Quiz #1 Operating Room Protocols P6-15

1. During patient positioning, which areas are of concern?

Providing support to the brachial plexus.

Avoidance of injury to the ulnar nerve.

All of the above.

None of the above.

During patient positioning, it is important to consider providing support to the brachial plexus and avoiding injury to the ulnar nerve. Both of these areas can be vulnerable during positioning and can result in nerve damage or injury if not properly supported or protected. Therefore, all of the above options are areas of concern during patient positioning.

Explanation

During patient positioning, it is important to consider providing support to the brachial plexus and avoiding injury to the ulnar nerve. Both of these areas can be vulnerable during positioning and can result in nerve damage or injury if not properly supported or protected. Therefore, all of the above options are areas of concern during patient positioning.

2. Why you should review the patients chart?

To ensure proper patient identification.

To gain a better understanding of the patient's health history.

To ascertain possible conditions likely to produce neurological deficits.

All of the above.

Reviewing the patient's chart is important because it helps ensure proper patient identification, as it contains essential information about the patient. Additionally, it provides a better understanding of the patient's health history, allowing healthcare professionals to make informed decisions and provide appropriate care. Lastly, reviewing the chart helps ascertain possible conditions that may produce neurological deficits, enabling healthcare professionals to take necessary precautions and provide targeted treatment. Therefore, all of the above reasons emphasize the importance of reviewing the patient's chart.

Explanation

Reviewing the patient's chart is important because it helps ensure proper patient identification, as it contains essential information about the patient. Additionally, it provides a better understanding of the patient's health history, allowing healthcare professionals to make informed decisions and provide appropriate care. Lastly, reviewing the chart helps ascertain possible conditions that may produce neurological deficits, enabling healthcare professionals to take necessary precautions and provide targeted treatment. Therefore, all of the above reasons emphasize the importance of reviewing the patient's chart.

3. What information is important to review with the surgeon prior to the patients arrival in the OR?

The planned procedure.

Historical details from the patient's chart.

X-rays, MRI's, and CT scans.

Pathology and planned modalities.

All of the above

Details from the patient's chart should only be discussed when relevent to the present surgery. Be sure that all other items listed above are thoroughly examined and discussed.

Explanation

Details from the patient's chart should only be discussed when relevent to the present surgery. Be sure that all other items listed above are thoroughly examined and discussed.

4. With whom should you make an introduction in the OR?

Surgical technologist

Circulating nurse

Anesthesiologist

Surgeon

All of the above.

Be sure to introduce yourself to all of the people listed above.

Explanation

Be sure to introduce yourself to all of the people listed above.

5. What should be verified with the anesthesiologist prior to the start of the surgery?

The type of neuromuscular blockade agent to be used.

The expected duration of the action.

Both A and B.

None of the above.

Be sure to discuss any anticipated concerns related to monitoring modalities.

Explanation

Be sure to discuss any anticipated concerns related to monitoring modalities.

6. Which of the items listed below is included in the patient face sheet and used to create the patients record in the biomedical system?

Patient's place of birth.

Patient's email address.

Patient's social security number.

Patient's medical record number.

Reminder: All of the patient's information must be kept confidential as mandated by HIPAA.

Explanation

Reminder: All of the patient's information must be kept confidential as mandated by HIPAA.

7. Which is not a standard precaution in the OR?

Use of aseptic technique and alcohol swabs to prep needle insertion points.

Use of bent needles to closely follow patient contours.

Discarding of contaminated needles.

Use of gloves, protective eyewear, and surgical mask.

Bent needles should not be inserted into the patient.

Explanation

Bent needles should not be inserted into the patient.

8. You should offer to assist the circulating nurse in transferring the patient from the gurney to the OR table.

True

False

Your role is one of limited capacity at this phase. Only assist if it is confirmed that your help is needed. Only offer suggestions as necessary. Be alert to any special pattient positioning considerations to avoid injury to the patient.

Explanation

Your role is one of limited capacity at this phase. Only assist if it is confirmed that your help is needed. Only offer suggestions as necessary. Be alert to any special pattient positioning considerations to avoid injury to the patient.

9. Upon arrival in the OR, what should you do first?

Set up equipment.

Verify the schedule and room assignment.

Perform a biomedical safety check.

Check in with the charge nurse.

After checking in with the charge nurse verify the schedule and room assignment, and then perform a biomedical safety check if it is required by the hospital.

Explanation

After checking in with the charge nurse verify the schedule and room assignment, and then perform a biomedical safety check if it is required by the hospital.

10. With whom should you confer to determine the most advantageous time to place subdermal needles?

The circulating nurse.

The surgeon.

The anesthesiologist.

None of the above.

The anesthesiologist is the correct answer because they are responsible for administering anesthesia and monitoring the patient's vital signs during surgery. They have the expertise and knowledge to determine the most advantageous time to place subdermal needles, taking into consideration the patient's condition and the surgical procedure being performed. The circulating nurse may assist in preparing the necessary equipment, but they do not have the same level of medical knowledge as the anesthesiologist. The surgeon's main focus is on performing the surgery, rather than determining the timing of subdermal needle placement. Therefore, the anesthesiologist is the most appropriate person to confer with in this situation.

Explanation

The anesthesiologist is the correct answer because they are responsible for administering anesthesia and monitoring the patient's vital signs during surgery. They have the expertise and knowledge to determine the most advantageous time to place subdermal needles, taking into consideration the patient's condition and the surgical procedure being performed. The circulating nurse may assist in preparing the necessary equipment, but they do not have the same level of medical knowledge as the anesthesiologist. The surgeon's main focus is on performing the surgery, rather than determining the timing of subdermal needle placement. Therefore, the anesthesiologist is the most appropriate person to confer with in this situation.

11. With whom should you confirm the EMG muscle selection location?

The circulating nurse.

The surgeon.

The anesthesiologist.

None of the above.

The surgeon should be the one to confirm the EMG muscle selection location because they are the ones performing the procedure and have the expertise and knowledge to ensure accurate placement. The circulating nurse and anesthesiologist may assist in the procedure, but ultimately it is the surgeon's responsibility to confirm the location.

Explanation

The surgeon should be the one to confirm the EMG muscle selection location because they are the ones performing the procedure and have the expertise and knowledge to ensure accurate placement. The circulating nurse and anesthesiologist may assist in the procedure, but ultimately it is the surgeon's responsibility to confirm the location.

12. EMG or scalp needles should be placed before the induction of general anesthesia.

True

False

EMG or scalp needles should be placed after the induction of general anesthesia.

Explanation

EMG or scalp needles should be placed after the induction of general anesthesia.

13. What is the first thing that you should put on when changing into scrubs?

Scrub shirt and pants.

Nametag.

Head cover.

Surgical mask.

Make sure to cover your head first tp prevent hair from getting on other clothing items.

Explanation

Make sure to cover your head first tp prevent hair from getting on other clothing items.

14. One form of identification is needed from the patient in the preoperative holding area.

True

False

Two forms of patient identification are required, one of which can be obtained by asking the patient his or her name, the other can be verified from the chart which should match the name and birth date on the patient's I.D. bracelet. Be sure to introduce yourself to the patient and explain your role and verify the procedure to be performed.

Explanation

Two forms of patient identification are required, one of which can be obtained by asking the patient his or her name, the other can be verified from the chart which should match the name and birth date on the patient's I.D. bracelet. Be sure to introduce yourself to the patient and explain your role and verify the procedure to be performed.

15. When setting up equipment, which is the best strategy for positioning it?

Place equipment closest to a convenient electrical outlet.

Avoid placing equipment close to blood warmers, electrocautery units, or microscopes.

Traffic will flow easily around your equipment, so position it early and others will navigate around it.

Place equipment as close to the patient as possible.

Beware of traffic flow and be prepared to move equipment. Don't block the path of others in accessing their equipment.

Explanation

Beware of traffic flow and be prepared to move equipment. Don't block the path of others in accessing their equipment.

16. When should OR personnel be advised of needle placement?

At the beginning of the case.

At the beginning and end of the case.

Prior to the start of the case.

At the end of the case.

It is just as important to advise the OR personnel of needle placement at the conclusion of the case.

Explanation

It is just as important to advise the OR personnel of needle placement at the conclusion of the case.

17. When is the best time for stick-on stimulating electrodes to be placed on the patient?

After anesthesia and before the surgical procedure.

In the preoperative holding area.

During the induction of the anesthetic.

After the patient has been transferred to the OR table.

The best time for stick-on stimulating electrodes to be placed on the patient is in the preoperative holding area. This is because it allows for proper preparation and positioning of the electrodes before the patient is taken into the operating room. Placing the electrodes after anesthesia and before the surgical procedure may be too late, as the patient may already be positioned on the operating table. Similarly, placing the electrodes during the induction of the anesthetic or after the patient has been transferred to the OR table may not allow for adequate time to properly attach and secure the electrodes.

Explanation

The best time for stick-on stimulating electrodes to be placed on the patient is in the preoperative holding area. This is because it allows for proper preparation and positioning of the electrodes before the patient is taken into the operating room. Placing the electrodes after anesthesia and before the surgical procedure may be too late, as the patient may already be positioned on the operating table. Similarly, placing the electrodes during the induction of the anesthetic or after the patient has been transferred to the OR table may not allow for adequate time to properly attach and secure the electrodes.

18. How often should the equipment be calibrated?

Prior to each surgery.

Monthly or as required by the hospital.

Semiannually or as required by the hospital.

Annually.

The equipment should be calibrated semiannually or as required by the hospital. Calibration is necessary to ensure that the equipment is functioning correctly and providing accurate results. Performing calibration prior to each surgery would be too frequent and time-consuming. Monthly calibration may be excessive for some equipment, while annual calibration may not be frequent enough to detect any potential issues. Therefore, semiannual calibration or following the hospital's requirements is the appropriate frequency for calibration.

Explanation

The equipment should be calibrated semiannually or as required by the hospital. Calibration is necessary to ensure that the equipment is functioning correctly and providing accurate results. Performing calibration prior to each surgery would be too frequent and time-consuming. Monthly calibration may be excessive for some equipment, while annual calibration may not be frequent enough to detect any potential issues. Therefore, semiannual calibration or following the hospital's requirements is the appropriate frequency for calibration.

19. Which of the following is NOT a consideration when determining the OR table selection?

Table selection affects the organization of computer leads and EMG electrodes.

Table function may require modification of the monitoring procedure to accomodate structures placed at risk.

Table selection can minimize abdominal pressure in turn reducing intra spinal pressure.

Table type is an important part of understanding the perimeters of the sterile field.

The table selection is an important element of the surgical environment. Knowing the type of table and how it will be used are paramount to the surgical procedure.

Explanation

The table selection is an important element of the surgical environment. Knowing the type of table and how it will be used are paramount to the surgical procedure.

20. What is the best reason for using differing lengths of wire in the OR?

To provide minimal excess wire and avoid entanglements.

To avoid impairment to fluoroscopic visualization.

To minimize the costs associated with cabling materials.

To enhance access to the stimulating box without stretching the lead wire.

A and B.

Using differing lengths of wire in the operating room (OR) can enhance access to the stimulating box without stretching the lead wire. This means that the wires can be adjusted to reach the stimulating box without causing any strain or tension on the lead wire. This is important because stretching the lead wire can potentially cause damage or impair the functionality of the wire. By using differing lengths of wire, the surgeon can ensure that there is enough wire to reach the stimulating box without any excess wire that could lead to entanglements. Additionally, this answer does not mention minimizing costs or avoiding impairment to fluoroscopic visualization, making it the best reason among the given options.

Explanation

Using differing lengths of wire in the operating room (OR) can enhance access to the stimulating box without stretching the lead wire. This means that the wires can be adjusted to reach the stimulating box without causing any strain or tension on the lead wire. This is important because stretching the lead wire can potentially cause damage or impair the functionality of the wire. By using differing lengths of wire, the surgeon can ensure that there is enough wire to reach the stimulating box without any excess wire that could lead to entanglements. Additionally, this answer does not mention minimizing costs or avoiding impairment to fluoroscopic visualization, making it the best reason among the given options.