AORN Electrosurgical Safety

Question 1

What is the primary mechanism by which a monopolar electrosurgical unit (ESU) cuts tissue?

Accepted Answer

Rapid cellular heating causes vaporization of intracellular fluid

Answer

Mechanical vibration disrupts cell membranes

Answer

Chemical reactions denature cellular proteins

Answer

Cryogenic temperatures destroy tissue

Question 2

Which electrosurgical waveform mode delivers a continuous, unmodulated current primarily used for cutting tissue?

Accepted Answer

Cut mode

Answer

Coagulation mode

Answer

Blend mode

Answer

Bipolar mode

Question 3

What is the primary purpose of the dispersive (return) electrode in monopolar electrosurgery?

Accepted Answer

To provide a large surface area for safe return of current to the ESU

Answer

To amplify the electrical current at the surgical site

Answer

To generate the cutting waveform from the generator

Answer

To neutralize electrical charge before it reaches the patient

Question 4

According to AORN guidelines, where is the most appropriate site for placing the dispersive electrode?

Accepted Answer

On a well-vascularized, large muscle mass closest to the operative site

Answer

Over a bony prominence closest to the surgical site

Answer

On the patient's chest, regardless of surgical site location

Answer

Over a scar or skin fold for better adhesion

Question 5

When a flammable alcohol-based antiseptic skin prep solution is used, what must the perioperative nurse ensure before electrosurgery is activated?

Accepted Answer

The solution has completely dried and pooling has been removed

Answer

The solution has been neutralized with saline irrigation

Answer

A non-flammable drape has been placed over the wet prep area

Answer

The ESU power setting has been reduced to a minimum

Question 6

What type of injury can result when the dispersive electrode is improperly placed or has inadequate skin contact during monopolar electrosurgery?

Accepted Answer

Electrosurgical burn at the dispersive electrode site

Answer

Pressure injury at the dispersive electrode site

Answer

Nerve stimulation injury at the active electrode site

Answer

Electromagnetic interference with monitoring equipment

Question 7

A patient with an implanted cardiac pacemaker requires monopolar electrosurgery. Which intervention should the perioperative nurse prioritize?

Accepted Answer

Place the dispersive electrode as far from the pacemaker as possible and use short, intermittent bursts

Answer

Use the highest available power setting to minimize procedure time

Answer

Remove the pacemaker before surgery begins

Answer

Switch the ESU to coagulation-only mode for the entire case