AORN Patient Safety 3 â Questions and Answers
Question 1: When using a smoke evacuator during laser or electrosurgical procedures, what is the minimum capture velocity recommended at the source?
- 35 feet per minute (fpm)
- 100 feet per minute (fpm) (Correct answer)
- 200 feet per minute (fpm)
- 350 feet per minute (fpm)
Correct answer: 100 feet per minute (fpm)
AORN and NIOSH recommend a capture velocity of at least 100â150 fpm at the source nozzle to effectively remove surgical smoke before it disperses into the breathing zone.
Question 2: A perioperative nurse preparing a sterile back table notices the outer wrap of a package is slightly damp. What should be done?
- Open the package and inspect the inner wrap; use if inner wrap is dry
- Use the package immediately to prevent further moisture exposure
- Consider the package contaminated and retrieve a replacement (Correct answer)
- Dry the package with a sterile towel and document the incident
Correct answer: Consider the package contaminated and retrieve a replacement
Moisture compromises packaging integrity and constitutes a strike-through event, rendering the contents potentially non-sterile; the package must be discarded.
Question 3: Which intraoperative position creates the greatest risk for compartment syndrome of the lower extremities?
- Supine with arms tucked
- Lithotomy with legs elevated in stirrups for more than 2 hours (Correct answer)
- Lateral with axillary roll in place
- Prone with chest rolls supporting the thorax
Correct answer: Lithotomy with legs elevated in stirrups for more than 2 hours
Prolonged lithotomy position elevates compartment pressure in the lower legs through combined compression and ischemia-reperfusion injury upon repositioning.
Question 4: What is the purpose of maintaining a minimum of 15 air exchanges per hour in an operating room?
- To maintain positive pressure relative to surrounding corridors
- To dilute and remove airborne contaminants and reduce surgical site infection risk (Correct answer)
- To keep temperature within the recommended range of 68°Fâ75°F
- To prevent static electricity buildup on equipment surfaces
Correct answer: To dilute and remove airborne contaminants and reduce surgical site infection risk
Fifteen or more total air exchanges per hour (with at least 3 being outside air) dilute microbial load and particulates, directly reducing surgical site infection (SSI) risk.
Question 5: During a robotic-assisted procedure, the patient is placed in steep Trendelenburg for 4 hours. Which complication should the perioperative nurse most closely monitor for postoperatively?
- Hypothermia due to prolonged exposure to OR temperature
- Corneal abrasion from eye pressure in steep Trendelenburg
- Facial and airway edema due to prolonged dependent positioning (Correct answer)
- Brachial plexus injury from shoulder braces
Correct answer: Facial and airway edema due to prolonged dependent positioning
Prolonged steep Trendelenburg causes cephalad fluid shift leading to facial, conjunctival, and pharyngeal edema, which can compromise the airway upon extubation.
Question 6: Which action is most appropriate when a perioperative team member witnesses a sterile field break?
- Note the break in the operative record and continue if minor
- Immediately verbalize the break and correct it before proceeding (Correct answer)
- Inform the surgeon after the procedure to maintain workflow
- Cover the contaminated area with a sterile drape and continue
Correct answer: Immediately verbalize the break and correct it before proceeding
Any breach in sterile technique must be immediately communicated and corrected; delay or concealment increases SSI risk and violates AORN patient safety standards.
Question 7: A patient with an implanted cardiac pacemaker is scheduled for a laparoscopic procedure using monopolar electrosurgery. What is the most important safety measure?
- Disable the pacemaker before the procedure begins
- Place the dispersive electrode as far from the pacemaker as possible
- Use the highest power setting to reduce activation time near the pacemaker
- Consult cardiology and consider using bipolar or ultrasonic energy devices instead (Correct answer)
Correct answer: Consult cardiology and consider using bipolar or ultrasonic energy devices instead
Monopolar electrosurgery can cause electromagnetic interference with pacemakers; cardiology consultation and substitution with bipolar or ultrasonic energy minimizes the risk of device malfunction.
AORN Patient Safety 3
When using a smoke evacuator during laser or electrosurgical procedures, what is the minimum capture velocity recommended at the source?