NIFA PERIOPERATIVE EXAM ACTUAL EXAM 300
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED
A+
The number one patient safety issue identified in a survey of peri-operative nurses is
preventing: - ANSWER: Wrong site/procedure/patient surgery
Reprocessing (flashing) instruments in the OR is high risk because: - 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: - ANSWER: 157 lbs
_______________ should be the primary decision makers for what equipment and
supplies are purchased and stocked in the difficult airway management cart. -
ANSWER: Anesthesia personnel
Proper specimen management techniques prevent errors and include all of the
following EXCEPT: - 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: - 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: - ANSWER: Increases risk of renal failure
Recommendations for preventing retained surgical items include all of the following
EXCEPT: - ANSWER: Utilizing a multidisciplinary team to resolve incorrect counts
Select the appropriate order for administering blood and blood products. - 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. - 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? - 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? - 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: - 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. - 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 _______________________. - 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: - ANSWER: patient identification and procedure performed.
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED
A+
The number one patient safety issue identified in a survey of peri-operative nurses is
preventing: - ANSWER: Wrong site/procedure/patient surgery
Reprocessing (flashing) instruments in the OR is high risk because: - 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: - ANSWER: 157 lbs
_______________ should be the primary decision makers for what equipment and
supplies are purchased and stocked in the difficult airway management cart. -
ANSWER: Anesthesia personnel
Proper specimen management techniques prevent errors and include all of the
following EXCEPT: - 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: - 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: - ANSWER: Increases risk of renal failure
Recommendations for preventing retained surgical items include all of the following
EXCEPT: - ANSWER: Utilizing a multidisciplinary team to resolve incorrect counts
Select the appropriate order for administering blood and blood products. - 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. - 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? - 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? - 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: - 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. - 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 _______________________. - 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: - ANSWER: patient identification and procedure performed.
