RNFA FINAL EXAM 2026/2027 | STUDY GUIDE, PRACTICE QUESTIONS, ANSWERS
& EXAM REVIEW
_______Precautions apply to blood, all body fluids, secretions, and excretions (except sweat), regardless
of whether they contain visible blood, mucous membranes, and non-intact skin. - correct answer
✔✔Standard
Which of the following anesthetics may result in fasciculations for the patient? - correct answer
✔✔Succinylcholine
Hypothermia has been shown to be a factor that may place the surgical patient at risk for infection and
delayed healing. What intervention is an engineered control factor to protect the patient from
hypothermia? - correct answer ✔✔b. set the ambient room temperature between 68° and 73° F
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: - correct answer
✔✔capnometer/end-tidal CO2 monitor
The first step in the decontamination process is: - correct answer ✔✔Cleaning
Which of the following requires at minimum, 2 patient identifiers on specimen labels? - correct answer
✔✔Joint Commission
A 9-year-old diabetic with an insulin pump, has arrived in the OR for emergency repair of superficial
facial and deep arm lacerations. The RNFA should consider which of the following options for energy-
generated hemostasis? - correct answer ✔✔Bipolar Electrosurgery Unit
During a hysteroscopy, sterile saline is used to expand the intrauterine compartment and enhance
visualization. The perioperative nurse is concerned that approximately 500 ml of fluid was unaccounted
for and alerted the surgeon and RNFA. The nurse's motive for this surveillance is to: - correct answer
✔✔Potential for Intervastation
Which of the following statements reflects the location of the arcuate line? - correct answer ✔✔one
third of the distance between the umbilicus and the symphysis pubis.
Laparoscopic procedures that emergently convert to open procedures place the patient at risk for
unintentional retained surgical items (RSI). What risk reduction strategy could prevent RSI? - correct
answer ✔✔Replacing or tagging sponges and laparotomy instruments with RFID chips.
The surgical hand scrub is designed to render the hands, nails, and arms - correct answer ✔✔Surgically
Clean
The RNFA instructed the new anesthesia resident in the proper positioning of the arm and hands on the
OR bed armboards. The resident was cautioned to avoid pressure on the elbow to prevent: - correct
answer ✔✔Ulnar Nerve Injury
,A type of suture to help eliminate tension on the primary suture line is known as: - correct answer
✔✔Retention Suture
Identify the primary substance found in the epidermis that protects the body from fluid loss and invasion
by pathogens. - correct answer ✔✔Keratin
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? - correct answer
✔✔Lipids
When buried in tissue, silk loses its tensile strength after what period of time? - correct answer ✔✔1
Year
Guidelines from WHO focus on which of the following in the prevention of surgical site infections? -
correct answer ✔✔Use of Prophylactic Antibiotics
To help visualize abdominal structures and to enhance safety during laparoscopic procedures, a
pneumoperitoneum is created. After Veress needle confirmation, insufflation tubing is connected and
the process begun. CO2 gas is used to insufflate the abdominal cavity at an ideal flow rate of ______ to
achieve an ideal intra-abdominal pressure of ______. - correct answer ✔✔9 L/min;14 to 16 mm Hg
Due to the BMI of the patient, the case you are participating in was converted to open laparotomy. Your
surgeon is uncertain as to which self retaining retractor is available within the facility. From the
following, which is an appropriate suggestion? - correct answer ✔✔Bookwalter
The safest and most commonly used method of sterilization is which of the following? - correct answer
✔✔Steam Sterilization
Has been identified to reduce SSIs and affect surgical outcomes? - correct answer ✔✔Antibiotics given IV
within 1 hour of the incision for every procedure with an incision or entered body system.
When applying sterile drapes to create the sterile field on the patient, which of the following principles is
most important. - correct answer ✔✔Drape the patient starting with the incision area and proceeding to
the periphery.
To prevent sharps injury, which of the following is a risk reduction strategy to be used by the sterile team
members? - correct answer ✔✔Passing sharp items using neutral/hands-free techniques instead of
passing hand to hand.
The most commonly used medication for local anesthesia is __________? - correct answer ✔✔Lidocaine
The OR was trialling a new insufflation system and the vendor representative was out of the room taking
a phone call. The perioperative nurse was concerned that the flow rate was well above 14 L/min and the
pressure had risen to 16 mm Hg. She alerted the surgeon and reduced the rate and pressure because she
feared that the elderly patient was at high risk for: - correct answer ✔✔Hypercarbia
, Your patient had an episode of vomiting during anesthesia induction and was effectively suctioned by
anesthesia. Upon extubation, the patient presented with coughing, wheezing, dyspnea, use of accessory
muscles, and tachypnea. What is this patient most likely experiencing? - correct answer
✔✔Bronchospasm
High-pressure insufflation rates can cause overpressurization of the intra-abdominal cavity. This
overpressurization can lead to which of the following? - correct answer ✔✔Hypercarbia
Laryngospasm is a serious complication often seen in the PACU setting. What is the ideal immediate and
last resort response by the anesthesia provider or perianesthesia nurse in an emerging patient who has
been in spasm for over 1 minute? - correct answer ✔✔suctioning, IV succinylcholine administration, and
reintubation
Which of the following is not a characteristic of silk suture? - correct answer ✔✔Memory
The first case of the day is scheduled as a knee arthroscopy for an otherwise healthy 24 year old patient.
Upon pre assessment, the patient admits to a family history of anesthesia and surgical complications.
Patient also states last oral intake consisted of eating a cheese steak and drinking 2 cans of beer the night
before at 11:30 PM. The patient subsequently vomited when intubation was performed and experienced
respiratory distress upon extubation. What measure could have been taken by the team to prevent
aspiration based on the patient's history? - correct answer ✔✔The perioperative nurse applying cricoid
pressure during induction through intubation
The instillation of a local anesthetic into the subarachnoid space is termed: - correct answer ✔✔Spinal
Anesthesia
What is the appropriate action if the doctor is delayed after the room and instruments have been
opened? - correct answer ✔✔Cover the instruments with a sterile drape and have the scrub nurse
continually visually observe the room for breaches in sterility.
Select the positioning device commonly used for positioning the head during procedures such as
craniotomies. - correct answer ✔✔Mayfield Head Positioners
Hypotension is a blood pressure reading that is 20% less than the patient's normal baseline pressure.
Hypovolemia is the most common cause of postoperative hypotension; however, hypotension may also
be caused by cardiac dysfunctions. Which of the following cardiac conditions will present with
hypotension? - correct answer ✔✔myocardial infarction, myocardial tamponade, and pulmonary
embolism
The ideal suture material is one that has handling characteristics such as: - correct answer ✔✔Pliability
Which of the following patient modifiable factors can contribute to surgical site infections? - correct
answer ✔✔Alcoholism
Which anesthetic agent could not be given if an IV-only anesthesia plan was employed? - correct answer
✔✔Desflurane
& EXAM REVIEW
_______Precautions apply to blood, all body fluids, secretions, and excretions (except sweat), regardless
of whether they contain visible blood, mucous membranes, and non-intact skin. - correct answer
✔✔Standard
Which of the following anesthetics may result in fasciculations for the patient? - correct answer
✔✔Succinylcholine
Hypothermia has been shown to be a factor that may place the surgical patient at risk for infection and
delayed healing. What intervention is an engineered control factor to protect the patient from
hypothermia? - correct answer ✔✔b. set the ambient room temperature between 68° and 73° F
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: - correct answer
✔✔capnometer/end-tidal CO2 monitor
The first step in the decontamination process is: - correct answer ✔✔Cleaning
Which of the following requires at minimum, 2 patient identifiers on specimen labels? - correct answer
✔✔Joint Commission
A 9-year-old diabetic with an insulin pump, has arrived in the OR for emergency repair of superficial
facial and deep arm lacerations. The RNFA should consider which of the following options for energy-
generated hemostasis? - correct answer ✔✔Bipolar Electrosurgery Unit
During a hysteroscopy, sterile saline is used to expand the intrauterine compartment and enhance
visualization. The perioperative nurse is concerned that approximately 500 ml of fluid was unaccounted
for and alerted the surgeon and RNFA. The nurse's motive for this surveillance is to: - correct answer
✔✔Potential for Intervastation
Which of the following statements reflects the location of the arcuate line? - correct answer ✔✔one
third of the distance between the umbilicus and the symphysis pubis.
Laparoscopic procedures that emergently convert to open procedures place the patient at risk for
unintentional retained surgical items (RSI). What risk reduction strategy could prevent RSI? - correct
answer ✔✔Replacing or tagging sponges and laparotomy instruments with RFID chips.
The surgical hand scrub is designed to render the hands, nails, and arms - correct answer ✔✔Surgically
Clean
The RNFA instructed the new anesthesia resident in the proper positioning of the arm and hands on the
OR bed armboards. The resident was cautioned to avoid pressure on the elbow to prevent: - correct
answer ✔✔Ulnar Nerve Injury
,A type of suture to help eliminate tension on the primary suture line is known as: - correct answer
✔✔Retention Suture
Identify the primary substance found in the epidermis that protects the body from fluid loss and invasion
by pathogens. - correct answer ✔✔Keratin
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? - correct answer
✔✔Lipids
When buried in tissue, silk loses its tensile strength after what period of time? - correct answer ✔✔1
Year
Guidelines from WHO focus on which of the following in the prevention of surgical site infections? -
correct answer ✔✔Use of Prophylactic Antibiotics
To help visualize abdominal structures and to enhance safety during laparoscopic procedures, a
pneumoperitoneum is created. After Veress needle confirmation, insufflation tubing is connected and
the process begun. CO2 gas is used to insufflate the abdominal cavity at an ideal flow rate of ______ to
achieve an ideal intra-abdominal pressure of ______. - correct answer ✔✔9 L/min;14 to 16 mm Hg
Due to the BMI of the patient, the case you are participating in was converted to open laparotomy. Your
surgeon is uncertain as to which self retaining retractor is available within the facility. From the
following, which is an appropriate suggestion? - correct answer ✔✔Bookwalter
The safest and most commonly used method of sterilization is which of the following? - correct answer
✔✔Steam Sterilization
Has been identified to reduce SSIs and affect surgical outcomes? - correct answer ✔✔Antibiotics given IV
within 1 hour of the incision for every procedure with an incision or entered body system.
When applying sterile drapes to create the sterile field on the patient, which of the following principles is
most important. - correct answer ✔✔Drape the patient starting with the incision area and proceeding to
the periphery.
To prevent sharps injury, which of the following is a risk reduction strategy to be used by the sterile team
members? - correct answer ✔✔Passing sharp items using neutral/hands-free techniques instead of
passing hand to hand.
The most commonly used medication for local anesthesia is __________? - correct answer ✔✔Lidocaine
The OR was trialling a new insufflation system and the vendor representative was out of the room taking
a phone call. The perioperative nurse was concerned that the flow rate was well above 14 L/min and the
pressure had risen to 16 mm Hg. She alerted the surgeon and reduced the rate and pressure because she
feared that the elderly patient was at high risk for: - correct answer ✔✔Hypercarbia
, Your patient had an episode of vomiting during anesthesia induction and was effectively suctioned by
anesthesia. Upon extubation, the patient presented with coughing, wheezing, dyspnea, use of accessory
muscles, and tachypnea. What is this patient most likely experiencing? - correct answer
✔✔Bronchospasm
High-pressure insufflation rates can cause overpressurization of the intra-abdominal cavity. This
overpressurization can lead to which of the following? - correct answer ✔✔Hypercarbia
Laryngospasm is a serious complication often seen in the PACU setting. What is the ideal immediate and
last resort response by the anesthesia provider or perianesthesia nurse in an emerging patient who has
been in spasm for over 1 minute? - correct answer ✔✔suctioning, IV succinylcholine administration, and
reintubation
Which of the following is not a characteristic of silk suture? - correct answer ✔✔Memory
The first case of the day is scheduled as a knee arthroscopy for an otherwise healthy 24 year old patient.
Upon pre assessment, the patient admits to a family history of anesthesia and surgical complications.
Patient also states last oral intake consisted of eating a cheese steak and drinking 2 cans of beer the night
before at 11:30 PM. The patient subsequently vomited when intubation was performed and experienced
respiratory distress upon extubation. What measure could have been taken by the team to prevent
aspiration based on the patient's history? - correct answer ✔✔The perioperative nurse applying cricoid
pressure during induction through intubation
The instillation of a local anesthetic into the subarachnoid space is termed: - correct answer ✔✔Spinal
Anesthesia
What is the appropriate action if the doctor is delayed after the room and instruments have been
opened? - correct answer ✔✔Cover the instruments with a sterile drape and have the scrub nurse
continually visually observe the room for breaches in sterility.
Select the positioning device commonly used for positioning the head during procedures such as
craniotomies. - correct answer ✔✔Mayfield Head Positioners
Hypotension is a blood pressure reading that is 20% less than the patient's normal baseline pressure.
Hypovolemia is the most common cause of postoperative hypotension; however, hypotension may also
be caused by cardiac dysfunctions. Which of the following cardiac conditions will present with
hypotension? - correct answer ✔✔myocardial infarction, myocardial tamponade, and pulmonary
embolism
The ideal suture material is one that has handling characteristics such as: - correct answer ✔✔Pliability
Which of the following patient modifiable factors can contribute to surgical site infections? - correct
answer ✔✔Alcoholism
Which anesthetic agent could not be given if an IV-only anesthesia plan was employed? - correct answer
✔✔Desflurane
