Question 1

Qualities of an effective packaging material must include these key characteristics.Select the three most important qualities.

Accepted Answer

A)  Cost,good barrier,lint-free writable surface 
B)  Good steam penetration and removal,good barrier,aseptic presentation 
C)  Aseptic presentation,event-related sterility indicators,writable surface 
D)  Stackable in sterilizer/storage shelf,comparable cost,low toxicity 
A)  Cost,good barrier,lint-free writable surface 
B)  Good steam penetration and removal,good barrier,aseptic presentation 
C)  Aseptic presentation,event-related sterility indicators,writable surface 
D)  Stackable in sterilizer/storage shelf,comparable cost,low toxicity

Question 2

Which of the following choices reflects the appropriate order of four of the steps in preparing for the surgical hand scrub procedure?

Accepted Answer

A)  Wash hands and wrists,remove jewelry,replace mask and eye protection,contain hair. 
B)  Contain hair and earrings in hat,wash hands and clean under nails,place mask and eye protection,remove jewelry. 
C)  Remove jewelry,contain hair,don fresh mask and eye protection,wash hands and forearms. 
D)  Don fresh mask,contain hair,place eye protection,clean under nails. 
A)  Wash hands and wrists,remove jewelry,replace mask and eye protection,contain hair. 
B)  Contain hair and earrings in hat,wash hands and clean under nails,place mask and eye protection,remove jewelry. 
C)  Remove jewelry,contain hair,don fresh mask and eye protection,wash hands and forearms. 
D)  Don fresh mask,contain hair,place eye protection,clean under nails.

Question 3

When applying sterile drapes to create the sterile field on the patient,which of the following principles is most important?

Accepted Answer

A)  The circulating nurse should monitor the scrub person's gowned arms when reaching over the unsterile parts of the patient. 
B)  Gently shake and fan out the drapes to open up the folds before approaching the patient. 
C)  Drape the patient starting with the incision area and proceeding to the periphery. 
D)  All of the options reflect violations of sterile technique. 
A)  The circulating nurse should monitor the scrub person's gowned arms when reaching over the unsterile parts of the patient. 
B)  Gently shake and fan out the drapes to open up the folds before approaching the patient. 
C)  Drape the patient starting with the incision area and proceeding to the periphery. 
D)  All of the options reflect violations of sterile technique.

Question 4

Positive-pressure air handling systems with unidirectional flow of non-recirculated air from the ceiling to the floor are designed to:

Accepted Answer

A)  create mild air turbulence to prevent dust from settling on surfaces. 
B)  augment the oxygen-enriched environment with dust-free air. 
C)  flow clean air over the patient and prevent corridor air intake. 
D)  All of the options are correct. 
A)  create mild air turbulence to prevent dust from settling on surfaces. 
B)  augment the oxygen-enriched environment with dust-free air. 
C)  flow clean air over the patient and prevent corridor air intake. 
D)  All of the options are correct.

Question 5

Sterilization prepares instruments to be used within,and on,sterile tissues.It kills vegetative microorganisms and endospores within a probability of 10⁶.The process of decontamination prepares instruments to be:

Accepted Answer

A)  handled without gloves and prepared for sterilization. 
B)  free of bioburden and safely handled with gloves. 
C)  clean at a high level of disinfection. 
D)  None of the options are correct. 
A)  handled without gloves and prepared for sterilization. 
B)  free of bioburden and safely handled with gloves. 
C)  clean at a high level of disinfection. 
D)  None of the options are correct.

Question 6

The mechanism of lethality (microbial death)with steam sterilization is achieved with this event.

Accepted Answer

A)  Time,temperature,and steam pressure 
B)  Reduced and limited mitosis within the bioburden 
C)  Saturated vaporization of the microbial cytoplasm 
D)  Denaturation and coagulation of enzyme proteins 
A)  Time,temperature,and steam pressure 
B)  Reduced and limited mitosis within the bioburden 
C)  Saturated vaporization of the microbial cytoplasm 
D)  Denaturation and coagulation of enzyme proteins

Question 7

The final step,after decontamination and before sterilization,is the prep,pack,and wrap process.The sterile processing technologist has taken the laparotomy set from the washer/decontaminator to prepare for sterilization.Select the most appropriate order that the instrument set must travel before reaching the steam sterilizer.

Accepted Answer

A)  Air-dry,inventory,inspect,lubricate,assemble and string instruments,wrap and tape 
B)  Inspect,unlock locked clamps,count and string instruments,place indicators,wrap and tape 
C)  Inspect,unlock locked clamps,string instruments,inventory,replace missing items,wrap 
D)  Inspect,inventory against list,assemble,place integrators,wrap and tape 
A)  Air-dry,inventory,inspect,lubricate,assemble and string instruments,wrap and tape 
B)  Inspect,unlock locked clamps,count and string instruments,place indicators,wrap and tape 
C)  Inspect,unlock locked clamps,string instruments,inventory,replace missing items,wrap 
D)  Inspect,inventory against list,assemble,place integrators,wrap and tape

Question 8

Decontamination of the hands can be done by a variety of methods.The Joint Commission (TJC)states that a thorough handwash with an antimicrobial agent may be as effective as the traditional surgical scrub using a brush or sponge.Facility infection control procedures govern the selection of materials and the methods used for surgical hand hygiene.Select the best practice for surgical hand hygiene.

Accepted Answer

A)  Alcohol-based hand rub 
B)  Anatomic counted strokes with 4% chlorhexidine gluconate brush 
C)  Anatomic timed strokes with povidine iodine sponge 
D)  Any of the options with an antimicrobial hand wash 
A)  Alcohol-based hand rub 
B)  Anatomic counted strokes with 4% chlorhexidine gluconate brush 
C)  Anatomic timed strokes with povidine iodine sponge 
D)  Any of the options with an antimicrobial hand wash

Question 9

Closed gloving is the technique of choice for the initial donning of sterile gloves by the scrubbed team member;however:

Accepted Answer

A)  it can only be used for the initial gloving. 
B)  it requires two people to execute without contamination. 
C)  there is a risk of contamination if the thumbs are not extended. 
D)  All of the options are correct. 
A)  it can only be used for the initial gloving. 
B)  it requires two people to execute without contamination. 
C)  there is a risk of contamination if the thumbs are not extended. 
D)  All of the options are correct.

Question 10

The surgical hand scrub is designed to render the hands,nails,and arms:

Accepted Answer

A)  surgically clean. 
B)  free of transient microorganisms,dirt,and skin oils. 
C)  coated with residual antimicrobial residue to prevent microbial regrowth. 
D)  All of the options are correct. 
A)  surgically clean. 
B)  free of transient microorganisms,dirt,and skin oils. 
C)  coated with residual antimicrobial residue to prevent microbial regrowth. 
D)  All of the options are correct.

Question 11

The skin preparation for a vaginal-assisted laparoscopic hysterectomy begins __ and _ before and after the procedure.

Accepted Answer

A)  At the vagina and perineum;the nurse should check with the anesthesia provider before touching the patient 
B)  At the incision site to the periphery of the abdomen only the nurse should begin and complete perioperative documentation of skin preparation including wound classification 
C)  At the cleanest area first and proceeds to less clean areas (abdomen then vagina/perineum);a skin assessment should be performed 
D)  At the vagina and perineum first with urinary catheter insertion and then proceeds to the pelvic abdomen;a skin assessment should be performed 
A)  At the vagina and perineum;the nurse should check with the anesthesia provider before touching the patient 
B)  At the incision site to the periphery of the abdomen only the nurse should begin and complete perioperative documentation of skin preparation including wound classification 
C)  At the cleanest area first and proceeds to less clean areas (abdomen then vagina/perineum);a skin assessment should be performed 
D)  At the vagina and perineum first with urinary catheter insertion and then proceeds to the pelvic abdomen;a skin assessment should be performed

Question 12

Within a steam sterilizer,at a temperature of 100° C (212° F),the water condensation and the steam are the same temperature.This scientific phenomenon is called ___ and will __.

Accepted Answer

A)  Steam saturation;not kill microorganisms 
B)  Steam distribution;promote microbial kill 
C)  Sterilization;kill all microorganisms to 106 
D)  Saturated steam;kill microbes at 106 
A)  Steam saturation;not kill microorganisms 
B)  Steam distribution;promote microbial kill 
C)  Sterilization;kill all microorganisms to 106 
D)  Saturated steam;kill microbes at 106

Question 13

Describe the best practice for aseptic removal of sterile gloves after removal of the sterile gown at the end of the procedure.Select the best practice to protect the wearer from cross-contamination.

Accepted Answer

A)  Remove both gloves together using the gloved fingers of one hand to secure the everted cuffs of the other hand,turning both gloves inside out.Discard gloves in regular trash since they are inside out.Remove mask by the ties and wash hands. 
B)  Using the gloved fingers of one hand to secure the everted cuff,remove the glove,turning it inside out.Discard appropriately.Using the ungloved hand,grasp the fold of the everted cuff of the other glove and remove the glove,inverting the glove as it is removed.Discard in biohazard trash.Remove mask by the ties and discard.Wash hands. 
C)  Both practices are appropriate. 
D)  Neither practice is appropriate. 
A)  Remove both gloves together using the gloved fingers of one hand to secure the everted cuffs of the other hand,turning both gloves inside out.Discard gloves in regular trash since they are inside out.Remove mask by the ties and wash hands. 
B)  Using the gloved fingers of one hand to secure the everted cuff,remove the glove,turning it inside out.Discard appropriately.Using the ungloved hand,grasp the fold of the everted cuff of the other glove and remove the glove,inverting the glove as it is removed.Discard in biohazard trash.Remove mask by the ties and discard.Wash hands. 
C)  Both practices are appropriate. 
D)  Neither practice is appropriate.

Question 14

Effective instrument decontamination is dependent on a particular sequence designed to lower bioburden to the lowest level.Number the steps below to reflect the correct order of processing a basic set of laparotomy instruments through decontamination.
a.During surgical procedure,wipe instruments with sterile water.
b.Transport in closed container to decontamination area.
c.Employ ultrasonic washer.
d.Preclean with neutral enzyme agent in leakproof container in procedure room.
e.Disassemble and unlock all instruments;place heavy instruments on bottom.
f.Rinse with cold water in deep sink.
g.Remove and discard all disposable sharps.
h.Place in automated instrument washer/decontaminator.

Accepted Answer

1 = A
2 = G
3 = E
4 = D
5 = B
6 = F
7 =

Question 15

The design of the physical space within an OR attempts to minimize horizontal surfaces by placing cabinets flush with the wall.This prevents dust settling on multiple surfaces and decreases the areas that have to be monitored and cleaned.Another concern with horizontal surfaces is that air turbulence from staff movement and activity plus door movement,when it opens and closes,can:

Accepted Answer

A)  mobilize resting dust from these surfaces. 
B)  contaminate sterile areas. 
C)  disrupt the unidirectional airflow. 
D)  All of the options are correct. 
A)  mobilize resting dust from these surfaces. 
B)  contaminate sterile areas. 
C)  disrupt the unidirectional airflow. 
D)  All of the options are correct.

Exam 3: Infection Prevention and Control in the Perioperative Setting

Qualities of an effective packaging material must include these key characteristics.Select the three most important qualities.

Which of the following choices reflects the appropriate order of four of the steps in preparing for the surgical hand scrub procedure?

When applying sterile drapes to create the sterile field on the patient,which of the following principles is most important?

Positive-pressure air handling systems with unidirectional flow of non-recirculated air from the ceiling to the floor are designed to:

Sterilization prepares instruments to be used within,and on,sterile tissues.It kills vegetative microorganisms and endospores within a probability of 10⁶.The process of decontamination prepares instruments to be:

The mechanism of lethality (microbial death)with steam sterilization is achieved with this event.

Closed gloving is the technique of choice for the initial donning of sterile gloves by the scrubbed team member;however:

The surgical hand scrub is designed to render the hands,nails,and arms:

The skin preparation for a vaginal-assisted laparoscopic hysterectomy begins __ and _ before and after the procedure.

Within a steam sterilizer,at a temperature of 100° C (212° F),the water condensation and the steam are the same temperature.This scientific phenomenon is called ___ and will __.

Describe the best practice for aseptic removal of sterile gloves after removal of the sterile gown at the end of the procedure.Select the best practice to protect the wearer from cross-contamination.

Concepts Basic to Perioperative Nursing

Patient Safety and Risk Management

Anesthesia

Positioning the Patient for Surgery

Sutures, Needles, and Instruments

Surgical Modalities

Wound Healing, Dressings, and Drains

Postoperative Patient Care and Pain Management

Gastrointestinal Surgery

Surgery of the Liver, Biliary Tract, Pancreas, and Spleen

Repair of Hernias

Gynecologic and Obstetric Surgery

Genitourinary Surgery

Thyroid and Parathyroid Surgery

Breast Surgery

Ophthalmic Surgery

Otorhinolaryngologic Surgery

Orthopedic Surgery

Neurosurgery

Plastic and Reconstructive Surgery

Thoracic Surgery

Vascular Surgery

Cardiac Surgery

Pediatric Surgery

Geriatric Surgery

Trauma Surgery

Interventional Radiology

Integrated Health Practices:Complementary and Alternative Therapies

Workplace Issues and Staff Safety

Filters

Within a steam sterilizer,at a temperature of 100° C (212° F),the water condensation and the steam are the same temperature.This scientific phenomenon is called _ and will .