d RNFA FINAL EXAM WITH COMPLETE d d d d
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The process of decontamination should initially begin at what point? - Correct Answer - Completion of
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the surgical procedure
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Side effects the patient may encounter as a result of extracoproreal circulation include: - Correct
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Answer - Inflammatory responses
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After retracting the nerve roots during a laminectomy, this structure is incised before getting to the
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disc. - Correct Answer - Posterior longitudinal ligament
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Of the following, which is not a symptom of compartment syndrome? - Correct Answer - Moderate
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pain
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Fibrocystic changes in the breast describe many different breast changes. These changes affect almost
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all women at some time in their lives. Nipple discharge is more commonly associated with benign
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lesions than with cancer; however, discharge is usually significant only if it is spontaneous, persistent,
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and: - Correct Answer - bloody
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Jan Stuyvesant, a perioperative nurse, was the scrub person during a robotic-assisted laparoscopic
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dcholecystectomy. She locked the robotic endoscissor into the adaptor on the robotic arm and
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dpositioned the tip end into the trocar port in order for the surgeon to dissect the cystic duct and
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dartery, while the surgical assistant placed the clips on the cystic duct and artery. As she reached across
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dthe sterile field to insert the cholangiocatheter through the port, the anesthesia provider accidentally
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dmade contact with the distal end of the catheter as he stood up to reach the monitor controls. The
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dcontaminated end of the catheter touched the endoscopic clip applier, the endoscissor connector that
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dthe surgeon was using, the glove of the assistant, and Jan's gown sleeve. The surgeon ordered
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deveryone to change their gown and gloves and covered the port area with a sterile towel. What was
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,d the rationale for the surgeon to co - Correct Answer - The surgeon was not in contact with the sterile
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d field because he worked from the robotic console.
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The ability to maintain thermoregulation is compromised in elders because of changes in the: - Correct
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Answer - vascular system
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Because herbal products are so readily available and have such widespread media attention, many
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people think that they can safely self-medicate. Why should the public be aware and educated about
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dietary supplements and potential harmful effects? - Correct Answer - Unknown substances may be
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present in these products.
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Talia Mendelson, a 27-year-old patient who had a lumpectomy for early-onset breast cancer, is now
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scheduled for infusion port insertion. Talia is very nervous because during the previous lumpectomy,
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performed using a local anesthetic, she was not entirely sedated. Talia tells the perioperative nurse
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that she was uncomfortable and heard everything in the room, but admitted that she did not feel
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pain. The nurse recognized Talia's anxiety related to the surgical intervention and prepared to
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implement corrective actions in the OR. What nursing intervention best reflects one that would
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ensure support or contribute to Talia realizing her expected outcome? - Correct Answer - Ensure a
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quiet and calm environment of care
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A 26-year-old female is rushed to the operating room after a primary and secondary survey in the
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emergency department. She was hit by a small truck as she was riding her bicycle through a busy
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intersection. She has sustained rib fractures and several fractured transverse vertebral processes.
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Renal injury is suspected. As the perioperative nurse prepares to insert a urinary catheter, she notices
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blood at the urinary meatus. What should the nurse's next action be? - Correct Answer - Discontinue
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the catheter insertion
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Open parathyroidectomy is currently being replaced with less invasive and more targeted techniques;
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however, the amount of parathyroid tissue that should be removed remains controversial and relates
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to whether single or multiple glands are involved. A portion of a gland must remain to: - Correct
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Answer - prevent hypocalcemia and its complications.
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Which of the following supplies blood to the transverse colon? - Correct Answer - Middle colic artery
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,Which of the following structures form the mouth? - Correct Answer - cheeks, the hard palate, the
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mandible, and the tongue
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The salivary glands produce saliva, which serves to moisten the mouth and initiate: - Correct Answer -
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carbohydrate digestion.
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Potential development of a direct inguinal hernia results from ___________and __________weakening
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or tearing. - Correct Answer - Aponeurosis of transversus abdominus and transversalis muscle
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When the patient arrives in the ED, the trauma team initiates a primary assessment. This is a logical,
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orderly process of patient assessment for potential life threats. These assessment activities are based
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on established protocols for advanced trauma life support (ATLS). The mnemonic "ABCDE" is used,
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representing assessment of the following: Airway, Breathing, Circulation, Disability, and Exposure. The
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D and E represent what degree of investigation? - Correct Answer - D = a brief neurologic
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examination; E = exposure to reveal all life-threatening injuries
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What structure covers the spermatic cord and contracts to make the testicles ascend in the scrotum? -
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Correct Answer - Cremaster muscle
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Which of the following is not included in the group of tendons that comprise the rotator cuff? -
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Correct Answer - Teres Major
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The cranial meninges are composed of all except _____. - Correct Answer - Pericranial mater
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Sara Gardiner is the perioperative nurse in the circulating role in OR 2, and is planning for her three
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neurosurgical procedures for the day. She is explaining the basic processes of the three procedures to
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the scrub person and double-scrubbed surgical technology student: (1) a VP shunt insertion, (2) a
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reconstructive craniosynostosis for an infant with severe deformity, and (3) exploration of a severe
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head injury with increased intracranial pressure (ICP) to evacuate a hematoma and possible brain
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tissue. To give the brain room to swell in the third procedure, the bone flap may need to be sterile-
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wrapped and stored, for later replacement. Sara asks the student to name the appropriate surgical
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, d approach to the brain for each of the procedures. She expects the correct sequence to be: - Correct
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d Answer - burr hole, craniectomy, and craniotomy.
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Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant. -
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Correct Answer - From the neck to midthigh; bedline to bedline
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Total thyroidectomy is the removal of both lobes of the thyroid and all thyroid tissue present. Total
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thyroidectomy is the desired surgical treatment for patients with: - Correct Answer - thyroid cancer.
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Which of the following describes a strangulated hernia? - Correct Answer - A persistent incarceration
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with a compromised blood supply
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The Glasgow Coma Scale (GCS) is commonly used to assess patients with brain injury using three
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indicators of cerebral function: eye opening, verbal communication, and motor response to verbal and
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noxious stimuli. Within the scoring range for the GCS, the best possible score is _____ and the worst
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possible score is ______. - Correct Answer - 15; 3
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What mouth structure is considered the boundary between the buccal cavity and the lingual cavity? -
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Correct Answer - Teeth
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Laryngoscopy is direct visual examination of the interior of the larynx by means of a rigid, lighted
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speculum known as a laryngoscope to obtain a specimen of tissue or secretions for pathologic
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examination. What risk reduction strategy should the perioperative nurse employ in preparing for the
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conclusion of the procedure? - Correct Answer - Maintain instrument setup until the patient leaves
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the OR.
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Marissa Walton is transferred to the OR from the burn unit for debridement of the partial-thickness
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burn areas and a dressing change under anesthesia. What important preparation for the procedure
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will the perioperative nurse perform before Marissa arrives in the OR? - Correct Answer - Prewarm
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the OR to above the ambient high temperature for an adult.
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