RNFA Exam 2022/2023 with complete solutions

What is the study of choice for tibial fracture? - ANSWER CT Scan What landmark is of value in Laparscopic GYN sx - ANSWER Round ligament Who should we involve as much as possible in the nursing process? - ANSWER 6 Pregnant put cardiac output increases how much - ANSWER 30% Hesselbachs triangle is made of what boundaries? - ANSWER Inferior Epigastric Artery, inguinal, and reclusive abdominal Preferred placement of laparoscopic surgery scope - ANSWER Palmers point Name the six sections of nursing process - ANSWER Assessment Diagnosis Outcome Planning Implementation Evaluation Which area of nursing process do you want to involve family? - ANSWER Assessment Which two nerves do you have to be careful of when assisting in a carotid? - ANSWER Hypoglossal Vagus How do you know the hypoglossal in a carotid has been damaged? - ANSWER Tongue deviation In a carotid case pt. Strokes and has weakness on the left ....where is the brain injury? - ANSWER On the right In assessing the abdomen which do you do first? Ascultate, palate, percuss - ANSWER Auscultate Test for carotid inexpensive? - ANSWER Doppler, ultra sound Three carotid complications - ANSWER Tongue deviation Facial numbness Hoarness In Hypoglossal injury tongue points to side of injury T/F - ANSWER True Cranial nerve that involves visual field - ANSWER 2-Optic 2 normal finding of metastasis post op in breast CA - ANSWER Green/Blue tinted urine Blue tinted areola Normal Bicarbonate level - ANSWER 22-26 Most damaging injury to tissue - ANSWER Crushing injury Dimensia difference with Dilemia - ANSWER Difficulty focusing Recommended breast conservation for which pt. - ANSWER Unifocal Tumor Which gas is volital? - ANSWER Carbonic acid In a pregnant women how much blood flow goes to the uterus - ANSWER 20% During pregnancy how much does your cardiac output increase - ANSWER 30% What is the early sign of malignant hyperthermia - ANSWER Increased end title co2 What's a late sign of MH - ANSWER Increase temperature What should we ask patients to stop before surgery - ANSWER Smoking because of wound healing Which cranial nerve is shrug shoulders - ANSWER 11 Marginal mandibular facial nerve function (3) - ANSWER -Supplies motor function to lower lip Usually courses inferior to the rim of the mandible Is in close proximity to importance facial artery lymph nodes along the mandible rim Which nerve has large veins coursing over it laterally in the submandibular triangle - ANSWER Hypoglossal The radical neck dissection removes what three things - ANSWER Sternocleidomastoid muscle Internal jugular vein Spinal accessory nerve What nerve does the modified neck dissection? - ANSWER Spinal Accessory Nerve This is important in what case to always preserve the spinal accessory nerve and is performed using similar neck incisions as a radical neck dissection - ANSWER A modified radical neck dissection Normal PH - ANSWER 7.34-7.45 Normal pCO2 - ANSWER 35-45 Normal HCO3 - ANSWER 22-26 Normal PO2 - ANSWER 75-100 A substance that donates H+ ions to a solution - ANSWER Acid This takes days of work to regulate H+ ions - ANSWER Kidneys Ph 7.45 - ANSWER Alkalosis This takes minutes to hours to work to regulate H+ ions - ANSWER Lungs A substance that accepts H+ ions - ANSWER Base Which SSI involves skin or subcutaneous tissue - ANSWER Superficial SSI Factors that lead to SSI - ANSWER Hx of previous surgery Prolonged surgery time Hypoalbuminemia Hx of COPD What are normal Glucose levels - ANSWER 80-108 Which Carotid artery has branches on it external or internal - ANSWER External Where does the vagus nerve lye that you have to be careful of? - ANSWER Under the external artery Best tests for a carotid dz - ANSWER Angiogram But ultrasound most commonly used Name three primary modes of treatment for carotid dz - ANSWER ASA, Endarectomy, stent never a balloon How do you prep for carotid - ANSWER Stern also knotch to ear lobe After carotid case how would you test for stroke - ANSWER Squeeze hand/ move toes Stick out tongue If pt. Wakes from endarectomy with deficits what do you first - ANSWER Re-explore the endarterectomy How do you follow/monitor up with pt before and after carotid surgery - ANSWER Every 6 months ultrasound What is the difference in a TIA and a stroke - ANSWER TIA lasts 30 min-2 hours symptoms resolve. Stroke does not resolve MRI will show damage What is a clinical way to check for carotid dz? - ANSWER Bruie with 25% over carotid What is the 4th leading cause of death - ANSWER Carotid dz What is amaurosis? - ANSWER Ocular symptoms that is like a sheet being pulled over a portion of your vision What is a volatile gas that can convert a liquid to a gas to be excreted by the lungs - ANSWER Carbonic acid Which organ excretes bicarb - ANSWER Kidney Cranial nerve 1 - ANSWER Olfactory Cranial nerve 2 - ANSWER Visual acuity Optic Romberg test is which cranial nerve - ANSWER 8 Acoustic whisper test Puffing out cheeks tests which cranial nerve - ANSWER 7 Facial Shrugging shoulders is which cranial nerve - ANSWER 11-spinal accessory What is the vagus nerve responsible for - ANSWER Parasympathetic: carotid reflex, stomach and intestines secretions, peristalsis Gag flex tests which nerve - ANSWER Glossopharyngeal What is the goal of breast reduction - ANSWER Preserve blood supply to the nipple What does the Mini-Cog test - ANSWER Dementia Alzheimer's- they draw hands on a clock What does a Weber test test for - ANSWER Physical assessment that tests lateralization with a tuning fork What does the Rinne test - ANSWER Bone conduction with running fork Facial expressions/sensation tests which cranial nerves - ANSWER V, Vll Swallow and gag tests which cranial nerve - ANSWER IX, x, xll What do you hear at Erb's point - ANSWER Point of maximum heart function What order do you asses the abdomen - ANSWER Look, auscultate, percuss, palpate What do we use to see function of gallbladder - ANSWER CCK What do we not place cricothyroidectomy if we can help it - ANSWER That is where the vocal cords are and we don't want to damage them What is your Glascowcoma scale if you are a level 1 trauma - ANSWER 9 What's a FAST exam for - ANSWER Abdominal bleeding exam for trauma patients What does distinction of neck. Wins tell you - ANSWER Cardio genie shock How do you treat A-fib - ANSWER Beta blocker, calcium channel blocker Intervention therapy for MI - ANSWER MONA therapy - MS, O2, Nitroglycerin, ASA How do you treat pulseless v-tach or V-fib - ANSWER Defibrillate Cardiovert which rhythms - ANSWER Stable catch Afib Don't shock which rhythms - ANSWER Asystole Shockable rhythms - ANSWER Vibe Puleless vtach How many cervical vertebrae are there - ANSWER 7 C5 function - ANSWER Biceps/Deltoid C6 function - ANSWER Brachioraidal C7 - ANSWER Triceps What do you need to remember to do with a patient getting a ALIF - ANSWER Place pulse ox on left foot Which patients are most likely to rupture there Abdominal Aortic Aneurysm - ANSWER Smoker Hypertension COPD What is the best screening test for AAA - ANSWER Duplex (Ultrasound) What size of Abdominal Aorta do we reapir - ANSWER 5.5 cm Which patients do we not use a aortic graph in - ANSWER Pt with infection Number of knots for silk - ANSWER 4 Number three f knots for Vicryl - ANSWER 4 Number of knots for prolene - ANSWER 7-10 What is a aneurysm call that does not go through all three layers - ANSWER Pseudo aneurysm What is a circumferential aneurysm called - ANSWER Fusiform What temperature does methylene Methacolate need to be at - ANSWER 65-68 degrees What is the 5th leading of adult cancer death - ANSWER Pancreatic adenocarcinoma Blood clots at capillary beds - ANSWER Trousseau' syndrome How do we diagnose pancreatic cancer - ANSWER CT, ERCP, MRI Which artery can be sacrificed for wipple - ANSWER GDA Gastrodeudernal artery What do we use to block pain for pancreatic pt - ANSWER Nerve block Routine surgical complication with wipple - ANSWER New onset diabetes blood clot If there is a tumor in tail of pancreas what stage is it - ANSWER Stage 4 Where do we get the best anesthesia effects for child birth - ANSWER T-10 numb at umbilicus C-section needs to be numb at what level of the spine - ANSWER T 5-10 If you loose function in your pinky you have a what - ANSWER Spinal not epidermal The pulling sensation in lower abdomen after child birth is do to what - ANSWER Illioinguinal nerve Iliophypogastric nerve Who is at risk for retroperoteal rupture - ANSWER BMI under 40 What's a good idea to do before placing a versa needle in the abdomen for Trocars - ANSWER Place NG tube What gives blood supply to retus muscles - ANSWER Inferior epigastic artery What do most anesthetic do to the nervous system - ANSWER Reduce activity of the sympathetic nervous system Each liter of fluid given lowers body temp by - ANSWER 0.25 What issues do peds under 10 have with cardiac out put - ANSWER It does not change Early sign of sepsis - ANSWER Decreased urine output What do you need to be careful of when doing thorocotomy - ANSWER That there is a nerve and vein running under each rib. You want to approach though top of. Rib to avoid hitting them What does anesthesia need for thoracotomy - ANSWER Double lumen tube What is study used for tibial fracture - ANSWER Ct scan Hesselbox triangle made up of - ANSWER Inferior epigastic artery, Retus Abdominal Inguinal Preferred placement of lap scope - ANSWER Palmers point Common cause of carotid injury - ANSWER Embolization of debri If using CO2 and increase to 15 can do what - ANSWER Air canary beds to cause coagulation Most common leg sores - ANSWER Venous related First phase of tissue injury - ANSWER Inflammatio Absorbable suture - ANSWER Vicryl Gut chromic Monocryl PDS Non absorbable - ANSWER Prolene Silk Nylon Ethilon Ethibond What two things should suture selection take into effect - ANSWER Post op swelling Tension that will be placed on itm Gold standard treatment for disco genie back pain - ANSWER Spinal fusion What percentage of communication is verbal - ANSWER 7% Weakness in muscle group c 7 effects what - ANSWER Triceps Which suture is natural no absorbable - ANSWER Silk Which has less infections monofilament or braided suture - ANSWER Monofilament Why would you want coated suture - ANSWER Slower absorption