d RNFA FINAL EXAM WITH COMPLETE d d d d
d SOLUTIONS d
The process of decontamination should initially begin at what point? - Correct Answer - Completion of
d d d d d d d d d d d dd d d d
the surgical procedure
d d d
Side effects the patient may encounter as a result of extracoproreal circulation include: - Correct
d d d d d d d d d d d d d d d
Answer - Inflammatory responses
d d d d
After retracting the nerve roots during a laminectomy, this structure is incised before getting to the
d d d d d d d d d d d d d d d
disc. - Correct Answer - Posterior longitudinal ligament
d d d dd d d d d
Of the following, which is not a symptom of compartment syndrome? - Correct Answer - Moderate
d d d d d d d d d d d d dd d d
pain
d
Fibrocystic changes in the breast describe many different breast changes. These changes affect almost
d d d d d d d d d d d d d
all women at some time in their lives. Nipple discharge is more commonly associated with benign
d d d d d d d d d d d d d d d d
lesions than with cancer; however, discharge is usually significant only if it is spontaneous, persistent,
d d d d d d d d d d d d d d d
and: - Correct Answer - bloody
d d d dd d d
Jan Stuyvesant, a perioperative nurse, was the scrub person during a robotic-assisted laparoscopic
d d d d d d d d d d d d
dcholecystectomy. She locked the robotic endoscissor into the adaptor on the robotic arm and
d d d d d d d d d d d d d
dpositioned the tip end into the trocar port in order for the surgeon to dissect the cystic duct and
d d d d d d d d d d d d d d d d d d
dartery, while the surgical assistant placed the clips on the cystic duct and artery. As she reached across
d d d d d d d d d d d d d d d d d
dthe sterile field to insert the cholangiocatheter through the port, the anesthesia provider accidentally
d d d d d d d d d d d d d
dmade contact with the distal end of the catheter as he stood up to reach the monitor controls. The
d d d d d d d d d d d d d d d d d d
dcontaminated end of the catheter touched the endoscopic clip applier, the endoscissor connector that
d d d d d d d d d d d d d
dthe surgeon was using, the glove of the assistant, and Jan's gown sleeve. The surgeon ordered
d d d d d d d d d d d d d d d
deveryone to change their gown and gloves and covered the port area with a sterile towel. What was
d d d d d d d d d d d d d d d d d
,d the rationale for the surgeon to co - Correct Answer - The surgeon was not in contact with the sterile
d d d d d d d d dd d d d d d d d d d d
d field because he worked from the robotic console.
d d d d d d d
The ability to maintain thermoregulation is compromised in elders because of changes in the: - Correct
d d d d d d d d d d d d d d d
Answer - vascular system
dd d d d
Because herbal products are so readily available and have such widespread media attention, many
d d d d d d d d d d d d d
people think that they can safely self-medicate. Why should the public be aware and educated about
d d d d d d d d d d d d d d d d
dietary supplements and potential harmful effects? - Correct Answer - Unknown substances may be
d d d d d d d d dd d d d d d
present in these products.
d d d d
Talia Mendelson, a 27-year-old patient who had a lumpectomy for early-onset breast cancer, is now
d d d d d d d d d d d d d d
scheduled for infusion port insertion. Talia is very nervous because during the previous lumpectomy,
d d d d d d d d d d d d d d
performed using a local anesthetic, she was not entirely sedated. Talia tells the perioperative nurse
d d d d d d d d d d d d d d d
that she was uncomfortable and heard everything in the room, but admitted that she did not feel
d d d d d d d d d d d d d d d d d
pain. The nurse recognized Talia's anxiety related to the surgical intervention and prepared to
d d d d d d d d d d d d d d
implement corrective actions in the OR. What nursing intervention best reflects one that would
d d d d d d d d d d d d d d
ensure support or contribute to Talia realizing her expected outcome? - Correct Answer - Ensure a
d d d d d d d d d d d d dd d d d
quiet and calm environment of care
d d d d d d
A 26-year-old female is rushed to the operating room after a primary and secondary survey in the
d d d d d d d d d d d d d d d d
emergency department. She was hit by a small truck as she was riding her bicycle through a busy
d d d d d d d d d d d d d d d d d d
intersection. She has sustained rib fractures and several fractured transverse vertebral processes.
d d d d d d d d d d d d
Renal injury is suspected. As the perioperative nurse prepares to insert a urinary catheter, she notices
d d d d d d d d d d d d d d d d
blood at the urinary meatus. What should the nurse's next action be? - Correct Answer - Discontinue
d d d d d d d d d d d d d d dd d d
the catheter insertion
d d d
Open parathyroidectomy is currently being replaced with less invasive and more targeted techniques;
d d d d d d d d d d d d
however, the amount of parathyroid tissue that should be removed remains controversial and relates
d d d d d d d d d d d d d d
to whether single or multiple glands are involved. A portion of a gland must remain to: - Correct
d d d d d d d d d d d d d d d d d d d
Answer - prevent hypocalcemia and its complications.
d d d d d d d
Which of the following supplies blood to the transverse colon? - Correct Answer - Middle colic artery
d d d d d d d d d d d dd d d d d
,Which of the following structures form the mouth? - Correct Answer - cheeks, the hard palate, the
d d d d d d d d d dd d d d d d d
mandible, and the tongue
d d d d
The salivary glands produce saliva, which serves to moisten the mouth and initiate: - Correct Answer -
d d d d d d d d d d d d d d dd d
carbohydrate digestion.
d d
Potential development of a direct inguinal hernia results from ___________and __________weakening
d d d d d d d d d d
or tearing. - Correct Answer - Aponeurosis of transversus abdominus and transversalis muscle
d d d d dd d d d d d d d d
When the patient arrives in the ED, the trauma team initiates a primary assessment. This is a logical,
d d d d d d d d d d d d d d d d d
orderly process of patient assessment for potential life threats. These assessment activities are based
d d d d d d d d d d d d d d
on established protocols for advanced trauma life support (ATLS). The mnemonic "ABCDE" is used,
d d d d d d d d d d d d d d
representing assessment of the following: Airway, Breathing, Circulation, Disability, and Exposure. The
d d d d d d d d d d d d
D and E represent what degree of investigation? - Correct Answer - D = a brief neurologic
d d d d d d d d d d dd d d d d d d
examination; E = exposure to reveal all life-threatening injuries
d d d d d d d d d
What structure covers the spermatic cord and contracts to make the testicles ascend in the scrotum? -
d d d d d d d d d d d d d d d d
Correct Answer - Cremaster muscle
d dd d d d
Which of the following is not included in the group of tendons that comprise the rotator cuff? -
d d d d d d d d d d d d d d d d d
Correct Answer - Teres Major
d dd d d d
The cranial meninges are composed of all except _____. - Correct Answer - Pericranial mater
d d d d d d d d d d dd d d d
Sara Gardiner is the perioperative nurse in the circulating role in OR 2, and is planning for her three
d d d d d d d d d d d d d d d d d d
neurosurgical procedures for the day. She is explaining the basic processes of the three procedures to
d d d d d d d d d d d d d d d d
the scrub person and double-scrubbed surgical technology student: (1) a VP shunt insertion, (2) a
d d d d d d d d d d d d d d d
reconstructive craniosynostosis for an infant with severe deformity, and (3) exploration of a severe
d d d d d d d d d d d d d d
head injury with increased intracranial pressure (ICP) to evacuate a hematoma and possible brain
d d d d d d d d d d d d d d
tissue. To give the brain room to swell in the third procedure, the bone flap may need to be sterile-
d d d d d d d d d d d d d d d d d d d d
wrapped and stored, for later replacement. Sara asks the student to name the appropriate surgical
d d d d d d d d d d d d d d
, d approach to the brain for each of the procedures. She expects the correct sequence to be: - Correct
d d d d d d d d d d d d d d d d d d
d Answer - burr hole, craniectomy, and craniotomy.
d d d d d d
Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant. -
d d d d d d d d d d d d d d d d d
Correct Answer - From the neck to midthigh; bedline to bedline
d dd d d d d d d d d d
Total thyroidectomy is the removal of both lobes of the thyroid and all thyroid tissue present. Total
d d d d d d d d d d d d d d d d
thyroidectomy is the desired surgical treatment for patients with: - Correct Answer - thyroid cancer.
d d d d d d d d d d d dd d d d
Which of the following describes a strangulated hernia? - Correct Answer - A persistent incarceration
d d d d d d d d d dd d d d d
with a compromised blood supply
d d d d d
The Glasgow Coma Scale (GCS) is commonly used to assess patients with brain injury using three
d d d d d d d d d d d d d d d
indicators of cerebral function: eye opening, verbal communication, and motor response to verbal and
d d d d d d d d d d d d d d
noxious stimuli. Within the scoring range for the GCS, the best possible score is _____ and the worst
d d d d d d d d d d d d d d d d d d
possible score is ______. - Correct Answer - 15; 3
d d d d d d dd d d d
What mouth structure is considered the boundary between the buccal cavity and the lingual cavity? -
d d d d d d d d d d d d d d d
Correct Answer - Teeth
d dd d d
Laryngoscopy is direct visual examination of the interior of the larynx by means of a rigid, lighted
d d d d d d d d d d d d d d d d
speculum known as a laryngoscope to obtain a specimen of tissue or secretions for pathologic
d d d d d d d d d d d d d d d
examination. What risk reduction strategy should the perioperative nurse employ in preparing for the
d d d d d d d d d d d d d d
conclusion of the procedure? - Correct Answer - Maintain instrument setup until the patient leaves
d d d d d d dd d d d d d d d d
the OR.
d d
Marissa Walton is transferred to the OR from the burn unit for debridement of the partial-thickness
d d d d d d d d d d d d d d d
burn areas and a dressing change under anesthesia. What important preparation for the procedure
d d d d d d d d d d d d d d
will the perioperative nurse perform before Marissa arrives in the OR? - Correct Answer - Prewarm
d d d d d d d d d d d d d dd d d
the OR to above the ambient high temperature for an adult.
d d d d d d d d d d d
d SOLUTIONS d
The process of decontamination should initially begin at what point? - Correct Answer - Completion of
d d d d d d d d d d d dd d d d
the surgical procedure
d d d
Side effects the patient may encounter as a result of extracoproreal circulation include: - Correct
d d d d d d d d d d d d d d d
Answer - Inflammatory responses
d d d d
After retracting the nerve roots during a laminectomy, this structure is incised before getting to the
d d d d d d d d d d d d d d d
disc. - Correct Answer - Posterior longitudinal ligament
d d d dd d d d d
Of the following, which is not a symptom of compartment syndrome? - Correct Answer - Moderate
d d d d d d d d d d d d dd d d
pain
d
Fibrocystic changes in the breast describe many different breast changes. These changes affect almost
d d d d d d d d d d d d d
all women at some time in their lives. Nipple discharge is more commonly associated with benign
d d d d d d d d d d d d d d d d
lesions than with cancer; however, discharge is usually significant only if it is spontaneous, persistent,
d d d d d d d d d d d d d d d
and: - Correct Answer - bloody
d d d dd d d
Jan Stuyvesant, a perioperative nurse, was the scrub person during a robotic-assisted laparoscopic
d d d d d d d d d d d d
dcholecystectomy. She locked the robotic endoscissor into the adaptor on the robotic arm and
d d d d d d d d d d d d d
dpositioned the tip end into the trocar port in order for the surgeon to dissect the cystic duct and
d d d d d d d d d d d d d d d d d d
dartery, while the surgical assistant placed the clips on the cystic duct and artery. As she reached across
d d d d d d d d d d d d d d d d d
dthe sterile field to insert the cholangiocatheter through the port, the anesthesia provider accidentally
d d d d d d d d d d d d d
dmade contact with the distal end of the catheter as he stood up to reach the monitor controls. The
d d d d d d d d d d d d d d d d d d
dcontaminated end of the catheter touched the endoscopic clip applier, the endoscissor connector that
d d d d d d d d d d d d d
dthe surgeon was using, the glove of the assistant, and Jan's gown sleeve. The surgeon ordered
d d d d d d d d d d d d d d d
deveryone to change their gown and gloves and covered the port area with a sterile towel. What was
d d d d d d d d d d d d d d d d d
,d the rationale for the surgeon to co - Correct Answer - The surgeon was not in contact with the sterile
d d d d d d d d dd d d d d d d d d d d
d field because he worked from the robotic console.
d d d d d d d
The ability to maintain thermoregulation is compromised in elders because of changes in the: - Correct
d d d d d d d d d d d d d d d
Answer - vascular system
dd d d d
Because herbal products are so readily available and have such widespread media attention, many
d d d d d d d d d d d d d
people think that they can safely self-medicate. Why should the public be aware and educated about
d d d d d d d d d d d d d d d d
dietary supplements and potential harmful effects? - Correct Answer - Unknown substances may be
d d d d d d d d dd d d d d d
present in these products.
d d d d
Talia Mendelson, a 27-year-old patient who had a lumpectomy for early-onset breast cancer, is now
d d d d d d d d d d d d d d
scheduled for infusion port insertion. Talia is very nervous because during the previous lumpectomy,
d d d d d d d d d d d d d d
performed using a local anesthetic, she was not entirely sedated. Talia tells the perioperative nurse
d d d d d d d d d d d d d d d
that she was uncomfortable and heard everything in the room, but admitted that she did not feel
d d d d d d d d d d d d d d d d d
pain. The nurse recognized Talia's anxiety related to the surgical intervention and prepared to
d d d d d d d d d d d d d d
implement corrective actions in the OR. What nursing intervention best reflects one that would
d d d d d d d d d d d d d d
ensure support or contribute to Talia realizing her expected outcome? - Correct Answer - Ensure a
d d d d d d d d d d d d dd d d d
quiet and calm environment of care
d d d d d d
A 26-year-old female is rushed to the operating room after a primary and secondary survey in the
d d d d d d d d d d d d d d d d
emergency department. She was hit by a small truck as she was riding her bicycle through a busy
d d d d d d d d d d d d d d d d d d
intersection. She has sustained rib fractures and several fractured transverse vertebral processes.
d d d d d d d d d d d d
Renal injury is suspected. As the perioperative nurse prepares to insert a urinary catheter, she notices
d d d d d d d d d d d d d d d d
blood at the urinary meatus. What should the nurse's next action be? - Correct Answer - Discontinue
d d d d d d d d d d d d d d dd d d
the catheter insertion
d d d
Open parathyroidectomy is currently being replaced with less invasive and more targeted techniques;
d d d d d d d d d d d d
however, the amount of parathyroid tissue that should be removed remains controversial and relates
d d d d d d d d d d d d d d
to whether single or multiple glands are involved. A portion of a gland must remain to: - Correct
d d d d d d d d d d d d d d d d d d d
Answer - prevent hypocalcemia and its complications.
d d d d d d d
Which of the following supplies blood to the transverse colon? - Correct Answer - Middle colic artery
d d d d d d d d d d d dd d d d d
,Which of the following structures form the mouth? - Correct Answer - cheeks, the hard palate, the
d d d d d d d d d dd d d d d d d
mandible, and the tongue
d d d d
The salivary glands produce saliva, which serves to moisten the mouth and initiate: - Correct Answer -
d d d d d d d d d d d d d d dd d
carbohydrate digestion.
d d
Potential development of a direct inguinal hernia results from ___________and __________weakening
d d d d d d d d d d
or tearing. - Correct Answer - Aponeurosis of transversus abdominus and transversalis muscle
d d d d dd d d d d d d d d
When the patient arrives in the ED, the trauma team initiates a primary assessment. This is a logical,
d d d d d d d d d d d d d d d d d
orderly process of patient assessment for potential life threats. These assessment activities are based
d d d d d d d d d d d d d d
on established protocols for advanced trauma life support (ATLS). The mnemonic "ABCDE" is used,
d d d d d d d d d d d d d d
representing assessment of the following: Airway, Breathing, Circulation, Disability, and Exposure. The
d d d d d d d d d d d d
D and E represent what degree of investigation? - Correct Answer - D = a brief neurologic
d d d d d d d d d d dd d d d d d d
examination; E = exposure to reveal all life-threatening injuries
d d d d d d d d d
What structure covers the spermatic cord and contracts to make the testicles ascend in the scrotum? -
d d d d d d d d d d d d d d d d
Correct Answer - Cremaster muscle
d dd d d d
Which of the following is not included in the group of tendons that comprise the rotator cuff? -
d d d d d d d d d d d d d d d d d
Correct Answer - Teres Major
d dd d d d
The cranial meninges are composed of all except _____. - Correct Answer - Pericranial mater
d d d d d d d d d d dd d d d
Sara Gardiner is the perioperative nurse in the circulating role in OR 2, and is planning for her three
d d d d d d d d d d d d d d d d d d
neurosurgical procedures for the day. She is explaining the basic processes of the three procedures to
d d d d d d d d d d d d d d d d
the scrub person and double-scrubbed surgical technology student: (1) a VP shunt insertion, (2) a
d d d d d d d d d d d d d d d
reconstructive craniosynostosis for an infant with severe deformity, and (3) exploration of a severe
d d d d d d d d d d d d d d
head injury with increased intracranial pressure (ICP) to evacuate a hematoma and possible brain
d d d d d d d d d d d d d d
tissue. To give the brain room to swell in the third procedure, the bone flap may need to be sterile-
d d d d d d d d d d d d d d d d d d d d
wrapped and stored, for later replacement. Sara asks the student to name the appropriate surgical
d d d d d d d d d d d d d d
, d approach to the brain for each of the procedures. She expects the correct sequence to be: - Correct
d d d d d d d d d d d d d d d d d d
d Answer - burr hole, craniectomy, and craniotomy.
d d d d d d
Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant. -
d d d d d d d d d d d d d d d d d
Correct Answer - From the neck to midthigh; bedline to bedline
d dd d d d d d d d d d
Total thyroidectomy is the removal of both lobes of the thyroid and all thyroid tissue present. Total
d d d d d d d d d d d d d d d d
thyroidectomy is the desired surgical treatment for patients with: - Correct Answer - thyroid cancer.
d d d d d d d d d d d dd d d d
Which of the following describes a strangulated hernia? - Correct Answer - A persistent incarceration
d d d d d d d d d dd d d d d
with a compromised blood supply
d d d d d
The Glasgow Coma Scale (GCS) is commonly used to assess patients with brain injury using three
d d d d d d d d d d d d d d d
indicators of cerebral function: eye opening, verbal communication, and motor response to verbal and
d d d d d d d d d d d d d d
noxious stimuli. Within the scoring range for the GCS, the best possible score is _____ and the worst
d d d d d d d d d d d d d d d d d d
possible score is ______. - Correct Answer - 15; 3
d d d d d d dd d d d
What mouth structure is considered the boundary between the buccal cavity and the lingual cavity? -
d d d d d d d d d d d d d d d
Correct Answer - Teeth
d dd d d
Laryngoscopy is direct visual examination of the interior of the larynx by means of a rigid, lighted
d d d d d d d d d d d d d d d d
speculum known as a laryngoscope to obtain a specimen of tissue or secretions for pathologic
d d d d d d d d d d d d d d d
examination. What risk reduction strategy should the perioperative nurse employ in preparing for the
d d d d d d d d d d d d d d
conclusion of the procedure? - Correct Answer - Maintain instrument setup until the patient leaves
d d d d d d dd d d d d d d d d
the OR.
d d
Marissa Walton is transferred to the OR from the burn unit for debridement of the partial-thickness
d d d d d d d d d d d d d d d
burn areas and a dressing change under anesthesia. What important preparation for the procedure
d d d d d d d d d d d d d d
will the perioperative nurse perform before Marissa arrives in the OR? - Correct Answer - Prewarm
d d d d d d d d d d d d d dd d d
the OR to above the ambient high temperature for an adult.
d d d d d d d d d d d
