NIFA STUDY GUIDE LATEST UPDATE 2024-2025 WITH 121 QUESTIONS AND VERIFIED CORRECT ANSWERS, Exams of Nursing

Download NIFA STUDY GUIDE LATEST UPDATE 2024-2025 WITH 121 QUESTIONS AND VERIFIED CORRECT ANSWERS and more Exams Nursing in PDF only on Docsity! 1 NIFA STUDY GUIDE LATEST UPDATE 2024-2025 WITH 121 QUESTIONS AND VERIFIED CORRECT ANSWERS GUARANTEED 100% SCORE RATE should be the primary decision makers for what equipment and supplies are purchased and stocked in the difficult airway management cart. - CORRECT ANSWER: Anesthesia personnel 35% of the refractive power of the eye is credited to which part of the eye - CORRECT ANSWER: Lens 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 ANSWER: Anthrax and smallpox A 68-year-old, American Society of Anesthesiologists (ASA) physical status (OS)-2 male with early-stage prostatic cancer, was intubated and positioned for a robotic- assisted laparoscopic radical prostatectomy. The initial position for insertion of the trocars was supine with arms tucked and secured within under-mattress sled arm positioners padded with gel. His hands were placed in a natural position with the fingers wrapped around gauze rolls and touching his lateral thighs. The new anesthesia provider, who had never seen a robotic prostatectomy, was concerned about anesthesia implications when the patient would be repositioned into extreme Trendelenburg for the dissection and anastomosis. The circulating nurse assured her that they would implement protective measures and work together to ensure the best patient outcome. Select all of the potentially harmful effects of extreme 45-degree Trendelenburg in a robotic pr - CORRECT ANSWER: 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 ANSWER: A self-retianing retractor post clamped to the OR bed rail and tightened against the patient's side. 2 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 ANSWER: PSDA and advance directives 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 ANSWER: 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. 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 ANSWER: consider and plan for the possibility of conversion to open thyroidectomy A needletype frequently used in microsurgery is - CORRECT ANSWER: cutting taper 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 ANSWER: Announce the transfer of each sharp before placing it in the neutral zone. A patient undergoing a laparoscopic Nissen fundoplication procedure will be positioned in both high and low lithotomy during the procedure. After the patient is re-positioned into lo lithotomy, the perioperative nurse should: - CORRECT ANSWER: reassess the patient for body alignment, tissue integrity, and pressure areas. 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 5 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 ANSWER: "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. 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 ANSWER: 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. Flat neurosurgical patties are flat sponges composed of soft compressed cotton or rayon with an embedded radiopaque element and string attached. They are often used in neurosurgical procedures. While used for hemostasis and exposure, what other use would be important in surgery? - CORRECT ANSWER: Application of topical steroids 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 ANSWER: Through the mitral valve into the left ventricle 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 ANSWER: concentrate and conduct incoming sound waves into the external auditory canal. he largest part of the mammary gland rests on the - CORRECT ANSWER: Pectoralis major muscle and serratus anterior Identify the class of medications that can increase the risk or severity of a reaction to contrast media - CORRECT ANSWER: Beta Blockers If a staff person receives a needlestick injury, what is the first corrective action? - CORRECT ANSWER: Wash wound with soap and water; flush mucous membranes. 6 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 ANSWER: Replacing or tagging sponges and laparotomy instruments with radiofrequency identification (RFID) chips Latex allergy reaction is best prevented by - CORRECT ANSWER: limiting exposure to latex Miotics and mydriatics produce opposite effects on the pupil of the eye. Select the most appropriate statement about miotic and mydriatic drugs - CORRECT ANSWER: Mydriatic drugs, such as phenylephrine, dilate the pupil. 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 ANSWER: enetrating; small entrance wound, puncture of the anterior wall of the sigmoid colon, no disruption of vessels, and bullet not found in pelvis New synthetic polymers such as PDS provide wound support up to months - CORRECT ANSWER: 3 Oculocardiac reflex (OCR) is an intraoperative emergency that can occur during eye surgery. Select the definition of the response and contributing factor(s) - CORRECT ANSWER: Trigeminal-vagal response caused by pressure on the globe or retrobulbar block On extubation, Daniel presented with coughing, wheezing, dyspnea, use of accessory muscles, and tachypnea. Daniel is presenting with probably caused by . - CORRECT ANSWER: bronchospasm; aspiration 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 ANSWER: Positive diagnosis of the SSI by the surgeon or attending physician Patients with chronic venous insufficiency (CVI) are not typically treated surgically as often as patients with arterial disease because: - CORRECT ANSWER: CVI is not life- threatening or limb-threatening Peri-operative hypothermia is an important issue for all anesthetized patients because of all of the following EXCEPT: - CORRECT ANSWER: Increases risk of renal failure 7 Pericardial tamponade includes which of the following signs or symptoms - CORRECT ANSWER: Narrow pulse pressure Positioning devices should be used according to the original equipment manufacturer's instructions to reduce the capillary interface pressure to below: - CORRECT ANSWER: 32 mm Hg Precautions apply to blood, all body fluids, secretions, and excretions (except sweat), regardless of whether they contain visible blood, mucous membranes, and nonintact skin. - CORRECT ANSWER: Standard Pressure against the skin above mm hg interferes with tissue perfusion - CORRECT ANSWER: 32 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 ANSWER: Perform a weekly fire risk assessment Primary divisions of a nerve are known as - CORRECT ANSWER: Rami 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 ANSWER: common peroneal; full leg pneumatic compression sleeves 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 ANSWER: Avoid placing specimens for frozen section in formalin. Proper specimen management techniques prevent errors and include all of the following EXCEPT: - CORRECT ANSWER: Receiving specimens from the surgical field then affixing patient label to each Pt with hepatobiliary disease, The perioperative nurse, during the preoperative assessment, questions and examines the patient for signs and symptoms of jaundice, petechiae, and lethargy and: - CORRECT ANSWER: review chart for bleeding and coagulation times and the platelet count. Qualities of an effective packaging material must include several key characteristics. Select the three most important qualities. - CORRECT ANSWER: Good steam penetration and removal, good microbial barrier, aseptic presentation. 10 CORRECT ANSWER: mitigated through . - in this sentence: The risk of the surgical hazard of can be 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 wrong patient, wrong site, and wrong side surgery; site marking and presurgical checklists The perioperative nurse must be prepared for which additional procedure when head and neck surgery is performed? - CORRECT ANSWER: 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 ANSWER: sterile mineral oil, tongue blades, and a mesher dermatome The perioperative nurse should plan to remain close to the elderly patient during induction because - CORRECT ANSWER: Airway anatomy changes in the elderly The potential for development of a direct inguinal hernia is - CORRECT ANSWER: When a weakening or a tear in the aponeurosis of the transversus abdominis and the transversalis fascia occurs, The primary use for suture is essentially to: - CORRECT ANSWER: ligate, suture, and close tissue. 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 ANSWER: 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 semi-invasive diagnostic test that illustrates heart wall motion and blood flow through the heart and quantifies cardiac function - CORRECT ANSWER: Radionuclide imaging the statement that reflects a true special consideration for skin preparation before facial surgery. - CORRECT ANSWER: Leave the eyebrows and eyelashes intact to preserve facial appearance and expression. the surgeon makes an incision through which of the following to access the cremaster muscle, inguinal canal, and cord structures - CORRECT ANSWER: External oblique muscle The tensile strength of lactic & glycolic acid polymers is sufficient for approximation of tissues for weeks. - CORRECT ANSWER: 2-3 11 There are several risk factors associated with dehiscence. Which of the following can be controlled by the RNFA - CORRECT ANSWER: Sutures placed too close together Tissue reaction characteristics that need considered when choosing suture include - CORRECT ANSWER: Absorption 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 ANSWER: 157 lbs TURP syndrome is often seen during the intraoperative period. Signs and symptoms exhibited by patients include - CORRECT ANSWER: restlessness, apprehension, irritability, confusion, nausea, slow pulse rate, seizures, dysrhythmias, and rising blood pressure may be suggestive of TURP syndrome, Vascular access in pediatric patients may be established intraoperatively for short-term (weeks) or long-term (months, years) use - CORRECT ANSWER: Central venous line 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 ANSWER: Keep a running total blood loss calculated from available sponges during procedure What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp - CORRECT ANSWER: Subgaleal space When a thyroglossal duct cyst is present in an adult, it exists as a pretracheal cystic pouch attached to what structure - CORRECT ANSWER: Hyoid Which list of medications best reflects medications indicated for latex sensitivity therapeutic management? - CORRECT ANSWER: Epinephrine, prednisone, and a beta-agonist inhaler Which of the following absorbable suture has the best tensile strength - CORRECT ANSWER: Polydioxanone Which of the following associations is incorrect pertaining to the blood supply of the brain - CORRECT ANSWER: Vertebral arteries --- supplies the occipital lobe Which of the following is an important statement regarding the prevention of degenerative orthopedic conditions - CORRECT ANSWER: Weight-bearing activities and joint movement prevent cartilage from becoming thin or damaged Which of the following is an indication for damage control surgery - CORRECT ANSWER: Indications for the potential need for damage control surgery include 12 hemodynamic instability, hemorrhagic shock, coagulopathy, hypotension, tachycardia, tachypnea, inaccessible major anatomic injury, concomitant major injury, and altered mental status Which of the following is not contained within the anterior mediastinum - CORRECT ANSWER: Great Vessels Which of the following may be a consequence of high-dose or full-body radiation? - CORRECT ANSWER: Nausea, vomiting, and diarrhea Which of the following sulci is of particular anatomic importance during surgery? - CORRECT ANSWER: 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 Which statement regarding level III and level IV trauma centers best describes the difference between the two types of centers - CORRECT ANSWER: A level III trauma center provides advanced cardiac life support (ACLS), surgery, stabilization, and transfer, while a level IV only provides ACLS services before immediate transfer to a higher level center which surgical approach reduces the morbidity and mortality in removal of an acoustic tumor - CORRECT ANSWER: Translabyrinthine approach Which two similar hernia repair approaches reestablish the integrity of the transversalis fascia and simultaneously reestablish and strengthen the posterior inguinal floor by sewing the transversalis fascia to the Poupart ligament? - CORRECT ANSWER: The McVay or the Cooper ligament repair 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 ANSWER: Antibiotics given intravenously within 1 hour of the incision for every procedure with an incision or entered body system. 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 ANSWER: venous thromboembolism (VTE) 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 ANSWER: around; body CORRECT draw sheet the arm and under the . -