RNFA course 1 period quizzes and answers.

RNFA course 1 period quizzes and answers.Select from the following a medication that is used for PONV and has the potential to prolong the QT interval a) droperidol b) dolasteran c) prochlorperazine d) scopolamine patch A) droperidol Allergic reactions to latex range from skin disease to asthma and anaphylaxis that can result in chronic illness, disability, career loss, hardship and death. What types of signs and symptoms would be indicative of an allergic contact dermatitis response to contact with natural rubber latex Pruritus, edema, erythema, and vesicles that develop 6 to 48 hours after exposure 00:45 01:41 The strength layer of the skin is found in the Dermis Two monitoring techniques used by anesthesia that have improved morbidity and mortality include: Pulse ox and capnography Jacob Sutzkever is a 62 year old man who had surgery 6 days ago for a ruptured diverticulum. He is back in the OR for a debridement and washout. Jacobs fever has subsided and the drainage is clear. The surgeon will continue with wet to dry dressings and schedules Jacob to return to the OR in 3 days for: Delayed primary sutured closure Which of the following is not an advantage to the use of silk suture Memory The stapler designed to close the end of a hollow organ is called EEA Which anesthetic agent could not be given if an IV-only anesthesia plan was employed Desflurane The process of decontamination should initially begin at what point? Completion of the surgical procedure Which statement about surgical dressings is true A) surgical dressing maintain tension on the suture line to prevent dehiscence B) surgical dressings cushion and protect the wound from trauma and gross contamination and absorb drainage C) surgical dressings protect surrounding drapes, linen and clothing from contamination D) surgical dressings cover the wound to maintain moisture to promote granulation B) surgical dressings cushion and protect the wound from trauma and gross contamination and absorb drainage Risk factors for PONV should be assessed preoperatively. Which of the following is a risk factor for PONV. Female gender Guidelines from the WHO focus on which of the following in the prevention of SSI's? Use of antibiotics The death of microorganisms occurs in stream sterilization as a result of which process? Denaturation and coagulation of enzyme proteins Laparoscopic procedures that emerge toy convert to open procedures place the patient at risk for unintentional retained foreign objects (RFO). What new and evolving risk reduction strategy could prevent RFO's and frustrating, time consuming miscount adventures at the end of these procedures? Replacing or tagging sponges and laparotomy instruments with RFID chips The name of the fascia that separates the anterior rectum from the vagina in females is called the: Rectovaginal fascia The area between the surgeon and the scrub person designed for passing sharps safely is referred to as the: Neutral zone The new general surgery fellow placed the three rep at ports for the laparoscopic appendectomy. The procedure was completed without incident; however, on postoperative day 1, the patient demonstrated signs and symptoms of sepsis. What might have been the unusual occurrence that could have resulted in patient sepsis. Inadvertent trocar puncture through the bowel on insertion. The patient stated that her mouth, lips, and tongue were numb and prickly feeling and she had a metallic taste after receiving local anesthesia for a procedure. The anesthesia provider suspected that the patient had————and responded by———-. A toxic overdose of local anesthetic; monitoring and increasing the flow rate of IV saline Which of the following medications is a specific depolarizinf muscle relaxant than can produce generalized fasciculations? Succinylcholine Sara was positioned, prepped and draped following general endotracheal anesthesia induction. The team assembled around Sara and the sterile field to perform the time out as described in the WHO surgical checklist. Successful employment of the time out can only be ensured when: The entire team stops and focuses attention together. Which member of the surgical team can be held liable in litigation for retained foreign bodies The entire team Which statement best explains the mechanism of action of general anesthetic agents? Inhibition of synaptic transmission of nerve impulses Sherry Ames is an endoscopy nurse in a busy free standing ambulatory surgery center. She is an RN with additional documented competency in providing an anesthesia modality to healthy patients having screening colonoscopies, bronchoscopies and upper GI endoscopes. This modality will allow this patient population. To tolerate potentially uncomfortable-procedures while maintains their own airway and be easily aroused from light sleep. Sherry is competent and legally qualified to provide which modality of anesthesia? Conscious sedation/analgesia Jacob Sutzkever, a 62 year old man, had surgery 6 days ago for a ruptured diverticulum. What was the wound classification at the time of his emergency surgery? Contaminated wound, classification III (counted wrong per NIFA grade. Look at page 250 on 16th Ed.) only other answer would be infected wound classification IV The incidence of intraoperative awareness (IOA) may increase in high risk patient populations. From the following, choose the group that is considered high risk for IOA Cardiac surgery patients The RNFA instructed the new anesthesia resident in the proper positioning of the arm and hand on the OR bed arm boards. The resident was cautioned to avoid pressure on the elbow to prevent: Ulnar nerve injury Surgical site infections (SSI) are most often caused by gram-positive cocci and may arise from the patients own endogenous sources. The most frequently identified microorganisms cultured from SSIs is: Staphylococcus aureus Select the statement below that best reflects the effects of hypothermia in the perianesthesia period. Shivering can increase the need for oxygen by 300% to 400% Select the appropriate order for administering blood and blood products. Verify informed consent for blood, separate blood bag from identification slips, sign slips, verify identification numbers and expiration dates with second licensed person, verify patient with blood tag and requisition slips. Verify informed consent for blood, verify patient identification and blood type and unit number against blood tag and requisition slip with second licensed person, sign slips. Hypotension is a blood pressure reading that is 20% less than the patients normal baseline pressure. Hypovolemia is the most common cause of postoperative hypotension; however, hypotension may also be caused by cardiac dysfunctions. Which of the following cardiac conditions will present with hypotension? Myocardial infarction, myocardial tamponade and pulmonary embolism. The Joint Commission suggests that surgical consent be written at what level to meet health literacy needs of all patients? 5th grade level The physiologic effects resulting from the inhalation is gaseous anesthetic agents and intravenous infusions of anesthetic drugs inhibit several areas of the central nervous system. The process by which they occur are explained by several proposed theories. Which of the options describes a plausible anesthetic mechanism of action? Synaptic transmission of nerve impulse in the CNS is inhibited. Which of the following is corrected regarding chromium salt coating on surgical gut suture? **??Speeds the absorption of the suture in the tissue??** says pg 177 in 16th ed While the Fowler's position offers the best respiratory excursion for the patient, the patient is at higher risk for —————- because of dependent pooling in the hips and legs. Venous thromboembolism (VTE) Select the appropriate nursing action that supports hands free instrument passing and sharps safety. Create a neutral hands free area between the scrub person and surgeon with a basin or magnetic mat. The circulating nurse received a phone call from the emergency department and called sterile supply to assemble the instrument for an abdominal trauma case with possible aortic rupture. When the cart arrived, she saw the vascular set; however the most important instrument set was missing. What important set was needed for this procedure besides the vascular set? Basic laparotomy set Which of the following absorbable suture has the best tensile strength? Polydioxanone Miriam Glass is a 78 year old female scheduled for compression nail insertion of a left fractured hip. She was positioned for a spinal injection to induce spinal anesthesia. During the process, the anesthesia provider inadvertently inserted the spinal needle into the subarachnoid space, not noticing the error until the entire syringe of lidocaine was emptied into the patient. Miriam immediately experienced rapid onset of hypotension, bradycardia and apnea. Miriams unintentional condition is called ———— and now must be managed with—————-. Cardiogenic shock; ACLS protocol Which of the following do not need to be counted and documented. Vascular inserts pg 199 16th Ed Infection control and prevention surveillance was underway in the cardiac intensive care unit because of an alarming prevalence of sternal wound infections. On postop day 2, a patient develop d edema, redness and purulent exudate that appeared to be isolated to the subcutaneous plane above the sternum. What important criteria must be met to conclusively define this is a surgical site infection (SSI) Positive diagnosis of the SSI by the surgeon or attending physician The final step, after decontamination and before sterilization, is the prep, pack, and wrap process. The sterile processing technologist has taken the laparotomy set from the washer/ decontaminator to prepare for sterilization. Select the most appropriate order that the instrument set must travel before reaching the steam sterilizer. Air dry, inventory, inspect, lubricate, assemble and string instruments, wrap and tape???? Pg 72 16th Ed. Many factors have contributed to the evolution and progressive growth of ambulatory surgery. Select three anesthetic agents that promote fast induction, rapid emergence and minimal side effects and have been credited as a significant factor in this trend. Sevoflurane, propofol, desflurane Surgical instruments that do not fall under the category of clamps, retractors, or cutting instruments, but are used in most procedures are typically included within the category of: Accessory and ancillary instruments The light transmission through an endoscope is achieved by way of: Bundles of fiber optic glass rods —————— Precautions apply to blood, all body fluid, secretions and excretions (except sweat) regardless of whether they contain visible blood, mucous membranes and not intact skin. Standard The OR was trialing a new insufflation system and the vendor representative was out of the room taking a phone call. The perioperative nurse was concerned that the flow rate was well above 14L/min and the pressure had risen to 16 mmHg. She alerted the surgeon and reduced the rate and pressure because she feared that the elderly patient was at high risk for: Hypercarbia