A. Suctioning the fluid from the abdomen as soon as possible will help limit postoperative complications such as infection or peritonitis.
C. The back table must remain sterile until the vascular patient leaves the room.
C. Complex ear procedures require the use of a mastoid dressing, the surgical technologist will prepare several fluffed sponges along with Kerlix and/or Kling (rolled gauze).
D. Webril is wrapped first in order to provide protection to the area in which the tourniquet is placed and inflated.
C. Schroeder is a tenaculum with a single tooth used to grasp the cervix.
A. The right lung has an upper, lower, and middle lobe. The left lung has only an upper and lower lobe because of the position of the heart.
B. Any break in technique must be corrected, and each person is responsible for taking appropriate action to correct the error.
A. Hydrocephalus is excessive production or build-up of cerebrospinal fluid in the brain or ventricles.
A. Lap sponges are used to provide pressure on bleeding vessels or to absorb excess blood.
C. The epiphyseal plate, or growth plate, is the center for ossification at each extremity of a long bone.
A. Many hospitals have a policy to rescind the DNR during surgery. The patient's assigned Power of Attorney is legally permitted to make medical decisions when incapacitated.
D. A watertight seal of all anastomoses is essential to prevent peritonitis. Irrigation aids in visually inspecting the seal.
B. The standard rate of air exchanges is a minimum of 15 and a maximum of 25 per hour in a standard OR suite.
C. The pathology department receives all tissue samples and other specimens from surgery.
B. Using this method, the dentures will be returned to the correct patient because they will be sent to the PACU.
A. Smoke plume contains intact or fragmented bacteria and viruses; disease transmission through smoke plume is a known risk. Smoke evacuators remove smoke at a rate of 100 to 150 feet per minute at the site of generation.
B. Vertical paramedian incisions, similar to median incisions, are used to provide access to any organ in the abdominal cavity; however, in cases of trauma, a median incision would be used. Lower left paramedian incisions are excellent for use in sigmoid surgery.
D. Sodium, potassium, and calcium are all regulated by renal excretion.
A. A pledget is a small square of Teflon sutured over a hole in a vessel; it exerts external pressure over any small needle holes to prevent bleeding and to promote clotting.
D. Green indicates minor injuries.
A. The dura mater is the first protective membranous layer over the brain and lies immediately beneath the bone (cranium).
B. The surgeon should be regowned and regloved. The surgeon walked up to a non-sterile area and prepped the patient.
B. Special preparation and examination of the tissue can determine whether it is malignant, if nodes are involved, and if margins are clear of malignant cells. Sending a frozen section will give the physician an immediate diagnosis and will be able to treat the patient correctly.
A. During closure of the fascia, a 0 or 2-0 suture is most often used on patients who are not obese, and a toothed tissue forceps is also used.
B. The open-gloving method is preferred as the gown cuffs are considered non-sterile.
C. The resectoscope is used to cut and coagulate prostate tissue.
C. Auscultation is listening to the lungs, heart, or abdomen through the stethoscope.
C. Neutral zones are established to provide hands-free passing of sharps and instruments.
D. A biological indicator is a test using living spores resistant to heat. It is the best method to check effectiveness of sterilization.
B. A Baron suction tip is very small and is used for ear procedures.
C. Association for the Advancement of Medical Instrumentation (AAMI) controls regulation of sterile processing.
C. Allis forceps would be most likely of the listed instruments to be placed on the second mayo designated for dirty instruments because the Allis forceps would be used at the start of anastomosis by holding onto a tubular structure that has been severed and is ready for anastomosis.
A. Heavy packs should be placed at the periphery of the load where steam enters the chamber.
C. A blunt needle is the least traumatic of all suture needles. It has a round shaft and blunt tip so rather than puncturing the tissue, it pushes it aside as it slides through it. It is primarily used for soft and spongy tissue such as the liver, kidneys, and spleen.
B. A variety of tunnelers exist that are specific for tunneling vascular grafts that don't allow twisting or kinking.
A. Monitored anesthesia care is accomplished with the use of nerve conduction block, pain relief, and sedation.
D. The CST must have a knife handle, scalpel blade, and tracheostomy tube available in case of patient airway compromise to prepare for an emergency tracheotomy.
B. The linea alba stretches from xiphoid process to pubis and is the joining of rectus muscles at the midline.
A. A three-way Foley catheter is used for irrigation and drainage of the bladder. The inflated balloon helps with hemostasis.
B. Pressure on the medial aspect of the elbow can increase pressure on the ulnar nerve.
A. The water-sealed drainage is used to pull fluid or air from the thoracic cavity after thoracic surgery or trauma to the thorax.
C. Unexplained tachycardia (heart rhythm over 100 beats per minute) is the first sign of malignant hyperthermia.
D. Heparinized saline would be used to irrigate the inside of an artery.
A. A rectocele is herniation of the rectum through the posterior vaginal wall.
C. Pharmaceutical or biochemical methods of hemostasis uses an array of different chemicals such as Gelfoam, thrombin, epinephrine, silver nitrate, Surgicel etc.
C. Proctoscopy is often done before a hemorrhoidectomy to look for a pathology in the rectum.
D. Pathogens actively replicate during the incubation phase. This may be a short or long period of time, but the host will show no symptoms. This period is affected by the physical status of the host.
A. The first priority is to have an unobstructed airway.
D. Gelfoam is a hemostatic coagulant agent that promotes the stoppage of bleeding with pressure.
A. A tonsillolith is a stone inside of a tonsil. The suffix -lith translates to stone.
B. Three minutes is the LEAST amount of time needed for proper immediate use sterilization.
C. The Esmarch bandage is used to displace blood by it being wrapped around the arm distally to proximal.
A. Anti diuretic hormone (ADH) is responsible for the dilution of urine. ADH may be secreted by the posterior pituitary gland and may be released if fluid levels shift as little as 1% due to dehydration or blood loss.
A. The specimen should be sent to pathology in a dry specimen container so that a frozen section can be completed.
D. Slander is spoken defamation.
C. During the sterilization process, the water within the lumen turns to steam and forces the air out of the lumen. This is important, because the air trapped within lumens can interfere with the sterilization process.
D. The insufflation tubing must be connected to the Veress needle to establish pneumoperitoneum.
C. Prions are non-living protein strands which lack DNA and RNA.
B. Malignant tumors can migrate from the primary focus to distant tissues via lymphatic or vascular systems.
D. Gelfoam is used in myringotomies to inhibit surface bleeding.
B. Dendrites contain numerous receptors which bind chemical messengers from other cells.
B. A surgical "time out" must be performed prior to the incision being made.
B. The foramen magnum is a large opening at the base of the skull for passage of the spinal cord.
A. Dynamic air removal sterilization removes residual air from instruments with lumens, whereas with gravity displaced air can interfere with the steam contact. For gravity displacement, instilling a little distilled water will heat up and ensure full steam contact within the cannula/lumen.
D. The jacket heats the steam, then it is forced into the chamber.
B. The adult brain consists of four major parts: brain stem, cerebellum, diencephalon, and cerebrum. Posterior to the brain stem is the cerebellum. Supported on the diencephalon and the brain stem is the cerebrum. Superior to the brain stem is the diencephalon.
C. Class III indicates that gross spillage from the gastrointestinal tract occurred during the procedure.
A. A Javid shunt is used only for this procedure due to the small size of the shunt and the incision.
B. A linear stapler is most commonly used for removing appendixes.
C. Cauterization is the method for controlling bleeding during a TURP.
A. Following proper procedures, the specimen can be cared for by both the sterile and the non-sterile members of the surgical team.
A. Visible debris and biologic matter should be removed because it will dirty the water quicker and ultrasonic cleaning only works on smaller particles.
A. If a wound is to be sutured, a low-capillary action suture is advised for utilization.
B. Bacillus atrophaeus is the biological indicator used for hydrogen gas plasma.
A. A pressure dressing or bolster is most often used over a skin graft. Slight pressure on the graft site prevents serous fluid from lifting the skin graft away from the recipient site.
C. Metzenbaum scissors would be the instrument of choice to dissect a breast mass, as they would not distort the margins of the mass.
B. Primary intention, or first intention, is the desired closure of wounds. It promotes quicker wound healing and leaves a less noticeable scar.
D. The anterior chamber is located between the cornea and the iris.
A. The brachial plexus is a group of nerves that run through the shoulder and can be injured when the arms are hyperextended.
D. Tendon is a type of connective tissue that connects muscle to bone.
A. The acronym TM means tympanic membrane in otorhinolaryngeal surgery.
A. The patient's legs are raised simultaneously into leg stirrups and secured; this is used for the lithotomy position.
D. The intense fiberoptic beam can ignite the patient's drapes and cause fires. Therefore, cameras should be turned off when not in use and should be appropriately placed during procedures.
A. The facial nerve splits the parotid gland into superficial and deep lobes, and must be identified and retracted to avoid injury during the removal of parotid tissue.
C. Using a laser-specific endotracheal tube will prevent a fire at the patient's face during laser surgery.
A. Subcostal incisions are generally used for an open cholecystectomy because it provides better visualization.
A. The Mayo is a heavy, curved, tapered needle used for general closure.
B. A sentinel event is an event that results in injury or death indicative of a process malfunction.
B. A drill pin (used or unused) would be disposed in a sharps container because it is sharp and are a common source of injury.
A. The Allen clamp is an intestinal clamp.
A. After pneumoperitoneum is established and trocars are placed, the stomach is mobilized and divided from the omentum.
C. A Key elevator is used to separate the periosteum from the bone.
D. An underwater drain is used to pull fluid or air from the thoracic cavity after surgery or trauma to the thorax. It is used to restore negative pressure to the thoracic cavity.
B. Laps, silk ties, and hemoclips are all used for acute hemostasis.
D. A plastic surgeon's primary anatomical system that is focused on is the integumentary system, because it has to do with the skin and subcutaneous tissue.
A. An effective packaging material would permit penetration by the steam.
D. The inflammatory phase is the first phase of wound healing and begins within minutes of injury and lasts for 3 to 5 days.
A. The label must include date of sterilization, sterilizer ID, cycle or load number, employee initials who prepared and processed the package, and the department for where the item is directed.
D. D. The syringe had 10 cc initially. Three refills occurred thereafter. 10 + (3 * 10 - 5) = 35
A. Hand cleaning is utilized at the point of use to prevent drying of blood, feces, or respiratory secretions, which can harbor embedded microorganisms and prevent penetration of the disinfecting agent.
D. Wrists and hands should be in line with forearms to ensure proper posture and circulation.
B. An angled Potts scissor is typically used to extend arteriotomies.
A. The Bowie Dick test or DART tests for the presence of pure air in the sterilization chamber.
D. Pressure may temporarily stop the bleeding, but the surgeon should be notified.
A. An Allis is a grasping forceps used to grasp the base of a hemorrhoid during a hemorrhoidectomy.
C. The midline incision runs along the linea alba and is used in most abdominal procedures, as it provides visualization to most of the abdominal contents.
D. A small Penrose drain is used to retract the spermatic vessels and vas deferens (spermatic cord). A surgical technologist should moisten the drain before passing it to the surgeon.
A. Cycloplegics act as a paralytic agent and provide pupil dilation.
D. A hydrocele is a benign fluid-filled sac that develops in the anterior testis.
D. A draining sinus is a contaminated area of the body. If the area is in the operating site, the surrounding area should be prepped first and the sinus should be prepped last.
C. The Stamey needle is used only in the Stamey procedure to treat incontinence. This is a type of bladder suspension procedure.
C. Jorgenson scissors are heavy and curved dissecting scissors used in OB/GYN surgery.
B. Inflow tubing allows for continuous flow of fluids into the knee.
A. Stainless steel suture is recommended for use in infected areas because it is non-absorbable with indefinite tensile strength.
B. Fibrocystic breast change is a common change producing breast masses, pain, and tenderness. This occurs in approximately 50% of women.
D. The anesthesiologist controls the airway and therefore movement of the patient during emergence.
A. Senn retractors or small rakes are used to expose the patellar tendon.
B. After a surgical procedure, infectious waste is separated from all other waste and placed in red bio-hazard disposable bags. The color and bio-hazard symbol alert all personnel who handle the bags or containers that the content contains infectious waste material.
B. Instruments should not be held together with rubber bands, paper clips, or tape. These items may prevent contact of the sterilant with the surface of the instruments.
C. A Mixter (right angle) clamp is necessary for an open cholecystectomy.
D. Four team members are required to transfer an unconscious patient to ensure a safe transfer.
B. Hematomas are caused by an injury to blood vessel walls and increase the likelihood of a potential for a surgical wound infection.
D. The reason for the procedure is to obtain the specimen. Specimens are collected intraoperatively and are labeled and identified for analysis intra or post operatively.
C. Someone who is immunosuppressed has an increased risk of SSI.
D. Glutaraldehyde is a form of high level disinfection recommended for semicritical items, such as endoscopes.
C. The common duct is preserved in order to drain bile or perform a common bile duct exploration.
D. Typically, a stockinette is used when draping for extremity procedures in this order: towels, drape sheet, adherent split sheet (u-drape drape or u-sheet), stockinette, and fenestrated extremity drape.
C. This is the correct side of the body. The flank would be elevated, and the kidney rest would be used.
D. Mannitol is a diuretic that reduces IOP.
A. The vermiform appendix is about 3 inches in length and is attached to the cecum.
C. Any time a tray or a tray wrapper is suspected to be wet, the tray should be removed from use and a new tray should be called for, regardless of sterilization parameters being met.
D. Lateral is the best position for insertion of a hip prosthesis.
C. A subcostal flank incision is made in a simple open nephrectomy.
B. The surgical technologist should obtain a new stapler from the circulator quickly so as not to delay the surgeon during the procedure.
C. An intraluminal stapler is used to anastomose tubular structures within the gastrointestinal tract. The stapler fires a double row of staples and then trims the lumen with a knife located within the head of the stapler. These staplers are commonly used during resection and reanastomosis of the distal colon or rectum. They can be inserted into the rectum and advanced.
D. The surgical technologist should keep track of the amounts so a total amount can be reported to the circulating nurse for documentation in the surgical record.
A. Sponges and towels must be kept wet with sterile water so they do not ignite.
B. Large power equipment are typically battery-powered. If power equipment is not functioning, the battery should be checked first.
C. Throughout the surgical procedure, the scrub person should clean soiled surgical instruments with sterile water. This takes place at the sterile field at the end of the case and sometimes throughout long cases.
A. The patient's legal name, surgeon's name, procedure, patient's legal signature, risk of anesthesia, signature of witness, and date and time of signatures are all required information.
A. Preference cards should be updated to prevent waste of supplies. The surgical technologist should consult with the surgeon to determine which supplies should be excluded or included on the preference card.
C. Kerrison is the rongeur used for this procedure.
D. Approximately 98% is removed by holding the suction wand 1 cm away from the impact/surgical site.
A. At the close of surgery, it is dangerous to handle each contaminated sharp again. The needle counter is disposable and should be closed and placed in the biohazard sharps container.
B. Biological monitors are used for routine load release, efficacy monitoring, qualification testing, and quality assurance.
D. Monofilament is the ideal suture. Since it is only one strand, it minimizes the risk of spreading.
A. Malignant hyperthermia is characterized by tachycardia, rising core body temperature, and rigid muscles. This condition is most common immediately after induction of anesthesia but can also occur postoperatively during emergence or even after transport to PACU while anesthetic gases are still in the body.
D. The surgeon is responsible for identification and clarification of the specimens' anatomical location. The surgical technologist in the scrub role is directly responsible for receiving and handling the specimen on the operative field. The circulating nurse is responsible for the specimen once passed off the operative field.
B. Ionizing radiation from x-rays may be stopped by lead or thick concrete. Lead at least 0.5 mm thick is the most effective protection against gamma rays. Alpha and beta particles do not require shielding.
A. A Weitlaner is the retractor of choice for a groin incision.