OUR LADY OF FATIMA UNIVERSITY Perioperative Nursing

Situation 1 – Team work is vital among members of the surgical team for a successful outcome of a surgical procedure. 1. According to Aseptic Technique, the sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out of these items by opening its outer cover?

A. Circulating nurse C. Surgeon B. Scrub nurse D. Anaesthesiologist

2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the Aseptic Technique by the OR Team?

A. Circulating nurse C. Surgeon B. Scrub nurse D. Anaesthesiologist

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where patient is confined. For cardiovascular cases such as PTCA, what department is usually informed to be present in the OR?

A. Rehabilitation department C. Maintenance department B. Laboratory department D. Radiology department

4. Joint replacement is a key treatment of pain for clients with Rheumatoid Arthritis. Aside from the usual surgical team, who else has to be present when a client undergoes Total Knee Replacement?

A. Information technician C. Electrician B. Biomedical technician D. Laboratory technician

5. In Trauma surgery, prompt replacement of compatible blood is crucial for the survival of the client. What department needs to be alerted to coordinate closely with the patient’s family for immediate blood component therapy?

A. Philippine Red Cross C. Social Service Section B. Department of Health D. Laboratory department

Situation 2 – In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality of patient delivery outcome. 6. Which of the following should be given highest priority when receiving a patient in the OR?

A. Assess level of consciousness B. Verify patient identification and informed consent C. Assess vital signs D. Check for CXR, 12L-ECG and other laboratories

7. A client with Diabetes Mellitus will undergo I and D (incision and drainage) and debridement of a non healing wound. The OR scheduling nurse will prioritize this case as?

A. Last case C. According to availability of anesthesiologist B. In between cases D. According to the surgeon’s preference

8. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intraoperative phase. As the scrub nurse, you make certain that throughout the procedure.

A. the surgeon is in a good mood B. the surgeon will have his favorite music C. the surgeon will not lose a raytec sponge in the abdomen D. the surgeon will have all that he wants for the case

9. A vital nursing responsibility of a circulating nurse in the induction of general anesthesia to prevent regurgitation is:

A. position the patient C. do the Sellick’s maneuver B. pre-procedural time-out D. check baseline vital signs

10. In the Post Anaesthesia Care Unit (PACU), a most common post surgical complication that the nurse should anticipate should be:

A. postoperative anxiety and stress C. postoperative pain management B. postoperative respiratory function D. postoperative gastrointestinal motility

Situation 3 – Nurses hold a variety of roles when providing care to a perioperative patient  11. Which of the following role would be the responsibility of the circulating nurse, except?

A. Assess the readiness of the client prior to surgery B. Ensure that the airway is adequate C. Account for the number of sponges, needle, supplies, used during the surgical procedure D. Anticipate the needs of the primary and the assistant surgeon

12. As a perioperative nurse, how can you the best meet the safety need of the client after administering preoperative narcotic inside the OR Suite?

A. Put the safety strap and stay beside the patient B. Put side rails up and ask client not to get out of bed C. Allow the relative to accompany the client D. Obtain informed consent

13. It is the responsibility of the pre-op nurse to do skin prep for patient undergoing surgery. Hair at the operative site is usually removed to make suturing easy and lessen chance of incision infection. What is the preferred method of hair removal?

A. Plucked C. Clipped B. Pulled D. Razor

14. It is also the nurse’s function to determine when the infection is developing in the surgical incision. The perioperative nurse should observe for what sign of impending infection?

A. Localized heat redness B. Serosanguinous exudates and skin blanching C. Separation of the incision D. Blood clots and scar tissue are visible

15. Which of the following nursing interventions is a priority when examining a surgical skin incision? A. Observe the dressing and type and odor of drainage in the incision if any B. The use of antiseptic agent such as Betadine Solution C. Do surgical hand scrub D. The use of sterile raytec sponges

Situation 4 – Team effort is the best demonstrated in OR.  16. If you are the nurse in charged for scheduling surgical cases, what important information do you need to ask the surgeon?

A. Who is your surgical assistant? B. Who is your surgical assistant, anesthesiologist, and what is your preferred time and

type of surgery? C. Who are your anesthesiologist, internist, and assistant? D. Who is your anesthesiologist?

17. In the OR, the indispensable nursing tandem for every surgery is: A. OR admitting nurse and circulating nurse B. OR admitting nurse, PACU nurse and circulating nurse C. Scrub nurse and instrument technician D. Surgical technologist and circulating nurse

18. While team effort is needed in OR for efficient and quality patient care delivery, we should limit the number of the people in the room for infection control. The following comprises the sterile team, except?

A. Surgeon

B. Nurse First Assistant C. Surgical Technologist D. Biomedical Technician

19. When surgery is on-going, who coordinates the activities outside and including the family? A. PACU Nurse C. Circulating nurse B. Operating Room Supervisor D. Main Surgeon

20. The breakdown in teamwork is often times a failure in: A. Aseptic Principle C. Surgical Conscience B. Communication D. Team coherence

Situation 4 – After an abdominal surgery, the circulating and scrub nurses have critical responsibility about sponge and instrument count.  21. When is the first sponge/instrument count of the case reported?

A. Before procedure C. Before closing the skin B. Before peritoneum is closed D. Before the fascia is sutured

22. What major supportive layer of the abdominal wall must be sutured by the surgeon to prevent evisceration of abdominal viscera?

A. Fascia C. Peritoneum B. Muscle D. Skin

23. If you are the scrub nurse, what suture would you prepare to close the subcutaneous layer? A. Plain Gut suture C. Ethibond suture B. Nylon suture D. Cotton suture

24. Another alternative “suture” for skin closure is use of_________ A. Staples C. Tegaderm B. Steri strips D. Opsite

25. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any discrepancy of count so that immediate and appropriate action is instituted?

A. Anaesthesiologist C. OR nurse supervisor B. Surgeon D. Circulating nurse

Situation 5 – Voluntary and written informed consent from the patient is necessary before non-emergent surgery can be performed  26. In which of the following situations is the informed consent valid?

A. The client signed the informed consent after receiving a dose of sedative. B. The nurse asked the client to sign the consent form after she explained what will happen to the

client during the surgery. C. The nurse witnessed the patient’s signature after ensuring that the client understood

the information provided by the surgeon and the anesthetist. D. The consent was signed before providing the client with appropriate information.

27. Who among the following is not legally allowed to witness the signing of a consent form to a surgical procedure?

A. The parents of a patient B. The patient’s surgeon C. The nurse in charge of the patient D. The head nurse

28. Who among the following patients is not legally allowed to give their consent to a surgery? A. A sixteen year old married male B. A fifteen year old female who is independently earning her own living C. The parents of a seven year old female D. A twenty five year old male given Demerol for preoperative pain

29. In the course of the preoperative assessment, the perioperative nurse should make sure that? A. Obtain informed consent from the patient B. Ensure that a signed informed consent is in the patient's chart C. Explain the risks and alternatives of the planned procedure D. All of the above

30. The primary role of the nurse in the acquisition of informed consent is? A. Obtain informed consent from the patient B. Ensure that a signed informed consent is in the patient's chart C. Explain the risks and alternatives of the planned procedure D. To witness the signing of the consent only

Situation 6 – Risk management is vital in the practice within the Operating Room 31. What is risk management for perioperative nurses?

A. It is the responsibility of the facility’s Risk Manager B. It is an ongoing effort of identifying and preventing potential harm to the patient by all members of the hospital staff C. It is only the responsibility of the surgeon D. none of the above

32. Policies and procedures on risk management of the institution or facility A. Need not be consistent with those of regulatory agencies B. Are not relevant to the management of risk in the perioperative setting C. Should be consistent with regulations of government and other outside agencies and professional standards of practice D. All of the above

33. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) model of risk management and quality assurance for healthcare facilities includes:

A. Continuing education and the use of patient survey data. B. Credentialing rules for healthcare practices. C. Establishing written criteria to evaluate risk. D. All of the above

34. Risk management areas of concern in the perioperative setting include: A. Effective communications; verifying patient ID, surgical site and procedure; and protecting patient property. B. Proper positioning of patients; maintaining aseptic technique; and making accurate counts. C. Operating equipment safely; preparing specimens, taking appropriate nursing actions; and documenting care accurately. D. All of the above

35. The doctrines of the captain of the ship and borrowed servant are favored by most court systems today in evaluating the legal responsibilities of nurses in the perioperative setting as they may apply to negligence and malpractice.

A. True B. False C. Sometimes D. Maybe

Situation 7 – The perioperative environment is a unique environment. 36. In the perioperative environment, the message must come across to patients arriving for surgery that

A. the patient should dispense with any preconceptions about surgery B. the surgical team has all the patient’s information it will need C. all equipment, staff and supplies are ready and waiting in the OR D. the patient is at the center of all we do

37. Upon arrival at a medical facility for surgery, considerable anxiety may be experienced by patients who

A. do not have enough information about their surgical procedure B. have had prior surgeries C. do not have serious illnesses D. meet any or all of criteria the above

38. The circulating nurse’s role is to A. conduct the instrument, sponge, and sharp counts with the scrub nurse. B. remain at the patient’s side to reassure the patient C. gather positioning equipment D. begin entering data on the perioperative record

39. In the semirestricted area of the OR A. traffic is limited to authorized personnel and patients B. there are areas where instruments may be stored or processed C. is where peripheral support areas are maintained D. all the above conditions apply

40. In the OR, the role of the scrub person may be filled by A. the circulating nurse B. the registered nurse first assistant C. a CNA D. an ST or CST

41. Perioperative nursing had its beginnings in A. World War I B. the Crimean War C. the Korean War D. the Spanish-American War

42. Maintaining the sterile field does not include A. scrubbing hands and forearms for at least two to five minutes B. donning a surgical gown selected from the sterile instrument table C. double-gloving and wearing masks D. holding the hands above the elbows after the scrub

43. In the OR, on the draped back table, only A. the table front and surface are sterile B. the area from two inches below the table surface and up is sterile C. the circulating nurse counts and positions instruments on the surface D. the surface is considered sterile

44. Sterile drapes should A. not be subjected to rapid movement B. be placed on the patient before entry into the OR C. be draped over the OR door to create a sterile barrier D. never be placed on OR equipment

45. Appropriate positioning of the patient for the procedure ensures A. the patient will be able to communicate with the team B. the patient will not be able to pull off the surgical drape C. optimal exposure to the surgical site D. opportunity for observation of the procedure

46. Calling a “time out” before beginning the procedure allows for opportunity to confirm A. the nature of the procedure B. the name of the patient C. the correct patient position D. all of the above

47. Teamwork in the OR includes A. understanding who is in charge B. maintaining an awareness of individual capabilities and responsibilities C. keeping track of who has made mistakes

D. offering to take over another’s duties 48. Fast-tracking a patient is possible because

A. health insurance companies support quick discharge of patients B. patients are motivated to be out of the hospital C. available medicines and postoperative care directions make home care more effective than it has been in the past D. new advances in anesthetics allow patients to be awake and stabilized in less time

49. In the first few minutes of PACU care, assessment should be made of the patient’s postoperative A. vital signs, cardiac status, and level of consciousness B. pain management, skin integrity, and experience of nausea C. allergies, sensitivities, and lucidity D. all of the above at the least

50. The person who develops the patient’s plan of care is the A. surgeon, using the physicians’ pick list B. circulating nurse, consulting HIPAA C. pre-admission nurse, using the PNDS D. preoperative nurse, using the PNDS

Situation 8 – Many complications can arise post-operatively due to the effects of anesthesia and immobility. To prevent these complications, patients need to be instructed to perform post-operative exercises  51. What is the best time to teach the client how to perform post-operative exercises?

A. While the client is recovering from the anesthesia and surgery in the post-anesthesia care unit. B. Three days after the surgery or when the pain from the surgery is already tolerable. C. On the day of the surgery. D. A few days before the surgery.

52. One of the post-operative skills that you need to teach the client is how to get out of the bed. If the client’s incision will be on the left side of the chest or abdomen, on which side of the bed will you tell him/her to turn to and get out of?

A. Left-side of the bed C. Foot of the bed B. Right side of the bed D. It doesn’t matter

53. Moving and turning in bed can add strain to the suture. What skill or exercise will you teach the client to prevent the additional strain on the suture when moving?

A. Moving in slow motion C. Splinting B. Deep-breathing exercises D. Leg exercises

54. Which of the following potential post-operative problems due to undue strain on the suture site pertains to the extrusion of internal organs and tissues through the incision?

A. Wound dehiscence C. Wound infection B. Wound evisceration D. Postoperative ileus

55. Leg exercises are also skills that the client needs to perform after the surgery. What is the rationale for the performance of leg exercises after the surgery?

A. To promote circulation and prevent thrombus formation B. To promote lung expansion and to promote airway clearance C. To prevent infection D. To prevent contractures

56. After the surgery, the client needs to perform deep breathing and coughing exercises. Which of the following is the best position when performing deep breathing and coughing exercises?

A. Side-lying position B. Sitting position C. Dorsal recumbent D. Semi-fowler’s position

 Situation 9 – It has been a tradition to place the client on NPO after midnight before the day of the surgery. However, the American Society of Anesthesiology has revised its guidelines for preoperative fasting for healthy clients undergoing elective procedures.  57. Which of the following is not a reason for the NPO order?

A. There is a danger for vomiting and aspirating B. The surgical area may be contaminated by feces C. The bladder may be injured during the procedure. D. None of the above

58. The revisions in the guidelines were based on reevaluation and researches. What is the least probable type of research used in determining the necessary revisions in the guidelines?

A. Descriptive C. Quasi-experimental B. Correlational D. Experimental

59. Which of the following is not allowed in revised guidelines for preoperative fasting? A. Eating a light breakfast 6 hours before the procedure B. Consumption of clear liquids up to 2 hours before elective surgery requiring general anesthesia. C. A heavier meal 8 hours before surgery D. None of the above

60. One of your responsibilities during the preoperative phase is to ensure that the nails are trimmed and free from polish. What is the main reason for this?

A. Chips in nail polish are good breeding sites of microorganisms B. Long nails are breeding sites of microorganisms C. Nail beds will be visible for assessing circulation D. To prevent infection

 Situation 10 – Due to the impairment in a client’s skin integrity, which predisposes the client to develop infections, during the surgery, a major focus during the intraoperative phase is maintaining surgical asepsis. Prior to your first day in the operating room, you reviewed the chain of infection because it is the basis of the principles of infection control and of asepsis.

61. Sometimes, it is necessary to remove hair from the surgical site. Which of the following is the least preferred method of removing hair?

A. Using electric clippers C. Using depilatory creams B. Using surgical blades D. None of the above

62. What is the best way to minimize the spread of microorganisms and, eventually, infections? A. Handwashing B. Sterilizing all instruments C. Bathing the client in antiseptics or germicides D. Cleaning the client’s environment using antiseptic agents

63. When performing surgical handwashing or sterile handwashing, how should the hands be positioned? A. Hands lower than the elbows C. Hands parallel to the ground B. Hands higher than the elbows D. Any of the above

64. After washing the hands using the sterile technique, how should you dry your hands using a towel? A. In a rotating motion from the fingers to the elbow. B. Using long strokes from the finger to the elbow C. In a rotating motion from the elbow to the fingers D. Using long strokes from the elbow to the fingers

 Situation 11 – Even healthy members of the surgical team are considered reservoirs of microorganisms.

Microorganisms may come from the surgical team member’s oral and respiratory tracts and skin. One way to ensure that these do not get transmitted to the clients is to wear OR attire properly. 65. How should shirts and waist drawstrings placed or worn?

A. Tuck the shirt, and cut the waist drawstrings short enough so that it will not be longer than your actual waist circumference B. Tuck both the shirt and the drawstring C. Untuck the shirt and just let the drawstring hang loose from the pants so that you won’t have to touch these possible breeding sites of microorganisms. D. Leave the shirt untucked so that you won’t have to touch this possible breeding sites of microorganisms, and cut the drawstrings short enough so that it will not be longer than your actual waist circumference.

66. To prevent transmitting microorganisms from the respiratory and oral tract, masks are worn by members of the surgical team. When going out of the operating room, what should you do with the mask?

A. Change it every time you go in and out of the operating room B. Let the mask to hang around the neck and do not touch it so that your hands will not be contaminated. C. Remove the mask and fold in such a way that the surface that is in contact with your own skin is exposed to the environment and the other surface is not exposed. D. None of the above.

67. When donning gloves using the closed method, in which hand are you going to put the gloves on first?

A. The left hand C. The dominant hand B. The right hand D. The nondominant hand

68. When a scrub nurse puts on a gown, which of the following ways of tying the waist tie will not maintain asepsis?

A. Have a coworker hold the tie using gloves or sterile forceps. Make a three-quarter turn, then take the tie and secure it in front of the gown. B. Have a coworker take the two ties at each side and tie it at the back of the gown. C. Reaching for the back and tying it herself. D. All will not maintain asepsis.

69. Which parts of the scrub nurse’s gown are considered sterile? A. From the front of the chest at the level of the shoulders to the waist; and from two inches above the elbow to the stockinette cuff B. From the front of the chest at the level of the shoulders to the level of the sterile field; and from two inches above the elbow to the stockinette cuff C. From the front of the chest at the level of the shoulders to the waist; and from two inches below the elbow to the stockinette cuff D. From the front of the chest at the level of the shoulders to the level of the sterile field; and from two inches below the elbow to the stockinette cuff

70. When entering the OR, how should the scrub nurse move? A. The nurse’s sides facing the wall B. The nurse facing the sterile field C. The nurse’s back facing the wall D. All except A

Situation 12 – Another major aspect of nursing care during the intraoperative phase is the proper positioning of the client to prevent injuries. 71. When is positioning done?

A. Before inducing anesthesia and before surgical draping B. After inducing anesthesia and before surgical draping C. Before inducing anesthesia and before surgical draping

D. After inducing anesthesia and before surgical draping 72. How should the client be placed into his or her position?

A. By pushing C. By lifting B. By pulling D. All of the above

73. Which of the following is not a major consideration in choosing the client’s position? A. Visualization and access to the surgical site B. Access for assessing and maintaining anesthesia and vital functions C. Preventing harm or injury to the client D. Visualization of the client’s whole body

74. A client will undergo explore laparotomy. In which position will you expect him to be placed? A. Dorsal recumbent C. Lithotomy B. Prone D. Trendelenberg

75. A female client will undergo vaginoplasty. In which position will you expect her to be placed? A. Dorsal recumbent C. Side-lying B. Lithotomy D. Trendelenberg

Situation 13: During the surgical procedure, the patient will need sedation, anesthesia, or a combination of these. Sedation and anesthesia has four levels: minimum sedation, moderate sedation, deep sedation and anesthesia. 76. Which of the following statements is true about sedation and anesthesia?

A. In both cases, the ventilation and cardiovascular functions are affected. B. In both cases, the patient is arousable. C. The difference between anesthesia and sedation is that the anesthetized person is not arousable. D. All are true except C.

77. Anesthesia has four stages. In the beginning anesthesia, the client will experience ringing, roaring or buzzing in the ears, as well as an exaggeration in the hearing of noises. In this situation, what will be your nursing diagnosis?

A. Anxiety C. Confusion B. Disturbed sensory perception D. All of the above

78. Which of the following measures is not appropriate in addressing the identified problem? A. Avoid making unnecessary motions B. Avoid making unnecessary noises C. Leaving the client by himself until the next stage of anesthesia D. None of the above. All are appropriate

79. The second stage of anesthesia is excitement, which is characterized by struggling, shouting, crying, laughing, singing, crying and possibly uncontrolled movements. Because of this, restraints are sometimes necessary. When restraints are used on a surgical client, which of the following should be observed or done?

A. The use of restraints should never be used. B. When restraining, a strap should always be placed across the patient’s thighs. C. The hand should be always be secured to an armboard. D. Restraints should never be applied over the operative site.

80. Medullary depression is reached when too much anesthesia has been administered. As a nurse, what will be your first action in relation to medullary depression?

A. Assist in monitoring the client’s vital signs and the reflexes of the pupils. B. Discontinue the anesthesia C. Initiate respiratory and circulatory support. D. Assist in administering stimulants.

81. Intravenous anesthesia has a pleasant onset as opposed to inhalation anesthesia, where the buzzing, roaring and dizziness occurs after its administration. However, intravenous anesthesia’s advantage is that it has a powerful respiratory depressant effect. As a nurse, what is your primary intervention?

A. Assess the client’s respiratory and cardiovascular function. B. Ensure that oxygen can be administered immediately. C. Maintain asepsis D. Ensure that consent form was signed.

82. Nausea and vomiting are potential intraoperative complications of spinal anesthesia. If gagging occurs, which of the following are you not going to do?

A. Turn the client’s head to the side C. Provide a basin B. Lower the head of the operating table D. None of the above

83. Another after effect of spinal anesthesia is headache. Which of the following are you supposed to do? A. Keep the client lying flat C. Keep the client well hydrated B. Keep the environment quiet D. All of the above

84. Malignant hyperthermia is an uncommon complication during the intraoperative phase but it has a mortality rate of 50%. It occurs due to the inability of the muscles cells to relax which leads to an excessive use of ATPs. This leads to hypermetabolism. What is the first intervention in relation to malignant hyperthermia?

A. Identifying risks factors that predispose the client to malignant hyperthermia preoperatively B. Monitoring the client’s vital signs during the surgery C. Ensuring the availability of medications and equipment D. All of the above

Situation 14 - After 3 weeks of being assigned to the operating rooms, you were then assigned to the postanesthesia care unit (PACU).  85. Which of the following statements is true about the postoperative phase?

A. It begins with the admission of the client in the pacu and ends with the discharge from the hospital. B. It begins when the anesthesia wears off and ends when the client is discharged from the PACU. C. It begins with the admission of the client in the pacu and ends when the healing is complete. D. It begins when the anesthesia wears off and ends when the healing is complete.

86. Which of the following will you not expect in a postanesthesia care environment? A. Soft, pleasing colors B. Bright colors C. Indirect lighting D. Soundproof ceiling and equipment that minimize noise

87. The PACU is sometimes divided into two phases: Phase I and Phase II. Which of the following statements are related to phase I?

A. Intensive nursing care C. Both a and B B. Preparation for discharge D. None of the above

88. Which of the following statements are related to phase II PACU? A. Intensive nursing care C. Both a and B B. Preparation for discharge D. None of the above

89. During phase I PACU, how often should you monitor the vital signs of the clients? A. Every 15 minutes for the first hour B. Every 15 minutes until vital signs are stable for 30 minutes C. Every 15 minutes until vital signs are consistent with preoperative vital signs for at least 30 minutes D. All except A

90. One of the main priorities during phase I PACU is the maintenance of a patent airway. Which of the following is the best way to assess the client’s breathing pattern?

A. Observe the rising and falling of the client’s chest and abdomen. B. Place you hands over the client’s abdomen and chest to palpate the movements C. Place the palm of your hand near the client’s nose and mouth

D. Cover the client’s nose and mouth using your palm to feel the client’s exhalation. 91. Due to anesthesia, muscles are relaxed including the lower jaw and the tongue. This situation is called hypopharyngeal obstruction. Signs include choking, noisy respirations, decreased oxygen saturation level and cyanosis. What is your nursing diagnosis in this situation?

A. Impaired breathing pattern C. Impaired gas exchange B. Ineffective airway clearance D. All of the above

92. The anesthetist may leave a hard rubber or a plastic airway in the patient’s mouth. When should it be removed?

A. Until the gag reflex has returned C. Upon admission to the PACU B. One hour post admission to the PACU D. After discharge from the PACU

Situation 15 – The following are concepts of scrubbing, gloving and gowning in the perioperative setting.

93. All of the following statements apply when drying the hands and arms except A. bend over slightly from the waist. B. begin drying with the hand and move up the arm. C. dry thoroughly to avoid skin irritation. D. roll the towel before discarding into the appropriate container.

94. The closed-glove technique is used A. only when the hands have never passed through the gown cuffs. B. when regloving without assistance during the procedure. C. to assist a surgeon in donning sterile attire. D. as a method for correcting glove contamination.

95. When a scrub person assists another team member with gowning and gloving, he or she does all of the following except

A. protect gloved hands by forming a cuff of the neck and shoulder area. B. release the gown when the team member’s hands are in the sleeves. C. handle the glove on the inside only. D. always offer the right glove first.

96. The sterile areas of the gown include 1) the front from two inches below the neck to waist or table level. 2) the gloves to two inches above the elbow. 3) the sides from axilla to waist or table level. 4) the back of a swing-back gown.

A. 1 and 2 B. 1 and 3, C. 1, 2, and 3 D. all of the above

97. During gowning, the circulating nurse assists the scrub person by A. pulling the bottom edge of the front of the gown to eliminate blousing. B. helping to get the creases out of the gowns sleeves by pulling the shoulders up. C. reaching inside the gown and pulling the inside seam. D. all of the above.

98. When taking off the gown at the end of the case, the glove cuffs usually turn down as the sleeves pass off the arms. The wearer removes the gloves using which one of the techniques listed below?

A. Pull off by fingers of each glove. B. Glove to glove and then skin to skin. C. Open-glove technique. D. If the gloves are not too dirty, it’s your choice how to do it.

99. Recommended scrub methods are A. the counted stroke scrub. B. the anatomic timed scrub. C. the surgical hand rub. D. all of the above.

100. When one or both gloves must be changed without assistance, which one of the following methods

listed below should be used? A. double gloving B. open-glove technique C. barehanded gloving D. closed-glove technique