RNFA FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE N
n n n n n n n n
EWEST 2024 ACTUAL EXAM 600 QUESTIONS AND CORREC
n n n n n n n
T DETAILED ANSWERS (VERIFIED ASNWERS)
n n n n
|ALREADY GRADED A+ n n
The nsurgicalnteamngentlynabductednMatilda'snarmsnintonpositionnonnpaddednarmboardsnatnlessnthann90nde
greesnwithnpalmsnfacingnup.nExtranpaddingnwasnplacednundernhernelbowsnandnannarmboardnstrapnwasnsec
urednovernhernforearm.nThenarmboardsnwere nlockednintonplace ntonpreventninadvertentnabduction.nThisnim
portantnmaneuvernisndesignednasnanrisknreductionnstrategyntonprevent:n-nanswer-brachialnplexusninjury.
Hownisnthe nilioinguinalnnerve nprotectednduringninguinalnherniorrhaphy?n-nanswer-
Retractnitnbacknalongnwithnthe nexternalnoblique naponeurosis
Whichnhemostaticnagentnshouldnbe navailable nfornallncranialnandnspinalncordnoperations?n-nanswer-
Bone nwax
Age-
relatednskinnchangesninclude nanthinningnepidermisnandndecreasednsubcutaneousnfatnandnelasticity.nWhatn
specialnconsiderationnwillnthenperioperativennurse nprovide,ninntermsnofnadditionalnattentionnandncare,ninn
one nofnthenfollowingnnursingnactions?n-nanswer-Gentlynlift,nnotnslide,nthenpatientntonandnfromnthe nORnbed
The nWhipple nprocedurenisnthenremovalnof nthenheadnofnthe npancreas,nthenentire nduodenum,nanportionno
fnthe njejunum,nthe ndistalnthirdnof nthe nstomach,nandnthe n asnansurgicalntreatment
for .n-nanswer-lowernhalf nof nthe ncommonnbile nduct;npancreaticncancer
Identifynthentriadnofnanatomicnsitesnofnabdominalnwallnweaknessnwithnanpotentialnfornhernias.n-nanswer-
n Inguinaln canal, n femoraln rings, n umbilicus
Ancomplicationnofnthyroidectomynthatnincludednannextendednthyroidndissectionnisnwhichnof nthe nfollowing?
-nanswer-Pneumothorax
SallynAndresnandnhernorientee nhave nreturnednfromnannairwaynfire nsimulationnexercise nwithnthe notorhinol
aryngologicnsurgeon,nfellow,nandnanesthesianprovider.nTheynwerenamazednatnthenstatisticsnfornORnfiresnan
dnthe nthreatnofnseriousninjuryntonthe npatientnandnteam.nPatientsnundergoingnotorhinolaryngologicnproced
uresnare natngreaternrisknfornfireninjurynbecause nofnthe nproximitynof nthensurgicalnfieldntonhighnconcentratio
nsnof noxygen.nThe nteamndiscussednanplanntonchange ntheirnpractices.nAn
,example nofnanrisknreductionnstrategynthatninvolvesncollaborationnofnthe nentire nsurgicalnteamnduringnotorhinola
ryngologicnsurgerynwouldnbe:n-nanswer-
conductingnregularlynschedulednteamnsimulationsnthatnrehearse nannairwaynfire nprotocol.
The nnose nisndividednintonthe nprominentnexternalnportionnandntheninternalnportionnknownnasnthe nnasalnc
avity.nThe nprimarynpurpose nofnthe nnose nisnto:n-nanswer-prepare ninspirednairnfornthe nlungs
Anesthesianprovidersnare nconcernednaboutnthenpotentialnincreasednrisknof ninstabilitynintraoperativelynr
esultingnfromninhibitionnofncoagulation.nWhichnherbalnsupplement,nfromnthenlistnbelow,nwouldnbenimpli
catedninnancoagulationninteraction?n- nanswer-Feverfew
LisanTorentino,nan29-year-
oldnwoman,nisninnthenemergencyndepartmentn(ED) nwithnanrupturednappendix.nBeforenthe nEDnnurse nandns
urgicalnresidentntransportednLisantonthenOR,nthe nnurse ncalledntoninformnthemnthatnLisanisn27nweeks'npregn
ant.nWhatnspecialnconsiderationsnmustnthe nperioperative nnursenandnanesthesianprovidernaddressnwithnthi
snnewninformation?n-nanswer-
The npatientnmaynneednrapidninductionnof ngeneralnanesthesia,nornspinalnanesthesia.
Duringnantotalnhipnarthroplasty,nthe ninstrumentnusedntonaccessnthe nfemoralncanalnisnthe .n-nanswer-
n Box n osteotome
Annexample nof nperinealnglandsnthatnsecrete nmucusnis:n-nanswer-Bartholin'snglands
Whatnmajornarterynsuppliesnthe ndescendingncolon?n-nanswer-Leftncolicnartery
AubreynScheelnarrivedntonthenpreoperativenreceivingnandnwaitingnloungenof nthenambulatorynsurgeryncent
ernfornannelective nhernianrepair.nThe nRNFAnbegannAubrey'snpreoperativennursingnassessment.nItnwasnanbea
utifulnandnwarmnspringndaynandnAubreynsharednhisnconcernnaboutnhownhenwouldnfeelnafternthe nprocedur
e.nHe nwantedntonknownwhennhenwouldnbenable ntongetnbackntonworknandnresumenhisnplacenasnpitchernonnhi
snsoftballnteam.nHe nalsontoldnthe nRNFAnthatnhenplannedntondonsome nyardnworkntodaynasnsoonnasnthenanest
hesian"wearsnoff."nWhichnone nof nthenfollowingnnursingndiagnosesnisngivennpriorityninnbothnpreoperative na
ndnpostoperative neducation?n-nanswer-
DeficientnKnowledge nrelatedntondisease nprocessnandnconvalescence
,The nroof nofnthe ninguinalncanalnconsistsnof nthe n while nthe n
makesnupnthenmajornsupportnfornthe nfl
oornof nthe ninguinalncanal.n-nanswer-externalnoblique naponeurosis;ntransversalisnaponeurosisnandnfascia
Prostate ncancernisnthenmostnfrequentlyndiagnosedncancerninnmennandnisnthenleadingncausenof ncancerndeat
hninnmen.nSelectnthe ntriadnthatnbestnreflectsnthe nindividualnwithnthe nhighestnrisknfornprostate ncancer.n-
n answer-65+ n years n old, n Africann descent, n fathern hadn prostate n cancer
Whatnincisionnisnusednfornlumbarnlaminectomy?n-nanswer-
Midline ndirectlynovernthe nappropriate nlumbarnspines
Whichnactionnbestnreflectsnthe nmovementnof nurine nfromnthe nrenalnpelvisntonthe nbladder?n-nanswer-
Slightndistentionnof nthe nrenalnpelvisninitiatesnanwave nof nmuscularncontractions.
Before nreachingnthenrectusnabdominisnmuscle nduringnsurgicalnexposure,nthensurgeonnmustnfirstnprogressnthrou
ghnwhichnofnthe nfollowing?n-nanswer-Scarpa'snfascia
Duringnurologicnsurgerynlarge nquantitiesnof nirrigatingnfluidsnareninfusednintraoperatively.nItnisnimportantnto
n avoidn the n use nofn distilled nwatern duringn TURP nasn thisn complication n may noccur, nChoosen thencomplication n f
romnthe nfollowing.n-nanswer-DilutionalnHyponatremia
Whichnof nthe nfollowingnisnnotnincludedninnthe nterrible ntriad?n-nanswer-PCLntear
Anchainnof nthree nsmallnarticulatednbonesnextendsnacrossnthenmiddle nearncavitynandnconductsnvibrationsnfr
omnthe ntympanicnmembrane nacrossnthe nmiddle nearnintonthe novalnwindownandnthe nfluid-
filledninnernear.nWhatnare nthe nnamesnofnthose nthree nsmallnarticulatingnbones?n-nanswer-
Malleus,nincus,nandnstapes
MelissanPepe nisnan17-year-
oldnfemale nwithncancernofnthenthyroidnsecondaryntonleukemia,nwhichnwentnintonremissionn7nyearsnearlier.n
She nisnverynconcernednaboutnscarringnfromnthensurgery.nThe nnursendiscussednMelissa'snconcernsnwithnthe
n surgicaln teamn before nthenincision n wasn made.n Melissan hadnan minimally n invasive nthyroidectomy napproach,
n whichn leftn an smalln scarn thatn wasn closed n withn an 4-
0nnonabsorbable nsubcuticularnsuture.nInnthenpostoperative nphase,nthe nnurse nprovidednMelissanwithnhernp
ostoperative neducationnrelativentonhernincision.nSelectnallnthenincisionncareninstructionsnthatnwouldnbenrel
evantnfornMelissa.n-nanswer-
Instructnherntonrefrainnfromnprolongednexposurentondirectnsunlightnorntanningnsalonsnwhile nthe nincisionnisn
healing.
, Bone ngraftingnusingnallograftsnornautograftsnmaynbenusedntonfillncavitiesnafternremovalnof nlarge namountsnof
n bone n thatn mightn resultninn instability, n orn ton filln bony ndefectsnandntonpromote nthen unionnofn fractures natnthe
n time n of n openn reduction.n Bone ngraftnthatnisn sealedn innan sterile n labeledn envelopenfromn antissuen transplantn
companynandnstoredninnanvacuum-sealednfreezer,nmonitorednwithnannalarm,nwouldnbenconsideredna/an:n-
n answer-allograft
Fluoroscopyntime nshouldnbenlimitednasnmuchnasnpossible.nWhichnofnthenfollowingnisnradiationnreductionntechni
que?n-nanswer-Fluoroscopynequipmentnisnrequiredntonhave nannaudible nalarmnaftern5nminutesnof nuse
Mohs'nsurgerynisnanspecializednexcisionnusedntontreatnbasalnandnsquamousncellnskinncancers.nSelectnthe nstatem
entnaboutnMohs'nsurgerynthatnbestnreflectsnthe nprocess,nprocedure, nandnoutcome ngoal.n-nanswer-
n Lesions n are n mapped, n excised, n andn examined n byn frozen n section n untiln clearn margins n are n found.
Uponnneurologicalnexamination,nyounnoticenannabnormalnpupillarynlightnreflex ninnanpatient'snrightneye.n
Whichnof nthe nfollowingnisnconsistentnwithnthisnsign?n-nanswer-compressionnof nthe noculomotornnerve
Duringnthe npreoperative nassessmentnofnannadultnwithnanpreviouslyncorrectedncongenitalnheartndefect,nthe
n perioperative n nursen should nben aware nofn anatomicn anomalies n associatedn withn the noriginaln defect, norn itsns
ubsequentnrepair,nthatnmaynalternthencurrentnsurgicalnplannfornanpatientnwhonhadnpriornpediatricncardiacn
surgery.nWhatnisnannappropriate nnursingnresponsenwhennthenassessmentnrevealsnthenadultnpatientnhasnu
ndergone npriornpediatricncardiacnsurgery?n-nanswer-
Alertnthe nstaff ntonanticipate nalterednanatomy,nspecialnsupplies,nandnpotentialncomplications
SharinDonaldsonnisnschedulednfornanthyroidectomy.nAsnthenRNFA,nitnisnimportantnthatnstressnthe nthenteamn
the nimportance nof nhavingnwhichntraynavailable nfornthisncase?n-nanswer-Tracheotomyntray
Fromnthe nfollowing,nchoose nandisadvantage ninnthe nuse nofnanshuntnduringnCEA.n-nanswer-
Possible ndislodgingnofndebrisnwithninsertion
The nphrenicnnerve ninnervatesnwhichnstructure?n-nanswer-The ndiaphragm
Anpatientnpresentsntonthe nORnwithnanninjuryntonthenanteriornchestnfromnbluntnforce ntrauma.nThenRNFAncannexp
ectndamage ntonwhichnof nthe nfollowing?n-nanswer-Rightnventricle
n n n n n n n n
EWEST 2024 ACTUAL EXAM 600 QUESTIONS AND CORREC
n n n n n n n
T DETAILED ANSWERS (VERIFIED ASNWERS)
n n n n
|ALREADY GRADED A+ n n
The nsurgicalnteamngentlynabductednMatilda'snarmsnintonpositionnonnpaddednarmboardsnatnlessnthann90nde
greesnwithnpalmsnfacingnup.nExtranpaddingnwasnplacednundernhernelbowsnandnannarmboardnstrapnwasnsec
urednovernhernforearm.nThenarmboardsnwere nlockednintonplace ntonpreventninadvertentnabduction.nThisnim
portantnmaneuvernisndesignednasnanrisknreductionnstrategyntonprevent:n-nanswer-brachialnplexusninjury.
Hownisnthe nilioinguinalnnerve nprotectednduringninguinalnherniorrhaphy?n-nanswer-
Retractnitnbacknalongnwithnthe nexternalnoblique naponeurosis
Whichnhemostaticnagentnshouldnbe navailable nfornallncranialnandnspinalncordnoperations?n-nanswer-
Bone nwax
Age-
relatednskinnchangesninclude nanthinningnepidermisnandndecreasednsubcutaneousnfatnandnelasticity.nWhatn
specialnconsiderationnwillnthenperioperativennurse nprovide,ninntermsnofnadditionalnattentionnandncare,ninn
one nofnthenfollowingnnursingnactions?n-nanswer-Gentlynlift,nnotnslide,nthenpatientntonandnfromnthe nORnbed
The nWhipple nprocedurenisnthenremovalnof nthenheadnofnthe npancreas,nthenentire nduodenum,nanportionno
fnthe njejunum,nthe ndistalnthirdnof nthe nstomach,nandnthe n asnansurgicalntreatment
for .n-nanswer-lowernhalf nof nthe ncommonnbile nduct;npancreaticncancer
Identifynthentriadnofnanatomicnsitesnofnabdominalnwallnweaknessnwithnanpotentialnfornhernias.n-nanswer-
n Inguinaln canal, n femoraln rings, n umbilicus
Ancomplicationnofnthyroidectomynthatnincludednannextendednthyroidndissectionnisnwhichnof nthe nfollowing?
-nanswer-Pneumothorax
SallynAndresnandnhernorientee nhave nreturnednfromnannairwaynfire nsimulationnexercise nwithnthe notorhinol
aryngologicnsurgeon,nfellow,nandnanesthesianprovider.nTheynwerenamazednatnthenstatisticsnfornORnfiresnan
dnthe nthreatnofnseriousninjuryntonthe npatientnandnteam.nPatientsnundergoingnotorhinolaryngologicnproced
uresnare natngreaternrisknfornfireninjurynbecause nofnthe nproximitynof nthensurgicalnfieldntonhighnconcentratio
nsnof noxygen.nThe nteamndiscussednanplanntonchange ntheirnpractices.nAn
,example nofnanrisknreductionnstrategynthatninvolvesncollaborationnofnthe nentire nsurgicalnteamnduringnotorhinola
ryngologicnsurgerynwouldnbe:n-nanswer-
conductingnregularlynschedulednteamnsimulationsnthatnrehearse nannairwaynfire nprotocol.
The nnose nisndividednintonthe nprominentnexternalnportionnandntheninternalnportionnknownnasnthe nnasalnc
avity.nThe nprimarynpurpose nofnthe nnose nisnto:n-nanswer-prepare ninspirednairnfornthe nlungs
Anesthesianprovidersnare nconcernednaboutnthenpotentialnincreasednrisknof ninstabilitynintraoperativelynr
esultingnfromninhibitionnofncoagulation.nWhichnherbalnsupplement,nfromnthenlistnbelow,nwouldnbenimpli
catedninnancoagulationninteraction?n- nanswer-Feverfew
LisanTorentino,nan29-year-
oldnwoman,nisninnthenemergencyndepartmentn(ED) nwithnanrupturednappendix.nBeforenthe nEDnnurse nandns
urgicalnresidentntransportednLisantonthenOR,nthe nnurse ncalledntoninformnthemnthatnLisanisn27nweeks'npregn
ant.nWhatnspecialnconsiderationsnmustnthe nperioperative nnursenandnanesthesianprovidernaddressnwithnthi
snnewninformation?n-nanswer-
The npatientnmaynneednrapidninductionnof ngeneralnanesthesia,nornspinalnanesthesia.
Duringnantotalnhipnarthroplasty,nthe ninstrumentnusedntonaccessnthe nfemoralncanalnisnthe .n-nanswer-
n Box n osteotome
Annexample nof nperinealnglandsnthatnsecrete nmucusnis:n-nanswer-Bartholin'snglands
Whatnmajornarterynsuppliesnthe ndescendingncolon?n-nanswer-Leftncolicnartery
AubreynScheelnarrivedntonthenpreoperativenreceivingnandnwaitingnloungenof nthenambulatorynsurgeryncent
ernfornannelective nhernianrepair.nThe nRNFAnbegannAubrey'snpreoperativennursingnassessment.nItnwasnanbea
utifulnandnwarmnspringndaynandnAubreynsharednhisnconcernnaboutnhownhenwouldnfeelnafternthe nprocedur
e.nHe nwantedntonknownwhennhenwouldnbenable ntongetnbackntonworknandnresumenhisnplacenasnpitchernonnhi
snsoftballnteam.nHe nalsontoldnthe nRNFAnthatnhenplannedntondonsome nyardnworkntodaynasnsoonnasnthenanest
hesian"wearsnoff."nWhichnone nof nthenfollowingnnursingndiagnosesnisngivennpriorityninnbothnpreoperative na
ndnpostoperative neducation?n-nanswer-
DeficientnKnowledge nrelatedntondisease nprocessnandnconvalescence
,The nroof nofnthe ninguinalncanalnconsistsnof nthe n while nthe n
makesnupnthenmajornsupportnfornthe nfl
oornof nthe ninguinalncanal.n-nanswer-externalnoblique naponeurosis;ntransversalisnaponeurosisnandnfascia
Prostate ncancernisnthenmostnfrequentlyndiagnosedncancerninnmennandnisnthenleadingncausenof ncancerndeat
hninnmen.nSelectnthe ntriadnthatnbestnreflectsnthe nindividualnwithnthe nhighestnrisknfornprostate ncancer.n-
n answer-65+ n years n old, n Africann descent, n fathern hadn prostate n cancer
Whatnincisionnisnusednfornlumbarnlaminectomy?n-nanswer-
Midline ndirectlynovernthe nappropriate nlumbarnspines
Whichnactionnbestnreflectsnthe nmovementnof nurine nfromnthe nrenalnpelvisntonthe nbladder?n-nanswer-
Slightndistentionnof nthe nrenalnpelvisninitiatesnanwave nof nmuscularncontractions.
Before nreachingnthenrectusnabdominisnmuscle nduringnsurgicalnexposure,nthensurgeonnmustnfirstnprogressnthrou
ghnwhichnofnthe nfollowing?n-nanswer-Scarpa'snfascia
Duringnurologicnsurgerynlarge nquantitiesnof nirrigatingnfluidsnareninfusednintraoperatively.nItnisnimportantnto
n avoidn the n use nofn distilled nwatern duringn TURP nasn thisn complication n may noccur, nChoosen thencomplication n f
romnthe nfollowing.n-nanswer-DilutionalnHyponatremia
Whichnof nthe nfollowingnisnnotnincludedninnthe nterrible ntriad?n-nanswer-PCLntear
Anchainnof nthree nsmallnarticulatednbonesnextendsnacrossnthenmiddle nearncavitynandnconductsnvibrationsnfr
omnthe ntympanicnmembrane nacrossnthe nmiddle nearnintonthe novalnwindownandnthe nfluid-
filledninnernear.nWhatnare nthe nnamesnofnthose nthree nsmallnarticulatingnbones?n-nanswer-
Malleus,nincus,nandnstapes
MelissanPepe nisnan17-year-
oldnfemale nwithncancernofnthenthyroidnsecondaryntonleukemia,nwhichnwentnintonremissionn7nyearsnearlier.n
She nisnverynconcernednaboutnscarringnfromnthensurgery.nThe nnursendiscussednMelissa'snconcernsnwithnthe
n surgicaln teamn before nthenincision n wasn made.n Melissan hadnan minimally n invasive nthyroidectomy napproach,
n whichn leftn an smalln scarn thatn wasn closed n withn an 4-
0nnonabsorbable nsubcuticularnsuture.nInnthenpostoperative nphase,nthe nnurse nprovidednMelissanwithnhernp
ostoperative neducationnrelativentonhernincision.nSelectnallnthenincisionncareninstructionsnthatnwouldnbenrel
evantnfornMelissa.n-nanswer-
Instructnherntonrefrainnfromnprolongednexposurentondirectnsunlightnorntanningnsalonsnwhile nthe nincisionnisn
healing.
, Bone ngraftingnusingnallograftsnornautograftsnmaynbenusedntonfillncavitiesnafternremovalnof nlarge namountsnof
n bone n thatn mightn resultninn instability, n orn ton filln bony ndefectsnandntonpromote nthen unionnofn fractures natnthe
n time n of n openn reduction.n Bone ngraftnthatnisn sealedn innan sterile n labeledn envelopenfromn antissuen transplantn
companynandnstoredninnanvacuum-sealednfreezer,nmonitorednwithnannalarm,nwouldnbenconsideredna/an:n-
n answer-allograft
Fluoroscopyntime nshouldnbenlimitednasnmuchnasnpossible.nWhichnofnthenfollowingnisnradiationnreductionntechni
que?n-nanswer-Fluoroscopynequipmentnisnrequiredntonhave nannaudible nalarmnaftern5nminutesnof nuse
Mohs'nsurgerynisnanspecializednexcisionnusedntontreatnbasalnandnsquamousncellnskinncancers.nSelectnthe nstatem
entnaboutnMohs'nsurgerynthatnbestnreflectsnthe nprocess,nprocedure, nandnoutcome ngoal.n-nanswer-
n Lesions n are n mapped, n excised, n andn examined n byn frozen n section n untiln clearn margins n are n found.
Uponnneurologicalnexamination,nyounnoticenannabnormalnpupillarynlightnreflex ninnanpatient'snrightneye.n
Whichnof nthe nfollowingnisnconsistentnwithnthisnsign?n-nanswer-compressionnof nthe noculomotornnerve
Duringnthe npreoperative nassessmentnofnannadultnwithnanpreviouslyncorrectedncongenitalnheartndefect,nthe
n perioperative n nursen should nben aware nofn anatomicn anomalies n associatedn withn the noriginaln defect, norn itsns
ubsequentnrepair,nthatnmaynalternthencurrentnsurgicalnplannfornanpatientnwhonhadnpriornpediatricncardiacn
surgery.nWhatnisnannappropriate nnursingnresponsenwhennthenassessmentnrevealsnthenadultnpatientnhasnu
ndergone npriornpediatricncardiacnsurgery?n-nanswer-
Alertnthe nstaff ntonanticipate nalterednanatomy,nspecialnsupplies,nandnpotentialncomplications
SharinDonaldsonnisnschedulednfornanthyroidectomy.nAsnthenRNFA,nitnisnimportantnthatnstressnthe nthenteamn
the nimportance nof nhavingnwhichntraynavailable nfornthisncase?n-nanswer-Tracheotomyntray
Fromnthe nfollowing,nchoose nandisadvantage ninnthe nuse nofnanshuntnduringnCEA.n-nanswer-
Possible ndislodgingnofndebrisnwithninsertion
The nphrenicnnerve ninnervatesnwhichnstructure?n-nanswer-The ndiaphragm
Anpatientnpresentsntonthe nORnwithnanninjuryntonthenanteriornchestnfromnbluntnforce ntrauma.nThenRNFAncannexp
ectndamage ntonwhichnof nthe nfollowing?n-nanswer-Rightnventricle
