Free CSSL Practice Questions

Question 1

Two service chiefs want the same full-day robotic surgery block. Urology needs a dependable morning session for a visiting surgeon; gynecology needs the same total operating time each week but can use afternoons on different days. Both chiefs initially insist on exclusive ownership of the block. The manager confirms that existing staffed sessions can accommodate both needs. Which proposal offers the strongest basis for agreement?

Accepted Answer

Reserve mornings for urology and an equivalent amount of reliable afternoon time for gynecology.

Answer

Alternate ownership of the full-day block each week to give both services equal access.

Answer

Award the block to the service with greater utilization and reconsider access next quarter.

Answer

Ask an executive outside perioperative services to choose between the two competing requests.

Question 2

A monthly perioperative labor report allows 700 productive nursing hours for the 140 cases completed. Actual use was 665 hours. The budgeted hourly rate was $48; the actual rate was $52 because temporary-staff use increased. All figures cover the same personnel and cost categories. The director proposes cutting hours to correct the $980 unfavorable total variance. What does the variance analysis reveal about that proposal?

Accepted Answer

Hours were $1,680 favorable; the higher hourly rate more than offset that saving.

Answer

The $980 unfavorable volume variance calls for a smaller workload allowance.

Answer

A $1,680 favorable rate variance was outweighed by inefficient use of productive nursing hours.

Answer

The $2,660 unfavorable efficiency variance identifies excess hours as the main cost driver.

Question 3

During laparoscopic surgery under a volatile anesthetic, end-tidal carbon dioxide rises and the pulse accelerates. Anesthesia increases minute ventilation and checks the circuit. Oxygen saturation remains stable, inspired carbon dioxide is near zero, and core temperature is 37.2°C. The charge nurse is coordinating support as the team evaluates the cause. Which additional finding most strongly favors malignant hyperthermia over carbon dioxide absorption or inadequate ventilation?

Accepted Answer

Generalized rigidity develops as carbon dioxide rises despite adequate ventilation.

Answer

Inspired carbon dioxide rises, accompanied by an abnormal capnogram baseline.

Answer

Carbon dioxide falls as ventilation increases, with temperature and muscle tone unchanged.

Answer

Tachycardia and carbon dioxide elevation resolve after the anesthetic is deepened.

Question 4

The annual staff survey shows more favorable engagement responses six months after a leadership initiative. The questions are unchanged, but far fewer staff respond, especially on nights. Individual responses cannot be linked across surveys. The director proposes reducing leadership rounding because the scores show that staff concerns have been resolved. What response should guide that decision?

Accepted Answer

Retain rounding while seeking night-shift feedback and reviewing the respondent mix.

Answer

Increase corrective rounding on nights because nonparticipation demonstrates worsening engagement.

Answer

Reduce rounding across shifts and use the next annual survey to check whether improvement lasts.

Answer

Discard the score increase because lower participation proves nonresponse bias.

Question 5

Two elective cases need dedicated circulators: a robotic colectomy and a vascular bypass. RN Lee is independently competent for both. RN Patel completed orientation recently and is independently validated for the robotic colectomy, including emergency undocking, but not for vascular bypass. All other required roles are staffed. The robotic surgeon requests Lee because of greater experience. How should the charge nurse assign the two RNs?

Accepted Answer

Assign Lee as the vascular circulator and Patel as the robotic circulator.

Answer

Assign Lee to robotics and Patel to vascular, with Lee available by telephone.

Answer

Assign Lee to vascular and delay robotics until another experienced circulator is available.

Answer

Assign Lee to robotics and pair Patel with a vascular-experienced scrub person.

Question 6

An infection prevention team reports a surgical-site infection standardized infection ratio of 0.72, with a 95% confidence interval of 0.38-1.24, using the CDC National Healthcare Safety Network model. Case data and risk adjustment have been validated. A board slide credits a recent prevention initiative with a statistically significant reduction below the predicted infection burden. Which replacement statement accurately describes the result?

Accepted Answer

Observed infections were below predicted; the interval does not show a statistically significant difference.

Answer

Infections decreased 28% from the preceding period, although the size of the initiative's benefit remains uncertain.

Answer

Observed and predicted infections are equivalent, so the initiative has not improved clinical outcomes.

Answer

The reduction is statistically significant because the ratio is below one and the case data are valid.

Question 7

Two PACU nurses receive a complete transfer report, including a pending laboratory result and a reassessment due in 30 minutes. Both indicate that they understand. Each later assumes the other accepted the follow-up tasks, and neither completes them on time. Staffing was adequate and no information was omitted. To prevent this failure from recurring, the handoff should require:

Accepted Answer

Receiver confirmation of each task's owner, deadline, and escalation plan.

Answer

A sender checklist confirming that each pending task was included in the report.

Answer

Independent review of the operative record by both nurses before accepting the patient.

Answer

Charge-nurse attendance and a cosignature whenever the report includes pending work.

Question 8

A hospital is investigating whether a disposable device is associated with an uncommon complication after a specific operation. A registry identifies all affected patients from a defined five-year period. The surgical roster identifies patients who underwent that operation in the same period; outcome status is known after the same follow-up interval for all patients. Device exposure requires manual record review, and the team can examine only a small fraction of procedures. Which study design makes the most efficient use of those records for an initial comparison of exposure?

Accepted Answer

Compare affected patients with a sample of eligible patients without the complication.

Answer

Review every eligible exposed and unexposed surgical patient's record, then compare complication rates.

Answer

Randomize future patients to the devices and compare subsequent complication rates.

Answer

Review affected patients' records and compare their exposure with clinicians' recollections.

Question 9

The only available colonoscope was last used for a patient colonized with vancomycin-resistant enterococci. Its leak testing, cleaning, high-level disinfection, rinsing, drying, and storage met the compatible manufacturer instructions. There is no reprocessing failure or associated outbreak. The scheduled examination will contact mucosa; any biopsy will use sterile single-use accessories. A team member requests cancellation for additional sterilization. Which disposition is appropriate for the colonoscope?

Accepted Answer

Release it for the examination after confirming the documented processing and device integrity.

Answer

Send it for sterilization because antibiotic resistance requires a higher processing level.

Answer

Quarantine it until surveillance cultures are negative for the resistant organism.

Answer

Repeat high-level disinfection with a longer exposure before the planned examination.

Question 10

Two elective services can fill the same six-hour OR block. Urgency, access priorities, readiness, and recovery capacity are equivalent. Service A can perform three two-hour cases, each with $6,200 net revenue and $3,200 variable cost. Service B can perform four 90-minute cases, each with $5,000 net revenue and $2,600 variable cost. Case times include turnover, and fixed costs will not change. Which allocation produces the greater contribution toward fixed costs?

Accepted Answer

Service B; its contribution is $9,600 per block, compared with Service A's $9,000.

Answer

Service A; its contribution is $3,000 per case, compared with Service B's $2,400.

Answer

Service A; its contribution margin is 48.4% of revenue, compared with Service B's 48.0%.

Answer

Service B; its additional $1,400 in block revenue is the additional amount available for fixed costs.

Free CSSL Practice Questions

Domain 1: Communication and Relationship Management 18% of exam

Question 1

Question 2

Domain 2: Strategic Management 12% of exam

Question 3

Domain 3: Financial Management 15% of exam

Question 4

Question 5

Domain 4: Human Resource Management 12% of exam

Question 6

Domain 5: Operational Management 18% of exam

Question 7

Question 8

Domain 6: Leadership 15% of exam

Question 9

Domain 7: Professionalism 10% of exam

Question 10

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