NIFA STUDY GUIDE EXAM QUESTIONS
AND ANSWERS
The number one patient safety issue identified in a survey of peri-
. . . . . . . . . . .
operative nurses is preventing: - Correct Answer - Wrong site/procedure/patient surgery . . . . . .. . . . .
Reprocessing .
(flashing) instruments in the OR is high risk because: - Correct Answer - OR personnel not properly trained to r
. . . . . . . . . . .. . . . . . . . .
eprocess instruments .
To safely transfer and position patients in a manner that prevents shearing, personnel should use a mechanica
. . . . . . . . . . . . . . . .
l lifting device for a supine-to-supine transfer of a patient weighing more than: - Correct Answer - 157 lbs
. . . . . . . . . . . . . . .. . . .
_______________ should be the primary decision makers for what equipment and supplies are purchased an . . . . . . . . . . . . . .
d stocked in the difficult airway management cart. - Correct Answer - Anesthesia personnel
. . . . . . . . . .. . . .
Proper specimen management techniques prevent errors and include all of the following EXCEPT: - Correct A
. . . . . . . . . . . . . . ..
nswer - 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 perfor
. . . . . . . . . . . . . . . . . .
m all of the following duties EXCEPT: - Correct Answer - Perform a weekly fire risk assessment
. . . . . . . . .. . . . . . . .
Peri-
operative hypothermia is an important issue for all anesthetized patients because of all of the following EXCEP
. . . . . . . . . . . . . . . .
T: - Correct Answer - Increases risk of renal failure
. . .. . . . . . .
Recommendations for preventing retained surgical items include all of the following EXCEPT: - Correct Answe . . . . . . . . . . . . . ..
r - Utilizing a multidisciplinary team to resolve incorrect counts
. . . . . . . . .
Select the appropriate order for administering blood and blood products. - Correct Answer - Verify informed c
. . . . . . . . . . . .. . . . .
onsent for blood, verify patient identification and blood type and unit numbers against blood tag and requisiti
. . . . . . . . . . . . . . . .
on slip with second licensed person, sign slips
. . . . . . .
Weighing sponges is a valuable tool for meticulous calculation of blood and fluid loss when conducted correctl
. . . . . . . . . . . . . . . .
y and used in appropriate circumstances. Select the response that correctly reflects the best practice in weighi
. . . . . . . . . . . . . . . .
ng sponges. - Correct Answer - Keep a running total blood loss calculated from available sponges during proce
. . . .. . . . . . . . . . . . . .
dure
Laparoscopic procedures that emergently convert to open procedures place the patient at risk for unintentio . . . . . . . . . . . . . .
nal 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? - Correct Answer - Replacing or tagging spon . . . . . . . . . . .. . . . . .
ges 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 ab
. . . . . . . . . . . . . . . . . . . . .
le 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 pa
. . . . . . . . . . . . . . . . . .
tient was taking full advantage of what provision for her care? - Correct Answer - PSDA and advance directives
. . . . . . . . . . . . .. . . . . .
A patient was presented with the prepared informed consent form during the discussion with her surgeon co
. . . . . . . . . . . . . . . .
ncerning her scheduled vaginal- . . .
assisted laparoscopic hysterectomy. She demonstrated and verbalized that she understood all of the tenets o
. . . . . . . . . . . . . .
f the procedure, risks, expected outcome, complications, and procedural process. Before she signed the cons
. . . . . . . . . . . . . .
ent form, she informed the surgeon that she did not want any medical students or surgical residents performi
. . . . . . . . . . . . . . . . .
ng any parts of the procedure other than assisting and did not want any photographs of her body taken. The su
. . . . . . . . . . . . . . . . . . . .
rgeon agreed, and she crossed out those portions of the form and initialed them before she signed. The patien
. . . . . . . . . . . . . . . . . .
t was exercising her: - Correct 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 immedi
. . . . . . . . . . . . . . . .
ately turned and addressed the entire team in a clear voice. Select the appropriate communication that the cir
. . . . . . . . . . . . . . . . .
culating nurse must employ during this count discrepancy. - Correct 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 identifyin
. . . . . . . . . . . . . . . . .
g, mitigating, and managing the hazards inherent in surgical care. Choose the answer below that completes th
. . . . . . . . . . . . . . . .
e blanks in this sentence: The risk of the surgical hazard of _________________ can be mitigated through ___
. . . . . . . . . . . . . . . . .
____________________. - Correct 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: - Correct Answer - patient identification and procedure performed. . . . . .. . . . . . .
AND ANSWERS
The number one patient safety issue identified in a survey of peri-
. . . . . . . . . . .
operative nurses is preventing: - Correct Answer - Wrong site/procedure/patient surgery . . . . . .. . . . .
Reprocessing .
(flashing) instruments in the OR is high risk because: - Correct Answer - OR personnel not properly trained to r
. . . . . . . . . . .. . . . . . . . .
eprocess instruments .
To safely transfer and position patients in a manner that prevents shearing, personnel should use a mechanica
. . . . . . . . . . . . . . . .
l lifting device for a supine-to-supine transfer of a patient weighing more than: - Correct Answer - 157 lbs
. . . . . . . . . . . . . . .. . . .
_______________ should be the primary decision makers for what equipment and supplies are purchased an . . . . . . . . . . . . . .
d stocked in the difficult airway management cart. - Correct Answer - Anesthesia personnel
. . . . . . . . . .. . . .
Proper specimen management techniques prevent errors and include all of the following EXCEPT: - Correct A
. . . . . . . . . . . . . . ..
nswer - 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 perfor
. . . . . . . . . . . . . . . . . .
m all of the following duties EXCEPT: - Correct Answer - Perform a weekly fire risk assessment
. . . . . . . . .. . . . . . . .
Peri-
operative hypothermia is an important issue for all anesthetized patients because of all of the following EXCEP
. . . . . . . . . . . . . . . .
T: - Correct Answer - Increases risk of renal failure
. . .. . . . . . .
Recommendations for preventing retained surgical items include all of the following EXCEPT: - Correct Answe . . . . . . . . . . . . . ..
r - Utilizing a multidisciplinary team to resolve incorrect counts
. . . . . . . . .
Select the appropriate order for administering blood and blood products. - Correct Answer - Verify informed c
. . . . . . . . . . . .. . . . .
onsent for blood, verify patient identification and blood type and unit numbers against blood tag and requisiti
. . . . . . . . . . . . . . . .
on slip with second licensed person, sign slips
. . . . . . .
Weighing sponges is a valuable tool for meticulous calculation of blood and fluid loss when conducted correctl
. . . . . . . . . . . . . . . .
y and used in appropriate circumstances. Select the response that correctly reflects the best practice in weighi
. . . . . . . . . . . . . . . .
ng sponges. - Correct Answer - Keep a running total blood loss calculated from available sponges during proce
. . . .. . . . . . . . . . . . . .
dure
Laparoscopic procedures that emergently convert to open procedures place the patient at risk for unintentio . . . . . . . . . . . . . .
nal 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? - Correct Answer - Replacing or tagging spon . . . . . . . . . . .. . . . . .
ges 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 ab
. . . . . . . . . . . . . . . . . . . . .
le 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 pa
. . . . . . . . . . . . . . . . . .
tient was taking full advantage of what provision for her care? - Correct Answer - PSDA and advance directives
. . . . . . . . . . . . .. . . . . .
A patient was presented with the prepared informed consent form during the discussion with her surgeon co
. . . . . . . . . . . . . . . .
ncerning her scheduled vaginal- . . .
assisted laparoscopic hysterectomy. She demonstrated and verbalized that she understood all of the tenets o
. . . . . . . . . . . . . .
f the procedure, risks, expected outcome, complications, and procedural process. Before she signed the cons
. . . . . . . . . . . . . .
ent form, she informed the surgeon that she did not want any medical students or surgical residents performi
. . . . . . . . . . . . . . . . .
ng any parts of the procedure other than assisting and did not want any photographs of her body taken. The su
. . . . . . . . . . . . . . . . . . . .
rgeon agreed, and she crossed out those portions of the form and initialed them before she signed. The patien
. . . . . . . . . . . . . . . . . .
t was exercising her: - Correct 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 immedi
. . . . . . . . . . . . . . . .
ately turned and addressed the entire team in a clear voice. Select the appropriate communication that the cir
. . . . . . . . . . . . . . . . .
culating nurse must employ during this count discrepancy. - Correct 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 identifyin
. . . . . . . . . . . . . . . . .
g, mitigating, and managing the hazards inherent in surgical care. Choose the answer below that completes th
. . . . . . . . . . . . . . . .
e blanks in this sentence: The risk of the surgical hazard of _________________ can be mitigated through ___
. . . . . . . . . . . . . . . . .
____________________. - Correct 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: - Correct Answer - patient identification and procedure performed. . . . . .. . . . . . .
