Answer the following questions by writing the letter that corresponds to your choice. 10.

It is recommended that a vigorous 2 to 5 minute scrub with a chemical agent is done. However, prolong scrubbing is not advisable. What is the rationale behind this? a. It is against the protocol of the institution b. Can release resident microbes from the deeper skin layers and is therefore counterproductive c. The chemical to be used has a broad spectrum of activity; is fast acting and has a persistent effect d. It is one of the principles of sterile technique

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You found a sterilized package inside the scrub room. Which of the following should you do? a. Consider it unsterile b. Return it to the CSR if the indicator is still present c. Ask other nurses in the OR if the package is still sterile d. Inform the supervisor All but one are the rationale for compliance to the principles of sterility: a. To avoid lawsuits b. To prevent infection c. To promote healing d. To follow hospital protocol Which of the following best describe what a surgical conscience means? a. Honesty in the practice of sterile technique even when no one is watching b. Compliance to the principles of sterility c. Reminders are given by the authority that everyone should practice sterile technique d. Honesty to all The term sporicidal refers to: a. Having the ability to reduce the number of bacteria b. Having the ability to kill the bacteria in their spores state c. The sterilization process d. The prevention of contamination Given the following steps, in what order should a nurse drape an unsterile table? A. Place the drape over the unsterile surface nearest oneself B. Protect gloved hands by cuffing a drape over them C. Cover the far side of the table with the remaining part of the drape a. A, C, B c. A, B, C b. C, A, B d. B, A, C In preparation for surgery, the intended area is shaved and cleansed with Betadine. What is the primary objective of skin prep? a. To clean the skin of excess oil and hair b. To prevent post-operative infection by sterilizing the skin c. To prevent post-operative infection by reducing the number of microorganisms normally present on the skin d. To provide a clear field for the incision Which of the following will prevent strike-through contamination? a. Use of sterile indicator b. Use of drapes/cover c. Use of impervious drapes/cover d. Use of disposable materials The following should be practiced when opening a sterile pack, except: a. When an unsterile person places a sterile pack on a sterile field, a distance of 2 feet or (60 cm) from the sterile field should be maintained b. When opening a package, turn it to its side and open it away from you c. Do not open the pack while facing the sterile field d. To expose the sterile content, pull open the package but do not tear the cover Which of the following statements is a principle of sterile technique? a. Sterile persons may not wear sterile gloves b. The edges of anything that encloses sterile contents are considered sterile c. Tables are sterile only at the table level d. Skin is sterilized

11. The following are the appropriate objectives of anesthesia during surgery, except: a. To depress the functions of the CNS b. To cut surgery time and avoid complications c. To prevent pain sensation d. To produce neuroleptanesthesia 12. Joyce, 25 years old, will undergo appendectomy. The anesthesia that will be inducted is spinal anesthesia. At what level will the spinal needle be inserted? a. L1 & L2 c. L3 & L4 b. S1 & S2 d. S2 & S3 13. Since Joyce has received spinal anesthesia, what is the most profound complication she can develop? a. Hypotension c. Headache b. Hematoma d. Paralysis

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14. Which is not an objective of a surgical scrub? a. To decrease the number of resident microorganisms on the skin to an irreducible minimum b. To suppress the population growth of microorganism c. To prevent infection of the surgical wound d. To sterilize the skin and avoid infection 15. It is recommended that a vigorous 2 to 5 minute scrub with a chemical agent is effective when doing surgical scrub. However, prolonged scrubbing is not recommended. What is the rationale behind this? a. It is against the protocol of the institution b. It leads to the release of resident microbes from the deep dermal layers and is therefore counterproductive c. The chemical used has the following qualities: broad spectrum of activity; fast-acting and persistent effect d. It is one of the principles of sterile technique 16. Surgical Conscience refers to: a. Observing the principles of sterility even when no one is watching b. Compliance to the principles of sterility during surgery c. Reminders done by the authority d. Honesty 17. You are a scrub nurse who will assist the surgeon in wearing the gown. The following are the correct steps in gowning another person, except: a. Unfold the gown carefully, holding it at the neck band. b. Keeping the hands on the outside of the gown and using the neck and shoulder area of the gown as protective cuff over the gloves, offer the inside of the gown to the surgeon. c. Release the gown d. Release the gown and offer it to the surgeon 18. As a scrub nurse, you also assist the surgeon in wearing sterile gloves. In what order must the following steps be performed? 1. Position the palm of the gloves toward the surgeon 2. Stretch the cuff sufficiently

3. 4. a. b.

Abduct your thumb Exert upward pressure as the surgeon plunges his/her hand into the gloves 1324 3214 c. d. 1234 2314

19. What is the adverse effect of placing a client in the Trendelenburg position? a. The heart is mechanically compressed by the internal organs and the diaphragm b. The client will feel uncomfortable because the bed is uneven c. The client will experience chest pain after surgery d. Hypovolemia 20. When placing the client in lithotomy position, which of the following should you not do? a. Place the stirrups at the same height b. Have two people raise the clients legs simultaneously and place them on the stirrups c. Secure the stirrups on each side of the OR rail at the level of the clients upper thigh d. Place the legs of the client one after another into the stirrups 21. After performing the first step of skin preparation, the following are the steps to be taken, except: a. Clean the area using a circular motion, starting from the inner area and moving out to the periphery b. After cleaning the area, place the sterile towel over towel over the site c. Apply antiseptic solution paint-style d. Get the towel and clean the site 22. What is the primary purpose of skin preparation a. To lessen bacteria in the skin b. To sterilize the skin c. To apply antiseptic solution d. To clean the skin 23. The following are the steps in draping a client during surgery, except: a. Drape the opposite side by reaching across the table with caution b. Hold a drape high enough to avoid touching non-sterile areas c. Hold a drape high until it is directly over the proper area and then lay it down d. Protect gloved hands by cuffing the end of the sheet over them

Begin exploring her fears and anxieties toward surgery Assist her to void prior to receiving preoperative medication d. Ask when her last meal was 26. During skin prep, Ms Salvadors right upper chest, right upper arm and axilla were shaved and cleansed with Betadine. The primary purpose of a skin prep is: a. To clean the skin of excess oils and hair b. To prevent postoperative infection by sterilizing the skin c. To reduce the number of microorganisms on the skin d. To provide a clear field for the incision 27. The surgeon decided to remove the right breast of Ms. Salvador. Which of the following will be the least accurate assessment parameter of bleeding? a. Number of sponges used b. Urine output c. Vital signs d. Secretion in the suction bottle 28. Application of pressure dressings are used for the following reasons, except: a. To distribute pressure drainage b. To help provide comfort c. To prevent bleeding d. To minimize change of dressing

b. c.

24. In the morning of surgery, you have been assigned to assist Mr. Salvador in the final preparations before conducting her to the OR. What will your initial action be when you assess Mr. Salvador? a. Prepare her preoperative medication b. Check if the operative permit has been signed c. Check to see if the preoperative laboratory reports had been placed with the chart d. Check the diet orders to be sure she had been placed on the NPO list 25. The following are the immediate preparation for surgery for Mr. Salvador, except: a. Tape the wedding band securely to her finger

29. Upon admission to the recovery room, Mr. Potter, who had general anesthesia, is very restless. His respirations are deep and somewhat irregular; he startles easily and moans when you touch him. You priority nursing action is: a. Pacify him by telling him that the operation is over b. Raise the side rails and remain quietly in attendance c. Administer Demerol HCl 100 mg IM d. Check his nailbed for cyanosis 30. You are monitoring Mr. Potters vital signs every 15 minutes. Which of the following changes should be reported immediately to the surgeon? a. Dry, cool skin b. A systolic blood pressure that drops to 20 mmHg or more c. A diastolic pressure below 70 d. A pulse rate that increases and decreases with respirations 31. Upon turning Mr. Potter to his left side, you noted a moderately large amount of serosanguineous drainage on the bedsheets. Your first action is: a. Remove the dressing to ascertain the origin of the bleeding b. Milk the Hemovac tubing using a downward motion c. Note vital signs, reinforce the dressing, and notify the surgeon immediately d. Recognize that this is a frequent occurrence with this type of surgery 32. How many cc of meperidine 75 mg will you inject if the stock dose is 50 mg/cc in a 2cc ampule a. 1.5 cc c. 1 cc b. 0.75 cc d. 2 cc 33. The relatives of Ms. Fontana came in and asked you when will their client be transferred to an ordinary room. Your response will be: a. Once the doctor ordered to transfer b. When the vital signs of the client has stabilized c. After two hours d. Just wait, I will inform you when she is ready

1. 2. 3. 4. 5. 6.

Validates with the surgeon his/her preference of sutures and surgical equipment/supplies. Establishes and maintains the integrity, safety, and efficiency of the sterile field throughout the procedure. Cleans the patient by removing unnecessary prep solutions, adhesive tapes, blood, and the like. Records all the sponges, sharps, and instruments to be used during the operation. Provides any supply, instruments, and equipment as needed. Assists in transferring the patient from the OR table to the PACU.

25. 26. 27. 28. 29.

Pneumonectomy Cholecystectomy Colectomy Mastectomy Nephrolithectomy

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The nurses responsibility in the signing of the informed consent. 8. The reason why the nurse ensures that: a. The denture is being removed prior to surgery? b. (9) Nail polish? c. (10) Jewelries? 11. How will the nurse ascertain that the patient is on NPO for 8 hours prior to surgery? 12. Coughing exercise 13. Turning exercise 14. Deep Breathing exercise

30. What is the purpose of cherries with antiseptic solution and OS 4x4 that are handed to the surgeon right after the operation ended? 31. What is the drug classification of the following medications given post-op? a. (31) Nalbuphine b. (32) Morphine SO4 c. (33) Ketorolac d. (34) Tramadol e. (35) Ranitidine f. (36) Cefuroxime 37. What is your nursing responsibility before you administer Morphine SO4 and Nubain? 38. Why do you give Ranitidine prior and post-surgery? 39. How will you position your patient post-surgery if: a. (39) The patient had a spinal anesthesia? (40) Why? b. (41) The patient had a general anesthesia? (42) Why? 43. & 44. What specific laboratory result will you look for to determine if the patient needed a blood transfusion?

15. 16. 17. 18. 19.

Thyroidectomy Herniorrhaphy (Inguinal) Vaginal Hysterectomy Appendectomy Left Nephrectomy

20. 21. 22. 23. 24.

Appendectomy Cholecystectomy Nephrectomy Cesarean Section (Bikini Cut) Gastrectomy

45. Blood clot that has moved to the lungs and blocks a pulmonary artery, thus, obstructing blood flow to a portion of the lungs. 46. Preventive intervention to #45. 47. Inadequate tissue perfusion resulting from markedly reduced circulating blood volume. 48. Separation of a suture line before the incision heals. 49. Extrusion of internal organs and tissues. 50. Nursing intervention to # 49.

It is one of the beautiful compensations of this life that no one can sincerely try to help another without helping himself. - Charles Dudly