Nursing Procedures

1. Surgical Handwashing/Hand Scrub

2. Gloving (Close Method)
3. Postural Drainage
4. Discharging client from a Health Care Agency
5. Adding items to a Sterile Field
6. Adding liquids to a Sterile Field
7. Performing Sterile Procedures
8. Opening a sterile item on a flat surface
9. Preparing a sterile field
10. Opening a sterile Pack
11. Types of Surgical Incision of the Abdomen
12. Areas of Skin Preparation
13. Skin Preparation
14. Drying Hands and Gowning
15. OR Technique
16. ECG Procedures
17. Suctioning a Nasopharyngeal and Oropharyngeal Areas
18. Guidelines for starting a Peripheral Intravenous Infusion

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
D

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
A. only when the hands have never passed through the gown cuffs

The sterile areas of the gown include the:

1. front from two inches below the neck to waist or table level
2. gloves and gown sleeve to two inches above the elbow
3. sides from axillae to waist or table level
4. back of a wraparound gown
A. 1 and 2 
B. 1 and 3 
C. 1, 2, and 3 
D. All of the above
A. 1 and 2 (Front from two inches below the neck to waist or table level and
gloves and gown sleeve to two inches above the elbow.)

The use of a brush for surgical hand scrubs is not necessary.

A. True 
B. False
A. True

During gowning, the circulating nurse can assist 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 gown's sleeves by pulling the
shoulders up 
C. reaching inside the gown and pulling the inside seam 
D. All of the above 
D. All of the above

When taking off the gown at the end of the case, the gloves' 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. Scrubbed person's choice if gloves are not too dirty 
B. Glove-to-glove and then skin-to-skin

When a team member other than the scrub nurse contaminates a glove during
the surgical procedure, the scrub nurse regloves the team member using
which one of the following methods?
A. Assisted gloving 
B. Reverse gloving 
C. Protected gloving 
D. Open gloving
This answer is actually considered an open assist.

When performing a surgical scrub with an antimicrobial agent, how far up the
arm must an individual scrub?
A. Up to the armpit 
B. Two inches above the elbow 
C. To the elbow 
D. Four inches above the wrist 
B. Two inches above the elbow

The purpose of the surgical hand scrub is to:

1. remove normal skin flora
2. sterilize the skin
3. suppress growth of microorganisms
4. remove soil and debris

A. 1 and 3 
B. 2 and 3 
C. 3 and 4 
D. All of the above 

Where should the scrubbed person hold onto his or her gown when lifting it up
to don it?
A. The sterile exterior of the gown 
B. The inside seams at armpits 
C. The inside front of the gown just below the neckband 
D. At the waist 
C. The inside front of the gown just below the neckband

Appropriate surgical attire for the scrub person includes:

1. headgear that covers all hair
2. protective eyewear
3. a face mask
4. shoes the provide protection

A. 1 and 3 
B. 1, 2, and 3 
C. 2, 3, and 4 
D. All of the above 
D. All of the above

Headgear that covers all hair, protective eyewear, a face mask, and shoes that
provide protection.

It is permissible to scrub without removing rings.

A. True 
B. False 
B. False.

Wearing artificial or acrylic nails in the surgical setting is:

A. permitted if they are in good repair 
B. unacceptable because they may harbor microorganisms 
C. permitted if polish is less than four days old 
D. unacceptable for aesthetic reasons 
B. unacceptable because they may harbor microorganisms

The scrub person may use the closed-glove method to change one or both
gloves if they become contaminated.
A. True 
B. False
B. False

Open or Closed Gloving?

The scrub person’s hands remain inside the gown sleeves and should not
touch the cuff edges.
Closed

Open or Closed Gloving?

Used for subsequent gloving and when performing procedures when a gown
is not worn
Open

Open or Closed Gloving?

The scrub person’s hands slide all the way through the sleeves and out
beyond the cuffs.
Describe the sterile areas of surgical attire:

Why should surgical personnel remove the surgical gloves AFTER removing
the surgical gown?

Why is it important for surgical personnel to wear protective eyewear during a

surgical procedure?

After the surgical hand scrub, the scrub person should keep the fingers of
their hands pointed in which direction to allow water to drip away from the
surgical attire?

After the surgical hand scrub and hand/arm drying with a sterile towel, the
scrub person should keep the fingers of their hands pointed in which direction
as they wait to gown?
Sterile technique

Choose the INCORRECT statement. Proper sterile technique:

A. Eliminates all microorganisms in the OR
B. Is a key responsibility of perioperative personnel
C. Helps prevent health care-associated infections in patients and medical
professionals
D. Includes wearing gowns, gloves, and surgical masks whose barrier
performance is appropriate for the specific procedure being performed 
A. Eliminates all microorganisms in the OR

When entering the OR or procedure area, nonscrubbed members of the

perioperative team should wear:
A. A head covering and clean, low-linting two-piece pantsuit, one-piece
coverall, or scrub dress
B. A clean or single-use long-sleeved scrub jacket that is buttoned or snapped
closed and fully covers the torso, arms and wrists
C. Shoe coverings, if spills or splashes are likely to occur
D. All of the above 
D. All of the above

Perioperative hand hygiene includes all of the following EXCEPT:

A. Removing bracelets and watches before washing hands or beginning a
surgical hand scrub
B. Removing chipped nail polish before entering the perioperative area
C. Removing visible soil on the hands and arms with an alcohol-based
antiseptic hand rub that meets US Food and Drug Administration standards
for antimicrobial activity
D. Using a disposable nail cleaner to clean under the nails
E. Removing rings before entering the perioperative area
C. Removing visible soil on the hands and arms with an alcohol-based antiseptic
hand rub that meets US Food and Drug Administration standards for
antimicrobial activity

The proper method of wearing a surgical mask is:

A. Tied closely to the face, to prevent venting of respiratory contaminants
around the sides
B. Tied loosely around the face, to facilitate ease of breathing
C. With the ties crossed around the back of the head
D. None of the above 
A. Tied closely to the face, to prevent venting of respiratory contaminants around
the sides

A surgical mask should be worn at all the following times EXCEPT:

A. During lumbar puncture
B. During insertion of a central venous catheter (CVC)
C. When placing a peripheral venous catheter
D. In the presence of opened packs of sterile supplies 
C. When placing a peripheral venous catheter

A surgical mask provides adequate protection when entering the room of a

patient who requires airborne precautions.
A. True
B. False
B. False

When performing a surgical hand scrub, it is acceptable to use an alcohol-

based antiseptic solution if it exhibits persistent, cumulative antimicrobial
activity that meets FDA standards
A. True
B. False
A. True

A surgical hand scrub should be performed:

A. Before donning sterile gowns and gloves for surgical and other invasive
procedures
B. Whenever you need to enter the OR
C. In the OR or invasive procedure area
D. Before opening a sterile instrument pack
A. Before donning sterile gowns and gloves for surgical and other invasive
procedures

Which areas of a surgical gown are considered sterile?

A. the front, from the chest to six inches below the surgical field
B. The front, from the chest to the level of the surgical field
C. The neck and shoulders
D. The axillary area
B. The front, from the chest to the level of the surgical field

When donning a surgical gown, it is permissible to:

A. Stand next to the instrument table
B. Grasp the outside back of the gown with your scrubbed hands
C. Accept help from an unscrubbed perioperative team member, so long as
the helper touches only the inside of the gown
D. Don the surgical gloves first, and then the gown
C. Accept help from an unscrubbed perioperative team member, so long as the
helper touches only the inside of the gown

When performing closed assisted gloving, you whould pull the gown cuffs up
over your wrists toward your elbows and then don the gloves
A. True
B. False
B. False

Even small perforations in surgical gloves increase risk of exposure to

bloodborne pathogens and potentially infectious materials. When wearing
surgical gloves, it is appropriate to do all of the following EXCEPT:
A. Double glove during surgical and other invasive procedures
B. Change gloves when contamination or perforation is suspected, even if you
are not sure it happened
C. Change gloves every 45 minutes during surgical and other invasive
procedures
D. Use a performance indicator system in which the inner pair of gloves is
colored to make perforations easier to see 
C. Change gloves every 45 minutes during surgical and other invasive
procedures

A sterile field includes which of the following?

A. The site surrounding an incision or tissue perforation
B. The site where an instrument has been introduced into a body orifice that
has been prepared for a surgical or other invasive procedure
C. Working areas, furniture, and equipment covered with sterile drapes and
drape accessories
D. Personnel in sterile attire
E. All of the above

When preparing a sterile field, the first thing that team members should do is:
A. Perform a surgical hand scrub
B. Don sterile gloves
C. Don a sterile gown
D. Don clean (nonsterile) gloves

To decrease risk of contamination, AORN recommends that a sterile field be:

A. Prepared in the room adjacent to where it will be used
B. Prepared as close as possible to the start time of the procedure
C. Prepared no more than 60 minutes before the start time of the procedure
D. Covered and left for up to two hours if a procedure is unexpectedly delayed

When opening a sterile package, the LAST flap to be opened should be:
A. The flap to your left
B. The flap closest to you
C. The flap to your right
D. The flap farthest from you

When two scrubbed team members need to change position during an

operative or other invasive procedure, they should do so by passing each
other:
A. Back to back
B. Front to front
C. Back to front
D. A or B

Which is NOT a recommended practice for maintaining a sterile field?

A. When scrubbed, keep hands and arms above waist level and away from
the axillary region at all times
B. When near the sterile field, speak only when necessary
C. If the surgery or procedure is delayed, tape the door to the procedure room
closed to prevent contamination from air currents
D. Minimize movements when near the sterile field, and do not move in
between two sterile fields

When is it acceptable for a scrubbed team member to move away from a

sterile field?
A. To retrieve items from a sterilizer
B. When radiographs (xrays) are being taken
C. when changing into sterile gown and gloves after announcing the change
to clean closure
D. All of the above

Scrubbed team members should sit during an operative or other invasive

procedure only if the entire procedure will be performed at that level
A. True
B. False

To prevent contamination of the sterile field, unscrubbed team members

should face the field when approaching it, should not walk between two sterile
fields or scrubbed persons, and should stay at least ______ away from a
sterile field and from scrubbed persons at all times
A. 6 inches
B. 12 inches
C. 18 inches
D. 24 inches

To promote facility wide best practice in sterile technique, AORN recommends

that registered nurses
A. Practice collaboration, leadership, and teamwork in the perioperative
environment
B. Take part in ongoing quality assurance, monitoring, and performance
activities designed to improve the performance of sterile technique
C. Help establish a culture in which concerns about breaches in sterile
technique are communicated immediately and appropriately
D. all of the above

List the areas of the sterile gown that are considered sterile:
 
What direction do you point your hands when doing a medical hand washing?

o A. 

Up

o B. 

Down

o C. 

Sideways

The surgical cap is worn to help: 

a. Keep blood off the specialist's hair. 

b. Keep hair out of the specialist's eyes. 

c. Prevent possible contamination of sterile field.

d. Help prevent electrostatic sparks.

Before donning a surgical gown, members of the surgical team are required to:

a. Scrub their hands.

b. Sterilize their hands and arms. 

c. Take a shower and shampoo their hair.

d. Don rubber glove.

 When the mask is removed, it should be held by the:

a. Nosepiece.

b. Lower edge.

c. Side edge.

d. Ties and/or elastic headband.

When using the brush-stroke method to scrub hands, circular strokes should be applied to all four sides of
each finger.
a. 20. 

b. 40. 

c. 50. 

d. 80.

If you touch the outside of your gown while putting it on, you should:

a. Do nothing. 

b. Report to your supervisor. 

c. Discard the gown.

True or False; When rinsing your hands, after a surgical scrub, you need to let the water
run from your elbows to your finger tips
False
The type of gloving using the palm to palm and thumb to thumb technique
Closed Gloving

Which area of the hands requires special attention before you begin a surgical hand scrub?
The area under each fingernailThe back of the handsThe area between each fingerThe palm of
each hand
The area under each fingernail
The area under the fingernails, called the subungual area, harbors micro-organisms. You must
clean it thoroughly during the first scrub of the day and whenever visibly soiled.