NAME____________________________________________________ DATE_________________

A. MULTIPLE CHOICE. Encircle the letter of the correct answer.

1. 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 these items by opening its outer cover?
a. Circulating nurse b. Anesthesiologist c. Surgeon d. Nursing aide

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. White the surgeon performs the surgical procedure, who monitors the status of the client like urine
output, blood loss, vital signs?
a. Scrub nurse b. Surgeon c. Anesthesiologist d. Circulating nurse

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where
the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?
a. Rehabilitation department b. Laboratory department c. Maintenance department d. Radiology department

4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team who else to be present when a
client undergoes laparoscopic surgery?
a. Information technician b. OR technician c. Electrician d. Laboratory technician

5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate
closely with the patient’s family for immediate blood component therapy?
a. Security Division b. Chaplaincy c. Social Service Section d. Laboratory department

6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the following
observation would prompt you to call the doctor?
a. Dressing is intact but partially soiled
b. Left foot is cold to touch and pedal pulse is absent
c. Left leg in limited functional anatomic position
d. BP 114/78, pulse of 82 beats/minute

7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm. The next dose of Demerol
50 mg I.M. is given:
a. When the client asks for the next dose
b. When the patient is in severe pain
c. At 11pm
d. At 12pm

8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors-indicate appropriate adaptation?
a. The client reports pain reduction and decreased activity
b. The client denies existence of pain
c. The client can distract himself during pain episodes
d. The client reports independence from watchers

16. Which of the following should be given highest priority when receiving patient in the OR?
a. Assess level of consciousness
b. Verify patient identification and informed consent
c. Assess vital signs
d. Check for jewelry, gown, manicure and dentures

17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered ‘dirty cases’.
When are these; procedures best scheduled?
a. Last case b. In between cases
c. According to availability of anesthesiologist d. According to the surgeon’s preference
18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intraoperative
phase. As the circulating nurse, you make certain that throughout the procedure…
a. the surgeon greets his client before induction of anesthesia
b. the surgeon and anesthesiologist are in tandem
c. strap made of strong non-abrasive material are fastened securely around the joints of the knees and ankles and around the 2
hands around an arm board
d. client is monitored throughout the surgery by the assistant anesthesiologist

19. Another nursing check that should not be missed before the induction of general anesthesia is:
a. check for presence underwear b. check for presence dentures
c. check patient’s blood studies d. check baseline vital signs

20. Which of the following role would be the responsibility of the scrub nurse?
a. Assess the readiness of the client prior to surgery
b. Ensure that the airway is adequate
c. Account for the number of sponges, needles, supplies, Used during the surgical procedure
d. Evaluate the type of anesthesia appropriate for the surgical client

22. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic?
a. Put side rails up and ask client not to get out of bed
b. Send the client to ORD with the family
c. Allow client to get up to go to the comfort room
d. Obtain consent form

21. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not
shaved, what should be done to make suturing easy and lessen chance of incision infection?
a. Draped b. Pulled c. Clipped d. Shampooed

22. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon?
a. Who is your internist
b. Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery?
c. Who are your anesthesiologist, internist, and assistant
d. Who is your anesthesiologist.

23. In the OR, the nursing tandem for every surgery is:
a. Instrument technician and circulating nurse
b. Nurse anesthetist, nurse assistant, and instrument technician
c. Scrub nurse and nurse anesthetist
d. Scrub and circulating nurses

24. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in
the room for infection control. Who comprise this team?
a. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
b. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
c. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
d. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

25. When surgery is on-going, who coordinates the activities outside, including the family?
a. Orderly b. Nurse supervisor c. Circulating nurse d. Anaesthesiologist

26. The breakdown in teamwork is often times a failure in:

a. Electricity b. Inadequate supply c. Relationship d. Communication

51. When is the first sponge/instrument count reported?

a. Before closing the subcutaneous layer
b. Before peritoneum is closed
c. Before dosing the skin
d. Before the fascia is sutured
27. What major supportive layer of the abdominal wall must be sutured with long tensile strength?
a. Fascia b. Muscle c. Peritoneum d. Skin

28. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient who is prone to keloid formation
and has a low threshold of pain, what needle would you prepare?
a. Round needle b. Atraumatic needle
c. Reverse cutting needle d. Tapered needle

29. Another alternative “suture” for skin closure is the use of:
a. Staple b. Therapeutic glue
c. Absorbent dressing d. invisible suture

30. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any discrepancy of
country so that immediate ‘and appropriate action in instituted?
a. Anesthesiologist b. Surgeon c. OR nurse supervisor d. Circulating nurse

31. Which of the following is the outcome of the processes by which an organization engages in environmental analysis, goal
formulation, and strategy development with the purpose of organizational growth?
a. Stake holder assessment
b. SWOT analysis
c. Operational Plan
d. Mission development

32. SWOT means

a. Strengths, weaknesses, opportunities, threats,
b. Strengths, worries, outcomes, threats
c. Strengths, weaknesses, opportunities, treatment
d. Structures, worries, outcomes, threats

33. Why is leadership development important for nurses if they are not in a managerial position?
a. it is not really important for nurses.
b. Leadership is important at all levels in an organization because nurses have expert knowledge interacting with and influencing
clients.
c. Nurse leaders have their jobs sooner for other positions.
d. Nurses who lead are less satisfied with their jobs

34. leadership is defined as

a. Being in a position with authority to exert control and power over subordinates.
b. A process of interaction in which he/she influences other towards goal achievement.
c. A process of coordinating actions and allocating resources to achieve organizational goals.
d. Being self-confident and autocratic

35. Management is defined as

a. Being in a position with authority to exert control and power over subordinates.
b. A process of interaction in which he/she influences other towards goal achievement.
c. A process of coordinating actions and allocating resources to achieve organizational goals.
d. Being self-confident and autocratic

36. Which of the following leadership is best used during and emergency or intensive crisis?
a. Laissez-faire b. Democratic c. Autocratic d. Liberal

37. Attributes of a good leader involve which of the following?

a. holds his members accountable for their wrongdoing and negligence.
b. aware of the members strengths and weaknesses
c. confident in his leadership skills
d. all of the above

38. The head nurse in the GTDMC OR DR is consistent in her decisions and compels the group to follow her. She performs
decision making without asking or getting any inputs from her members. Which type of leadership is she following?
a. Laissez-faire b. Democratic c. Autocratic d. none of the above
39. Which of the following leadership styles has more risks of negligence from the members?
a. Laissez-faire b. Democratic c. Autocratic d. Liberal

40. The loose style of leadership is

a. Laissez-faire b. Democratic c. Autocratic d. none of the above

41. Mich is a young head nurse of the GTDMC OR. Most of her staff nurses are senior to her, very articulate, confident and
sometimes aggressive. Mich feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her
department. Which of the best action that she must take?
a. identify the source of conflict and understand the points of friction
b. disregard what she feels and continue to work independently.
c. seek help from the director of nursing.
d. quit her job and look for another employment

42. As a young manager she knows that conflict occurs in any organization. Which of the following statements regarding conflict
is not true?
a. can be destructive if level is too high
b. is not beneficial; hence it should be prevented at all times
c. may result in poor performance
d. may create leaders.

43. Mich knows that one of her staff in experiencing burnout. Which of the following is best thing for her to do?
a. advise her staff to go on a vacation.
b. ignore her observations; it will be resolved then without intervention.
c. remind her to show her loyalty to the institution.
d. let the staff ventilate her feelings and ask how she can be of help.

44. She knows that performance appraisal consists of all the following activities EXCEPT:
a. Setting specific standards and activities for individual performance.
b. Using agency standards as a guide.
c. Determine areas of strength and weaknesses.
d. Focusing activity on the correction of identified behavior.

45. Which of the following statements is NOT true about performance appraisal?
a. Informing the staff about the specific impressions of their work help improve their performance.
b. A verbal appraisal is an acceptable substitute for a written report.
c. Patients are the best source of information regarding personnel appraisal.
d. The outcome of performance appraisal rests primarily with the staff.

46-60. SCHEDULING. You are a head nurse in a department of 13 members. 5 of which are senior nurses who will be in your help
in ensuring quality patient care. The remaining staffs are novice nurses who were still somewhat dependent on you and their
seniors. You as head nurse has a flexible schedule, it may be 6 am to 2pm or 8am to 4pm.Remember that in making staff
schedule, burnouts on staff should not be observed.
In another sheet of paper, create a one week schedule with a maximum of TWO day offs per staff. Each day should have at
least 3 nurses in AM, 3 nurses in PM and 3 nurses in NYT.

Request duty:

Senior nurse 1 OFF ON MONDAY AND AM ON SUNDAY

Senior nurse 2 OFF ON SUNDAY
Senior nurse 3 OFF ON TUESDAY AND AM ON THURSDAY
Senior nurse 4 PM ON MONDAY
Junior nurse 1 OFF ON WEDNESDAY
Junior nurse 2 NYT IN MONDAY
Junior nurse 3 OFF ON MONDAY
Junior nurse 4 OFF ON TUESDAY AND NYT ON WEDNESDAY
JUNIOR NURSE 5 OFF ON FRIDAY AND AM IN WEDENESDAY