RNFA quiz 1B

RNFA quiz 1B Marvin Deloitte, a 19 year-old male, received in intravenous peripheral nerve block (PNB/Bier block) for an ORIF of about ankle fracture. The anesthesia provider injected a a distal dorsal vein of Marvin's right foot with 2% lidocaine, after placing a single cuffed pneumatic tourniquet circumferentially around Marvins upper thigh. The surgeon looked through the OR window to check on anesthesia progress as he scrubbed at the sink outside of the OR. The circulating nurse had the leg elevated and was prepping the ankle. The surgeon noticed that the cuff seemed to be deflating and that the anesthesia provider was turned away from the patient. The circulating nurse also noticed the movement under the protective towel placed over the cuff, and saw the tourniquet tubing fall to the floor. The nurses first response should be: - CORRECT ANSWER-Alert the anesthesia provider, reconnect thw tubing to cuff and inflate, and send the surgeon for the code cart The perioperative nurse visited Mr. Jennings in the ICU the next day and noticed abrasions on the elbow. Mr. Jennings told her that the ICU nurses had difficulty pulling him back up in bed every time he slid down toward the bottom and he was not able to be much help in moving himself. The skin injury was probably the result of which physical force - CORRECT ANSWER-A friction from the elbows rubbing over the sheets when slid up in the bed. Malignant hyperthermia (MH) is a rare, multifaceted syndrome with an increased incidence in individuals with central core diseases such as: - CORRECT ANSWERCongenital myopathies David Reese, a 14 year-old patient with marked scoliosis, is in prone position with gel rolls, gel pads, and pillows for a spinal fusion Before the skin is begun, the perioperative nurse should check the positioning for pressure areas of the: - CORRECT ANSWERGenitals, knees, toes, and eyes A reverse cutting needle is preferred for _________________ suturing. - CORRECT ANSWER-Cutaneous The installation of a local anesthetic into the subarachnoid space is termed: - CORRECT ANSWER-Spinal anesthesia Susie Reynolds, a 9 year old softball player, has arrived in the OR for emergency repair of superficial facial and deep arm lacerations when she ran into the chain link fence during practice. The perioperative nurse discovers that Susie has an insulin pump that should remain connected during the short procedure. The RNFA should consider which of the following options for energy generated hemostasis? - CORRECT ANSWERBipolar electrosurgery unit Lateral, lateral chest and lateral kidney positions all place pressure on structures of the dependent side: ears, shoulder, ribs, hips, greater femoral head, knees and ankles. The potential for injury to the patient is significant, based on these pressure areas. Which resultant injury or harm could not be related to these lateral positions? - CORRECT ANSWER-********look at pg 174 in 15th Ed and 173-174 in 16th Ed. ******** Which of the following regarding specimen labeling is a regulatory requirement? - CORRECT ANSWER-Biohazard information pg 32 15th Ed pg 27 16th Ed. Which of the following is a major infectious risk for healthcare workers? - CORRECT ANSWER-Hepatitis B The ideal suture material is one that has handling characteristics such as: - CORRECT ANSWER-Pliability The perianesthesia nurse completes a systematic and comprehensive secondary assessment of the patient (e. g. Head to toe assessment or major body systems approach). Select the response that best reflects the parameters of a comprehensive respiratory assessment. - CORRECT ANSWER-Rate, rhythm and breath sounds Ketamine is a short acting induction and IV or IM maintenance agent. Patients are able to maintain their airways. It is a suitable agent to use with small children and burn patients. The concerns with this agent is that in large doses it may cause: - CORRECT ANSWER-Respiratory depression Tissue reaction characteristics that need considered when choosing suture include: - CORRECT ANSWER-Absorption Sandra Williams was presented with the prepared informed consent form during the discussion with her surgeon concerning her scheduled vaginal assisted laparoscopic hysterectomy. She demonstrates and verbalized that she understood al 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. Sandy was exercising her: - CORRECT ANSWER-Right to informed consent What vaccine should healthcare workers receive if they are caring for immunocompromised patients? - CORRECT ANSWER-Inactivated influenza vaccine Sponge counts should be performed at the time of permanent relief of either the scrub person or the circulating nurse, and __________________ - CORRECT ANSWER-Pg 25 16th Ed In several studies, it was determined that the risk of contamination and subsequent infection to the wearer can be reduced by wearing two pair of sterile surgical gloves, as opposed to wearing one pair. Select the correct statement that refers to double gloving in terms of best practice. - CORRECT ANSWER-The cdc, the American college of surgeons and the American academy of orthopedic surgeons support double gloving during invasive surgical procedures. Pg 95 16 th Ed. Pg. 113 15th Ed. Suture can be used for more than repairing tissue. Choose uses of suture from the following. - CORRECT ANSWER-Ligate, suture and close tissue New synthetic polymer such as PDS provide wound support up to ______ months - CORRECT ANSWER-3 What kind of needle would be used on the skin? - CORRECT ANSWER-Reverse cutting The highest risk of injury per needle use is attributed to the: - CORRECT ANSWERKeith needle Which of the following statements reflect the location of the arcuate line? - CORRECT ANSWER-One third of the distance between the umbilicus and the symphysis pubis The intracorporeal suture technique uses the suture tying process analogous to the - CORRECT ANSWER-Instrument tie A stitch that is tied and cut before placing another stitch is called: - CORRECT ANSWER-Interrupted The surgical hand scrub is designed to render the hands, nails and arms - CORRECT ANSWER-Surgical clean If a sterile glove becomes contaminated during the procedure, the best practice odor corrective action is: - CORRECT ANSWER-Reglove with assisted gloving technique Jacob Sutzkever had a temperature of 103 degree f and returned to the OR for the debridement and washout of purple my drainage from his wound on postoperative day 3. What was wound classification at the time of his debridement and washout surgery? - CORRECT ANSWER-Infected wound classification IV The pediatric patient is at risk for imbalanced fluid volume related to invasive surgery and accompanying blood loss. Select the outcome indicator that would best reflect that the goal of maintaining fluid balance was attained. - CORRECT ANSWER-Blood pressure within acceptable range.