CRNFA (AORN) 2 — Questions and Answers
Question 1: According to AORN guidelines, which action is the RNFA's primary responsibility when managing intraoperative bleeding?
- Apply direct pressure and use hemostatic agents as directed by the surgeon (Correct answer)
- Administer IV fluids independently to compensate for blood loss
- Order packed red blood cells without surgeon consultation
- Document blood loss only after the procedure is complete
Correct answer: Apply direct pressure and use hemostatic agents as directed by the surgeon
The RNFA assists in hemostasis by applying pressure and using hemostatic agents under the surgeon's direction, consistent with AORN first assistant scope.
Question 2: AORN's Recommended Practice for Sterile Technique states that a sterile field is considered contaminated when:
- A sterile item falls below the level of the sterile field table (Correct answer)
- A scrub person touches a sterile item with sterile gloves
- Sterile saline is poured into a sterile basin
- The surgeon repositions within the sterile field
Correct answer: A sterile item falls below the level of the sterile field table
Items that fall below the table edge or waist level are considered contaminated per AORN sterile technique guidelines.
Question 3: Which AORN guideline addresses the RNFA's role in patient positioning during surgery?
- Guideline for Positioning the Patient (Correct answer)
- Guideline for Surgical Attire
- Guideline for Environmental Cleaning
- Guideline for Medication Safety
Correct answer: Guideline for Positioning the Patient
AORN's Guideline for Positioning the Patient covers safe positioning practices, including RNFA responsibilities in preventing pressure injuries and nerve damage.
Question 4: According to AORN standards, how should the RNFA handle a needlestick injury sustained during surgery?
- Stop, remove gloves, wash the wound, and report per institutional protocol immediately (Correct answer)
- Continue the procedure and report the injury after surgery is complete
- Apply a new glove over the punctured glove and continue
- Notify the surgeon only if bleeding occurs at the puncture site
Correct answer: Stop, remove gloves, wash the wound, and report per institutional protocol immediately
AORN mandates immediate wound care and incident reporting following any sharps injury to protect the healthcare worker and ensure proper follow-up.
Question 5: AORN recommends that the RNFA demonstrate competency in first assistant skills through which mechanism?
- Annual competency validation and continuing education (Correct answer)
- One-time certification upon hire with no further validation
- Peer observation only, without formal documentation
- Verbal confirmation of skills by the surgeon on record
Correct answer: Annual competency validation and continuing education
AORN requires ongoing competency validation through annual assessments and continuing education to ensure safe practice.
Question 6: In the context of AORN's ethical framework, when the RNFA disagrees with a surgical decision that may harm the patient, the appropriate first action is to:
- Voice concerns directly to the surgeon and document the concern (Correct answer)
- Remain silent and carry out the surgeon's instructions without question
- Immediately contact the hospital administrator during the procedure
- Leave the sterile field in protest of the decision
Correct answer: Voice concerns directly to the surgeon and document the concern
AORN's ethical standards require the RNFA to advocate for the patient by expressing concerns through appropriate channels, starting with direct communication.
Question 7: According to AORN guidelines, which type of instrument count should be performed before the surgical incision is closed?
- All sponge, sharps, and instrument counts must be reconciled and documented (Correct answer)
- Only sponge counts are required before closure
- Counts are only required for procedures lasting more than two hours
- Sharps counts are performed only when the surgeon requests them
Correct answer: All sponge, sharps, and instrument counts must be reconciled and documented
AORN requires a complete reconciliation of all sponge, sharps, and instrument counts before wound closure to prevent retained surgical items.
CRNFA (AORN) 2
According to AORN guidelines, which action is the RNFA's primary responsibility when managing intraoperative bleeding?