Deck 12: Surgical Case Management

Question 1

Which of the following would NOT be an appropriate method of performing a surgical scrub/skin preparation?

A) anatomical timed
B) brushless/waterless
C) counted strokes
D) medical hand wash

Answer 1

D

Question 2

During the process of setting up the sterile field, efficiency and economy of motion recommend that the surgical technologist (ST):

A) move items only once if possible
B) position back table close to door
C) place as many instruments on Mayo stand as possible
D) request that circulating RN open all supplies for case after ST is gowned and gloved

Answer 2

A

Question 3

What is the purpose of a radiofrequency tracking system in the operating room?

A) Aid in chargeable items being input into system.
B) Assist CSPD personnel in locating instrument trays.
C) Prevent potential for patient misidentification.
D) Reduce possibility of retained foreign objects.

Answer 3

D

Question 4

Which term describes the condition of a surgical technologist's skin following skin prep?

A) debrided
B) medically clean
C) surgically clean
D) sterile

Question 5

Which gloving method should be performed by the surgical technologist after donning a sterile gown and before setting up the back table?

A) assisted gloving
B) closed gloving
C) open gloving
D) triple gloving

Question 6

The patient undergoing laparotomy should be prepped:

A) in a side-to-side motion from bedside level to bedside level
B) in vertical strokes from superior prep margins to inferior prep margins
C) from the periphery inward toward the incision site in a circular motion
D) from the incision site outward toward the periphery in a circular motion

Question 7

Up to what area of the arms does a surgical technologist scrub?

A) 1 inch below the elbows
B) 2 inches below the elbows
C) 1 inch above the elbows
D) 2 inches above the elbows

Question 8

During the surgical skin prep, areas that are considered contaminated should:

A) not be scrubbed at all
B) need no special attention
C) be scrubbed separately or last
D) be scrubbed vigorously and first

Question 9

Which of the following describes the configuration of a Mayo stand cover?

A) flat
B) rigid
C) cylindrical
D) wraparound

Question 10

An assistant may be needed to properly perform which type of surgical skin prep?

A) circumferential extremity
B) midline vertical abdominal
C) two-step prep with scrub and paint
D) vaginal/perineal prep in lithotomy position

Question 11

Which type of sterile gown uses battery-powered ventilation for the wearer?

A) reusable cloth
B) impervious backed
C) full coverage system
D) disposable fluid resistant

Question 12

Which of the following statements regarding hair removal is INCORRECT?

A) Hair must be shaved from every incisional and ECG lead site.
B) Hair removal should be performed as close to the time of the procedure as possible.
C) Hair removal is dependent upon surgeon's preference, patient factors, and surgical site.
D) Hair removal using a razor can result in microabrasions and increased microbial count.

Question 13

Which of the following techniques of counting sponges on the sterile field is an example of best practice?

A) Count packages, leaving paper bands around and intact to prevent mixing of sponges before use.
B) Count quietly and to yourself, and record totals with a skin marker on the back table cover.
C) Remove paper bands around sponges; separate each sponge into separate piles while counting aloud with RN.
D) Remove paper bands around sponges, hold pack in hand and fan out to separate, and then count aloud while touching each sponge.

Question 14

Which component of personal protective equipment (PPE) has shown the ability to decrease disease transmission from needle punctures?

A) double gloving
B) full coverage system
C) lead aprons/shields
D) splash guard mask

Question 15

Which towel is placed first when squaring off the operative site?

A) inferior margin
B) superior margin
C) same side as person applying towels
D) opposite side from person applying towels

Question 16

The main purpose of the surgical skin prep is to:

A) provide a visible area of paint where the incision will be made
B) reduce the microbial count on the skin to an irreducible minimum
C) remove all resident and transient flora from the planned incision site
D) sterilize the patient's skin to prevent post-op surgical site infections

Question 17

In preparing a patient for surgery, which of the following should be removed to facilitate oxygen blood level assessment?

A) dentures
B) hearing aids
C) nail polish
D) makeup

Question 18

What is the appropriate method for delivering a sterile item to the back table from a peel package?

A) Open peel pack away from self, using top flap to cover hand and arm; open item over center of back table.
B) Open package laterally, and carefully slide item over glued edge onto top of back table.
C) Open package toward self; then project item into air, aiming for back table.
D) Open package laterally and completely; gently toss item without touching glued edge or going over back table.

Question 19

What is the term used when a surgical team member who is on standby must return to the facility to do a case?

A) called in
B) called up
C) pulled in
D) pulled up

Question 20

Which position is routinely used for flexible colonoscopy procedures and may be performed on the patient's stretcher?

A) Fowler's
B) Kraske
C) lithotomy
D) Sims'

Question 21

What would be the likely result of positioning the patient's arms on armboards at a greater than 90° angle from the torso?

A) brachial plexus hyperextension
B) foot drop
C) hamstring strain
D) restriction of respiratory freedom

Question 22

What is the term used for the area beneath the fingernails that is cleaned with a pick during the surgical scrub?

A) subacromial
B) subdermal
C) sublingual
D) subungual

Question 23

When transporting a patient on a stretcher through the OR suite corridors, which method should be followed?

A) Pull the stretcher with the patient facing feet first and the patient flat and restrained.
B) Pull the stretcher with the patient facing head first and the patient flat and restrained.
C) Push the stretcher with the patient facing feet first in the position most comfortable for the patient.
D) Push the stretcher with the patient facing head first in the position most comfortable for the patient.

Question 24

Which method of gloving is appropriate for placement of a urinary catheter as part of the skin prep?

A) closed gloving
B) open gloving
C) double gloving
D) unsterile gloving

Question 25

What should the surgical technologist do with his or her gown and gloves in preparation for donning after scrubbing?

A) Open and toss gown and gloves into the basin set.
B) Open and toss gown and gloves onto the back table.
C) Open and toss gown and gloves onto unsterile Mayo stand.
D) Open gown wrapper on unsterile Mayo stand, and open and toss gloves onto gown.

Question 26

Radiation, convection, conduction, and evaporation are examples of:

A) instrument sterilization methods
B) mechanisms of intraoperative heat loss
C) methods of thermal hemostasis
D) surgical suite ventilation controls

Question 27

Where is the safety belt or strap placed on a patient in supine position on the OR table?

A) 2 inches proximal to the ankles
B) 2 inches distal to the knees
C) 2 inches proximal to the knees
D) 2 inches distal to the perineal region

Question 28

What is the temporary position for a female patient for placement of urinary catheter prior to abdominal hysterectomy?

A) frog-legged
B) jackknife
C) low lithotomy
D) semi-Fowler's

Question 29

Which of the following are NOT considered countable items for potential of retained foreign objects?

A) dressings
B) instruments
C) sharps
D) sponges

Question 30

What is the name of the common disposable surgical gown style?

A) cylindrical
B) turnaround
C) wraparound
D) circumferential

Question 31

The sitting position is a modification of which position?

A) Trendelenburg
B) lithotomy
C) Fowler's
D) Kraske

Question 32

What is the proper way to open a small, sterilely wrapped item for delivery to the sterile field?

A) First flap is pulled and opened away from self and tucked into palm, side flaps are pulled and tucked into palm, and last flap is pulled toward self and secured before tossing item onto field.
B) First flap is pulled and opened toward self, the side flaps are pulled open, and the last flap is pulled and opened away from self; then item is tossed onto field.
C) Right flap is pulled and tucked into palm, left flap is pulled and tucked, top flap is pulled and opened toward self, and the bottom flap is opened away from self and secured before tossing onto field.
D) Left flap is pulled and tucked into palm, right flap is pulled and tucked, top flap is pulled and opened away from self and tucked, and bottom flap is pulled toward self and secured before tossing item onto field.

Question 33

Before opening any supplies for delivery to the sterile field, what must be verified?

A) Removal of charge sticker
B) Initials of person who prepared item
C) Length of time item has been in storage
D) Package integrity being intact and not violated

Question 34

How many individuals are required to safely transfer a recently anesthetized patient from the OR table to the stretcher?

A) None--wait until patient can move him- or herself.
B) 2
C) 3
D) 4

Question 35

Which position requires anesthesia administration and intubation to be performed on the patient's stretcher prior to final positioning?

A) lateral
B) lithotomy
C) prone
D) supine

Question 36

For which position would the head of the OR table be moved to the foot before the patient is placed on the table?

A) Trendelenburg
B) lithotomy
C) lateral kidney
D) jackknife

Question 37

Which statement regarding instrument counts is CORRECT?

A) They should be counted while all still on back table.
B) They are unnecessary if only one tray is opened for use.
C) They are required by state law for every surgical procedure.
D) They have been replaced by routine practice of post-op x-ray to verify no retained instruments.

Question 38

What is the term for the normal resident microbial populations found on human skin?

A) bioburden
B) flora
C) fomites
D) biologicals

Question 39

Which of the following statements about lateral kidney positioning is INCORRECT?

A) The lower leg is flexed, the upper leg is straight, and a pillow is between them.
B) The lower leg is straight and the upper leg is flexed, with a pillow under the lower leg.
C) A small roll is placed under the nonoperative side axillary area to facilitate respiration.
D) The patient's flank is positioned over the kidney lift to provide greater exposure of the operative area.

Question 40

If a pack of sponges is found to have an incorrect number during the count process and the patient is on the OR table, what should be done?

A) Discard the sponge pack into a trash hamper.
B) Hand off the pack to the circulator who will remove it from the room.
C) Ask the circulator to record the actual number on the count board for closing count verification.
D) Hand off the pack to the circulator who will bag, label as incorrect, and isolate off field until case completion.

Question 41

Which of the following is NOT an example of blunt dissection of tissue?

A) Ray-Tec is used over gloved finger against tissue.
B) Kitner is loaded on a Pean clamp during herniorrhaphy.
C) Surgeon and assistant pull open peritoneum bilaterally.
D) Endo Shears are used through laparoscopic trocar to separate tissue.

Question 42

What is the comparison between a neonate's and an adult's normal pulse rate?

A) Neonate's pulse is twice as fast as an adult's.
B) Neonate's pulse is three times as fast as an adult's.
C) Neonate's pulse is half as fast as an adult's.
D) Neonate's pulse is typically the same as an adult's.

Question 43

Which of the following descriptions of how to pour liquids into a container on the sterile field is correct?

A) Hold the bottle 6 inches above and over the basin.
B) Hold the bottle 6 inches above but with only the lip of the bottle over the basin.
C) Hold the bottle 12 inches above and over the basin.
D) Hold the bottle 12 inches above and with only the lip of the bottle over the basin.

Question 45

When turning the sterile gown, what is handed to the circulator that completes the gowning process?

A) gloved hand
B) glove wrapper
C) gown tab or card
D) gown wrapper

Question 46

Which of the following statements regarding transfer of an awake, mobile patient from stretcher to OR table is INCORRECT?

A) Both table and stretcher must be locked to prevent movement during transfer.
B) One staff member is positioned on table side to receive patient and one on stretcher side to stabilize.
C) Instruct patient to keep the blanket on during transfer, preventing hypothermia and for privacy.
D) The safety strap is secured tightly across patient's waist to prevent possible fall due to narrow OR table.

Question 47

Which two members of the surgical team are responsible for performing the counts to prevent retained items?

A) circulator and surgeon
B) circulator and surgical technologist
C) surgeon and first assistant
D) surgeon and surgical technologist

Question 48

Trendelenburg, reverse Trendelenburg, Fowler's, and lithotomy are variations of which basic position?

A) decubitus
B) lateral
C) prone
D) supine

Question 49

What is the name of the device used to manually assess blood pressure?

A) electrocardiograph
B) glucometer
C) pulse oximeter
D) sphygmomanometer

Question 50

Best practice states that all of the following items remain sterile until the patient leaves the room, EXCEPT the:

A) back table
B) basin set
C) Mayo stand
D) surgical drapes

Question 51

The legs of a patient being placed in the lithotomy position should be raised and lowered slowly and simultaneously by two unsterile personnel.

Question 52

To secure the Mayo stand from moving during draping, what should be done?

A) Push the Mayo stand against the wall.
B) Step on one leg of the Mayo stand.
C) Have the circulator hold the Mayo stand post.
D) Grasp the back side of the tray with one hand.

Question 53

Which position would facilitate exposure of the operative area during a laparoscopic cholecystectomy?

A) Trendelenburg with slight tilt to the left
B) Trendelenburg with slight tilt to the right
C) reverse Trendelenburg with slight tilt to the left
D) reverse Trendelenburg with slight tilt to the right

Question 54

Which member of the surgical team gives permission for the patient to be positioned or transferred?

A) CRNA
B) circulator
C) CSFA
D) CST

Question 55

With what amount and which fluid is a 16 Fr., two-way Foley catheter with 5 cc balloon filled?

A) 5 mL of sterile water
B) 5 mL of sterile normal saline
C) 10 mL of sterile water
D) 10 mL of sterile normal saline

Question 56

Suction tubing and ESU cords are attached to the sterile drape with perforating towel clips to prevent contamination.

Question 57

Which table attachment is required to safely maintain a patient in the reverse Trendelenburg position?

A) anesthesia screen
B) kidney braces
C) padded footboard
D) shoulder braces

Question 58

The proper sequence for performing intraoperative and closing counts is operative site, Mayo stand, back table, basins, kick bucket or off field.

Question 59

What does the circulating nurse verify before the surgical technologist places the basket of instruments on the back table?

A) The internal indicator has changed color.
B) The filter on the container lid has changed color.
C) The filters on the bottom of the container are intact and the container is dry.
D) The numbers of instruments in the tray are correct on the count sheet from CSPD.

Question 60

The purpose of the preoperative skin prep is to sterilize the patient's skin to prevent surgical site infections.

Question 61

The ability to anticipate the needs of the surgeon is one of the most important skills for a surgical technologist to develop.