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Examination: Outpatient Laparoscopic Nissen Fundoplication
MAY 2002, VOL 7 5 , NO 5
Examination OUTPATIENT LAPAROSCOPIC NISSEN FUNDOPLICATION
a. an area of circular muscle fibers at the levcl of the diaphragm that relax to admit ingesta. b. a band of circular fibers around the lower end of the coininon bile duct. c. a double set of circular smooth bowel muscles at the opening of the anus. d. a group of circular fibers arranged i n a narrow band that constrict the dilation pupillae.
1.One or more of the following lines of defense fail, allowing noxious content of the stomach to have increased contact time with the esophagus, except a. allowing hydrogen ions to enter the cells o f t h e esophagus. b. butfering of gastrointestinal (GI) fluid content. c. mechanical barrier from the stomach. d. peristalsis of the esophagus.
7.The stomach consists of the a. LES, splenic flexure, and crura. b. gastric flexure, body, and antrum. c. fiindus, body, and antrum. d. antrum, LES, and crura.
2. Swallowed saliva and esophageal bicarbonate secretions buffer the normally acidic GI fluids to a pH a. greater than two. b. less than six. c. greater than four. d. less than eight.
8.The
has surgical landmark value but plays no significant part in the disease process. a. pancreas b. caudate lobe of the liver c. diaphragm d. duodenum
3.Over time, acute and chronic inflammation occurs after multiple recurrent retlux events, leading to a. decreased motility and possibly gastroesophageal retlux. b. gastroesophageal retlux and possibly esophageal stricture formation. c. hemorrhagic gastritis and possibly esophageal stricture fortnation. d. GI obstruction and possibly hemorrhagic gastritis.
9. Patients who suffer from typical symptoms ol' gastroesophageal retlux disease (GERD) complain about a. d y sp hag i a, od y n o p hag i a, hem at em es i s or inelena. b. retlux asthma, hoarseness, pharyngitis, or pyrosis. c. chronic halitosis and reflux asthma caused by gastric contents being aspirated in the airway. d. heartburn and retlux of gastric contents into the esophagus when bending over or lying down.
.
4.What organs initially are responsible for food digestion and bodily nourishment'? a. stomach, colon. liver, and small intestine b. mouth, pancreas, colon, and pharynx c. stomach, sinall intestines, liver, and pancreas d. mouth, pharynx, esophagus, and stomach
5.
10.Noninvasive medical treatment includes all ofthe following except a. weight loss and dietary changes. b. increased physical exercise. c. medications. d. bed rest.
&The lower esophageal sphincter (LES) is
11.Substances known to decrease lower esophageal
and of solids and liquids start the digestive process. a. Hydrolysishnastication b. Masticationieniulsitication c. Hydrolysisiemulsification d. Masticatiodcatalysis
980 AORN JOURNAL
MAY 2002, VOL 15, NO 5
d. greater than 40 mm Hg.
sphincter pressure (LESP) that should be avoided in patients with GERD include a. tobacco, caffeine, nuts, and mint. b. calcium, alcohol, tobacco, and chocolate. c. nuts, alcohol, mint. and calcium. d. alcohol. chocolate, mint, and tobacco.
18.Atypical GERD symptoms include all of the following except a. regurgitation. b. nonobstructional dysphagia. c, aspiration-induced asthma. d. dental decay.
1 2 0 p e n antiretlux procedures were not perfomied on a regular basis for all of the following reasons except a. increased morbidity and mortality. b. long postoperative hospital stay. c. collateral organ damage. d. high failure rate.
19.The most accurate gauge ofacid being present in the esophageal Iunlen is a a. manometry study. b. upper gastrointestinal study. c. esophagogastroduodenoscopy. d. 24-hour pH monitoring examination.
13.The incidence of recurrent heartburn after laparoscopic Nissen fiindoplication is and does not appear to be clinically significant. a. less than 2% b. approximately 5% c. less than 10% d. approximately 12%
#).Evidence suggests unequivocally that acid retlux is present if acid remains in the esophagus of the time. a. less than 4% b. 4% to 7% c. 8% to 12% d. 10% to 15'%
14.A manometry study is indicated to rule out a. abnormal inotility. b. carcinoma. c. ulcerations. d. strictures.
21.A type
hiatal hernia exists if the gastroesophageal junction and a portion o f t h e stomach protrude into the mediastinum. a. one b. two c. three d. four
15.An open Nissen fiindoplication procedure primarily is indicated for a. Barrett's esophagus or unsuccessful medication treatment. b. complex esophageal processes or Barrett's esophagus. c. esophageal strictures or desire not to take medications long term. d. complex esophageal processes or inability to pay for long-term medication treatment.
=Sliding of the hernia is stress dependent and varies in severity depending on the volume present in the stomach. a. true b. false =Patients older than age 40 must undergo the tollowing preoperative examinations: a. electrocardiogram (EKG), urinalysis. and chest x-ray. b. complete blood count (CBC), EKG, and chest x-ray. c. EKG, CBC, and electrolyte profile. d. electrolyte profile, chest x-ray, and treadmill.
16.
also can be monitored during a manometry study. a. Thoracic aorta abnormalities b. Esophageal diverticuli c. Intra-abdominal pressure changes d. Intrathoracic pressure changes
17.Patients who suffer from GERD have an LESP a. between 5 mni Hg and 15 nim Hg. b. less than 10 mni Hg. c. between 10 mni Hg and 45 mm Hg.
=The anesthesia classification for patients undergoing outpatient surgery should not exceed American Society of Anesthesiology class a. I 981
AORN JOURNAL
MAY 2002, VOL 75,NO 5
b. I1 Irr d. IV
30.Which of the following interim outcomc criteria would be applicable for the nursing diagnosis “Acute pain related to tissue trauma secondary to surgical procedure‘?’’ a. Patient’s vital signs and oxygen saturation levels remain within expected values. b. Patient will consume an adequate amount of fluids and nutrients to meet the basal inetabolic needs of the postoperative period. c. Patient will maintain body weight or lose no more than 20 Ibs afier surgery. d. Patient does not demonstrate nonverbal pain behaviors.
C.
25.Droperidol is administered preoperatively to a. prevent or reduce postoperative nausea and vomiting (N&V). b. induce relaxation and drowsiness. c. decrease secretions and block cardiac vagal reflexes. d. produce sedation. 26.0ndansetron hydrochloride is administered postoperatively a. to reverse neuromiiscular blockers. b. to prevent hypotension. c. to treat short-term acute pain. d. to prevent N&V. =.The minor instrument set is placed on the back table to be used a. during the procedure for retraction. b. at the end of the procedure for wound closure. c. during the procedure for dissection. d. at the beginning of the procedure for trocar placement. =All of the following interventions are applicable to decrease the risk of infection for the patient undergoing laparoscopic Nissen fundoplication except a. assesses renal status (eg, renal function studies, urinalysis, health history) preoperatively. b. ensures that the patient is well hydrated with parenteral fluids. c. inspects the wound during wound closure. d. washes the wound and surrounding area to ensure that preoperative prep solution and blood are removed. =.Which of the following nursing diagnoses would be applicable for the patient undergoing laparoscopic Nissen fundoplication? a. Risk for activity intolerance related to intraoperative positioning. b. Risk for ineffective breathing patterns related to hypothennia. c. Risk of iinbalanced nutrition related to inability to ingest food. d. Risk for sleep patteiii disturbances related to gastroesophageal reflux.
31.The RN first assistant (RNFA) at the surgery center is responsible for all of the following tasks except a. accompanying the patient to the postanesthesia care unit and writing discharge orders. b. providing preoperative and postoperative patient education. c. operating the camera intraoperatively. d. using the nonlocking bowel grasper to retract and create counter traction. =After placing the patient in the low lithotoiny position, the nurse carefully abducts the patient’s legs and a. ensures that the patient’s femerol, obturator, and sciatic nerves are not injured. b. externally rotates the patient’s legs for improved perineal exposure. c. inserts an indwelling urinary catheter. d. pads the sacrum to prevent sacral injury. =Preemptive anesthesia refers to a. the surgeon injecting local anesthcsia in the preoperative admitting area. b. the anesthesia care provider assessing the patient in the preoperative area. c. the anesthesia care provider ordering sedation to be administered preoperatively. d. the surgeon injecting local anesthesia into the incisional sites before making the initial incision. =Why is the OR bed repositioned to reverse Trendelenburg’s during the procedure? a. to allow the scrub person adequate room to stand between the patient’s legs b. to treat concurrent hypotension experienced
982 AOIIN J O U R N A L
MAY 2002, VOL 75, NO 5
to six weeks.
with retraction o f t h e peritoneal wall c. to allow the RNFA adequate room to stand between the patient’s legs d. to increase the visual field by allowing gravity to assist in retraction =.How does the surgeon minimize potential bleeding when passing thc stomach posterior to the esophagus to create the fundus wrap‘! a. by injecting lidocaine with epinephrine locally as a hemostatic agent b. by separating the right crus muscle from the esophagus to develop an avascular plain c. by applying gelatin sponge or cellulose gauze topically to attain hemostasis d. by using 0 absorbable endoscopic stitches as necessary to make the area avascular =The patient is not required to void before being discharged from the surgery center. a. true b. M s e 37.All of the following are postoperative dietary instructions following laparoscopic Nissen h n doplication except a. remain on a liquid diet for five days. b. do not consiime carbonated beverages. c. advance from sott to full diet during the next two to four weeks. d. advance from soft to fiill diet during next five AORN, Association of perioperative Registered Nurses, is accredited as a provider of continuing education in nursing by the American Nurses Credentialing Center’s (ANCCs) Commission on Accreditation AORN recognizes this activity as continuing education for registered nurses. This recognition does not imply that AORN or the ANCCs Comniission on Accreditation approves or endorses any product included in the activity AORN maintains the foilowing state board of nursing provider numbers: Alabama ABNP0075, California CfPI3019, and Florida FBN 2296. Check
=Shoulder pain is common after undergoing laparoscopic abdominal surgery, so the RNFA instructs the patient to a. take antitlatulant medications routinely every four to six hours for 48 hours. b. lie on the affected side with a pillow under the hip, which allows the gas to move from the diaphragm to the pelvic area. c. take antiflatulant medications as needed every two to four hours for 48 hours. d. remain on bed rest for 24 hours.
3 9 . A long-tenn, follow-up visit is scheduled for six months later for all of the following reasons except to a. ensure that there are no problems with excessive weight gain. b. ensure that there are no problems with swallowing dif’ficulties. c. ensure that there are no problems with excessive weight loss. d. assess nutritional status. 40.In the case study, the patient desired medical treatment before surgery so the surgeon prescribed a. pancreatic enzymes. b. nonsteroidal anti-inflammatory medication. c. proton pump inhibitor medication. d. analgesics and antipyretics. with your state board of nursing for acceptability of education activi/y for relicensure. Professional nurses are invited to submit manuscripts for the Home Study Program Manuscripts or queries should be sent to Editoc AORN Journal, 2 I70 S Parker Rd, Suite 300, Denver, CO 8023 I 57 I I As with all manuscripts sent to the Journal, papers submitted for Home Study Pragrams should not have been previouslypubIished or submitted simultaneously to any other publication
983 AORN JOURNAL
MAY 2002, VOL. 7 5 , NO 5
Answer Sheet OUTPATIENT LAPAROSCOPIC NISSEN FUNDOPLICATION
P ~
lease fill out the application and answer fonn on this page and the evaluation fom1 on the back of this page Tear the page out of the Joiir-nd or make photocopies and mail to AORN Customer Service c/o Home Study Program 2 170 S Parker Rd, Suite 300 Denver, CO 8023 1-57 1 1 or fax with credit card information to (303) 750-32 I2
ID Number
:I
00000000000000000000 0000000080
A score of 70% correct is required for credit.
Session Number
Session ## 6481 Event # 02083 Contact hours: 3 Fee: Members $15; Nonmembers $30 Program offered May 2002. The deadline for this program is May 3 I , 2005. I . Record your six-digit member identification nuinber in the appropriate section below (see your meinher card). 2. Completely darken the space that indicates your answer to the examination starting with question one. Use blue or black ink. 3. fiecord the time required to complete the program
Mark only one answer per question.
4. Enclose fee if infomiation is mailed. AORN (ID) ## Name Address City State RN license ## State Phone number (
M
0000000000~
O0OO000OOOm
Zip
Fee enclosed or bill the credit card indicated P MC IIIVisa n Am Express LI Discover Card # Expiration date Signature (Ihr C I C ~ I I c;wd iiiillioiii.~li~)ii~
985 AOKN IOURNAL
MAY 2002, VOL 75, NO 5
Learner Evaluation OUTPATIENT LAPAROSCOPIC NISSEN FUNDOPLICATION
The following evaluation is used to determine the extent to which this Home Study Program met your learning needs. Rate the following items on a scale of 1 to 5. OBJECTIVES
Session Number
To what extent were the lbllowing objectives of this Home Study Program achieved'! Identify the anatomy of the upper alimentary tract. Discuss the preoperative care 01' the patient with gastroesophageal retlux disease. Explain the perioperative nursing care ol'thc patient undergoing laparoscopic Nisscn iiindoplication. Describe the surgical steps of'the lapasoscopic Nissen fundoplication procedure. Discuss the postoperative course of the patient recovering from laparoscopic Nissen hndoplication.
.'-
0000000000$ 0000000000~ 0000000000 p
(Low) (High) (Low) (High)
PURPOSWGOAL
To educate the perioperative nurse about performing outpatient laparoscopic Nissen fiindoplication. CONTENT
(6) Did this article increase your knowledge of the subject matter'? ( 7 ) Was the content clear and organized? (8) Did this article facilitate learning? (9) Were your individual (hjectives met? ( 10) How well did the objectives relate to the overall purposeigoal? TEST QUESTIONS/ANSWERS
( 1 I ) Were they reflective of the content? ( 12) Were they easy to understand? ( 13) Did they address important points'?
What other topics would you like to see addressed in a tuture Home Study Program'? Would you be interested or do you know someone who would be interested in writing an article on this topic'? Topic( s):
Author names and addresses:
986 A O R N JOURNAL
Examination OUTPATIENT LAPAROSCOPIC NISSEN FUNDOPLICATION
a. an area of circular muscle fibers at the levcl of the diaphragm that relax to admit ingesta. b. a band of circular fibers around the lower end of the coininon bile duct. c. a double set of circular smooth bowel muscles at the opening of the anus. d. a group of circular fibers arranged i n a narrow band that constrict the dilation pupillae.
1.One or more of the following lines of defense fail, allowing noxious content of the stomach to have increased contact time with the esophagus, except a. allowing hydrogen ions to enter the cells o f t h e esophagus. b. butfering of gastrointestinal (GI) fluid content. c. mechanical barrier from the stomach. d. peristalsis of the esophagus.
7.The stomach consists of the a. LES, splenic flexure, and crura. b. gastric flexure, body, and antrum. c. fiindus, body, and antrum. d. antrum, LES, and crura.
2. Swallowed saliva and esophageal bicarbonate secretions buffer the normally acidic GI fluids to a pH a. greater than two. b. less than six. c. greater than four. d. less than eight.
8.The
has surgical landmark value but plays no significant part in the disease process. a. pancreas b. caudate lobe of the liver c. diaphragm d. duodenum
3.Over time, acute and chronic inflammation occurs after multiple recurrent retlux events, leading to a. decreased motility and possibly gastroesophageal retlux. b. gastroesophageal retlux and possibly esophageal stricture formation. c. hemorrhagic gastritis and possibly esophageal stricture fortnation. d. GI obstruction and possibly hemorrhagic gastritis.
9. Patients who suffer from typical symptoms ol' gastroesophageal retlux disease (GERD) complain about a. d y sp hag i a, od y n o p hag i a, hem at em es i s or inelena. b. retlux asthma, hoarseness, pharyngitis, or pyrosis. c. chronic halitosis and reflux asthma caused by gastric contents being aspirated in the airway. d. heartburn and retlux of gastric contents into the esophagus when bending over or lying down.
.
4.What organs initially are responsible for food digestion and bodily nourishment'? a. stomach, colon. liver, and small intestine b. mouth, pancreas, colon, and pharynx c. stomach, sinall intestines, liver, and pancreas d. mouth, pharynx, esophagus, and stomach
5.
10.Noninvasive medical treatment includes all ofthe following except a. weight loss and dietary changes. b. increased physical exercise. c. medications. d. bed rest.
&The lower esophageal sphincter (LES) is
11.Substances known to decrease lower esophageal
and of solids and liquids start the digestive process. a. Hydrolysishnastication b. Masticationieniulsitication c. Hydrolysisiemulsification d. Masticatiodcatalysis
980 AORN JOURNAL
MAY 2002, VOL 15, NO 5
d. greater than 40 mm Hg.
sphincter pressure (LESP) that should be avoided in patients with GERD include a. tobacco, caffeine, nuts, and mint. b. calcium, alcohol, tobacco, and chocolate. c. nuts, alcohol, mint. and calcium. d. alcohol. chocolate, mint, and tobacco.
18.Atypical GERD symptoms include all of the following except a. regurgitation. b. nonobstructional dysphagia. c, aspiration-induced asthma. d. dental decay.
1 2 0 p e n antiretlux procedures were not perfomied on a regular basis for all of the following reasons except a. increased morbidity and mortality. b. long postoperative hospital stay. c. collateral organ damage. d. high failure rate.
19.The most accurate gauge ofacid being present in the esophageal Iunlen is a a. manometry study. b. upper gastrointestinal study. c. esophagogastroduodenoscopy. d. 24-hour pH monitoring examination.
13.The incidence of recurrent heartburn after laparoscopic Nissen fiindoplication is and does not appear to be clinically significant. a. less than 2% b. approximately 5% c. less than 10% d. approximately 12%
#).Evidence suggests unequivocally that acid retlux is present if acid remains in the esophagus of the time. a. less than 4% b. 4% to 7% c. 8% to 12% d. 10% to 15'%
14.A manometry study is indicated to rule out a. abnormal inotility. b. carcinoma. c. ulcerations. d. strictures.
21.A type
hiatal hernia exists if the gastroesophageal junction and a portion o f t h e stomach protrude into the mediastinum. a. one b. two c. three d. four
15.An open Nissen fiindoplication procedure primarily is indicated for a. Barrett's esophagus or unsuccessful medication treatment. b. complex esophageal processes or Barrett's esophagus. c. esophageal strictures or desire not to take medications long term. d. complex esophageal processes or inability to pay for long-term medication treatment.
=Sliding of the hernia is stress dependent and varies in severity depending on the volume present in the stomach. a. true b. false =Patients older than age 40 must undergo the tollowing preoperative examinations: a. electrocardiogram (EKG), urinalysis. and chest x-ray. b. complete blood count (CBC), EKG, and chest x-ray. c. EKG, CBC, and electrolyte profile. d. electrolyte profile, chest x-ray, and treadmill.
16.
also can be monitored during a manometry study. a. Thoracic aorta abnormalities b. Esophageal diverticuli c. Intra-abdominal pressure changes d. Intrathoracic pressure changes
17.Patients who suffer from GERD have an LESP a. between 5 mni Hg and 15 nim Hg. b. less than 10 mni Hg. c. between 10 mni Hg and 45 mm Hg.
=The anesthesia classification for patients undergoing outpatient surgery should not exceed American Society of Anesthesiology class a. I 981
AORN JOURNAL
MAY 2002, VOL 75,NO 5
b. I1 Irr d. IV
30.Which of the following interim outcomc criteria would be applicable for the nursing diagnosis “Acute pain related to tissue trauma secondary to surgical procedure‘?’’ a. Patient’s vital signs and oxygen saturation levels remain within expected values. b. Patient will consume an adequate amount of fluids and nutrients to meet the basal inetabolic needs of the postoperative period. c. Patient will maintain body weight or lose no more than 20 Ibs afier surgery. d. Patient does not demonstrate nonverbal pain behaviors.
C.
25.Droperidol is administered preoperatively to a. prevent or reduce postoperative nausea and vomiting (N&V). b. induce relaxation and drowsiness. c. decrease secretions and block cardiac vagal reflexes. d. produce sedation. 26.0ndansetron hydrochloride is administered postoperatively a. to reverse neuromiiscular blockers. b. to prevent hypotension. c. to treat short-term acute pain. d. to prevent N&V. =.The minor instrument set is placed on the back table to be used a. during the procedure for retraction. b. at the end of the procedure for wound closure. c. during the procedure for dissection. d. at the beginning of the procedure for trocar placement. =All of the following interventions are applicable to decrease the risk of infection for the patient undergoing laparoscopic Nissen fundoplication except a. assesses renal status (eg, renal function studies, urinalysis, health history) preoperatively. b. ensures that the patient is well hydrated with parenteral fluids. c. inspects the wound during wound closure. d. washes the wound and surrounding area to ensure that preoperative prep solution and blood are removed. =.Which of the following nursing diagnoses would be applicable for the patient undergoing laparoscopic Nissen fundoplication? a. Risk for activity intolerance related to intraoperative positioning. b. Risk for ineffective breathing patterns related to hypothennia. c. Risk of iinbalanced nutrition related to inability to ingest food. d. Risk for sleep patteiii disturbances related to gastroesophageal reflux.
31.The RN first assistant (RNFA) at the surgery center is responsible for all of the following tasks except a. accompanying the patient to the postanesthesia care unit and writing discharge orders. b. providing preoperative and postoperative patient education. c. operating the camera intraoperatively. d. using the nonlocking bowel grasper to retract and create counter traction. =After placing the patient in the low lithotoiny position, the nurse carefully abducts the patient’s legs and a. ensures that the patient’s femerol, obturator, and sciatic nerves are not injured. b. externally rotates the patient’s legs for improved perineal exposure. c. inserts an indwelling urinary catheter. d. pads the sacrum to prevent sacral injury. =Preemptive anesthesia refers to a. the surgeon injecting local anesthcsia in the preoperative admitting area. b. the anesthesia care provider assessing the patient in the preoperative area. c. the anesthesia care provider ordering sedation to be administered preoperatively. d. the surgeon injecting local anesthesia into the incisional sites before making the initial incision. =Why is the OR bed repositioned to reverse Trendelenburg’s during the procedure? a. to allow the scrub person adequate room to stand between the patient’s legs b. to treat concurrent hypotension experienced
982 AOIIN J O U R N A L
MAY 2002, VOL 75, NO 5
to six weeks.
with retraction o f t h e peritoneal wall c. to allow the RNFA adequate room to stand between the patient’s legs d. to increase the visual field by allowing gravity to assist in retraction =.How does the surgeon minimize potential bleeding when passing thc stomach posterior to the esophagus to create the fundus wrap‘! a. by injecting lidocaine with epinephrine locally as a hemostatic agent b. by separating the right crus muscle from the esophagus to develop an avascular plain c. by applying gelatin sponge or cellulose gauze topically to attain hemostasis d. by using 0 absorbable endoscopic stitches as necessary to make the area avascular =The patient is not required to void before being discharged from the surgery center. a. true b. M s e 37.All of the following are postoperative dietary instructions following laparoscopic Nissen h n doplication except a. remain on a liquid diet for five days. b. do not consiime carbonated beverages. c. advance from sott to full diet during the next two to four weeks. d. advance from soft to fiill diet during next five AORN, Association of perioperative Registered Nurses, is accredited as a provider of continuing education in nursing by the American Nurses Credentialing Center’s (ANCCs) Commission on Accreditation AORN recognizes this activity as continuing education for registered nurses. This recognition does not imply that AORN or the ANCCs Comniission on Accreditation approves or endorses any product included in the activity AORN maintains the foilowing state board of nursing provider numbers: Alabama ABNP0075, California CfPI3019, and Florida FBN 2296. Check
=Shoulder pain is common after undergoing laparoscopic abdominal surgery, so the RNFA instructs the patient to a. take antitlatulant medications routinely every four to six hours for 48 hours. b. lie on the affected side with a pillow under the hip, which allows the gas to move from the diaphragm to the pelvic area. c. take antiflatulant medications as needed every two to four hours for 48 hours. d. remain on bed rest for 24 hours.
3 9 . A long-tenn, follow-up visit is scheduled for six months later for all of the following reasons except to a. ensure that there are no problems with excessive weight gain. b. ensure that there are no problems with swallowing dif’ficulties. c. ensure that there are no problems with excessive weight loss. d. assess nutritional status. 40.In the case study, the patient desired medical treatment before surgery so the surgeon prescribed a. pancreatic enzymes. b. nonsteroidal anti-inflammatory medication. c. proton pump inhibitor medication. d. analgesics and antipyretics. with your state board of nursing for acceptability of education activi/y for relicensure. Professional nurses are invited to submit manuscripts for the Home Study Program Manuscripts or queries should be sent to Editoc AORN Journal, 2 I70 S Parker Rd, Suite 300, Denver, CO 8023 I 57 I I As with all manuscripts sent to the Journal, papers submitted for Home Study Pragrams should not have been previouslypubIished or submitted simultaneously to any other publication
983 AORN JOURNAL
MAY 2002, VOL. 7 5 , NO 5
Answer Sheet OUTPATIENT LAPAROSCOPIC NISSEN FUNDOPLICATION
P ~
lease fill out the application and answer fonn on this page and the evaluation fom1 on the back of this page Tear the page out of the Joiir-nd or make photocopies and mail to AORN Customer Service c/o Home Study Program 2 170 S Parker Rd, Suite 300 Denver, CO 8023 1-57 1 1 or fax with credit card information to (303) 750-32 I2
ID Number
:I
00000000000000000000 0000000080
A score of 70% correct is required for credit.
Session Number
Session ## 6481 Event # 02083 Contact hours: 3 Fee: Members $15; Nonmembers $30 Program offered May 2002. The deadline for this program is May 3 I , 2005. I . Record your six-digit member identification nuinber in the appropriate section below (see your meinher card). 2. Completely darken the space that indicates your answer to the examination starting with question one. Use blue or black ink. 3. fiecord the time required to complete the program
Mark only one answer per question.
4. Enclose fee if infomiation is mailed. AORN (ID) ## Name Address City State RN license ## State Phone number (
M
0000000000~
O0OO000OOOm
Zip
Fee enclosed or bill the credit card indicated P MC IIIVisa n Am Express LI Discover Card # Expiration date Signature (Ihr C I C ~ I I c;wd iiiillioiii.~li~)ii~
985 AOKN IOURNAL
MAY 2002, VOL 75, NO 5
Learner Evaluation OUTPATIENT LAPAROSCOPIC NISSEN FUNDOPLICATION
The following evaluation is used to determine the extent to which this Home Study Program met your learning needs. Rate the following items on a scale of 1 to 5. OBJECTIVES
Session Number
To what extent were the lbllowing objectives of this Home Study Program achieved'! Identify the anatomy of the upper alimentary tract. Discuss the preoperative care 01' the patient with gastroesophageal retlux disease. Explain the perioperative nursing care ol'thc patient undergoing laparoscopic Nisscn iiindoplication. Describe the surgical steps of'the lapasoscopic Nissen fundoplication procedure. Discuss the postoperative course of the patient recovering from laparoscopic Nissen hndoplication.
.'-
0000000000$ 0000000000~ 0000000000 p
(Low) (High) (Low) (High)
PURPOSWGOAL
To educate the perioperative nurse about performing outpatient laparoscopic Nissen fiindoplication. CONTENT
(6) Did this article increase your knowledge of the subject matter'? ( 7 ) Was the content clear and organized? (8) Did this article facilitate learning? (9) Were your individual (hjectives met? ( 10) How well did the objectives relate to the overall purposeigoal? TEST QUESTIONS/ANSWERS
( 1 I ) Were they reflective of the content? ( 12) Were they easy to understand? ( 13) Did they address important points'?
What other topics would you like to see addressed in a tuture Home Study Program'? Would you be interested or do you know someone who would be interested in writing an article on this topic'? Topic( s):
Author names and addresses:
986 A O R N JOURNAL