A 47-year-old man was admitted to the emergency department (ED) with respiratory symptoms, facial and upper body abrasions, burns, and moist lesions after a small package, delivered to his office, exploded and sprayed him dried powder and glass shards. In response to the reported mechanism of injury, the ED team sequestered him in a secluded area away from the rest of the patients. The team believed that this was highly suspicious of a bio-terrorism event. The epidemiologist was called, and the patient was transferred to a negative-pressure isolation room and placed on standard, contact, airborne, and droplet precautions. Based on these actions, which microorganism agents might be suspected to be involved? Components of the electrosurgical circuit include:
a. Active electrode, dispersive electrode, and generator.
b. Dispersive electrode, fiber, and generator.
c. Active electrode, dispersive electrode, generator, and scratch pad.
d. Dispersive electrode, fiber, generator, and key.
Four core principles of perioperative risk reduction are:
a. readiness, response, rationality, root cause analysis.
b. perception, prevention, process and policy.
c. competence, communication, compassion, charting.
d. training, treatment, testing, teamwork.
A, B, C, E, F, G, H
Right dose, indication, time, patient, route, medications, and documentation.
Match the Human factor with its Description.
a. Skill based behavior
b. Knowledge based performance errors
c. Attention and situational factors.
1. This type of error arises when a nurse misinterprets a situation or incorrectly applies a rule. Mistakes include errors in perception judgment, inference, and interpretation.
2. This type of error generally occurs when our attention is diverted and we fail to monitor the actions we are performing.
3. These types of factors significantly contribute to medical errors: distraction, fatigue, and/or sleep loss, juggling multiple activities, stress, boredom, frustration, anxiety, and anger.
A perioperative nurse experienced in general, orthopedic, and neurosurgery has started a preceptorship in the CV service. What aspects of the CV service should be especially emphasized by the nurse's preceptor?
1. Electrosurgical safety, preoperative medication history.
2. Location of vascular implants and devices.
3. Advanced cardiovascular anatomy and physiology, surgeon preferences.
4. Common cardiovascular procedures, possible complications and related potential safety risks.
a. 1, 3, 4
b. 2, 3, 4
c. 1, 2, 4
d. all of the above
Surgical site infection (SSI) is a dreaded complication of surgery. Knowledge of both risk factors and effective interventions is important for preparing the patient for surgery and preventing infection. Which of the following discussion topics might be especially important between an advanced beginner and the preceptor?
1. Susceptibility to infection (pt history of immunosuppression, type 2 DM, hepatic disorders, renal failure, alcoholism.)
2. Immune status (expected range of WBC within normal limits 3-30 days after surgery)
3. Clinical factors (proposed length of procedure, wound class, prophylactic antibiotic infusion)
4. Situational factors (exposure to community-acquired infectious agents, lack of immunizations, limited personal hygiene, chronic diseases)'
a. 1, 2, 3
b. 1, 3, 4
c. 1, 2, 4
d. All of the above
A clinically proficient nursing colleague is helping a novice nurse to prepare for a 75 y.o. patient scheduled for a cataract surgery. The patient's history and physical examination include a history of coronary artery disease, pacemaker insertion 3 years earlier, and a history of occasional chest discomfort. The patient's blood pressure, heart rate, and temperature are WNL, his weight is 140# or 63.5kg. Medication is one "baby" aspirin daily. In planning the care for the patient, which of the following might the proficient nurse emphasize in discussions with the novice nurse?
1. Having the crash cart readily available.
2. Ensuring availability of 2 units PRBCs
3. Applying a pulse ox finger cot
4. Applying EKG leads
5. Starting an IV line
a. 2, 3, 4, 5
b. 1, 2, 3, 4
c. 1, 3, 4, 5
d. All of the above.
Identify the correct order of tasks to complete in an assessment.
1. Ask questions to determine the patient's knowledge of the procedure.
2. Determine, from the patient's responses, the patient's knowledge.
3. Collate information from the patient's previous medical records.
a. 1, 2, 3
b. 3, 2, 1
c. 3, 1, 2
d. 2, 1, 3
The three overriding principles of operating room fire safety are:
a. awareness, communication, teamwork.
b. oxidizing source, heat source, fuel source
c. inspect, check, respond
d. prevent, extinguish, evacuate
e. source, extinguish, safety
Patients and personnel must be evacuated because of an OR fire. The proper order of steps to take is:
a. alarm, confine/contain, rescue, evacuate
b. rescue, alarm, confine/contain, evacuate
c. rescue, evacuate, alarm, confine/contain
d. confine/contain, alarm, rescue, evacuate
e. alarm, rescue, evacuate, confine/contain
NPO status, allergies, weight, metal implants, previous surgeries, skin integrity, significant labs and imaging results, contact lenses or eye glasses, hearing aides or other prostheses, informed consent documentation, and presence of family or significant other.