RNFA COURSE 1 PERIOD QUIZ & COURSE 1 TESTS
2023-2024 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |AGRADE
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
- ANSWER- B) surgical dressings cushion and protect the wound from trauma and
gross contamination and absorb drainage
Risk factors for PONV should be assessed preoperatively. Which of the following
is a risk factor for PONV. – ANSWER- Female gender
Guidelines from the WHO focus on which of the following in the prevention of
SSI’s? – ANSWER- Use of antibiotics
The death of microorganisms occurs in stream sterilization as a result of which
process? – ANSWER- Denaturation and coagulation of enzyme proteins
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? – ANSWERReplacing or tagging sponges and laparotomy instruments with RFID chips
The name of the fascia that separates the anterior rectum from the vagina in
females is called the: – ANSWER- Rectovaginal fascia
The area between the surgeon and the scrub person designed for passing sharps
safely is referred to as the: – ANSWER- Neutral zone
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. –
ANSWER- Inadvertent trocar puncture through the bowel on insertion.
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——
—-. – ANSWER- A toxic overdose of local anesthetic; monitoring and increasing
the flow rate of IV saline
Which of the following medications is a specific depolarizinf muscle relaxant than
can produce generalized fasciculations? – ANSWER- Succinylcholine
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: – ANSWER- The entire
team stops and focuses attention together.
Which member of the surgical team can be held liable in litigation for retained
foreign bodies – ANSWER- The entire team
Which statement best explains the mechanism of action of general anesthetic
agents? – ANSWER- Inhibition of synaptic transmission of nerve impulses
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? – ANSWER- Conscious
sedation/analgesia
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? – ANSWER- 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
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 – ANSWER- Cardiac surgery patients
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: – ANSWER- Ulnar nerve injury
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: – ANSWER- Staphylococcus
aureus
Select the statement below that best reflects the effects of hypothermia in the
perianesthesia period. – ANSWER- Shivering can increase the need for oxygen by
300% to 400%
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. – ANSWER- 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 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 – ANSWER- A) droperidol
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 – ANSWER- Pruritus, edema,
erythema, and vesicles that develop 6 to 48 hours after exposure
The strength layer of the skin is found in the – ANSWER- Dermis
Two monitoring techniques used by anesthesia that have improved morbidity and
mortality include: – ANSWER- Pulse ox and capnography
RNFA STUDY GUIDE WITH QUESTIONS 2023 QUESTIONS 500
QUESTIONS AND CORRECT DETAILED ANSWERS
(100%VERIFIED ANSWERS) |ALREADY GRADED A+ (BRAND
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What is the initiative that encompasses improvements in quality and effectiveness,
based on ethical and economic perspectives? – ANSWER- Performance
improvement is the initiative that encompasses improvements in quality and
effectiveness, based on ethical and economic perspectives.
What are some examples of emerging roles in the OR? – ANSWER- Emerging
roles include care coordinator, family liaison, robotics coordinator, and informatics
specialist.
Define the phase of the nursing process that focuses on the patient’s progress in
attaining identified outcomes. – ANSWER- The evaluation phase focuses on the
patient’s progress in attaining identified outcomes.
What certification is available to perioperative nurses that demonstrates
proficiency in support of quality patient care and sets a standard of commitment to
the profession of OR nursing? – ANSWER- Certified Nurse, Operating Room
(CNOR) is the certification for perioperative nursing.
List the types of advanced practice nurses who may practice in the perioperative
environment. – ANSWER- Nurse practitioners (NPs), certified registered nurse
anesthetists (CRNAs), and clinical nurse specialists (CNSs) are examples of nurses
who may practice in the advanced role in the perioperative environment.
Define the phase of the nursing process concerned with the collection of relevant
data about the patient. – ANSWER- The assessment phase is associated with the
collection of relevant data about the patient.
How is a count recorded in the record when an item is missing but not located on
an X-ray? – ANSWER- Unresolved counts are documented as follows: if the X-ray
is negative, the count is recorded as incorrect, and the X-ray results are noted on
the patient’s intraoperative record. An incident/occurrence/event report should be
initiated according to institution policy.
Define the term electrolytes. – ANSWER- Electrolytes are substances in the blood
essential to transmission of nerve impulses, regulation of water distribution,
contraction of muscles, generation of adenosine triphosphate (ATP, needed for
cellular energy), regulation of acid-base balance, and hemostasis.
Define the term root cause analysis. – ANSWER- A root cause analysis is a
systematized process used to identify variations in performance that cause or could
cause untoward patient events.
Define the term sentinel event. – ANSWER- Sentinel events are unexpected
occurrences involving death or risk of serious physical or psychologic injury to a
patient.
Define the term active transport. – ANSWER- Active transport is the process by
which molecules are moved across a cell membrane against a concentration
gradient, with the use of external energy.
List examples of initiatives developed by the World Health Organization (WHO)
to promote patient safety. – ANSWER- The WHO has endorsed the Hand Hygiene
Initiative (Clean Care is Safer Care), the Surgical Hand Preparation guideline, and
the Surgical Safety Checklist (Safe Surgery Saves Lives).
Describe the verification steps for transfusion of blood or blood products. –
ANSWER- The circulating nurse and anesthesia provider (or a second licensed
individual) confirm the following during blood and blood product verification: (1)
The unit number on the blood product corresponds with the unit number on the
blood requisition. (2) The name, birth date, and number on the patient’s
identification band agrees with the name, birth date, and number on the slip with
the blood product. (3) The patient’s name on the blood product corresponds with
the name on the requisition. (4) The blood group indicated on the blood product
corresponds with that of the patient. (5) The date and time of expiration have not
been reached. (6) The blood product bag is free of leaks, damage, or signs of
possible bacterial contamination (e.g., presence of fine gas bubbles, discoloration,
clots or excessive air in the bag).
Define the term diffusion. – ANSWER- Diffusion is the movement of molecules
from an area of high concentration to one of low concentration.
List examples of physical risks to patients in the perioperative environment. –
ANSWER- Physical risks include any damaging or noxious element that comes
into contact with the patient to cause harm, such as: electrosurgical/laser beam,
pooled prep solution, glutaraldehyde retained in an endoscope, or a retained
foreign object.
Describe the steps used when weighing sponges to estimate blood loss. –
ANSWER- The procedure for weighing sponges is as follows: (1) Weigh a dry
sponge in a plastic bag, and adjust the scale to register zero. (2) Place used, bagged
sponges on the scale. (3) Record the scale reading: 1 g equals 1 mL of blood loss.
(4) Note the blood loss on the record. (5) Add subsequent weight to the preceding
weight each time sponges are weighed so that a running total blood loss, calculated
from sponges, is available. (6) Measure blood in the suction canister(s) at regular
intervals, subtracting the amount of any irrigating solution used. (7) Add the
amount of blood loss calculated from suction canisters to the total recorded from
sponges to obtain accurate blood loss estimates.
What are the key elements of informed consent? – ANSWER- During informed
consent, the patient must be informed about the proposed operation or other
invasive procedure and its inherent risks, benefits, alternatives, and complications
in terms that he or she can understand.
How are first, second, and third spacing defined? – ANSWER- First spacing is the
normal distribution of fluid in extracellular and intracellular compartments. Second
spacing refers to excess accumulation of interstitial fluid (edema), while third
spacing occurs when fluid accumulates in areas that normally have no fluid or only
a minimal amount of fluid.
Define the acronym SBAR. – ANSWER- SBAR stands for: S=Situation,
B=Background, A=Assessment, R=Recommendation.
What are the signs and symptoms of a transfusion reaction? – ANSWER- Signs and
symptoms of a transfusion reaction include: increased intraoperative bleeding,
hyperthermia, weak pulse, hypotension, visible hemoglobinuria, vasomotor
instability, and greatly decreased or no urinary output.
Describe the minimal level of education required for an advanced practice nurse. –
ANSWER- A Master’s degree is required for advanced practice nursing.
What is the nursing model created by the Association of periOperative Registererd
Nurses (AORN) featuring domains that are in continuous interaction with the
health system and encircling the focus of perioperative nursing practice—the
patient? – ANSWER- The AORN model is referred to as the Perioperative PatientFocused Model.
Define the phase of the nursing process characterized by preparation for what will
or may happen and determining the priorities for care. – ANSWER- The planning
phase is characterized by preparation for what will or may happen and determining
the priorities for care.
Institutional standards are usually directive about specific actions in specific
circumstances within a facility or system. What type of standards typically provide
generalized authoritative statements that can be implemented in all settings? –
ANSWER- National standards provide generalized authoritative statements that
can be implemented in all settings.
Define the phase of the nursing process characterized by performing the nursing
care activities and interventions that were planned, and responding with critical
thinking and orderly action. – ANSWER- The implementation phase is
characterized by performing the nursing care activities and interventions that were
planned, and responding with critical thinking and orderly action.
Define the phase of the nursing process that focuses on identifying and classifying
data collected in the assessment in a way that provides a focus to plan nursing care.
- ANSWER- The nursing diagnosis phase focuses on identifying and classifying
data collected in the assessment in a way that provides a focus to plan nursing care.
What is the expanded perioperative role characterized by handling and cutting
tissue, using instruments and medical devices, providing exposure and hemostasis,
and suturing, all as components of assisting-at-surgery behaviors? – ANSWERThe registered nurse first assistant (RNFA) is an example of an expanded
perioperative nursing role.
The AORN publication, Standards of Perioperative Nursing, is an example of what
kind of standard? – ANSWER- The AORN Standards are an example of processbased standards.
What is the specialty nursing language that provides a uniform and systematic
method to collect and document the basic elements of perioperative nursing care? –
RNFA TEST 1,2 & 3 LATEST 2023 ACTUAL TESTS 400
QUESTIONS AND CORRECT DETAILED ANSWERS
(100%VERIFIED ANSWERS) ||AGRADE
The intracorporeal suture technique uses the suture-tying process analogous to the:
- ANSWER- instrument tie
High-pressure insufflation rates can cause overpressurization of the intraabdominal cavity. This overpressurization can lead to which of the following? –
ANSWER- hypercarbaria
Which statement best explains the mechanism of action of general anesthetic
agents? – ANSWER- inhibition of synaptic transmission of nerve impulse
Which statement about surgical dressings is true? – ANSWER- Surgical dressings
cushion and protect the wound from trauma and gross contamination, and absorb
drainage
The surgeon used the ESU in monopolar mode to cut and coagulate through the
subcutaneous tissue on opening the abdomen during a bariatric bypass procedure.
As she began to proceed through the muscle and fascia layer, she asked the
circulating nurse to increase the cut and coagulation modes on the ESU. What
measure could the scrub person take to enhance energy delivery? – ANSWERClean the charred tissue from the active electrode blade
Which of the following is correct regarding the chromium salt coating on surgical
gut suture? – ANSWER- Should be rinsed from the suture before use in eye cases
Successful employment of the time-out can only be ensured when: – ANSWERthe entire team stops and focuses attention together
A 19-year-old male received an intravenous peripheral nerve block for an ORIF of
an ankle fracture. The anesthesia provider injected a distal dorsal vein of the
patient’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? – ANSWER- metallic taste in mouth
Which of the following patients would be most likely to have a latex allergy? –
ANSWER- spina bifida patient
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. – ANSWER- The American College of
Surgeons endorses double gloving for all surgery and invasive procedures.
During the process of performing the spinal, 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. The patient
immediately experienced rapid onset of hypotension, bradycardia, and apnea. The
resulting condition is called and now must be managed with _. –
ANSWER- total spinal anesthesia; general endotracheal anesthesia
During the preliminary sponge count on closure of a repair of a ruptured abdominal
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. – ANSWER- “We have a
count discrepancy. We started with 70 sponges and find only 68. We are missing 2
lap sponges.”
When creating a vascular or intestinal anastomosis, the surgeon will typically
suture one half of the anastomosis with one half of the suture and the other half of
the anastomosis with the other half of the suture. This technique minimizes the
drag and wear on the suture material and needle. The correct name for this type of
suture and needle is: – ANSWER- double-armed
Risk factors for PONV should be assessed preoperatively. Which of the following
is a risk factor for PONV? – ANSWER- female
The first case of the day is scheduled as a knee arthroscopy for an otherwise
healthy 24 year old patient. Upon pre assessment, the patient admits to a family
history of anesthesia and surgical complications. Patient also states last oral intake
consisted of eating a cheese steak and drinking 2 cans of beer the night before at
11:30 PM. The patient subsequently vomited when intubation was performed and
experienced respiratory distress upon extubation. What measure could have been
taken by the team to prevent aspiration based on the patient’s history? – ANSWER-
The perioperative nurse applying cricoid pressure during induction through
intubation
Select the positioning device commonly used for positioning the head during
procedures such as craniotomies. – ANSWER- mayfield head positioner
A type of suture to help eliminate tension on the primary suture line is known as: –
ANSWER- retention
What is the appropriate action if the doctor is delayed after the room and
instruments have been opened? – ANSWER- Cover the instruments with a sterile
drape and have the scrub nurse continually visually observe the room for breaches
in sterility
What one factor describes the high incidence of musculoskeletal disorders among
surgical technologists and perioperative nurses? – ANSWER- The cumulative
effect of repeated patient handling events.
_ is a side effect that can occur rapidly after spinal anesthesia is
administered. – ANSWER- hypotensive episode
Prolonged lithotomy positioning can result in neuropathies of the legs. The most
frequently injured nerves are the obturator, sciatic, femoral, and _ nerve, which can result in injury from _. – ANSWER- common peroneal; Direct
compression from the stirrup bars
Which of the following lists the correct order in the removal of soiled sterile attire
when breaking scrub? – ANSWER- gown gloves mask
The OR was trialling 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 14 L/min and the pressure had risen to 16 mm Hg. She
alerted the surgeon and reduced the rate and pressure because she feared that the
elderly patient was at high risk for: – ANSWER- hypercarbia
The immature blood-brain barrier and decreased protein binding in infants increase
their sensitivity to which group of medications? – ANSWER- opioids, hypnotics
Which of the following medications is a specific depolarizing muscle relaxant than
can produce generalized fasciculations? – ANSWER- succinylcholine
There are many factors that influence surgical wound healing. Some are helpful
and some are beyond the scope of the surgical team. Select the response below that
reflects a factor with high influence over wound healing and is within the control
of the surgical team. – ANSWER- tissue handling
Guidelines from WHO focus on which of the following in the prevention of
surgical site infections? – ANSWER- prophylactic antibiotics
Malignant Hyperthermia (MH) is a rare, multifaceted syndrome with an increased
incidence in individuals that exhibit which of the following? – ANSWERcongenital myopathies
The linea alba is extends from to ___. – ANSWER- above xiphoid
to pubis
Which of the following statements reflects the location of the arcuate line? –
ANSWER- one third distance from umbilicus to symphysis pubis
The instillation of a local anesthetic into the subarachnoid space is termed: –
ANSWER- spinal anesthesia
Suture permanently attached to the needle are referred to as____________. –
ANSWER- swaged
The scrub person was precepting a surgical technology student an orthopedic case.
The scrub person explained the importance of keeping the instruments free of
blood and bioburden during the procedure and demonstrated the best practice and
how to: – ANSWER- wipe the instruments with a sponge moistened with sterile
water after each use.
Which of the following is not a characteristic of silk suture? a. Soft
b. handling ability
c. knot security
d. memory – ANSWER- memory
It is important to assess pressure points when positioning a patient prone. Which of
the following are included in this assessment to prevent pressure injury? –
ANSWER- genitals, knees, toes, and eyes
RNFA FINAL PRACTICE EXAM 2023 REAL EXAM
QUESTIONS 400 QUESTIONS AND CORRECT DETAILED
ANSWERS (100%VERIFIED ANSWERS) |ALREADY GRADED
A+ (BRAND NEW!!)
Sara Gardiner is the perioperative nurse in the circulating role in OR 2, and is
planning for her three neurosurgical procedures for the day. She is explaining the
basic processes of the three procedures to the scrub person and double-scrubbed
surgical technology student: (1) a VP shunt insertion, (2) a reconstructive
craniosynostosis for an infant with severe deformity, and (3) exploration of a
severe head injury with increased intracranial pressure (ICP) to evacuate a
hematoma and possible brain tissue. To give the brain room to swell in the third
procedure, the bone flap may need to be sterile-wrapped and stored, for later
replacement. Sara asks the student to name the appropriate surgical approach to the
brain for each of the procedures. She expects the correct sequence to be: –
ANSWER- burr hole, craniectomy, and craniotomy.
Describe the boundaries of the surgical skin prep for the patient about to receive a
liver transplant. – ANSWER- From the neck to midthigh; bedline to bedline
Total thyroidectomy is the removal of both lobes of the thyroid and all thyroid
tissue present. Total thyroidectomy is the desired surgical treatment for patients
with: – ANSWER- thyroid cancer.
Which of the following describes a strangulated hernia? – ANSWER- A persistent
incarceration with a compromised blood supply
The Glasgow Coma Scale (GCS) is commonly used to assess patients with brain
injury using three indicators of cerebral function: eye opening, verbal
communication, and motor response to verbal and noxious stimuli. Within the
scoring range for the GCS, the best possible score is _ and the worst possible score is __. – ANSWER- 15; 3
What mouth structure is considered the boundary between the buccal cavity and
the lingual cavity? – ANSWER- Teeth
Laryngoscopy is direct visual examination of the interior of the larynx by means of
a rigid, lighted speculum known as a laryngoscope to obtain a specimen of tissue
or secretions for pathologic examination. What risk reduction strategy should the
perioperative nurse employ in preparing for the conclusion of the procedure? –
ANSWER- Maintain instrument setup until the patient leaves the OR.
Marissa Walton is transferred to the OR from the burn unit for debridement of the
partial-thickness burn areas and a dressing change under anesthesia. What
important preparation for the procedure will the perioperative nurse perform before
Marissa arrives in the OR? – ANSWER- Prewarm the OR to above the ambient
high temperature for an adult.
FESS provides a more functional approach to treat sinus disease. FESS involves
the endoscopic resection of inflammatory and anatomic defects of the sinuses
while preserving natural function in a surgical procedure that is minimally
invasive. From the following, choose an important finding that should be
communicated to the surgeon immediately during this procedure. – ANSWEREncroachment of the orbit
Administration of cyclogyl should be used in caution with which of the following
patient groups? – ANSWER- Patients on tricyclics
What drug can be used to reverse the effects of heparin ? – ANSWER- Protamine
sulfate
When assisting with an open inguinal hernia repair, the surgeon makes an incision
through which of the following to access the cremaster muscle, inguinal canal, and
cord structures? Choose the correct answer. – ANSWER- External oblique muscle
Identify the type of fracture that has more than two fragments. – ANSWERComminuted
Identify the correct path of the cardiac conduction system. – ANSWER- From the
SA node to the AV node to the bundle of His to the Purkinje system
Transsphenoidal hypophysectomy (TSH) is performed with the patient
administered a general endotracheal anesthetic, combined with a local anesthetic.
The surgical team places the patient in a semisitting position, with the head against
the headrest. A transnasal or a sublabial incision can be used for rapid access to the
sella turcica. Select the diad (2) of conditions that would be appropriate indications
for TSH. – ANSWER- Hypopituitarism and small pituitary tumors
Describe a pantaloon hernia. – ANSWER- A combination direct and indirect hernia
In renal transplantation a kidney with __ artery(ies) is preferred. –
ANSWER- single
With injury to the brain, swelling may occur quickly, requiring aggressive
decisions to manage increasing intracranial pressure (ICP). What is an appropriate
diuretic medication to give and what nursing actions would be indicated for an
older adult patient with traumatic brain injury, increased ICP, and a history of
congestive heart failure (CHF)? – ANSWER- Furosemide (Lasix) 20-80 mg IV;
monitor for hypotension and note extent of diuresis
The production of CSF occurs where? – ANSWER- Choroid plexus of the
ventricles
Select the true statement about antimetabolite drugs and their indications for use. –
ANSWER- 5-Fluorouracil and mitomycin can both be administered topically to
inhibit scars and pterygium excision
Select the statement that best reflects the functional components of the
gastrointestinal (GI) tract. – ANSWER- The alimentary canal extends from the
mouth to the anus.
As the surgeon prepared to clamp and transect the bowel during a small bowel
resection for tumor, the scrub person transferred instruments from the Mayo stand
to the back table and prepared the sterile field for bowel isolation technique. The
rationale for this technique in tumor removal/cancer procedures is to: – ANSWERPrevent mechanical metastasis
Heparin sodium is an anticoagulant. The basic mechanism of heparin’s action is
best described as: – ANSWER- prevents the conversion of fibrinogen to fibrin.
Which of the following associations is incorrect regarding gallstones? – ANSWERGallstones in cystic duct = cholangitis
The ovarian artery is a branch of which vessel? – ANSWER- Aorta
The double layer of fatty peritoneum attached to the greater curve of the stomach is
known as the __. – ANSWER- Omentum
There are several risk factors associated with dehiscence. Which of the following
can be controlled by the RNFA? – ANSWER- Sutures placed too close together
Skin grafting provides an effective way to cover a wound if vascularity is
adequate, infection is absent, and hemostasis is achieved. Skin from the donor site
is detached from its blood supply and placed in the recipient site. The best
description of a successful skin graft outcome is: – ANSWER- the recipient site
develops a new blood supply from the base of the wound.
Which of the following is the first major branch of the internal carotid artery? –
ANSWER- Opthalmic artery
As a person ages. there is reduced blood flow to the abdominal viscera, reduced
amounts of hydrochloric acid, and delayed gastric emptying. The result of of these
physical changes include: – ANSWER- Altered absorption of drugs
From the following, choose where the hypothalamus is located. – ANSWERAlong the floor of the third ventricle
Select the true statement about dacryocystorhinostomy (DCR). – ANSWER- DCR
establishes a new passageway for tear drainage into the nasal cavity.
A minimally invasive video-assisted thyroidectomy (MIVAT) procedure relies on
Miccoli instruments added to the standard thyroid or neck dissection setup, a 30-
degree endoscope, and an ultrasonic (harmonic) scalpel with scissors to ligate and
divide the vessels. An important risk reduction strategy for any minimally invasive
procedure would be ? – ANSWER- consider and plan for the possibility of
conversion to open thyroidectomy.
When laryngoscopy, bronchoscopy, and esophagoscopy are performed in a single
session on a patient, the procedure is termed triple endoscopy or panendoscopy.
The purpose of triple endoscopy is usually diagnostic. A critical role of the
perioperative nurse during this complex diagnostic procedure is that of: –
ANSWER- identifying, containing, and labeling all specimens accurately.
Which of the following is not a reason to convert a case from laparoscopic to an
open abdominal case? – ANSWER- Lack of warmer for insufflation gas
RNFA FINAL EXAM 2023 VERSION 1 & 2 ACTUAL EXAM 320
QUESTIONS AND CORRECT DETAILED ANSWERS
(100%VERIFIED ANSWERS) |ALREADY GRADED A+(BRAND
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The RNFA with the vascular surgery service is preparing to discharge Mark
Weston, a 51 yr old male who recently had endovascular surgery. He will be taking
anticoagulation therapy for the next 12 weeks. What statement regarding
anticoagulation therapy, that is relevant to Mark, is true? – ANSWER- Do not use
tools such as saws or hammers, which could lead to an accident.
Pericardial tamponade includes which of the following signs or symptoms? –
ANSWER- Narrow pulse pressure
Identify the venous structure that prevents blood back flow. – ANSWERSemilunar Intimal folds
Velour grafts are impregnated with which of the following to ease handling
without the need to preclot? – ANSWER- Gelatin
The blood is oxygenated in the lungs and returns to the left atrium through the
pulmonary veins. Where does the blood flow after leaving the left atrium? –
ANSWER- Through the mitral valve into the left ventricle
Which of the following documentation requirements is unique to vascular surgery?
- ANSWER- Clamp application and removal times
Identify from the following, the correct branch of the left main coronary artery. –
ANSWER- Circumflex coronary artery
What does the presence of bruit on auscultation of a blood vessel mean? –
ANSWER- Blood flow is disrupted
Of the following ocular blocks, which carries the highest risk? – ANSWERRetrobulbar Block
A portion of a parathyroid glands must remain for which of the following reasons? - ANSWER- Prevent hypocalcemia and it’s complications
Select the set of symptoms that is most commonly associated with hypothyroidism
- ANSWER- Increased swearing, insomnia, tremor, and muscle weakness
An important anatomical landmark in thyroid surgery is known as – ANSWERPoles
A power drill and assorted roasting burrs are essential for middle ear surgery and
some sinus procedures. During drill and power saw use, the scrub person keeps
irrigation solution on the sterile field to – ANSWER- Prevent clogging of the burr
and contamination of the area with bone dust
Which nodes in the lymphatic system are responsible for drainage from the mouth,
lips, and external nose? – ANSWER- Submandibular
Fibrous bands of tissue found between abdominal structures that are not normally
connected are known as – ANSWER- Adhesions
Choose the correct flow of bile from the gallbladder – ANSWER- Cystic duct,
common duct, ampulla of Vater, duodenum
Select the statement that best reflects the functional components of the
gastrointestinal tract – ANSWER- The alimentary canal extends from the mouth to
the anus
Which of the following hernia types is considered a surgical emergency –
ANSWER- Strangulated
Closed thoracostomy will require which of the following – ANSWER- Chest
catheters and water-seal drainage
A minimally invasive technique that may be used to remove parathyroid tumors
deep in the mediastinum is known as – ANSWER- Thoracoscopy
The common bile duct drains into the – ANSWER- Duodenum
Before reaching the rectus abdominis muscle during surgical exposure, the surgeon
must first progress through which of the following? – ANSWER- Scarpa’s fascia
The transverse colon ends at the – ANSWER- Splenic flexure
The mediastinal surface of the lungs contains a structure known as _ in
which nerves, vessels, bronchus, and lymphatics enter and leave the lung –
ANSWER- Hilum
The absence of distinct teniae serves as a visual landmark for what abdominal
structure – ANSWER- Upper margin of the rectum
A benefit to the patient undergoing SILS procedure is which of the following –
ANSWER- Less postoperative pain
Hernia that occur within Hesselbach’s triangle are called – ANSWER- Direct
inguinal hernia
Innervation of the lungs is part of the _______System – ANSWER- Autonomic
During kidney transplant surgery and prior to clamping the renal vessels, which of
the following drugs are administered to prevent intravascular clotting and
maximize diuresis – ANSWER- Heparin and mannitol
What term is used to describe inflammation of the gallbladder – ANSWERCholecystitis
Each lung contains how many segments – ANSWER- 10
The head of the pancreas is fixed to which structure – ANSWER- Duodenum
The pantaloon hernia can best be described as – ANSWER- A combination of
direct and indirect hernia
There are several risk factors associated with dehiscence. Which of the following
can be controlled by the RNFA? – ANSWER- Sutures placed too close together
James Romano, a 68 year old retired teacher, presents for surgical intervention of
recently diagnosed bladder cancer. He states the cancer is located in the urothelial
layer. As the RNFA you realize this is ________layer of the bladder – ANSWERInner
The most commonly injured Intraabdominal organ in blunt trauma is the –
ANSWER- Spleen
The mesh plug open hernia repair technique is indicated for which types of hernias
- ANSWER- Recurrent indirect inguinal hernias
The liver, pancreas, and spleen share many similarities. Select the statement about
these organs that is true – ANSWER- All three are solid organs and very vascular
From the following, choose a hernia type that is common in children and
frequently disappears spontaneously – ANSWER- Umbilical hernia
An example of a potential risk associated with pneumoperitoneum would be –
ANSWER- gas embolus into an exposed blood vessel during the procedure.
Femoral hernias occur more frequently in which group of individuals – ANSWERFemales
The renal artery and vein enter and exit the kidney the medical side of the organ
through a concave area known as the – ANSWER- Hilum
Select the triad of the boundaries of Hesselbach triangle – ANSWER- Inguinal
ligament, rectus abdominis muscle, deep epigastric vessels
Which of the following is a triangle anatomic landmark in surgical removal of the
gallbladder and may be remembered by the 3 Cs – ANSWER- Calot’s
Choose the correct statement regarding the trigone of the bladder – ANSWERForms the base of the bladder
An orchiopexy is the surgical placement and fixation of the testicles in a normal
anatomic position in the scrotal sac. If the testis fails to descend into the scrotum
during gestation, it is considered undescended. Which statement regarding
indications for orchiopexy is true – ANSWER- All testes that are undescended after
1 year require surgical placement in the scrotum
Which of the following describes a hydrocele – ANSWER- It refers to excess fluid
within the tunica vaginalis
Which of the following layers of the uterus contains the lymphatics – ANSWERMyometrium