Certified Ambulatory Surgery Nurse Practice Test

CNAMB test Format | Course Contents | Course Outline | test Syllabus | test Objectives

- Perioperative Patient Assessment and Diagnosis
- Informed consent or waivers
- surgical
- anesthesia
- blood
- photographs
- visitors

- Collect- analyze- and prioritize patient data
- vital signs
- pain assessment
- allergies
- lab values
- other medical conditions
- medical conditions for which they would need clearance
- previous relevant surgical management
- chart review
- NPO status
- family history of anesthesia problems

- Use age and sociocultural appropriate health assessment techniques to evaluate patient status
- interview
- observation
- communication barriers
- Conduct medication reconciliation
- preoperative meds
- home meds
- alternative/herbal meds
- medical marijuana
- alcohol use
- recreational drug use

- Conduct physical assessment
- skin integrity
- mobility
- body piercings
- implants/foreign objects
- Antibiotic stewardship
- Pain management
- ERAS
- multi-modal
- regional blocks

- Advance directives ( DNR- AND (Allow Natural Death) processes)
- Selection criteria
- BMI
- ASA
- sleep apnea
- infectious disease
- age

- Pre-surgery risk assessment
- medications
- previoussurgeries
- special needs
- comorbidities
- preop instructions

- Discharge needs
- home care
- durable medical equipment
- transportation
- care giver
- medications
- rehab
- Approved nursing diagnoses
- North American Nursing Diagnosis Administration [NANDA]
- Perioperative Nursing Data Set [PNDS]

- Preoperative Plan of Care
- Physiologic responses: Risk of infection
- Physiologic responses: Altered tissue perfusion
- Physiologic responses: Thermal regulation
- Behavioral responses

- Transcultural nursing theory
- cultural and ethnic influences
- family patterns
- spirituality and related practices
- Identify and plan for expected patient outcomes/postoperative needs
- responsible supervision
- transportation
- sleep apnea

- Community networking and institutional resources
- supplies
- equipment
- patient transfer agreements
- courierservice
- emergency services
- Conduct site preparation
- hair removal
- skin antisepsis
- Preoperative patient preparation
- IV
- removal of jewelry
- hair removal

- Intraoperative Care
- Optimize physiological responses of the patient
- Normothermia
- Infection prevention/control
- Perfusion
- Surgical procedure
- Wound healing
- Monitor and maintain patient and personnel safety
- Maintain the dignity- modesty- and privacy of the patient

- Utilize ergonomics and proper body mechanics in performing patient care.
- Chemical
- Fire
- Hazardous materials
- Radiation
- Smoke plume
- Energy generating devices
- Positioning
- Potential complications
- Patient/personnel safety
- Ergonomics/body mechanics

- Optimize patient care based on behavioral responses
- comfort
- anxiety
- pain management
- sociocultural and/or ethical issues
- Select procedure-specific protective materials and equipment
- lead aprons
- laser goggles
- smoke evacuators
- extinguishers

- Identify and control environment factors
- humidity
- noise
- temperature
- traffic
- Maintain a sterile field using aseptic technique
- Ensure the sterility of surgical products and instrumentation
- expiration date
- package integrity
- Aseptic technique
- Wound classifications

- Verify and document specimens with surgical team
- Prepare- label- and transport specimens
- Confirm- present- and prepare implants
- Prepare explants for final disposition
- Monitor and evaluate the effects of pharmacological and anesthetic agents
- Assist with anesthesia management
- induction
- airway protection
- extubation
- cricoid pressure

- Adhere to Universal Protocol
- time out
- WHO checklist
- National Patient Safety Goals (NPSGs)
- Manage patient hemodynamic needs
- fluid replacement
- Prepare- label- and administer moderate and local sedation/analgesia with appropriate monitoring
- capnography
- pulse oximeter

- Communicate patientstatus and changes to interdisciplinary healthcare providers
- Utilize effective communication for continuity of patient care
- hand-off
- debrief
- Methods and requirements for reporting to interdisciplinary healthcare providers
- critical lab values
- medical condition
- medications
- allergies
- implants/implantable devices
- read back orders

- Information technology
- software applications
- security
- HIPAA
- Barriersto communication
- patient
- family
- team
- chain of command

- Interdisciplinary services for care coordination
- nutrition
- wound care
- social work
- referrals
- transportation
- convalescent center
- physical therapy
- Evaluate patient status to facilitate transfer to the next level of care
- PACU
- home
- rehab facility
- hospital
- 23-hour observation

- Document patient care
- Provide and document post-discharge follow-up communication according to regulatory guidelines
- Assist with management of:
- airway
- pain
- hemodynamic monitoring
- Pain management
- ERAS
- multi-modal
- regional blocks

- Select appropriate methods and products for processing
cleaning
disinfecting
packaging
sterilizing
transportation
storage
- Cleaning products and techniques
- manual washing
- ultrasonic
- Packaging techniques
- crates
- peel packs
- wraps

- Transportation of equipment- instruments- and supplies
- Perform and document disinfection procedures
- high-level disinfection
- decontamination
- Handle and dispose of hazardous materials
- chemo drugs
- radioactive materials
- Handle and dispose of biohazard materials
- blood
- tissue

- Perform and document sterilization procedures including biological and chemical monitoring
- load parameters
- steam sterilization
- low- temperature sterilization
- Perform and document immediate use steam sterilization (IUSS)
- Quality assurance testing
- washer-disinfector
- sterilizer
- Perform nursing interventions based on age-specific needs
- Coordinate members of the interdisciplinary healthcare team during internal/external emergency situations

- Preparation for and management of medical emergencies:
- Malignant Hyperthermia (MH)
- Preparation for and management of medical emergencies:
- Anaphylaxis
- Cardiac arrest
- Hemorrhage
- Roles ofthe interdisciplinary healthcare team during internal/external emergency situations
- triage
- FEMA
- EMS
- community resources

- Preparations for and management of environmental hazards and natural disasters
- fire
- toxic fumes
- natural disasters
- terrorism
- power outage
- active shooter

- Acquire equipment- supplies- and personnel
- Coordinate and document preventive maintenance of equipment
- Monitor availability and sterility of supplies
- Perioperative resource management
- equipment
- supplies
- staffing
- Supervise- educate- and mentor healthcare team members
- Delegate perioperative tasks to appropriate personnel within their scope of practice

- Supervise non-OR personnel
- vendors
- students
- visitors
- family
- Adjunct roles- assigned staff- and responsibilities
- medication safety
- laser safety
- employee health
- Privacy officer
- Facility officer
- Risk manager
- infection prevention

- Role of non-perioperative personnel
- vendor
- students
- visitors
- family
- medical records
- admissions
- Scope of practice for the interdisciplinary team per regulatory agencies: Nurse Practice Act
- Monitor and assist with implementation of cost-containment measures
- Implement environmental sustainability practices
- reprocessing
- recycling
- Waste management
- reprocessing to include single-use devices
- supply standardization

- Ensure use of Personal Protective Equipment (PPE)
- Oversee environmental cleaning
- spills
- room turnover
- terminal cleaning
- physical plant
- Track biological implants
- order
- reconstitute
- storage
- use/waste
- Radiation safety
- dosimetry badges
- time
- distance
- shielding
- lead protection

- Protect patient confidentiality
- Advocate for and protect patients’ rights
- Report unanticipated events and good catches
- Perform functions within scope of practice
- Comply with regulatory and accreditation guidelines
- life safety
- Local
- state
- federal regulatory requirements
- FDA
- CDC
- CMS
- OSHA
- DEA

- Demonstrate competency in perioperative nursing practice
- Acknowledge personal bias and limitations and seek assistance as needed
- Utilize standards and recommended practices
- AORN
- APIC
- AAMI
- IAHCSSM
- ASPAN
- Demonstrate evidence-based practice
- hand hygiene
- safe injection practices
- surgical attire

- Accreditation standards and organization guidelines
- AORN Guidelines for Perioperative Nursing
- Perioperative
- Explications for the ANA Code of Ethics for:
- Nurses
- ASPAN
- APIC
- AAMI
- EBP
- Hand hygiene
- Safe injection practices
- Surgical attire

- Identify and take appropriate action regarding behaviors that undermine a culture ofsafety
- disruptive behavior
- Participate in professional development activities
- shared governance
- staff education
- committees
- certifications
- advanced degrees
- professional Organizations

- Risk management
- eventreporting
- good catch
- disclosure of unanticipated events
- recalls
- Safe Medical Device Act
- Quality improvement processes
- research
- data collection
- evidence-based practice
- performance improvement
- CMS quality measure
- reimbursements

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CCI Certified Ambulatory Surgery Nurse
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Question: 1531
You have noticed that the surgical team often lacks the necessary supplies during procedures, causing
delays. What strategy would be most effective in preventing this issue?
A. Implement a just-in-time ordering system for supplies
B. Increase the quantity of supplies ordered without analysis
C. Rely on verbal communication about supply needs during procedures
D. Regularly review and adjust the par levels based on usage patterns
Answer: D
Explanation: Regularly reviewing and adjusting the par levels based on usage patterns helps ensure that
the surgical team has the necessary supplies available, thus preventing delays and improving efficiency.
Question: 1532
During a surgical procedure, a team member fails to wear a required protective mask while handling
hazardous chemicals. What is the most appropriate action for the nurse to take in this situation?
A. Notify the team member after the procedure
B. Assume the team member is aware of the risks and do nothing
C. Document the incident for future reference
D. Immediately remind the team member to wear the mask
Answer: D
Explanation: Immediately reminding the team member to wear the mask ensures compliance with safety
protocols and protects everyone in the surgical environment from potential hazards.
Question: 1533
In the context of safe injection practices, which of the following statements is true regarding the use of
multi-dose vials?
A. Multi-dose vials can be used for multiple patients if they are kept in a sterile environment
B. Once opened, multi-dose vials must be discarded after 24 hours
C. Multi-dose vials can be shared among patients if labeled correctly
D. Multi-dose vials should be dedicated to a single patient whenever possible
Answer: D
Explanation: It is best practice to dedicate multi-dose vials to a single patient whenever possible to
reduce the risk of cross-contamination.
Question: 1534
Informed consent for anesthesia must include which of the following components to ensure that the
patient is fully informed?
A. The total cost of the anesthesia services
B. The names of the anesthesia team members
C. The location of the surgical procedure
D. The type of anesthesia to be used and its common side effects
Answer: D
Explanation: The informed consent for anesthesia should provide detailed information about the type of
anesthesia being administered, potential side effects, and risks, allowing the patient to make an informed
decision.
Question: 1535
During an audit of surgical procedures, a nurse discovers that some staff members are not adhering to the
established waste disposal protocols. What is the most effective action the nurse should take to address
this issue?
A. Conduct a mandatory retraining session on waste disposal
B. Report the non-compliance to management immediately
C. Implement a peer review system for waste management practices
D. Monitor compliance over the next few weeks before taking action
Answer: A
Explanation: Conducting a mandatory retraining session on waste disposal is the most effective way to
ensure all staff are aware of and adhere to proper protocols.
Question: 1536
What is the primary role of an ultrasonic cleaner in the surgical instrument processing workflow?
A. To prepare instruments for immediate use
B. To provide a final sterilization step
C. To store instruments safely
D. To facilitate the removal of organic material
Answer: D
Explanation: The ultrasonic cleaner is specifically designed to facilitate the removal of organic material
from instruments, making it an essential step in the cleaning process.
Question: 1537
During a community emergency response exercise involving terrorism, what is the most critical factor for
the surgical center to evaluate regarding its emergency plan?
A. The training level of staff in emergency response protocols
B. The availability of surgical supplies for mass casualties
C. The adequacy of communication systems with local law enforcement
D. The effectiveness of evacuation routes from the facility
Answer: C
Explanation: Evaluating the adequacy of communication systems with local law enforcement is critical
for ensuring coordination and effective response during a terrorism-related incident.
Question: 1538
A nurse is tasked with ensuring that the surgical team adheres to safety protocols for a procedure
involving hazardous materials. What is the most effective strategy for promoting compliance?
A. Wait for a safety incident to address protocol adherence
B. Document any non-compliance after the procedure
C. Assume that all team members know the protocols
D. Remind the team of the protocols at the start of the procedure and monitor adherence
Answer: D
Explanation: Reminding the team of the protocols at the start of the procedure and actively monitoring
adherence promotes compliance and enhances safety throughout the surgical process.
Question: 1539
Which of the following is a critical component of monitoring a patient who has received moderate
sedation, especially in relation to airway management?
A. Monitoring only the patient�s heart rate periodically
B. Ensuring the patient is placed in a supine position without any additional support
C. Regularly assessing the patient's level of consciousness and airway patency
D. Conducting a post-sedation assessment only after the procedure is complete
Answer: C
Explanation: Regular assessment of the patient's level of consciousness and airway patency is critical for
ensuring safety during and after moderate sedation.
Question: 1540
During the preoperative assessment, a nurse notes that a patient has a high body mass index (BMI).
Which physiological response should the nurse be most vigilant about to prevent complications during
surgery?
A. Risk of thermal instability
B. Impaired wound healing
C. Altered metabolic responses
D. Increased risk of venous thromboembolism
Answer: D
Explanation: Patients with a high BMI are at increased risk for venous thromboembolism due to reduced
mobility and potential alterations in hemodynamics during surgery.
Question: 1541
An ambulatory surgery unit is facing increases in supply costs. Which of the following actions would be
most effective in implementing supply standardization?
A. Reviewing and consolidating frequently used supplies across procedures
B. Allowing each surgeon to choose their preferred supplies
C. Purchasing supplies from multiple vendors for better pricing
D. Reducing the number of suppliers to streamline orders
Answer: A
Explanation: Reviewing and consolidating frequently used supplies across procedures can lead to more
efficient use and cost savings, while still meeting the needs of the surgical team.
Question: 1542
When analyzing performance improvement data, a nurse discovers an upward trend in medication errors.
What should be the first step taken to address this issue?
A. Implement additional training for nursing staff
B. Increase staffing levels to reduce workload
C. Review the medication administration process
D. Conduct a survey to understand staff perceptions
Answer: C
Explanation: Reviewing the medication administration process is essential to identify specific areas of
concern and develop targeted interventions to reduce medication errors.
Question: 1543
A patient recovering from surgery develops sudden onset chest pain and shortness of breath. As a nurse
assessing the situation, which immediate action should be taken?
A. Administer prescribed pain medication
B. Elevate the head of the bed and assess vital signs
C. Document the patient's symptoms in the chart
D. Notify the physician only if symptoms persist
Answer: B
Explanation: Elevating the head of the bed and assessing vital signs are critical initial actions to ensure
the patient's safety and evaluate the severity of their symptoms.
Question: 1544
In a preoperative assessment, a patient's response to stress is noted to be significant. Which intervention
can the nurse implement to support the patient's behavioral response most effectively?
A. Offer to reschedule the surgery for a later date
B. Provide the patient with a written outline of the procedure
C. Facilitate a meeting with a psychologist for preoperative counseling
D. Encourage the patient to express their feelings and concerns
Answer: D
Explanation: Encouraging open expression of feelings and concerns allows the patient to process their
anxiety and can lead to improved coping strategies.
Question: 1545
When assessing the readiness of a surgical team for an upcoming procedure, what key elements should
the supervising nurse evaluate to ensure optimal performance and patient safety?
A. Only the surgical instruments available for the procedure
B. Team members� previous experiences and personal preferences
C. The time allocated for the procedure based on previous cases
D. Communication protocols, equipment functionality, and personnel assignments
Answer: D
Explanation: Evaluating communication protocols, equipment functionality, and personnel assignments is
essential for ensuring optimal team performance and maintaining patient safety.
Question: 1546
During a surgical procedure, a nurse observes a colleague consistently interrupting the surgical team with
irrelevant comments, which distracts from patient care and compromises safety. What is the most
appropriate initial action for the nurse to take in addressing this disruptive behavior?
A. Discuss the behavior with the surgical team leader after the procedure
B. Confront the colleague in front of the surgical team to highlight the issue
C. Document the behavior in the incident report for future reference
D. Speak to the colleague privately to address the disruptive behavior
Answer: D
Explanation: Speaking privately to the colleague allows for a constructive dialogue without escalating the
situation publicly, fostering a culture of safety and teamwork.
Question: 1547
A nurse is conducting a preoperative assessment for an adult patient with cognitive impairment. What is
the most appropriate nursing intervention to ensure effective communication?
A. Use complex medical terminology to explain the procedure
B. Minimize interaction to avoid overwhelming the patient
C. Provide written materials in advanced medical language
D. Involve family members in the explanation of the surgical process
Answer: D
Explanation: Involving family members can help facilitate understanding and provide support for the
patient with cognitive impairment during the preoperative process.
Question: 1548
In the intraoperative phase, the nurse is responsible for monitoring the patient�s response to the
anesthetic. Which of the following signs would indicate a potential adverse reaction to the anesthetic
agent?
A. Increased heart rate and elevated blood pressure
B. The patient remains calm and responsive
C. Decreased respiratory rate and shallow breathing
D. Fluctuations in oxygen saturation levels
Answer: C
Explanation: Decreased respiratory rate and shallow breathing are critical signs of an adverse reaction to
anesthetic agents, necessitating immediate intervention.
Question: 1549
Which of the following statements best describes the importance of utilizing a debriefing process after a
complex surgical procedure?
A. It provides an opportunity to review the surgical outcomes and identify areas for improvement in
patient care
B. It allows the surgical team to discuss personal performance and individual contributions
C. It serves as a form of documentation for administrative purposes
D. It is primarily focused on addressing any patient complaints or feedback
Answer: A
Explanation: The debriefing process provides an opportunity to review surgical outcomes and identify
areas for improvement, which is essential for enhancing patient safety and care quality in future
procedures.
Question: 1550
In preparing a 50-year-old patient for surgery, the surgical team reviews his lab values. Which specific
lab finding would most likely indicate a need for further evaluation before proceeding with the surgery?
A. Mildly elevated creatinine level
B. Normal blood glucose levels
C. Elevated white blood cell count
D. Electrolyte levels within normal range
Answer: A
Explanation: A mildly elevated creatinine level may indicate renal impairment, which requires further
evaluation to assess the patient�s ability to handle anesthesia and medication clearance, thus impacting
surgical safety.
Question: 1551
During surgery, which physiological response should be prioritized to optimize patient outcomes?
A. Maintaining stable body temperature
B. Hyperglycemia management
C. Monitoring intraoperative pain levels
D. Continuous sedation assessment
Answer: A
Explanation: Maintaining stable body temperature is crucial during surgery as it affects metabolic rates,
coagulation, and overall recovery outcomes.
Question: 1552
Which action should a nurse take to effectively advocate for a patient's right to participate in their own
care decisions?
A. Provide them with a list of treatment options without explanations
B. Assume the patient agrees with the medical team's recommendations
C. Make decisions on their behalf to expedite care
D. Encourage them to ask questions and express their preferences regarding treatment
Answer: D
Explanation: Encouraging patients to ask questions and express their preferences fosters their right to
participate in their own care decisions, aligning with principles of patient-centered care.
Question: 1553
During a routine inspection, a nurse notices that the sterilization indicators on a batch of wrapped surgical
instruments did not change color. What is the most appropriate action for the nurse to take?
A. Use the instruments anyway, as they look clean
B. Check if the indicators were placed correctly
C. Document the findings and report to the supervisor
D. Reprocess the instruments in a new batch
Answer: D
Explanation: Instruments that fail to show proper sterilization indicators must be reprocessed to ensure
patient safety, as they may not be sterile.
Question: 1554
During a departmental meeting, a nurse expresses concern about a colleague�s disruptive behavior that
has been affecting team dynamics. What is the best approach for the nurse to advocate for a culture of
safety in this situation?
A. Present specific examples of the behavior and its impact on team performance.
B. Request that management take disciplinary action against the colleague.
C. Suggest that the colleague be placed on probation to prevent future issues.
D. Encourage the team to tolerate the behavior to maintain harmony.
Answer: A
Explanation: Providing specific examples allows for a constructive discussion on how the behavior
affects the team, fostering an environment focused on safety.
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