Rnfa Final Exam

RNFA FINAL EXAM In health care settings, the primary occupational source of radiation exposure is: - ANS Scatter Which of the following best describes the semi-restricted surgical practice area? - ANS Used for communication of information between the surgical suite and the rest of the health care facility If a health care worker who works with radiation become pregnant, she should: - ANS Promptly inform the radiation safety officer When using a single drape for a lithotomy, the following instructions are correct, except: - ANS Place the drape so the edge is 2 inches from the perineum When updating the patient's support person during surgery, a nurse should: - ANS Discuss a projected time frame for completion of the surgery Safe injection practices: - ANS Include using one syringe per injection Preoperative assessment helps determine if patients are suitable candidates for outpatient orthopedic surgery. Based on the information provided, which of the following patients is the BEST candidate for orthopedic surgery in an ASC? - ANS A patient who needs a total hip replacement, is otherwise healthy, and has a short-term home care assistant When opening a sterile package, the LAST flap to be opened should be the flap: - ANS Closest to you As of the following wound healing complications are attributed to smoking except: - ANS Decreased blood viscosity A patient had the following lab values noted intraoperatively: pH 7.35, PCO2 35 mmHg, HCO322mEq/L. This patient is in: - ANS Metabolic acidosis This classification of medication can affect wound healing in the surgical patient: - ANS Anticoagulants When choosing a suture needle for tissue such as peritoneum, dura, and subcutaneous tissue, the most appropriate choice is the _______ needle. - ANS Taper During a THA using the posterior lateral approach, the RNFA will dislocated the head of the femur using: - ANS Flexion, adduction, external rotation Which of the following muscles are critical for stabilization of the knee joint? - ANS Quadriceps femoris During the cementing of components during total joint replacement, a new CRNA who has never worked in orthopedics before begins to panic. A side effect that possibly occurred with this patient as a result of the cement is: - ANS Hypotension A medication often used in cardiac surgery to prevent spasms of vessels is: - ANS Papaverine Physicians may consider which of the following options when determining the best treatment option for breast cancer surgery. - ANS Size of tumor The most commonly used incision for Cesarean section is the: - ANS Pfannensteil This technique is primarily reserved for the patient having prophylactic mastectomy and immediate breast reconstruction. - ANS Nipple sparing The RNFA should be prepared to assist with the _______ procedure if a patient needs surgical intervention for the treatment of atrial fibrillation - ANS Maze Prepping for an abdominal hysterectomy that may include the cervix should be performed in what order? - ANS Dirty then clean Care must be taken when placing reactors as an RNFA assisting with inguinal hernia repair. Which of the following is a vessel that is located in the area of i in inguinal hernias? - ANS Inferior epigastric When intraoperative cholangiograms are performed, the cholangiogram catheter is placed in the: - ANS Cystic duct When preoperatively assessing a patient for cardiac surgery, the RNFA should consider all of the following except: - ANS RBC count Pre-op markings to determine nipple positioning for reduction mammoplasty will be drawn on the patient's chest _____________. - ANS While sitting upright The wound classification assigned by the CDC to breast surgery. - ANS Clean Identify the marginal boundaries of the breasts. - ANS Second to sixth rib and horizontally from the lateral edge of sternum to anterior axillary line Reduction mammoplasty is not indicated for which of the following? - ANS hyperthelia The RNFA with the vascular surgery service is preparing to discharge Mark Weston, a 51 yr old male who recently had endovascular surgery. He will be taking anticoagulation therapy for the next 12 weeks. What statement regarding anticoagulation therapy, that is relevant to Mark, is true? - ANS Do not use tools such as saws or hammers, which could lead to an accident. Pericardial tamponade includes which of the following signs or symptoms? - ANS Narrow pulse pressure Identify the venous structure that prevents blood back flow. - ANS Semilunar Intimal folds Velour grafts are impregnated with which of the following to ease handling without the need to preclot? - ANS Gelatin The blood is oxygenated in the lungs and returns to the left atrium through the pulmonary veins. Where does the blood flow after leaving the left atrium? - ANS Through the mitral valve into the left ventricle Which of the following documentation requirements is unique to vascular surgery? - ANS Clamp application and removal times Identify from the following, the correct branch of the left main coronary artery. - ANS Circumflex coronary artery What does the presence of bruit on auscultation of a blood vessel mean? - ANS Blood flow is disrupted Of the following ocular blocks, which carries the highest risk? - ANS Retrobulbar Block A portion of a parathyroid glands must remain for which of the following reasons? - ANS Prevent hypocalcemia and it's complications Select the set of symptoms that is most commonly associated with hypothyroidism - ANS Increased swearing, insomnia, tremor, and muscle weakness An important anatomical landmark in thyroid surgery is known as - ANS Poles A power drill and assorted roasting burrs are essential for middle ear surgery and some sinus procedures. During drill and power saw use, the scrub person keeps irrigation solution on the sterile field to - ANS Prevent clogging of the burr and contamination of the area with bone dust Which nodes in the lymphatic system are responsible for drainage from the mouth, lips, and external nose? - ANS Submandibular Fibrous bands of tissue found between abdominal structures that are not normally connected are known as - ANS Adhesions Choose the correct flow of bile from the gallbladder - ANS Cystic duct, common duct, ampulla of Vater, duodenum Select the statement that best reflects the functional components of the gastrointestinal tract - ANS The alimentary canal extends from the mouth to the anus Which of the following hernia types is considered a surgical emergency - ANS Strangulated Closed thoracostomy will require which of the following - ANS Chest catheters and water-seal drainage A minimally invasive technique that may be used to remove parathyroid tumors deep in the mediastinum is known as - ANS Thoracoscopy The common bile duct drains into the - ANS Duodenum Before reaching the rectus abdominis muscle during surgical exposure, the surgeon must first progress through which of the following? - ANS Scarpa's fascia The transverse colon ends at the - ANS Splenic flexure The mediastinal surface of the lungs contains a structure known as ___________ in which nerves, vessels, bronchus, and lymphatics enter and leave the lung - ANS Hilum The absence of distinct teniae serves as a visual landmark for what abdominal structure - ANS Upper margin of the rectum A benefit to the patient undergoing SILS procedure is which of the following - ANS Less postoperative pain Hernia that occur within Hesselbach's triangle are called - ANS Direct inguinal hernia Innervation of the lungs is part of the _______System - ANS Autonomic During kidney transplant surgery and prior to clamping the renal vessels, which of the following drugs are administered to prevent intravascular clotting and maximize diuresis - ANS Heparin and mannitol What term is used to describe inflammation of the gallbladder - ANS Cholecystitis Each lung contains how many segments - ANS 10 The head of the pancreas is fixed to which structure - ANS Duodenum The pantaloon hernia can best be described as - ANS A combination of direct and indirect hernia There are several risk factors associated with dehiscence. Which of the following can be controlled by the RNFA? - ANS Sutures placed too close together James Romano, a 68 year old retired teacher, presents for surgical intervention of recently diagnosed bladder cancer. He states the cancer is located in the urothelial layer. As the RNFA you realize this is ________layer of the bladder - ANS Inner The most commonly injured Intraabdominal organ in blunt trauma is the - ANS Spleen The mesh plug open hernia repair technique is indicated for which types of hernias - ANS Recurrent indirect inguinal hernias The liver, pancreas, and spleen share many similarities. Select the statement about these organs that is true - ANS All three are solid organs and very vascular From the following, choose a hernia type that is common in children and frequently disappears spontaneously - ANS Umbilical hernia An example of a potential risk associated with pneumoperitoneum would be - ANS gas embolus into an exposed blood vessel during the procedure. Femoral hernias occur more frequently in which group of individuals - ANS Females The renal artery and vein enter and exit the kidney the medical side of the organ through a concave area known as the - ANS Hilum Select the triad of the boundaries of Hesselbach triangle - ANS Inguinal ligament, rectus abdominis muscle, deep epigastric vessels Which of the following is a triangle anatomic landmark in surgical removal of the gallbladder and may be remembered by the 3 Cs - ANS Calot's Choose the correct statement regarding the trigone of the bladder - ANS Forms the base of the bladder An orchiopexy is the surgical placement and fixation of the testicles in a normal anatomic position in the scrotal sac. If the testis fails to descend into the scrotum during gestation, it is considered undescended. Which statement regarding indications for orchiopexy is true - ANS All testes that are undescended after 1 year require surgical placement in the scrotum Which of the following describes a hydrocele - ANS It refers to excess fluid within the tunica vaginalis Which of the following layers of the uterus contains the lymphatics - ANS Myometrium The ovarian artery is a branch of which vessel - ANS Aorta While removing a cancerous testis, the surgeon will typically initiate the incision in which of the following locations - ANS Just above the inguinal ring Select the statement about the prostate that best reflects its location, size, and weight - ANS The prostate sits below the base of the bladder, is 4 cm at the base, and weighs 20 to 30 grams The pelvic floor consists of which muscle groups - ANS Levator ani and coccygeal muscles TURP syndrome is often seen during the intraoperative period. Signs and symptoms exhibited by patients include - ANS Seizures The production of CSF occurs - ANS In the Choroid plexus of the ventricles Tear of the middle meningeal artery, often caused by a blow to the head, results in the formation of a _______ hematoma - ANS Epidural Suction applied directly to neural tissue can be harmful. To prevent tissue damage, a _______ should be placed between the neural tissue and the suction tip - ANS Cottonoid The innermost membrane of the brain is known as - ANS Pia mater Pressure against which cranial never accounts for pupillary dilation when temporal lobe herniation is present - ANS Cranial nerve III What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp - ANS Subgaleal space The trigeminal nerve provides motor innervation to which muscle group - ANS Mastication Identify the cranial nerve that is responsible for pupillary reaction - ANS Cranial III Which of the following is a complication of patellectomy - ANS Reduced knee extension The rotator cuff consists of which muscle group - ANS Supraspinatus, infraspinatus, teres Minor, and subscapularis What is the desired outcome for patients undergoing laminotomy - ANS Resolve extremity pain Postoperative infection in any total replacement surgery is - ANS Usually catastrophic Bone graft that is sealed in a sterile labeled envelope from a tissue transplant company and stored in a vacuum sealed freezer and monitored with an alarm would be considered an - ANS Allograft The recommended length of time for inflation of an upper extremity tourniquet on a patient under 50 is ________ while the recommended pressure is - ANS 1 hr; 250-300 mmHg Which of the following regarding PMMA is not an affect on local tissue? - ANS Skin burns due to exothermic reaction Which of the following is the instrument of choice in removing a foreign body from an infant or child airway - ANS Rigid bronchoscope The most commonly fractured carpal bone is the - ANS Scaphoid Metastatic cancer to the spine can occur in the thoracic spine, lumbar spine, and cervical spine area. Select the statement that best reflects a therapeutic goal for a metastatic tumor of the spine - ANS Preservation of neurologic function The use of PMMA can result in adverse patient reactions. Which of the following is considered an adverse patient reaction - ANS Transient hypotension While not as prevalent as arthroplasty of the shoulder, knee, or hip, total elbow replacement is indicated for patients with traumatic lesions or excessive bone loss from arthritis. The prosthesis may be used with or without PMMA. If PMMA is not used, what replacement product, element, or substance is used? - ANS Autologous bone graft Harrington rods are often used in scoliosis surgery. Of the following, which is a disadvantage of Harrington rods? - ANS Rod breakage is increased Surgeons use open reduction and internal fixation when they are unable to reduce a fracture using closed reduction and skeletal traction is not indicated. What would be an advantage for an ORIF rather than closed? - ANS Direct observation and verification of fracture alignment Which of the following represents the correct attachment of the capsule of the knee joint - ANS Upper end of the fibula and distally to the condyles of the femur The connective tissue that covers all bones and supplies nutrients is known as - ANS Periosteum An important aspect to bone healing that is preserved through intermedullary reaming is - ANS Maintenance of fracture hematoma Identify the type of fracture that has more than two fragments - ANS comminuted Which of the following is not included in the terrible triad - ANS PCL tear What part of the hip are the hemispherical reamers used on - ANS Acetabulum Closed reduction is the treatment of choice for fractures because of - ANS Decreased opportunity for infection Changes to the elderly persons skeleton can present challenges to the intraoperative team. In terms of additional attention and care, what intervention can the team provide - ANS Position the patient using appropriate padding and joint protection devices After retracting the nerve roots during a laminectomy, this structure is invited before getting to the disc - ANS Posterior longitudinal ligament FAST may assist with diagnosis in difficult situations. What group of scans is performed and what do they identify - ANS Chest, pelvic, and four abdominal scans; collections of fluid and free air GCS is commonly used to assess patients with brain injuries using three indicators of cerebral function: eye opening, verbal communication, and motor responses to verbal and noxious stimuli. Within the scoring range for the GCS the best possible score is ____ and the worst is ______ - ANS 15;3 Blunt trauma injuries may not fully reveal the degree or depth of injury. What noninvasive diagnostic test is critical to diagnose potential traumatic brain injury - ANS CT scan of the head In the case of an adult victim with a low-velocity, low-caliber gunshot wound, at far range, of the anterior left quadrant off the lower abdomen, what is the mechanism of injury and description of the possible injuries - ANS Penetrating, small entrance wound, puncture of the anterior wall of the signed colon, no disruption of vessels, and bullet not found in pelvis Which of the following is an indication for damage control surgery - ANS Coagulopathy A 26 year old female is rushed to the OR after being hit by a truck as she was riding her bike. She has rib fractures and several fractures transverse verbal processes. Recall injury is suspected. As the OR nurse prepares to insert a urinary catheter she notices blood at the urinary meatus. What should her next action be - ANS Discontinue the catheter insertion