AORN Perioperative Patient Care 2 — Questions and Answers
Question 1: During the intraoperative phase, which position is most commonly associated with brachial plexus injury?
- Lithotomy
- Prone
- Lateral
- Trendelenburg with arm abduction beyond 90 degrees (Correct answer)
Correct answer: Trendelenburg with arm abduction beyond 90 degrees
Arm abduction greater than 90 degrees in Trendelenburg stretches the brachial plexus, causing nerve injury.
Question 2: A patient is scheduled for a bowel resection. Which type of anesthesia monitoring is MOST important to assess intraoperatively for fluid balance?
- End-tidal CO2
- Urine output via Foley catheter (Correct answer)
- Pulse oximetry
- Bispectral index (BIS)
Correct answer: Urine output via Foley catheter
Urine output via Foley catheter provides real-time assessment of renal perfusion and fluid balance during major abdominal surgery.
Question 3: According to AORN guidelines, which action best prevents retained surgical items (RSIs)?
- Relying on the surgeon's memory
- Performing standardized counts at designated time points (Correct answer)
- Using only disposable items
- Limiting the number of personnel in the OR
Correct answer: Performing standardized counts at designated time points
AORN recommends standardized surgical counts at opening, before closure, and at closure to prevent RSIs.
Question 4: Which electrosurgical unit (ESU) complication is specifically related to improper dispersive electrode pad placement?
- Ventricular fibrillation
- Alternate site burns (Correct answer)
- Air embolism
- Hypothermia
Correct answer: Alternate site burns
An improperly placed dispersive electrode concentrates current at an alternate contact site, causing burns away from the surgical field.
Question 5: A patient receiving spinal anesthesia suddenly develops hypotension and bradycardia. What is the priority nursing intervention?
- Administer epinephrine 1 mg IV push
- Elevate the patient's legs and notify anesthesia (Correct answer)
- Apply supplemental oxygen only
- Begin chest compressions immediately
Correct answer: Elevate the patient's legs and notify anesthesia
Leg elevation increases venous return, and notifying anesthesia allows for vasopressor and fluid administration to treat spinal-induced hypotension.
Question 6: Which of the following is a key component of a surgical time-out per The Joint Commission Universal Protocol?
- Reviewing the patient's insurance information
- Confirming patient identity, procedure, and site (Correct answer)
- Obtaining verbal consent from the patient
- Documenting postoperative pain scores
Correct answer: Confirming patient identity, procedure, and site
The Universal Protocol time-out requires active verification of patient identity, correct procedure, and correct site before incision.
Question 7: In the PACU, a patient exhibits stridor, use of accessory muscles, and SpO2 of 88%. What is the most likely cause?
- Pulmonary embolism
- Laryngospasm or upper airway obstruction (Correct answer)
- Shivering from hypothermia
- Pain-related tachypnea
Correct answer: Laryngospasm or upper airway obstruction
Stridor with accessory muscle use and low SpO2 indicates laryngospasm or airway obstruction, a life-threatening postoperative emergency.
AORN Perioperative Patient Care 2
During the intraoperative phase, which position is most commonly associated with brachial plexus injury?