RNFA FINAL PRACTICE The process of decontamination should initially begin at what point? - Completion of the surgical procedure Side effects the patient may encounter as a result of extracoproreal circulation include: - Inflammatory responses After retracting the nerve roots during a laminectomy, this structure is incised before getting to the disc. - Posterior longitudinal ligament Of the following, which is not a symptom of compartment syndrome? - Moderate pain Fibrocystic changes in the breast describe many different breast changes. These changes affect almost all women at some time in their lives. Nipple discharge is more commonly associated with benign lesions than with cancer; however, discharge is usually si gnificant only if it is spontaneous, persistent, and: - bloody Jan Stuyvesant, a perioperative nurse, was the scrub person during a robotic -assisted laparoscopic cholecystectomy. She locked the robotic endoscissor into the adaptor on the robotic arm and positioned the tip end into the trocar port in order for the surg eon to dissect the cystic duct and artery, while the surgical assistant placed the clips on the cystic duct and artery. As she reached across the sterile field to insert the cholangiocatheter through the port, the anesthesia provider accidentally made cont act with the distal end of the catheter as he stood up to reach the monitor controls. The contaminated end of the catheter touched the endoscopic clip applier, the endoscissor connector that the surgeon was using, the glove of the assistant, and Jan's gown sleeve. The surgeon ordered everyone to change their gown and gloves and covered the port area with a sterile towel. What was the rationale for the surgeon to co - The surgeon was not in contact with the sterile field because he worked from the robotic console. The ability to maintain thermoregulation is compromised in elders because of changes in the: - vascular system Because herbal products are so readily available and have such widespread media attention, many people think that they can safely self -medicate. Why should the public be aware and educated about dietary supplements and potential harmful effects? - Unknown substances may be present in these products. Talia Mendelson, a 27 -year -old patient who had a lumpectomy for early -onset breast cancer, is now scheduled for infusion port insertion. Talia is very nervous because during the previous lumpectomy, performed using a local anesthetic, she was not entirely sedated. Talia tells the perioperative nurse that she was uncomfortable and heard everything in the room, but admitted that she did not feel pain. The nurse recognized Talia's anxiety related to the surgical intervention and prepared to implement correctiv e actions in the OR. What nursing intervention best reflects one that would ensure support or contribute to Talia realizing her expected outcome? - Ensure a quiet and calm environment of care A 26 -year -old female is rushed to the operating room after a primary and secondary survey in the emergency department. She was hit by a small truck as she was riding her bicycle through a busy intersection. She has sustained rib fractures and several fract ured transverse vertebral processes. Renal injury is suspected. As the perioperative nurse prepares to insert a urinary catheter, she notices blood at the urinary meatus. What should the nurse's next action be? - Discontinue the catheter insertion Open parathyroidectomy is currently being replaced with less invasive and more targeted techniques; however, the amount of parathyroid tissue that should be removed remains controversial and relates to whether single or multiple glands are involved. A porti on of a gland must remain to: - prevent hypocalcemia and its complications. Which of the following supplies blood to the transverse colon? - Middle colic artery Which of the following structures form the mouth? - cheeks, the hard palate, the mandible, and the tongue The salivary glands produce saliva, which serves to moisten the mouth and initiate: - carbohydrate digestion. Potential development of a direct inguinal hernia results from ___________and __________weakening or tearing. - Aponeurosis of transversus abdominus and transversalis muscle When the patient arrives in the ED, the trauma team initiates a primary assessment. This is a logical, orderly process of patient assessment for potential life threats. These assessment activities are based on established protocols for advanced trauma life support (ATLS). The mnemonic "ABCDE" is used, representing assessment of the following: Airway, Breathing, Circulation, Disability, and Exposure. The D and E represent what degree of investigation? - D = a brief neurologic examination; E = exposure to reveal all life -threatening injuries What structure covers the spermatic cord and contracts to make the testicles ascend in the scrotum? - Cremaster muscle Which of the following is not included in the group of tendons that comprise the rotator cuff? - Teres Major The cranial meninges are composed of all except _____. - Pericranial mater 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 tec hnology 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. T o 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: - burr hole, craniectomy, and craniotomy. Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant. - 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: - thyroid cancer. Which of the following describes a strangulated hernia? - 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 ______. - 15; 3 What mouth structure is considered the boundary between the buccal cavity and the lingual cavity? - 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 periopera tive nurse employ in preparing for the conclusion of the procedure? - 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? - 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 follo wing, choose an important finding that should be communicated to the surgeon immediately during this procedure. - Encroachment of the orbit Administration of cyclogyl should be used in caution with which of the following patient groups? - Patients on tricyclics What drug can be used to reverse the effects of heparin ? - 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. - External oblique muscle Identify the type of fracture that has more than two fragments. - Comminuted
