NIFA STUDY GUIDE questions and answers
2026\2027 A+ Grade
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 reprocess instruments
To safely transfer and position patients in a manner that prevents shearing, personnel should use a
mechanical 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 and 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 answer 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
perform 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 EXCEPT:
- correct answer Increases risk of renal failure
Recommendations for preventing retained surgical items include all of the following EXCEPT:
- correct answer Utilizing a multidisciplinary team to resolve incorrect counts
,Select the appropriate order for administering blood and blood products.
- correct answer Verify informed consent for blood, verify patient identification and blood type and unit
numbers against blood tag and requisition slip with second licensed person, sign slips
Weighing sponges is a valuable tool for meticulous calculation of blood and fluid loss when conducted
correctly and used in appropriate circumstances. Select the response that correctly reflects the best
practice in weighing sponges.
- correct answer Keep a running total blood loss calculated from available sponges during procedure
Laparoscopic procedures that emergently convert to open procedures place the patient at risk for
unintentional 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 sponges 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 able 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 patient 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 concerning her scheduled vaginal-assisted laparoscopic hysterectomy. She demonstrated and
verbalized that she understood all 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. The patient 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 immediately turned and addressed the entire team in a clear voice. Select the
, appropriate communication that the circulating 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 identifying, mitigating, and managing the hazards inherent in surgical care. Choose the
answer below that completes the 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.
If a staff person receives a needlestick injury, what is the first corrective action?
- correct answer Wash wound with soap and water; flush mucous membranes.
Contact with infected patients or infectious material places healthcare workers at risk for occupational-
acquired infection. Which communicable disease are healthcare workers at risk for acquiring or
transmitting?
- correct answer Seasonal influenza
Select the appropriate nursing action that supports hands-free instrument passing and sharps safety.
- correct answer Create a neutral hands-free area between the scrub person and surgeon with a basin or
magnetic mat.
Select the guideline that complements the design of the culture of safety model.
- correct answer Incorporate safe practices into your daily work when handling sharps.
A neutral zone is a predetermined location on the surgical field where sharps are placed for retrieval by
the surgeon. Which of the following is a best practice for the use of the neutral zone?
- correct answer Announce the transfer of each sharp before placing it in the neutral zone.
2026\2027 A+ Grade
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 reprocess instruments
To safely transfer and position patients in a manner that prevents shearing, personnel should use a
mechanical 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 and 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 answer 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
perform 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 EXCEPT:
- correct answer Increases risk of renal failure
Recommendations for preventing retained surgical items include all of the following EXCEPT:
- correct answer Utilizing a multidisciplinary team to resolve incorrect counts
,Select the appropriate order for administering blood and blood products.
- correct answer Verify informed consent for blood, verify patient identification and blood type and unit
numbers against blood tag and requisition slip with second licensed person, sign slips
Weighing sponges is a valuable tool for meticulous calculation of blood and fluid loss when conducted
correctly and used in appropriate circumstances. Select the response that correctly reflects the best
practice in weighing sponges.
- correct answer Keep a running total blood loss calculated from available sponges during procedure
Laparoscopic procedures that emergently convert to open procedures place the patient at risk for
unintentional 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 sponges 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 able 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 patient 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 concerning her scheduled vaginal-assisted laparoscopic hysterectomy. She demonstrated and
verbalized that she understood all 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. The patient 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 immediately turned and addressed the entire team in a clear voice. Select the
, appropriate communication that the circulating 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 identifying, mitigating, and managing the hazards inherent in surgical care. Choose the
answer below that completes the 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.
If a staff person receives a needlestick injury, what is the first corrective action?
- correct answer Wash wound with soap and water; flush mucous membranes.
Contact with infected patients or infectious material places healthcare workers at risk for occupational-
acquired infection. Which communicable disease are healthcare workers at risk for acquiring or
transmitting?
- correct answer Seasonal influenza
Select the appropriate nursing action that supports hands-free instrument passing and sharps safety.
- correct answer Create a neutral hands-free area between the scrub person and surgeon with a basin or
magnetic mat.
Select the guideline that complements the design of the culture of safety model.
- correct answer Incorporate safe practices into your daily work when handling sharps.
A neutral zone is a predetermined location on the surgical field where sharps are placed for retrieval by
the surgeon. Which of the following is a best practice for the use of the neutral zone?
- correct answer Announce the transfer of each sharp before placing it in the neutral zone.
