Free Skin Prep & Surgical Site Marking Practice Questions

1. When performing a surgical skin prep, the general principle of application directs that the prep solution should be applied:

• From the periphery of the surgical site toward the incision
• From the incision site outward to the periphery, never returning to the clean center with a used sponge
• In random strokes to ensure complete coverage
• Only to the area immediately surrounding the incision line

2. Which antiseptic solution is CONTRAINDICATED for use near the eyes and ears during surgical skin preparation?

• Povidone-iodine (Betadine)
• Chlorhexidine gluconate (CHG)
• Sterile saline
• Isopropyl alcohol

3. A patient scheduled for perineal surgery (e.g., hemorrhoidectomy) requires a modified skin prep. Which statement about perineal preps is correct?

• The perineal area is prepped from the incision site outward, and the anal opening is prepped last as the most contaminated area, using a separate sponge that is then discarded
• The perineal area does not require antiseptic prep because it cannot be made sterile
• Alcohol-based preps are preferred for perineal surgery because of superior antimicrobial activity
• The perineal prep begins at the anus and works outward since this is the surgical site

4. A ChloraPrep applicator is used for skin preparation before a laparoscopic procedure. After application, the circulating nurse notices that the alcohol-based solution has pooled beneath the patient on the OR table pad. What is the MOST significant risk and appropriate action?

• The pooled solution will cause a skin rash; wipe it up with a sterile towel and proceed
• The pooled alcohol-based solution creates a fire hazard when electrosurgery is used; the pooled solution must be completely dried or absorbed, and adequate drying time must be allowed before draping
• The pooled solution will dilute the antiseptic effect; reapply the prep over the incision site
• The pooled solution indicates too much prep was applied; document the incident but proceed with draping

5. The residual antimicrobial activity of chlorhexidine gluconate (CHG) on the skin differs from povidone-iodine in that:

• CHG provides persistent antimicrobial activity for up to 48 hours by binding to the stratum corneum, while povidone-iodine activity ceases once it dries
• Povidone-iodine provides longer residual activity than CHG
• Both agents provide identical residual antimicrobial activity lasting 6 hours
• CHG loses its antimicrobial activity when it contacts blood or body fluids, while povidone-iodine does not