RNFA

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. Select the appropriate communication that the circulating nurse must employ in addressing the entire team during this count discrepancy.

"We have a count discrepancy. We started with 70 sponges and find only 68. We are missing 2 lap sponges."

The surgeon used the ESU in monopolar 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 nurse to increase the cut and coagulation modes on the ESU. What measure could the scrub person take to enhance energy delivery?

Clean the charred tissue from the active electrode blade

What is the appropriate action if the doctor is delayed after the room and instruments have been opened?

Cover the instruments with a sterile drape and have the scrub nurse continually visually observe the room for breaches in sterility

Which of the following absorbable suture has the best tensile strength?

Polydioxanone

Which of the following is correct regarding the chromium salt coating on surgical gut suture?

Should be rinsed from the suture before use in eye cases

Which statement about surgical dressings is true?

Surgical dressings cushion and protect the wound from trauma and gross contamination, and absorb drainage

In several studies, it was determined that the risk of contamination and subsequent infection to the wearer can be reduced by wearing two pairs of sterile surgical gloves, as opposed to wearing one pair. Select the correct statement that refers to double gloving in terms of a best practice.

The American College of Surgeons endorses double gloving for all surgery and invasive procedures.

What one factor describes the high incidence of musculoskeletal disorders among surgical technologists and perioperative nurses?

The cumulative effect of repeated patient handling events.

The first case of the day is scheduled as a knee arthroscopy for an otherwise healthy 24 year old patient. Upon pre assessment, the patient admits to a family history of anesthesia and surgical complications. Patient also states last oral intake consisted of eating a cheese steak and drinking 2 cans of beer the night before at 11:30 PM. The patient subsequently vomited when intubation was performed and experienced respiratory distress upon extubation. What measure could have been taken by the team to prevent aspiration based on the patient's history?

The perioperative nurse applying cricoid pressure during induction through intubation

While Fowler's position offers the best respiratory excursion for the patient, the patient is at higher risk for _______ because of dependent pooling in the hips and legs.

Venous thrombosis

To protect the forearms, hands, and clothing from contacting bacteria on the outside of the used gown and gloves, members of the scrubbed surgical team should use the following procedure to remove soiled gowns and gloves. Which choice lists the appropriate first 3 steps in the removal of the sterile gown?

Wipe gloves clean, untie side gown closure, grasp gown at one shoulder seam

Albert Janson, a 325-pound patient, is scheduled for a 6-hour abdominal surgery. While assessing Mr. Jennings 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 OR bed for a long surgery. Which of the following factors might the RNFA recognize as having the potential to produce pressure?

a self-retaining retractor post clamped to the OR bed rail and tightened against the patient's side

The linea alba is extends from ______to _________.

above xiphoid to pubis

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.

avoid placing specimen in formalin

Due to the BMI of the patient, the case you are participating in was converted to open laparotomy. Your surgeon is uncertain as to which self retaining retractor is available within the facility. From the following, which is an appropriate suggestion?

bookwalter

Your patient had an episode of vomiting during anesthesia induction and was effectively suctioned by anesthesia. Upon extubation, the patient presented with coughing, wheezing, dyspnea, use of accessory muscles, and tachypnea. What is this patient most likely experiencing?

bronchospasm

Sources of radiation exposure in the OR include:

c arm fluoro

From the following, choose the correct statement regarding closed gloving.

closed gloving only for initial gowning

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 ______.

common peroneal; Direct compression from the stirrup bars

Malignant Hyperthermia (MH) is a rare, multifaceted syndrome with an increased incidence in individuals that exhibit which of the following?

congenital myopathies

When creating a vascular or intestinal anastomosis, the surgeon will typically suture one half of the anastomosis with one half of the suture and the other half of the anastomosis with the other half of the suture. This technique minimizes the drag and wear on the suture material and needle. The correct name for this type of suture and needle is:

double-armed

Risk factors for PONV should be assessed preoperatively. Which of the following is a risk factor for PONV?

female

It is important to assess pressure points when positioning a patient prone. Which of the following are included in this assessment to prevent pressure injury?

genitals, knees, toes, and eyes

Which of the following lists the correct order in the removal of soiled sterile attire when breaking scrub?

gown gloves mask

High-pressure insufflation rates can cause overpressurization of the intra-abdominal cavity. This overpressurization can lead to which of the following?

hypercarbaria

The OR was trialling a new insufflation system and the vendor representative was out of the room taking a phone call. The perioperative nurse was concerned that the flow rate was well above 14 L/min and the pressure had risen to 16 mm Hg. She alerted the surgeon and reduced the rate and pressure because she feared that the elderly patient was at high risk for:

hypercarbia

_____________ is a side effect that can occur rapidly after spinal anesthesia is administered.

hypotensive episode

Which statement best explains the mechanism of action of general anesthetic agents?

inhibition of synaptic transmission of nerve impulse

The intracorporeal suture technique uses the suture-tying process analogous to the:

instrument tie

A stitch that is placed and tied before placing another stitch is called _____.

interrupted

Select the positioning device commonly used for positioning the head during procedures such as craniotomies.

mayfield head positioner

Which of the following is not a characteristic of silk suture? a. Soft b. handling ability c. knot security d. memory

memory

A 19-year-old male received an intravenous peripheral nerve block for an ORIF of an ankle fracture. The anesthesia provider injected a distal dorsal vein of the patient'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?

metallic taste in mouth

From the following, choose the type of anesthesia that will allow patients to tolerate potentially uncomfortable procedures while maintaining their own airway and be easily aroused from light sleep.

moderate sedation

Which of the following statements reflects the location of the arcuate line?

one third distance from umbilicus to symphysis pubis

The immature blood-brain barrier and decreased protein binding in infants increase their sensitivity to which group of medications?

opioids, hypnotics

The most accurate method for routine post operative temperature monitoring is via:

oral

Guidelines from WHO focus on which of the following in the prevention of surgical site infections?

prophylactic antibiotics

A type of suture to help eliminate tension on the primary suture line is known as:

retention

Which of the following needles are most likely to be chosen for skin closure?

reverse cutting

Hypothermia has been shown to be a factor that may place the surgical patient at risk for infection and delayed healing. Select the intervention that is an engineered control factor to protect the patient from hypothermia.

set ambient temp 68-73

Which of the following patients would be most likely to have a latex allergy?

spina bifida patient

The instillation of a local anesthetic into the subarachnoid space is termed:

spinal anesthesia

Which of the following medications is a specific depolarizing muscle relaxant than can produce generalized fasciculations?

succinylcholine

Suture permanently attached to the needle are referred to as____________.

swaged

Successful employment of the time-out can only be ensured when:

the entire team stops and focuses attention together

There are many factors that influence surgical wound healing. Some are helpful and some are beyond the scope of the surgical team. Select the response below that reflects a factor with high influence over wound healing and is within the control of the surgical team.

tissue handling

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 ________.

total spinal anesthesia; general endotracheal anesthesia

Skin injuries related to shearing occur most commonly as a result of which of the following positions?

trendelenberg

The scrub person was precepting a surgical technology student an orthopedic case. The scrub person explained the importance of keeping the instruments free of blood and bioburden during the procedure and demonstrated the best practice and how to:

wipe the instruments with a sponge moistened with sterile water after each use.