The surgeon is performing an inguinal herniorraphy procedure and has made the incision and dissected down a short way into the underlying tissue. Which of
... [Show More] the following retractors should the surgical technologist have ready to pass?
Bookwalter
Senn
Harrington
Army-Navy
Army- Navy
Rationale: To facilitate proper exposure for length and depth of incision for hernia repair, Army-Navy retractors are best utilized for retraction needs of short depths, as is specified in this case description. A Bookwalter is a large self-retaining retractor used in larger abdominal procedures. A Senn is a small, hand-held retractor for superficial incisions. A Harrington is a larger hand-held retractor often used to retract the liver or spleen.
Postoperatively a hernia repair patient complains of ulnar pain, numbness and tingling bilaterally. The most likely cause of the patient's discomfort is that the surgical technologist forgot to
adduct the arm.
place the axillary roll.
place arm pads.
abduct the arm.
Place arm pads
Rationale: Adduction/abduction are motions performed during surgery. Axillary rolls are used during the lateral position. Arm pads are used throughout surgery to prevent damage to the ulnar nerve. The arms are placed on arm boards with the palm facing upwards.
During an abdominal hysterectomy, the surgeon found a lesion on the ovary. The surgeon excised the lesion and asked that the specimen be sent to the lab for immediate analysis. Which of the following types of specimen is this?
permanent
frozen
partial
fresh
frozen
Rationale: A frozen specimen is sent to the lab dry for immediate analysis. It is useful for checking margins on the specimen. Permanent sections are placed in a fixative solution for further analysis later. A fresh specimen is one that has to be sent to the lab dry and then will be fixed with a fixative solution upon arrival in the lab.
Which of the following patients is at the greatest risk for OR-acquired pressure ulcer development?
77-year-old undergoing a coronary artery bypass graft
35-year-old undergoing a transverse colectomy
2-year-old undergoing hypospadias repair
82-year-old undergoing cochlear implantation
77-year-old undergoing a coronary artery bypass graft
Senior patients are at a higher risk of developing pressure ulcers due to their preexisting conditions that include mobility restrictions, nutritional deficits, reduced blood flow, nerve damage and thin or fragile skin. The reason that "D" is not the better answer is that even though it is an elderly patient, a cochlear implant is a very quick procedure, and there is a lesser likelihood of developing a pressure ulcer during this short operative time
A patient is having a laparoscopic assisted vaginal hysterectomy. If the surgeon is unable to extract the uterus vaginally, which of the following equipment should the surgical technologist have available to retrieve the uterus?
harmonic scalpel
ligasure
morcellator
enseal
Morcellator
Morcellation, during gynecological procedures, means cutting the specimen into smaller pieces for easier removal. This has many benefits to the patient, including smaller incisions and shorter surgery time. The harmonic scalpel would not be helpful in retrieving the uterus because it is used to cut and coagulate tissue simultaneously. Ligasure and Enseal are used to help seal vessels.
A patient has a latex allergy and is scheduled for an abdominal hysterectomy. A catheter will be inserted in the patient's bladder pre-operatively. Which of the following is the proper catheter to use for this patient?
rubber Foley catheter
Teflon ureteral catheter
polyethylene Malecot catheter
silicone retention catheter
silicone retention catheter
While Teflon, polyethylene, and silicone are all substitute material options for latex products, the difference is in the types of catheters listed. A Malecot is a wing-tipped catheter often used for suprapubic catheter placement. A ureteral catheter is placed in the ureters, not the bladder. A rubber Foley is the traditional Foley that contains latex.
In anticipation of a visually impaired patient's surgical procedure, the best practice in facilitating movement would be for the surgical technologist to
explain the process of moving from stretcher to bed then guide the patient's hand to aid him while he moves.
guide the patient by touching him then explain the process of moving from the stretcher to the operating bed.
allow the patient to become familiar moving by feeling around on his own.
explain the process of moving then allow the patient to move on his own.
explain the process of moving from stretcher to bed then guide the patient's hand to aid him while he moves.
Rationale: Since the patient is visually impaired they cannot see that well what you are telling them to do. Someone should explain to the patient, what will be needed from them to move over to the operating room bed. The surgical technologist should guide the patient's hand and tell them where it is expected for them to move. The patient should be told what to do first ,and then have them move over to the correct position, with guidance as they move.
The surgeon requests suture to close the skin incision. Which of the following types of needles should be used?
tapered
blunt
Veress
cutting
cutting
Rationale: Cutting needles are used for passage of suture material through tough tissue difficult to penetrate, such as skin. Blunt and tapered needles do not pass through skin tissue as well as a cutting needle. A Veress needle is used to insufflate the abdomen for a laparoscopy.
Which of the following must the surgical technologist verify before implants are opened during a total knee replacement? (Select the three (3) correct answers.)
expiration date
name of component
lot number
size
manufacturer name
Correct response:
expiration date, name of component, size
Rationale: Manufacturer name and lot number do not have to be verified by the surgical technologist, but are charted by the circulator for documentation. Always verify implant type, size, and expiration date, prior to opening.
Which of the following is being tested when doing a Bowie-Dick test on an autoclave?
population of spores left in the autoclave
amount of air removed from the autoclave
correct pressure is attained
correct amount of steam present
Correct response:
amount of air removed from the autoclave
Rationale: Bowie-Dick is the most commonly known DART test that should be performed on the autoclave. It ensures that the air is completely removed from the chamber and that it has been successfully replaced with steam.
The surgical technologist prepared a breast lump to send as a frozen section to pathology. The surgical technologist should pass off the specimen placed
in normal saline.
on a raytec sponge.
on a telfa pad.
in formalin.
On a telfa pad
Rationale: A fresh frozen specimen means that the specimen is not in formalin, or any fixative agent. The STs responsibility is to place the specimen on a moist Telfa, which will allow it to be easily removed in the lab and not stick to an untreated surface. The ST should pass the specimen off on the Telfa to her circulator who will then place it in a clean specimen container and arrange for immediate transport to pathology.
The surgical technologist should use which of the following disinfectants when reprocessing an endotracheal tube used during surgery?
alcohol (70-90%)
phenolic
quaternary ammonium
cidex OPA
cidex OPA
Rationale: Alcohol (70-90%) is not used as a disinfectant. Phenolic is a detergent used for environmental cleaning only. Quaternary ammonium is used for low level environmental cleaning and has limited effectiveness. Cidex OPA is a chemical disinfect that is used for medical devices such as an endotracheal tube.
Which of the following procedures requires a surgical site dressing?
myringotomy
hysteroscopy
ureteroscopy
laparotomy
Laparotomy
Rationale: The laparotomy procedure is the only one that would have an incision big enough for a surgical site dressing. The myringotomy is a small incision in the ear to place a vent tube. A hysteroscopy is used for visualization of the uterus and uses a scope and no incisions are made. A ureteroscopy is also used for visualization, but of the ureters. No incision is made in a ureteroscopy either.
During a vaginal hysterectomy the surgical team noticed that the safety belt was left off the patient before the drape was applied and discovered after draping. How can the patient be secured to the OR bed without interrupting the sterile field or procedure?
The surgical technologist can watch for movement of the patient and inform the circulator.
The anesthesiologist can secure the head to prevent shifting.
The circulator can reach under the sterile drape and apply the safety strap.
The surgeon can request sterile coban to secure the patient.
The circulator can reach under the sterile drape and apply the safety strap.
Rationale: The underside of the drape is not sterile, therefore, can be touched by the unsterile circulating nurse, while she secures the patient with the safety strap.
A patient presents to the operating room for irrigation and debridement of a wound caused by penetrating trauma. The surgeon states that the wound will heal by secondary intention. Which of the following dressing types should the surgical technologist ask the circulator for?
Steri-Strips
bio-occlusive Opsite
ABD
bolsters
ABD dressing
Rationale: The ABD would be used because of the drainage that will follow after doing the irrigation and debridement so it can absorb fluid. Steri strips and the bio-occlusive opsite have an adhesive backing and would stick to the incision, so they are not the appropriate dressing. Bolsters are used over suture strands to keep them from cutting into the skin when suture is placed in a high tension area. A wound that will heal by secondary intention is not sutured closed. [Show Less]