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

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NIFA FINAL EXAMS WITH ACTUAL

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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

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

Percutaneous transluminal angioplasty The mitral valve is anchored to the left ventricular wall the semi-invasive diagnostic test that illustrates heart wall motion and blood flow through the heart and quantifies cardiac function Radionuclide imaging Primary divisions of a nerve are known as Rami the correct branch of the Left main coronary artery Circumflex coronary artery When a thyroglossal duct cyst is present in an adult, it exists as a pretracheal cystic pouch attached to what structure Hyoid statement regarding risk factors for developing vascular disease is true Arteriosclerosis is a natural part of the aging process. Which of the following is an indication for damage control surgery Indications for the potential need for damage control surgery include hemodynamic instability, hemorrhagic shock, coagulopathy, hypotension, tachycardia, tachypnea, inaccessible major anatomic injury, concomitant major injury, and altered mental status The most common congenital cyst found in the neck is Thyroglossal duct cysts The potential for development of a direct inguinal hernia is When a weakening or a tear in the aponeurosis of the transversus abdominis and the transversalis fascia occurs, A vena cava filter (Greenfield filter) maintains a patent vena cava but prevents pulmonary emboli (PE) by trapping the emboli at the apex of the device. This procedure may be performed in the OR, radiology suite, or ICU for critical patients Right jugular and right femoral There are several risk factors associated with dehiscence. Which of the following can be controlled by the RNFA Sutures placed too close together Access to the substernal compartment is typically facilitated by:

using long instruments through a regular thyroid incision. Pressure against the skin above ____mm hg interferes with tissue perfusion 32 Latex allergy reaction is best prevented by 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)? Positive diagnosis of the SSI by the surgeon or attending physician

Suture can be used for more than repairing tissue. ligate, suture, and close tissue. Which of the following absorbable suture has the best tensile strength Polydioxanone The light transmission through an endoscope is achieved by way of bundles of fiberoptic glass rods 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- 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 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

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.

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.

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: <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? Anthrax and smallpox Qualities of an effective packaging material must include several key characteristics. Select the three most important qualities. Good steam penetration and removal, good microbial barrier, aseptic presentation. The design of the physical space within an OR attempts to minimize horizontal surfaces by placing cabinets flush with the wall. This prevents dust settling on multiple surfaces and decreases the areas that have to be monitored and cleaned. Another concern with horizontal surfaces is that is turbulence from staff movement and activity plus door movement, when it opens and closes, can: mobilizing resting dust from these surfaces. An 86-year-old male was admitted to the intensive care unit (ICU) 3 weeks ago for heart failure and intractable atrial fibrillation. He has had diarrhea for 4 days that has cultured C. difficile. The transmission-based precautions sign on the door to his room alerts the staff to employ which practice precaution? Both standard precautions and contact precautions Closed gloving is the technique of choice for the initial donning of sterile gloves by the scrubbed team member; however: it can only be used for the initial gloving. the final step, after decontamination and before sterilization, is the prep, pack, and wrap process. The sterile processing technologist has taken the laparotomy set from the washer/decontaminator to prepare for sterilization. Select the most appropriate order that the instrument set must travel before reaching the steam sterilizer. Inspect, inventory against list, assemble, place integrators, wrap and tape 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:

reassess the patient for body alignment, tissue integrity, and pressure areas. 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 procedure. 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? 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 _________. 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 ____________. around; body 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. venous thromboembolism (VTE) Positioning devices should be used according to the original equipment manufacturer's instructions to reduce the capillary interface pressure to below: 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. 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?

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

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

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 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

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 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 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

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

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,

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 Percutaneous transluminal angioplasty The mitral valve is anchored to the left ventricular wall the semi-invasive diagnostic test that illustrates heart wall motion and blood flow through the heart and quantifies cardiac function Radionuclide imaging Primary divisions of a nerve are known as Rami the correct branch of the Left main coronary artery Circumflex coronary artery When a thyroglossal duct cyst is present in an adult, it exists as a pretracheal cystic pouch attached to what structure Hyoid statement regarding risk factors for developing vascular disease is true Arteriosclerosis is a natural part of the aging process. Which of the following is an indication for damage control surgery Indications for the potential need for damage control surgery include hemodynamic instability, hemorrhagic shock, coagulopathy, hypotension, tachycardia, tachypnea, inaccessible major anatomic injury, concomitant major injury, and altered mental status

The most common congenital cyst found in the neck is Thyroglossal duct cysts The potential for development of a direct inguinal hernia is When a weakening or a tear in the aponeurosis of the transversus abdominis and the transversalis fascia occurs, A vena cava filter (Greenfield filter) maintains a patent vena cava but prevents pulmonary emboli (PE) by trapping the emboli at the apex of the device. This procedure may be performed in the OR, radiology suite, or ICU for critical patients Right jugular and right femoral There are several risk factors associated with dehiscence. Which of the following can be controlled by the RNFA Sutures placed too close together Access to the substernal compartment is typically facilitated by: using long instruments through a regular thyroid incision. Pressure against the skin above ____mm hg interferes with tissue perfusion 32 Latex allergy reaction is best prevented by 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)? Positive diagnosis of the SSI by the surgeon or attending physician

Suture can be used for more than repairing tissue. ligate, suture, and close tissue. Which of the following absorbable suture has the best tensile strength Polydioxanone The light transmission through an endoscope is achieved by way of bundles of fiberoptic glass rods

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- 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?

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

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

A familiarity with basic neurologic assessment tools gives the nurse the ability to perform a standardized neurologic exam that can be used preoperatively to establish a baseline assessment and postoperatively to establish a return to baseline or assess postoperative neurologic stability. The Glasgow Coma Scale (GCS) is commonly used to assess patients with brain injury using three indicators of cerebral function: eye opening, verbal communication, and motor response to verbal and noxious stimuli. Within the scoring range for the GCS, the best possible score is _____ and the worst possible score is ______. a. 15, 3 Marissa Walton is a 6-year-old girl with full-thickness burns involving both lower legs, circumferentially, excluding her feet, over less than 2% of her body surface area (BSA) and partial-thickness burns over less than 15% of her BSA, after her clothes caught fire during a camping trip when she stepped into the campfire. Based on the American Burn Association and the "Rule of Nines" classifications, Marissa's burns would be classified as ______________ with a burn surface area percentage of approximately ______________. c. minor 9% A direct inguinal hernia is located _____. a. Inside Hesselbach's triangle Following an argument with his wife in which a man backed through a glass storm door resulting in deep laceration of his buttocks, he is having great difficulty walking. To better understand the nature of his disability, you ask him to stand on one foot. By doing so, you are doing all of the following except: d. evaluating the function of the gluteus maximus. A broad range of implant materials are used in plastic and reconstructive surgery. Select the implant that represents a biologic composition of a surgical implan a. Autologous human tissue A variety of implantable devices are used in aesthetic and reconstructive plastic surgery procedures. Tracking of these devices is critical to patient safety. Institutions must report any incident of death or serious injury relating to the use of a medical device. What regulatory agency, commission, or act mandates this process when medical devices fail or cause injury? d. Safe Medical Device Act All of the following may be associated with a "heart block" except: a. section of the superior part of the thoracic sympathetic trunk. A plain radiograph of a patient following a knife wound to the left side of his neck showed elevation of the left hemidiaphragm, narrowing of the left intercostals spaces, and displacement of the trachea to the left. You suspect: b. pneumothorax due to knife penetration of the cervical pleura.

This tissue contains fat cells. c. yellow marrow When using the posterolateral incisional approach, which muscles are retracted anteriorly to expose the femoral fracture site c. Vastus lateralis and vastus intermedius What structure traverses the opening indicated by the arrow in the following figure? c. Aorta

Non-union can be caused when bone graft isn't used to fill a bony deficit at the fracture site true Which of the following is incorrect pertaining to the hamstrings? d. One of them is partially innervated by the common fibular division of the sciatic nerve. Baby Boy Doe is a newborn found outside of the emergency department (ED). He is hypothermic and has several deep lacerations across his back, abdomen, and legs that will require surgical repair. He is transferred to the surgical bay of the ED and prepared for anesthesia induction. What risk reduction strategies are appropriate during the preanesthetic phase to achieve and maintain normothermia? b. Provide a radiant heat lamp during placement of monitoring lines and induction Trina Gasterson, a 7-year-old girl recovering from a successful kidney transplant, is visited by her perioperative nurse on her day of discharge. While they conversed, Trina's mother opened a bottle of herbal supplement tablets from a local nutrition and dietary supplement store, whose label the nurse recognized a. Astragalus, licorice, and echinacea When preparing for pars plana vitrectomy in the posterior segment, the perioperative nurse must be aware that a combined scleral buckling procedure may be necessary. Other important information the perioperative nurse should know before preparing the OR for the procedure includes the location of the ocular problem, the surgeon's plan to address the problem, and the instrumentation and biomedical equipment and devices to be used. Technologic advances in ophthalmic surgery require that perioperative nurses be familiar with complex biomedical equipment. A best practice, stated below, relevant to the safe use of complex equipment would be:

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