NIFA Perioperative quiz with correct answers., Exams of Medicine

Download NIFA Perioperative quiz with correct answers. and more Exams Medicine in PDF only on Docsity! NIFA Perioperative quiz with correct answers. Of the following choices, which would not be a consideration for choosing suture? A. Type of procedure B. The tissue being reapproximated C. Type of reapproximation D. Scrub person preference - Correct Answer D. Scrub person preference Alexanders 15th P192 Which of the following is not an event that would adversely affect the pulse ox reading? A. Hypothermia B. Hypertension C. Vasoconstriction D. Hypovolemia - Correct Answer B. Hypertension Alexanders 15th P132 Skin injuries related to shearing occur most commonly as a result of which of the following positions? A. Trendelenburg B. Prone C. Lateral D. Lithotomy - Correct Answer A. Trendelenburg Alexanders 15th P165 A basic anesthesia monitoring device that is used during general anesthesia to confirm successful endotracheal tube placement and determine the presence of gas exchange is the: A. Pulse oximetry device B. Stethoscope C. Capnometer/end-tidal CO2 monitor D. Post-intubation arterial blood gas - Correct Answer C. Capnometer/ The immature blood-brain barrier and decreased protein binding in infants increase their sensitivity to which group of medications? A. anticholinergics, parasympathetics B. Antidysrhythmic agents C. Opioids and hypnotics D. Adrenerics - Correct Answer C. Opioids and hypnotics Alexander 15th p1009 Proper care and handling of surgical specimens is imperative for correct diagnosis, treatment, and prognosis planning of the patient. Select the response that best reflects correct specimen care and handling. A. Label consecutive specimens B. Send all specimens to the lab together as one pickup, including the frozen sections C. Avoid placing specimens for frozen section in formalin D. Neutralize formalin/formaldehyde spills with glycerin and call the hazmat team. - Correct Answer C. Avoid placing specimens for frozen section in formalin Alexander 15th p32 From the following, choose the types of anesthesia that will allow patients to tolerate potentially uncomfortable procedures while maintaining their own airway and be easily aroused from light sleep. A. Moderate anesthesia care B. Local infiltraion C. Moderate sedation/analgesia D. Regional anesthesia - Correct Answer C. Moderate Sedation/analgesia Alexander 15th P130 Risk factors for postoperative nausea and vomiting should be assessed preoperatively. Which of the following is a risk factor for PONV? A. Male gender B. Female gender C. Postoperative use of NSAIDS D. Surgery under 60 minutes - Correct Answer B. Female gender Alexanders 16th p269 Which of the following is a true statement about the use of liquids in the OR? A. Use of volitile liquids such as acetone is limited to cleaning and they must be properly stored B. Flammable liquids are prohobited in the OR unless an ESU is in use A. Hemostat B. Occluding clamp C. Kocher D. Forceps - Correct Answer A. Hemostat Alexanders 15th 201 ________ Precautions apply to blood, all body fluids, and excretions (except sweat), regardless of whether they contain visible blood, mucous membranes, and non-intact skin. A. Hospital B. Standard C. Isolation D. Contact - Correct Answer B. Standard Alexanders 15th p62 From the following, choose the correct statement regarding close gloving. A. Closed gloving can only be used for the initial gloving B. Closed gloving requires two people to execute without contamination C. There is an increased risk of contamination if the thumbs are not extended D. Closed gloving requires the hands to be kept in direct view - Correct Answer A. Closed gloving can only be used for initial gloving Alexanders 15th p95-96 During the preliminary sponge count on closure of a repair of a ruptured aortic aneurysm, the circulating nurse was unable to account for 2 lap sponges. Select the appropriate communication that the circulating nurse must employ in addressing the entire team during this count discrepancy. A. "Stop everything! I'm missing a couple of sponges. They are not in the trash or back table. Check the wound". B. "I think you are missing 2 sponges. Shall I call X-Ray while the scrub person checks her table again? Doctor, please check the incision site. C. "We have a count discrepancy. We started with 70 sponges and find only 68. We are missing 2 lap sponges". D. " Ive called X-Ray because we are short 2 lap sponges. I've called the charge RN to get someone to help me check the trash and linen. The rapid response team is on the way. - Correct Answer C. We have a count discrepancy. We started with 70 sponges and find only 68. We are missing 2 lap sponges. Alexanders 15th p32 Select from the following medication that is used for PONV and has the potential for prolonged QT interval. A. Scopolamine patch B. Dolasteran C. Droperidol D. Prochlorperazine - Correct Answer C. Droperidol Alexanders 15th p 277 The type of wound closure that occurs when approximation of the wound edges does not occur for 3 or more days after a surgical procedure. A. Primary Intention B. Secondary intention C. Granulation and contraction D. Third Intention - Correct Answer D. Third Intention or Delayed primary closure Alexanders 15 p256 Which statement about surgical dressings is true? A.Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage. B. Surgical dressings cover the wound to maintain moisture to promote granulation C. Surgical dressings maintain tension on the suture line to prevent dehiscence D. Surgical dressings protect surrounding drapes, linens, and clothing from contamination. - Correct Answer A. Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage. Alexander 15th p266 Which of the following absorbable suture has the best tensile strength? A. Surgical gut B. Polypropylene C. Surgical silk D. Polydioxanone - Correct Answer D. Polydioxanone or PDS A type of suture to help eliminate tension on the primary suture line is known as: A. Retention B. Interrupted C. Subcuticular D. Buried - Correct Answer A. Retention Alex 15th p193 A common dysrythmia after surgery is: A. SVT B. Sinus Tachycardia C. Bradycardia D. Atrial Fibrillation - Correct Answer B. Sinus Tachycardia Alexanders 15th P 275 The new general surgery fellow placed the three trocar ports for the laparoscopic appendectomy. The procedure was completed without incident; however, on post op day 1, the patient demonstrated signs and symptoms of sepsis. What might have been the unusual occurrence that could ave resulted in patient sepsis? A. Unrecognized appendiceal rupture. B. Significant break in sterile technique C. Inadvertent trocar puncture through the bowel on insertion D. Recent H1N1 outbreak on the surgery unit at the hospital - Correct Answer C. Inadvertent trocar puncture through the bowel on insertion Once a count discrepancy is identified, an important step scrubbed team member should do to aid in resolving the discrepancy is which of the following: A. Allowing the circulator to search the sterile drapes and drape folds B. Continue closure of the incision C. Order intraoperative imaging D. Notify the charge RN - Correct Answer C. Order intraoperative imaging Alexanders 15th P32 A 19yo M received an IV peripheral nerve block for an ORIF of an ankle fracture. The anesthesia provider injected a distal dorsal vein of the pt's right foot with 2% lidocaine, after placing a single cuffed pneumatic tourniquet around the upper thigh. The surgeon noticed that the cuff seemed to be deflating and anticipated that the patient would initially complain of which of the following? A. Metallic taste in his mouth B. Seizures by cobining functions. An appropriate combined function for a laproscopic instrument would be A. Ultrasound capability in a suturing forceps B. Electrosurgery conduction through the tips of a babcock grasper C. Blunt dissection with a smooth, rounded edge of the closed endoscopic scissors D. Suction and irrigation combined with an argon beam coagulation handpiece. - Correct Answer C. Blunt dissection with the smooth, rounded edge of the closed endoscopic scissors Alexanders 15th P 214 Suture permanently attached to the needle are referred to as A. Engineered crimp B. Controlled release C. Reverse cutting D. Swaged - Correct Answer D. Swaged Alexanders 15 P 191 The surgeon used the ESU in mono polar mode to cut and coagulate through the subcutaneous tissue on opening the abdomen during a bariatric bypass procedure. As she began to proceed through the muscle and fascia layer, she asked the circulating RN to increase the cut and coagulation modes on the ESU. What measure could the scrub person take to enhance energy delivery? A. Unwrap the ESU cord from around the tower damp handle B. Clean the charred tissue from the active electrode blade. C. Change the settings to blend mode D. Replace the active electrode blade with a coated blade. - Correct Answer B. Clean the charred tissue from the active electrode blade Alexanders 15th P 233 Which of the following is not a characteristic of silk suture? A. Soft B. Handling ability C. Knot security D. Memory - Correct Answer D. Memory Alexanders 15th p 189 Of the following, which measure, supported by evidence, has been identified to reduce SSI's and affect surgical outcomes? A. Antibiotics given IV within 1 hr of the incision for every procedure with an incision or entered body system B. Tobramycin and methylmethacrylate bead implants into deep orthopedic incisions at risk for osteomyelitis C. Bacitracin ointment on a clean subcuticular sutured incision as part of the dressing D. Vancomycin paste applied to cut edges of the sternum in cardiac surgery - Correct Answer A. Antibiotics given within 1 hr of incision for every procedure with an incision of entered body system Alexanders 15th P 77 Recommended practice for sponge, sharp and instrument counts should follow which of the following? A. JACHO rules B. Institutional policy C. Legislation D. CDC recommendations - Correct Answer B. Institutional policy Alexander 15th P 29 A reverse cutting needle is preferred for __________ suturing A. Cutaneous B. Opthalmic C. Microsurgical D. Plastics - Correct Answer A. Cutaneous Alexanders 15th P 192 During the process of performing the spinal, 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. The patient immediately experienced rapid onset of hypotension, bradycardia, and apnea. The resulting condition is called ____ and now must be managed with _____. A. Total subarachnoid syndrome, mechanical ventilation B. Hypotensive apnea episode, tracheostomy and humidified positive end- expiratory pressure C. Cardiogenic shock, ACLS protocol D. Total spinal anesthesia, general endotracheal anesthesia. - Correct Answer D. Total spinal anesthesia, general endotracheal anesthesia Care of the patient in surgery 15th P 145 When buried in tissue, silk loses its tinsile strength after what period of time? A. 6 months B. 1yr C. 90 days D. 2 qwwka - Correct Answer B. 1 Yr Alexanders 15th P 189 What is the appropriate action if the delayed after the room and instruments have been opened? A. Cover the instruments with a sterile drape. B. Cover the instruments with a sterile drape and have the scrub RN continually visually observe the room for breaches in sterility C. Do not cover open supplies and have the scrub RN continually visually observe the room for breaches in sterility D. Do not cover open supplies. Assign any OR personnel to observe the room for breaches in sterility. - Correct Answer A. Cover the instruments with a sterile drape AORN, Sterile technique, Maintaining a sterile Field, p 1039-1041 Healthcare professionals should employ which strategy to reduce their risk of allergic reaction to latex in the preoperative environment? A. Use power-free gloves that have low levels of protein and chemical allergens B. Use sterile oil-based hand creams before donning gloves if latex gloves must be worn C. Use cotton under gloves if latex gloves must be worn D. Wear an OR hat without elastic headband and do not wear rubber tennis shoes - Correct Answer A. Use power-free gloves that have low levels of protein and chemical allergens Alexanders 15th P 65 During you preoperative assessment, the patient reports a latex allergy and they always carry an epi pen adn a beta-agonist inhaler. What type of latex allergy does this patient have? A. Allergy contact dermatitis B. Irritant contact dermatitis C. True latex allergy D. Combined effect latex allergy - Correct Answer C. True latex allergy Alexanders 15th p54