CRNFA (AORN) 3 — Questions and Answers
Question 1: AORN's Guideline for Transmission-Based Precautions in the Perioperative Setting recommends that the RNFA wear which PPE when operating on a patient with active pulmonary tuberculosis?
- N95 or higher respirator, gown, gloves, and eye protection (Correct answer)
- Standard surgical mask, gown, and gloves only
- Face shield alone is sufficient for airborne precautions
- No additional PPE beyond standard sterile attire is required
Correct answer: N95 or higher respirator, gown, gloves, and eye protection
AORN aligns with CDC airborne precaution requirements, mandating an N95 or higher respirator for procedures involving patients with active TB.
Question 2: According to AORN, which practice best reduces the risk of wrong-site surgery in the perioperative setting?
- Completing a standardized surgical safety checklist including site marking and time-out (Correct answer)
- Relying solely on the surgeon's verbal confirmation of the operative site
- Checking the patient's armband only at preoperative admission
- Reviewing the operative schedule without directly verifying with the patient
Correct answer: Completing a standardized surgical safety checklist including site marking and time-out
AORN endorses the Universal Protocol, which includes site marking and a time-out, as the primary strategy to prevent wrong-site surgery.
Question 3: When the RNFA performs tissue retraction during surgery, AORN guidelines emphasize which primary consideration?
- Using the least amount of pressure necessary to avoid ischemia and nerve injury (Correct answer)
- Applying maximum retraction force to optimize the surgeon's exposure
- Retractor placement is solely the surgeon's responsibility, not the RNFA's
- Retraction time is irrelevant as long as the surgical field is visible
Correct answer: Using the least amount of pressure necessary to avoid ischemia and nerve injury
AORN's first assistant guidelines stress minimizing retraction pressure and duration to prevent pressure-related tissue ischemia and nerve damage.
Question 4: AORN's recommended practice for surgical smoke evacuation requires that smoke plumes be evacuated because they:
- Contain viable cellular material, carcinogens, and infectious particles (Correct answer)
- Only create a visual obstruction with no known health hazards
- Are primarily composed of water vapor with minimal particulate matter
- Are regulated only for cosmetic surgery procedures
Correct answer: Contain viable cellular material, carcinogens, and infectious particles
AORN has documented that surgical smoke contains mutagenic and carcinogenic compounds, viable viral and bacterial particles, and requires evacuation to protect OR personnel.
Question 5: Under AORN standards, a latex-safe environment in the OR requires which of the following?
- Removing all latex-containing products from the room and using non-latex alternatives throughout the procedure (Correct answer)
- Simply placing a latex allergy sign on the door while continuing to use latex gloves
- Using latex gloves only during the closing phase of surgery
- Administering prophylactic antihistamines as the sole latex precaution
Correct answer: Removing all latex-containing products from the room and using non-latex alternatives throughout the procedure
AORN requires complete removal of latex-containing items and substitution with non-latex products to create a truly latex-safe environment.
Question 6: AORN guidelines state that the RNFA's scope of practice must be defined by which combination of factors?
- State nurse practice act, institutional policies, and demonstrated clinical competency (Correct answer)
- Surgeon preference alone, regardless of institutional policies
- AORN guidelines alone, without reference to state law
- Federal regulations only, which supersede state nurse practice acts
Correct answer: State nurse practice act, institutional policies, and demonstrated clinical competency
AORN stipulates that the RNFA's scope is determined by state law, institutional credentialing policies, and documented competency—all three must align.
Question 7: According to AORN's Guideline for Hand Hygiene, alcohol-based hand rub is NOT appropriate before the surgical hand antisepsis if the hands are:
- Visibly soiled or contaminated with blood or body fluids (Correct answer)
- Dry from frequent handwashing earlier in the shift
- Being prepared for a second consecutive procedure
- Exposed to non-sterile equipment in the scrub area
Correct answer: Visibly soiled or contaminated with blood or body fluids
AORN and CDC guidelines require soap-and-water handwashing when hands are visibly soiled before performing surgical hand antisepsis.
CRNFA (AORN) 3
AORN's Guideline for Transmission-Based Precautions in the Perioperative Setting recommends that the RNFA wear which PPE when operating on a patient with active pulmonary tuberculosis?