NIFA STUDY GUIDE
1. The primary role of the Registered Nurse First Assistant (RNFA) during surgery is:
A. Administer anesthesia
B. Provide direct surgical assistance under the surgeon’s supervision
C. Monitor vital signs in PACU
D. Transport the patient postoperatively
✅ Answer: B
Rationale: The RNFA assists the surgeon directly by performing tasks such as tissue
handling, suturing, and controlling bleeding.
2. Which surgical position is most commonly used for abdominal procedures?
A. Lithotomy
B. Trendelenburg
C. Supine
D. Fowler’s
✅ Answer: C
Rationale: The supine position provides optimal access to the abdominal cavity and
maintains patient comfort and stability.
3. When performing a time-out before incision, the RNFA verifies all of the following
EXCEPT:
A. Correct patient identity
B. Correct surgical site
C. Correct procedure
D. Estimated blood loss
✅ Answer: D
,Rationale: Time-out confirms patient, site, and procedure — blood loss estimation
occurs during intraoperative planning, not verification.
4. The sterile field is considered contaminated if:
A. The surgeon touches the drape
B. A non-sterile item contacts it
C. It is left unattended
D. The field is established in the OR
✅ Answer: B
Rationale: Any contact by a non-sterile object immediately contaminates the sterile
field.
5. Which suture is absorbable?
A. Silk
B. Nylon
C. Vicryl
D. Prolene
✅ Answer: C
Rationale: Vicryl (polyglactin 910) is a synthetic absorbable suture used for internal
soft tissue approximation.
6. Aseptic technique requires that:
A. The scrub nurse maintains only the sterile instrument table
B. Sterile personnel stay within the sterile field
C. Gloves are changed only after the procedure
D. The circulator handles all sterile instruments
✅ Answer: B
Rationale: Sterile personnel must remain in the sterile field to prevent
contamination.
7. During laparoscopic procedures, CO₂ insufflation is used to:
A. Control bleeding
, B. Expand the abdominal cavity
C. Decrease infection risk
D. Stabilize blood pressure
✅ Answer: B
Rationale: CO₂ expands the peritoneal cavity, allowing visualization and instrument
movement.
8. The most common site for an arterial line insertion is:
A. Radial artery
B. Femoral artery
C. Brachial artery
D. Carotid artery
✅ Answer: A
Rationale: The radial artery is preferred for arterial monitoring due to accessibility
and low complication risk.
9. Which medication is used to reverse heparin?
A. Atropine
B. Protamine sulfate
C. Naloxone
D. Epinephrine
✅ Answer: B
Rationale: Protamine sulfate neutralizes the anticoagulant effect of heparin.
10. The first scrub counts surgical sponges with:
A. The surgeon
B. The anesthesia provider
C. The circulator
D. The charge nurse
✅ Answer: C
Rationale: The scrub and circulator perform counts together for accountability.
1. The primary role of the Registered Nurse First Assistant (RNFA) during surgery is:
A. Administer anesthesia
B. Provide direct surgical assistance under the surgeon’s supervision
C. Monitor vital signs in PACU
D. Transport the patient postoperatively
✅ Answer: B
Rationale: The RNFA assists the surgeon directly by performing tasks such as tissue
handling, suturing, and controlling bleeding.
2. Which surgical position is most commonly used for abdominal procedures?
A. Lithotomy
B. Trendelenburg
C. Supine
D. Fowler’s
✅ Answer: C
Rationale: The supine position provides optimal access to the abdominal cavity and
maintains patient comfort and stability.
3. When performing a time-out before incision, the RNFA verifies all of the following
EXCEPT:
A. Correct patient identity
B. Correct surgical site
C. Correct procedure
D. Estimated blood loss
✅ Answer: D
,Rationale: Time-out confirms patient, site, and procedure — blood loss estimation
occurs during intraoperative planning, not verification.
4. The sterile field is considered contaminated if:
A. The surgeon touches the drape
B. A non-sterile item contacts it
C. It is left unattended
D. The field is established in the OR
✅ Answer: B
Rationale: Any contact by a non-sterile object immediately contaminates the sterile
field.
5. Which suture is absorbable?
A. Silk
B. Nylon
C. Vicryl
D. Prolene
✅ Answer: C
Rationale: Vicryl (polyglactin 910) is a synthetic absorbable suture used for internal
soft tissue approximation.
6. Aseptic technique requires that:
A. The scrub nurse maintains only the sterile instrument table
B. Sterile personnel stay within the sterile field
C. Gloves are changed only after the procedure
D. The circulator handles all sterile instruments
✅ Answer: B
Rationale: Sterile personnel must remain in the sterile field to prevent
contamination.
7. During laparoscopic procedures, CO₂ insufflation is used to:
A. Control bleeding
, B. Expand the abdominal cavity
C. Decrease infection risk
D. Stabilize blood pressure
✅ Answer: B
Rationale: CO₂ expands the peritoneal cavity, allowing visualization and instrument
movement.
8. The most common site for an arterial line insertion is:
A. Radial artery
B. Femoral artery
C. Brachial artery
D. Carotid artery
✅ Answer: A
Rationale: The radial artery is preferred for arterial monitoring due to accessibility
and low complication risk.
9. Which medication is used to reverse heparin?
A. Atropine
B. Protamine sulfate
C. Naloxone
D. Epinephrine
✅ Answer: B
Rationale: Protamine sulfate neutralizes the anticoagulant effect of heparin.
10. The first scrub counts surgical sponges with:
A. The surgeon
B. The anesthesia provider
C. The circulator
D. The charge nurse
✅ Answer: C
Rationale: The scrub and circulator perform counts together for accountability.
