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NIFA Exam Bundle (Graded A)
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NIFA STUDY GUIDE LATEST UPDATED (GRADED A)
The number one patient safety issue identified in a survey of peri-operative nurses is preventing: - Answer- Wrong site/procedure/patient surgery Reproc... [Show More] essing (flashing) instruments in the OR is high risk because: - Answer- OR personnel not properly trained to reprocess instruments To safely transfer and position patients in a manner that prevents shearing, personnel should use a mechanical lifting device for a supine-to-supine transfer of a patient weighing more than: - Answer- 157 lbs _______________ should be the primary decision makers for what equipment and supplies are purchased and stocked in the difficult airway management cart. - Answer- Anesthesia personnel Proper specimen management techniques prevent errors and include all of the following EXCEPT: - Answer- Receiving specimens from the surgical field then affixing patient label to each Preventing surgical fires is a top priority for all OR personnel and members of the surgical team should perform all of the following duties EXCEPT: - Answer- Perform a weekly fire risk assessment Peri-operative hypothermia is an important issue for all anesthetized patients because of all of the following EXCEPT: - Answer- Increases risk of renal failure Recommendations for preventing retained surgical items include all of the following EXCEPT: - Answer- Utilizing a multidisciplinary team to resolve incorrect counts Select the appropriate order for administering blood and blood products. - Answer- Verify informed consent for blood, verify patient identification and blood type and unit numbers against blood tag and requisition slip with second licensed person, sign slips Weighing sponges is a valuable tool for meticulous calculation of blood and fluid loss when conducted correctly and used in appropriate circumstances. Select the response that correctly reflects the best practice in weighing sponges. - Answer- Keep a running total blood loss calculated from available sponges during procedure Laparoscopic procedures that emergently convert to open procedures place the patient at risk for unintentional retained foreign objects (RFOs). What new and evolving risk reduction strategy could prevent RFOs and frustrating, time-consuming miscount adventures at the end of these procedures? - Answer- Replacing or tagging sponges and laparotomy instruments with radiofrequency identification (RFID) chips A female patient with end-stage pancreatic cancer was admitted from hospice for a celiac plexus block to treat intractable pain. She had a Whipple procedure 18 months earlier and enjoyed a good quality of life until 3 weeks ago. She wanted to be able to complete "getting her things in order" and saying good-bye to her friends and family while enjoying her last days pain-free. The patient insisted that her Do Not Resuscitate (DNR) status NOT be rescinded. She was conscious and competent and knew what was best for herself. The patient was taking full advantage of what provision for her care? - Answer- PSDA and advance directives A patient was presented with the prepared informed consent form during the discussion with her surgeon concerning her scheduled vaginal-assisted laparoscopic hysterectomy. She demonstrated and verbalized that she understood all of the tenets of the procedure, risks, expected outcome, complications, and procedural process. Before she signed the consent form, she informed the surgeon that she did not want any medical students or surgical residents performing any parts of the procedure other than assisting and did not want any photographs of her body taken. The surgeon agreed, and she crossed out those portions of the form and initialed them before she signed. The patient was exercising her: - Answer- right to informed consent. Early on, 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. He had meticulously maintained accountability for all sponges and instruments discarded from the sterile field and bagged each sponge carefully. He immediately turned and addressed the entire team in a clear voice. Select the appropriate communication that the circulating nurse must employ 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. Everyone, please check your areas. The OR is a danger-prone area for both patients and staff. Providing a safe environment of care for the patient involves identifying, mitigating, and managing the hazards inherent in surgical care. Choose the answer below that completes the blanks in this sentence: The risk of the surgical hazard of _________________ can be mitigated through _______________________. - Answer- wrong patient, wrong site, and wrong side surgery; site marking and presurgical checklists A patient was transferred to the postanesthesia care unit (PACU) by the anesthesia provider and perioperative nurse. A hand-off report was given, using situation, background, assessment, recommendation (SBAR) format, to the accepting PACU nurse. The first element of information that should be presented in the hand-off report is: - Answer- patient identification and procedure performed. If a staff person receives a needlestick injury, what is the first corrective action? - Answer- Wash wound with soap and water; flush mucous membranes. Contact with infected patients or infectious material places healthcare workers at risk for occupational-acquired infection. Which communicable disease are healthcare workers at risk for acquiring or transmitting? - Answer- Seasonal influenza Select the appropriate nursing action that supports hands-free instrument passing and sharps safety. - Answer- Create a neutral hands-free area between the scrub person and surgeon with a basin or magnetic mat. Select the guideline that complements the design of the culture of safety model. - Answer- Incorporate safe practices into your daily work when handling sharps. A neutral zone is a predetermined location on the surgical field where sharps are placed for retrieval by the surgeon. Which of the following is a best practice for the use of the neutral zone? - Answer- Announce the transfer of each sharp before placing it in the neutral zone. Which of the following may be a consequence of high-dose or full-body radiation? - Answer- Nausea, vomiting, and diarrhea Exposure to blood-borne pathogens occurs during all phases of the perioperative process. Observing safety precautions during all phases of surgery, from setup to cleanup, reduces the number of injuries and exposures for all OR personnel. For the prevention of sharps injuries in the pre-procedure and post-procedure phases, which safe handling practices reflect appropriate nursing actions? - Answer- Use standardized sterile field setups throughout the surgical service department. Transport reusable sharps in a safe, closed container to the decontamination cleanup area. Do not place hands or fingers into a container to dispose of a device. Inspect the sharps container for overfilling before discarding disposable sharps in it. Which list of medications best reflects medications indicated for latex sensitivity therapeutic management? - Answer- Epinephrine, prednisone, and a beta-agonist inhaler While antibiotics have been credited with saving lives, misuse of antibiotics has contributed to the evolution of multidrug-resistant organisms (MDROs). Select the antibiotic application that has evident to support it as a best practice and not, potentially, a misuse of antibiotics. - Answer- Antibiotics given intravenously within 1 hour of the incision for every procedure with an incision or entered body system. With the production of more steam in the sterilizer chamber, the pressure increases as well. The steam should contain little or no entrapped liquid water. Steam quality is the term that describes the amount of water mixed with the steam. The constitution of high-quality steam would be measured by: - Answer- <3% of the mixture is liquid water. A 47-year-old man was admitted to the emergency department (ED) with respiratory symptoms, facial and upper body abrasions, burns, and moist lesions after a small package, delivered to his office, exploded and sprayed him dried powder and glass shards. In response to the reported mechanism of injury, the ED team sequestered him in a secluded area away from the rest of the patients. The team believed that this was highly suspicious of a bio-terrorism event. The epidemiologist was called, and the patient was transferred to a negative-pressure isolation room and placed on standard, contact, airborne, and droplet precautions. Based on these actions, which microorganism agents might be suspected to be involved? - Answer- Anthrax and smallpox Qualities of an effective packaging material must include several key characteristics. Select the three most important qualities. - Answer- Good steam penetration and removal, good microbial barrier, aseptic presentation. The design of the physical space within an OR attempts to minimize horizontal surfaces by placing cabinets flush with the wall. This prevents dust settling on multiple surfaces and decreases the areas that have to be monitored and cleaned. Another concern with horizontal surfaces is that is turbulence from staff movement and activity plus door movement, when it opens and closes, can: - Answer- mobilizing resting dust from these surfaces. An 86-year-old male was admitted to the intensive care unit (ICU) 3 weeks ago for heart failure and intractable atrial fibrillation. He has had diarrhea for 4 days that has cultured C. difficile. The transmission-based precautions sign on the door to his room alerts the staff to employ which practice precaution? - Answer- Both standard precautions and contact precautions Closed gloving is the technique of choice for the initial donning of sterile gloves by the scrubbed team member; however: - Answer- it can only be used for the initial gloving. the final step, after decontamination and before sterilization, is the prep, pack, and wrap process. The sterile processing technologist has taken the laparotomy set from the washer/decontaminator to prepare for sterilization. Select the most appropriate order that the instrument set must travel before reaching the steam sterilizer. - Answer- Inspect, inventory against list, assemble, place integrators, wrap and tape A patient undergoing a laparoscopic Nissen fundoplication procedure will be positioned in both high and low lithotomy during the procedure. After the patient is re-positioned into lo lithotomy, the perioperative nurse should: - Answer- reassess the patient for body alignment, tissue integrity, and pressure areas. A 68-year-old, American Society of Anesthesiologists (ASA) physical status (OS)-2 male with early-stage prostatic cancer, was intubated and positioned for a robotic-assisted laparoscopic radical prostatectomy. The initial position for insertion of the trocars was supine with arms tucked and secured within under-mattress sled arm positioners padded with gel. His hands were placed in a natural position with the fingers wrapped around gauze rolls and touching his lateral thighs. The new anesthesia provider, who had never seen a robotic prostatectomy, was concerned about anesthesia implications when the patient would be repositioned into extreme Trendelenburg for the dissection and anastomosis. The circulating nurse assured her that they would implement protective measures and work together to ensure the best patient outcome. Select all of the potentially harmful effects of extreme 45-degree Trendelenburg in a robotic procedure. - Answer- Respiratory compromise and ventilation resistance Shearing injury to soft tissues A 325-pound male is scheduled for a 6-hour abdominal surgery. While assessing the patient in the preoperative holding area, the perioperative nurse is concerned about the risk for pressure injury because of the weight of the patient's body pressing against the surface of the operating room bed for a long surgery. Which of these other factors may also produce pressure? - Answer- A self-retianing retractor post clamped to the OR bed rail and tightened against the patient's side. 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; full leg pneumatic compression sleeves While tucking the arms at the sides of the patient in supine position offers comfort, safety, and easy access to the patient by the scrubbed team, improper positioning and securing of the arms can result in significant injury. Injury can be avoided by tucking the draw sheet ___________ the arm and under the ____________. - Answer- around; body While Fowler's position offers the best respiratory excursion for the patient, the patient is at higher rick for _________ because of dependent pooling in the hips and legs. - Answer- venous thromboembolism (VTE) Positioning devices should be used according to the original equipment manufacturer's instructions to reduce the capillary interface pressure to below: - Answer- 32 mm Hg A frail and thin 91-pound, 83-year-old woman is scheduled for a right pneumonectomy for non-small cell lung cancer. She will be positioned in left lateral position for her procedure. Based on the perioperative nurse's preoperative assessment, identify three position-related nursing diagnoses for this procedure and four relevant nursing interventions. Select from the options to fill in the blanks. - Answer- Hypothermia; impaired skin integrity; falls; remain at patient's side during induction; use under- and over-body forced air warming blanket; use at least four people to assist with lift and transfer; pad all bony prominences with foam or gel pads. The lateral kidney position allows approach to the retro-peritoneal area of the flank. To render the kidney region readily accessible, the _________________ is raised, and the bed flexed so that the area between the twelfth rib and the iliac crest is elevated. Compression of the ________________ can occur when the flank is raised too high. - Answer- kidney bridge; vena cava A veteran perioperative nurse remembers a time when all suture needles had eyes, and she even had her own needle rack. She hand-threaded all sutures according to the surgeon's preference. The newer sutures were originally called "atraumatic" sutures because they did not double back through a needle eye and cause tissue trauma during pulling or suturing through the tissue. Today, we call this manufacturing process of connecting the suture thread to the needle: - Answer- swaged The ideal suture material is one that has handling characteristics such as: - Answer- ease of tying Careful counting (according to established policy), situational awareness, and conscientious and meticulous attention to the field are believed to prevent miscounts and lost items. A recent patient safety statement about preventing retained foreign objects recommends which of these practices? - Answer- Verbal handoff must include count status at time of relief. An older surgeon explains his justification for this suture choice to the new perioperative nurse in the scrub role. He prefers to suture his intestinal anastomosis with a suture that has multiple filaments braided together because it ties well and holds the knot, which tightens when the thread absorbs the tissue fluids. He also needs a strand that is easy to see and only needs to retain its tensile strength for about 1 year, at which time the intestinal junction will be healed, even though this suture is considered nonabsorbable. He will ask the nurse for a 24-inch 4-0: - Answer- Sofsilk Flat neurosurgical patties are flat sponges composed of soft compressed cotton or rayon with an embedded radiopaque element and string attached. They are often used in neurosurgical procedures. While used for hemostasis and exposure, what other use would be important in surgery? - Answer- Application of topical steroids the circulating nurse received the trauma call from the emergency department (ED) and called sterile supply to assemble the instruments for an abdominal trauma case with possible aortic rupture. When the cart arrived, she saw the vascular set; however , the most important set was missing. What important instrument set was needed for this procedure besides the vascular set? - Answer- Basic laparotomy set The primary use for suture is essentially to: - Answer- ligate, suture, and close tissue. Wound tissue healing is enhanced by the use of stapling instruments that mechanically apply internal staples for ligation and division, resection, and anastomoses. What feature of the mechanical process reduces tissue manipulation, edema, and inflammation? - Answer- The non-crushing B shape of the staples allows nutrients to pass through. According to a 2010 article published in The Journal of the American College of Surgeons and citing data from a 1998 study, where do more that half of needle-stick injuries involving suture needles occur? - Answer- During the suturing of fascia or muscle tissue The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the - Answer- Superior hypogastric plexus Which of the following is an important statement regarding the prevention of degenerative orthopedic conditions - Answer- Weight-bearing activities and joint movement prevent cartilage from becoming thin or damaged The cerebellar tentorium supports which structures of the cerebral hemispheres - Answer- Temporal lobe the surgeon makes an incision through which of the following to access the cremaster muscle, inguinal canal, and cord structures - Answer- External oblique muscle a physical barrier used in the prevention of adhesions that can take up to 2 weeks to absorb - Answer- Interseed Tissue reaction characteristics that need considered when choosing suture include - Answer- Absorption The diagnostic test that is performed to differentiate between acute and chronic thrombosis - Answer- Digital subtraction angiography Morbidity and mortality may be greater with penetrating trauma because identification of injuries may be more difficult when injuries are less obvious. In the case of an adult victim with a low-velocity, low-caliber gunshot wound, at far range, of the anterior left quadrant of the lower abdomen, what is the MOI and description of the possible injuries - Answer- enetrating; small entrance wound, puncture of the anterior wall of the sigmoid colon, no disruption of vessels, and bullet not found in pelvis 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 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. a possible benefit to the paramedian incision - Answer- decreased risk for hernia An example of an indication for liver transplantation would be - Answer- primary hepatic cancer he largest part of the mammary gland rests on the - Answer- Pectoralis major muscle and serratus anterior During ventriculoperitoneal shunt placement, - Answer- The unit is soaked in NS & antibiotic solution, never lubricated. Patients with chronic venous insufficiency (CVI) are not typically treated surgically as often as patients with arterial disease because: - Answer- CVI is not life-threatening or limb-threatening 35% of the refractive power of the eye is credited to which part of the eye - Answer- Lens Oculocardiac reflex (OCR) is an intraoperative emergency that can occur during eye surgery. Select the definition of the response and contributing factor(s) - Answer- Trigeminal-vagal response caused by pressure on the globe or retrobulbar block The perioperative nurse must be prepared for which additional procedure when head and neck surgery is performed? - Answer- Tracheostomy The perioperative nurse preparing for a procedure where STSGs will be taken to cover several large burn areas will need to have available: - Answer- sterile mineral oil, tongue blades, and a mesher dermatome the correct term to describe the inward turning of one or both eyes - Answer- Esotropia The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the - Answer- Superior hypogastric plexus which surgical approach reduces the morbidity and mortality in removal of an acoustic tumor - Answer- Translabyrinthine approach Pt with hepatobiliary disease, The perioperative nurse, during the preoperative assessment, questions and examines the patient for signs and symptoms of jaundice, petechiae, and lethargy and: - Answer- review chart for bleeding and coagulation times and the platelet count. The external ear canal lining - Answer- reduces bacterial levels in the outer ear Miotics and mydriatics produce opposite effects on the pupil of the eye. Select the most appropriate statement about miotic and mydriatic drugs - Answer- Mydriatic drugs, such as phenylephrine, dilate the pupil. Vascular access in pediatric patients may be established intraoperatively for short-term (weeks) or long-term (months, years) use - Answer- Central venous line What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp - Answer- Subgaleal space Pericardial tamponade includes which of the following signs or symptoms - Answer- Narrow pulse pressure Which statement regarding level III and level IV trauma centers best describes the difference between the two types of centers - Answer- A level III trauma center provides advanced cardiac life support (ACLS), surgery, stabilization, and transfer, while a level IV only provides ACLS services before immediate transfer to a higher level center A percutaneous method of instituting femoral vein-femoral artery cardiopulmonary bypass (CPB) can be used for minimally invasive (or conventional open) procedures and in emergency situations where the environment is not conducive to traditional CPB methods. Select the areas where percutaneous CPB would be indicated - Answer- Cardiac catheterization unit and intensive care unit Which two similar hernia repair approaches reestablish the integrity of the transversalis fascia and simultaneously reestablish and strengthen the posterior inguinal floor by sewing the transversalis fascia to the Poupart ligament? - Answer- The McVay or the Cooper ligament repair Identify the class of medications that can increase the risk or severity of a reaction to contrast media - Answer- Beta Blockers The recommended length of time for inflation of an upper extremity tourniquet on a [Show Less]
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NIFA FINAL EXAM QUESTIONS AND ANSWERS
peripheral nerve block for ankle ORIF would complain if which symptom - Answer- metallic taste in mouth positioning arms correctly to avoid pressure on ... [Show More] the elbow to prevent - Answer- ulnar nerve injury positioning device for bariatric patients prior to intubation - Answer- upper body ramp depolarizing muscle relaxant that produces generalized fasciculations - Answer- succinylcholine hemostatic device offers rapid and secure method of clamping, metal and MRI compatible - Answer- ligating clip positioning device for head cases - Answer- mayfield head positioner suture permanently attached at the end of the needle referred to as - Answer- swaged overpressurization can lead to - Answer- hypercarbaria most commonly used local anesthetic - Answer- lidocaine double gloving - Answer- the american college of surgeons endorses double gloving for all surgery and invasive procedures anesthesia that lets patients maintain their own airway and be easily aroused from sleep - Answer- moderate sedation / analgesia who requires two patient identifiers on specimen labels - Answer- JCO factor with high influence on wound healing that the surgical team can control - Answer- tissue handling patient at highest risk for hypothermia in perianesthesia phase - Answer- 3 week old neonate for cardiac anomaly suture best suited for intestinal anastomosis - Answer- vicryl trailing a new insuflation system, over-pressurization leads to - Answer- hypercarbia process of decontamination begins when - Answer- at completion of the surgical procedure which injury is NOT related to a patient being placed in the lateral position - Answer- compression of abdominal cavity primary substance found in epidermis that protects body from fluid loss and invasion of pathogens - Answer- keratin correct statement regarding closed gloving - Answer- closed gloving can only be used for initial gloving what measure can be taken to prevent aspiration based on patient's history - Answer- cricoid pressure during induction on factor that describes high incidence of musculoskeletal disorders among surgical techs and nurses - Answer- the cumulative effect of repeated patient handling events q allergic contact dermatitis with natural rubber latex - Answer- puritis, edema, erythema and visicles 6-48 hours after exposure patient reports latex allergy, carries epi pen and beta-agonist inhaler - Answer- true latex allergy 191.18 kg patient scheduled for surgery; interventions to enhance patient safety - Answer- use of an OR bed to accommodate patient weight and size risk reduction strategy to reduce sharps injury - Answer- passing sharp items using neutral / hands free techniques instead of passing hand to hand self retaining retractor for large patient - Answer- bookwalter silk loses tensile strength after what period of time - Answer- 1 year physical characteristic of suture - Answer- knot strength appropriate steps to remove sterile gown - Answer- wipe gloves clean, untie side of gown, grasp gown at one shoulder seam practice for sponge, sharp, and instrument counts follows: - Answer- institutional policy laparoscopic trocars placed by resident; unusual occurance that could lead to sepsis - Answer- inadvertent trocar puncture through bowel on insertion risk factor for PONV - Answer- FEMALE GENDER source of radiation in OR - Answer- C arm ideal suture material is one that has handling characteristics such as - Answer- pliability NOT a characteristic of silk suture - Answer- memory risk reduction strategy to reduce RSI - Answer- replacing or tagging sponges and laparotomy instruments with RFID chips skin injuries related to shearing occur when the patient is in what position - Answer- trendelenburg intracorporeal suture technique uses suture tying process analogous to - Answer- instrument tying health professionals should employ which strategy to reduce risk of allergic reaction to latex - Answer- use powder free gloves that have low levels of protein and chemical allergens patient right regarding consent - Answer- right to informed consent patient has numb and tingly mouth, lips and tongue, and metallic taste after peripheral nerve block - Answer- a toxic overdose to local anesthetic, monitoring and increasing flow rate in IV saline select the intervention that is an engineered control factor to protect patient from hypothermia - Answer- set ambient room temp between 68-73 CO2 gas is used to insufflate to: - Answer- 9 L/min, 14-16 mm Hg treatment for LAST includes - Answer- lipids correct order of removal for soiled sterile attire - Answer- gown, gloves, mask sponge counts should be performed - Answer- before the procedure, before closure of each body cavity, before wound closure, at skin closure suture that helps eliminate tension of primary suture line - Answer- retention tensile strength of lactic and glycolic acid polymers is sufficient for how many weeks - Answer- 2-3 concern with large doses of ketamine - Answer- respiratory depression patient having cardiac surgery, consider all of the following except: - Answer- RBCcount? there are blank main coronary arteries which originate in the blank - Answer- 2, sinuses of valsalva most stable and rigid fixation of a fracture - Answer- locked plating system NOT included in the retroperitoneal space - Answer- spleen filtering mechanism if located in which region of the kidney - Answer- renal cortex ? damage to cranial nerve VII - Answer- drooping of the corned of the mouth which lab values are indicative of acute pancreatitis resulting from blockage in the ampulla of vater - Answer- amylase, lipase absolute contraindication for a cholecystectomy is - Answer- uncontrolled coagulopathy ductal ectasia is difficult to distinguish from cancer because it presents with - Answer- a hard irregular mass, nipple discharge, and enlarged axillary nodes wound classification for breast surgery - Answer- clean correct path of cardiac conduction system - Answer- SA, AV< bundle of his, purkinjie fibers branch of the left main coronary artery - Answer- circumflex coronary artery patient with CVI is not often treated surgically because - Answer- CVI is not life threatening or limb threatening venous structure that prevents blood backflow - Answer- semilunar intimal folds communication with anesthesia in cases involving facial nerves - Answer- muscle relaxants, paralytic agents, and some local anesthetics must be avoided primary function of three thyroid hormones - Answer- regulate energy metabolism absences of distinct teniae serves as visual landmark for - Answer- upper margin of rectum lymphatics of small bowel and portions of colon are located in - Answer- mesentary point of insertion for iliopsoas muscle - Answer- lesser trochanter femoral hernias occur more frequently in - Answer- women minimally invasive technique used to remove thyroid tumors deep in the mediastinum - Answer- thoracoscopy colon wall has 5 layers which include - Answer- mucosa possible benefit to paramedian incision - Answer- decreased risk for hernia transthoracic esophagectomy with lymph node dissection for cancer of esophagus; which approach - Answer- upper midline abdominal and right thoracotomy burn patient; preparation performed before patient comes to OR - Answer- prewarm the OR to above the ambient high temp for adult distinguishing characteristic of large intestine - Answer- teniae coli, haustra, epiploic appendages 51 y/o male with hepatobiliary disease; pre op assessment includes - Answer- review his chart for bleeding and coagulation times and platelet count boundaries for skin prep for patient receiving liver transplant - Answer- neck to midthigh, bedline to bedline during kidney transplant prior to clamping vessels, drugs given - Answer- heparin and mannitol hernias that occur in the heselbach's triangle - Answer- direct inguinal hernia incision for removing cancerous testis - Answer- midportion of scrotum correct statement regarding trigone of bladder - Answer- forms the base of the bladder nerve supply for female pelvis comes from - Answer- superior hypogastric plexus tear to the meningeal artery results in what kind of hematoma - Answer- epidural bloodless plane that contains loose areolar tissue and permits mobility of scalp - Answer- subgleal space vessels of the circle of willis include - Answer- posterior communicating artery cranial nerve responsible for pupillary reaction - Answer- cranial nerve III primary divisions of nerve are known as - Answer- rami disadvantage of harrington rods - Answer- rod breakage is increased nerves in the lower extremity not commonly implicated in positioning related neuropathies - Answer- popliteal use of PMMA can result in which adverse reaction - Answer- transient hypotension ASPECT OF BONE HEALING THAT IS PRESERVED THROUGH INTRAMEDULLARY REAMING - Answer- maintenance of fracture hematoma closed reduction is the treatment of choice for fractures because - Answer- decreased opportunity for infection most commonly used pediatric premedication - Answer- versed child is being pre oped for surgery and nurse notices mild myotonia congenita; appropriate risk reduction strategy would be - Answer- perform careful assessment of family hx to identify risk for developing MH congenital anomaly that best reflects indications of fetal surgery - Answer- congenital diaphragmatic hernia scoring range for GCS - Answer- 15, 3 pneumonic AMPLE - Answer- allergies, medications, PMH, last meal, event leading to injury why must evidence be placed in a paper bag and not a plastic bag - Answer- mulitple trauma wound patient, what is appropriate for rapid preparation of this patient - Answer- prep patient from suprasternal notch to mid thigh B why must evidence be placed in a paper bag and not a plastic bag - Answer- plastic bags may trap moisture and allow mold growth, destroying evidence person responsible for marking the patient - Answer- surgeon concept of risk management - Answer- all of the above patient safety strategy that reduces medication errors - Answer- tracing origin and insertion of all tubes and catheters contributing factors to friction and shearing - Answer- transfer process from OR bed to stretcher most common pattern of hearing loss in older adults - Answer- bilateral symmetric sensorineural skin injuries are often overlooked or not linked to surgery because - Answer- injuries often have a delay in appearance the perioperative nurse - Answer- all of the above JCAHO model of risk management includes - Answer- all of the above cutting suture knots of non absorbable suture - Answer- 1/2 inch most common complication following ACDF - Answer- difficulty swallowing humidity levels in the OR range between - Answer- 40-70 complication that can occur as a result of rapid high pressure is - Answer- hypotension dry time for most skin preps - Answer- 3-5 minutes structures located within the broad ligaments - Answer- fallopian tubes, ureters, uterine vessels most common size needle for skin closure - Answer- 3/8 one of the two strongest layers in tissue closure - Answer- fascia aortic root is located - Answer- at the junction of the origin of the ascending aorta and the left ventricle a reason for conversion of lap cholecystectomy to open - Answer- inability to remove a stone from the CBD via ERCP must consider which of the following when decided treatment for breast cancer - Answer- size of tumor absolute contraindication for cholecystectomy - Answer- uncontrolled coagulopathies most common used incision for C section - Answer- pfannensteil another name for the left colonic flexure - Answer- splenic flexure what structures comprise the medial border of Hesselbach's triangle - Answer- lateral edge of the rectus abdominal muscle ligament that connects the laminae of the spine - Answer- ligamentum flavum medication used in cardiac surgery to prevent spasms of vessels - Answer- papaverine muscle critical in stabilization of knee joint - Answer- quad borders of the triangle of calot - Answer- hepatic duct, cystic duct, inferior edge of right lobe of the liver during a THA using the posterior lateral approach, the RNFA will dislocate the head of the femur using - Answer- flexion, adduction, external rotation identify the fascia which is an extension of the internal oblique muscle and covers the spermatic cord - Answer- cremaster technique primarily used for women having prophylactic mastectomy with immediate reconstruction - Answer- nipple sparing patient uses ephedra, if halothane is used during procedure, patient is at risk for - Answer- ventricular arrhythmias left and right lobes of the liver are divided by - Answer- falciform ligament of the nerves associated with thyroid gland, which can be affected by compression resulting from enlarged left atrium - Answer- NOT right recurrent left recurrent ? positioning considerations for a patient undergoing TRAM flap reconstruction - Answer- raise head of bed to low fowlers flex position to reduce stretching on abdominal donor graft wound site fine needle aspiration of suspicious breast in males - Answer- aspirate fluid is cytologically examined incision for a modified radical mastectomy - Answer- oblique elliptical incision with lateral extension towards axilla patients with acute arterial insufficiency present with 6 Ps; occlusion can be result of which condition - Answer- rupture of an unstable atherosclerotic plaque desirable characteristic that influences surgeon's choice of graft - Answer- hypoallergenic discharge planning for patient who underwent endovascular surgery going home on anticoagulation therapy - Answer- do not use tools such as saws or hammers which could lead to an accident first major branch of the internal carotid artery - Answer- ophthalmic artery velour grafts are impregnated with which of the following - Answer- gelatin statement regarding doppler is true - Answer- water soluble gel is needed when the doppler is used on intact skin AAAs occur primarily in what area - Answer- between renal arteries and the aortic bifurcation correct branch of the left main coronary artery - Answer- circumflex coronary artery documentation requirement unique to vascular surgery - Answer- clamp application and removed times presence of a bruit on auscultation of a blood vessel - Answer- blood flow is disrupted boundary between buccal cavity and lingual cavity - Answer- teeth which surgical approach reduces morbidity and mortality in removal of an acoustic tumor - Answer- translabryinthine approach patient schedule for nasal surgery using epinephrine; what should be considered - Answer- cardiac history patient scheduled for thyroidectomy, which tray should be readily available - Answer- trach tray which ocular blocks carries the highest risk - Answer- retrobulbar block UPPP is performed to relieve OSA and snoring; common indications for UPPP - Answer- o2 saturation below 80, apnea index worse than 20 benefit to patient undergoing SILS procedure - Answer- less post operative pain hernia that involves both a direct and indirect hernia - Answer- pantaloon hernia which is NOT a risk factor for developing ventral hernias - Answer- male gender innervation of the lungs is part of what system - Answer- autonomic blood supply to the jejunum and ileum come entirely from branches of the - Answer- superior mesenteric artery blood supply to the transverse colon - Answer- middle colic artery rationale for technique in tumor removal/cancer procedures is - Answer- prevent mechanical metastasis the renal artery and vein enter the kidney o the medial side through a concave area known as the - Answer- hilum best description of a successful skin graft outcome - Answer- the recipient site develops a new blood supply from the base of the wound statement about the liver, pancreas, and spleen that is true - Answer- all three are solid organs and are very vascular "triangle" anotomic landmark that is knowns by the 3 C's - Answer- Calot's most common complication of Meckel's diverticulum - Answer- GI bleeding layer before reaching the rectus abdominis muscle - Answer- scarpa's fascia structures located in the inguinal canal - Answer- spermatic cord and round ligament cancer in the urothelial layer of the bladder - Answer- inner the inner thoracic lymph nodes can also be a channel for - Answer- spread of metastasis the mediastinal surface of the lungs contains a structure known as - Answer- hilum the adrenal glands can be located by their shapes, which are - Answer- triangular, crescent most commonly injured intra-abdominal organ in blunt trauma - Answer- spleen statement that best reflects the functional components of the GI tract - Answer- alimentary canal extends from the mouth to the anus The mesh-plug open hernia repair technique is indicated for which type(s) of hernias? - Answer- recurrent indirect inguinal hernias how much of the entire circulating blood volume do the kidneys process - Answer- 1/5 Incision for open cholecystectomy - Answer- right subcostal perineal glands that secrete mucus - Answer- bartholin glands potential risk associated with pneumoperitoneum - Answer- gas embolus into an exposed blood vessel during the procedure fibrous bands of tissue found between abdominal structures not normally connected - Answer- adhesions practice designed to prevent unique MIS problem - Answer- direct coupling physical barrier used in prevention of adhesions that can take up to two weeks to absorb and is indicated in most open procedures - Answer- NOT seprafilm interceed? triad of anatomic sites of abdominal wall weakness with a potential for hernias - Answer- inguinal canal, fermoral rings, umbilicus treatments for a fire fighter who experienced full thickness burns - Answer- debridement and allograft placement during initial healing benefit to paramedian incision - Answer- decreased risk for hernia most common non emergent surgery in USA - Answer- cholecystectomy teniae coli consist of how many longitudinal bands of muscle - Answer- 3 correct flow of bile from the gallbladder - Answer- cystic duct, common duct, ampulla of vater, duodenum each lunch contains how many segments - Answer- 3 ? page 855 when removing a cancerous testis, incision will be - Answer- just above the inguinal ring pelvic floor consist of which muscle group - Answer- levator ani and coccygeal muscles structure that supports the uterus and contains uterine artery and vein - Answer- cardinal ligaments which describes a hydrocele - Answer- refers to an excess of fluid within the tunica vaginalis of the scrotum which statement about the prostate best reflects its location, size and weight - Answer- the prostate sits below the base of the bladder, is 4 cm at the base and weighs 20-30 grams ovarian artery is a branch of which vessel - Answer- aorta nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the - Answer- superior hypogastric plexus which layer or the uterus contains the lymphatics - Answer- myometrium signs of symptoms of TURP syndrome - Answer- seizures cranial nerve that, if injured in surgery, results in vocal cord paralysis - Answer- x singular bones in the cranial cavity - Answer- frontal, ethmoid, sphenoid, occipital trigeminal nerve provides motor innervation for which muscle group - Answer- muscle of mastication bloodless plane that contains loose areolar tissue and permits mobility of scalp - Answer- subgleal space dura fold that separates right and left cerebral hemispheres - Answer- falx cerebri brainstem consists of what three structures - Answer- midbrain, pons, medulla oblongata which sulci is of particular anatomic importance during surgery - Answer- lateral sulcus What part of the hip are the hemispherical reamers used on? - Answer- acetabulum potential for limb shortening and malformation when the fracture line involes the - Answer- epiphyseal plate The part of the femur that is most susceptible to fracture in conjunction with osteoporosis is: - Answer- femoral neck good candidates for replantation are those with the following amputations - Answer- almost any body part of a child intervention provided for elderly patient's skeleton - Answer- position the patient using appropriate padding and joint protection devices which of the following regarding PMMA is NOT an effect on local tissue - Answer- skin burns due to exothermic reaction postoperative infection in any joint replacement is - Answer- usually catastrophic young children are predisposed to increased vagal tones which can be induced by - Answer- painful stimuli such as eye surgery or abdominal retraction procedure designed to create a competent antireflux barrier - Answer- nissen which is not included in the terrible triad - Answer- PCL tear if PMMA is not used, what replacement product, element, or substances is - Answer- autologous bone graft during a total hip, the instrument used to access the femoral canal is - Answer- box osteotome ? (p. 723) during lumbar laminectomy, residual bleeding can be controlled using - Answer- bipolar bayonet forceps structure located within the cancellous bone that is important for weight bearing and providing strength to withstand stresses placed on the bone - Answer- trabeculae length of time for inflation of an upper extremity tourniquet on a patient under 50 years old - Answer- 1 hour, 250-300 mmHg bone graft sealed in a sterile labeled envelope from a tissue transplant company stores in a vacuum sealed freezer and monitored with an alarm - Answer- allograft advantage of an open rather than closed reduction technique - Answer- direct observation and verification of fracture alignment complication of patellectomy - Answer- reduced knee extension one cause of avascular necrosis - Answer- decreased blood supply to the femoral head most commonly fractures carpal bone - Answer- scaphoid rotator cuff consists of which group of muscles - Answer- supraspinatus, infraspinatus, teres minor, subscapularis femoral neck fractures are more common in women than men because of - Answer- osteoporosis what event needs to take place before a cervical collar can be removed - Answer- a cervical radiograph is obtained to rule out injury to the neck contraindication to using autotransfusion as a blood replacement source - Answer- blood contaminated with food, bowel contents, or antibiotic irrigation what group of scans is performs and what do they identify - Answer- chest, pelvic, and four abdominal scans; collections of fluid and free air laceration on the neck that involves the lower trachea; which structure can be involved - Answer- brachiocephalic artery blood at the urinary meatus when attempting to insert a catheter - Answer- discontinue catheter insertion injury to the anterior chest from blunt force trauma, damage to what area - Answer- right ventricle device used during anesthesia to confirm successful endotracheal tube placement and gas exchange - Answer- capnometer statement about surgical dressings - Answer- cushion and protect the wound from trauma and gross contamination, and absorb drainage abdominal trauma case; instrument set needed besides a vascular set - Answer- laparotomy set technique that minimizes drag and wear on the suture material and needle - Answer- double armed response to a patient experiencing laryngospasm for longer than 1 minute - Answer- suctioning, IV succ, reintubation correct specimen care and handling - Answer- avoid placing specimens for frozen section in formalin The linea alba extends from _____ to the _____ - Answer- above the xiphoid process to the pubis correct regarding non-absorbable suture - Answer- increased reactive properties in tissue which of the following pressure points are included in an assessment to prevent pressure injury - Answer- genitals, knees, toes, and eyes injury can be avoided by tucking the draw sheet () the arm and under the () - Answer- over, the body which is true about the use of liquids in the OR - Answer- skin prepping solutions can cause chemical burns surgery to repair ruptured diverticulum has a wound classification of - Answer- contaminated wound; class III best practice for keeping instruments free of blood and bioburden during procedure - Answer- wipe instruments with a sponge moistened with sterile water after each use instillation of local anesthetic into the subarachnoid space - Answer- spinal anesthesia appropriate way to address a count discrepancy - Answer- we have a count discrepancy, we started with 70 sponges and find only 68, we are missing 2 sponges surgical consents should be written on what grade level - Answer- 5th area between the surgeon and the scrub person for passing sharps safely - Answer- neutral zone patient most likely to have a true latex allergy - Answer- patient with spina bifida most commonly used method of sterilization - Answer- steam sterilization which anesthetic could NOT be given if IV only anesthesia was planned - Answer- desflurane lithotomy position; most frequently injured nerves are the obturator, sciatic, femoral and (), which can result in injury from () - Answer- common peroneal; direct compression from the stirrup bars 9 y/o diabetic patient with insulin pump comes for surgery; what should be considered - Answer- bipolar MH is a rare, multifaceted syndrome with an increased incidence in patients that exhibit - Answer- congenital myopathies uses of suture - Answer- ligate, suture, and close tissue medication used for PONV that has potential to prolong QT interval - Answer- droperidol BLANK precautions apply to blood, all body fluids, secretions, and excretions regardless of - Answer- standard which is NOT an event that would adversely affect pulse ox reading - Answer- hypertension most common method to prevent hypothermia is through the use of - Answer- forces air warming blankets suture best suited for intestinal anastomosis based on handling capability, high tensile strength that decreases after 1 year and is not [Show Less]
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NIFA Perioperative quiz 2023 (solved)
Of the following choices, which would not be a consideration for choosing suture? A. Type of procedure B. The tissue being reapproximated C. Type of rea... [Show More] pproximation D. Scrub person preference - Answer- D. Scrub person preference Alexanders 15th P192 Which of the following is not an event that would adversely affect the pulse ox reading? A. Hypothermia B. Hypertension C. Vasoconstriction D. Hypovolemia - Answer- B. Hypertension Alexanders 15th P132 Skin injuries related to shearing occur most commonly as a result of which of the following positions? A. Trendelenburg B. Prone C. Lateral D. Lithotomy - Answer- A. Trendelenburg Alexanders 15th P165 A basic anesthesia monitoring device that is used during general anesthesia to confirm successful endotracheal tube placement and determine the presence of gas exchange is the: A. Pulse oximetry device B. Stethoscope C. Capnometer/end-tidal CO2 monitor D. Post-intubation arterial blood gas - Answer- C. Capnometer/ The immature blood-brain barrier and decreased protein binding in infants increase their sensitivity to which group of medications? A. anticholinergics, parasympathetics B. Antidysrhythmic agents C. Opioids and hypnotics D. Adrenerics - Answer- C. Opioids and hypnotics Alexander 15th p1009 Proper care and handling of surgical specimens is imperative for correct diagnosis, treatment, and prognosis planning of the patient. Select the response that best reflects correct specimen care and handling. A. Label consecutive specimens B. Send all specimens to the lab together as one pickup, including the frozen sections C. Avoid placing specimens for frozen section in formalin D. Neutralize formalin/formaldehyde spills with glycerin and call the hazmat team. - Answer- C. Avoid placing specimens for frozen section in formalin Alexander 15th p32 From the following, choose the types of anesthesia that will allow patients to tolerate potentially uncomfortable procedures while maintaining their own airway and be easily aroused from light sleep. A. Moderate anesthesia care B. Local infiltraion C. Moderate sedation/analgesia D. Regional anesthesia - Answer- C. Moderate Sedation/analgesia Alexander 15th P130 Risk factors for postoperative nausea and vomiting should be assessed preoperatively. Which of the following is a risk factor for PONV? A. Male gender B. Female gender C. Postoperative use of NSAIDS D. Surgery under 60 minutes - Answer- B. Female gender Alexanders 16th p269 Which of the following is a true statement about the use of liquids in the OR? A. Use of volitile liquids such as acetone is limited to cleaning and they must be properly stored B. Flammable liquids are prohobited in the OR unless an ESU is in use C. Skin prepping solutions can cause chemical burns D. Betadine skin prep does not cause chemical burns - Answer- C. Skin prepping solution can cause chemical burns Alexander 15th p33 This hemostatic device offers a rapid and secure method of clamping arteries, veins, nerves, and other small structures. This device remains in the patient, is not counted, and is made of a metal that is not compatible with MRI. Select the correct hemostatic device that fits this description. A. Hemostat B. Alligator forcep C. Ligating clip D. Bulldog clamp - Answer- C. Ligating clip Alexanders 15th p198 The most commonly used medication for local anesthesia is? A. Lidocaine B. Tetracaine C. Marcaine D. Cocaine HCL - Answer- A. Lidocaine Alexanders 15 p150 Linda Gardner is highly allergic to latex and the anesthesia provider plans to give Linda prophylactic medications before anesthesia. What medications might be administered to Linda in the preoperative holding area? A. Epinepherine and an H2-blocker B. Vasopressin and atropine C. Prednisone and a beta-agonist inhaler D. Dimethylxanthine - Answer- C. Prednisone and a beta-agonist inhaler Alexander 15 p66 When a patient absorbs an unsafe amount of local anesthetic into the bloodstream, a catastrophic outcome is possible. Treatment for LAST includes the use of which of the following? A. Lipids B. LR bolus of 500cc C. NS Bolus of 500CC D. Diphenhydramine - Answer- A. Lipids Alexanders 15 p147 From the following, select an advantage polyester suture has over other nonabsorbable sutures. A. Greater tinsile strength B. Greater tissue reactivity C. Able to absorb tissue fluids D. decreased knot slippage - Answer- A. Greater tinsile strength Alexanders 15th p190 While tucking the arms at the sides of the patient in supine position offers comfort, safety, and easy access to the patient by the scrubbed team, improper positioning and securing of the arms can result in significant injury. Injury can be avoided by tucking the draw sheet ___________ the arm and under the ____________. A. Over, Body B. Under, Mattress C. Over, Mattress D. Around, OR bedrail - Answer- A. Over, Body Alexanders 15th p163 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. A. The American College of Surgeons endorses double gloving for all surgery and invasive procedures B. Wearing two glove layers permits re-gloving using the closed-glove technique for a contaminated glove. C. Wearing a glove liner between both layers of gloves may eliminate the risk of perforation to the inner glove, protecting the wearer from sharps injury. D. The AORN publication titled Recommended Practices for Prevention of Transmissible Infections in the Perioperative Practice Setting recommends the Double-Glove procedure during invasive procedures. - Answer- A. The American College of Surgeons endorses gloving for all surgery and invasive procedures. Alexanders 15th p113 An instrument that is used to occlude a vessel is know as: A. Hemostat B. Occluding clamp C. Kocher D. Forceps - Answer- A. Hemostat Alexanders 15th 201 ________ Precautions apply to blood, all body fluids, and excretions (except sweat), regardless of whether they contain visible blood, mucous membranes, and non-intact skin. A. Hospital B. Standard C. Isolation D. Contact - Answer- B. Standard Alexanders 15th p62 From the following, choose the correct statement regarding close gloving. A. Closed gloving can only be used for the initial gloving B. Closed gloving requires two people to execute without contamination C. There is an increased risk of contamination if the thumbs are not extended D. Closed gloving requires the hands to be kept in direct view - Answer- A. Closed gloving can only be used for initial gloving Alexanders 15th p95-96 During the preliminary sponge count on closure of a repair of a ruptured 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. A. "Stop everything! I'm missing a couple of sponges. They are not in the trash or back table. Check the wound". B. "I think you are missing 2 sponges. Shall I call X-Ray while the scrub person checks her table again? Doctor, please check the incision site. C. "We have a count discrepancy. We started with 70 sponges and find only 68. We are missing 2 lap sponges". D. " Ive called X-Ray because we are short 2 lap sponges. I've called the charge RN to get someone to help me check the trash and linen. The rapid response team is on the way. - Answer- C. We have a count discrepancy. We started with 70 sponges and find only 68. We are missing 2 lap sponges. Alexanders 15th p32 Select from the following medication that is used for PONV and has the potential for prolonged QT interval. A. Scopolamine patch B. Dolasteran C. Droperidol D. Prochlorperazine - Answer- C. Droperidol Alexanders 15th p 277 The type of wound closure that occurs when approximation of the wound edges does not occur for 3 or more days after a surgical procedure. A. Primary Intention B. Secondary intention C. Granulation and contraction D. Third Intention - Answer- D. Third Intention or Delayed primary closure Alexanders 15 p256 Which statement about surgical dressings is true? A.Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage. B. Surgical dressings cover the wound to maintain moisture to promote granulation C. Surgical dressings maintain tension on the suture line to prevent dehiscence D. Surgical dressings protect surrounding drapes, linens, and clothing from contamination. - Answer- A. Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage. Alexander 15th p266 Which of the following absorbable suture has the best tensile strength? A. Surgical gut B. Polypropylene C. Surgical silk D. Polydioxanone - Answer- D. Polydioxanone or PDS [Show Less]
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Nifa practice test B1 2023 (Answered)
what statements regarding vascular clamps are true? select all that apply - Answer- a. vascular clamps are designed to partiall occlude blood flow. b. vas... [Show More] cular clamps are designed to totally occlude blood flow. c. all vascular clamps are designed to hold vessels securely without trauma. what incision is used for lumbar laminectomy - Answer- a. midline direcly over the appropriate lumbar spine Franklin hardy with mulitple moles skin lesions - Answer- the perioperative nurse recognized his signs and symptoms of bupivicaine and lidocaine toxicity and began immediate treatment with airway support. when cathing a female patient the periop nurse must locate the urethra. - Answer- mons pubis, labia majora, labia minora, clitoris, urethra, vaginal opening. tui nyugen 32 year old hysteroscopy patient. What patient safety info relevant to hysteroscopy should be given to the receiving relief nurse before break? - Answer- a. a review of the amount of hyskon infused and fluid received back b. a reminder to monitor for discrepancies over 500ml which of the following is incorrect pertaining to the pancreas - Answer- a. the superior mesenteric artery lies anterior to its neck. a number of screening tools have been developed for comprehensive geriatric assessment (CGA) - Answer- d. indentifying at-risk individuals blunt force to the larnyz can result in fracture and impose immediate airway obstruction - Answer- a. assist the anesthesia provider with securing the airway while applying cricoid pressure recommended long-term pain management in the elderly includes - Answer- c. opoid analgesics (low potential for addiction) select the statement that most correctly matches a risk factor for adhesions with an appropriate preventitive strategy - Answer- c. patients with endometriosis may be best served with a laparoscopic approach another name for the left colic flexure is - Answer- splenic flexure which of the following is not typically visable in a PA chest radiograph - Answer- a. the interventricular septum an exapmple of an indicaiton for liver transplantation would be - Answer- d. primary hepatic cancer which of the following associations is correct - Answer- e. pancreatic cancer-rarely metastasizes replantation is an attempt to reattach a completely amputated digit or other body part. good candidates for replantation are those with the following amputations - Answer- a. almost any body part of a child what mechanisms do chest catheters and drainage systems use to remove fluid and air from the pleural cavity - Answer- c. expiratory pressure and gravity study comparing tep and tapp techniques. - Answer- b. mesh infection rate was low with both techniques d. there was no apparent difference in teh rate of hernia recurrence upon palpating the anterior abdominal wall of a patient you notice an intense reflexive muscular contraction in the abdominal muscles which is not correct> - Answer- d. it is best observed when the patient is perfectly supine. this tissue is concerned with the formation of red blood cells - Answer- c. red marrow during a lap chole, the scrub person inspects the integrity of the insulation along the shaft. what nursing outcome is expected. the patient will be free from: - Answer- c. impaired skin integrity which of the following associations is incorrect - Answer- c. left border of the heart-mainly left atrium the most likely reason for avascular necrosis in an 80 year old woman following a hip fracture is that the - Answer- b. fracture split the neck of the femur longitudinally while not as prevalent as arthoplasty of the shoulder, knee or hip, total elbow replacement is indicated for patients with traumatic lesions or excessive bone loss from rheumatic or degenerative arthritis. It may be used with or without pmma depending on the quality of the - Answer- d. Side plates, screws, and circumferential wires In the following illustration, the arrow points to the: - Answer- a. left vagus nerve. Identify the marginal boundaries of the breasts - Answer- c. Second to sixth rib and horizontally from the lateral edge of sternum to anterior axillary line Which of the following is not correct pertaining to the cavernous sinus? - Answer- e. contains the mandibular division of the trigeminal nerve The science of plastic and reconstructive surgery, which means to mold or create form and shape, improves appearance and body image through an understanding of: - Answer- b. the anatomy and biology of tissue Which of the following is incorrect for the cricoid cartilage? - Answer- c. It is an attachment of the vocal ligaments A familiarity with basic neurologic assessment tools gives the nurse the ability to perform a standardized neurologic exam that can be used preoperatively to establish a baseline assessment and postoperatively to establish a return to baseline or assess postoperative neurologic stability. 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- a. 15, 3 Marissa Walton is a 6-year-old girl with full-thickness burns involving both lower legs, circumferentially, excluding her feet, over less than 2% of her body surface area (BSA) and partial-thickness burns over less than 15% of her BSA, after her clothes caught fire during a camping trip when she stepped into the campfire. Based on the American Burn Association and the "Rule of Nines" classifications, Marissa's burns would be classified as ______________ with a burn surface area percentage of approximately ______________. - Answer- c. minor 9% A direct inguinal hernia is located _____. - Answer- a. Inside Hesselbach's triangle Following an argument with his wife in which a man backed through a glass storm door resulting in deep laceration of his buttocks, he is having great difficulty walking. To better understand the nature of his disability, you ask him to stand on one foot. By doing so, you are doing all of the following except: - Answer- d. evaluating the function of the gluteus maximus. A broad range of implant materials are used in plastic and reconstructive surgery. Select the implant that represents a biologic composition of a surgical implan - Answer- a. Autologous human tissue A variety of implantable devices are used in aesthetic and reconstructive plastic surgery procedures. Tracking of these devices is critical to patient safety. Institutions must report any incident of death or serious injury relating to the use of a medical device. What regulatory agency, commission, or act mandates this process when medical devices fail or cause injury? - Answer- d. Safe Medical Device Act All of the following may be associated with a "heart block" except: - Answer- a. section of the superior part of the thoracic sympathetic trunk. A plain radiograph of a patient following a knife wound to the left side of his neck showed elevation of the left hemidiaphragm, narrowing of the left intercostals spaces, and displacement of the trachea to the left. You suspect: - Answer- b. pneumothorax due to knife penetration of the cervical pleura. This tissue contains fat cells. - Answer- c. yellow marrow When using the posterolateral incisional approach, which muscles are retracted anteriorly to expose the femoral fracture site - Answer- c. Vastus lateralis and vastus intermedius What structure traverses the opening indicated by the arrow in the following figure? - Answer- c. Aorta Non-union can be caused when bone graft isn't used to fill a bony deficit at the fracture site - Answer- true Which of the following is incorrect pertaining to the hamstrings? - Answer- d. One of them is partially innervated by the common fibular division of the sciatic nerve. Baby Boy Doe is a newborn found outside of the emergency department (ED). He is hypothermic and has several deep lacerations across his back, abdomen, and legs that will require surgical repair. He is transferred to the surgical bay of the ED and prepared for anesthesia induction. What risk reduction strategies are appropriate during the preanesthetic phase to achieve and maintain normothermia? - Answer- b. Provide a radiant heat lamp during placement of monitoring lines and induction Trina Gasterson, a 7-year-old girl recovering from a successful kidney transplant, is visited by her perioperative nurse on her day of discharge. While they conversed, Trina's mother opened a bottle of herbal supplement tablets from a local nutrition and dietary supplement store, whose label the nurse recognized - Answer- a. Astragalus, licorice, and echinacea When preparing for pars plana vitrectomy in the posterior segment, the perioperative nurse must be aware that a combined scleral buckling procedure may be necessary. Other important information the perioperative nurse should know before preparing the OR for the procedure includes the location of the ocular problem, the surgeon's plan to address the problem, and the instrumentation and biomedical equipment and devices to be used. Technologic advances in ophthalmic surgery require that perioperative nurses be familiar with complex biomedical equipment. A best practice, stated below, relevant to the safe use of complex equipment would be: - Answer- b. demonstrate competence with equipment and check each piece carefully before the patient arrives in the OR. Herbal, orthomolecular, individual biologic therapies and special dietary treatments are encompassed in biologically based therapies. Which of the biologically based therapies listed below are classified as therapeutic nutrition? - Answer- a. The diets of Drs. Atkins, Pritikin, and Weil Neuropathologic conditions requiring surgical intervention can be found in any age group. What are the most common problems requiring neurosurgical proce [Show Less]
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nifa study guide with complete solutions
The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the - Answer- Superior hypogastric plexus Which of ... [Show More] the following is an important statement regarding the prevention of degenerative orthopedic conditions - Answer- Weight-bearing activities and joint movement prevent cartilage from becoming thin or damaged The cerebellar tentorium supports which structures of the cerebral hemispheres - Answer- Temporal lobe the surgeon makes an incision through which of the following to access the cremaster muscle, inguinal canal, and cord structures - Answer- External oblique muscle a physical barrier used in the prevention of adhesions that can take up to 2 weeks to absorb - Answer- Interseed Tissue reaction characteristics that need considered when choosing suture include - Answer- Absorption The diagnostic test that is performed to differentiate between acute and chronic thrombosis - Answer- Digital subtraction angiography Morbidity and mortality may be greater with penetrating trauma because identification of injuries may be more difficult when injuries are less obvious. In the case of an adult victim with a low-velocity, low-caliber gunshot wound, at far range, of the anterior left quadrant of the lower abdomen, what is the MOI and description of the possible injuries - Answer- enetrating; small entrance wound, puncture of the anterior wall of the sigmoid colon, no disruption of vessels, and bullet not found in pelvis 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 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. a possible benefit to the paramedian incision - Answer- decreased risk for hernia An example of an indication for liver transplantation would be - Answer- primary hepatic cancer he largest part of the mammary gland rests on the - Answer- Pectoralis major muscle and serratus anterior During ventriculoperitoneal shunt placement, - Answer- The unit is soaked in NS & antibiotic solution, never lubricated. Patients with chronic venous insufficiency (CVI) are not typically treated surgically as often as patients with arterial disease because: - Answer- CVI is not life-threatening or limb-threatening 35% of the refractive power of the eye is credited to which part of the eye - Answer- Lens Oculocardiac reflex (OCR) is an intraoperative emergency that can occur during eye surgery. Select the definition of the response and contributing factor(s) - Answer- Trigeminal-vagal response caused by pressure on the globe or retrobulbar block The perioperative nurse must be prepared for which additional procedure when head and neck surgery is performed? - Answer- Tracheostomy The perioperative nurse preparing for a procedure where STSGs will be taken to cover several large burn areas will need to have available: - Answer- sterile mineral oil, tongue blades, and a mesher dermatome the correct term to describe the inward turning of one or both eyes - Answer- Esotropia The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the - Answer- Superior hypogastric plexus which surgical approach reduces the morbidity and mortality in removal of an acoustic tumor - Answer- Translabyrinthine approach Pt with hepatobiliary disease, The perioperative nurse, during the preoperative assessment, questions and examines the patient for signs and symptoms of jaundice, petechiae, and lethargy and: - Answer- review chart for bleeding and coagulation times and the platelet count. The external ear canal lining - Answer- reduces bacterial levels in the outer ear Miotics and mydriatics produce opposite effects on the pupil of the eye. Select the most appropriate statement about miotic and mydriatic drugs - Answer- Mydriatic drugs, such as phenylephrine, dilate the pupil. Vascular access in pediatric patients may be established intraoperatively for short-term (weeks) or long-term (months, years) use - Answer- Central venous line What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp - Answer- Subgaleal space Pericardial tamponade includes which of the following signs or symptoms - Answer- Narrow pulse pressure Which statement regarding level III and level IV trauma centers best describes the difference between the two types of centers - Answer- A level III trauma center provides advanced cardiac life support (ACLS), surgery, stabilization, and transfer, while a level IV only provides ACLS services before immediate transfer to a higher level center A percutaneous method of instituting femoral vein-femoral artery cardiopulmonary bypass (CPB) can be used for minimally invasive (or conventional open) procedures and in emergency situations where the environment is not conducive to traditional CPB methods. Select the areas where percutaneous CPB would be indicated - Answer- Cardiac catheterization unit and intensive care unit Which two similar hernia repair approaches reestablish the integrity of the transversalis fascia and simultaneously reestablish and strengthen the posterior inguinal floor by sewing the transversalis fascia to the Poupart ligament? - Answer- The McVay or the Cooper ligament repair Identify the class of medications that can increase the risk or severity of a reaction to contrast media - Answer- Beta Blockers The recommended length of time for inflation of an upper extremity tourniquet on a patient under 50 years old is_______while the recommended pressure is _____. - Answer- 1 hour; 250-300 mmHg continuous tourniquet pressure less than 1 hour on the upper extremity and less than 2 hours on the thigh. Tourniquet pressure should not exceed the recommended maximum cuff pressure limits of 300 to 350 mm Hg for the thigh and 250 to 300 mm Hg for the arm and the lower leg. the statement that reflects a true special consideration for skin preparation before facial surgery. - Answer- Leave the eyebrows and eyelashes intact to preserve facial appearance and expression. 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 he external ear, which includes the auricle (or pinna) and external auditory canal, is composed of cartilage covered with skin. The primary function of the auricle is to - Answer- concentrate and conduct incoming sound waves into the external auditory canal. Describe the internal inguinal ring - Answer- Structures that traverse the inguinal canal enter it from the abdomen by the internal ring, a natural opening in the transversalis fascia The perioperative nurse should plan to remain close to the elderly patient during induction because - Answer- Airway anatomy changes in the elderly The child inhales the favorite flavor while drifting off to sleep. This complementary therapy falls within the category of: - Answer- clinical aromatherapy Which of the following sulci is of particular anatomic importance during surgery? - Answer- Two sulci of particular anatomic importance during surgery are: (1) the lateral sulcus, or sylvian fissure, which divides the temporal lobe from the frontal and parietal lobes, and (2) the central sulcus, or fissure of Rolando, which separates the frontal from the parietal lobe Which of the following associations is incorrect pertaining to the blood supply of the brain - Answer- Vertebral arteries --- supplies the occipital lobe TURP syndrome is often seen during the intraoperative period. Signs and symptoms exhibited by patients include - Answer- restlessness, apprehension, irritability, confusion, nausea, slow pulse rate, seizures, dysrhythmias, and rising blood pressure may be suggestive of TURP syndrome, he 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 is not contained within the anterior mediastinum - Answer- Great Vessels Definitive information about the extent and location of ischemic heart disease can be obtained from which of the following tests - Answer- Cardiac catherization An interventional radiology procedure used to open a blocked or narrowed blood vessel as a result of atherosclerosis - Answer- Percutaneous transluminal angioplasty The mitral valve is anchored to the - Answer- left ventricular wall the semi-invasive diagnostic test that illustrates heart wall motion and blood flow through the heart and quantifies cardiac function - Answer- Radionuclide imaging Primary divisions of a nerve are known as - Answer- Rami the correct branch of the Left main coronary artery - Answer- Circumflex coronary artery When a thyroglossal duct cyst is present in an adult, it exists as a pretracheal cystic pouch attached to what structure - Answer- Hyoid statement regarding risk factors for developing vascular disease is true - [Show Less]
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