(Test Bank) Berry & Kohn’s Operating Room Technique

Phillips, 13

Nursing

Test Bank

13th Edition

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Test Bank for Berry & Kohn’s Operating Room Technique, The downloadable file consists of 308 pages, and the total size of the file is 2.46 MB. Purchase now only for highly discounted price.

Author(s): Phillips

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Study Note Preview

Berry & Kohn’s Operating Room Technique 13th Edition Phillips Test Bank Chapter 01: Perioperative Education Phillips: Berry & Kohn’s Operating Room Technique, 13th Edition MULTIPLE CHOICE 1. Communication is an essential part of working as a team. What is another key element of communication? a. Attitude b. Body language c. Education d. Constant talking ANS: B Appropriate body language is also necessary for successful communication. Body language can send a message. Sometimes it can send a negative message, such as rolling of the eyes. REF: 11 2. Entry -level education for perioperative practice prepares nurses to be a. urologists. b. orthopedists. c. neurologists. d. generalists. ANS: D Basic perioperative nursing elective programs focus on the role of the nurse as a generalist scrub person and circulating NnuUrsReS. REF: 3 3. Perioperative experience teaches that minor procedures may be fairly quick, but still have risks such as a. cardiac arrest. b. hypoglycemia and hyperglycemia. c. severe bleeding. d. All the above ANS: D All procedures carry a risk and can become unpredictable. REF: 10 4. Skills are best learned through a. listening to an expert tell how to do it. b. watching a movie about a task. c. actual hands -on experience. d. reading about it. ANS: C Skills are best learned through actual hands -on experience in applying the theory learned in the classroom or self -study laborator y. REF: 10 5. Which objective should a perioperative learner strive to attain? a. Realize that a team approach to surgical procedures cannot always occur. b. Validate the need for constant patient observation. c. Maintain the belief that competent behaviors are more vital than humane behaviors. d. Hands -on experience is the most important means to understanding surgery. ANS: B Constant patient observation is essential to maintain their safety. REF: 10 6. The team approach involves a. a coordinated effort by all caregivers. b. working to obtain specific personal goals. c. incompetence. d. direct caregivers with access to patient data. ANS: A A team effort is necessary to meet the patient's preoperative goals. REF: 11 7. Not everyone learns at the same speed or attains information in the same manner. Knowing how a student l earns will h elNp thRe edIucaGtor cBo.mCe upMwith the right . a. answer b. environment c. teaching methods d. learning styles ANS: C Learning is a process and takes time to master skills. With the right teaching methods, a student will be able to apply their knowledge of basic sciences with hands on practice to master their skills. REF: 4 | 10 8. Describe one way a relatively safe procedure can rapidly become a catastrophic or fatal event. a. Preoperative patient anxiety b. Postoperative pain c. Unknown patient allergies d. Subjective responses to OR activities ANS: C Answers include patient development of uncontrollable bleeding; seizure; irreversible shock; overwhelming postoperative infection; cardiac arrest; or an unknown allergy or sensitivity to a chemical, substance, medication, or anesthetic. REF: 10 N R I G B.C M 9. What is the common goal of a perioperative team? a. Do not report any surgical mishaps to patients or family members. b. Keep general anesthesia to a minimum. c. Complete every surgical procedure in less than 4 hours. d. Deliver efficient patient care for each procedure. ANS: D The common goal is effective delivery of care in a safe, efficient, and timely manner. REF: 11 TRUE/FALSE 1. A surgical procedure may be invasive, minimally invasive, or noninvasive. ANS: T Any invasive or minimally invasive procedure enters the body either through an opening in tissue or a natural body orifice. Noninvasive procedures do not enter the body and are usually for diagnostic purposes. REF: 2 2. Students may work for compensation during official clinical hours. ANS: F Some students are hired into apprenticeships before graduation enabling them to work in the OR in a limited capacity in an tUicipSatioNn ofTa permOanent position. Schools that permit students to work while they are still participating in the education process should have a policy in place to delineate the student role from the employee role. Thus students may not work for compensation while completing clinical hours in the operating room setting. REF: 3 3. A perioperative nurse’s role only encompasses supervision of unlicensed personnel who scrub and requires knowledge of practices and procedures. ANS: F The nurse can function as a scrub person after proper training. REF: 3 | 4 4. The term educator refers to the person responsible for planning, implementing, and evaluating the learner’s experiences in the classroom and clinical setting. ANS: T This definition describes the responsibilities of the perioperative nurse educator. REF: 5 5. Students should have a tour of the perioperative environment and know the basic standards and protocol before starting clinicals. ANS: T This prevents learning questionable shortcuts or improper technique. REF: 4 6. Surgical technology programs focus primarily on scrubbing in to prepare and maintain the sterile field and handle instruments. ANS: T Most surgical technology programs provide scrub experiences in many specialties. REF: 3 7. The perioperative caregiver should displ ay attributes and communication skills that inspire confidence and trust in patients. ANS: T A patient’s sense of security is grounded in how he or she perceives the behavior of the perioperative team. This leaves a lasting impression on the patient. REF: 10 COMPLETION 1. It can take monNtUhsRtoSINGTB.CyOeMar(s) to feel confid ent about a functioning perioperative team member. ANS: 6; 1 A transition from dependent learner to independent practitioner evolves over a period of time. The realities of the work environment and the emotional and ethical dilemmas of some situations are experienced as basic competencies are developed. It can take 6 months to 1 year to feel confident as a functioning perioperative team member. REF: 12 MATCHING Match each term with the correct description below. a. Works with orientees and learners according to a prescribed task -oriented lesson plan b. Has more experience with personnel and the OR’s climate; provides insight into the department’s social atmosphere c. Staff member who is emulated and respected for his or her clinical competence 1. Mentor 2. Role model 3. Preceptor 1. ANS: B REF: 13 2. ANS: C REF: 13 3. ANS: A REF: 12 Chapter 02: Foundations of Perioperative Patient Care Standards Phillips: Berry & Kohn’s Operating Room Technique, 13th Edition MULTIPLE CHOICE 1. Who is responsible for documenting the final counts at the end of the case as correct or incorrect? a. Scrub person b. Surgeon c. Anesthesiologist d. Circulating nurse ANS: D The circulating nurse is responsible for final documentation. REF: 22 2. Optimal patient care requires which element? a. Deterring an admission of fault in sterile technique b. Anatomic separation c. Dynamic tension of surgical team members d. Application of asepsis and sterile technique principles ANS: D Asepsis and sterile technique are expected and necessary practices in the OR setting for favorable patient outcomes. REF REF: 21 | 22 3. The circulating nurse should assess a patient for which type of injury before entering the OR? a. Medication error b. Wrong IV site c. Skin injury d. Sharp object ANS: C Skin injuries can be caused by many things in the OR. The nurse should assess the skin before and after the procedure to make sure no damage has been done. REF: 24 4. Caregivers should always know why they are doing a particu lar action. Actions should be based on . a. self-taught methods b. preceptor actions c. nursing process d. evidence -based practice Evidence -based practice is a systematic process that is based on research. The research is the base for best practices. Practices are constantly evaluated for the best methods for performing patient care. REF: 26 5. When does the intraoperative phase begin? a. Placement of the patient on the OR bed b. When the patient enters the OR c. When waiting in the holding area d. When taken to the recovery area or PACU ANS: A The intraoperative phase begins with the patient on the OR bed and continues until the patient is transported to the PACU. REF: 28 6. What documentation goes into the patient’s chart and becomes part of the permanent record? a. Specimen results b. Intraoperative notes only c. All routine and individualized care d. Physical changes ANS: C All patient care interventions and observations are documented. Standardized language provides legal evidence for the plans of care and revisions of those plans. REF: 31 7. Which identifies one aspect of safe patient movement from the OR table to the stretcher? a. The circulating nurse counts to synchronize the patient’s movement. b. The person guiding the head counts to synchronize the movement. c. The person at the left side of the patient also guides the head and counts to start the movement. d. Two people are needed to move an anesthetized patient from the table to the stretcher. ANS: B There should be at least one person on either side of the patient, one at the foot, and one at the head to monitor the airway. The person guiding the patient’s head should be the one who counts “one, two, three” to pace the synchronized movement from one surface to another. REF: 22 8. Which is one of the “seven rights” of medication administration for each patient? a. Right pharmacy b. Right color c. Right route d. Right answer ANS: C The seven rights of medication administration include right patient, right drug, right dose, right reason, right time, right route, and right documentation. REF: 24 9. All are included in the definition of professionalism except a. self-centered for profit group. b. requires special skills and knowledge. c. has its own standards and code of ethics. d. acts responsibly to gain public trust. ANS: A Professionalism is the combination of knowledge, skills, ethics and ideas that regulate a profession. It also uses critical thinking and judgement. REF: 25 10. Which event is included on Medicare's “No Pay List” and will not be reimbursed? a. Myocardial infarction b. Wrong site surgery c. Documented Alzheimer’s d. Incision and drainage of a chronic hip abscess ANS: B Wrong site surgery is an easily preventable occurrence and is not reimbursed for by Medicare. REF: 18 TRUE/FALSE 1. Surgical conscience is considered the Golden Rule: Do unto the patient as you would have others do unto you. ANS: T Surgical conscience develops over time. The caregiver should consider each patient as himself or herself or as a loved one. It is just one element for optimal patient care. REF: 16 2. A patient advocate is the person who accompanies the patient to the facility. ANS: F A patient advocate is a caregiver, who recognizes the patient and family’s need for information and assistance. They act as the patient’s representative to help make informed decisions. They identify specific care needs and assist in coping. REF: 16 3. Access to health care is a privilege of every human being. ANS: F Access is a right, not a privilege, of all patients. REF: 16 4. Accountability means being responsible for only one’s self. ANS: F Accountability means answering to someone for an obligatory action. Caregivers are accountable to their patients, employer, team members, profession, and upholding standards of practice. REF: 16 5. Failure of a caregiver to provide accountability is considered negligence. ANS: T Lack of accountability can result in patient injury. Health care providers have a legal and moral obligation to keep their patients safe. Every caregiver is responsible for his or her own negligent acts. REF: 16 6. Standards of care are guidelines put in place for all personnel to follow based on recommended practices and scientific research. ANS: T Every facility has written policies and procedures to standardize practice. Each profession has a set of standa rds that sets guNidUelRinSesIfNorGbTehBa.viCorO, eMducation, r esponsi bility, education, and performance. There are also agencies governed by laws to help keep patients safe. REF: 17 7. Health care providers are required to sign a document acknowledging policies, procedures, and HIPPA laws. ANS: T Some policies and procedures are for all employees, others may vary according to department. These documents are mandatory to follow and describe how to perform procedures correctly. REF: 18 8. A plastic identification wristband is the only way patients are identified. ANS: F The patient’s wrist band is checked while they state or spell their name. They must also acknowledge their birthdate. If the patient cannot do this, a parent, guardian, or power of attorney may do this identification. At least two forms of identification are required. REF: 20 9. A universal checklist provides documentation for each step of care for patients undergoing a surgical procedure. ANS: T Three points are confirmed by the surgical team throughout the process: “sign -in” (before administration of surgical drugs), “time -out” (identifying correct patient and surgical procedure), and “sign -out” summary of what was completed in surgery. REF: 21 10. Identifying the surgical site is always done by placing an “X” over the site. ANS: F An “X” is inappropriate because it may be misunderstood. Every facility has its policy for identifications. REF: 20 11. Postoperative infection can originate only in the OR from a break in technique by the surgeon or team. ANS: F Infection can occur in any area where microorganisms can be transferred into the body through any orifice. REF: 22 Chapter 03: Legal, Regulatory, and Ethical Issues Phillips: Berry & Kohn’s Operating Room Technique, 13th Edition MULTIPLE CHOICE 1. Who can be named in a lawsuit? a. The patient b. Any caregiver c. The head nurse d. The surgeon ANS: B Any caregiver can be named in a lawsuit. Attorneys frequently name everyone involved with the patient in the suit. REF: 36 2. Negligence is a. professional misconduct. b. unreasonable lack of skill. c. the failure to use care or skills that any caregiver in a similar situation might use. d. illegal or immoral conduct. ANS: C These acts of omission or commission that can cause damage to a patient can lead to a lawsuit. REF: 37 3. Who obtains the informed consent for a surgical procedure? a. Perioperative nurse b. Surgeon/physician c. Scrub person d. Head nurse ANS: B Informed consent must be obtained by the surgeon or physician. REF: 43 4. Which component is included in an informed consent? a. Risks and benefits b. Cost of surgery c. DNR orders d. Length of hospital stay ANS: A Included in an informed consent are name of the procedure, who is performing the procedure, risks and benefits, and procedure alternatives. REF: 43 U S N T O 5. Which is an example of a reportable sentinel event? a. Surgery on the wrong site b. Any near miss c. Going into surgery 3 hours late d. Unsuccessful suicide attempt ANS: A Surgery on the wrong patient or the wrong body part is one example of a reportable sentinel event. REF: 41 6. Which best describes a DNR order? a. Does not hold up in the OR b. Patients cannot have surgery c. Before going to the OR, the DNR order should be clarified d. Does not hold up in an emergency ANS: C Any patient with a standing DNR order should have the order clarified by the patient, guardian, or power of attorney. The physician must be clear of the actio n of the order. REF: 51 7. Which is one of the four “D’s” of malpractice? a. Deviation of duty by omission b. Demonstr ation of stand arNds oRf caIre G B.C M c. Damage to subcutaneous tissue d. Divided surgical care of the patient. ANS: A The 4 D's of malpractice include (1) a duty to deliver a standard of care proportional to training received, (2) a deviation from that duty by omission or commission, (3) direct causation of a personal injury or damage because of deviation of duty, and (4) damages to a patient or personal property caused by the deviation from the standard of care. REF: 37 8. Which is a charting modality used to document patient care? a. Hand -off reporting b. Verbal report c. Block charting d. Paper and pen charting ANS: C Modalities include narrative charting; block charting; focus charting; subjective -objective charting; problem -oriented charting; computer -generated charting; and computer software programs, check -off forms, and flow sheets. REF: 46 U S N T O 9. Which is a coping method that may help OR team members when a patient dies? a. Identify with the loss b. Identify those responsible for the patient death c. Reduce the dependence on teamwork to maintain patient safety in a crisis d. Take ownership for the patient death and review actions with risk management team ANS: A Coping methods include realization that everyone involved is part of a team effort; believe in a power greater than the skills of the team; share feelings with others; identify personally with the loss; attend a support group to help deal with the loss; and visit with the hospital chaplain or rabbi. REF: 52 10. A “Never Event” as defined by CMS includes: a. bariatric surgical procedure. b. myocardial infarction. c. poor blood sugar control. d. coronary artery disease. ANS: C Poor blood sugar control is an event that CMS deems not to be consistent with quality patient care rendered to hospitalized individuals. REF: 41 11. Which is a benefit of EMR inNtheRhoIspitGal seBtt.inCg? M a. Documentation can be transmitted to multiple caregivers quickly. b. Patients can ask for copies of their health care records. c. Everyone can view the health care records of any patient within a particular facility. d. Laboratory results are hard to decipher when downloaded. ANS: A Electronic medical records (EMR) allow multiple health care providers access quickly and easily in order to plan treatments and care to patients. REF: 46 TRUE/FALSE 1. The person who initiates a lawsuit is a defendant. ANS: F The person who initiates a lawsuit is known as a plaintiff. REF: 36 | 37 2. Professional associations do not recommend that health care workers carry professional liability insurance. ANS: F Most facilities carry insuranc e that covers incidents that result in harm to a patient when policies and procedures are followed; however, they may not cover the employee who fails to follow the established protocol. Carrying personal liability insurance protects against a possible discrepancy with the facility’s insurance coverage and provides the employee with the opportunity for representation by a personal attorney. REF: 38 3. When writing an incident report, it is acceptable to include interpretations and opinions. ANS: F Details written in the report should be statements of fact that are objective, complete, and accurate. REF: 47 | 48 4. Euthanasia is derived from the Greek words meaning “harsh or painful death.” ANS: F Euthanasia is derived from the Greek words meaning “good or merciful death.” REF: 51 5. A 17-year-old mentally competent person can execute a living will or an advance directive. ANS: F A mentally competent adult older than the age of 18 can execute a living will or advance directive. REF: 51 6. One of AST’s Codes of Ethics for surgical technologists is to always maintain the highest standards of professional conduct and patient care. ANS: T Professions have codes of conduct and documents that include value statements derived from moral concepts. The Code of Ethics of the Association of Surgical Technologists (AST) provides guidance for surgical technologists. REF: 49 7. When a mishap occurs in patient care, the cause of the event is compared with other cases similar to that one. ANS: F The cause of the event is compared with local or national standards of care. REF: 38 8. National Patient Safety Goals were implemented by the Joint Commission to keep patients safe. ANS: T NPSGs are part of Universal Protocol to prevent wrong patient, wrong site and wrong surgery. REF: 41 9. Assault is an unlawful physical threat to harm another person. ANS: T Assault is an unlawful threat to harm another physically. REF: 39 COMPLETION 1. consists of leaving the patient for any reason when the patient’s condition is contingent on the presence of the caregiver. ANS: Abandonment Abandonment consists of leaving the patient for any reason when the patient’s condition is contingent on the presence of the caregiver. If the caregiver leaves the room knowing there is a potential need for care during his or her absence, even under the order of a physician, the caregiver is liable for his or hNeUr oRwSnIaNctiGoTnsB. .COM REF: 40