CNOR Operating Room 4 — Questions and Answers
Question 1: A scrub person notices that a suture package has a compromised seal. What is the correct action?
- Open it and use it if the suture looks intact
- Pass it off to the circulator and open a new package (Correct answer)
- Hand it to the surgeon for evaluation
- Place it back in the suture drawer for later use
Correct answer: Pass it off to the circulator and open a new package
A compromised seal means sterility cannot be guaranteed; the item must be removed from the sterile field and replaced.
Question 2: Which hemostatic agent works by providing a physical matrix that promotes platelet aggregation and fibrin deposition?
- Epinephrine
- Thrombin
- Gelatin foam (Gelfoam) (Correct answer)
- Tranexamic acid
Correct answer: Gelatin foam (Gelfoam)
Gelatin foam acts as a physical scaffold that absorbs blood and supports the natural clotting cascade through platelet aggregation.
Question 3: The perioperative nurse notes that a patient's core temperature is 35.2°C intraoperatively. Which intervention is most appropriate?
- Increase room temperature and apply a forced-air warming blanket (Correct answer)
- Administer IV epinephrine to increase metabolic heat production
- Decrease IV fluid rate to reduce cold fluid infusion
- Notify the surgeon to expedite closure
Correct answer: Increase room temperature and apply a forced-air warming blanket
Increasing ambient temperature and applying active warming devices are the first-line interventions for intraoperative hypothermia.
Question 4: Which gas is used to insufflate the abdominal cavity during laparoscopic surgery and why?
- Oxygen, because it supports combustion for laser use
- Nitrogen, because it is inert and safe
- Carbon dioxide, because it is non-flammable, highly soluble, and rapidly absorbed (Correct answer)
- Helium, because it does not cause pain
Correct answer: Carbon dioxide, because it is non-flammable, highly soluble, and rapidly absorbed
CO2 is used because it is non-combustible, rapidly absorbed by the body, and inexpensive, minimizing embolic risk compared to other gases.
Question 5: Which instrument is used to visualize the vocal cords for endotracheal intubation?
- Bronchoscope
- Laryngoscope (Correct answer)
- Rhinoscope
- Otoscope
Correct answer: Laryngoscope
A laryngoscope is used to directly visualize the larynx and vocal cords to guide endotracheal tube placement.
Question 6: What is the primary purpose of a sterile drape placed over the surgical field?
- To absorb blood and surgical fluids
- To create a sterile barrier between the surgical site and surrounding environment (Correct answer)
- To provide cushioning and patient comfort
- To monitor skin temperature during surgery
Correct answer: To create a sterile barrier between the surgical site and surrounding environment
Drapes establish and maintain a sterile field by creating a microbial barrier around the operative site.
Question 7: A patient undergoing general anesthesia develops masseter muscle rigidity after succinylcholine administration. What condition should be suspected immediately?
- Neuroleptic malignant syndrome
- Malignant hyperthermia (Correct answer)
- Laryngospasm
- Opioid-induced rigidity
Correct answer: Malignant hyperthermia
Masseter muscle rigidity following succinylcholine is an early warning sign of malignant hyperthermia, a life-threatening hypermetabolic crisis triggered by certain anesthetic agents.
CNOR Operating Room 4
A scrub person notices that a suture package has a compromised seal.
What is the correct action?