1. Shelf life for sterile supplies is determined by all of the following except the method of:
A. sterilization.
B. handling.
C. packaging.
D. storage.
Reference: AORN Standards, Recommended Practices and Guidelines – 2006 – p. 578.
Rationale: The method of sterilization (i.e., steam, EO, plasma) does not affect shelf life of an item.
2. A patient is scheduled for outpatient surgery under local anesthesia. The surgeon uses lidocaine (Xylocaine) 1% with epinephrine 1:100,000. Epinephrine is added to local infiltration anesthetic agents to:
A. prolong the action of the local anesthetic.
B. increase the blood levels of the anesthetic drug.
C. prevent a decrease in the patient's heart rate.
D. avoid a drop in the patient's blood pressure.
Reference: Alexander's Care of the Patient in Surgery, Rothrock, J.C, 13th ed., 2007, p. 367, 661.
Rationale: Epinephrine is a vasoconstrictor, prolonging the action of the local anesthetic.
3. Exploratory laparotomy procedures require continuously available warm normal saline for irrigation. The perioperative nurse should pour the needed amount of saline into a sterile container and the remaining solution should be:
A. returned to the warmer for reuse when needed.
B. recapped and poured again as needed.
C. left uncapped and poured again as needed.
D. discarded and a new bottle opened each time more is needed
Reference: AORN Standards, Recommended Practices, and Guidelines – 2006 – p. 624.
Rationale: The entire contents of the liquid container should be poured into a sterile receptacle on the sterile field. Any remaining fluids would need to be discarded. The edge of a container is considered contaminated after the cap has been removed.
4. A patient has been intubated and is to be moved from the supine position on the transportation vehicle to the prone position on the OR bed. To ensure adequate ventilation, chest rolls must be placed:
A. perpendicular to the patient's spine across the nipple line and iliac crest.
B. lengthwise from the acromioclavicular joint to the iliac crest.
C. along the patient's lateral chest wall from the nipple line to mid-thigh.
D. from the rib cage to the greater trochanter.
Reference: Alexander’s Care of the Patient in Surgery, Rothrock, JC, 13th ed., 2007, p 154.
Rationale: Chest rolls from the shoulder to the iliac crest are needed so that chest expansion is not compromised.
5.During an exploratory laparotomy, a patient exhibits a sinus tachycardia along with an increased end-tidal carbon dioxide (ETCO) level. The anesthesia provider suspects a malignant hyperthermia (MH) episode. Which of the following drugs should be available to reverse an MH crisis?
A. diazepam (Valium)
B. meperidine (Demerol)
C. dantrolene (Dantrium)
D. sodium bicarbonate
Reference: AORN Standards, Recommended Practice and Guidelines – 2006 – p. 217.
Rationale: Diazepam is a useful premedication that decreases anxiety. Meperidine is an opioid analgesic with atropine effects, resulting in tachycardia. Sodium bicarbonate is used to correct metabolic acidosis. Dantrolene is a hydantoin skeletal muscle relaxant that also has effects on vascular and cardiac muscles.
ANSWER KEY
1. A
2. A
3. D
4. B
5. C
