Deck 6: Sutures, Needles, and Instruments

Question 1

Tissue reaction characteristics are important in a suture material because:

A) the suture should absorb and nourish the healing tissue.
B) the suture should not cause tissue inflammation or an allergic response.
C) the suture should not support infection.
D) the suture should not cause tissue inflammation or an allergic response and the suture should not support infection

Answer 1

D
The ideal suture material is one that causes minimal inflammation and tissue reaction while providing maximal strength during the lag phase of wound healing.Tissue reaction characteristics include inflammatory and fibrous cell reaction,absorption,potentiation of infection,and allergic reaction.

Question 2

Linda,a veteran perioperative nurse,remembers a time when all suture needles had eyes and she even had her own needle rack.She hand-threaded all sutures according to the surgeon's preference.The newer sutures were originally called "atraumatic" sutures because they did not double back through a needle eye and cause tissue trauma during pulling or suturing through the tissue.Today,we call this manufacturing process of connecting the suture thread to the needle:

A) engineered crimp.
B) controlled release.
C) reverse cutting.
D) swaged.

Answer 2

D
The swaged needle is the most universally used needle type,eliminating threading eyed needles before and during surgery.A single strand of suture material is drawn through the tissue,and tissue damage is minimized (atraumatic).The swaged needle may need to be cut off with suture scissors or swaged for controlled release of the suture (semi-swaged).

Question 3

The perioperative nurse and the surgical technologist have a responsibility to maintain a safe environment of care for the surgical patient.A surgical complication concerning surgical counts that poses serious harm for the patient and potential consequences for the involved staff is called:

A) a malpractice suit.
B) a retained foreign object.
C) "res ipsa loquitur."
D) criminal negligence.

Answer 3

B
In 2002 the AORN initiated its Patient Safety First Program and has continued to assist perioperative nurses in maintaining a safe environment for surgical patients.Retained foreign objects after surgery are a complication with serious potential consequences for the people involved.

Question 4

Dan Clements had a vasectomy in his urologist's office.The small incision was closed with sutures that are synthetic and will "dissolve and fall out" after 2 to 3 weeks.As the procedure ended,he heard the doctor ask the nurse for 5-0:

A) silk.
B) polyglactin.
C) plain gut.
D) chromic gut.

Question 5

Careful counting (according to established policy),situational awareness,and conscientious and meticulous attention to the field are believed to prevent miscounts and lost items.A recent patient safety statement about preventing retained foreign objects recommends which of these practices?

A) Consistent practice according to a routine
B) Good communication among the team
C) Wound exploration by the surgeon before closure
D) All of the options are best practices.

Question 6

When creating a vascular or intestinal anastomosis (connecting two tubular structures together)the surgeon will typically suture one half of the anastomosis with one half of the suture and the other half of the anastomosis with the other half of the suture.This technique minimizes the drag and wear on the suture material and needle.The correct name for this type of suture and needle is:

A) controlled release.
B) retention.
C) double-armed.
D) multi-strand cardiovascular.

Question 7

Dr.Garrison was teaching the new residents as he closed the muscle and fascia layer following an open cholecystectomy.He stated that he liked the tensile strength of this monofilamented synthetic suture and also liked the pretty blue color,but it was hard to manage with its memory and slipperiness and normally needed six surgeon's knots to hold.He was using:

A) Ethilon.
B) Prolene.
C) Sofsilk.
D) Monocryl.

Question 8

Dr.Schuman decided to convert to an open instead of the laparoscopic approach for the colectomy because the patient was morbidly obese and he needed a larger incision.He asked the circulating nurse to bring the largest self-retaining retractor in the sterile storage room.Select the appropriate retractor.

A) Large wide Deavers
B) Bookwalter
C) Weitlaner
D) Balfour

Question 9

The circulating nurse received the trauma call from the emergency department and called sterile supply to assemble the instruments for an abdominal trauma case with possible aortic rupture.When the cart arrived,she saw the vascular set;however,the most important instrument set was missing.What important instrument set was needed for this procedure besides the vascular set?

A) Sternal saw and blades
B) Basic laparotomy set
C) Basic laparoscopy set
D) Minor set

Question 10

Surgical instruments that do not fall under the category of clamps,retractors,or cutting instruments,but are used in most procedures,are typically included within the category of:

A) specialty instruments.
B) microsurgical instruments.
C) endomechanicals.
D) accessory and ancillary instruments.

Question 11

The surgeon needs a suture material that will not degrade over time,but becomes encapsulated and supports a tissue structure that will continue to be exposed to pressure and stretching forces throughout the patient's life.These physical properties are best described by a suture that:

A) is nonabsorbable,has good tensile and knot strength,and is the appropriate diameter for the tissue.
B) has a large diameter,is nonabsorbable,is highly reactive,and is a monofilament.
C) is a monofilament,is synthetically manufactured,is absorbable,and has a large diameter.
D) has good tensile strength,memory,and ease of tying and is absorbable.

Question 12

This hemostatic device offers a rapid and secure method of clamping arteries,veins,nerves,and other small structures.They will remain in the patient,are not counted,and are made of a metal that is compatible with MRI.Select the correct hemostatic device that fits this description.

A) Hemostat
B) Alligator forcep
C) Ligating clip
D) Bulldog clamp

Question 13

The instrument devices depicted below are designed to ligate,divide,resect suture,and anastomose tissue.They are commonly called:

A) endomechanical clamps.
B) stapling instruments.
C) surgical staplers.
D) stapling instruments and surgical staplers.

Question 14

The safest practice for passing sharps and instruments is to:

A) use a "no-touch" technique by passing all instruments and sharps with a sponge forceps.
B) establish a neutral zone on the closest corner of the Mayo stand.
C) employ a robotic arm designed to deliver sharps and instruments to the surgeon.
D) None of the options are best practices.

Question 15

The primary use for suture is essentially to:

A) strengthen,re-form,and close tissue.
B) ligate,suture,and close tissue.
C) ligate,strengthen,and stop bleeding.
D) clamp,divide,and attach tissue.

Question 16

The ideal suture material is one that has handling characteristics such as:

A) memory.
B) slickness.
C) ease of tying.
D) removable knots.

Question 17

The scrub person,Toby,was precepting a surgical technology student,Mandy,on her first orthopedic case,a tibial IM rodding.Toby explained the importance of keeping the instruments free of blood and bioburden during the procedure and demonstrated the best practice and how to:

A) dip and agitate the instruments in saline after the surgeon returns them.
B) wipe the instruments with a sponge moistened with sterile water after each use.
C) rinse or soak the instruments in sterile water and dry them before placing on the back table.
D) wipe the instruments with a sponge moistened with sterile water after each use and rinse or soak the instruments in sterile water and dry them before placing on the back table

Question 18

These hemostatic devices date back to a period in time when they consisted of a product that was harvested from the ocean.They continue to be used today in every surgical procedure where a considerable amount of bleeding may be encountered and are still made of a natural product,but not from the ocean.Select the appropriate hemostatic device that fits this description.

A) Laparotomy sponges
B) Green towels
C) Bovine thrombin
D) All of the options are correct.

Question 19

During the draping procedure,Dr.Martin Newhouse (the anesthesia provider)asked the scrub person for two towel clamps to secure the top of the drape to the IV poles.The scrub person had two penetrating and two nonpenetrating clamps on her back table.She knew she would need to secure the suction and electrosurgical pencil to the sterile field as soon as draping was finished.How should the scrub person respond to Dr.Newhouse's request for towel clips?

A) Refuse to give him any towel clamps because they are counted.
B) Give him two Allis clamps instead.
C) Give him the penetrating towel clamps.
D) Give him the nonpenetrating towel clamps.

Question 20

Dr.Schumann,an older surgeon who was educated in Germany,explains his justification for his suture choice to the new perioperative nurse in the scrub role.He prefers to suture his intestinal anastomosis with a suture that has multiple filaments braided together because it ties well and holds the knot,which tightens when the thread absorbs the tissue fluids.He also needs a strand that is easy to see and only needs to retain its tensile strength for about 1 year,at which time the intestinal junction will be healed,even though this suture is considered nonabsorbable.He will ask the nurse for a 24-inch 4-0:

A) Vicryl.
B) Prolene.
C) Monocryl.
D) Sofsilk.