RNFA FINAL EXAM V1
1. The OR was trialling a new insufflation system and the vendor represen- tative 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 pressurebecause she feared that the elderly patient was at high risk for::
Hypercarbia
2. Your patient had an episode of vomiting during anesthesia induction andwas effectively
suctioned by anesthesia. Upon extubation, the patient pre- sented with coughing, wheezing,
dyspnea, use of accessory muscles, and tachypnea. What is this patient most likely
experiencing?: Bronchospasm
3. High-pressure insufflation rates can cause overpressurization of the in- tra-abdominal
cavity. This overpressurization can lead to which of the following?: Hypercarbia
4. 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?: suctioning, IV succinylcholine
administration, and rein-tubation
5. Which of the following is not a characteristic of silk suture?: Memory
6. The first case of the day is scheduled as a knee arthroscopy for an other-wise healthy 24
year old patient. Upon pre assessment, the patient admits toa family history of anesthesia and
surgical complications. Patient also stateslast oral intake consisted of eating a cheese steak and
drinking 2 cans of beerthe night before at 11:30 PM. The patient subsequently vomited when
intu- bation was performed and experienced respiratory distress upon extubation.What
measure could have been taken by the team to prevent aspiration basedon the patient's history?:
The perioperative nurse applying cricoid pressure duringinduction through intubation
7. The instillation of a local anesthetic into the subarachnoid space istermed:: Spinal
Anesthesia
8. What is the appropriate action if the doctor is delayed after the room and instruments have
been opened?: Cover the instruments with a sterile drape and have the scrub nurse continually
visually observe the room for breaches in sterility.
9. Select the positioning device commonly used for positioning the headduring procedures
such as craniotomies.: Mayfield Head Positioners
10. Hypotension is a blood pressure reading that is 20% less than the pa- tient's normal
baseline pressure. Hypovolemia is the most common cause of postoperative hypotension;
however, hypotension may also be caused bycardiac dysfunctions. Which of the following
cardiac conditions will present with hypotension?: myocardial infarction, myocardial
tamponade, and pulmonaryembolism
11. The ideal suture material is one that has handling characteristics suchas:: Pliability
12. Which of the following patient modifiable factors can contribute to surgicalsite infections?:
,Alcoholism
13. Which anesthetic agent could not be given if an IV-only anesthesia planwas employed?:
Desflurane
14. A type of monofilament suture that does not require the user to tie knotsis known as::
Barbed
15. Which statement about surgical dressings is true?: Surgical dressings cush-ion and protect
the wound from trauma and gross contamination, and absorb drainage.
16. A common dysrythmia seen after surgery is:: Sinus Tachycardia
17. The type of wound closure that occurs when approximation of the woundedges does not
occur for 3 or more days after a surgical procedure.: Third Intention
18. Your patient was presented with the prepared informed consent form during the
discussion with her surgeon concerning her scheduled surgery. Before signing the consent
form, the patient informed the surgeon that they did not want any medical students or surgical
residents performing any partsof the procedure other than assisting and did not want any
photographs taken.The surgeon agreed and crossed out those portions of the form. The patient
initialed them prior to signing the consent. Your patient was exercising whichpatient right?:
Right to Informed Consent
19. A reverse cutting needle is preferred for suturing.:
Cutaneous
20. 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?: Prednisoneand a beta-agonist inhaler
21. Precautions apply to blood, all body fluids, secretions, and excre-tions
(except sweat), regardless of whether they contain visible blood, mucousmembranes, and non-
intact skin.: Standard
22. Which of the following anesthetics may result in fasiculations for the pa-tient?:
Succhinylcholine
23. 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?: b. set theambient room temperature between 68° and 73° F
24. A basic anesthesia monitoring device that is used during general anes- thesia to confirm
successful endotracheal tube placement and determine thepresence of gas exchange is the::
capnometer/end-tidal CO2 monitor
25. The first step in the decontamination process is:: Cleaning
26. Which of the following requires at minimum, 2 patient identifiers on speci- men labels?:
Joint Commission
, 27. A 9-year-old diabetic with an insulin pump, has arrived in the OR for emer- gency repair
of superficial facial and deep arm lacerations. The RNFA should consider which of the
following options for energy-generated hemostasis?: -Bipolar Electrosurgery Unit
28. During a hysteroscopy, sterile saline is used to expand the intrauterine com-partment and
enhance visualization. The perioperative nurse is concerned that approximately 500 ml of
fluid was unaccounted for and alerted the sur- geon and RNFA. The nurse's motive for this
surveillance is to:: Potential for Intervastation
29. Which of the following statements reflects the location of the arcuate line?-
: one third of the distance between the umbilicus and the symphysis pubis.
30. Laparoscopic procedures that emergently convert to open procedures place the patient at
risk for unintentional retained surgical items (RSI). Whatrisk reduction strategy could prevent
RSI?: Replacing or tagging sponges andlaparotomy instruments with RFID chips.
31. The surgical hand scrub is designed to render the hands, nails, and arms-
: Surgically Clean
32. 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:: Ulnar Nerve Injury
33. A type of suture to help eliminate tension on the primary suture line is known as::
Retention Suture
34. Identify the primary substance found in the epidermis that protects the body from fluid
loss and invasion by pathogens.: Keratin
35. When a patient absorbs an unsafe amount of local anesthetic into the bloodstream, a
catastrophic outcome is possible.Treatment for LAST includesthe use of which of the
following?: Lipids
36. When buried in tissue, silk loses its tensile strength after what period oftime?: 1 Year
37. Guidelines from WHO focus on which of the following in the prevention ofsurgical site
infections?: Use of Prophylactic Antibiotics
38. To help visualize abdominal structures and to enhance safety during la- paroscopic
procedures, a pneumoperitoneum is created. After Veress needleconfirmation, 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 .: 9 L/min;14 to 16
mm Hg
39. 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 isan appropriate suggestion?: Bookwalter
1. The OR was trialling a new insufflation system and the vendor represen- tative 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 pressurebecause she feared that the elderly patient was at high risk for::
Hypercarbia
2. Your patient had an episode of vomiting during anesthesia induction andwas effectively
suctioned by anesthesia. Upon extubation, the patient pre- sented with coughing, wheezing,
dyspnea, use of accessory muscles, and tachypnea. What is this patient most likely
experiencing?: Bronchospasm
3. High-pressure insufflation rates can cause overpressurization of the in- tra-abdominal
cavity. This overpressurization can lead to which of the following?: Hypercarbia
4. 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?: suctioning, IV succinylcholine
administration, and rein-tubation
5. Which of the following is not a characteristic of silk suture?: Memory
6. The first case of the day is scheduled as a knee arthroscopy for an other-wise healthy 24
year old patient. Upon pre assessment, the patient admits toa family history of anesthesia and
surgical complications. Patient also stateslast oral intake consisted of eating a cheese steak and
drinking 2 cans of beerthe night before at 11:30 PM. The patient subsequently vomited when
intu- bation was performed and experienced respiratory distress upon extubation.What
measure could have been taken by the team to prevent aspiration basedon the patient's history?:
The perioperative nurse applying cricoid pressure duringinduction through intubation
7. The instillation of a local anesthetic into the subarachnoid space istermed:: Spinal
Anesthesia
8. What is the appropriate action if the doctor is delayed after the room and instruments have
been opened?: Cover the instruments with a sterile drape and have the scrub nurse continually
visually observe the room for breaches in sterility.
9. Select the positioning device commonly used for positioning the headduring procedures
such as craniotomies.: Mayfield Head Positioners
10. Hypotension is a blood pressure reading that is 20% less than the pa- tient's normal
baseline pressure. Hypovolemia is the most common cause of postoperative hypotension;
however, hypotension may also be caused bycardiac dysfunctions. Which of the following
cardiac conditions will present with hypotension?: myocardial infarction, myocardial
tamponade, and pulmonaryembolism
11. The ideal suture material is one that has handling characteristics suchas:: Pliability
12. Which of the following patient modifiable factors can contribute to surgicalsite infections?:
,Alcoholism
13. Which anesthetic agent could not be given if an IV-only anesthesia planwas employed?:
Desflurane
14. A type of monofilament suture that does not require the user to tie knotsis known as::
Barbed
15. Which statement about surgical dressings is true?: Surgical dressings cush-ion and protect
the wound from trauma and gross contamination, and absorb drainage.
16. A common dysrythmia seen after surgery is:: Sinus Tachycardia
17. The type of wound closure that occurs when approximation of the woundedges does not
occur for 3 or more days after a surgical procedure.: Third Intention
18. Your patient was presented with the prepared informed consent form during the
discussion with her surgeon concerning her scheduled surgery. Before signing the consent
form, the patient informed the surgeon that they did not want any medical students or surgical
residents performing any partsof the procedure other than assisting and did not want any
photographs taken.The surgeon agreed and crossed out those portions of the form. The patient
initialed them prior to signing the consent. Your patient was exercising whichpatient right?:
Right to Informed Consent
19. A reverse cutting needle is preferred for suturing.:
Cutaneous
20. 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?: Prednisoneand a beta-agonist inhaler
21. Precautions apply to blood, all body fluids, secretions, and excre-tions
(except sweat), regardless of whether they contain visible blood, mucousmembranes, and non-
intact skin.: Standard
22. Which of the following anesthetics may result in fasiculations for the pa-tient?:
Succhinylcholine
23. 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?: b. set theambient room temperature between 68° and 73° F
24. A basic anesthesia monitoring device that is used during general anes- thesia to confirm
successful endotracheal tube placement and determine thepresence of gas exchange is the::
capnometer/end-tidal CO2 monitor
25. The first step in the decontamination process is:: Cleaning
26. Which of the following requires at minimum, 2 patient identifiers on speci- men labels?:
Joint Commission
, 27. A 9-year-old diabetic with an insulin pump, has arrived in the OR for emer- gency repair
of superficial facial and deep arm lacerations. The RNFA should consider which of the
following options for energy-generated hemostasis?: -Bipolar Electrosurgery Unit
28. During a hysteroscopy, sterile saline is used to expand the intrauterine com-partment and
enhance visualization. The perioperative nurse is concerned that approximately 500 ml of
fluid was unaccounted for and alerted the sur- geon and RNFA. The nurse's motive for this
surveillance is to:: Potential for Intervastation
29. Which of the following statements reflects the location of the arcuate line?-
: one third of the distance between the umbilicus and the symphysis pubis.
30. Laparoscopic procedures that emergently convert to open procedures place the patient at
risk for unintentional retained surgical items (RSI). Whatrisk reduction strategy could prevent
RSI?: Replacing or tagging sponges andlaparotomy instruments with RFID chips.
31. The surgical hand scrub is designed to render the hands, nails, and arms-
: Surgically Clean
32. 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:: Ulnar Nerve Injury
33. A type of suture to help eliminate tension on the primary suture line is known as::
Retention Suture
34. Identify the primary substance found in the epidermis that protects the body from fluid
loss and invasion by pathogens.: Keratin
35. When a patient absorbs an unsafe amount of local anesthetic into the bloodstream, a
catastrophic outcome is possible.Treatment for LAST includesthe use of which of the
following?: Lipids
36. When buried in tissue, silk loses its tensile strength after what period oftime?: 1 Year
37. Guidelines from WHO focus on which of the following in the prevention ofsurgical site
infections?: Use of Prophylactic Antibiotics
38. To help visualize abdominal structures and to enhance safety during la- paroscopic
procedures, a pneumoperitoneum is created. After Veress needleconfirmation, 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 .: 9 L/min;14 to 16
mm Hg
39. 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 isan appropriate suggestion?: Bookwalter
