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A comprehensive set of practice questions and detailed, verified answers for the cnor (certified perioperative nurse) final exam. Covering a wide range of topics related to surgical patient care, including dosage sensitivity, communication protocols, contraindications, surgical checklists, medication considerations, risk factors, and safety measures. It serves as an excellent resource for perioperative nurses preparing for certification or seeking to enhance their knowledge and skills in ensuring patient safety and optimal outcomes during surgical procedures. The material is designed to help nurses understand and apply best practices in the perioperative setting, improving their ability to provide high-quality care.
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Which client population is more sensitive to dosage errors A. Male clients 25 - 40 B. Bariatric clients C. A client with a history of polypharmacy D. Pediatric clients - CORRECT ANS:->>>-D. Pediatric clients The National patient Safety Goals directed at improving staffcommunication review the need for A. ensuring important test results are communicated to the right personon time B. transferring clients to the correct next level of care C. completing perioperative charting prior to transfer to the postanesthesia care unit D. Conducting a daily huddle on the unit - CORRECT ANS:->>>-A, ensuring important test results are communicated to the right person on time Which of the following is a potential contraindication to the use of apneumatic tourniquet? A. Pt has undergone prev joint replacement surgery B. Pt is older than 80 years old
C. Pt has sickle cell anemia D. Pt's operative extremity has been shaved - CORRECT ANS:->>>-C. Sickle cellanemia Which of the following is part of the surgical check list A. When the pt last ate food or drank fluids B. whether any special equipment, devices or implants will be needed C. Whom the surgeon should talk to after surgery D. What pharmacy the client uses - CORRECT ANS:->>>-B. Whether any specialequipment, devices or implants will be needed A pt taking ginger preoperatively is at risk for surgical complications thatinclude bleeding, hypotension and A. hypoglycemia B. Bradycardia C. hypokalemia D. liver dysfunction - CORRECT ANS:->>>-B. Bradycardia
D. just before the surgeon makes the incision - CORRECT ANS:->>>-C. in thepreoperative holding area Which of the following indicators demonstrates a client who is atincreased risk of developing a pressure ulcer during a surgical procedure
preoperativenutritional status Based on data collected during the client assessment, theperioperative RN
nursingdiagnosis
Liquid peracetic acid low-temperature sterilant is used for devices that meet all of the following criteria except:
During surgery the clients respirations become increasingly shallow, and the pupils become smaller and smaller until they are pinpoint. Howshould this situation be managed?
naloxone (Narcan) should be administered
C. The anesthetic should be discontinued, and a narcotic antagonistsuch as naloxone (Narcan) should be administered NPO Guidelines: Food and fluids as desired - CORRECT ANS:->>>-Up to 8 hours
Airborne precautions are instated for pathogens that are how big? - CORRECT ANS:->>>-Small, 5 micrometers or less and can therefore can stay suspended in the air. Which precaution has pathogens greater than 5 micrometers in size - CORRECT ANS:->>>-Droplet What diseases are present for Contact precautions - CORRECT ANS:->>>-HIV HEP B HEP C Staph aureus C-Diff What Herbs may increase bleeding - CORRECT ANS:->>>-Feverfew Garlic Ginger Ginko Biloba Ginseng Vitamin E
What Herbs may cause liver Inflammation - CORRECT ANS:->>>- EchinaceaKava What Herbs may elevate Blood Pressure - CORRECT ANS:->>>-Goldenseal Licorice What Herbs may prolong the effects of anesthesia - CORRECT ANS:->>>- KavaSt. johns Wort Valerian What are the three tenets that radiation safety is based on - CORRECT ANS:->>>- Time, distance and sheilding A clients life threatening injuries prevent required hair removal before transfer to the OR. The best course of action for the perioperative caregiverto follow is to
thearea to be prepped and use a disposable clipper When prescribed, intermittent pneumatic compression devices shouldbe applied and functioning
within the path of the beam that originates from the x-raytube
within the path of the beam that originates fromthe x-ray tube. - CORRECT ANS:->>>-A. between the client and the source of radiation, but not within the path of the beam that originates from thex-ray tube An 18 year old pt is hesitant to remove her acrylic tongue piercingbefore and ex-lap for a possible ruptured ovarian cyst. The most appropriate verbal response for the perioperative RN to provide is
your airway or be pushed into your lung
the electrocautery - CORRECT ANS:->>>-B. If the piercing is dislodgedwhile the breathing tube is put in, it could block your airway or be pushed into your lung Which of the following statements reflects a female paitents accurateunderstanding of her scheduled total abdominal hysterectomy
C. I'mhaving my uterus removed The plan of care for an obese client in the supine position may include
head 25 degrees Assessing the surgical clients psychosocial state allows the RN tocontribute to the plan of care by
-D.Providing explanation, comfort and emotional support A pt scheduled for a bronchoscopy states he has had a persistent coughwith blood- tinged sputum, night sweats and a loss of appetite with significant weight loss over the past three months. Which action shouldbe taken
supplement normal room air exchanges.
prevention specialist is available
system has had time to remove 99% of airborne particles -
on the bed - CORRECT ANS:->>>-over the distal break to allow for bending the knees and to secure the pt, and to protect from undueshear during the procedure When performing preoperative skin antisepsis, the perioperative RNshould
toward the incision site.
the antiseptic.
manufacturers instructions for use before the surgical drapes are applied - CORRECT ANS:->>>-D. Allow the antiseptic solution to dry for the full time recommended in the manufacturers instructions for use before thesurgical drapes are applied A must be used to remove waste anesthesia gases from theoperating room
Local anesthetic systemic toxicity is treated by administering
Placing the client on the OR bed in the supine position with arms extended on armboards at greater that 90 degrees may cause injury tothe
The correct time to label containers designated for medications orsolutions is
to the field
thetime the medication is delivered to the sterile field A periop caregiver is preparing to perform a skin prep for a client scheduled for a
D. perform hand hygiene and wear long sleeved scrub attire Clients placed in the steep trendelenberg position may be at risk for
due to the pressure of abdominal contents against the diaphragm What type of extinguisher should be used in an electrical fire - CORRECT ANS:->>>-Halon because it will not leave a residue on the equipment When risk for exposure to blood and body fluids exists, the followingtypes of PPE should be worn - CORRECT ANS:->>>-gloves, surgical masks, fluid resistant gown, eye protection What airflow pressures and total air exchanges per hour is the most appropriate for sterile storage areas - CORRECT ANS:->>>-positive airflow pressurewith a min of 4 total air exchanges per hour What incision should be used for a C-Section of a baby in breechposition?
What is a Kronig incision - CORRECT ANS:->>>-An 8cm vertical incision made in thelower uterine segment after the bladder is separated and retracted away A Sterile field has been prepared for a vaginal hyst. The surgeon has been called away for an emergency C-Section, delaying the scheduledcase by at least 1 hour. the appropriate method for maintaining the sterile field for a delayed case is to
-C.Cover the sterile field with a sterile drape and remain in the room A pt has lost 750mL of blood intraop. Vitals are WNL. Which of thefollowing interventions sould the caregiver anticipate.
additionalcrystalloids
sterilization method if biological and class V indicators are placed in the load An 18 y/o pt is scheduled for surgery to have cochlear implants placed,The client refuses to have the implants tracked even after the team has informed her of the possible implications of a recall or adverse event. What is the next course of action
client has refused to allow tracking of the medical device
Proceed with the surgery and document in the perioperative notes thatthe client has refused to allow tracking of the medical device When should the scrub person transfer specimens from the sterile fieldto the RN
In the OR humidity should be maintained between - CORRECT ANS:->>>-20%- 60% In the OR temperature should be maintained between - CORRECT ANS:->>>- 68 and 75
What is a late sign of Malignant Hyperthermia? - CORRECT ANS:->>>-Increased Temperature malignant hyperthermia is a life threatening condition triggered by - CORRECT ANS:->>>-medications used in anesthesia; inhaled anesthetics, succinylcholine Symptoms of MH - CORRECT ANS:->>>-hypercarbia, tachypnea, tachycardia, metabolic and resp acidosis, cardiac dysrhythmias, and temp elevation What is an early indication of MH - CORRECT ANS:->>>-rigidity of the jaw, identified during intubation What is the treatment for MH - CORRECT ANS:->>>-Dantrolene 2.5mg/KG What is the one medication used as a preoperative anxiolytic? - CORRECT ANS:->>>-Midazolam Hetastarch - CORRECT ANS:->>>-A substitute for blood plasma and has oxygen carrying capabilities What are the three primary methods of hand hygiene? - CORRECT ANS:->>>- Washing with soap and water performing surgical hand scrub using surgical hand rubs