Certified Registered Nurse First Assistant MCQ Flashcards

During a laparoscopic cholecystectomy, the CRNFA notices the surgeon is applying excessive traction on the cystic duct before the critical view of safety is achieved. What is the most appropriate action?

Answer: Verbally communicate the concern and recommend pausing to identify anatomy

The CRNFA must advocate for patient safety by communicating concerns about anatomic identification before irreversible actions are taken.

Which suture material is most appropriate for closing a contaminated abdominal wound where infection risk is high?

Answer: Nylon monofilament (non-absorbable)

Monofilament sutures like nylon harbor fewer bacteria than braided sutures and are preferred in contaminated wounds.

A patient undergoing a right hemicolectomy is placed in the supine position with arms extended. Which nerve is most at risk for compression injury in this position?

Answer: Brachial plexus

Arms abducted beyond 90° on arm boards place the brachial plexus at risk for stretch and compression injury.

When using monopolar electrosurgery, the CRNFA should ensure the dispersive electrode (grounding pad) is placed:

Answer: On a well-vascularized muscle mass close to the operative site

The dispersive electrode must be placed on a well-vascularized site near the surgical field to ensure adequate current dispersion and reduce burn risk.

During fascial closure of a midline laparotomy, the CRNFA uses a running Smead-Jones suture technique. What is the primary advantage of this technique?

Answer: It distributes tension across a wide fascial bite to reduce dehiscence risk

The Smead-Jones far-near near-far technique incorporates a wide fascial bite that distributes closure tension and significantly reduces dehiscence rates.

A patient on therapeutic anticoagulation with warfarin undergoes emergency surgery. Intraoperatively, the CRNFA observes persistent oozing from tissue planes. Which agent is most appropriate to request for pharmacologic hemostasis?

Answer: Fresh frozen plasma (FFP)

Fresh frozen plasma contains all clotting factors and is the preferred reversal agent for warfarin-induced coagulopathy in emergency surgery.

Which of the following is a recognized role of the CRNFA that distinguishes them from a scrub technician?

Answer: Providing tissue retraction, hemostasis, and suturing under surgeon direction

The CRNFA actively assists at the surgical field by retracting tissue, controlling bleeding, and suturing—tasks beyond the scope of a scrub technician.