Surgical 1st Inc. Annual Competency Placement Tests
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Conscious Sedation/Moderate Analgesia/Sedation Competency
**Please select the appropriate answer for each question**
1. Patients receiving sedation:
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a. Do not need to be NPO
b. Should he NPO 2 hours before the procedure
c. Should be NPO 6-8 hours prior to the procedure, except for clear liquids 2-3hours prior to the procedure
2. Patients receiving sedation:
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a. Need to have a responsible adult with them to drive them home
b. Can drive themselves home
c. Can take public transportation home
3. The use of analgesics in combination with benzodiazepines:
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a. Has no effect on the patient’s respiratory status
b. Can lead to increased respiration
c. Can lead to severe respiratory depression
4. The antagonist for narcotics is:
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a. Flumazenil (Romazicon) 0.2mg
b. Naloxone (Narcan) 0.1-0.2mg at 2-3 minute intervals
c. Naloxone (Narcan) 02mg over 30 minutes
5. The antagonist for benzodiazepines is:
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a. Flumazenil (Romazicon) 0.2mg over 15 seconds
b. Naloxone (Narcan) 0.1-0.2mg at 2-3 minute intervals
c. Flumazenil (Romazicon) 0.2mg over 30 minutes
Electrosurgery/Fire Safety in OR Competency
1. The best placement of the return electrode is:
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a. over scar tissue
b. as close to the operative site as possible
c. near an implanted pacemaker
2. The ESU foot pedal is controlled by the scrub person:
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a. True
b. False
3. When the patient is repositioned during surgery, the patient return electrode is inspected for integrity and position:
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a. True
b. False
4. It is not necessary to allow alcohol based products to dry before draping thepatient:
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a. True
b. False
5. Areas to avoid for placement of the patient return electrode are:
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a. bony prominences
b. scar tissue
c. metal implants
d. pacemaker
e. all of the above
Infection Prevention Competency
1. Boiling is a method of sterilization:
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a. True
b. False
2. Items such as pickups, forceps suture needles and surgical scrub brushes should not be left soaking in antiseptic or disinfectant solution.
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a. True
b. False
3. Hands should always be washed after removing gloves.
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a. True
b. False
4. To reduce contamination, limit the number of people permitted in the OR and processing rooms.
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a. True
b. False
5.If instruments will be sterilized or high-level disinfected, cleaning with detergent and water is not necessary.
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a. True
b. False
6. Housekeeping staff should wear utility gloves when cleaning OR’s and procedure rooms.
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a. True
b. False
7. Proper storage of instruments and other items is as important as careful sterilization or high-level disinfection.
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a. True
b. False
8. Hepatitis B can be transmitted to a health care worker through splashes of blood or other body fluids onto unbroken skin.
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a. True
b. False
9. Transmission of bloodborne infections from infected health care workers to their clients is a common problem.
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a. True
b. False
10. Sterilization is preferred over high level disinfection For items that will come in contact with the bloodstream and tissues under the skin.
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a. True
b. False
11. Single use exam gloves are not acceptable for use during pelvic exams.
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a. True
b. False
12. Most surgical site infections occur from contamination of the wound after the client leaves the health care facility
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a. True
b. False
13. Housekeeping equipment such as mops, brushes, sponges, and buckets do not need to be decontaminated and cleaned since those items used with a disinfectant cleaning solution.
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a. True
b. False
14. Proper infection prevention practices are important for:
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a. Preventing infections in service providers and other staff
b. Preventing surgical site infections, abscesses and pelvic inflammatory disease in clients.
c. Protecting the community from infections that originate in health care facilities.
d. All of the above.
15. Decontaminating instruments and other items in a 0.5% chlorine solution:
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a. Reduces the risk of infections in facility staff by killing HIV and hepatitis viruses.
b. Should be done after cleaning if the items are very bloody
c. Allows instruments and other items to be reused immediately.
d. None of the above.
16. Handwashing:
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a. Decreases client sickness and death.
b. Is usually performed correctly and when appropriate in most health facilities.
c. Is not necessary if the hands appear to be clean.
d. All of the above.
17. To reduce the risk of infection and injury:
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a. Recap all hypodermic needles immediately after use by holding the needle still in one hand and carefully placing the cap over the needle with the other hand.
b. When passing sharps, transfer the sharp from your hand to the other person’s hand.
c. Dispose of sharp objects along with medical waste, such as used bandages and gauze.
d. None of the above.
18. Housekeeping staff are at risk of infections:
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a. When cleaning administrative offices and other non-client areas.
b.When disposing of medical waste.
c. When mixing a disinfectant cleaning solution.
d. These staff are not at risk of infections if they are not directly involved in client care activities.
19. Which of the following are appropriate infection prevention practices?
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a. Changing the needle, but not the syringe, between injections.
b. Leaving a hypodermic needle inserted through the stopper of a multidose vial
c. Using a new needle and syringe to draw up medication from a multidose vial.
d. All of the above.
20. HIV can be transmitted by all of the following except:
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a. Insect bites
b. Unprotected vaginal intercourse
c. Breastfeeding
d. Blood transfusion
e. Use of contaminated syringes
21. Which of the following will likely cause contamination:
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a. Leaving gauze sponges soaking in antiseptic.
b. Pressing the cotton to the lip of the antiseptic container and inverting it.
c. Dipping cotton into the main antiseptic container
d. All of the above.
22. Which statement about surgical attire is correct:
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a. If shoe covers are not available, staff may walk around the OR with bare feet.
b. Caps and masks worn in the OR should be sterile.
c. Sterile surgical gloves should be considered contaminated if the gloved hands drop below the level of the waist.
d. When removing surgical gloves, always remove the first glove completely and then remove the second glove with your bare hand.
23. Which of the following are considered medical waste?
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a. Outdated client records
b. Used bandages
c. Trash from the breakroom
d. Unused condoms
e. None of the above
Informed Consent Competency
1. May facility personnel witness a patient’ signature on the consent form?
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a. Yes
b. No
2. The Informed Consent is valid for how many days?
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a. 1 day
b. 30 days
c. 60 days
d.90 days
3. Who maintains sole responsibility for ensuring that informed consent is obtained inaccordance with federal and state law and other applicable rules and regulations ineffect at the time informed consent is obtained?
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a. Nurse
b. Anesthesia Provider
c. Physican
d. Family members
4. What is one exception to obtaining Informed Consent?
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a. Physician forgot
b. Emergency
c. Patient refused to sign
d. Patient unable to read
5. Which of these individuals is NOT authorized to give consent?
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a. Parent for their child
b. Husband for his wife
c. Nurse for her patient
Life Safety/MSDS/HIPPA/Infection Control/Bloodborne Pathogens/ Universal Precautions Competency
1. Electrical safety can be increased by:
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a. pulling on cord to unplug from wall
b. stabilizing power cords under wheels of the bed
c. removing equipment that have frayed cords from use
d. removing the third prong from the plug
2. The acronym R-A-C-E stands for:
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a. Run, alert, careful, escape
b. Run, alarm, chase, extinguish
c. Rescue alarm, confine, extinguish
d. Rescue, away, confirm, evaluate
3. MSDS stands for:
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a. Metric Standard Dose Sheet
b. Medical Safety Data Sheet
c. Material Safety Data Sheet
4. The MSDS provides valuable information about hazardous material like:
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a. first aid treatment for exposures
b. manufacturer’s name and phone number
c. how to dispose of the chemical
d. personal protective equipment needed to handle the chemical
e. all of the above
5. When using a fire extinguisher:
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a. aim the extinguisher at the top of the flame
b. aim the extinguisher at the middle of the flame
c. aim the extinguisher at the bottom of the flame
6. Universal Precautions refers to:
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a. ensure patient avoids falls
b. ensure you use proper body mechanics
c. treating all blood/body fluids as if they are contaminated
7. It is appropriate to wear goggles anytime there is a risk that your eyes might be exposed to splashing contaminated fluids.
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a. True
b. False
8. HIPAA stands for Health Insurance Portability and Accountability Act
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a. True
b. False
9. The following healthcare providers need to comply with HIPAA
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a. Nurses
b. Physicians
c. Medical Assistant
d. All of the above
10. The best way to avoid infections is good handwashing skills
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a.True
b. False
Patient Abuse and Neglect Competency
1. It is the responsibility of every healthcare worker to report abuse and neglect
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a.True
b. False
2. Signs of adult abuse/neglect may include which of the following:
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a. Injury not consistent with explanation and/or injury not cared for
b. Cuts, wounds, bruises and whelps
c. Poor personal hygiene
d. Overly medicated or sedated
e. Withheld food, clothing not appropriate for weather
f. Soiled clothing/bedding
g. Fear, anxiety, agitation, anger
h. Withdrawn, depressed
i. Hesitation to talk openly
j. Contradictory statements or stories
k. All of the above
3. Elder abuse can occur in families regardless of income
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a.True
b. False
4. Two thirds of elder abuse occurs by family members
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a.True
b. False
5. Report signs of neglect/abuse to physician or direct supervisor
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a.True
b. False
Pediatric Competency
1. Which of the following is correct?
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a.Children and adults are equally likely to have cardiac arrest.
b. Children and adults are equally likely to have respiratory distress.
c. Adults are more likely to have respiratory distress.
d. Children are more likely to have respiratory distress.
2. Respiratory distress or failure can be classified into one or more of thefollowing types:
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a. Upper airway obstruction, lower airway obstruction, asthma, disorderedcontrol of breathing.
b. Upper airway obstruction, lower airway obstruction, lung tissue disease,disordered control of breathing.
c. Lung tissue disease, COPD, wheezing, lower airway obstruction.
d. Disordered control of breathing, upper airway obstruction, lower airway obstruction, tachypnea.
3. Shock is always related to blood loss.
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a.True
b. False
4. Signs of anaphylactic shock include:
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a. Anxiety, urticaria, tachycardia
b. N&V, hypertension
c. Hemorrhage, hypoglycemia, tachycardia
d. CHF, N&V, oliguria
5. What is the correct medication/dose for treatment of bradycardia?
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a. Diphenhydramine 25mg IV
b. Epinephrine 0.01mg/kg of 1:10 000 concentration
c. Epinephrine 0.1mg/kg of 1:10 000 concentration
d. Atropine 1mg/kg
6. Which is NOT used for the treatment of VT/SVT?
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a. Adenosine 0.1mg/kg IV
b. Vagal maneuvers
c. Pacing
d. Synchronized cardioversion
7. Children above 10 years old should be able to use the “Faces” Pain assessment tool.
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a.True
b. False
Quality and Culture Competency
1. Cross-cultural misunderstandings between providers and patients can lead to mistrust and frustration, but are unlikely to have an impact on objectively measure clinical outcomes.
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a.True
b. False
2. When the patient and provider come from different cultural backgrounds, the medical history obtained may not be accurate.
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a.True
b. False
3. When a provider expects that a patient will understand a condition and follow a regimen, the patient is more likely to do so than if the provider has doubts about the patient.
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a.True
b. False
4. A really conscientious health provider can eliminate his or her own prejudices or negative assumptions about certain types of patients.
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a.True
b. False
5. When taking a medical history from a patient with a limited ability to speak English, which of the following is LEAST useful?
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a. Asking questions that require a patient to give a simple “yes” or “no” answer, such as “Do you have trouble breathing?” or “Does your knee hurt?”
b. Encouraging the patient to give a description of his/her medical situation, and beliefs about health and illness.
c. Asking the patient whether he/she would like to have a qualified interpreter for the medical visit
d. Asking the patient questions such as “How has your condition changed over the past 2 days?” or “What makes your condition get better or worse?”
6. During a medical interview with a patient from a different cultural background, which is the LEAST usefultechnique?
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a.Asking questions about what the patient believes about his/her illness-what caused the illness, how severe it is, and what type of treatment is needed.
b. Gently explaining which beliefs about the illness are not correct.
c. Explain the “Western” or “American” beliefs about the patient’s illness.
d. Discussing differences in beliefs without being judgmental.
7. When a patient is not adhering to a prescribed treatment after several visits, which of the following approaches is NOT likely to lead to adherence?
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a.Involving family members.
b. Repeating the instructions very loudly and several times to emphasize the importance of the treatment.
c. Agreeing to a compromise in the timing or amount of treatment
d. Spending time listening to discussions of folk or alternative remedies.
8. When a patient who has not adhered to a treatment regimen states that she/he cannot afford themedications prescribed, it is appropriate to assume that financial factors are indeed the real reasons andnot explore the situation further.
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a.True
b. False
9. Which of the following are the correct ways to communicate with a patient through a interpreter?
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a. Making eye contact with the interpreter when you are speaking, then looking at the patient while the interpreter is telling the patient what you said.
b. Speaking slowly, pausing between words.
c. Asking the interpreter to further explain the patient’s statement in order to get a more complete picture of the patient’s condition.
d. None of the above.
10. If a family member speaks English as well as the patient’s native language, and is willing to act as interpreter, this is the best possible solution to the problem of interpreting.
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a.True
b. False
11. Which of the following statements is TRUE?
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a. People who speak the same language have the same culture.
b. The people living on the African continent share the same main features of African culture.
c. Cultural background, diet, religious, and health practices, as well as language, can differ widely within a given country or part of a country.
d. An alert provider can usually predict a patient’s health behaviors by knowing what country she/he comes from.
12. Which of the following statements is NOT TRUE?
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a. Friendly (non-sexual) physical contact is an important part of communication for many Latin American people.
b. Many Asian people think it is disrespectful to ask questions of a health provider.
c. Most African people are either Christian or follow a traditional religion.
d. Eastern Europeans are highly diverse in terms of customs, language and religion.
13. Which of the following statement is NOT TRUE?
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a. The incidence of complications of diabetes, including lower-limb amputations and end-stage renal disease, among the African American population is double that of European Americans.
b. Japanese men who migrate to the US retain their low susceptibility to coronary heart disease.
c. Hispanic women have a lower incidence of breast cancer than the majority population.
d. Some Native American/American Indians and Pacific Islanders have the highest rate of type II diabetes mellitus in the world.
14. Because Hispanics have a lower incidence of certain cancers than the majority of the US population, their mortality rate from these diseases is correspondingly lower.
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a.True
b. False
15. Minority and immigrant patients in the US who go to traditional healers and use traditional medicines generally avoid conventional Western treatments.
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a.True
b. False
16. Providers whose patients are mostly European-American, US born, and middle class still need to know about health practices from different world cultures.
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a.True
b. False
17. Which of the following is good advice for a provider attempting to use and interpret non-verbal communication?
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a. The provider should recognize that a smile may express unhappiness or dissatisfaction in some cultures.
b. To express sympathy, a health care provider can lightly touch a patient’s arm or pat the patient on the back.
c. If a patient will not make eye contact with a health care provider, it is likely that the patient is hiding the truth.
d. When there is a language barrier, the provider can use hand gestures to bridge the gap.
18. Some symbols-a positive nod of the head, a pointing finger, a “thumbs-up” sign are universal and can help bridge the gap.
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a.True
b. False
19. Out of respect for a patient’s privacy, the provider should always begin a relationship by seeing an adultpatient alone and drawing the family in as needed.
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a.True
b. False
20. In some cultures, it may be appropriate for female relatives to ask the husband of a pregnant woman tosign consent forms or to explain t him the suggested treatment options of the patient agrees and this islegally permissible.
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a.True
b. False
21. Which of the following is NOT TRUE of an organization that values cultural competence?
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a.The organization employs or has access to professional interpreters that speak all or at least most of the languages of its clients.
b. The organization posts signs in different languages and has patient education materials in different languages.
c. The organization tries to hire staff that mirror the ethnic and cultural mix of its clients.
The organization assumes that professional medical staff do not need to be reminded to treat all patients with respect.
22. A female Muslim patient may avoid eye contact and/or physical contact because:
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a. She doesn’t want to spread germs.
b. Muslim women are taught to be submissive.
c. Modesty is very important in Islamic tradition
d. She doesn’t like the provider.
23. Which of the following statements is NOT TRUE:
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a. Diet is an important part of both Islam and Hinduism
b. North African countries have health care systems that suffer because of political problems.
c. Arab people have not historically had an impact on the medical field.
Safety Competency
1. Your safety is ultimately the company's responsibility?
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a.True
b. False
2. an employee's injury impacts:
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a. the company
b. the injured employee
c. the injured employee's family
d. All of the above
3. working safely involves:
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a. following only those company policies & procedures you like
b. wearing only PPE that is comfortable
c. attending safety training when you feel like it
d. Looking our for the safety of co-workers as well as yourself
e. none of the above
4. it is very important to report to work on time and rested
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a.True
b. False
5. only operate a piece of equipment if you have been properly trained & authorized
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a.True
b. False
6. Employees potentially exposed to bloodborne pathogens must:
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a. receive appropriate training
b. be offered the hepatitis B vaccine series at no cost
c. wear necessary PPE
d. All of the above
7. If you come in contact with blood or other potentially infectious body fluids, you should notify your supervisor immediately
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a.True
b. False
8. Treat all blood & body fluids as potentially infectious
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a.True
b. False
9. Areas of the body that come in contact with blood or other potentially infectious body fluids should be wiped off with a dry towel
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a.True
b. False
10. Which of the following are types of PPE?
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a.safety glasses
b. gloves
c. gown
d. respirator
e. All of the above
11. In the event of a tornado or hurricane you should immediately exit the building and go to your designated assembly area
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a.True
b. False
12. Identify the types of fire extinguishers located in our facility:
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a.Type A- used for combustible materials such as cloth, wood, rubber, paper, and many plastics
b. Type B- used on fires involving flammable liquids, such as grease, gasoline, oil, and oil based paints.
c. Type C - used on fires involving appliances, tools, or other equipment that is electrically energized or plugged in.
d. a combination of type A, B, & C
Radiation Competency
1. It is the Center's discretion as to whether the walls in the OR are lined with lead.
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a.True
b. False
2. Individuals have the discretion of whether to wear protective aprons/thyroid shields/x-ray badge.
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a.True
b. False
3. It is not necessary to protect the patient during x-ray exposure.
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a.True
b. False
4. Instruments in the surgical field do not affect the quality of the image
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a.True
b. False
5. How is exposure monitored on employees?
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1. There's a monitor on the C-arm that measures exposure
2. X-ray badge
3. The lead aprons have a monitor for exposure
6. If you cannot wear a lead apron, how can you avoid exposure? 1. stand behind someone wearing an apron 2. stand behind the C-arm 3. leave the room during exposure 4. move as far away in the room from the C-arm as possible
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a. 1,2,3
b. 1,3,4
c. 2,3,4
Time Out, Patient Verification Competency
1. Prior to performing surgical procedures, a standardized approach is used to identifypatients, verify and document correct procedure, side and site.
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a.True
b. False
2. Verification and Time Out include all of the following EXCEPT
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a. Two patient identifiers
b. Procedure as listed on informed consent
c. Correct site/side is marked
d. Requested implants, special equipment, instruments and imaging studies are available.
e. Correct patient position
f. Correct anesthesia
3. Time Out includes patient, physician, nurse anesthetist, RN and MA/Scrub Tech inOR room or before any procedure.
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a.True
b. False
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