RNFA – REGISTERED NURSE FIRST ASSISTANT CERTIFICATION AND
PRACTICE GUIDE (2025 EDITION) 500+ QUESTIONS AND CORRECT
ANSWERS COVERING THE MOST TESTED QUESTIONS GRADED A+
THIS RESOURCE OFFERS A COMPLETE GUIDE TO THE RNFA ROLE, INCLUDING
EDUCATION, CERTIFICATION, AND CLINICAL RESPONSIBILITIES IN THE
SURGICAL SETTING. IT COVERS KEY COMPETENCIES SUCH AS TISSUE
MANIPULATION, SUTURING, AND INTRAOPERATIVE SUPPORT, ALIGNED WITH
AORN AND CNOR STANDARDS. IDEAL FOR REGISTERED NURSES PURSUING
FIRST ASSISTANT CREDENTIALING IN 2025.
Describe the minimal level of education required for an advanced practice nurse. - CORRECT
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? - CORRECT 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. - CORRECT 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? - CORRECT 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. -
CORRECT 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. - CORRECT 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? - CORRECT 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? -
CORRECT 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? - CORRECT 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. - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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. - CORRECT 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? - CORRECT
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. -
CORRECT 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. - CORRECT 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? -
CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT ANSWER-Sentinel events are unexpected occurrences
involving death or risk of serious physical or psychologic injury to a patient.
, Define the term active transport. - CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT 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 solution used. (7) Add the amount of blood loss calculated from suction
canisters to the total recorded from sponges to obtain accurate blood loss estimates.
What are the key elements of informed consent? - CORRECT ANSWER-During informed consent,
the patient must be informed about the proposed operation or other invasive procedure and its
inherent risks, benefits, alternatives, and complications in terms that he or she can understand.
PRACTICE GUIDE (2025 EDITION) 500+ QUESTIONS AND CORRECT
ANSWERS COVERING THE MOST TESTED QUESTIONS GRADED A+
THIS RESOURCE OFFERS A COMPLETE GUIDE TO THE RNFA ROLE, INCLUDING
EDUCATION, CERTIFICATION, AND CLINICAL RESPONSIBILITIES IN THE
SURGICAL SETTING. IT COVERS KEY COMPETENCIES SUCH AS TISSUE
MANIPULATION, SUTURING, AND INTRAOPERATIVE SUPPORT, ALIGNED WITH
AORN AND CNOR STANDARDS. IDEAL FOR REGISTERED NURSES PURSUING
FIRST ASSISTANT CREDENTIALING IN 2025.
Describe the minimal level of education required for an advanced practice nurse. - CORRECT
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? - CORRECT 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. - CORRECT 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? - CORRECT 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. -
CORRECT 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. - CORRECT 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? - CORRECT 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? -
CORRECT 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? - CORRECT 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. - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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. - CORRECT 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? - CORRECT
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. -
CORRECT 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. - CORRECT 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? -
CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT ANSWER-Sentinel events are unexpected occurrences
involving death or risk of serious physical or psychologic injury to a patient.
, Define the term active transport. - CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT 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. - CORRECT 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 solution used. (7) Add the amount of blood loss calculated from suction
canisters to the total recorded from sponges to obtain accurate blood loss estimates.
What are the key elements of informed consent? - CORRECT ANSWER-During informed consent,
the patient must be informed about the proposed operation or other invasive procedure and its
inherent risks, benefits, alternatives, and complications in terms that he or she can understand.
