CNOR D2 Intraoperative Patient Care and Safety

Question 1

What is the primary position for most surgical procedures?

Answer 1

Supine position.

AORN Guideline for Positioning the Patient

Question 2

True or False:

The supine position requires the patient to lie flat on their back.

Answer 2

True

AORN Guideline for Positioning the Patient

Question 3

Fill in the blank:

When positioning a patient supine, it is important to use ________ to protect bony prominences.

Answer 3

padding

AORN Guideline for Positioning the Patient

Question 4

What is the purpose of padding in the supine position?

Answer 4

Relieve, reduce, and redistribute contact pressure at bony prominences

AORN Guideline for Positioning the Patient

Question 5

Which anatomical areas are particularly vulnerable when a patient is in the supine position?

Answer 5

Heels, sacrum, and elbows.

AORN Guideline for Positioning the Patient

Question 6

What should be done to ensure the patient’s head is properly positioned in supine position?

Answer 6

The head should be supported and maintain alignment with the spine.

AORN Guideline for Positioning the Patient

Question 7

What is the role of the surgical team during patient positioning?

Answer 7

To ensure safety, comfort, and proper alignment.

AORN Guideline for Positioning the Patient

Question 8

True or False:

A safety strap is recommended to secure the patient in the supine position.

Answer 8

True

AORN Guideline for Positioning the Patient

Question 9

What is required for verifying the correct route when administering intravenous medications?

Answer 9

Tracing of all tubing to the point of origin and point of insertion.

It is a regulatory requirement.

AORN Guideline for Medication Safety

Question 10

Why is it critical to document the patient’s current weight related to medication administration?

Answer 10

For weight-based medications verify that the medication dose is correctly adjusted to the patient’s weight before administration.

AORN Guideline for Medication Safety

Question 11

Fill in the blank:

The best way to prevent errors is to use only _______ on spinal, epidural, and combined spinal/epidural devices

Answer 11

non-Luer-lock connectors

AORN Guideline for Medication Safety

Question 12

What methods can be employed to prevent retained surgical items (RSIs)?

Answer 12

Audible counting, ensuring item separation, restarting interrupted counts, excluding manufacturer errors

AORN Guideline for Retained Surgical Items

Question 13

What is the goal of preventing retained surgical items?

Answer 13

Active participation, consistency, collaboration, and communication

AORN Guideline for Retained Surgical Items

Question 14

What steps should be taken during the surgical count to prevent RSIs?

Answer 14

Count all sharps, observe for dropped items, actively participate in count reconciliation, document count, verify final count status

AORN Guideline for Retained Surgical Items

Question 15

What should be included in specimen labeling?

Answer 15

Name of specimen, date and time of removal, patient identification, chemical fixative information

AORN Guideline for Specimen Management

Question 16

What environmental hazards are present in the perioperative environment?

Answer 16

Chemical, fire, smoke plumes, radiation, electrical, laser

AORN Guideline for Environment of Care

Question 17

What safety measures should be taken regarding radiation exposure?

Answer 17

Wear dosimeters, report exposure levels, notify radiation officer if pregnant, use shielding

AORN Guideline for Radiation Safety

Question 18

What should be done with specimens immediately after excision?

Answer 18

Maintain integrity, verify identification, label immediately, and use standard precautions

AORN Guideline for Specimen Managment

Question 19

What should be included in a specimen requisition form?

Answer 19

Patient identification, specimen identification, required pathology examination, physician’s name

AORN Guideline for Specimen Managment

Question 20

What are the protocols for handling forensic specimens?

Answer 20

Preserve chain of custody, keep specimens separate, use standard precautions, document all handling

AORN Guideline for Specimen Managment

Question 21

What are the components of medication safety in the perioperative environment?

Answer 21

Medication rights, labeling, verifying correct medications, and ensuring proper storage

AORN Guideline for Specimen Managment

Question 22

What documentation is required for autologous tissue management?

Answer 22

Labeling with patient identifiers, source of tissue, type of tissue, and medical diagnosis

AORN Guideline for Autologous Tissue Management

Question 23

What is the primary toxic fume produced by formalin?

Answer 23

Formaldehyde (37% formaldehyde)

AORN Guideline for Environment of Care

Question 24

What is a key component of hazardous medication management?

Answer 24

Hazard medication management plan

AORN Guideline for Medication Management

Question 25

What must be accessible and presented in relation to hazardous medications?

Answer 25

SDS (Safety Data Sheet) | SDS provides essential information about the hazards and safe handling o ## Footnote AORN Guideline Environment of Care

Question 26

Which regulations must storage of hazardous medications comply with?

Answer 26

USP 800 requirements ## Footnote AORN Guideline Medication Safety

Question 27

Who should not be involved in the use of cytotoxic agents?

Answer 27

Pregnant staff ## Footnote AORN Guideline Medication Management

Question 28

What is a key practice for skin antisepsis before surgery?

Answer 28

Preoperative bathing ## Footnote AORN Guideline Patient Skin Antisepsis

Question 29

What three qualities should an antiseptic skin cleansing agent possess?

Answer 29

* Broad-spectrum antimicrobial activity * Quickly applied * Safe without skin irritation ## Footnote AORN Guideline Patient Skin Antisepsis

Question 30

An effective antiseptic should remain active in the presence of what two substances?

Answer 30

* Alcohol * Organic matter ## Footnote AORN Guideline Patient Skin Antisepsis

Question 31

What is an important characteristic of antiseptics when used with high-energy devices?

Answer 31

Nonflammable when dried ## Footnote AORN Guideline Patient Skin Antisepsis

Question 32

What must be included in medication orders?

Answer 32

* Date and time of the order * Patient’s name * Patient’s age and weight * Name of medication * Dose, frequency, and route * Name of the prescriber * If applicable, dose calculation requirements, exact concentration, quantity and duration, specific IFU ## Footnote AORN Guideline Medication Management

Question 33

What is the standard naming convention for medications according to facility policy?

Answer 33

Standard name according to facility policy is to use the generic name followed by the brand name when necessary. ## Footnote AORN Guideline Medication Management

Question 34

What must standing orders include?

Answer 34

* Medically appropriate * Verified by a licensed health care provider * Documented in the patient’s medical record * Authenticated by provider ASAP * Reviewed for accuracy by provider at least annually ## Footnote AORN Guideline Medication Management

Question 35

# True or False: Verbal orders can be used for chemotherapy agents.

Answer 35

False ## Footnote AORN Guideline Medication Management

Question 36

What are the key components of nursing interventions related to medication?

Answer 36

* Nursing assessment * Verify all medication orders * Clarify medication orders as needed with physician * Collaborate with pharmacy to obtain medications not in inventory ## Footnote AORN Guideline Medication Management

Question 37

What should be verified when transferring medications to the sterile field?

Answer 37

* Medication’s name * Strength * Dosage * Expiration date ## Footnote AORN Guideline Medication Safety

Question 38

What should happen if a medication is not labeled on the sterile field?

Answer 38

It should be discarded. ## Footnote AORN Guideline Medication Safety

Question 39

What must be confirmed when administering IV medications?

Answer 39

* Correct vascular access * Trace all tubing * Label all tubing and injection ports ## Footnote AORN Guideline Medication Safety

Question 40

List the components of hand-offs in nursing interventions.

Answer 40

* Medication history * Anesthesia type * Pending lab work * Patient risk factors ## Footnote AORN Guideline Team Communication