RNFA FINAL PRACTICE
The process of decontamination should initially begin at what point? - Answer- Completion of the surgical procedure
Side effects the patient may encounter as a result of extracoproreal circulation include: -
Answer- Inflammatory responses
After retracting the nerve roots during a laminectomy, this structure is incised before getting to the disc. - Answer- Posterior longitudinal ligament
Of the following, which is not a symptom of compartment syndrome? - Answer- 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 significant only if it is spontaneous, persistent, and: - Answer- 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 surgeon 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 contact 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 continue to dissect and not change his attire? - Answer- 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: - Answer- 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? - Answer- 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
corrective actions in the OR. What nursing intervention best reflects one that would ensure support or contribute to Talia realizing her expected outcome? - Answer- 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 fractured 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? - Answer- 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 portion of a gland must remain to: - Answer- prevent hypocalcemia and its complications.
Which of the following supplies blood to the transverse colon? - Answer- Middle colic artery
Which of the following structures form the mouth? - Answer- cheeks, the hard palate, the mandible, and the tongue
The salivary glands produce saliva, which serves to moisten the mouth and initiate: - Answer- carbohydrate digestion.
Potential development of a direct inguinal hernia results from ___________and __________weakening or tearing. - Answer- 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? - Answer- 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? - Answer- Cremaster muscle
Which of the following is not included in the group of tendons that comprise the rotator cuff? - Answer- Teres Major The cranial meninges are composed of all except _____. - Answer- 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 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. - Answer- Encroachment 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. - Answer- Comminuted
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.
