RNFA Study Guide
Describe the minimal level of education required for an advanced practice nurse. - Answer-A Master's
degree is required for advanced practice nursing.
What is the nursing model created by the Association of periOperative Registererd Nurses (AORN)
featuring domains that are in continuous interaction with the health system and encircling the focus of
perioperative nursing practice—the patient? - Answer-The AORN model is referred to as the
Perioperative Patient-Focused Model.
Define the phase of the nursing process characterized by preparation for what will or may happen and
determining the priorities for care. - Answer-The planning phase is characterized by preparation for
what will or may happen and determining the priorities for care.
Institutional standards are usually directive about specific actions in specific circumstances within a
facility or system. What type of standards typically provide generalized authoritative statements that
can be implemented in all settings? - Answer-National standards provide generalized authoritative
statements that can be implemented in all settings.
Define the phase of the nursing process characterized by performing the nursing care activities and
interventions that were planned, and responding with critical thinking and orderly action. - Answer-The
implementation phase is characterized by performing the nursing care activities and interventions that
were planned, and responding with critical thinking and orderly action.
Define the phase of the nursing process that focuses on identifying and classifying data collected in the
assessment in a way that provides a focus to plan nursing care. - Answer-The nursing diagnosis phase
focuses on identifying and classifying data collected in the assessment in a way that provides a focus to
plan nursing care.
,What is the expanded perioperative role characterized by handling and cutting tissue, using instruments
and medical devices, providing exposure and hemostasis, and suturing, all as components of assisting-
at-surgery behaviors? - Answer-The registered nurse first assistant (RNFA) is an example of an expanded
perioperative nursing role.
The AORN publication, Standards of Perioperative Nursing, is an example of what kind of standard? -
Answer-The AORN Standards are an example of process-based standards.
What is the specialty nursing language that provides a uniform and systematic method to collect and
document the basic elements of perioperative nursing care? - Answer-Perioperative Nursing Data Set
(PNDS) is the name of the specialty nursing language that provides a uniform and systematic method to
collect and document the basic elements of perioperative nursing care.
Define the phase of the nursing process typically associated with describing the desired or favorable
patient condition that can be achieved through nursing interventions. - Answer-The outcome
identification phase describes the desired or favorable patient condition that can be achieved through
nursing interventions.
What is the act of transferring the authority for a selected nursing task or tasks in a selected situation(s)
to a competent person? - Answer-Delegation is the act of transferring the authority for a selected
nursing task or tasks in a selected situation(s) to a competent person.
What standards are based on and describe the application of the nursing process in perioperative
nursing? - Answer-Standards of care are based on and describe the application of the nursing process in
perioperative nursing. They include the collection and analysis of data, identification of expected
outcomes, planning and implementation of care, and evaluation of outcomes.
What is the initiative that encompasses improvements in quality and effectiveness, based on ethical and
economic perspectives? - Answer-Performance improvement is the initiative that encompasses
improvements in quality and effectiveness, based on ethical and economic perspectives.
,What are some examples of emerging roles in the OR? - Answer-Emerging roles include care
coordinator, family liaison, robotics coordinator, and informatics specialist.
Define the phase of the nursing process that focuses on the patient's progress in attaining identified
outcomes. - Answer-The evaluation phase focuses on the patient's progress in attaining identified
outcomes.
What certification is available to perioperative nurses that demonstrates proficiency in support of
quality patient care and sets a standard of commitment to the profession of OR nursing? - Answer-
Certified Nurse, Operating Room (CNOR) is the certification for perioperative nursing.
List the types of advanced practice nurses who may practice in the perioperative environment. - Answer-
Nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists
(CNSs) are examples of nurses who may practice in the advanced role in the perioperative environment.
Define the phase of the nursing process concerned with the collection of relevant data about the
patient. - Answer-The assessment phase is associated with the collection of relevant data about the
patient.
How is a count recorded in the record when an item is missing but not located on an X-ray? - Answer-
Unresolved counts are documented as follows: if the X-ray is negative, the count is recorded as
incorrect, and the X-ray results are noted on the patient's intraoperative record. An
incident/occurrence/event report should be initiated according to institution policy.
Define the term electrolytes. - Answer-Electrolytes are substances in the blood essential to transmission
of nerve impulses, regulation of water distribution, contraction of muscles, generation of adenosine
triphosphate (ATP, needed for cellular energy), regulation of acid-base balance, and hemostasis.
Define the term root cause analysis. - Answer-A root cause analysis is a systematized process used to
identify variations in performance that cause or could cause untoward patient events.
, Define the term sentinel event. - Answer-Sentinel events are unexpected occurrences involving death or
risk of serious physical or psychologic injury to a patient.
Define the term active transport. - Answer-Active transport is the process by which molecules are
moved across a cell membrane against a concentration gradient, with the use of external energy.
List examples of initiatives developed by the World Health Organization (WHO) to promote patient
safety. - Answer-The WHO has endorsed the Hand Hygiene Initiative (Clean Care is Safer Care), the
Surgical Hand Preparation guideline, and the Surgical Safety Checklist (Safe Surgery Saves Lives).
Describe the verification steps for transfusion of blood or blood products. - Answer-The circulating nurse
and anesthesia provider (or a second licensed individual) confirm the following during blood and blood
product verification: (1) The unit number on the blood product corresponds with the unit number on the
blood requisition. (2) The name, birth date, and number on the patient's identification band agrees with
the name, birth date, and number on the slip with the blood product. (3) The patient's name on the
blood product corresponds with the name on the requisition. (4) The blood group indicated on the
blood product corresponds with that of the patient. (5) The date and time of expiration have not been
reached. (6) The blood product bag is free of leaks, damage, or signs of possible bacterial contamination
(e.g., presence of fine gas bubbles, discoloration, clots or excessive air in the bag).
Define the term diffusion. - Answer-Diffusion is the movement of molecules from an area of high
concentration to one of low concentration.
List examples of physical risks to patients in the perioperative environment. - Answer-Physical risks
include any damaging or noxious element that comes into contact with the patient to cause harm, such
as: electrosurgical/laser beam, pooled prep solution, glutaraldehyde retained in an endoscope, or a
retained foreign object.
Describe the steps used when weighing sponges to estimate blood loss. - Answer-The procedure for
weighing sponges is as follows: (1) Weigh a dry sponge in a plastic bag, and adjust the scale to register
zero. (2) Place used, bagged sponges on the scale. (3) Record the scale reading: 1 g equals 1 mL of blood
loss. (4) Note the blood loss on the record. (5) Add subsequent weight to the preceding weight each
time sponges are weighed so that a running total blood loss, calculated from sponges, is available. (6)
Measure blood in the suction canister(s) at regular intervals, subtracting the amount of any irrigating
Describe the minimal level of education required for an advanced practice nurse. - Answer-A Master's
degree is required for advanced practice nursing.
What is the nursing model created by the Association of periOperative Registererd Nurses (AORN)
featuring domains that are in continuous interaction with the health system and encircling the focus of
perioperative nursing practice—the patient? - Answer-The AORN model is referred to as the
Perioperative Patient-Focused Model.
Define the phase of the nursing process characterized by preparation for what will or may happen and
determining the priorities for care. - Answer-The planning phase is characterized by preparation for
what will or may happen and determining the priorities for care.
Institutional standards are usually directive about specific actions in specific circumstances within a
facility or system. What type of standards typically provide generalized authoritative statements that
can be implemented in all settings? - Answer-National standards provide generalized authoritative
statements that can be implemented in all settings.
Define the phase of the nursing process characterized by performing the nursing care activities and
interventions that were planned, and responding with critical thinking and orderly action. - Answer-The
implementation phase is characterized by performing the nursing care activities and interventions that
were planned, and responding with critical thinking and orderly action.
Define the phase of the nursing process that focuses on identifying and classifying data collected in the
assessment in a way that provides a focus to plan nursing care. - Answer-The nursing diagnosis phase
focuses on identifying and classifying data collected in the assessment in a way that provides a focus to
plan nursing care.
,What is the expanded perioperative role characterized by handling and cutting tissue, using instruments
and medical devices, providing exposure and hemostasis, and suturing, all as components of assisting-
at-surgery behaviors? - Answer-The registered nurse first assistant (RNFA) is an example of an expanded
perioperative nursing role.
The AORN publication, Standards of Perioperative Nursing, is an example of what kind of standard? -
Answer-The AORN Standards are an example of process-based standards.
What is the specialty nursing language that provides a uniform and systematic method to collect and
document the basic elements of perioperative nursing care? - Answer-Perioperative Nursing Data Set
(PNDS) is the name of the specialty nursing language that provides a uniform and systematic method to
collect and document the basic elements of perioperative nursing care.
Define the phase of the nursing process typically associated with describing the desired or favorable
patient condition that can be achieved through nursing interventions. - Answer-The outcome
identification phase describes the desired or favorable patient condition that can be achieved through
nursing interventions.
What is the act of transferring the authority for a selected nursing task or tasks in a selected situation(s)
to a competent person? - Answer-Delegation is the act of transferring the authority for a selected
nursing task or tasks in a selected situation(s) to a competent person.
What standards are based on and describe the application of the nursing process in perioperative
nursing? - Answer-Standards of care are based on and describe the application of the nursing process in
perioperative nursing. They include the collection and analysis of data, identification of expected
outcomes, planning and implementation of care, and evaluation of outcomes.
What is the initiative that encompasses improvements in quality and effectiveness, based on ethical and
economic perspectives? - Answer-Performance improvement is the initiative that encompasses
improvements in quality and effectiveness, based on ethical and economic perspectives.
,What are some examples of emerging roles in the OR? - Answer-Emerging roles include care
coordinator, family liaison, robotics coordinator, and informatics specialist.
Define the phase of the nursing process that focuses on the patient's progress in attaining identified
outcomes. - Answer-The evaluation phase focuses on the patient's progress in attaining identified
outcomes.
What certification is available to perioperative nurses that demonstrates proficiency in support of
quality patient care and sets a standard of commitment to the profession of OR nursing? - Answer-
Certified Nurse, Operating Room (CNOR) is the certification for perioperative nursing.
List the types of advanced practice nurses who may practice in the perioperative environment. - Answer-
Nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists
(CNSs) are examples of nurses who may practice in the advanced role in the perioperative environment.
Define the phase of the nursing process concerned with the collection of relevant data about the
patient. - Answer-The assessment phase is associated with the collection of relevant data about the
patient.
How is a count recorded in the record when an item is missing but not located on an X-ray? - Answer-
Unresolved counts are documented as follows: if the X-ray is negative, the count is recorded as
incorrect, and the X-ray results are noted on the patient's intraoperative record. An
incident/occurrence/event report should be initiated according to institution policy.
Define the term electrolytes. - Answer-Electrolytes are substances in the blood essential to transmission
of nerve impulses, regulation of water distribution, contraction of muscles, generation of adenosine
triphosphate (ATP, needed for cellular energy), regulation of acid-base balance, and hemostasis.
Define the term root cause analysis. - Answer-A root cause analysis is a systematized process used to
identify variations in performance that cause or could cause untoward patient events.
, Define the term sentinel event. - Answer-Sentinel events are unexpected occurrences involving death or
risk of serious physical or psychologic injury to a patient.
Define the term active transport. - Answer-Active transport is the process by which molecules are
moved across a cell membrane against a concentration gradient, with the use of external energy.
List examples of initiatives developed by the World Health Organization (WHO) to promote patient
safety. - Answer-The WHO has endorsed the Hand Hygiene Initiative (Clean Care is Safer Care), the
Surgical Hand Preparation guideline, and the Surgical Safety Checklist (Safe Surgery Saves Lives).
Describe the verification steps for transfusion of blood or blood products. - Answer-The circulating nurse
and anesthesia provider (or a second licensed individual) confirm the following during blood and blood
product verification: (1) The unit number on the blood product corresponds with the unit number on the
blood requisition. (2) The name, birth date, and number on the patient's identification band agrees with
the name, birth date, and number on the slip with the blood product. (3) The patient's name on the
blood product corresponds with the name on the requisition. (4) The blood group indicated on the
blood product corresponds with that of the patient. (5) The date and time of expiration have not been
reached. (6) The blood product bag is free of leaks, damage, or signs of possible bacterial contamination
(e.g., presence of fine gas bubbles, discoloration, clots or excessive air in the bag).
Define the term diffusion. - Answer-Diffusion is the movement of molecules from an area of high
concentration to one of low concentration.
List examples of physical risks to patients in the perioperative environment. - Answer-Physical risks
include any damaging or noxious element that comes into contact with the patient to cause harm, such
as: electrosurgical/laser beam, pooled prep solution, glutaraldehyde retained in an endoscope, or a
retained foreign object.
Describe the steps used when weighing sponges to estimate blood loss. - Answer-The procedure for
weighing sponges is as follows: (1) Weigh a dry sponge in a plastic bag, and adjust the scale to register
zero. (2) Place used, bagged sponges on the scale. (3) Record the scale reading: 1 g equals 1 mL of blood
loss. (4) Note the blood loss on the record. (5) Add subsequent weight to the preceding weight each
time sponges are weighed so that a running total blood loss, calculated from sponges, is available. (6)
Measure blood in the suction canister(s) at regular intervals, subtracting the amount of any irrigating
