AORN Perioperative Patient Care 3 — Questions and Answers
Question 1: Which of the following is the recommended method for verifying instrument sterility at the point of use?
- Checking the expiration date on the package
- Inspecting the chemical indicator inside the package (Correct answer)
- Smelling the package for chemical odor
- Confirming the item was autoclaved within 24 hours
Correct answer: Inspecting the chemical indicator inside the package
An internal chemical indicator changes color when sterilization parameters have been met, providing point-of-use verification of sterility.
Question 2: A scrub person inadvertently contaminates a glove during a procedure. What is the correct action?
- Continue the case and change gloves at the end
- Notify the circulator and perform a glove change using the closed technique (Correct answer)
- Apply sterile drape over the contaminated glove
- Spray the glove with antiseptic and continue
Correct answer: Notify the circulator and perform a glove change using the closed technique
Any break in sterile technique requires immediate correction; the scrub person must change the contaminated glove using a closed-glove technique.
Question 3: When caring for a patient undergoing laparoscopic surgery, which risk is unique to the pneumoperitoneum?
- Pressure ulcer formation
- CO2 gas embolism (Correct answer)
- Latex allergy reaction
- Surgical site infection
Correct answer: CO2 gas embolism
CO2 used to create pneumoperitoneum can enter the bloodstream through injured vessels, causing potentially fatal gas embolism.
Question 4: Which assessment finding in the preoperative holding area requires the nurse to notify the surgeon before proceeding?
- Mild anxiety about the procedure
- Patient reports taking aspirin daily and took it this morning (Correct answer)
- Blood pressure of 128/82 mmHg
- Patient had clear liquids 4 hours ago
Correct answer: Patient reports taking aspirin daily and took it this morning
Aspirin taken the day of surgery increases bleeding risk, and the surgeon must decide whether to delay or proceed with appropriate precautions.
Question 5: During orthopedic surgery requiring a tourniquet, which complication should the perioperative nurse monitor for when the tourniquet is released?
- Hypertension and bradycardia
- Tourniquet pain and reperfusion syndrome (Correct answer)
- Corneal abrasion
- Hypothermia from cold irrigation
Correct answer: Tourniquet pain and reperfusion syndrome
Tourniquet release causes ischemic metabolites to flood the systemic circulation, potentially causing hemodynamic instability and reperfusion injury.
Question 6: Which AORN-recommended practice addresses smoke plume generated during laser or electrosurgical procedures?
- Opening OR doors to ventilate
- Using a smoke evacuator at the source of plume generation (Correct answer)
- Wearing standard surgical masks only
- Limiting smoke exposure to 10 minutes per procedure
Correct answer: Using a smoke evacuator at the source of plume generation
AORN requires smoke evacuators be placed within 2 cm of the plume source to capture carcinogenic and infectious aerosols before dispersal.
Question 7: A patient in the PACU reports severe pain (9/10) after a laparotomy. Vital signs are stable. What is the priority nursing action?
- Reassure the patient and recheck in 30 minutes
- Assess pain quality and administer prescribed analgesic per protocol (Correct answer)
- Notify the surgeon immediately
- Apply ice packs to the abdomen
Correct answer: Assess pain quality and administer prescribed analgesic per protocol
Uncontrolled postoperative pain impairs recovery and must be addressed promptly through assessment and evidence-based analgesic administration.
AORN Perioperative Patient Care 3
Which of the following is the recommended method for verifying instrument sterility at the point of use?