CNOR Operating Room 5 — Questions and Answers
Question 1: Which principle guides the placement of instruments on the sterile back table?
- Items should be grouped by surgeon preference only
- Items are arranged in order of use with frequently used items closest to the scrub person (Correct answer)
- All instruments must be placed in a single row to save space
- Instruments should be placed in alphabetical order
Correct answer: Items are arranged in order of use with frequently used items closest to the scrub person
Organizing instruments by order of use and placing frequently needed items closest to the scrub person promotes efficiency and reduces breaks in sterile technique.
Question 2: What is the function of the electrosurgical dispersive electrode (grounding pad)?
- To generate electrical current for cutting tissue
- To provide a large surface area for the return of current to the ESU unit, preventing burns (Correct answer)
- To monitor the patient's cardiac rhythm during surgery
- To protect the surgeon from electrical shock
Correct answer: To provide a large surface area for the return of current to the ESU unit, preventing burns
The dispersive electrode spreads the returning current over a large body surface area, reducing current density and preventing burns at the return site.
Question 3: Which patient population is at highest risk for latex allergy in the perioperative setting?
- Elderly patients undergoing elective procedures
- Patients with multiple previous surgeries, spina bifida, or healthcare worker history (Correct answer)
- Pediatric patients undergoing first surgeries
- Patients with a history of asthma
Correct answer: Patients with multiple previous surgeries, spina bifida, or healthcare worker history
Repeated latex exposure through surgeries, spina bifida management, or occupational contact significantly increases sensitization risk.
Question 4: After a surgical sponge count discrepancy is identified at wound closure, what is the FIRST action the perioperative nurse should take?
- Inform the charge nurse
- Recount all sponges thoroughly with the scrub person (Correct answer)
- Immediately perform an X-ray of the patient
- Document the discrepancy and proceed with closure
Correct answer: Recount all sponges thoroughly with the scrub person
Recounting all sponges is the first step when a discrepancy is identified, followed by a search of the surgical field, and then imaging if still unresolved.
Question 5: Which sterilization method is preferred for heat-sensitive surgical instruments such as endoscopes?
- Gravity displacement steam sterilization
- Flash (IUSS) steam sterilization
- Ethylene oxide (EtO) or hydrogen peroxide plasma sterilization (Correct answer)
- Dry heat sterilization
Correct answer: Ethylene oxide (EtO) or hydrogen peroxide plasma sterilization
Low-temperature sterilization methods such as ethylene oxide and hydrogen peroxide gas plasma are used for heat- and moisture-sensitive items like flexible endoscopes.
Question 6: The anesthesia provider announces the patient has a difficult airway. Which piece of equipment should the perioperative nurse ensure is immediately available?
- Biopsy forceps
- Chest tube insertion tray
- Video laryngoscope and surgical airway kit (Correct answer)
- Defibrillator and crash cart
Correct answer: Video laryngoscope and surgical airway kit
A video laryngoscope improves visualization of a difficult airway, and a surgical airway kit allows emergency cricothyrotomy if intubation fails.
Question 7: What does the acronym 'STSR' stand for in the perioperative setting?
- Sterile Technique and Safety Record
- Surgical Technologist in Scrub Role (Correct answer)
- Standardized Tray Setup Reference
- Sterilization Tracking and Safety Report
Correct answer: Surgical Technologist in Scrub Role
STSR stands for Surgical Technologist in Scrub Role, referring to the allied health professional who serves as the primary scrub person during surgery.
CNOR Operating Room 5
Which principle guides the placement of instruments on the sterile back table?