NIFA STUDY GUIDE – QUESTIONS AND
ANSWERS
The number one patient safety issue identified in a survey of peri-operative
nurses is preventing: Correct Ans - Wrong site/procedure/patient surgery
Reprocessing (flashing) instruments in the OR is high risk because: Correct
Ans - 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: Correct Ans - 157 lbs
_______________ should be the primary decision makers for what equipment
and supplies are purchased and stocked in the difficult airway management
cart. Correct Ans - Anesthesia personnel
Proper specimen management techniques prevent errors and include all of
the following EXCEPT: Correct Ans - 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: Correct
Ans - Perform a weekly fire risk assessment
Peri-operative hypothermia is an important issue for all anesthetized patients
because of all of the following EXCEPT: Correct Ans - Increases risk of
renal failure
Recommendations for preventing retained surgical items include all of the
following EXCEPT: Correct Ans - Utilizing a multidisciplinary team to
resolve incorrect counts
Select the appropriate order for administering blood and blood products.
Correct Ans - 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. Correct Ans - 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?
Correct Ans - 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?
Correct Ans - 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: Correct Ans - 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. Correct Ans - "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 _______________________. Correct
Ans - wrong patient, wrong site, and wrong side surgery; site marking and
presurgical checklists
ANSWERS
The number one patient safety issue identified in a survey of peri-operative
nurses is preventing: Correct Ans - Wrong site/procedure/patient surgery
Reprocessing (flashing) instruments in the OR is high risk because: Correct
Ans - 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: Correct Ans - 157 lbs
_______________ should be the primary decision makers for what equipment
and supplies are purchased and stocked in the difficult airway management
cart. Correct Ans - Anesthesia personnel
Proper specimen management techniques prevent errors and include all of
the following EXCEPT: Correct Ans - 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: Correct
Ans - Perform a weekly fire risk assessment
Peri-operative hypothermia is an important issue for all anesthetized patients
because of all of the following EXCEPT: Correct Ans - Increases risk of
renal failure
Recommendations for preventing retained surgical items include all of the
following EXCEPT: Correct Ans - Utilizing a multidisciplinary team to
resolve incorrect counts
Select the appropriate order for administering blood and blood products.
Correct Ans - 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. Correct Ans - 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?
Correct Ans - 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?
Correct Ans - 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: Correct Ans - 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. Correct Ans - "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 _______________________. Correct
Ans - wrong patient, wrong site, and wrong side surgery; site marking and
presurgical checklists
