AORN Safety and Emergency Preparedness 3 — Questions and Answers
Question 1: During a mass casualty event, the perioperative team activates the hospital incident command system (HICS). Which role is responsible for overall management of the OR during the event?
- The charge nurse acting as OR resource coordinator (Correct answer)
- The anesthesia attending
- The surgical team leader of the first incoming case
- The circulating nurse of the trauma OR
Correct answer: The charge nurse acting as OR resource coordinator
In HICS, the charge nurse or designee typically functions as OR resource coordinator, managing personnel and room assignments during mass casualty events.
Question 2: Which action best prevents retained surgical items (RSIs) during an emergency case when a counting policy cannot be fully followed?
- Skip documentation and proceed without any count
- Perform an intraoperative X-ray before wound closure (Correct answer)
- Rely on the surgeon's memory
- Use only instrument trays without sponges
Correct answer: Perform an intraoperative X-ray before wound closure
Intraoperative radiographic imaging before closure is the safest backup measure when a standard count cannot be completed.
Question 3: A patient undergoing general anesthesia suddenly develops unexplained tachycardia, muscle rigidity, and a rising end-tidal CO2. The perioperative nurse's priority action is:
- Administer oxygen and prepare dantrolene sodium (Correct answer)
- Increase the volatile anesthetic concentration
- Notify the charge nurse and document the event
- Apply a cooling blanket and monitor vitals
Correct answer: Administer oxygen and prepare dantrolene sodium
These are classic signs of malignant hyperthermia; administering oxygen and preparing dantrolene are first-line responses per MH protocol.
Question 4: The AORN-recommended minimum number of personnel required to perform a surgical count is:
- One scrub person only
- Two qualified individuals, typically the scrub person and circulating nurse (Correct answer)
- The surgeon and scrub person
- Three nurses plus the surgical technologist
Correct answer: Two qualified individuals, typically the scrub person and circulating nurse
AORN guidelines require two qualified individuals—usually the scrub person and circulating nurse—to perform counts concurrently and audibly.
Question 5: Which PPE is required for perioperative personnel when preparing chemotherapy agents in the OR environment?
- Standard surgical gloves only
- Double chemotherapy-rated gloves, gown, and eye protection under a ventilated hood (Correct answer)
- N95 mask and standard gown
- Full-body chemical suit with supplied air
Correct answer: Double chemotherapy-rated gloves, gown, and eye protection under a ventilated hood
NIOSH guidelines require double chemotherapy-rated gloves, an impermeable gown, eye protection, and a ventilated hood or biological safety cabinet when handling hazardous drugs.
Question 6: When using a powered air-purifying respirator (PAPR) in the OR, the perioperative nurse must ensure:
- The filter is changed after every shift regardless of use
- The device is fit-tested annually like an N95
- The battery is charged and the filter is within its service life before each use (Correct answer)
- The blower unit is stored inside the sterile field
Correct answer: The battery is charged and the filter is within its service life before each use
PAPRs require a charged battery and an unexpired filter to provide adequate respiratory protection during each use.
Question 7: Under OSHA's Hazard Communication Standard, a Safety Data Sheet (SDS) for a surgical chemical must be:
- Kept locked in the pharmacy only
- Immediately accessible to all OR personnel during their work shift (Correct answer)
- Reviewed only during annual competency training
- Available within 24 hours upon written request
Correct answer: Immediately accessible to all OR personnel during their work shift
OSHA requires SDS documents to be immediately accessible to employees at all times during their work shift in case of emergency exposure.
AORN Safety and Emergency Preparedness 3
During a mass casualty event, the perioperative team activates the hospital incident command system (HICS).
Which role is responsible for overall management of the OR during the event?