔C. The patient has a dialysis access device on the operative side Rationale: The perioperative nursing assessment should include any medication conditions that may be contraindicated during the preparation and care of the patient undergoing surgery. Tourniquet use is contraindicated on limbs with a dialysis access device present because use of the tourniquet on that limb will diminish blood flow to the fistula, increasing the risk for clot formation in the fistula. 4. Which of the following is part of the surgical safety checklist? A. When the patient last ate food or drank liquids 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 - ✔✔B. Whether any special equipment, devices, or implants will be needed Rationale: The comprehensive surgical checklist is part of the Universal Protocol that is supported and endorsed by both the World Health Organization and The Joint Commission. Identifying if there are any special equipment, devices, or implants needed for the surgical procedure is part of the preoperative check-in. 5. Which of the following authoritative organizations is responsible for delineating the accepted list of nursing diagnosis? A. NANDA International B. American Nurses Association C. AORN D. The Joint Commission - ✔✔A. NANDA International Rationale: NANDA International is the organization responsible for creating and updating the current list of nursing diagnoses. NANDA classifies human response patterns and standardizes the terminology for all nursing diagnoses. 6. Surgical site marking should be performed by the: A. patient before coming to the hospital B. surgeon after the site and side (if applicable) have been surgically prepped and draped. C. nurse doing the patient preoperative assessment D. surgeon before the patient receives any sedatives - ✔✔D. Surgeon before the patient receives any sedatives Rationale: Surgical site marking should be performed by the surgeon before the patient receives any sedatives. The nurse performing the perioperative assessment verifies the site and side (if applicable) and this site verification is performed again with the surgical team before the incision is made. 7. What part of the preoperative assessment indicates that a patient is at risk for postoperative deep vein thrombosis (DVT)? A. History of varicosities B. History of alcohol abuse C. Recent upper respiratory infection D. Body mass index greater than 26 - ✔✔A. History of varicosities Rationale: During the preoperative assessment, the nurse should assess the patient for conditions that may suggest an increased risk of DVT development. These risks include a personal or family history of thrombosis, coagulopathy, blood clots, blood-clotting disorders, previous deep vein thrombosis or pulmonary embolism, varicosities or leg swelling, smoking, or living sedentary or nonambulatory lifestyle for more than 72 hours. 8. Actively warming surgical patients with forced air to prevent hypothermia should begin: A. as soon as the patient enters the OR or procedure room B. in the recovery room C. in the preoperative holding area D. just before the surgeon makes the incision - ✔✔C. in the preoperative holding area Rationale: Research has shown that, to be most effective, forced air warming should be initiated in the preoperative holding area and continued intraoperatively. Preoperatively warming the patient with forced air warming before induction of anesthesia minimizes heat loss more effectively than use of warmed cotton blankets alone. 9. Which of the following indicators demonstrates a patient who is at increased risk of developing a pressure ulcer during a surgical procedure? A. Aged 50 or older B. History of recent gallbladder surgery C. Female patient D. Poor preoperative nutritional status - ✔✔D. Poor preoperative nutritional status Rationale: The perioperative nurse should take additional precautions to decrease the risk of developing a pressure ulcer in patients who are older than 70 years of age; who require vascular procedures or any procedure lasting longer than four hours; who are thin, small in stature, or have poor preoperative nutritional status; who are diabetic or have vascular disease; or who have a preoperative Braden score that is less than 20. 10. The perioperative nurse performs a preoperative assessment on a surgical patient to aid in the development of: A. the complete medical record B. the patient's plan of care C. the surgeon's postoperative note D. future research in perioperative nursing - ✔✔B. the patient's plan of care Rationale: The perioperative nurse must complete a preoperative assessment on his or her patient to facilitate identification of the appropriate nursing diagnosis, development of a plan for the appropriate interventions and care, and achievement of the desired surgical outcomes. 1. A patient's 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 - ✔✔C. moisten the area to be prepped and use a disposable clipper Rationale: Prevention of hair dispersal for hair removed in the OR may be accomplished by wet clipping. 2. The optimal time to apply intermittent compression pneumatic devices to prevent deep vein thrombosis is: A. when the surgical procedure is scheduled B. when the patient arrives in the preoperative area C. immediately upon arrival in the OR D. before induction of anesthesia - ✔✔B. when the patient arrives in the preoperative area Rationale: The risk for formation of deep vein thrombosis increases with preoperative immobility. 3. 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 lift device, three caregivers, and the anesthesia professional - ✔✔B. A lateral transfer device, one caregivers, and the anesthesia professional Rationale: For patients up to 52 pounds, a lateral transfer device, one caregiver, and an anesthesia professional should be used for supine-to-supine patient transfer. 4. A patient undergoing placement of a cardiac stent is at highest risk for _____________ secondary to exposure to ionizing radiation. A. impaired skin integrity B. cancer C. decreased cardiac output D. nausea - ✔✔A. impaired skin integrity Rationale: The patient exposed to ionizing radiation is at greatest risk for impaired skin integrity. 5. An 18-year old patient is hesitant to remove her acrylic tongue piercing before an exploratory laparoscopy for a possible ruptured ovarian cyst. The most appropriate verbal response for the perioperative RN to provide is: A. "You can always get another piercing if the opening for this one closes." B. "If the piercing is dislodged while the breathing tube is put in, it could block your airway or be pushed into your lung." C. "It's our policy that all jewelry be removed prior to surgery." D. "Your tongue could be burned if jewelry serves as an alternate ground for the electrocautery." - ✔✔B. "If the piercing is dislodged while the breathing tube is put in, it could block your airway or be pushed into your lung." Rationale: A tongue piercing is an aspiration risk and should be removed if at all possible. 6. Which of the following statements reflects a female patient's accurate understanding of her scheduled total abdominal hysterectomy? A. "I'm having all my female parts removed." B. "I'm having a TAH." C. "I'm having my uterus removed." D. "I'm having my uterus removed through my vagina." - ✔✔C. "I'm having my uterus removed." Rationale: A total abdominal hysterectomy involves removal of the uterus and cervix. 7. Each of the following patients is having a lumbar discectomy, L4-L5, performed. Which patient's plan of care will require additional padding to address an identified increased risk for impaired tissue integrity? A. A patient with an A1c of 6.8 B. A patient with a body mass index of 24 C. A patient with intermittent claudication D. A patient with a history of transient ischemic attacks - ✔✔C. A patient with intermittent claudication Rationale: Patients with peripheral vascular disease are at increased risk for developing pressure ulcers. 8. The primary purpose for developing a perioperative plan of care is to: A. meet Joint Commission requirements for accreditation B. ensure the procedure meets reimbursement criteria by Centers for Medicare & Medicaid Services (CMS) C. eliminate the need to revise goals during the procedure. D. identify nursing interventions to assist the patient in meeting desired outcomes. - ✔✔D. identify nursing interventions to assist the patient in meeting desired outcomes. Rationale: The plan of care is developed by the perioperative nurse to describe actions undertaken to achieve desired outcomes. 9. A patient 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 type of transmission-based precaution should be undertaken? A. Leave the portable HEPA filter unit "on" while the patient is intubated to supplement normal room air exchange. B. Schedule the patient for the first procedure of the day, when the infection preventionist is available. C. Provide the patient with a NIOSH N-95 fit-tested respirator to wear during transport. D. Notify the environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles. - ✔✔D. Notify the environmental services to delay cleaning the OR until the air exchange system has had time to remove 99% of airborne particles. Rationale: Cleaning and disinfecting the procedural area should be delayed until 99% of airborne contaminants have been removed via the air exchange system. The amount of time needed to clean the air of 99.9% of airborne pathogens varies by the exchange rate; 15 exchange rates per hour for 28 minutes removes 99.9% of airborne contaminants. 10. A 28-year-old Hispanic male is schedule 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 perioperative nurse to ensure informed consent for this patient is to: A. witness the patient's 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. - ✔✔B. arrange for a medical interpreter. Rationale: The patient must be provided information related to his surgery in terms that he can understand. To maintain patient confidentiality, a medical interpreter should be provided to assist nonEnglish speaking patients. Ventilation of OR - ✔✔*Air should enter from ceiling or high vents *Air should exit through vents low on wall or bar floor *Total of 20 Air exchanges should occur per hour with minimum of 4 exchanges coming from outside. Humidity of OR - ✔✔should be maintained between 20% and 60% Temperature of the OR - ✔✔maintained between 68F and 75F (20C and 24C) The perioperative nurse is using an alcohol-based skin antiseptic on a patient with a suspected ruptured appendix. The surgeon is anxious to begin the procedure and wants to begin draping as soon as the nurse completes the prep. The most appropriate response for the nurse to ensure patient safety is to: A. allow the surgeon to drape the patient and begin the procedure before the prep agent dries. B. tell the surgeon that it is against hospital policy to drape before the skin antiseptic is dry. C. inform the surgeon that a flammable antiseptic skin agent has been used and he/she will assume responsibility if there is a fire. D. remind the surgeon that allowing the prep agent to dry will prevent volatile fumes from being trapped under the drape. - ✔✔D. remind the surgeon that allowing the prep agent to dry will prevent volatile fumes from being trapped under the drape. Rationale: Adequate time should be allowed for flammable skin antiseptics to dry and fumes to dissipate before applying drapes. The accumulation of volatile fumes under the drapes constitutes and additional fire hazard. The primary source of waste anesthesia gas is the result of: A. a leak in the endotracheal tube B. a poor-fitting mask C. the anesthesia professional's practice D. spilling liquid halogenated agents - ✔✔C. the anesthesia professional's practice Rationale: The major source of waste gas in the OR is intentional outflow of gases from the anesthetic breathing system. Local anesthesia systemic toxicity (LAST) is treated by administering: A. 10% lipid emulsion B. 15% hetastarch C. 20% lipid emulsion D. 25% hetastarch - ✔✔C. 20% lipid emulsio [Show More]

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