NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024, Exams of Nursing

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NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 The number one patient safety issue identified in a survey of peri- operative nurses is preventing: - Correct Answers ✅Wrong site/procedure/patient surgery Reprocessing (flashing) instruments in the OR is high risk because: - Correct Answers ✅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 Answers ✅157 lbs _______________ should be the primary decision makers for what equipment and supplies are purchased and stocked in the difficult airway management cart. - Correct Answers ✅Anesthesia personnel Proper specimen management techniques prevent errors and include all of the following EXCEPT: - Correct Answers ✅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 Answers ✅Perform a weekly fire risk assessment NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 Peri-operative hypothermia is an important issue for all anesthetized patients because of all of the following EXCEPT: - Correct Answers ✅Increases risk of renal failure Recommendations for preventing retained surgical items include all of the following EXCEPT: - Correct Answers ✅Utilizing a multidisciplinary team to resolve incorrect counts Select the appropriate order for administering blood and blood products. - Correct Answers ✅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 Answers ✅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 Answers ✅Replacing or tagging sponges and laparotomy instruments with radiofrequency identification (RFID) chips NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 If a staff person receives a needlestick injury, what is the first corrective action? - Correct Answers ✅Wash wound with soap and water; flush mucous membranes. Contact with infected patients or infectious material places healthcare workers at risk for occupational-acquired infection. Which communicable disease are healthcare workers at risk for acquiring or transmitting? - Correct Answers ✅Seasonal influenza Select the appropriate nursing action that supports hands-free instrument passing and sharps safety. - Correct Answers ✅Create a neutral hands-free area between the scrub person and surgeon with a basin or magnetic mat. Select the guideline that complements the design of the culture of safety model. - Correct Answers ✅Incorporate safe practices into your daily work when handling sharps. A neutral zone is a predetermined location on the surgical field where sharps are placed for retrieval by the surgeon. Which of the following is a best practice for the use of the neutral zone? - Correct Answers ✅Announce the transfer of each sharp before placing it in the neutral zone. NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 Which of the following may be a consequence of high-dose or full-body radiation? - Correct Answers ✅Nausea, vomiting, and diarrhea Exposure to blood-borne pathogens occurs during all phases of the perioperative process. Observing safety precautions during all phases of surgery, from setup to cleanup, reduces the number of injuries and exposures for all OR personnel. For the prevention of sharps injuries in the pre-procedure and post-procedure phases, which safe handling practices reflect appropriate nursing actions? - Correct Answers ✅Use standardized sterile field setups throughout the surgical service department. Transport reusable sharps in a safe, closed container to the decontamination cleanup area. Do not place hands or fingers into a container to dispose of a device. Inspect the sharps container for overfilling before discarding disposable sharps in it. Which list of medications best reflects medications indicated for latex sensitivity therapeutic management? - Correct Answers ✅Epinephrine, prednisone, and a beta-agonist inhaler NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 While antibiotics have been credited with saving lives, misuse of antibiotics has contributed to the evolution of multidrug-resistant organisms (MDROs). Select the antibiotic application that has evident to support it as a best practice and not, potentially, a misuse of antibiotics. - Correct Answers ✅Antibiotics given intravenously within 1 hour of the incision for every procedure with an incision or entered body system. With the production of more steam in the sterilizer chamber, the pressure increases as well. The steam should contain little or no entrapped liquid water. Steam quality is the term that describes the amount of water mixed with the steam. The constitution of high-quality steam would be measured by: - Correct Answers ✅<3% of the mixture is liquid water. A 47-year-old man was admitted to the emergency department (ED) with respiratory symptoms, facial and upper body abrasions, burns, and moist lesions after a small package, delivered to his office, exploded and sprayed him dried powder and glass shards. In response to the reported mechanism of injury, the ED team sequestered him in a secluded area away from the rest of the patients. The team believed that this was highly suspicious of a bio-terrorism event. The epidemiologist was called, and the patient was transferred to a negative-pressure isolation room and placed on standard, contact, airborne, and droplet precautions. Based on these actions, which microorganism agents might be suspected to be involved? - Correct Answers ✅Anthrax and smallpox NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 45-degree Trendelenburg in a robotic pr - Correct Answers ✅Respiratory compromise and ventilation resistance Shearing injury to soft tissues A 325-pound male is scheduled for a 6-hour abdominal surgery. While assessing the patient in the preoperative holding area, the perioperative nurse is concerned about the risk for pressure injury because of the weight of the patient's body pressing against the surface of the operating room bed for a long surgery. Which of these other factors may also produce pressure? - Correct Answers ✅A self- retianing retractor post clamped to the OR bed rail and tightened against the patient's side. Prolonged lithotomy positioning can result in neuropathies of the legs. The most frequently injured nerves are the obturator, sciatic, femoral, and __________nerve, which can result in injury from _________. - Correct Answers ✅common peroneal; full leg pneumatic compression sleeves While tucking the arms at the sides of the patient in supine position offers comfort, safety, and easy access to the patient by the scrubbed team, improper positioning and securing of the arms can result in significant injury. Injury can be avoided by tucking the draw sheet ___________ the arm and under the ____________. - Correct Answers ✅around; body NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 While Fowler's position offers the best respiratory excursion for the patient, the patient is at higher rick for _________ because of dependent pooling in the hips and legs. - Correct Answers ✅venous thromboembolism (VTE) Positioning devices should be used according to the original equipment manufacturer's instructions to reduce the capillary interface pressure to below: - Correct Answers ✅32 mm Hg A frail and thin 91-pound, 83-year-old woman is scheduled for a right pneumonectomy for non-small cell lung cancer. She will be positioned in left lateral position for her procedure. Based on the perioperative nurse's preoperative assessment, identify three position-related nursing diagnoses for this procedure and four relevant nursing interventions. Select from the options to fill in the blanks. - Correct Answers ✅Hypothermia; impaired skin integrity; falls; remain at patient's side during induction; use under- and over-body forced air warming blanket; use at least four people to assist with lift and transfer; pad all bony prominences with foam or gel pads. The lateral kidney position allows approach to the retro-peritoneal area of the flank. To render the kidney region readily accessible, the _________________ is raised, and the bed flexed so that the area between the twelfth rib and the iliac crest is elevated. Compression of NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 the ________________ can occur when the flank is raised too high. - Correct Answers ✅kidney bridge; vena cava A veteran perioperative nurse remembers a time when all suture needles had eyes, and she even had her own needle rack. She hand- threaded all sutures according to the surgeon's preference. The newer sutures were originally called "atraumatic" sutures because they did not double back through a needle eye and cause tissue trauma during pulling or suturing through the tissue. Today, we call this manufacturing process of connecting the suture thread to the needle: - Correct Answers ✅swaged The ideal suture material is one that has handling characteristics such as: - Correct Answers ✅ease of tying Careful counting (according to established policy), situational awareness, and conscientious and meticulous attention to the field are believed to prevent miscounts and lost items. A recent patient safety statement about preventing retained foreign objects recommends which of these practices? - Correct Answers ✅Verbal handoff must include count status at time of relief. An older surgeon explains his justification for this suture choice to the new perioperative nurse in the scrub role. He prefers to suture his intestinal anastomosis with a suture that has multiple filaments braided together because it ties well and holds the knot, which tightens when NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 a physical barrier used in the prevention of adhesions that can take up to 2 weeks to absorb - Correct Answers ✅Interseed Tissue reaction characteristics that need considered when choosing suture include - Correct Answers ✅Absorption The diagnostic test that is performed to differentiate between acute and chronic thrombosis - Correct Answers ✅Digital subtraction angiography Morbidity and mortality may be greater with penetrating trauma because identification of injuries may be more difficult when injuries are less obvious. In the case of an adult victim with a low-velocity, low- caliber gunshot wound, at far range, of the anterior left quadrant of the lower abdomen, what is the MOI and description of the possible injuries - Correct Answers ✅enetrating; small entrance wound, puncture of the anterior wall of the sigmoid colon, no disruption of vessels, and bullet not found in pelvis With injury to the brain, swelling may occur quickly, requiring aggressive decisions to manage increasing intracranial pressure (ICP). What is an appropriate diuretic medication to give and what nursing actions would be indicated for an older adult patient with traumatic brain injury, increased ICP, and a history of congestive heart failure NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 (CHF) - Correct Answers ✅Furosemide (Lasix) 20-80 mg IV; monitor for hypotension and note extent of diuresis 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 Answers ✅Unknown substances may be present in these products. a possible benefit to the paramedian incision - Correct Answers ✅decreased risk for hernia An example of an indication for liver transplantation would be - Correct Answers ✅primary hepatic cancer he largest part of the mammary gland rests on the - Correct Answers ✅Pectoralis major muscle and serratus anterior During ventriculoperitoneal shunt placement, - Correct Answers ✅The unit is soaked in NS & antibiotic solution, never lubricated. Patients with chronic venous insufficiency (CVI) are not typically treated surgically as often as patients with arterial disease because: - Correct Answers ✅CVI is not life-threatening or limb-threatening NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 35% of the refractive power of the eye is credited to which part of the eye - Correct Answers ✅Lens Oculocardiac reflex (OCR) is an intraoperative emergency that can occur during eye surgery. Select the definition of the response and contributing factor(s) - Correct Answers ✅Trigeminal-vagal response caused by pressure on the globe or retrobulbar block The perioperative nurse must be prepared for which additional procedure when head and neck surgery is performed? - Correct Answers ✅Tracheostomy The perioperative nurse preparing for a procedure where STSGs will be taken to cover several large burn areas will need to have available: - Correct Answers ✅sterile mineral oil, tongue blades, and a mesher dermatome the correct term to describe the inward turning of one or both eyes - Correct Answers ✅Esotropia The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the - Correct Answers ✅Superior hypogastric plexus NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 Identify the class of medications that can increase the risk or severity of a reaction to contrast media - Correct Answers ✅Beta Blockers The recommended length of time for inflation of an upper extremity tourniquet on a patient under 50 years old is_______while the recommended pressure is _____. - Correct Answers ✅1 hour; 250- 300 mmHg continuous tourniquet pressure less than 1 hour on the upper extremity and less than 2 hours on the thigh. Tourniquet pressure should not exceed the recommended maximum cuff pressure limits of 300 to 350 mm Hg for the thigh and 250 to 300 mm Hg for the arm and the lower leg. the statement that reflects a true special consideration for skin preparation before facial surgery. - Correct Answers ✅Leave the eyebrows and eyelashes intact to preserve facial appearance and expression. A minimally invasive video-assisted thyroidectomy (MIVAT) procedure relies on Miccoli instruments added to the standard thyroid or neck dissection setup, a 30-degree endoscope, and an ultrasonic (harmonic) scalpel with scissors to ligate and divide the vessels. An important risk reduction strategy for any minimally invasive procedure would be - Correct Answers ✅consider and plan for the possibility of conversion to open thyroidectomy NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 he external ear, which includes the auricle (or pinna) and external auditory canal, is composed of cartilage covered with skin. The primary function of the auricle is to - Correct Answers ✅concentrate and conduct incoming sound waves into the external auditory canal. Describe the internal inguinal ring - Correct Answers ✅Structures that traverse the inguinal canal enter it from the abdomen by the internal ring, a natural opening in the transversalis fascia The perioperative nurse should plan to remain close to the elderly patient during induction because - Correct Answers ✅Airway anatomy changes in the elderly The child inhales the favorite flavor while drifting off to sleep. This complementary therapy falls within the category of: - Correct Answers ✅clinical aromatherapy Which of the following sulci is of particular anatomic importance during surgery? - Correct Answers ✅Two sulci of particular anatomic importance during surgery are: (1) the lateral sulcus, or sylvian fissure, which divides the temporal lobe from the frontal and parietal lobes, and (2) the central sulcus, or fissure of Rolando, which separates the frontal from the parietal lobe NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 Which of the following associations is incorrect pertaining to the blood supply of the brain - Correct Answers ✅Vertebral arteries --- supplies the occipital lobe TURP syndrome is often seen during the intraoperative period. Signs and symptoms exhibited by patients include - Correct Answers ✅restlessness, apprehension, irritability, confusion, nausea, slow pulse rate, seizures, dysrhythmias, and rising blood pressure may be suggestive of TURP syndrome, he blood is oxygenated in the lungs and returns to the left atrium through the pulmonary veins. Where does the blood flow after leaving the left atrium - Correct Answers ✅Through the mitral valve into the left ventricle Which of the following is not contained within the anterior mediastinum - Correct Answers ✅Great Vessels Definitive information about the extent and location of ischemic heart disease can be obtained from which of the following tests - Correct Answers ✅Cardiac catherization An interventional radiology procedure used to open a blocked or narrowed blood vessel as a result of atherosclerosis - Correct Answers ✅Percutaneous transluminal angioplasty NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 Pressure against the skin above ____mm hg interferes with tissue perfusion - Correct Answers ✅32 Latex allergy reaction is best prevented by - Correct Answers ✅limiting exposure to latex On postoperative day 2, a patient developed edema, redness, and purulent exudate that appeared to be isolated to the subcutaneous plane above the sternum. What important criteria must be met to conclusively define this as surgical site infection (SSI)? - Correct Answers ✅Positive diagnosis of the SSI by the surgeon or attending physician Suture can be used for more than repairing tissue. - Correct Answers ✅ligate, suture, and close tissue. Which of the following absorbable suture has the best tensile strength - Correct Answers ✅Polydioxanone The light transmission through an endoscope is achieved by way of - Correct Answers ✅bundles of fiberoptic glass rods Precautions apply to blood, all body fluids, secretions, and excretions (except sweat), regardless of whether they contain visible blood, NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 mucous membranes, and nonintact skin. - Correct Answers ✅Standard On extubation, Daniel presented with coughing, wheezing, dyspnea, use of accessory muscles, and tachypnea. Daniel is presenting with _______ probably caused by _______. - Correct Answers ✅bronchospasm; aspiration The tensile strength of lactic & glycolic acid polymers is sufficient for approximation of tissues for _____ weeks. - Correct Answers ✅2-3 New synthetic polymers such as PDS provide wound support up to _____ months - Correct Answers ✅3 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 - Correct Answers ✅Avoid placing specimens for frozen section in formalin. Terminal cleaning and disinfection of the operating room should be done - Correct Answers ✅daily when the areas are being used NIFA STUDY GUIDE EXAM QUESTION & ANSWERS 2024 A needletype frequently used in microsurgery is - Correct Answers ✅cutting taper