RNFA course 1 period quiz
—————— Precautions apply to blood, all body fluid, secretions and excretions (except
sweat) regardless of whether they contain visible blood, mucous membranes and not intact skin.
- ANS-Standard
A common dysrhythmia seen after surgery is: - ANS-Sinus tachycardia
A type of monofilament suture that does not require the user to the knots is known as -
ANS-Barbed
Allergic reactions to latex range from skin disease to asthma and anaphylaxis that can result in
chronic illness, disability, career loss, hardship and death. What types of signs and symptoms
would be indicative of an allergic contact dermatitis response to contact with natural rubber latex
- ANS-Pruritus, edema, erythema, and vesicles that develop 6 to 48 hours after exposure
Guidelines from the WHO focus on which of the following in the prevention of SSI's? - ANS-Use
of antibiotics
Hypotension is a blood pressure reading that is 20% less than the patients normal baseline
pressure. Hypovolemia is the most common cause of postoperative hypotension; however,
hypotension may also be caused by cardiac dysfunctions. Which of the following cardiac
conditions will present with hypotension? - ANS-Myocardial infarction, myocardial tamponade
and pulmonary embolism.
Infection control and prevention surveillance was underway in the cardiac intensive care unit
because of an alarming prevalence of sternal wound infections. On postop day 2, a patient
develop d edema, redness and purulent exudate that appeared to be isolated to the
subcutaneous plane above the sternum. What important criteria must be met to conclusively
define this is a surgical site infection (SSI) - ANS-Positive diagnosis of the SSI by the surgeon or
attending physician
Jacob Sutzkever is a 62 year old man who had surgery 6 days ago for a ruptured diverticulum.
He is back in the OR for a debridement and washout. Jacobs fever has subsided and the
drainage is clear. The surgeon will continue with wet to dry dressings and schedules Jacob to
return to the OR in 3 days for: - ANS-Delayed primary sutured closure
Jacob Sutzkever, a 62 year old man, had surgery 6 days ago for a ruptured diverticulum. What
was the wound classification at the time of his emergency surgery? - ANS-Contaminated
wound, classification III (counted wrong per NIFA grade. Look at page 250 on 16th Ed.) only
other answer would be infected wound classification IV
Laparoscopic procedures that emerge toy convert to open procedures place the patient at risk
for unintentional retained foreign objects (RFO). What new and evolving risk reduction strategy
could prevent RFO's and frustrating, time consuming miscount adventures at the end of these
procedures? - ANS-Replacing or tagging sponges and laparotomy instruments with RFID chips
Many factors have contributed to the evolution and progressive growth of ambulatory surgery.
Select three anesthetic agents that promote fast induction, rapid emergence and minimal side
effects and have been credited as a significant factor in this trend. - ANS-Sevoflurane, propofol,
desflurane
Miriam Glass is a 78 year old female scheduled for compression nail insertion of a left fractured
hip. She was positioned for a spinal injection to induce spinal anesthesia. During the process,
the anesthesia provider inadvertently inserted the spinal needle into the subarachnoid space,
not noticing the error until the entire syringe of lidocaine was emptied into the patient. Miriam
immediately experienced rapid onset of hypotension, bradycardia and apnea. Miriams
unintentional condition is called ———— and now must be managed with—————-. -
ANS-Cardiogenic shock; ACLS protocol
Risk factors for PONV should be assessed preoperatively. Which of the following is a risk factor
for PONV. - ANS-Female gender
Sara was positioned, prepped and draped following general endotracheal anesthesia induction.
The team assembled around Sara and the sterile field to perform the time out as described in
the WHO surgical checklist. Successful employment of the time out can only be ensured when: -
ANS-The entire team stops and focuses attention together.
Select all the injuries or conditions that reflect probable child abuse or neglect - ANS-Severe
injuries inconsistent with the history
Select from the following a medication that is used for PONV and has the potential to prolong
the QT interval
a) droperidol
b) dolasteran
c) prochlorperazine
d) scopolamine patch - ANS-A) droperidol
Select the appropriate nursing action that supports hands free instrument passing and sharps
safety. - ANS-Create a neutral hands free area between the scrub person and surgeon with a
basin or magnetic mat.
Select the appropriate order for administering blood and blood products. Verify informed
consent for blood, separate blood bag from identification slips, sign slips, verify identification
numbers and expiration dates with second licensed person, verify patient with blood tag and
requisition slips. - ANS-Verify informed consent for blood, verify patient identification and blood
type and unit number against blood tag and requisition slip with second licensed person, sign
slips.
Select the statement below that best reflects the effects of hypothermia in the perianesthesia
period. - ANS-Shivering can increase the need for oxygen by 300% to 400%
Sherry Ames is an endoscopy nurse in a busy free standing ambulatory surgery center. She is
an RN with additional documented competency in providing an anesthesia modality to healthy
patients having screening colonoscopies, bronchoscopies and upper GI endoscopes. This
modality will allow this patient population. To tolerate potentially uncomfortable-procedures while
maintains their own airway and be easily aroused from light sleep. Sherry is competent and
legally qualified to provide which modality of anesthesia? - ANS-Conscious sedation/analgesia
Surgical instruments that do not fall under the category of clamps, retractors, or cutting
instruments, but are used in most procedures are typically included within the category of: -
ANS-Accessory and ancillary instruments
Surgical site infections (SSI) are most often caused by gram-positive cocci and may arise from
the patients own endogenous sources. The most frequently identified microorganisms cultured
from SSIs is: - ANS-Staphylococcus aureus
The area between the surgeon and the scrub person designed for passing sharps safely is
referred to as the: - ANS-Neutral zone
The circulating nurse received a phone call from the emergency department and called sterile
supply to assemble the instrument for an abdominal trauma case with possible aortic rupture.
When the cart arrived, she saw the vascular set; however the most important instrument set was
missing. What important set was needed for this procedure besides the vascular set? -
ANS-Basic laparotomy set
The death of microorganisms occurs in stream sterilization as a result of which process? -
ANS-Denaturation and coagulation of enzyme proteins
The final step, after decontamination and before sterilization, is the prep, pack, and wrap
process. The sterile processing technologist has taken the laparotomy set from the washer/
decontaminator to prepare for sterilization. Select the most appropriate order that the instrument
set must travel before reaching the steam sterilizer. - ANS-Air dry, inventory, inspect, lubricate,
assemble and string instruments, wrap and tape????
Pg 72 16th Ed.
The incidence of intraoperative awareness (IOA) may increase in high risk patient populations.
From the following, choose the group that is considered high risk for IOA - ANS-Cardiac surgery
patients
The Joint Commission suggests that surgical consent be written at what level to meet health
literacy needs of all patients? - ANS-5th grade level
The light transmission through an endoscope is achieved by way of: - ANS-Bundles of fiber
optic glass rods
The name of the fascia that separates the anterior rectum from the vagina in females is called
the: - ANS-Rectovaginal fascia
The new general surgery fellow placed the three rep at ports for the laparoscopic
appendectomy. The procedure was completed without incident; however, on postoperative day
1, the patient demonstrated signs and symptoms of sepsis. What might have been the unusual
occurrence that could have resulted in patient sepsis. - ANS-Inadvertent trocar puncture through
the bowel on insertion.
The OR was trialing a new insufflation system and the vendor representative was out of the
room taking a phone call. The perioperative nurse was concerned that the flow rate was well
above 14L/min and the pressure had risen to 16 mmHg. She alerted the surgeon and reduced
the rate and pressure because she feared that the elderly patient was at high risk for: -
ANS-Hypercarbia
The patient stated that her mouth, lips, and tongue were numb and prickly feeling and she had a
metallic taste after receiving local anesthesia for a procedure. The anesthesia provider
suspected that the patient had————and responded by———-. - ANS-A toxic overdose of
local anesthetic; monitoring and increasing the flow rate of IV saline
The physiologic effects resulting from the inhalation is gaseous anesthetic agents and
intravenous infusions of anesthetic drugs inhibit several areas of the central nervous system.
The process by which they occur are explained by several proposed theories. Which of the
options describes a plausible anesthetic mechanism of action? - ANS-Synaptic transmission of
nerve impulse in the CNS is inhibited.
The process of decontamination should initially begin at what point? - ANS-Completion of the
surgical procedure
The RNFA instructed the new anesthesia resident in the proper positioning of the arm and hand
on the OR bed arm boards. The resident was cautioned to avoid pressure on the elbow to
prevent: - ANS-Ulnar nerve injury
The stapler designed to close the end of a hollow organ is called - ANS-EEA
The strength layer of the skin is found in the - ANS-Dermis
Two monitoring techniques used by anesthesia that have improved morbidity and mortality
include: - ANS-Pulse ox and capnography
When applying the sterile drapes to create the sterile field on the patient, which of the following
principles is most important? - ANS-Drape the patient starting with the incision area and
proceeding to the periphery.
Which anesthetic agent could not be given if an IV-only anesthesia plan was employed -
ANS-Desflurane
Which member of the surgical team can be held liable in litigation for retained foreign bodies -
ANS-The entire team
Which of the following absorbable suture has the best tensile strength? - ANS-Polydioxanone
Which of the following do not need to be counted and documented. - ANS-Vascular inserts pg
199 16th Ed
Which of the following is corrected regarding chromium salt coating on surgical gut suture? -
ANS-***??Speeds the absorption of the suture in the tissue??*** says pg 177 in 16th ed
Which of the following is not an advantage to the use of silk suture - ANS-Memory
Which of the following medications is a specific depolarizinf muscle relaxant than can produce
generalized fasciculations? - ANS-Succinylcholine
Which statement about surgical dressings is true
A) surgical dressing maintain tension on the suture line to prevent dehiscence
B) surgical dressings cushion and protect the wound from trauma and gross contamination and
absorb drainage
C) surgical dressings protect surrounding drapes, linen and clothing from contamination
D) surgical dressings cover the wound to maintain moisture to promote granulation - ANS-B)
surgical dressings cushion and protect the wound from trauma and gross contamination and
absorb drainage
Which statement best explains the mechanism of action of general anesthetic agents? -
ANS-Inhibition of synaptic transmission of nerve impulses
While the Fowler's position offers the best respiratory excursion for the patient, the patient is at
higher risk for —————- because of dependent pooling in the hips and legs. - ANS-Venous
thromboembolism (VTE)
