CNOR Questions & Answers. 100% Accurate. Graded A.

CNOR Questions & Answers. 100% Accurate. Graded A. While completing the preoperative assessment, a nurse notices the pt R knee has been marked by the surgeon but the pt is scheduled for the L Knee arthroplasty. What ...

CNOR Questions & Answers. 100% Accurate. Graded A. While completing the preoperative assessment, a nurse notices the pt R knee has been marked by the surgeon but the pt is scheduled for the L Knee arthroplasty. What is the best action for the nurse? - ✔✔verify with the surgeon A pt age 7 is scheduled for a tonsillectomy and adenoidectomy at the ambulatory surgery center. During the preoperative telephone interview, the mother asks the preoperative nurse if her daughter will be able to take her favorite stuffed animal into the OR. Which of the following is the best response based on the child's developmental level - ✔✔we will make sure the toy stays with your daughter until the anesthetic takes effect The periperative registered nurse notes that the pt is taking garlic as a prophylactic cold remedy. This information is reported to which of the following health care providers? - ✔✔Anesthesia care provider, because garlic can prolong bleeding A pt who has just received a local anesthetic block is beginning to demonstrate decreased breathing rate & depth, tremors, and muscle twitching, the nurse should suspect a/an - ✔✔toxic reaction to the local anesthesia the perioperative nurse can expect the would /ostomy/continence nurse to mark the site for the stoma for a colostomy at - ✔✔rectus muscle During a local procedure, the nurse notices that the pt is exhibiting a sense of uneasiness, agitation, coughing & wheezing. The nrse should suspect a/an - ✔✔allergic reaction to the local anesthesia the 3 tops risk factors associated w/ pt falls are medications, gait, and - ✔✔previous fall normal hematocrit for pt age 10 years ranges from - ✔✔34-40% universal protocol is a process to keep pt safe in surgery. Verbal confirmation is performed at 3 points during the perioperative period. Which of the following is identified as 1 of the 3 critical points? - ✔✔sign in before induction of anesthesia a 12 year old boy is scheduled for srgery to repair a fracture to the knee involving the epiphyseal plate. The perioperative nurse recognizes the primary complication resulting from the injury is - ✔✔impaired growth to the affected leg a pt suffers a cardiac arrest following the injection of bupivacaine 0.5% w/ epi 1:200,000 25 mL as a peripheral nerve block for L knee arthroscopy. The perioperative nurse can anticipate obtaining which of the following drugs for the anesthesia care provider? - ✔✔20% lipid emulsion Which of the following is an assessment parameter monitored through the use of perioperative nurse process? - ✔✔documentation of potential needs preoperative pt assessment of the use of herbs is an important function of the perioperative nurse so that - ✔✔the appropriate healthcare provider can be notified of potential risks to the surgical procedure which electrolyte is important to check preoperatively after bowel prep the day before? - ✔✔Potassium AORN peripoperative nursing data set (PNDS) is the structured nursing vocabulary designed to describe nursing care in the perioperative setting. At the core of the PNDS conceptual model is the - ✔✔patient What Is Defined As The Standardized Process To Keep Patients Safe In Surgery? - ✔✔Universal protocol The purpose of witnessing a surgical consent is to attest to which of the following? - ✔✔the signature was voluntary and not coerced Which one of the following antibiotics can potentiate neuromuscular blocking agents? - ✔✔piperacillin Universal protocol is - ✔✔a standardized means for ensuring pt safety during surgery during the discharge medication reconciliation process, the postanesthesia care unit nurse educates the pt and family members to - ✔✔use 1 pharmacy for filling all prescriptions and OTC medications a pt scheduled for an emergency hip arthroplasty has a preoperative prothrombin result of 12 seconds. The best action of the RN circulator is to - ✔✔inform the surgical team and transport the patient to the OR suite During the preoperative assessment, the pt states that "donor-directed" RBCs are available and should be sued if a blood transfusion is necessary. Which of the following is accurate about donor directed RBCs? - ✔✔donated blood is tested and processed by the blood bank What is the physiological change associated w/ the normal aging process in geriatric pt? - ✔✔increased vascular resistance during the preoperative assessment, the perioperative nurse notes on the history & physical that the pt has an entrapped median nerve on the volar surface of the wrist secondary to her work as an IT specialist. The nurse will set up for which of the following procedures? - ✔✔carpal tunnel repair which of the following pt is at increased risk of inadvertent hypothermia? - ✔✔82 year old undergoing colectomy pt is admitted from a long term facility with a fractured hip. The pt has a " do not resuscitate" (DNR) order in his medical record. The perioperative nurse's next action is to - ✔✔ensure that the pt, anesthesia care provider & surgeon have an opportunity to discuss options and answer questions It is the responsibility of the _____ to obtain informed consent for a proposed surgical procedure - ✔✔practitioner performing the procedure a form of standardized language in the perioperative setting is reinforced by the use of which documentation format? - ✔✔PNDS Pneumatic tourniquet inflation pressures are determined by - ✔✔systolic BP, age of pt, & circumference of extremity placing sequential compression devices ( SCDs) on a pt legs preoperatively addresses which of the following risk factors for the development of deep vain thrombosis (DVT)? - ✔✔venous stasis a pt is scheduled for a laparoscopic cholecystectomy at 1000. In response to a question related to NPO status, the pt states she had a sip of water with her usual dose of metoprolol/hydrochlorothiazide at 0700. The perioperative nurse's next response is to: - ✔✔proceed with the case as scheduled bone wax should be immediately available for craniotomies conducted in the Fowler position because of this position's increased risk for: - ✔✔air embolus for a pt with a history of serum cholinesterase deficiency, which of the following anesthetic agents should be avoided? - ✔✔succinylcholin the perioperative registered nurse is caring for a developmentally delayed male pt aged 46 years whose cognitive level is comparable to a child aged 9 years.Which of the following is the most appropriate pain assessment tool? - ✔✔using a FACES pain rating scale Pt with a possible injury within the cranium should not be placed in a ____ position unless absolutely necessary - ✔✔Trendelenburg Which of the following is an example of education using the pt centered care approach? - ✔✔call the dr if the blood on your dressing is bigger than a fifty cent piece greatest risk for transmitting the HIV virus is through exposure - ✔✔to infected blood or body fluids via a large bore hollow needle which of the following complementary therapies may provide relief for postoperative nausea & vomiting? - ✔✔peppermint aromatherapy the major benefit of using the Perioperative Nursing Data set (PNDS) is its - ✔✔ability to document pt care that is unique to perioperative nursing pt preoperative health assessment form indicates that he uses a continuous positive airway pressuse (CPCP) machine at night for sleep apnea. The perioperative nurse knows to transfer this information to the postanesthesia care unit (PACU) nurse so that the pt can be monitored more closely for signs & symptoms of : - ✔✔hypoxia administration of the preoperative prophylactic antibiotic is the responsibility of - ✔✔a designated perioperative health care provider compared to adults, infants are at increased risk for hypothermia due to - ✔✔increased body surface area to weight ratio accountability for surgical counts is a professional responsibility that rests primarily on the - ✔✔scrub person & RN circulator PNDS uses ____ domains to address the perioperative nursing process - ✔✔4 the nurse should place a specimen in a container with ___ when sending to pathology for a frozen section - ✔✔Nothing specimens should be transferred from the sterile field to the appropriate container using ___ precautions - ✔✔standard 34 year old female pt with a diagnosis of breast cancer is scheduled for a R breast mastectomy. When performing the surgical skin prep, the nurse - ✔✔uses a no touch technique during prepping if the alimentary, respiratory & genitourinary tracts or oropharyngeal cavity are entered under controlled conditions without significant spillage or unusual contamination, the surgical wound is classified as which of the following? - ✔✔clean contaminated wound Rational: correct wound classification should be completed after conclusion of the surgical procedures. Determination of any alteration related to spillage of contaminated contents must be considered when applying the wound classification. Any GI or GU tracts are considered clean contaminated unless alterations occur. During a subtotal thyroidectomy, both the R & L recurrent laryngeal nerves are ligated. The perioperative nurse can anticipate the need for which of the following interventions? - ✔✔obtaining an emergency tracheotomy tray a pt with a fractured anterior fossa of the skull may have an alteration in which sense? - ✔✔smell Rational: fractures of the anterior fossa of the skull may affect the olfactory nerve, which is responsible for the sense of smell the preferred incisional type for an exploratory laparotomy is - ✔✔midline vertical Rational: a midline vertical incision is preferred for an exploratory laparotomy because it enables fast entry into the abdomen and excellent exposure to the abdominal contents and because it can be closed securely and rapidly A ____ is a major cause of death during & immediately following a surgical procedure that can result from blood pooling in low pressure areas - ✔✔pulmonary embolism Rational: PE can be caused by blood clots or other debris like fat. Debris blocks the pulmonary artery or one of the branches. A PE is most often caused by stasis of blood in deep veins during extended proceedures. in the absence of a sterile transfer device when dispensing medication to the sterile field, the best option is to - ✔✔have the RN circulator draw up the medication in syringe & transfer Rational: The best option is to use a sterile transfer device. If one is not available, the next best option is for the RN circulator to draw up the medication in a syringe and remove the needle prior to dispensing on the field most medication errors in pediatric care occur because this pt population varies dramatically in - ✔✔weight Rational: pediatric medication administration is based on the pt weight. An accurate wt measurement upon admission in both pounds and kg is an essential part of preventing medication errors. determining whether re-anastomosis is possible after a low anterior resection of the sigmoid colon depends on - ✔✔cancer free margin of the distal rectum Rational: the ability to reestablish continuity of the proximal sigmoid colon and the rectum is contingent on whether the distal rectal margin is cancer free and if there is sufficient length of the bowel to vreate a tension- free anastomosis what is the American Society of Anesthesiologists (ASA) classification of a pt with severe hypertention? - ✔✔ASA Class 3 Rational: Class 3 defined as pt having severe systemic disease that limits activity but does not completely incapacitate the pt. the chemical indicator inside a wrapped instrument tray has not changed to the appropriate color. The perioperative nurse should first - ✔✔review the sterilizer print out Rational: the sterilizer print out should be checked 1st to determine whether cycle parameters have been met. Physical monitors can provide a rapid means of identification of sterilizer failure. Subsequent actions are based on whether the reason for the failure is due to operator or sterilizer causes using ___ after high level disinfection of flexible endoscopes may help dry the lumen to prevent microorganisms from multiplying - ✔✔70-90% ethyl alcohol Rational: flushing w/70-90% ethyl or isopropyl alcohol should be determined by the interdisciplinary team at the organization. Flushing with alcohol may not be necessary if the flexible endoscope is dried properly pt is scheduled for burr holes to remove fluid accumulated secondary to blunt head trauma. The best option for a drain that removes cerebral spinal fluid while monitoring intracranial pressure is a - ✔✔ventriculostomy Rational: A ventriculostomy provides the most accurate method of monitoring intracranial pressure while providing the ability to drain cerebrospinal fluid mcburney's incision is used by surgeons when performin an open - ✔✔appendectomy Rational: this method involved pressing on the R lower quadrant below the umbilicus and medial to the anterior superior iliac spine. This is known as the McBurney's point the primary goal for moderate sedation/analgesia is for the pt to exhibit a depression level of consciousness while - ✔✔being aroused with tactile stimulation Rational: goals of moderate sedation include independent maintenance of airway and appropriate response to physical and verbal stimulation. Although the pain threshold is elevated, all painfull sensation may NOT be eliminated shoes worn by perioperative team members within the surgical suite should have closed toes & backs, low heels, and non skid soles & must meet ___ requirements - ✔✔OSHA pulse oximetry measures - ✔✔saturated hemoglobin in arterial blood local anesthesia injected during an epidural is diffused by the - ✔✔rate of injection Rational: the concentration, volume, and rate of injection determine the spread and diffusion of medication during an epidural injection which of the following is an effective way to prevent hypothermia in the perioperative pt? - ✔✔warm pt before induction of anesthesia which perioperative team member (s) is/are responsible for prevention of retained surgical items? - ✔✔all perioperative team memberst Rational: The entire surgical team should be reasonable for ensuring pt safety and prevention of retained surgical items. A system that includes a multidisciplinary approach based on team skill and intervention is the best way to prevent pt injury passive drains like a Penrose provide - ✔✔ during the ___ stage of healing, granulation tissue can be felt as a firm ridge under the edges of the incision - ✔✔proliferative Rational: granulation tissue forms during the proliferative stage and resolves during the remodeling phase blood salvage for autotransfusion should not be done intraoperatively if there is presence of amniotic fluid, enteric organisms or - ✔✔Avitene Rational: Avitene may not be removed when the cells are washed and could lead to disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). Avitene is a collagen used for hemostasis the recommended maximum cuff pressure limit for a pneumatic tourniquets applied to the lower leg is - ✔✔250-300 Rational: Tourniquet pressure should not exceed the recommended maximum cuff pressure limits of 250-300mmHg for the lower leg. in the event of an incorrect count during closing procedures, what is the 1st thing the nurse should do? - ✔✔immediately inform the surgeon Rational: the surgeon should be informed immediately to allow him to search the wound area while temporarily suspending the closure. In some cases, the surgeon may continue to close based on the pt health status. which of the following is a sign of a blood transfusion reaction in the anesthetizing pt? - ✔✔temperature change Rational: pt under anesthesia may demonstrate profound