RNFA FINAL PRACTICE 2022/2023 Questions And
Answers
The process of decontamination should initially begin at what point? Correct
Ans - Completion of the surgical procedure
Side effects the patient may encounter as a result of extracoproreal
circulation include: Correct Ans - Inflammatory responses
After retracting the nerve roots during a laminectomy, this structure is
incised before getting to the disc. Correct Ans - Posterior longitudinal
ligament
Of the following, which is not a symptom of compartment syndrome?
Correct Ans - Moderate pain
Fibrocystic changes in the breast describe many different breast changes.
These changes affect almost all women at some time in their lives. Nipple
discharge is more commonly associated with benign lesions than with
cancer; however, discharge is usually significant only if it is spontaneous,
persistent, and: Correct Ans - bloody
Jan Stuyvesant, a perioperative nurse, was the scrub person during a robotic-
assisted laparoscopic cholecystectomy. She locked the robotic endoscissor
into the adaptor on the robotic arm and positioned the tip end into the trocar
port in order for the surgeon to dissect the cystic duct and artery, while the
surgical assistant placed the clips on the cystic duct and artery. As she
reached across the sterile field to insert the cholangiocatheter through the
port, the anesthesia provider accidentally made contact with the distal end
of the catheter as he stood up to reach the monitor controls. The
contaminated end of the catheter touched the endoscopic clip applier, the
endoscissor connector that the surgeon was using, the glove of the assistant,
and Jan's gown sleeve. The surgeon ordered everyone to change their gown
and gloves and covered the port area with a sterile towel. What was the
rationale for the surgeon to continue to dissect and not change his attire?
Correct Ans - The surgeon was not in contact with the sterile field because
he worked from the robotic console.
The ability to maintain thermoregulation is compromised in elders because
of changes in the: Correct Ans - vascular system
Because herbal products are so readily available and have such widespread
media attention, many people think that they can safely self-medicate. Why
should the public be aware and educated about dietary supplements and
,potential harmful effects? Correct Ans - Unknown substances may be
present in these products.
Talia Mendelson, a 27-year-old patient who had a lumpectomy for early-
onset breast cancer, is now scheduled for infusion port insertion. Talia is very
nervous because during the previous lumpectomy, performed using a local
anesthetic, she was not entirely sedated. Talia tells the perioperative nurse
that she was uncomfortable and heard everything in the room, but admitted
that she did not feel pain. The nurse recognized Talia's anxiety related to the
surgical intervention and prepared to implement corrective actions in the
OR. What nursing intervention best reflects one that would ensure support or
contribute to Talia realizing her expected outcome? Correct Ans - Ensure
a quiet and calm environment of care
A 26-year-old female is rushed to the operating room after a primary and
secondary survey in the emergency department. She was hit by a small
truck as she was riding her bicycle through a busy intersection. She has
sustained rib fractures and several fractured transverse vertebral processes.
Renal injury is suspected. As the perioperative nurse prepares to insert a
urinary catheter, she notices blood at the urinary meatus. What should the
nurse's next action be? Correct Ans - Discontinue the catheter insertion
Open parathyroidectomy is currently being replaced with less invasive and
more targeted techniques; however, the amount of parathyroid tissue that
should be removed remains controversial and relates to whether single or
multiple glands are involved. A portion of a gland must remain to: Correct
Ans - prevent hypocalcemia and its complications.
Which of the following supplies blood to the transverse colon? Correct Ans -
Middle colic artery
Which of the following structures form the mouth? Correct Ans - cheeks,
the hard palate, the mandible, and the tongue
The salivary glands produce saliva, which serves to moisten the mouth and
initiate: Correct Ans - carbohydrate digestion.
Potential development of a direct inguinal hernia results from ___________and
__________weakening or tearing. Correct Ans - Aponeurosis of transversus
abdominus and transversalis muscle
When the patient arrives in the ED, the trauma team initiates a primary
assessment. This is a logical, orderly process of patient assessment for
potential life threats. These assessment activities are based on established
protocols for advanced trauma life support (ATLS). The mnemonic "ABCDE" is
used, representing assessment of the following: Airway, Breathing,
,Circulation, Disability, and Exposure. The D and E represent what degree of
investigation? Correct Ans - D = a brief neurologic examination; E =
exposure to reveal all life-threatening injuries
What structure covers the spermatic cord and contracts to make the testicles
ascend in the scrotum? Correct Ans - Cremaster muscle
Which of the following is not included in the group of tendons that comprise
the rotator cuff? Correct Ans - Teres Major
The cranial meninges are composed of all except _____. Correct Ans -
Pericranial mater
Sara Gardiner is the perioperative nurse in the circulating role in OR 2, and is
planning for her three neurosurgical procedures for the day. She is
explaining the basic processes of the three procedures to the scrub person
and double-scrubbed surgical technology student: (1) a VP shunt insertion,
(2) a reconstructive craniosynostosis for an infant with severe deformity, and
(3) exploration of a severe head injury with increased intracranial pressure
(ICP) to evacuate a hematoma and possible brain tissue. To give the brain
room to swell in the third procedure, the bone flap may need to be sterile-
wrapped and stored, for later replacement. Sara asks the student to name
the appropriate surgical approach to the brain for each of the procedures.
She expects the correct sequence to be: Correct Ans - burr hole,
craniectomy, and craniotomy.
Describe the boundaries of the surgical skin prep for the patient about to
receive a liver transplant. Correct Ans - From the neck to midthigh;
bedline to bedline
Total thyroidectomy is the removal of both lobes of the thyroid and all
thyroid tissue present. Total thyroidectomy is the desired surgical treatment
for patients with: Correct Ans - thyroid cancer.
Which of the following describes a strangulated hernia? Correct Ans - A
persistent incarceration with a compromised blood supply
The Glasgow Coma Scale (GCS) is commonly used to assess patients with
brain injury using three indicators of cerebral function: eye opening, verbal
communication, and motor response to verbal and noxious stimuli. Within
the scoring range for the GCS, the best possible score is _____ and the worst
possible score is ______. Correct Ans - 15; 3
What mouth structure is considered the boundary between the buccal cavity
and the lingual cavity? Correct Ans - Teeth
, Laryngoscopy is direct visual examination of the interior of the larynx by
means of a rigid, lighted speculum known as a laryngoscope to obtain a
specimen of tissue or secretions for pathologic examination. What risk
reduction strategy should the perioperative nurse employ in preparing for
the conclusion of the procedure? Correct Ans - Maintain instrument setup
until the patient leaves the OR.
Marissa Walton is transferred to the OR from the burn unit for debridement
of the partial-thickness burn areas and a dressing change under anesthesia.
What important preparation for the procedure will the perioperative nurse
perform before Marissa arrives in the OR? Correct Ans - Prewarm the OR
to above the ambient high temperature for an adult.
FESS provides a more functional approach to treat sinus disease. FESS
involves the endoscopic resection of inflammatory and anatomic defects of
the sinuses while preserving natural function in a surgical procedure that is
minimally invasive. From the following, choose an important finding that
should be communicated to the surgeon immediately during this procedure.
Correct Ans - Encroachment of the orbit
Administration of cyclogyl should be used in caution with which of the
following patient groups? Correct Ans - Patients on tricyclics
What drug can be used to reverse the effects of heparin ? Correct Ans -
Protamine sulfate
When assisting with an open inguinal hernia repair, the surgeon makes an
incision through which of the following to access the cremaster muscle,
inguinal canal, and cord structures? Choose the correct answer. Correct Ans
- External oblique muscle
Identify the type of fracture that has more than two fragments. Correct Ans
- Comminuted
Identify the correct path of the cardiac conduction system. Correct Ans -
From the SA node to the AV node to the bundle of His to the Purkinje system
Transsphenoidal hypophysectomy (TSH) is performed with the patient
administered a general endotracheal anesthetic, combined with a local
anesthetic. The surgical team places the patient in a semisitting position,
with the head against the headrest. A transnasal or a sublabial incision can
be used for rapid access to the sella turcica. Select the diad (2) of conditions
that would be appropriate indications for TSH. Correct Ans -
Hypopituitarism and small pituitary tumors
Answers
The process of decontamination should initially begin at what point? Correct
Ans - Completion of the surgical procedure
Side effects the patient may encounter as a result of extracoproreal
circulation include: Correct Ans - Inflammatory responses
After retracting the nerve roots during a laminectomy, this structure is
incised before getting to the disc. Correct Ans - Posterior longitudinal
ligament
Of the following, which is not a symptom of compartment syndrome?
Correct Ans - Moderate pain
Fibrocystic changes in the breast describe many different breast changes.
These changes affect almost all women at some time in their lives. Nipple
discharge is more commonly associated with benign lesions than with
cancer; however, discharge is usually significant only if it is spontaneous,
persistent, and: Correct Ans - bloody
Jan Stuyvesant, a perioperative nurse, was the scrub person during a robotic-
assisted laparoscopic cholecystectomy. She locked the robotic endoscissor
into the adaptor on the robotic arm and positioned the tip end into the trocar
port in order for the surgeon to dissect the cystic duct and artery, while the
surgical assistant placed the clips on the cystic duct and artery. As she
reached across the sterile field to insert the cholangiocatheter through the
port, the anesthesia provider accidentally made contact with the distal end
of the catheter as he stood up to reach the monitor controls. The
contaminated end of the catheter touched the endoscopic clip applier, the
endoscissor connector that the surgeon was using, the glove of the assistant,
and Jan's gown sleeve. The surgeon ordered everyone to change their gown
and gloves and covered the port area with a sterile towel. What was the
rationale for the surgeon to continue to dissect and not change his attire?
Correct Ans - The surgeon was not in contact with the sterile field because
he worked from the robotic console.
The ability to maintain thermoregulation is compromised in elders because
of changes in the: Correct Ans - vascular system
Because herbal products are so readily available and have such widespread
media attention, many people think that they can safely self-medicate. Why
should the public be aware and educated about dietary supplements and
,potential harmful effects? Correct Ans - Unknown substances may be
present in these products.
Talia Mendelson, a 27-year-old patient who had a lumpectomy for early-
onset breast cancer, is now scheduled for infusion port insertion. Talia is very
nervous because during the previous lumpectomy, performed using a local
anesthetic, she was not entirely sedated. Talia tells the perioperative nurse
that she was uncomfortable and heard everything in the room, but admitted
that she did not feel pain. The nurse recognized Talia's anxiety related to the
surgical intervention and prepared to implement corrective actions in the
OR. What nursing intervention best reflects one that would ensure support or
contribute to Talia realizing her expected outcome? Correct Ans - Ensure
a quiet and calm environment of care
A 26-year-old female is rushed to the operating room after a primary and
secondary survey in the emergency department. She was hit by a small
truck as she was riding her bicycle through a busy intersection. She has
sustained rib fractures and several fractured transverse vertebral processes.
Renal injury is suspected. As the perioperative nurse prepares to insert a
urinary catheter, she notices blood at the urinary meatus. What should the
nurse's next action be? Correct Ans - Discontinue the catheter insertion
Open parathyroidectomy is currently being replaced with less invasive and
more targeted techniques; however, the amount of parathyroid tissue that
should be removed remains controversial and relates to whether single or
multiple glands are involved. A portion of a gland must remain to: Correct
Ans - prevent hypocalcemia and its complications.
Which of the following supplies blood to the transverse colon? Correct Ans -
Middle colic artery
Which of the following structures form the mouth? Correct Ans - cheeks,
the hard palate, the mandible, and the tongue
The salivary glands produce saliva, which serves to moisten the mouth and
initiate: Correct Ans - carbohydrate digestion.
Potential development of a direct inguinal hernia results from ___________and
__________weakening or tearing. Correct Ans - Aponeurosis of transversus
abdominus and transversalis muscle
When the patient arrives in the ED, the trauma team initiates a primary
assessment. This is a logical, orderly process of patient assessment for
potential life threats. These assessment activities are based on established
protocols for advanced trauma life support (ATLS). The mnemonic "ABCDE" is
used, representing assessment of the following: Airway, Breathing,
,Circulation, Disability, and Exposure. The D and E represent what degree of
investigation? Correct Ans - D = a brief neurologic examination; E =
exposure to reveal all life-threatening injuries
What structure covers the spermatic cord and contracts to make the testicles
ascend in the scrotum? Correct Ans - Cremaster muscle
Which of the following is not included in the group of tendons that comprise
the rotator cuff? Correct Ans - Teres Major
The cranial meninges are composed of all except _____. Correct Ans -
Pericranial mater
Sara Gardiner is the perioperative nurse in the circulating role in OR 2, and is
planning for her three neurosurgical procedures for the day. She is
explaining the basic processes of the three procedures to the scrub person
and double-scrubbed surgical technology student: (1) a VP shunt insertion,
(2) a reconstructive craniosynostosis for an infant with severe deformity, and
(3) exploration of a severe head injury with increased intracranial pressure
(ICP) to evacuate a hematoma and possible brain tissue. To give the brain
room to swell in the third procedure, the bone flap may need to be sterile-
wrapped and stored, for later replacement. Sara asks the student to name
the appropriate surgical approach to the brain for each of the procedures.
She expects the correct sequence to be: Correct Ans - burr hole,
craniectomy, and craniotomy.
Describe the boundaries of the surgical skin prep for the patient about to
receive a liver transplant. Correct Ans - From the neck to midthigh;
bedline to bedline
Total thyroidectomy is the removal of both lobes of the thyroid and all
thyroid tissue present. Total thyroidectomy is the desired surgical treatment
for patients with: Correct Ans - thyroid cancer.
Which of the following describes a strangulated hernia? Correct Ans - A
persistent incarceration with a compromised blood supply
The Glasgow Coma Scale (GCS) is commonly used to assess patients with
brain injury using three indicators of cerebral function: eye opening, verbal
communication, and motor response to verbal and noxious stimuli. Within
the scoring range for the GCS, the best possible score is _____ and the worst
possible score is ______. Correct Ans - 15; 3
What mouth structure is considered the boundary between the buccal cavity
and the lingual cavity? Correct Ans - Teeth
, Laryngoscopy is direct visual examination of the interior of the larynx by
means of a rigid, lighted speculum known as a laryngoscope to obtain a
specimen of tissue or secretions for pathologic examination. What risk
reduction strategy should the perioperative nurse employ in preparing for
the conclusion of the procedure? Correct Ans - Maintain instrument setup
until the patient leaves the OR.
Marissa Walton is transferred to the OR from the burn unit for debridement
of the partial-thickness burn areas and a dressing change under anesthesia.
What important preparation for the procedure will the perioperative nurse
perform before Marissa arrives in the OR? Correct Ans - Prewarm the OR
to above the ambient high temperature for an adult.
FESS provides a more functional approach to treat sinus disease. FESS
involves the endoscopic resection of inflammatory and anatomic defects of
the sinuses while preserving natural function in a surgical procedure that is
minimally invasive. From the following, choose an important finding that
should be communicated to the surgeon immediately during this procedure.
Correct Ans - Encroachment of the orbit
Administration of cyclogyl should be used in caution with which of the
following patient groups? Correct Ans - Patients on tricyclics
What drug can be used to reverse the effects of heparin ? Correct Ans -
Protamine sulfate
When assisting with an open inguinal hernia repair, the surgeon makes an
incision through which of the following to access the cremaster muscle,
inguinal canal, and cord structures? Choose the correct answer. Correct Ans
- External oblique muscle
Identify the type of fracture that has more than two fragments. Correct Ans
- Comminuted
Identify the correct path of the cardiac conduction system. Correct Ans -
From the SA node to the AV node to the bundle of His to the Purkinje system
Transsphenoidal hypophysectomy (TSH) is performed with the patient
administered a general endotracheal anesthetic, combined with a local
anesthetic. The surgical team places the patient in a semisitting position,
with the head against the headrest. A transnasal or a sublabial incision can
be used for rapid access to the sella turcica. Select the diad (2) of conditions
that would be appropriate indications for TSH. Correct Ans -
Hypopituitarism and small pituitary tumors
