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NIFA FINAL EXAM LATEST UPDATE 2024- 2025
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"triangle" anotomic landmark that is knowns by the 3 C's - CORRECT ANSWER: Calot's 9 y/o diabetic patient with insulin pump comes for surgery; what should be considered - CORRECT ANSWER: bipolar 35% of the refractive power of the eye is credited to which part of the eye - CORRECT ANSWER: lens 51 y/o male with hepatobiliary disease; pre op assessment includes - CORRECT ANSWER: review his chart for bleeding and coagulation times and platelet count 191.18 kg patient scheduled for surgery; interventions to enhance patient safety - CORRECT ANSWER: use of an OR bed to accommodate patient weight and size a () should be placed between neural tissue and the suction tip - CORRECT ANSWER: cottonoid a long bone fracture in a child can have devastating consequences... - CORRECT ANSWER: epiphyseal plate a patient having a major vascular procedure will require which of the following interventions that are not required of a major gastrointestinal case - CORRECT ANSWER: rapid infusion pumps and blood products present in the OR a positive Kehr's sign is - CORRECT ANSWER: left shoulder pain a rapid rise in thyroid hormone levels is caused by - CORRECT ANSWER: thyroid and parathyroid surgery radioiodine therapy / contrast dye withdrawal of antithyroid drug therapy vigorous thyroid palpitation thyroid hormone medication a reason for conversion of lap cholecystectomy to open - CORRECT ANSWER: inability to remove a stone from the CBD via ERCP a tear in the meningeal artery results in the formation of () hematoma - CORRECT ANSWER: epidural AAAs commonly occur - CORRECT ANSWER: below the renal arteries and the aortic bifurcation
AAAs occur primarily in what area - CORRECT ANSWER: between renal arteries and the aortic bifurcation ABCDE - CORRECT ANSWER: D = a brief neurologic exam; E = exposure to reveal all life-threatening injuries abdominal trauma case; instrument set needed besides a vascular set - CORRECT ANSWER: laparotomy set abnormal pupillary reflex in the patient's right eye - CORRECT ANSWER: compression of the oculomotor nerve absences of distinct teniae serves as visual landmark for - CORRECT ANSWER: upper margin of rectum absolute contraindication for a cholecystectomy is - CORRECT ANSWER: uncontrolled coagulopathy absolute contraindication for cholecystectomy - CORRECT ANSWER: uncontrolled coagulopathies Access to the substernal compartment is typically facilitated by: - CORRECT ANSWER: using long instruments through a regular thyroid incision administration of cyclogyl should be used in caution in which patient group - CORRECT ANSWER: down's syndrome advantage of an open rather than closed reduction technique - CORRECT ANSWER: direct observation and verification of fracture alignment after closure of the arteriotomy during carotid endarterectomy is complete, which clamp is removed last - CORRECT ANSWER: the internal carotid After retracting the nerve roots, this structure is incised before getting to the disc. - CORRECT ANSWER: posterior longitudinal ligament age related skin changes - CORRECT ANSWER: gently lift, not slide, the patient to and from the OR bed allergic contact dermatitis with natural rubber latex - CORRECT ANSWER: puritis, edema, erythema and visicles 6 - 48 hours after exposure alternative treatment for patients with chronic pulmonary emphysema - CORRECT ANSWER: lung volume reduction surgery
appropriate action if the doctor is delayed after the room ad instruments have been opened - CORRECT ANSWER: cover the instruments with a sterile drape and have the scrub nurse continually visually observe the room for breaches in sterility appropriate intervention for preschool age children - CORRECT ANSWER: allow them to play with their own mask and place on their stuffed bunny's face appropriate nursing action in the event of a lost airway after anesthesia induction and before intubation - CORRECT ANSWER: assist the anesthesia provider with securing the airway while applying cricoid pressure appropriate steps to remove sterile gown - CORRECT ANSWER: wipe gloves clean, untie side of gown, grasp gown at one shoulder seam appropriate way to address a count discrepancy - CORRECT ANSWER: we have a count discrepancy, we started with 70 sponges and find only 68, we are missing 2 sponges area between the surgeon and the scrub person for passing sharps safely - CORRECT ANSWER: neutral zone arterial supply for the scalp - CORRECT ANSWER: external carotid artery ASPECT OF BONE HEALING THAT IS PRESERVED THROUGH INTRAMEDULLARY REAMING - CORRECT ANSWER: maintenance of fracture hematoma assessing pediatric trauma patient for level of consciousness - CORRECT ANSWER: use a modified GCS for children At a regional MH testing center Davis Washington is undergoing a muscle biopsy for suspected genetic predisposition to malignant hyperthermia. The anesthesia provider will provide light intravenous (IV) sedation while the surgeon infiltrates the biopsy site with a local anesthetic. This will facilitate Davis' tolerance of the procedure and minimize his risk for an MH episode. What is the current correct name for this anesthesia modality? - CORRECT ANSWER: MAC aubrey Scheel - CORRECT ANSWER: explain the signs and symptoms of an incarcerated hernia and appropriate action baby boy doe; achieve ad maintain normothermia - CORRECT ANSWER: provide a radiant heat lamp during placement of monitoring lines and induction benefit of patient undergoing SILS procedure - CORRECT ANSWER: less post op pain benefit to paramedian incision - CORRECT ANSWER: decreased risk for hernia
benefit to patient undergoing SILS procedure - CORRECT ANSWER: less post operative pain best description of a successful skin graft outcome - CORRECT ANSWER: the recipient site develops a new blood supply from the base of the wound best practice for double gloving - CORRECT ANSWER: the CDC endorses double gloving for all surgery and invasive procedures best practice for keeping instruments free of blood and bioburden during procedure - CORRECT ANSWER: wipe instruments with a sponge moistened with sterile water after each use Biologically based therapies classified as therapeutic nutrition - CORRECT ANSWER: diets of Dr.s Atkins, Pritikin, and Well BLANK precautions apply to blood, all body fluids, secretions, and excretions regardless of - CORRECT ANSWER: standard blood at the urinary meatus when attempting to insert a catheter - CORRECT ANSWER: discontinue catheter insertion blood supply to the jejunum and ileum come entirely from branches of the - CORRECT ANSWER: superior mesenteric artery blood supply to the transverse colon - CORRECT ANSWER: middle colic artery bloodless plane that contains loose areolar tissue and permits mobility of scalp - CORRECT ANSWER: subgleal space bloodless plane that contains loose areolar tissue and permits mobility of scalp - CORRECT ANSWER: subgleal space bone graft sealed in a sterile labeled envelope from a tissue transplant company stores in a vacuum sealed freezer and monitored with an alarm - CORRECT ANSWER: allograft borders of the triangle of calot - CORRECT ANSWER: hepatic duct, cystic duct, inferior edge of right lobe of the liver both adenoids and tonsils consist of - CORRECT ANSWER: lymphoid tissue boundaries for skin prep for patient receiving liver transplant - CORRECT ANSWER: neck to midthigh, bedline to bedline
colon wall has 5 layers which include - CORRECT ANSWER: mucosa combined kidney-pancreas transplant; what instruments is the scrub person unlikely to need during the procedure - CORRECT ANSWER: laparoscopic instruments are not needed commonly implicated in SAH, the vessels of the circle of willis include - CORRECT ANSWER: posterior communicating artery communication with anesthesia in cases involving facial nerves - CORRECT ANSWER: muscle relaxants, paralytic agents, and some local anesthetics must be avoided complex biomedical equipment - CORRECT ANSWER: use the device according to the manufacturer's directions and test for proper performance before the patient enters the OR complication of patellectomy - CORRECT ANSWER: reduced knee extension complication of thyroidectomy that included an extended thyroid dissection - CORRECT ANSWER: pneumothorax complication that can occur as a result of rapid high pressure is - CORRECT ANSWER: hypotension concept of risk management - CORRECT ANSWER: all of the above concern with large doses of ketamine - CORRECT ANSWER: respiratory depression concern with large doses of ketamine - CORRECT ANSWER: respiratory depression congenital anomaly that best reflects indications of fetal surgery - CORRECT ANSWER: congenital diaphragmatic hernia connective tissue that covers all bone and supplies nutrients - CORRECT ANSWER: periosteum consequence of acute exposure to ionizing radiation - CORRECT ANSWER: dermatitis contraindication to using autotransfusion as a blood replacement source - CORRECT ANSWER: blood contaminated with food, bowel contents, or antibiotic irrigation contributing factors to friction and shearing - CORRECT ANSWER: transfer process from OR bed to stretcher correct attachment of the capsule to the knee joint - CORRECT ANSWER: upper end of the fibular and distally to the condyles of the femur
correct branch of the left main coronary artery - CORRECT ANSWER: circumflex coronary artery correct flow of bile from the gallbladder - CORRECT ANSWER: cystic duct, common duct, ampulla of vater, duodenum correct order of removal for soiled sterile attire - CORRECT ANSWER: gown, gloves, mask correct path of cardiac conduction system - CORRECT ANSWER: SA, AV< bundle of his, purkinjie fibers correct rationale for not using methylene blue as a skin marker in the neurosurgical OR
- CORRECT ANSWER: methylene blue produces an inflammatory reaction in CNS tissue correct regarding non-absorbable suture - CORRECT ANSWER: increased reactive properties in tissue correct specimen care and handling - CORRECT ANSWER: avoid placing specimens for frozen section in formalin correct statement regarding closed gloving - CORRECT ANSWER: closed gloving can only be used for initial gloving correct statement regarding trigone of bladder - CORRECT ANSWER: forms the base of the bladder cranial nerve responsible for pupillary reaction - CORRECT ANSWER: cranial nerve III cranial nerve that, if injured in surgery, results in vocal cord paralysis - CORRECT ANSWER: x cryosurgery can be used to treat cancers of the - CORRECT ANSWER: lung cutting suture knots of non absorbable suture - CORRECT ANSWER: 1/2 inch damage to cranial nerve VII - CORRECT ANSWER: drooping of the corned of the mouth Dan clements - CORRECT ANSWER: polyglactin Definitive information about the extent and location of ischemic heart disease can be obtained from which of the following tests - CORRECT ANSWER: cardiac catheterization
during a total hip, the instrument used to access the femoral canal is - CORRECT ANSWER: box osteotome? (p. 723) during kidney transplant prior to clamping vessels, drugs given - CORRECT ANSWER: heparin and mannitol during lumbar laminectomy, residual bleeding can be controlled using - CORRECT ANSWER: bipolar bayonet forceps each lunch contains how many segments - CORRECT ANSWER: 3? page 855 emma clements; common side effect of spinal anesthesia - CORRECT ANSWER: hypotensive episode exopthalmos can be associated with - CORRECT ANSWER: hyperthyroidism extravasation; select the appropriate corrective treatment action - CORRECT ANSWER: apple warm or cold compress eye sutures should be handled as little as possible to avoid - CORRECT ANSWER: weakening and fraying factor with high influence on wound healing that the surgical team can control - CORRECT ANSWER: tissue handling factors that influence the behavioral manifestations of pain in pediatric patients - CORRECT ANSWER: developmental level culture coping ability temperament activity level femoral hernias occur more frequently in - CORRECT ANSWER: women femoral neck fractures are more common in women than men because of - CORRECT ANSWER: osteoporosis fibrous bands of tissue found between abdominal structures not normally connected - CORRECT ANSWER: adhesions filtering mechanism if located in which region of the kidney - CORRECT ANSWER: renal cortex? fine needle aspiration of suspicious breast in males - CORRECT ANSWER: aspirate fluid is cytologically examined
first diagnostic test performed in thyroid assessment - CORRECT ANSWER: ultrasound first major branch of the internal carotid artery - CORRECT ANSWER: ophthalmic artery first step to be taken after a needlestick - CORRECT ANSWER: wash with soap and water for indirect hernia repair, the - CORRECT ANSWER: hernia contents are reduced to the abdominal cavity GCS score - CORRECT ANSWER: 15, 3 goal of bunion surgery - CORRECT ANSWER: restore normal range of motion good candidates for replantation are those with the following amputations - CORRECT ANSWER: almost any body part of a child health professionals should employ which strategy to reduce risk of allergic reaction to latex - CORRECT ANSWER: use powder free gloves that have low levels of protein and chemical allergens hemostatic device offers rapid and secure method of clamping, metal and MRI compatible - CORRECT ANSWER: ligating clip hernia that involves both a direct and indirect hernia - CORRECT ANSWER: pantaloon hernia hernia type that is common in children and usually disappears spontaneously - CORRECT ANSWER: umbilical hernia hernias that occur in the heselbach's triangle - CORRECT ANSWER: direct inguinal hernia how much of the entire circulating blood volume do the kidneys process - CORRECT ANSWER: 1/ humidity levels in the OR range between - CORRECT ANSWER: 40 - 70 ICD patches; what nursing action would be appropriate during this procedure - CORRECT ANSWER: be prepared for emergency intervention of there is excessive bleeding
incision used for a lumbar laminectomy - CORRECT ANSWER: midline directly over the appropriate lumbar spines incision used for a open appendectomy - CORRECT ANSWER: mcburney indication for damage control surgery - CORRECT ANSWER: coagulopathy indication for liver transplant - CORRECT ANSWER: primary hepatic cancer chronic hepatocellular disease chronic cholestatic disease metabolic liver disease acute fulminant liver disease inborn errors of metabolism indirect hernias occur () to the deep epigastric vessels - CORRECT ANSWER: laterally inflammation of the gallbladder - CORRECT ANSWER: cholecystitis injury can be avoided by tucking the draw sheet () the arm and under the () - CORRECT ANSWER: over, the body injury to the anterior chest from blunt force trauma, damage to what area - CORRECT ANSWER: right ventricle innermost membrane of the brain - CORRECT ANSWER: pia mater innervation of the lungs is part of what system - CORRECT ANSWER: autonomic innervation of the lungs is part of what system - CORRECT ANSWER: autonomic nervous system instillation of local anesthetic into the subarachnoid space - CORRECT ANSWER: spinal anesthesia instrument used to occlude a vessel - CORRECT ANSWER: hemostat instruments that do not fall under the categories of clamps, retractors, or cutting instruments are - CORRECT ANSWER: accessory or ancillary instruments intervention provided for elderly patient's skeleton - CORRECT ANSWER: position the patient using appropriate padding and joint protection devices intracorporeal suture technique uses suture tying process analogous to - CORRECT ANSWER: instrument tying jacob sutzkever - CORRECT ANSWER: infected wound
Jan Stuyvesant, a surgical technologist, was the scrub person during a robotic-assisted laparoscopic cholecystectomy. She locked the robotic endoscissor into the adaptor on the robotic arm and positioned the tip end into the trocar port in order for the surgeon to dissect the cystic duct and artery, while the surgical assistant placed the clips on the cystic duct and artery. As she reached across the sterile field to insert the cholangiocatheter through the port, the anesthesia provider accidentally made contact with the distal end of the catheter as he stood up to reach the monitor controls. The contaminated end of the catheter touched the endoscopic clip applier, the endoscissor connector that the surgeon was using, the glove of the assistant, and Jan's gown sleeve. The surgeon ordered everyone to change their gown and gloves and covered the port area with a sterile towel. What was the rationale for the surgeon to - CORRECT ANSWER: the surgeon was not in contact with the sterile field because he worked from the robotic console JCAHO model of risk management includes - CORRECT ANSWER: all of the above jennings; skin injury - CORRECT ANSWER: friction from his elbows rubbing over the sheets when slip up in bed key component of the culture of safety in regards to blood exposure - CORRECT ANSWER: a goal of the culture of safety is to reduce the risk of blood exposure and sharps injuries to staff laceration on the neck that involves the lower trachea; which structure can be involved - CORRECT ANSWER: brachiocephalic artery laparoscopic trocars placed by resident; unusual occurance that could lead to sepsis - CORRECT ANSWER: inadvertent trocar puncture through bowel on insertion largest salivary gland - CORRECT ANSWER: parotid latex allergy reaction is best prevented by - CORRECT ANSWER: limiting exposure to latex layer before reaching the rectus abdominis muscle - CORRECT ANSWER: scarpa's fascia left and right lobes of the liver are divided by - CORRECT ANSWER: falciform ligament length of time for inflation of an upper extremity tourniquet on a patient under 50 years old - CORRECT ANSWER: 1 hour, 250- 300 mmHg ligament that connects the laminae of the spine - CORRECT ANSWER: ligamentum flavum
mechanism by which parathyroid glands maintain calcium homeostasis - CORRECT ANSWER: the produce a hormone that, with calcitonin, takes calcium from the bones and promotes calcium absorption by the intestines mechanism of general anesthetic agents - CORRECT ANSWER: inhibition of synaptic transmission of nerve impulses medical device classification for lasers - CORRECT ANSWER: III medication used for PONV that has potential to prolong QT interval - CORRECT ANSWER: droperidol medication used in cardiac surgery to prevent spasms of vessels - CORRECT ANSWER: papaverine MH is a rare, multifaceted syndrome with an increased incidence in patients that exhibit
- CORRECT ANSWER: congenital myopathies microsurgical techniques; efficiency ad expediting the microsurgical procedure - CORRECT ANSWER: hand instruments proficiently, in direction of use, without delay minimally invasive technique to remove parathyroid tumors deep from the mediastinum
- CORRECT ANSWER: thoracoscopy minimally invasive technique used to remove thyroid tumors deep in the mediastinum - CORRECT ANSWER: thoracoscopy Miriam Glass is a 78-year-old female scheduled for compression nail insertion of a left fractured hip. She was positioned for a spinal injection to induce spinal anesthesia. During the process, the anesthesia provider inadvertently inserted the spinal needle into the subarachnoid space, not noticing the error until the entire syringe of lidocaine was emptied into the patient. Miriam immediately experienced rapid onset of hypotension, bradycardia, and apnea. Miriam's unintentional condition is called and now must be managed with. - CORRECT ANSWER: total spinal anesthesia, general endotracheal anesthesia MIS in pediatric patients - CORRECT ANSWER: pediatric patients having MIS procedures have less prevalence of adhesion formation modified radical mastectomy, which incision will the periop nurse describe to the patient
- CORRECT ANSWER: an oblique elliptical incision with lateral extension toward the axilla is made through the subcutaneous tissue Mohs' surgery is a technique used to treat skin cancer - CORRECT ANSWER: lesions are mapped, excised, and examined by frozen section until clear margins are found
MOI / kinematics of head on collision where the head hits the windshield and the chest hits the steering wheel - CORRECT ANSWER: acceleration/deceleration; injury to the anterior and posterior brain and internal thoracic organs and vessels monofilament suture that does not require the surgeon to tie knots - CORRECT ANSWER: barbed most accurate method for post op temp monitoring - CORRECT ANSWER: oral most common complication following ACDF - CORRECT ANSWER: difficulty swallowing most common complication of Meckel's diverticulum - CORRECT ANSWER: GI bleeding most common congenital cyst found in the neck - CORRECT ANSWER: thyroglossal duct cysts Most common endocrine problem in the US - CORRECT ANSWER: thyroid nodule most common method to prevent hypothermia is through the use of - CORRECT ANSWER: forces air warming blankets most common non emergent surgery in USA - CORRECT ANSWER: cholecystectomy most common pattern of hearing loss in older adults - CORRECT ANSWER: bilateral symmetric sensorineural most common size needle for skin closure - CORRECT ANSWER: 3/ most common used incision for C section - CORRECT ANSWER: pfannensteil most commonly fractures carpal bone - CORRECT ANSWER: scaphoid most commonly injured intra-abdominal organ in blunt trauma - CORRECT ANSWER: spleen most commonly performed procedure in general surgery - CORRECT ANSWER: cholecystectomy most commonly used local anesthetic - CORRECT ANSWER: lidocaine most commonly used method of sterilization - CORRECT ANSWER: steam sterilization most commonly used pediatric premedication - CORRECT ANSWER: versed
NOT an advantage of silk suture - CORRECT ANSWER: memory NOT included in the retroperitoneal space - CORRECT ANSWER: spleen nourishment to the lungs is supplies via the - CORRECT ANSWER: bronchial arteries nursing consideration is significant relative to submandibular surgery - CORRECT ANSWER: avoid local anesthetics on the sterile field if identification of major nerves will take place nursing intervention to reduce the risk of a thyroid storm - CORRECT ANSWER: provide a quiet, calm atmosphere and help the patient relax, comfort measures, cooling blanket OCR in an emergency that can occur during eye surgery - CORRECT ANSWER: trigeminal vagal response caused by pressure on the globe of the retrobulbar block of the nerves associated with thyroid gland, which can be affected by compression resulting from enlarged left atrium - CORRECT ANSWER: NOT right recurrent left recurrent? of the two muscle groups, how many are represented in each eye - CORRECT ANSWER: four recti muscles and two oblique muscles on factor that describes high incidence of musculoskeletal disorders among surgical techs and nurses - CORRECT ANSWER: the cumulative effect of repeated patient handling events q one cause of avascular necrosis - CORRECT ANSWER: decreased blood supply to the femoral head one of the two strongest layers in tissue closure - CORRECT ANSWER: fascia one source of catgut - CORRECT ANSWER: small intestines of sheep ongoing assessment of graft integrity includes - CORRECT ANSWER: use of intraoperative and post-operative doppler to detect presence of graft pulse open commissurotomy - CORRECT ANSWER: have valve replacement instruments available OR personnel can reduce their exposure to ionizing radiation by - CORRECT ANSWER: maintaining the greatest practicable distance from the ionizing source order that a instrument set must travel before reaching the steam sterilizer - CORRECT ANSWER: inspect, inventory against list, assemble, place integrators, wrap and tape
orthopedic diagnosis that is a complex deformity and diagnosed prenatally through ultrasound or at birth - CORRECT ANSWER: club foot osteomalacia is due to a deficiency of () that can be treated by () - CORRECT ANSWER: vitamin D, dietary supplements and exposure to sunlight outcome indicator that would best reflect that the goal of maintained fluid balance was attained - CORRECT ANSWER: blood pressure within acceptable range ovarian artery is a branch of which vessel - CORRECT ANSWER: aorta overactive thyroid conditions; which has an increased risk of development that can lead to premature death - CORRECT ANSWER: atrial fibrillation overpressurization can lead to - CORRECT ANSWER: hypercarbaria Paget's disease , the degenerative process results in - CORRECT ANSWER: rapid, disorganized bone remodeling Pamela Morris is a 62-year-old woman with a 4-year history of Graves' disease that has not responded to medical therapy. She is scheduled for a subtotal thyroidectomy. What condition, a complication of Graves' disease, is her probable indication for a subtotal thyroidectomy? - CORRECT ANSWER: tracheal obstruction parameters of a comprehensive respiratory assessment - CORRECT ANSWER: rate, rhythm, and breath sounds patient at highest risk for hypothermia in perianesthesia phase - CORRECT ANSWER: 3 week old neonate for cardiac anomaly patient has numb and tingly mouth, lips and tongue, and metallic taste after peripheral nerve block - CORRECT ANSWER: a toxic overdose to local anesthetic, monitoring and increasing flow rate in IV saline patient having cardiac surgery, consider all of the following except: - CORRECT ANSWER: RBCcount? patient most likely to have a true latex allergy - CORRECT ANSWER: patient with spina bifida patient presents with an acoustic neuroma will demonstrate which symptoms - CORRECT ANSWER: unilateral deafness patient reports latex allergy, carries epi pen and beta-agonist inhaler - CORRECT ANSWER: true latex allergy
