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NIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS , Exams of Nursing

NIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATENIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATENIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATENIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATENIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATE

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Download NIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS and more Exams Nursing in PDF only on Docsity! 1 | P a g e NIFA FINAL EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATE A percutaneous method of instituting femoral vein-femoral artery cardiopulmonary bypass (CPB) can be used for minimally invasive (or conventional open) procedures and in emergency situations where the environment is not conducive to traditional CPB methods. Select the areas where percutaneous CPB would be indicated Cardiac catheterization unit and intensive care unit 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? The McVay or the Cooper ligament repair Identify the class of medications that can increase the risk or severity of a reaction to contrast media 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 _____. 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. 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 2 | P a g e consider and plan for the possibility of conversion to open thyroidectomy 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 concentrate and conduct incoming sound waves into the external auditory canal. Describe the internal inguinal ring 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 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: clinical aromatherapy Which of the following sulci is of particular anatomic importance during surgery? 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 of the following associations is incorrect pertaining to the blood supply of the brain Vertebral arteries --- supplies the occipital lobe TURP syndrome is often seen during the intraoperative period. Signs and symptoms exhibited by patients include 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 Through the mitral valve into the left ventricle Which of the following is not contained within the anterior mediastinum Great Vessels Definitive information about the extent and location of ischemic heart disease can be obtained from which of the following tests Cardiac catherization An interventional radiology procedure used to open a blocked or narrowed blood vessel as a result of atherosclerosis 5 | P a g e Terminal cleaning and disinfection of the operating room should be done daily when the areas are being used A needletype frequently used in microsurgery is cutting taper The number one patient safety issue identified in a survey of peri-operative nurses is preventing: Wrong site/procedure/patient surgery Reprocessing (flashing) instruments in the OR is high risk because: 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: 157 lbs _______________ should be the primary decision makers for what equipment and supplies are purchased and stocked in the difficult airway management cart. Anesthesia personnel Proper specimen management techniques prevent errors and include all of the following EXCEPT: 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: Perform a weekly fire risk assessment Peri-operative hypothermia is an important issue for all anesthetized patients because of all of the following EXCEPT: Increases risk of renal failure Recommendations for preventing retained surgical items include all of the following EXCEPT: Utilizing a multidisciplinary team to resolve incorrect counts Select the appropriate order for administering blood and blood products. 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. Keep a running total blood loss calculated from available sponges during procedure 6 | P a g e 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? 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? 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: 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. "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 _______________________. wrong patient, wrong site, and wrong side surgery; site marking and presurgical checklists A patient was transferred to the postanesthesia care unit (PACU) by the anesthesia provider and perioperative nurse. A hand-off report was given, using situation, background, assessment, recommendation (SBAR) format, to the accepting PACU nurse. The first element of information that should be presented in the hand-off report is: patient identification and procedure performed. 7 | P a g e If a staff person receives a needlestick injury, what is the first corrective action? 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? Seasonal influenza Select the appropriate nursing action that supports hands-free instrument passing and sharps safety. 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. 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? Announce the transfer of each sharp before placing it in the neutral zone. Which of the following may be a consequence of high-dose or full-body radiation? 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? 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? Epinephrine, prednisone, and a beta-agonist inhaler 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. Antibiotics given intravenously within 1 hour of the incision for every procedure with an incision or entered body system. 10 | P a g e 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. 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 the ________________ can occur when the flank is raised too high. 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: swaged The ideal suture material is one that has handling characteristics such as: 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? 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 the thread absorbs the tissue fluids. He also needs a strand that is easy to see and only needs to retain its tensile strength for about 1 year, at which time the intestinal junction will be healed, even though this suture is considered nonabsorbable. He will ask the nurse for a 24-inch 4-0: Sofsilk 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? Application of topical steroids the circulating nurse received the trauma call from the emergency department (ED) and called sterile supply to assemble the instruments for an abdominal trauma case with possible aortic rupture. When the cart arrived, she saw the vascular set; however , the most important set was missing. What important instrument set was needed for this procedure besides the vascular set? 11 | P a g e Basic laparotomy set The primary use for suture is essentially to: ligate, suture, and close tissue. Wound tissue healing is enhanced by the use of stapling instruments that mechanically apply internal staples for ligation and division, resection, and anastomoses. What feature of the mechanical process reduces tissue manipulation, edema, and inflammation? The non-crushing B shape of the staples allows nutrients to pass through. According to a 2010 article published in The Journal of the American College of Surgeons and citing data from a 1998 study, where do more that half of needle-stick injuries involving suture needles occur? During the suturing of fascia or muscle tissue The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the Superior hypogastric plexus Which of the following is an important statement regarding the prevention of degenerative orthopedic conditions Weight-bearing activities and joint movement prevent cartilage from becoming thin or damaged The cerebellar tentorium supports which structures of the cerebral hemispheres Temporal lobe the surgeon makes an incision through which of the following to access the cremaster muscle, inguinal canal, and cord structures External oblique muscle a physical barrier used in the prevention of adhesions that can take up to 2 weeks to absorb Interseed Tissue reaction characteristics that need considered when choosing suture include Absorption The diagnostic test that is performed to differentiate between acute and chronic thrombosis 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 12 | P a g e 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 (CHF) 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 Unknown substances may be present in these products. a possible benefit to the paramedian incision decreased risk for hernia An example of an indication for liver transplantation would be primary hepatic cancer he largest part of the mammary gland rests on the Pectoralis major muscle and serratus anterior During ventriculoperitoneal shunt placement, 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: CVI is not life-threatening or limb-threatening 35% of the refractive power of the eye is credited to which part of the eye Lens Oculocardiac reflex (OCR) is an intraoperative emergency that can occur during eye surgery. Select the definition of the response and contributing factor(s) 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? Tracheostomy 15 | P a g e Unknown substances may be present in these products. a possible benefit to the paramedian incision decreased risk for hernia An example of an indication for liver transplantation would be primary hepatic cancer he largest part of the mammary gland rests on the Pectoralis major muscle and serratus anterior During ventriculoperitoneal shunt placement, 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: CVI is not life-threatening or limb-threatening 35% of the refractive power of the eye is credited to which part of the eye Lens Oculocardiac reflex (OCR) is an intraoperative emergency that can occur during eye surgery. Select the definition of the response and contributing factor(s) 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? Tracheostomy The perioperative nurse preparing for a procedure where STSGs will be taken to cover several large burn areas will need to have available: sterile mineral oil, tongue blades, and a mesher dermatome the correct term to describe the inward turning of one or both eyes Esotropia The nerve supply for the female pelvis comes from the autonomic nerves that enter the pelvis through the Superior hypogastric plexus 16 | P a g e which surgical approach reduces the morbidity and mortality in removal of an acoustic tumor Translabyrinthine approach 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: review chart for bleeding and coagulation times and the platelet count. The external ear canal lining reduces bacterial levels in the outer ear Miotics and mydriatics produce opposite effects on the pupil of the eye. Select the most appropriate statement about miotic and mydriatic drugs Mydriatic drugs, such as phenylephrine, dilate the pupil. Vascular access in pediatric patients may be established intraoperatively for short-term (weeks) or long- term (months, years) use Central venous line What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp Subgaleal space Pericardial tamponade includes which of the following signs or symptoms Narrow pulse pressure Which statement regarding level III and level IV trauma centers best describes the difference between the two types of centers 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 A percutaneous method of instituting femoral vein-femoral artery cardiopulmonary bypass (CPB) can be used for minimally invasive (or conventional open) procedures and in emergency situations where the environment is not conducive to traditional CPB methods. Select the areas where percutaneous CPB would be indicated Cardiac catheterization unit and intensive care unit 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? The McVay or the Cooper ligament repair Identify the class of medications that can increase the risk or severity of a reaction to contrast media Beta Blockers 17 | P a g e 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 _____. 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. 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 consider and plan for the possibility of conversion to open thyroidectomy 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 concentrate and conduct incoming sound waves into the external auditory canal. Describe the internal inguinal ring 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 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: clinical aromatherapy Which of the following sulci is of particular anatomic importance during surgery? 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 of the following associations is incorrect pertaining to the blood supply of the brain Vertebral arteries --- supplies the occipital lobe TURP syndrome is often seen during the intraoperative period. Signs and symptoms exhibited by patients include restlessness, apprehension, irritability, confusion, nausea, slow pulse rate, seizures, dysrhythmias, and rising blood pressure may be suggestive of TURP syndrome, 20 | P a g e Precautions apply to blood, all body fluids, secretions, and excretions (except sweat), regardless of whether they contain visible blood, mucous membranes, and nonintact skin. Standard On extubation, Daniel presented with coughing, wheezing, dyspnea, use of accessory muscles, and tachypnea. Daniel is presenting with _______ probably caused by _______. bronchospasm; aspiration The tensile strength of lactic & glycolic acid polymers is sufficient for approximation of tissues for _____ weeks. 2-3 New synthetic polymers such as PDS provide wound support up to _____ months 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 Avoid placing specimens for frozen section in formalin. Terminal cleaning and disinfection of the operating room should be done daily when the areas are being used A needletype frequently used in microsurgery is cutting taper what statements regarding vascular clamps are true? select all that apply a. vascular clamps are designed to partiall occlude blood flow. b. vascular clamps are designed to totally occlude blood flow. c. all vascular clamps are designed to hold vessels securely without trauma. what incision is used for lumbar laminectomy a. midline direcly over the appropriate lumbar spine Franklin hardy with mulitple moles skin lesions the perioperative nurse recognized his signs and symptoms of bupivicaine and lidocaine toxicity and began immediate treatment with airway support. when cathing a female patient the periop nurse must locate the urethra. mons pubis, labia majora, labia minora, clitoris, urethra, vaginal opening. tui nyugen 32 year old hysteroscopy patient. What patient safety info relevant to hysteroscopy should be given to the receiving relief nurse before break? 21 | P a g e a. a review of the amount of hyskon infused and fluid received back b. a reminder to monitor for discrepancies over 500ml which of the following is incorrect pertaining to the pancreas a. the superior mesenteric artery lies anterior to its neck. a number of screening tools have been developed for comprehensive geriatric assessment (CGA) d. indentifying at-risk individuals blunt force to the larnyz can result in fracture and impose immediate airway obstruction a. assist the anesthesia provider with securing the airway while applying cricoid pressure recommended long-term pain management in the elderly includes c. opoid analgesics (low potential for addiction) select the statement that most correctly matches a risk factor for adhesions with an appropriate preventitive strategy c. patients with endometriosis may be best served with a laparoscopic approach another name for the left colic flexure is splenic flexure which of the following is not typically visable in a PA chest radiograph a. the interventricular septum an exapmple of an indicaiton for liver transplantation would be d. primary hepatic cancer which of the following associations is correct e. pancreatic cancer-rarely metastasizes replantation is an attempt to reattach a completely amputated digit or other body part. good candidates for replantation are those with the following amputations a. almost any body part of a child what mechanisms do chest catheters and drainage systems use to remove fluid and air from the pleural cavity c. expiratory pressure and gravity study comparing tep and tapp techniques. b. mesh infection rate was low with both techniques d. there was no apparent difference in teh rate of hernia recurrence 22 | P a g e upon palpating the anterior abdominal wall of a patient you notice an intense reflexive muscular contraction in the abdominal muscles which is not correct> d. it is best observed when the patient is perfectly supine. this tissue is concerned with the formation of red blood cells c. red marrow during a lap chole, the scrub person inspects the integrity of the insulation along the shaft. what nursing outcome is expected. the patient will be free from: c. impaired skin integrity which of the following associations is incorrect c. left border of the heart-mainly left atrium the most likely reason for avascular necrosis in an 80 year old woman following a hip fracture is that the b. fracture split the neck of the femur longitudinally while not as prevalent as arthoplasty of the shoulder, knee or hip, total elbow replacement is indicated for patients with traumatic lesions or excessive bone loss from rheumatic or degenerative arthritis. It may be used with or without pmma depending on the quality of the d. Side plates, screws, and circumferential wires In the following illustration, the arrow points to the: a. left vagus nerve. Identify the marginal boundaries of the breasts c. Second to sixth rib and horizontally from the lateral edge of sternum to anterior axillary line Which of the following is not correct pertaining to the cavernous sinus? e. contains the mandibular division of the trigeminal nerve The science of plastic and reconstructive surgery, which means to mold or create form and shape, improves appearance and body image through an understanding of: b. the anatomy and biology of tissue Which of the following is incorrect for the cricoid cartilage? c. It is an attachment of the vocal ligaments 25 | P a g e b. demonstrate competence with equipment and check each piece carefully before the patient arrives in the OR. Herbal, orthomolecular, individual biologic therapies and special dietary treatments are encompassed in biologically based therapies. Which of the biologically based therapies listed below are classified as therapeutic nutrition? a. The diets of Drs. Atkins, Pritikin, and Weil Neuropathologic conditions requiring surgical intervention can be found in any age group. What are the most common problems requiring neurosurgical procedures in infants and children? d. All of the options are correct. When preparing an adult for flexible bronchoscopy, what patient considerations must the nurse keep in mind? d. all of the above Both ears provide stereophonic hearing that gives us very specific hearing capabilities. Binaural hearing makes it possible for: a. determination of the source location of sounds This orthopedic diagnosis is a complex deformity that is diagnosed prenatally through ultrasound or at birth. It may occur unilaterally or bilaterally and may be idiopathic or one in a combination of other syndromes with associated anomalies. The general characteristic for all cases includes inversion of the foot such that the anterior foot is located in the typical position of the posterior foot; often there is a deep crease in the midfoot. Select the orthopedic diagnosis. b. Clubfoot Denise Michaelson, a 46-year-old woman with an early-stage second primary cancer in her left breast, has elected to have a bilateral mastectomy with saline implants. She has requested that the surgeon also revise a small unsightly scar on her right knee and pierce her ears. While Denise's breast tumor could be treated with an excisional biopsy, she has decided to have a mastectomy of both breasts, which is considered an appropriate preemptive (preventative) surgery for a woman of her age with two primary cancers of the breast. The saline implant insertion surgery is considered a _______________ procedure, the scar revision is considered a ___________ procedure, and the ear piercing is considered a _______________ procedure. d. reconstructive, cosmetic and cosmetic Marvin Townsend is a 29-year-old man with paraplegia caused by spinal cord injury from a diving accident 4 years ago. He is transported into the trauma ED after being hit by a car as he was crossing the street in his wheelchair. He has a possible rupture of his liver and is scheduled for surgery. The perioperative nurse, on response to the trauma call, meets him in the ED to conduct a preoperative assessment and prepare for his procedure. Marvin tells the nurse that he is latex-sensitive because he 26 | P a g e was told that as a spinal cord injured person he should always be considered latex-allergic. An appropriate risk reduction strategy for Marvin's latex sensitivity/allergy would be to: b. alert the OR and postoperative recovery areas of his latex allergy, check the setup for latex-containing items, and replace those items with non-latex alternatives During the preoperative nursing assessment in the ambulatory surgery receiving unit, the nurse notices bruises and abrasions in various stages of healing on her patient's abdomen, arms, and breasts. In a quiet and respectful manner the nurse said, "The staff at our facility are concerned about your safety. We know that many things can happen in our lives that affect our mental and physical health." This technique is an appropriate method of establishing a sense of __________ with the patient while conveying caring and concern. b. normalizing Of the three salivary glands, which one is the largest? d. Parotid Jordan Gribbins, a 69-year-old pipe smoker with a history of cardiac disease and atrial rhythm disturbance, is scheduled for a supratentorial craniotomy and is securely positioned in a semisitting position. The perioperative nurse and anesthesia provider have discussed the anesthesia plan and Mr. Gribbin's surgical and anesthesia risks, and agree that he is at risk for venous air embolism (VAE). Sequential compression devices have been placed on both legs. Pulmonary lines have been placed and the nurse has prepared an area for preparation of TEE (transesophageal electrocardiography), if needed. During the procedure, Mr. Gribbins reacted with decreases in arterial pressure and end-tidal CO2. Precordial "washing machine" sounds emanated from the Doppler. What should the perioperative nurse anticipate as a possible next response? c. Reposition the patient in left lateral decubitus position to entrap air in the right atrium. Select the name of the procedure that the patient in the picture is positioned for c. Stereotactic brain biopsy Identify the dura fold that separates the right and left cerebral hemispheres. c. Falx cerebelli All of the following are true of the mediastinum except: ?b. it contains the lungs Specific malignant conditions that may require splenectomy include all EXCEPT _____. 27 | P a g e d. Carcinoma of left kidney Steven Morganstein, a 51-year-old male with hepatobiliary disease, is scheduled for surgery. The perioperative nurse, during the preoperative assessment, questions and examines the patient for signs and symptoms of jaundice, petechiae, and lethargy and: a. reviews his chart for bleeding and coagulation times and the platelet count Wilber Johnson, an 84-year-old retired musician of Jamaican descent, was seen by his family practice physician for urinary problems. His physician performed a digital rectal exam (DRE), which was abnormal, ordered a PSA, and referred him to a urologist. Wilber's PSA was 12 ng/ml. His transrectal prostatic biopsy was positive. The biopsy specimen determined a Gleason score of 10 and his AUA score was D2. Based on this clinical diagnostic information, what is the best surgical treatment plan for Wilber? d. No surgery. Wilber is not a candidate for surgery What type of drainage is placed in the common bile duct after a CBDE is performed? d. T-tube The 3-teniae coli converge at what point? b. The cecum at the base of the appendix What major artery supplies the descending colon? a. Inferior mesenteric Colles' (wrist) fracture is a dorsally angulated fracture of the distal end of the radius. Most of these fractures can be managed successfully with closed reduction and immobilization, but external fixation is especially useful in the case of a comminuted intra-articular fracture. Internal fixation with Kirschner wires (K wires) is indicated when the distal end of the radius is severely comminuted and displaced. Select the nursing considerations for a patient with a Colles' fracture fixation. b. Provide soft tissue instruments in OR and casting supplies available outside OR. The brainstem is located in the posterior fossa and forms the floor of the fourth ventricle. It is the site of many ascending and descending fiber tracts that allow for communication among the structures of the brain and between the brain and spinal cord. The brainstem consists of what three structures? b. Midbrain, pons, and medulla oblongata Which of the following associations pertaining to the dural venous sinuses is incorrect? a. arachnoid granulations—calcifications of arachnoid mater within the sinuses associated with arteriosclerosis The adrenal glands lie retroperitoneally beneath the diaphragm, capping the medial aspects of the superior pole of each kidney. The adrenal medulla secretes ______________ while the adrenal cortex secretes ____________ and ____________. 30 | P a g e Which of the following will the perioperative nurse be sure to have when setting up for a mediastinoscopy? c. suture and needle holders Which of the following is incorrect pertaining to the pattern of referred pain typically associated with angina pectoris? d. may be felt in left fingers An abdominal perineal resection, or APR, for a patient at high risk for colon cancer without anal/rectal involvement (e.g., familial adenopolyposis [FAP]) can be accomplished through an open laparotomy or laparoscopic-assisted ileoanal pull-through approach, per surgeon preference and appropriate patient selection. Which of these statements about approaches for APR is correct? c. Both procedures require only an abdominal skin incision(s) as the rectal segment is removed and anastomosed intraluminally While the pancreas' function is carbohydrate metabolism with the production of insulin and digestive enzymes, the spleen's function is primarily ___________ with the production of _______________. a. immunologic; leukocytes Which of the following is incorrect pertaining to the umbilicus? e. The umbilicus is in the L1 dermatome. Which of the following is incorrect pertaining to the CSF? a. It returns to the venous system by passing into the vertebral venous plexuses. The renal artery and vein enter and exit the kidney on the medial side of the organ through a concave area known as the: c. hilum. Marla, the perioperative nurse circulating for a skin contracture release of the ear on a 5-year-old boy, transfers 0.25% bupivacaine via syringe to the scrub person's sterile back table. The scrub person, Jake, questions why she is not giving him bupivacaine with epinephrine, since there may be bleeding expected at the incision site. Marla's reply to Jake is based on the fact that: a. epinephrine is contraindicated in areas with limited vascularity, such as the ears Osteomalacia is a metabolic bone disease characterized by inadequate mineralization of bone, which leads to a reduced absorption of calcium and phosphorus. This malabsorptive condition is due to a deficiency of ______________ that can be treated by __________________. b. vitamin D; dietary supplements and exposure to sunlight Local anesthesia, or monitored anesthesia care (MAC), is used for most ophthalmic surgery. The local anesthetic regimen, administered by the operative surgeon, is typically a combination of anesthesia 31 | P a g e delivery methods, or routes. Select the anesthetic plan that is administered by the surgeon before the start of surgery. b. Topical anesthetic eye drops, subconjunctival infiltration, and retrobulbar block The hepatorenal recess (Morison pouch): c. receives infected fluids draining from the omental bursa in the supine position Substituting a cryo-preserved cadaveric vein or an in situ or reversed vein graft from the patient for an arterial bypass graft is an option for patients who have healthy, easily accessed saphenous veins. How does an in situ vein graft differ from a reversed vein graft? b. The in situ method leaves the vein in its position and the valves are removed. When microlaryngoscopy is performed to remove polyps or nodules from the vocal cords, what important postoperative instruction must the nurse give the patient during discharge teaching? a. Complete voice rest is important Denise Michaelson had a scar revision of her knee performed along with her bilateral mastectomy with saline implants and ear piercing procedures. The knee scar, before revision, was an 8-cm linear, thin scar that extended obliquely across the anterior portion of her knee. The tension of the scar tissue met resistance when she would bend her knee. The surgeon opted to remove the scar with a procedure to break up the linear scar and rearrange the tissue direction to form a natural line. The proper name of this tissue transfer scar revision is the: d. Z-plasty. A cross section of the mid-shaft of the femur would appear _____. d. Triangular Marla Moriarity, a 32-year-old recently unemployed and uninsured college professor, is diagnosed with an early ectopic pregnancy. Her obstetrician has given her the option of surgical or medical therapy. She is well-informed about the details of each medical and surgical option, but her primary concern about her condition is that her decision will be based upon her strong cultural belief system that will not sanction the destruction of the fetus. Marla's treatment decision will most likely be: b. laparoscopic injection of methotrexate to the extrauterine gestational sac. The aortic root is located: a. At the junction of the origin of the ascending aorta and the left ventricle b. Psuedomonas Which of the following pathogens is both endogenous and exogenous? The RNFA should be prepared to assist with the ______________surgical procedure if a patient needs surgical intervention for the treatment of atrial fibrillation. Maze 32 | P a g e Inadvertent removal of the parathyroid glands may result in: Hypocalcemia Pfannensteil most commonly used incision for Cesarean section is the: inferior epigastric vessels located in the area of inguinal hernias Triangle of Calot Hepatic duct, cystic duct, and inferior edge of right lobe of the liver oblique elliptic incision lateral extension toward the axilla is made through the subcutaneous tissue fine needle aspiration of a suspicious breast mass The aspirate fluid is cytologically examined Mediastinum responsible for division between left and right chest cavity bruit flow is disrupted by an obstruction, stenosis, curve, or bifurcation, the particle motion first major branch of the internal carotid artery ophthalmic artery The right and left coronary arteries originate in the corresponding sinuses of Valsava which are located Posterior to the cusps of the aortic valve Aortic stenosis produces an obstruction to which of the following? left ventricular outflow Which of the following best describes Mohs' procedure? Used to treat basal and squamous cell carcinoma Vestibular Schwannoma (Acoustic Neuroma) major surgical lesion of the eighth nerve Vestibular Schwannoma (Acoustic Neuroma) benign tumor growing from the nerve sheath at its entrance into the internal auditory meatus. 35 | P a g e According to the AIM, aviation orange and white paint is always required for daytime marking on structures exceeding: A. 200 feet B. 400 feet C. 500 feet D. 1000 feet C. 500 Aim 2-2-3 Which of the following is NOT listed in the AIM as a weather condition that would cause a SPECI METAR to be issued? A. Visibility change from 4SM to 2SM B. Sky conditions change from OVC040 to BKN025 C. Wind shift from 100° at 15 knots to 180° D. Lightning strike 11SM from the airport D. Lightning strike 11SM from the airport One of the other pilots in the flying club lost their pilot certificate. They went to FAA Airmen Services website and received a document with temporary authority to exercise certificate privileges. How long would this be valid? A. 45 days B. 60 days C. 90 days D. 120 days B. 60 Days In Class E airspace, ADS-B Out is required at and above ___ excluding the airspace at and below 2,500' above the surface. Does this include Hawaii? A. 3000' MSL; Yes B. 5000' MSL; No C. 10,000' MSL; Yes D. 10,000' MSL; No C. 10,000' MSL; Yes According to the AIM, military pilots (VFR or IFR) within restricted or warning areas should use what transponder code? A. 1203 B. 4000 C. 1277 D. 7777 C. 1277 aside from the different scale, what else is shown on the Salt Lake City terminal area chart you are using that would not be on a Salt Lake City sectional chart? 36 | P a g e a. VFR waypoints b. IFR Routes and VFR Transition Routes c. Airport Data blocks include Control Tower operating hours d. National Security Areas b. IFR Routes and VFR Transition Routes Referencing the Chart Supplement for U42, what does the symbol mean at the end of the following airport remark? Attended 1400-0400Z‡ a. Times will be one hour earlier than shown during Daylight Savings Time b. Times will be one hour later than shown during Daylight Savings Time c. Daylight Savings Time corrections do not apply here d. Operating times apply on dates other than Daylight Savings Time a. Times will be one hour earlier than shown during Daylight Savings Time 15. East of VPCHS, there is an obstacle north of Magna at 4,543 MSL. What does the notation "UC" mean? a. The obstacle is under construction b. The obstacle height is unverified c. The obstacle is objectional d. The obstacle changes height a. The obstacle is under construction When is it recommended to monitor and communicate on KTVY's CTAF? a. Once you begin your descent b. 15 miles out c. 10 miles out d. 10 minutes out c. 10 miles out Aim 4-1-9 As you climb out of KTVY, your CFI starts to familiarize you with the onboard FIS-B products available in N9034T. What does FIS-B stand for? a. Flight Integrated System for Wind and Cloud-Broadcast b. Flight Information Services-Broadcast c. Future Intelligence System for Meteorology-Broadcast d. Future Routine Weather Reports-Broadcast b. Flight Information Services-Broadcast AIM 7-1-9 What is the update interval for TAF products utilizing FIS-B? a. 6 Hours (+-15 Minutes) b. 12 Hours (+-15 Minutes) c. 24 Hours (+-15 Minutes) d. As Available a. 6 Hours (+-15 Minutes) AIM TBL 7-1-2 37 | P a g e What does PEM stand for on the chart supplement for KHIF? a. Permeable b. Pilot emergency maneuver c. Part concrete, part asphalt d. Pilot elected maintenance c. Part concrete, part asphalt Overflying KSLC, you notice RWY 17 has a Runway Centerline Lighting System (RCLS). At what distance from the end of the runway does the RCLS transition to alternating white and red lights? a. 500 Feet b. 1,000 Feet c. 2,000 Feet d. 3,000 Feet d. 3,000 Feet 2-1-5 There is restricted area off to your left around Grayling. Who do you need to talk to if you wanted clearance through restricted airspace? a. You need to be on an active flight plan or flight following b. There are no restrictions for VFR aircraft c. You need permission from the controlling or using agency d. You are never permitted in restricted airspace c. You need permission from the controlling or using agency Traverse City is conducting LAHSO to crossing runways. What minimum weather should be present for ATC to issue LAHSO clearances? a. 5sm visibility and 3,000' ceiling b. 3sm visibility and 1,000' ceiling c. 1sm visibility d. No recommended minimums, whenever you accept it b. 3sm visibility and 1,000' ceiling That runway is much wider than you are used to! What is the tendency when landing on a runway wider than you are accustomed to? a. You will fly lower than normal b. You will fly higher than normal c. You will fly faster than normal d. You will fly slower than normal b. You will fly higher than normal His next question is why an airport has an "X" over it. What do you tell him? a. It is abandoned and depicted for landmark value or to prevent confusion with an adjacent landing area b. The landing area is available but warranting more than ordinary precaution due to lack of current 40 | P a g e You will land runway 01 at Talkeetna, as you line up on final, you see the following: 4 white bars. What does this tell you about where you currently are in relation to the glide path? a. You are on glide path b. You are below glide path c. You are above glide path d. Nothing, the PAPI/VASI is NOTAM'ed out c. You are above glide path As you consider that magnetic heading, you wonder if you're flying the right altitude. What are VFR cruise altitudes based on? a. True Course b. True Heading c. Magnetic Course d. Magnetic Heading c. Magnetic Course On your initial takeoff from ELO (Class Echo), what are your VFR weather minimums? a. 1 statute mile visibility, clear of clouds. b. 3 statute miles visibility, clear of clouds. c. 3 statute miles visibility, 500' below/1000' above/2000' horizontally from clouds. d. 5 statute miles visibility, 500' below/1000' above/2000' horizontally from clouds. c. 3 statute miles visibility, 500' below/1000' above/2000' horizontally from clouds. In cruise, your brother is glancing at your chart and notices the airport marked "Objectionable" to the south of your route. What does this indicate? a. The airport has hazardous runway conditions or obstacles near the runway. b. The airport name contains terms which may be considered offensive. c. The airport has unusual operating restrictions. d. There is no current information available about the condition of the airport. a. The airport has hazardous runway conditions or obstacles near the runway. As you begin your final approach to runway 4 [PAPI(P2L)], what lighting indication should you see if you are on the glide path? a. 2 white lights closer to the approach end of the runway, and 2 red lights a little further down the runway. b. 1 white light and 1 red light side by side. c. 2 white lights and 2 red lights side by side. d. None. b. 1 white light and 1 red light side by side. As you cross back into Minnesota, you notice the gray line labeled VR604 which intersects your route of flight. What should you do? a. Use extreme vigilance; there could be aircraft operating along that line in excess of 250 knots. 41 | P a g e b. Call Minneapolis Center on 127.9 for permission to cross the airspace boundary. c. Descend to an altitude below the floor of the Snoopy MOA. d. Nothing, aircraft operating in that area will be at very low altitudes. a. Use extreme vigilance; there could be aircraft operating along that line in excess of 250 knots. Thinking ahead, what are the VFR weather minimums to land at Murfreesboro airport (class G day <1,200 AGL?) a. 1sm visibility, clear of clouds b. 3sm visibility, clear of clouds c. 3sm visibility, 500' below, 1000' above, 2000' horizontally from clouds d. 5sm visibility, 1000' below, 1000' above, 1sm horizontally from clouds a. 1sm visibility, clear of clouds What would be required prior to entering KBNA's Class Charlie airspace? a. Nothing, it's just Class C airspace b. Mode C transponder c. Two-way radio communication d. Both B and C d. Both B and C What information does an AWOS-3 provide? a. Altimeter, winds, temperature, dew point, and density altitude b. Altimeter, winds, temperature, dew point, density altitude, and visibility c. Altimeter, winds, temperature, dew point, density altitude, visibility, and cloud/ceiling data d. Altimeter, winds, temperature, dew point, density altitude, visibility, cloud/ceiling data, and precipitation information c. Altimeter, winds, temperature, dew point, density altitude, visibility, and cloud/ceiling data Looking down at your sectional you see the blue numbers in each block. How are MEFs calculated when there is a manmade obstacle at least 200' above the terrain? a. Highest obstacle, plus 100', plus 200', rounded up to the nearest 100' b. Highest obstacle, plus 100', rounded up to the nearest 100' c. Highest obstacle, plus 200', rounded up to the nearest 100' d. Highest obstacle, plus 1000', rounded up to the nearest 100' b. Highest obstacle, plus 100', rounded up to the nearest 100' As you are doing your preflight you watch an airplane bounce a landing and strike their prop, do they need to report this to the FAA? a. Yes b. No c. No, but they need to report it immediately to the NTSB d. No, but they need to report it to the FBO 42 | P a g e b. No On the chart you notice a lookout tower, what does the number next to it indicate? a. The base of the tower MSL b. The base of the tower AGL c. The height of the tower MSL d. The height of the tower AGL a. The base of the tower MSL Colin knows about the parachuting in the area and starts telling you about random facts he has heard. Which of these are false? i. Parachutes made of nylon material must be repacked within 60 days ii. Parachutes made of silk must be repacked within 180 days iii. Unless each occupant of the aircraft wears a parachute, no PIC may intentionally make a maneuver that exceeds 30° pitch or exceeds 60° bank a. i b. i and ii c. iii d. None of these are false c. iii