RNFA Final Practice
Exam Questions
and Complete
Solutions Graded
A+
Denning [Date] [Course title]
,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 co -
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