Which of the following is a type of tissue forceps?
The Brown-Adson tissue forceps are used during minor procedures to grasp tissue.
Which endoscope is used to visualize the heart and major vessels?
The angioscope is used for visualization of the heart and major vessels.
The goal of the surgical scrub is to lower the population of which flora to an irreducible minimum?
- Explanation: Resident microbes habitually live in the epidermis, deep in the crevices and folds of the skin.
Which needle is used during the bladder suspension procedure for treating stress incontinence in women?
Explanation: The Stamey procedure involves suspending the fascial attachments of the bladder to the rectus fascia with sutures placed through a Stamey needle.
Which procedure can be performed without making an incision to treat varicose veins?
- Explanation: Sclerotherapy is the injection of sodium chloride, dextrose or saline solution into the small varicosities to destroy the lumen.
When repairing a direct hernia, the surgeon works within the anatomical triangle formed by the inguinal ligament, inferior epigastric vessels and the lateral border of the rectus abdominis called:
There are many anatomical triangles throughout the body to aid the surgeon and surgical team in describing the location of a pathology; a direct hernia presents through Hesselbach's triangle.
Which of the following is the correct postoperative sequence of actions completed by the surgical technologist?
Remove drapes, remove gown and gloves, assist with postoperative patient care, break down sterile setup
Explanation: The sequence of actions completed by the surgical technologist is remove outer pair of sterile gloves, remove drapes, remove gown and gloves, don pair of non-sterile gloves, assist with immediate postoperative care of the patient, breakdown the Mayo stand and backtable.
What should be completed before the sterile items are opened for the first procedure of the day?
Wipe down furniture and surfaces
Explanation: Prior to opening sterile supplies for the first case of the day the OR furniture, equipment, surfaces and lights should be wiped down (also referred to as "damp dusting" with a disinfectant solution.
Cardiac muscles are controlled by which division of the nervous system:
Explanation: The autonomic nervous system (ANS) conducts impulses to the cardiac muscles.
Oophor/o is the root word for which anatomical structure?
Oophor/o is the root word for ovary.
In which of the following would absorbable suture be contraindicated?
Explanation: When a vascular anastomosis is being performed, it requires the ability to heal and have a long term, secure anastomosis; therefore, absorbable suture would not be used.
During a cesarean section, which organ is freed from the uterus to prevent injury?
Explanation: Before the incision is made in the uterus, the bladder is dissected free from the uterus and retracted inferiorly.
Which of the following refers to the absence of pathogens?
Explanation: Aseptic means without sepsis or no pathogens are present.
What surgical procedure would use the instrument shown below?
Explanation: The Sims uterine curettes have sharp ends that are graduated in size used during a D&C to obtain endocervical and endometrial tissue specimens.
What must be done prior to positioning a patient undergoing a posterior lumbar laminectomy?
Explanation: Prior to positioning the patient undergoing a posterior lumbar laminectomy, endotracheal intubation is completed.
What is the name of the instrument shown below?
Explanation: The Pennington clamp may be used by a surgeon to grasp a hemorrhoid for excision or a small piece of the lung during a segmental resection.
Which of the following damages the mastoid air cells and ossicles of the ear?
- Explanation: Cholesteatoma is a benign tumor that invades the mastoid cavity and destroys the mastoid air cells and can also damage the ossicles.
When placing a swaged needle onto a needle holder, the needle should be clamped:
One-third distance from swaged end of needle
Explanation: The needle holder is clamped approximately one-third of the distance from the swaged end of the needle
Which endoscope is used for the removal of foreign bodies from the airway of a pediatric patient?
- Rigid bronchoscope
- Explanation: Rigid bronchoscopy is usually performed for the removal of foreign objects from the airway of children.
Which of the following elements primarily make up the body's mass?
Oxygen, carbon, hydrogen, nitrogen
Explanation: 96% of the body's mass is made up of oxygen, carbon, hydrogen and nitrogen.
Which instrument is used to contract the ribs for suturing purposes?
The Bailey rib contractor is positioned over two ribs and tightened to bring them together to facilitate suturing.
The largest muscle of the upper calf is the:
The gastrocnemius is the muscle that forms the bulk of the upper calf.
What is the length of time when thrombin loses its potency?
- 3 hours
- Explanation: Thrombin should be immediately used when reconstituted with saline or discarded if not used within several hours because it loses potency.
The function of the small intestine is:
Absorption of nutrients
Explanation: The functions of the small intestine are digestion and absorption.
The teeth are composed primarily of :
- Explanation: Teeth are composed of dentin, a calcified connective tissue.
The basis for the design of electrical equipment in the OR is:
- Electron theory
- Explanation: The principles that govern the movement of electrons is the electron theory that serves as the basis for the design of all types of electrical equipment.
Which of the following procedures is performed to decrease gastric secretions?
- Explanation: To aid in controlling gastric secretions a vagotomy is performed.
A patient who underwent an appendectomy enters the emergency department with severe abdominal pain, constipation, and vomiting. Which of the following is occurring?
Explanation: The patient most likely is experiencing an obstructed bowel due to the formation of postoperative adhesions.
Which organ shares the same blood supply with the pancreas and must be removed during a Whipple procedure?
- Explanation: The head of the pancreas shares the same arterial supply with the duodenum. Since the Whipple procedure is performed for cancer of the head of the pancreas, the duodenum must be removed.
During a cleft palate procedure, which equipment should the surgical technologist be prepared to set up quickly?
- Explanation: To facilitate placement of the sutures in the hard palate the surgeon may use a drill with drill bit.
The muscle that flexes and supinates the forearm and covers the anterior portion of the upper arm is the:
- Biceps brachii
- Explanation: The biceps brachii flexes and supinates the forearm and covers the anterior portion of the upper arm.
A surgeon tells a patient she has terminal cancer but requires prophylactic surgery to prevent a bowel obstruction and the patient replies, "This can't be happening to me." Which stage of grief is the patient displaying?
Denial is the first stage of the five stages of grief in which the patient doesn't accept what is happening to him/her.
What is the purpose of inserting a ureteral stent catheter?
Bypass calculi obstruction
Explanation: The ureteral catheter stent is implanted to bypass partial or total obstructions of the ureter due to ureteral tumors, calculi or strictures.
Which of the following instruments is used to create the trough on the anterior glenoid during a Bankart procedure?
- Shaver with abrader tip
- Explanation: Once exposure is completed, the repair of a rotator cuff begins by creating a bony trough on the humerus near the tuberosity using a rongeur, curette, curved osteotome or powered bur.
Which of the following secretes hydrochloric acid?
Explanation: Parietal cells are glands that are located in the stomach and secrete the digestive juice hydrochloric acid.
Which of the following preoperative diagnostic tests would be administered to a patient with a brain injury?
Explanation: Electroencephalography is a recording of the electrical activity of the brain used to help diagnose seizure disorders, brain tumors, epilepsy, and injuries to the brain.
Which of the following is a type of fenestrated drape?
Explanation: The extremity drape has an opening, called a fenestration, for placing over an extremity.
The walls of the vagina are lined with:
Explanation: The vagina is a tubular, fibromuscular organ lined with mucous membrane.
Which type of scalpel uses ultrasonic energy to cut and coagulate tissue?
Explanation: The ultrasonic scalpel (Harmonic scalpel) uses a single-use titanium blade attached to a handpiece and connected to a generator that causes the blade to move by rapid ultrasonic motion to cut and coagulate.
A Fogarty catheter is used during a/an:
- Explanation: The balloon-tipped Fogarty catheter is inserted through an arteriotomy to facilitate removal of an embolus.
Which of the following positioning devices is needed when placing the patient in supine position?
Explanation: One of the pressure points of the supine position is the elbows; gel pads or foam should be used for protection.
During a trabeculectomy, what two layers are incised at the beginning of the procedure?
- Conjunctiva; Tenon's capsule
- Explanation: The layers initially incised during a trabeculectomy procedure is the conjunctiva and Tenon's capsule.
What instrument set should the surgical technologist have available in the OR when preparing for an inguinal herniorraphy?
Explanation: The surgical technologist should always anticipate strangulated or incarcerated bowel when preparing for an inguinal herniorraphy and have the bowel instruments in the room in case a bowel resection has to be performed.
Which of the following is used to obtain specimens during a bronchoscopy?
- Lukens tube
- Explanation: The Lukens tube is connected to the suction system of the bronchoscope to collect the specimens.
Which suture material would be used in the presence of infection?
- Explanation: Steel is the least inert material used as a suture material and is used in the presence of a wound infection.
What surgical procedure would the instrument below be used?
- Explanation: The Stevens tenotomy scissors are used during delicate procedures such as eye surgery.
Which surgical specialty most often uses the instrument shown below?
Explanation: The Sims retractor is used most often in gynecologic surgery.
Which of the following hernias can result in necrosis of the viscera?
Explanation: A strangulated hernia occurs when bowel is trapped within the hernia sac and the blood supply is compromised.
When the surgeon makes a McBurney's incision, which muscle is encountered first and divided in the direction of its fibers?
Explanation: When using the McBurney's incision for an appendectomy, the first muscle encountered is the external oblique which is bluntly divided in the direction of its fibers.
Which of the following maintains the position of the uterus?
Explanation: The broad, uterosacral and cardinal ligaments maintain the position of the uterus.
Transverse colectomy is incised through what incision?
Explanation: A transverse colectomy is the excision of the transverse colon; an upper midline or transverse incision is made.
What kind of uterine tissue can grow in abnormal locations, including the ovaries, pelvic peritoneum and small intestine?
- Explanation: The endometrium is the inner layer of the uterus; the abnormal growth and implantation of the tissue on the outside of the uterus is called endometriosis.
Which preoperative diagnostic exam is quickly completed to confirm ectopic pregnancy?
- Explanation: An ultrasound is performed to confirm fluid in the peritoneal cavity.
How would you position a patient with an intertrochanteric fracture?
A fracture table is used to position the patient in supine to reduce the fracture.
What position allows optimal exposure of the retroperitoneal area of the flank?
- Explanation: The lateral kidney position provides optimal exposure to the retroperitoneal area of the flank for a transverse incision.
Which of the following is the correct sequence of instruments for placing a screw into bone?
The correct sequence of instruments when a screw is placed in bone is drill, depth gauge, tap and screw driver; the same sequence is used for placement of all the screws.
The removal of fibrous thickening of the visceral pleura is:
Explanation: When blood or pus from a chest injury is not properly drained from the pleural cavity, it coagulates and forms a fibrin layer over the pleura called empyema; decortication is dissection of the fibrin.
The only depolarizing muscle relaxant in clinical use is
Explanation: Succinylcholine is the only depolarizing muscle relaxant in use; it acts rapidly but its effects must be allowed to wear off since there is no reversal agent currently available.
What type of hernia involves a direct and indirect inguinal hernia?
A pantaloon hernia refers to the presence of a direct and indirect hernia.
How are the legs of the patient positioned for lateral position?
- Lower leg flexed; upper leg straight
- Explanation: When placing a patient in the lateral position, the lower leg is flexed and the upper leg is straight with a pillow placed between the legs.
The neuroglia of the nervous system:
- Support and bind
- Explanation: The neuroglia are specialized nerve cells that provide support and protection.
The method of inhalation anesthesia that allows complete rebreathing of expired gases is:
Explanation: A closed system allows complete rebreathing of expired gases; exhaled carbon dioxide is absorbed by soda lime.
Which member of the surgical team is responsible for protecting an unsplinted fracture during positioning?
The surgeon is responsible for moving the unsplinted fracture to protect it from further injury when positioning the patient.
What personal protective equipment should the surgical technologist don prior to the start of an extracorporeal shock-wave lithotripsy procedure?
- Lead apron
- Explanation: Fluoroscopy may be used to identify the exact location of the urinary stone; therefore, the surgical team should wear a lead apron.
Another name for tonsil suction is:
- Explanation: The Yankauer is also referred to as the Tonsil suction tip; the angle of the suction tip makes it ideal for pharyngeal suctioning during a tonsillectomy.
Which muscles relax when a small pad is placed under a patient's head in the supine position?
- Explanation: Placement of a small pad under the patient's head in the supine position allows the strap muscles to relax and avoids neck strain.
When a medication or local anesthetic is passed to the surgeon, the surgical technologist should:
Every time the surgical technologist passes a medication to the surgeon he/she should verbally provide the name of the drug, strength and amount.
A type of bone-holding forceps is:
- Explanation: There are several types of bone holding clamps that vary in size; one type is the Dingman that has a single tooth on the end for grasping the bone.
Which surgical procedure would use the instrument below?
- Coronary artery bypass
- Explanation: The Satinsky vena cava clamp, also called the Satinsky partial occlusion clamp, is an atraumatic clamp available in various lengths used during major cardiothoracic procedures, such as the CABG.
According to OSHA standards, protective eyewear of some form must be worn:
An absolute requirement of Standard Precautions is the wearing of adequate protective eyewear on all surgical procedures.
Which pathological condition of the small intestine could be misdiagnosed as acute appendicitis?
Explanation: Meckel's diverticulum is a congenital diverticulum that presents as a small bulge in the small intestine and can present signs and symptoms that are the same as acute appendicitis.
Which piece of equipment is required for administration of a Bier block?
- Double-cuffed tourniquet
- Explanation: A double-cuffed tourniquet is used; one cuff is inflated and if it becomes uncomfortable for the patient, the other cuff is inflated and the first deflated.
Which subcategory of drug preparation is a combination of two liquids that cannot mix?
- Explanation: A form of liquid medication is an emulsion; the medication is mixed with water and oil and held together by an emulsifier. A common emulsion used in surgery is propofol (Diprivan®).
What is the average normal respiration rate for children?
- 18 to 30
- Explanation: The average normal respiration rate for children (1-7 years of age) is 18-30 per minute.
Introduction of radiopaque contrast medium into an artery or vein is called a/an:
Explanation: Angiography is the primary diagnostic procedure performed for the evaluation of peripheral vascular disease.
What anatomical structure must be approximated after a colectomy to prevent herniation of abdominal contents?
Explanation: The mesentery is approximated to aid in keeping the intestine in normal anatomical position in order to prevent herniation and maintain the blood supply.
To prevent density, instrument sets should not exceed:
- 25 lbs.
- Explanation: The Association for the Advancement of Medical Instrumentation recommends that instrument sets should not exceed 25 lbs.
When surgically treating hydrocephalus, where is the shunt placed?
- Lateral ventricle
- Explanation: The multi-holed ventricular catheter is placed in the lateral ventricle of the brain.
Which of the following is a type of uterine fibroid?
Leiomyomas are a type of uterine fibroid that can cause lower abdominal pain, pelvic congestion, menorrhagia, dysmenorrhea and increased fertility. A myomectomy is a surgical procedure performed to remove the fibroids.
The ureters enter the bladder medially:
The ureters enter the urinary bladder medially from the posterior aspect.
The pathogen that most often causes postoperative surgical site infections is:
Explanation: The pathogen that is most commonly associated with the cause of postoperative SSIs is Staphylococcus aureus.
Which organ is the most frequently injured during a motor vehicle accident?
- Explanation: The spleen is the number one organ injured during motor vehicle accidents.
Where would the surgical technologist find pertinent information for "pulling" a case?
The surgeon's preference card lists the supplies, equipment, instrumentation, suture, dressing materials and surgeon's personal preferences for a procedure.
Suture material that becomes encapsulated by fibrous tissue during the healing stage is:
Explanation: Non-absorbable sutures become encapsulated during the healing process and remain in the tissues for many years.
If a mentoplasty is being performed, the surgical technologist should confirm a prosthesis is available for the:
Explanation: Mentoplasty is reconstruction of the chin which can involve placement of a prosthesis.
Which of the following means cell "eating? "
Phagocytosis is the engulfment of large particles and is sometimes called cell "eating."
What nerve could be damaged when the patient is placed in Fowler's position?
Explanation: The sciatic nerve is a long nerve that extends through the muscles of the thigh, leg, and foot with numerous branches. When a patient is placed in Fowler's (sitting position), adequate padding must be provided to prevent damage to the nerve.
What the is correct order for donning OR attire?
Hair Cover, Scrub Suit, Mask, Shoe Covers
Explanation: Hair covers are donned first to decrease the possibility of hair shedding onto the scrub suit and decrease microbial shedding.
The cranial nerve responsible for hearing and balance is the:
Explanation: The vestibulocochlear (VIII) is the cranial nerve that contains special fibers for hearing as well as balance.
Which of the following is not a hemostatic agent used in orthopedic surgery?
- Explanation: Xeroform is a nonpermeable, occlusive dressing made of fine mesh gauze; it is commonly used as the first layer in a three-layer dressing.
Which of the following is responsible for disseminated intravascular coagulation?
- Explanation: Endotoxins cause the overstimulation of coagulating proteins, which causes systemic intravascular clotting that in turn results in tissue necrosis.
The copper wire in the electrosurgical unit that allows the flow of free electrons is called the:
Explanation: Materials that allow the flow of free electrons are called conductors; materials include copper, aluminum, brass and carbon.
At the end of a procedure, the surgeon asks for the local anesthetic to inject intra-articular. Where is the surgeon injecting the local drug?
Explanation: Intra-articular refers to "within a joint;" therefore, the surgeon will be injecting the local anesthetic inside the joint.
Which preoperative diagnostic test is useful in diabetic patients with small vessel arterial disease?
- Explanation: Plethysmography is useful in patients with small arterial vessel disease; it records variations in the amount of blood in an extremity.
Which of the following is the most effective method for sterilizing items that can be damaged by steam sterilization?
Explanation: EtO is the most effective sterilizing agent for items that can be eroded or corroded due to being heat and/or moisture sensitive.
The mandible articulates with which bone?
- Explanation: The mandible articulates with the temporal bone.
What could result from crossing the patient's arms across his/her chest in the supine position?
Interference with respiration
Explanation: In the supine position, crossing the patient's arms across his/her chest causes interference with respirations by tightening the thoracic region and not allowing full expansion of the lungs.
Which of the following is incorrect when preparing a paper-plastic peel pack?
- Instruments are held together with autoclave tape within the peel pack
- Explanation: Rubber bands, paper clips or tape should not be used to hold items together inside a peel pack; the binding material prevents the sterilizing agent from making contact.
Which of the following degrees in Celsius equals 98.6 degrees Fahrenheit?
Explanation: 98.6 - 32 = 66.6; 66.6 ÷ 1.8 = 37° C Pharm 76
When the surgical technologist is preparing surgical instruments for transport to the decontamination room, which statement is incorrect?
Instruments with multiple parts should be assembled
Explanation: Instruments with multiple parts, such as the Balfour retractor, should be dissassembled when breaking down the backtable and Mayo stand.
If a short bone is being removed from the wrist due to arthritis, what is being removed?
Explanation: An example of a short bone are the carpal bones of the wrist; the exception is the pisiform which is a sesamoid bone.
Which of the following heals by contraction, granulation and connective tissue?
Explanation: Third intention or delayed primary closure heals by contraction, granulation and connective tissue repair.
Before transporting instruments to the decontamination room, what should the surgical technologist complete?
Presoak instruments in detergent solution
Explanation: The first step in the decontamination process begins at the point of use in the OR. The surgical technologist is responsible for presoaking the instruments in a container of either sterile water, enzymatic or detergent solution.
Which solution is best for presoaking instruments in the OR at the end of a procedure?
Explanation: An enzyme solution is best since it removes moistened and dried debris without requiring mechanical action.
A mesh that is contraindicated in the presence of infection is:
- Explanation: PTFE is nonabsorbable and should not be used when an infection is present.
Which of the following provides additional protection to prevent contamination of a sterile package?
- Dust cover
- Explanation: Sterile packages can be placed inside a protective plastic wrap/bag called a dust cover to provide additional barrier protection.
The stripes on steam chemical indicators change to what color upon exposure to sterilization parameters?
Explanation: The diagonal stripes on the steam autoclave tape and the stripe on the chemical indicator strip should change to black when exposed to the steam sterilization parameters.
For which fracture is the instrument below best used?
Explanation: The Lowman bone holding clamp, nicknamed 'turkey claw," is used for grasping medium sized bones such as the radius and ulna to reduce a fracture and hold in place.
During a kidney transplant, the renal vein of the donor kidney is anastomosed to the:
- External iliac vein
- Explanation: The renal vein of the donor kidney is attached to the external iliac vein by an end-to-side anastomosis.
Which procedure corrects testicular torsion?
Explanation: Orchiopexy is performed to treat testicular torsion, position a retracted testicle or undescended testicle.
Which instrument is used to incise the tympanic membrane?
Explanation: The incision is made in the inferior posterior portion of the tympanic membrane with a disposable myringotomy knife.
An example of a nonadherent inner layer dressing is:
- Explanation: The inner layer of the dressing covers the wound completely and remains in contact; a nonpermeable dressing is a fine mesh gauze that is impregnated with an emulsion; examples are Vaseline Gauze and Xeroform Gauze.
To prevent a cerebral aneurysm from rupturing, the surgeon will:
Apply specially designed clip at base of aneurysm
Explanation: A straight, curved or angled aneurysm clip is placed across the neck of the aneurysm.
The ophthalmologist tells the surgical technologist to place 2 drops atropine sulfate OU. What does this mean?
Both eyes dilated
Explanation: OU (oculus uterque) is the abbreviation for both eyes and atropine sulfate is a commonly used mydriatic drug that dilates the pupil; it is instilled preoperatively for catatract surgery.
If a patient requests to see a member of the clergy upon arrival to preoperative holding:
- Call for a clergy person before the anesthesia is administered
- Explanation: The patient's request should be fulfilled; refusal of the request can cause anxiety and irritation in the patient who needs reassurance from the clergy person.
If cultures cannot be immediately transported from the surgery department to pathology, they should be:
- Placed in a refrigerator
- Explanation: If cultures are not immediately transported to the pathology department, they should be placed in a refrigerator.
In terms of transmitting an infection, what is a fomite?
- Inanimate object
- Explanation: A fomite is an inanimate object that is not in itself harmful, but that is able to harbor pathogenic organisms, thus serving as an agent for transmission of infection.
When positioning the patient for a cesarean section, where is the bolster placed and why?
- Right side; relieve pressure on vena cava
- Explanation: The patient is placed in supine position with a bolster placed under the right side to prevent excessive pressure on the inferior vena cava.
The conducting fibers that extend from the AV node to the interventricular septum form the:
Bundle of His
Explanation: The conducting fibers that run from the atrioventricular (AV) node down the inteventricular septum is referred to as the bundle of His.
Items that are impenetrable to X-rays are referred to as being:
- Explanation: Items that do not allow the passage of X-rays are referred to as being radiopaque; examples include contrast media and the radiopaque strip on sterile sponges.
During surgical rotation, the skills of a surgical technology student may be evaluated by the:
At teaching healthcare facilities where surgical technology students complete rotation, CSTs who have an interest in teaching and working with adult learners serve in the preceptor role.
During a TRAM procedure, what is used to identify and preserve the superior epigastric arteries?
Explanation: A sterile Doppler probe will be used to identify the superior and inferior epigastric arteries; the superior vessels must be preserved.
Which of the following should be accomplished when preparing an Esmarch bandage for sterilization?
- Layer of Webril® rolled with bandage
- Explanation: Rubber or silastic items should not be folded, tightly rolled or placed in a mound because steam will either not penetrate or displace the air. The Esmarch bandage should be loosely rolled with a layer of Webril® in between.
Which of the following is the correct order of the layers of the colon?
Mucosa, Submucosa, Muscularis, Serosa
Explanation: The correct order of the four layers of the colon are mucosa, submucosa, muscularis, serosa.
Air or fluid accumulation due to poorly approximated wound edges could result in:
Explanation: Dead space is the space caused by separation of wound edges and leads to the accumulation of air or fluid which can then lead to a surgical site infection.
What is the first step of opening a small, sterile wrapped package when establishing the sterile field?
Open first flap away from self
Explanation: The first step in opening a sterile package is to open the first flap away from the body, side flaps next and last flap toward body.
Which surgical approach is often used for a craniotomy for aneurysm repair?
Explanation: The patient is positioned supine with the head slightly turned away from the effected side for a unilateral frontotemporal approach.
Which of the following forceps would be used during a splenectomy?
- Right angle
- Explanation: Ties are loaded onto long right angle clamps to facilitate placing the ties around vessels.
A blood pH of 7.5 indicates:
- Explanation: The pH level of a solution or other liquid such as blood refers to its acidity versus alkalinity levels.
Which knife blade should be placed on the knife handle when preparing the Mayo stand for a knee arthroscopy?
- Explanation: The surgeon ususally uses a #11 knife blade to make the initial stab incision for placement of the trocars.
What is the function of phagocytic white blood cells?
Engulf and destroy bacteria
Explanation: Phagocytic white blood cells engulf and destroy bacteria.
A surgical technologist is talking with a patient in the PACU with arms folded and at a distance. This could be interpreted by the patient as:
Explanation: There are several negative body language signals that should be avoided when communicating with patients, patient's family members, peers and the public including tightly folded arms, distancing oneself from patient, frowning, and tapping fingers or foot.
Which of the following describes the action of histamine (H2) blockers?
Decrease gastric volume in the stomach
Explanation: H2 blockers, such as cimetidine, ranitidine and sodium citrate, inhibit hydrochloric acid secretion in the stomach or neutralize stomach acid.
What decision should the OR team make when treating a minor who requires a blood transfusion, but the family religion is Jehovah's Witness?
Do not give transfusion
Explanation: The religious values and standards of Jehovah's Witness should be recognized and upheld by the surgery team, including no transfusion of blood. There are other blood replacement products available.
What does "x" equal in the proportion 3:5 = 9:x?
Which surgical procedure uses the instrument shown below?
- Abdominal hysterectomy
- Explanation: The O'Sullivan-O'Connor self-retaining retractor is commonly used during total abdominal hysterectomy.
During a suprapubic prostatectomy, which needle holder may be used when reconstructing the bladder outlet?
Explanation: To facilitate placement of the sutures in the prostatic fossa to control bleeding and reconstruct the bladder outlet, the surgeon may use a Heaney needle holder.
When performing a total knee arthroplasty, the surgeon removes the osteophytes from the rim of the femur and tibia with a:
- Explanation: The osteophytes are removed with a Kerrison rongeur.
Which suture technique provides an excellent cosmetic closure?
A subcuticular closure is often used during plastic surgery procedures; the technique minimizes scarring.
During a radical neck dissection with mandibulectomy, which bone is harvested for the graft?
- Explanation: The fibula is commonly used to obtain a composite graft to reconstruct the mandible.
To prevent charring of bone when it is being cut or drilled, the surgical technologist should use:
- Suction irrigator
- Explanation: When the drill or saw is being used, it produces heat which can char and destroy the bone; a suction irrigator is used by the surgical technologist to prevent the heat build-up
Pain, heat, redness and swelling are the signs of which of the following conditions?
Explanation: The classic signs of inflammation are pain, heat, redness, swelling and loss of function in reaction to injured tissues.
Which clamp is most often used to grasp the appendix?
The Babcock clamp is the primary atraumatic instrument for grasping the appendix during an appendectomy.
The inner lining of the uterus is the:
- Explanation: The inner layer of the uterus is the endometrium; the outer layer is the perimetrium and middle layer is the myometrium.
Which type of dressing washes or wears off after several days?
- Explanation: Liquid collodion is a type of chemical dressing that is applied to the wound and dries forming a seal; it is often used for pediatric procedures.
A patient requires a stat cesarean section. Which of the following might be omitted?
- Explanation: There are certain instances when the initial count and possibly subsequent counts may be omitted. Two examples are emergency cesarean section and ruptured abdominal aortic aneurysm.
Which of the following is the first action to be taken following a needle stick?
Remove needle from the sterile field
Explanation: When a needle stick occurs, the surgical technologist should immediately remove the needle from the sterile field.
Which of the following drapes is used for a thyroidectomy?
- Explanation: The thyroid drape is approximately the same size as a laparotomy drape and has a transverse fenestration.
Testosterone is secreted by the:
Explanation: The cells of Leydig are specialized cells that secrete the male hormone testosterone.
When a surgeon is using a Kocher subcostal incision, which muscle is divided by electrosurgery?
- Rectus abdominis
- Explanation: The surgeon usually divides the rectus sheath and muscle with electrosurgery
What are the boundaries of the skin prep for a total hip arthroplasty?
- Level of umbilicus to foot
- Explanation: The patient skin prep is level of umbilicus to the foot, including the hip region and entire circumference of the leg and entire foot.
Which of the following are abdominal skin prep perimeters for an exploratory laparotomy?
Nipple line to midthigh
Explanation: The skin prep boundaries are nipple line to symphysis pubis and often extended to midthigh and bilaterally.
Which of the following is the main reason for wearing the OR attire?
Limit spread of microbes
Explanation: Clean scrub attire is worn to protect the patient and surgery staff by limiting the spread of microbes.
Which of the following substances are absorbed in the stomach?
- Explanation: Most substances are not absorbed into the blood from the stomach; the absorption takes place in the small intestine. However, some substances that are absorbed from the stomach are water, electrolytes, some drugs and alcohol.
A laparotomy drape is placed on the left side inguinal area of the patient, but should have been placed on the right side. What should be done to correct the error?
- Remove drape and place new drape on right side
- Explanation: When applying sterile technique, the drape should be removed and a new drape placed.
Which stapling device would be used during an esophagectomy to divide the esophagus?
- Explanation: The TA linear stapling device is best used for dividing the esophagus for removal.
Movement disorder diseases caused by radiation therapy are characterized by destruction of the:
- Myelin sheath
- Explanation: Demyelination can occur when a patient is undergoing radiation therapy and/or chemotherapy for cancer treatment.
During which procedure would a Gigli saw possibly be used?
Explanation: A Gigli saw may be used by the surgeon to cut the cranium between the bur holes during a craniotomy.
A surgeon indicates that she may place a shunt during a carotid endarterectomy. What should the surgical technologist have available in the OR?
- Explanation: The Argyle and Javid are two types of shunts used during a carotid endarterectomy.
What is the best synthetic substitute for stainless steel?
- Explanation: Polypropylene is the suture material of choice as a substitute for stainless steel where strength and nonreactivity are required, but stainless steel is not appropriate for use in the tissue.
Which of the following microorganisms is used within the biological indicator for ethylene oxide sterilization?
- Baccilus atrophaeus
- Explanation: B . atrophaeus in spore form is placed within the EtO BI.
What does the suffix -itis mean?
The suffix -itis means inflammation, such as appendicitis.
To prevent peel pack pouches from opening during sterilization, the surgical technologist should:
- Force out air from pouch
- Explanation: As much air as possible should be forced out of the peel pack to prevent bulging and rupture during the sterilization cycle.
Retention bridges are used to:
- Prevent heavy sutures from cutting into the skin
- Explanation: Bridges are plastic devices that are placed over the incision like a bridge; retention sutures are brought through holes in the bridge and tied in the middle.
During a CABG procedure, the saphenous vein is sutured to the:
- Coronary artery
- Explanation: To reestablish blood flow and reoxygenate the heart muscle, the saphenous vein or internal mammary artery is sutured to the coronary artery to bypass the obstruction.
Which of the following would be used to remove the lamina during a laminectomy?
- Kerrison rongeur
- Explanation: A Kerrison rongeur is used to excise the lamina followed by the pituitary rongeurs to remove disk material.
What category of instruments are a Hibbs and Hohmann?
The Hibbs and Hohmann retractors are used in large orthopedic surgical procedures.
What drain should the surgical technologist have available for insertion into the common bile duct during an exploration?
- Explanation: The T-tube is used for insertion into the common bile duct to facilitate bile drainage; one arm of the "T" is placed distally and the other arm placed proximally.
A padded footboard is used in which surgical position?
- Reverse Trendelenburg
- Explanation: The reverse Trendelenburg (head up) position requires the use of a padded footboard to keep the patient from sliding off the OR table.
The inner lining of the gastrointestinal tract is composed of what type of tissue?
Explanation: The inner lining of the GI tract is composed of epithelium.
Which of the following statements is incorrect when double peel packing an item(s) for sterilization?
- Inner peel pack is folded
- Explanation: The inner peel pack should not be sealed or folded to prevent the entrapment of air during sterilization.
If a surgeon performs a surgical procedure without the patient having signed the consent form, the surgeon can be charged with:
- Explanation: If a surgeon performs surgery without having obtained a signed consent by the patient, the commission of battery has occurred. battery are physical contact that causes harm or offensive contact without that person's consent.
Spores are a:
- Form assumed by bacilli
- Explanation: Spores are a form assumed by bacilli in order to survive adverse conditions; in this form they are the most difficult microorganism to be destroyed by methods of sterilization
Which of the following applies to a patient who suffers a burn due to improper placement of the patient return electrode?
- Unintentional tort
- Explanation: Patient burns are ususally considered an unintentional tort or in other words, an error that is reported as an adverse patient incident.
Which graft material does not require pre-clotting for placement during an abdominal aortic aneurysmectomy?
- Explanation: Polytetrafluoroethylene (PTFE) is a non-absorbable flexible material that is used for grafting during a AAA; it does not require preclotting.