NIFA PERIOPERATIVE EXAM 2023-2024 ACTUAL
EXAM 300 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
In several studies, it was determined that the risk of contamination and subsequent
infection to the wearer can be reduced by wearing two pairs of sterile surgical gloves, as
opposed to wearing one pair. Select the correct statement that refers to double gloving
in terms of a best practice.
A. The American College of Surgeons endorses double gloving for all surgery and
invasive procedures
B. Wearing two glove layers permits re-gloving using the closed-glove technique for a
contaminated glove.
C. Wearing a glove liner between both layers of gloves may eliminate the risk of
perforation to the inner glove, protecting the wearer from sharps injury.
D. The AORN publication titled Recommended Practices for Prevention of
Transmissible Infections in the Perioperative Practice Setting recommends the DoubleGlove procedure during invasive procedures. – …ANSWER…A. The American College
of Surgeons endorses gloving for all surgery and invasive procedures.
Alexanders 15th p113
An instrument that is used to occlude a vessel is know as:
A. Hemostat
B. Occluding clamp
C. Kocher
D. Forceps – …ANSWER…A. Hemostat
Alexanders 15th 201
__ Precautions apply to blood, all body fluids, and excretions (except sweat),
regardless of whether they contain visible blood, mucous membranes, and non-intact
skin.
A. Hospital
B. Standard
C. Isolation
D. Contact – …ANSWER…B. Standard
Alexanders 15th p62
From the following, choose the correct statement regarding close gloving.
A. Closed gloving can only be used for the initial gloving
B. Closed gloving requires two people to execute without contamination
C. There is an increased risk of contamination if the thumbs are not extended
D. Closed gloving requires the hands to be kept in direct view – …ANSWER…A. Closed
gloving can only be used for initial gloving
Alexanders 15th p95-96
During the preliminary sponge count on closure of a repair of a ruptured aortic
aneurysm, the circulating nurse was unable to account for 2 lap sponges. Select the
appropriate communication that the circulating nurse must employ in addressing the
entire team during this count discrepancy.
A. “Stop everything! I’m missing a couple of sponges. They are not in the trash or back
table. Check the wound”.
B. “I think you are missing 2 sponges. Shall I call X-Ray while the scrub person checks
her table again? Doctor, please check the incision site.
C. “We have a count discrepancy. We started with 70 sponges and find only 68. We are
missing 2 lap sponges”.
D. ” Ive called X-Ray because we are short 2 lap sponges. I’ve called the charge RN to
get someone to help me check the trash and linen. The rapid response team is on the
way. – …ANSWER…C. We have a count discrepancy. We started with 70 sponges and
find only 68. We are missing 2 lap sponges.
Alexanders 15th p32
Select from the following medication that is used for PONV and has the potential for
prolonged QT interval.
A. Scopolamine patch
B. Dolasteran
C. Droperidol
D. Prochlorperazine – …ANSWER…C. Droperidol
Alexanders 15th p 277
The type of wound closure that occurs when approximation of the wound edges does
not occur for 3 or more days after a surgical procedure.
A. Primary Intention
B. Secondary intention
C. Granulation and contraction
D. Third Intention – …ANSWER…D. Third Intention or Delayed primary closure
Alexanders 15 p256
Which statement about surgical dressings is true?
A.Surgical dressings cushion and protect the wound from trauma and gross
contamination, and absorb drainage.
B. Surgical dressings cover the wound to maintain moisture to promote granulation
C. Surgical dressings maintain tension on the suture line to prevent dehiscence
D. Surgical dressings protect surrounding drapes, linens, and clothing from
contamination. – …ANSWER…A. Surgical dressings cushion and protect the wound
from trauma and gross contamination, and absorb drainage.
Alexander 15th p266
Which of the following absorbable suture has the best tensile strength?
A. Surgical gut
B. Polypropylene
C. Surgical silk
D. Polydioxanone – …ANSWER…D. Polydioxanone or PDS
A type of suture to help eliminate tension on the primary suture line is known as:
A. Retention
B. Interrupted
C. Subcuticular
D. Buried – …ANSWER…A. Retention
Alex 15th p193
A common dysrythmia after surgery is:
A. SVT
B. Sinus Tachycardia
C. Bradycardia
D. Atrial Fibrillation – …ANSWER…B. Sinus Tachycardia
Alexanders 15th P 275
The new general surgery fellow placed the three trocar ports for the laparoscopic
appendectomy. The procedure was completed without incident; however, on post op
day 1, the patient demonstrated signs and symptoms of sepsis. What might have been
the unusual occurrence that could ave resulted in patient sepsis?
A. Unrecognized appendiceal rupture.
B. Significant break in sterile technique
C. Inadvertent trocar puncture through the bowel on insertion
D. Recent H1N1 outbreak on the surgery unit at the hospital – …ANSWER…C.
Inadvertent trocar puncture through the bowel on insertion
Once a count discrepancy is identified, an important step scrubbed team member
should do to aid in resolving the discrepancy is which of the following:
A. Allowing the circulator to search the sterile drapes and drape folds
B. Continue closure of the incision
C. Order intraoperative imaging
D. Notify the charge RN – …ANSWER…C. Order intraoperative imaging
Alexanders 15th P32
A 19yo M received an IV peripheral nerve block for an ORIF of an ankle fracture. The
anesthesia provider injected a distal dorsal vein of the pt’s right foot with 2% lidocaine,
after placing a single cuffed pneumatic tourniquet around the upper thigh. The surgeon
noticed that the cuff seemed to be deflating and anticipated that the patient would
initially complain of which of the following?
A. Metallic taste in his mouth
B. Seizures
C. Dizziness
D. Respiratory arrest – …ANSWER…A. Metallic taste in his mouth
Alexanders 15th P 148
Your patient was presented with the prepared informed consent for during the
discussion with her surgeon concerning her scheduled surgery. Before signing the
consent form, the patient informed the surgeon that they did not want any medical
students or surgical residents performing any parts of the procedure other than assisting
and did not want photographs taken. The surgeon agreed and crossed out those
portions of the form. The patient initialed them prior to signing the consent. Your patient
was exercising which patient right?
A. Understanding and rights under the Patient Self-Determination Act
B Right to informed consent
C. Autonomy to protect herself from negligence and malpractice
D. Hope that everyone would honor HIPPA – …ANSWER…B. Right to informed consent
Alexanders 15th Pg 41
Hypothermia is a common side effect of surgery and the peri-anesthesia setting. The
most common and effective method to prevent hypothermia is through the use of:
A. Applying blankets to the OR bed prior to the patient arrival
B. Forced air-warming blankets
C. Continious fluid-circulating blankets or warm-water mattresses
D. Wrapping the patient’s head with warm blankets – …ANSWER…B. Forced airwarming blankets
Alexanders 15th P 10
Laryngospasm is a serious complication often seen in the PACU setting. What is the
ideal immediate and last resort response by the anesthesia provider or perianesthesia
RN in an emerging patient who has been in spasm for over 1 minute?
A. Gentle stimulation and bag valve mask ventilation with oxygen
B. Suctioning, IV succinylcholine administration, and reintubation
C. Emergency tracheostomy with a cricothyrotomy approach
D. IV bronchodilator administration and nebulized oxygen treatment in the PACU –
…ANSWER…B Suctioning, IV succinylcholine administration, and reintubation
Which of the following suture choices would be the best suited for intestinal
anastamosis based on the quantities of excellent handling capability, high tinsile
strength that decreases after 1 yr, and is not a true nonabsorbable suture?
A. Vicryl
B. Prolene
C. Monocryl
D. Silk – …ANSWER…D. Silk
Alexanders 15th P189
The surgical hand scrub is designed to render the hands, nails, and arms:
A. Surgically clean