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