1.
In a gastrointestinal closure, the mucosa of the intestinal tract is closed with
Correct Answer
A. Chromic 4-0 or 3-0
Explanation
The correct answer is chromic 4-0 or 3-0. Chromic refers to chromic gut suture, which is an absorbable suture material commonly used in gastrointestinal closures. The numbers 4-0 or 3-0 refer to the size of the suture, with smaller numbers indicating thicker sutures. These sizes are appropriate for closing the mucosa of the intestinal tract, providing adequate strength and support for the closure. Silk, Dacron, and Novafil are not commonly used for gastrointestinal closures, making them incorrect choices.
2.
Which type of suture would be used to invert the stump of an appendix?
Correct Answer
B. Purse-string
Explanation
A purse-string suture is used to invert the stump of an appendix during an appendectomy. This type of suture involves placing a continuous stitch around the base of the stump, which is then tightened to create a purse-string effect. This technique helps to prevent leakage of fluid or contents from the stump, reducing the risk of infection or complications.
3.
Why are bumpers or bolsters used on retention sutures?
Correct Answer
A. To prevent the suture from cutting into the skin suture
Explanation
Bumpers or bolsters are used on retention sutures to prevent the suture from cutting into the skin. These devices provide a cushioning effect and distribute the pressure evenly, reducing the risk of the suture digging into the skin and causing damage. This helps to maintain the integrity of the suture and promotes proper healing of the wound.
4.
A Nissen Fundoplication procedure is done to correct
Correct Answer
B. Antireflux disease
Explanation
A Nissen Fundoplication procedure is performed to correct antireflux disease. This procedure involves wrapping the upper part of the stomach around the lower part of the esophagus to strengthen the valve between them. This helps prevent stomach acid and food from flowing back into the esophagus, alleviating symptoms such as heartburn, regurgitation, and difficulty swallowing. By correcting the antireflux disease, the Nissen Fundoplication procedure aims to improve the patient's quality of life and reduce the risk of complications associated with chronic acid reflux.
5.
A dissecting sponge that is a small roll of heavy cotton tape is a
Correct Answer
A. Kitner
6.
Which procedure would not require a pressure dressing?
Correct Answer
D. Hysterectomy
Explanation
A hysterectomy is a surgical procedure to remove the uterus. Unlike plastic surgery, knee surgery, and radical mastectomy, a hysterectomy does not involve any incisions or removal of tissues that would require a pressure dressing to control bleeding or promote healing. Therefore, a hysterectomy would not require a pressure dressing.
7.
Peanuts and dissecting sponges are generally
Correct Answer
B. Moistened with saline
Explanation
Peanuts and dissecting sponges are generally moistened with saline because saline solution is isotonic to the body's fluids and tissues. This means that it has the same salt concentration as the body, making it less likely to cause damage or irritation. Moistening them with saline also helps to keep them moist and prevent them from drying out, which could potentially cause discomfort or complications during use.
8.
Intraabdominally, lap pads are most often used
Correct Answer
B. Moistened with saline
Explanation
Lap pads are commonly used intraabdominally during surgical procedures to absorb any fluids or blood that may be present. Moistening the lap pads with saline helps to enhance their absorbency and effectiveness in soaking up the fluids. Saline is a sterile solution of salt and water that is safe to use in the body, making it a suitable choice for moistening lap pads during surgery. Using saline helps to maintain a clean and sterile environment in the abdominal cavity, reducing the risk of infection or complications.
9.
A catheter commonly used in a gastrostomy is a
Correct Answer
A. Mushroom
Explanation
A catheter commonly used in a gastrostomy is a mushroom.
10.
Before handing a Penrose drain to the surgeon
Correct Answer
D. Moisten with saline
Explanation
Moistening the Penrose drain with saline before handing it to the surgeon is important because it helps to lubricate the drain, making it easier to insert into the surgical site. The saline also helps to keep the drain moist, preventing it from drying out and becoming less effective. Additionally, moistening the drain with saline can help to minimize tissue trauma and discomfort for the patient during insertion.
11.
A closed-wound suction system works by
Correct Answer
B. Negative-pressure vacuum
Explanation
A closed-wound suction system works by creating a negative-pressure vacuum. This means that the system creates a pressure lower than atmospheric pressure, which helps to remove fluids or air from a closed wound. The negative pressure allows the system to draw out any excess fluids or air, promoting healing and preventing infection. It is an effective method for drainage and maintaining a clean wound environment.
12.
Which condition regarding sterile technique in NOT recommended?
Correct Answer
B. Sterile tables may be set up and safety covered until time of surgery
Explanation
The condition regarding sterile technique that is NOT recommended is "sterile tables may be set up and safety covered until time of surgery." This is because sterile tables should be set up just before the operation, not beforehand and covered. This is to ensure that the tables remain sterile and free from any potential contamination.
13.
The disposable circular staple designed to hold two tubular strutures together after resection is known as
Correct Answer
C. EEA
Explanation
The correct answer is EEA. EEA stands for End-to-End Anastomosis, which is a surgical technique used to connect two tubular structures after resection. The disposable circular staple mentioned in the question refers to the EEA stapler, which is specifically designed for this purpose. It allows for a secure and efficient connection between the tubular structures, promoting proper healing and functionality.
14.
When a sterile item is hanging or extending over the sterile table edge, the scrub nurse
Correct Answer
B. Does not touch the part hanging below table level
Explanation
When a sterile item is hanging or extending over the sterile table edge, the scrub nurse must not touch the part hanging below table level. This is because touching the part hanging below the table level can cause contamination and compromise the sterility of the item. The nurse should be vigilant and ensure that no one comes near the item to prevent any accidental contact that may lead to contamination. If the item is hanging or extending over the table edge, the nurse should pull it back onto the table to maintain its sterility. Using the item in this situation would also risk contamination and is therefore not the correct course of action.
15.
Which of the following is considered a break in technique?
Correct Answer
C. A sterile person sits or leans against a nonsterile surface
Explanation
Sitting or leaning against a nonsterile surface is considered a break in technique because it can potentially contaminate the sterile person or their equipment. Maintaining a sterile field is crucial in healthcare settings to prevent the spread of infection, and any contact with nonsterile surfaces should be avoided to ensure the integrity of the sterile environment.
16.
In which situation should sterility be questioned?
Correct Answer
A. If a sterilized pack is found in an unsterile workroom
Explanation
Sterility should be questioned if a sterilized pack is found in an unsterile workroom because the presence of a sterilized pack in an unsterile environment raises concerns about the effectiveness of the sterilization process and the potential for contamination. It is important to maintain a sterile environment to prevent the introduction of microorganisms that can cause infections during medical procedures.
17.
Transduodenal sphincterotomy refers to the incision made into the _________ to relieve stenosis.
Correct Answer
C. SpHincter of Oddi
Explanation
Transduodenal sphincterotomy refers to the incision made into the sphincter of Oddi to relieve stenosis. The sphincter of Oddi is a muscular valve located at the junction of the common bile duct and the pancreatic duct, controlling the flow of bile and pancreatic juices into the duodenum. If the sphincter becomes narrowed or blocked, it can lead to various digestive problems. A sphincterotomy involves cutting the sphincter to widen the opening and improve the flow of fluids, providing relief from the stenosis.
18.
When handing skin towels to the surgeon, where should the scrub person stand in relation to the surgeon?
Correct Answer
B. On the same side of the table
Explanation
The scrub person should stand on the same side of the table as the surgeon when handing skin towels. This allows for efficient communication and coordination between the two individuals during the surgical procedure. Being on the same side ensures that the towels can be easily handed off without any obstruction or confusion. It also allows the scrub person to anticipate the surgeon's needs and provide the necessary support throughout the operation.
19.
Irrigating fluid used to flush the organ between harvest and transplantation of a liver is known as
Correct Answer
C. Collin's
Explanation
Collin's is the correct answer because it refers to the irrigating fluid used to flush the organ between harvest and transplantation of a liver. Ringer's Lactate, Physiosol, and normal saline are not specifically used for this purpose.
20.
Each of the following actions by a scrub person prevents wounds and punctures, according to CDC guildlines EXCEPT
Correct Answer
B. Recap injection needles
Explanation
The scrub person should not recap injection needles as it increases the risk of needlestick injuries. Recapping needles can lead to accidental punctures and exposure to bloodborne pathogens. The CDC guidelines recommend using safer alternatives such as using a one-handed technique or a needle recapping device to prevent needlestick injuries.
21.
Which of the following is NOT an acceptable technique when draping a patient?
Correct Answer
C. Unfold the drapes before bringing them to the OR table
Explanation
Unfolding the drapes before bringing them to the OR table is not an acceptable technique when draping a patient. Drapes should be unfolded directly over the proper area to minimize the risk of contamination. Unfolding them before bringing them to the table increases the chances of contact with potentially unsterile surfaces, compromising the sterile field.
22.
The procedure to follow if a hair is found on the operative field is to
Correct Answer
C. Remove it with a clamp, cover over area
Explanation
If a hair is found on the operative field, the correct procedure is to remove it with a clamp and cover the area. This is important to ensure a clean and sterile environment during the procedure, as any foreign object, including hair, can increase the risk of infection or other complications. Removing the hair with a clamp helps to prevent it from falling into the wound or contaminating the surgical site, while covering the area helps to maintain the sterile field. Notifying the circulator and completing an incident report may also be necessary steps to document the occurrence and ensure proper follow-up.
23.
Cancer technique in surgery refers to
Correct Answer
B. The discarding of instruments coming in contact with tumor after each use
Explanation
The correct answer is the discarding of instruments coming in contact with tumor after each use. This technique is important in surgery to prevent the spread of cancer cells to other areas of the body. By discarding instruments that have come into contact with the tumor, the risk of contamination and spreading of cancer cells is minimized. This helps to ensure that the surgery is as effective as possible in removing the tumor and reducing the chances of recurrence.
24.
Why are gowns, gloves, drapes, and instruments changed following a breast biopsy and before incision for a mastectomy?
Correct Answer
D. To protect margins of healthy tissue from tumor cells
Explanation
The reason gowns, gloves, drapes, and instruments are changed following a breast biopsy and before incision for a mastectomy is to protect the margins of healthy tissue from tumor cells. By changing these items, any potential contamination from the biopsy procedure is eliminated, reducing the risk of spreading tumor cells to healthy tissue during the mastectomy. This ensures that the surgical site remains as clean and free from tumor cells as possible, improving the chances of successful removal of the cancerous tissue.
25.
A postoperative complication attributed to glove powder entering a wound is
Correct Answer
A. Granulomata
Explanation
Glove powder can lead to the formation of granulomata, which are small nodules that develop in response to foreign substances. When the powder enters a wound, it can cause an inflammatory reaction, leading to the formation of these nodules. Infection and inflammation are also possible complications, but in this case, the specific complication attributed to glove powder is granulomata. Keloid formation refers to the excessive growth of scar tissue and is not directly related to glove powder entering a wound.
26.
The correct procedure for sterile dressing application is
Correct Answer
B. Apply dressing before drape removal
Explanation
Applying the dressing before removing the drape is the correct procedure for sterile dressing application. This is because the drape acts as a barrier to prevent contamination from entering the wound during the procedure. Removing the drape before applying the dressing would expose the wound to potential contaminants, increasing the risk of infection. Therefore, it is essential to apply the dressing before removing the drape to maintain sterility and ensure proper wound healing.
27.
When drop technique for an intestinal procedure is utilized
Correct Answer
C. Contaminated instruments are discarded, gloves are changed
Explanation
When the drop technique is used for an intestinal procedure, contaminated instruments are discarded and gloves are changed. This is because the drop technique involves dropping instruments onto a sterile field, and if any instruments come into contact with non-sterile surfaces or are contaminated during the procedure, they must be discarded to maintain asepsis. Changing gloves is also necessary to prevent the spread of contamination. The use of two Mayo stands, not changing drapes and gloves, and using a separate setup for closure are not related to the drop technique and do not address the issue of contamination.
28.
If the floor or wall becomes contaminated with organic debris during a case, the circulator
Correct Answer
B. Decontaminates promptly
Explanation
In order to maintain a clean and sterile environment during a surgical case, it is crucial for the circulator to promptly decontaminate the floor or wall if it becomes contaminated with organic debris. This helps to prevent the spread of bacteria and potential infections. Waiting until the case is complete or deferring the task for terminal cleaning could lead to further contamination and compromise the safety of the surgical team and the patient. Therefore, prompt decontamination is necessary.
29.
The Sengstaken-Blakemore tube is used for
Correct Answer
A. EsopHageal hemorrhage
Explanation
The Sengstaken-Blakemore tube is a medical device used for esophageal hemorrhage. This tube consists of two balloons, one in the esophagus and the other in the stomach, which when inflated, exert pressure on the bleeding vessels to stop the hemorrhage. It is specifically designed for managing severe bleeding in the esophagus, typically caused by conditions such as esophageal varices. This device is not used for tonsillar, uterine, or nasal hemorrhage.
30.
A specially treated form of surgical gauze that has a hemostatic effect when buried in tissue is
Correct Answer
D. Oxycel
Explanation
Oxycel is a specially treated form of surgical gauze that has a hemostatic effect when buried in tissue. It is designed to stop bleeding by promoting clotting and accelerating the healing process. This makes it an effective option for controlling bleeding during surgical procedures.
31.
An enzyme extract from bovine blood used as a topical hemostatic agent is
Correct Answer
C. Thrombin
Explanation
Thrombin is the correct answer because it is an enzyme that plays a key role in the blood clotting process. When applied topically, it can help control bleeding by promoting the formation of blood clots. Oxytocin is a hormone involved in labor and breastfeeding, tannic acid is a compound found in plants, and collagen is a protein found in connective tissues. None of these substances have the same hemostatic properties as thrombin.
32.
A common complication of extubation is
Correct Answer
C. Hypoxia
Explanation
Hypoxia refers to a condition where there is a decrease in the oxygen supply to the body's tissues. Extubation, the removal of a breathing tube, can lead to hypoxia due to various reasons such as inadequate ventilation or impaired lung function. This can result in a decrease in oxygen levels in the blood, leading to symptoms like shortness of breath, dizziness, and confusion. Therefore, hypoxia is a common complication of extubation.
33.
The desirable position for better visualization in the lower abdomen or pelvis is
Correct Answer
C. Trendelenburg
Explanation
The correct answer is Trendelenburg. Trendelenburg position involves tilting the patient's body with the head lower than the feet. This position is commonly used in surgeries or procedures involving the lower abdomen or pelvis. It helps to improve visualization by allowing gravity to pull the intestines away from the surgical site, providing better access and visibility for the surgeon.
34.
Another name for the Kraske position is
Correct Answer
D. Jackknife
Explanation
The Kraske position is also known as the jackknife position. This position is used in surgery and involves the patient lying face down with their hips flexed and their chest and knees resting on the operating table. The name "jackknife" refers to the shape the patient's body resembles when in this position, as it resembles the folding knife known as a jackknife.
35.
All of the following are helpful in keeping accurate account of sponges EXCEPT
Correct Answer
C. Keep all sponges and tapes in a basin or close together on the field
Explanation
Keeping all sponges and tapes in a basin or close together on the field would not be helpful in keeping an accurate account of sponges. This is because it would make it difficult to differentiate between the different sponges and tapes, increasing the chances of miscounting or losing track of them. To keep an accurate account, it is important to keep sponges separate from linen and instruments, keep needles separate from sponges, and maintain a mental count of the number of sponges on the field at any given time.
36.
Dark blood in the operative field may indicate that the patient is
Correct Answer
D. Hypoxic
Explanation
Dark blood in the operative field may indicate that the patient is hypoxic. Hypoxia refers to a condition where there is a lack of oxygen supply to the tissues. Dark blood signifies that the blood has been deprived of oxygen for a longer duration. Therefore, the presence of dark blood in the operative field suggests that the patient may be experiencing a lack of oxygen, leading to hypoxia.
37.
In an extreme patient emergency, a sponge count
Correct Answer
A. May be omitted
Explanation
In extreme patient emergencies, such as when a patient's life is at immediate risk, certain protocols and procedures may be omitted or modified to prioritize saving the patient's life. In such cases, a sponge count, which is the process of keeping track of surgical sponges used during a procedure to ensure none are left inside the patient, may be omitted to expedite the surgery and save time. This decision is made with the understanding that the potential risks associated with a missed sponge are outweighed by the urgency of the situation.
38.
Cultures obtained during surgery
Correct Answer
B. Are passed off the sterile field into a bag or container held by the circulator
Explanation
During surgery, cultures obtained are passed off the sterile field into a bag or container held by the circulator. This is done to maintain the sterility of the surgical field and prevent contamination. The circulator, who is responsible for handling and organizing instruments and supplies, takes control of the cultures to ensure they are properly collected and transported to the lab for analysis. This practice helps to maintain the integrity of the cultures and ensures accurate results in the laboratory.
39.
How is a frozen section sent to the lab?
Correct Answer
D. Dry
Explanation
A frozen section is not sent to the lab in any liquid or solution. It is sent dry, without any additional substances such as formalin, saline, or water. This is because a frozen section is a technique used in histology where a tissue specimen is frozen and then cut into thin slices for microscopic examination. Adding liquid to the specimen would interfere with the freezing process and compromise the quality of the section. Therefore, the correct answer is "dry".
40.
Which of the following specimens is NOT placed in preservative solution?
Correct Answer
A. Stones
Explanation
Stones are not typically placed in a preservative solution because they are inanimate objects and do not require preservation. On the other hand, curettings, tonsils, and uterus are biological specimens that are often preserved in a solution to maintain their integrity and prevent decomposition.
41.
The term transduldenal sphincterotomy indicates surgery of the
Correct Answer
C. Distal end of the common bile duct
Explanation
Transduldenal sphincterotomy refers to a surgical procedure performed on the distal end of the common bile duct. This procedure involves making an incision in the sphincter of Oddi, a muscular valve that regulates the flow of bile and pancreatic juices into the small intestine. By performing a sphincterotomy at the distal end of the common bile duct, it allows for improved drainage of bile and can help treat conditions such as gallstones or biliary strictures.
42.
McBurney is an incision used for
Correct Answer
A. Appendectomy
Explanation
McBurney is an incision commonly used for appendectomy, which is the surgical removal of the appendix. The incision is made in the lower right abdomen, at a point called McBurney's point, which is located between the navel and the right hip bone. This incision provides access to the appendix for its removal, as it is the most common surgical procedure for treating appendicitis, which is the inflammation of the appendix.
43.
The simplest abdominal incision offering good exposure to any part of the abdominal cavity is the
Correct Answer
D. Vertical midline
Explanation
The vertical midline incision is considered the simplest abdominal incision because it provides good exposure to any part of the abdominal cavity. This type of incision is made along the midline of the abdomen, from the pubic bone to the sternum. It allows for easy access to various organs and structures within the abdominal cavity, making it a versatile choice for surgical procedures.
44.
During an appendectomy, a purse-string suture is placed around the appendix stump to
Correct Answer
D. Invert the stump of the apppendix
Explanation
During an appendectomy, a purse-string suture is placed around the appendix stump to invert the stump of the appendix. Inverting the stump helps to prevent the leakage of any fluid or bacteria from the appendix into the abdominal cavity. This technique also helps to ensure that the stump is securely closed and reduces the risk of postoperative complications such as infection or abscess formation. By inverting the stump, the surgeon creates a more secure closure and promotes faster healing of the surgical site.
45.
Gastrointestinal technique is required in all of the following procedures EXCEPT
Correct Answer
A. Cholecystectomy
Explanation
Gastrointestinal technique is required in all of the given procedures except cholecystectomy. Cholecystectomy is the surgical removal of the gallbladder, which is not directly related to the gastrointestinal tract. On the other hand, low anterior colon resection, appendectomy, and hemicolectomy all involve the gastrointestinal tract and require specific techniques for their execution.
46.
A hernia occurring in Hesselback's triangle is called
Correct Answer
C. Direct
Explanation
A hernia occurring in Hesselback's triangle is called a direct hernia. Hesselback's triangle is a region in the groin where direct hernias typically occur. Direct hernias protrude through the posterior wall of the inguinal canal, which is formed by the transversalis fascia. In contrast, indirect hernias occur when the hernial sac enters the inguinal canal through the deep inguinal ring and follow the path of the spermatic cord. Therefore, in this context, the correct answer is "direct."
47.
Pathologic enlargement of the male beast is called
Correct Answer
B. Gynecomastia
Explanation
Gynecomastia is the correct answer because it refers to the pathologic enlargement of the male breast. It is characterized by the development of glandular tissue in the male breast, leading to a breast-like appearance. This condition can be caused by hormonal imbalances, certain medications, or underlying medical conditions. Subcutaneous adenoma, hypoplasia, and cystic mastitis do not specifically refer to the enlargement of the male breast, making them incorrect choices.
48.
Sutures placed in a wound to prevent wound evisceration are called
Correct Answer
C. Retention
Explanation
Sutures placed in a wound to prevent wound evisceration are called retention. This term refers to the act of keeping something in place or preventing it from moving or being removed. In the context of wound care, sutures are used to hold the edges of a wound together, promoting healing and preventing the contents of the wound from protruding. Therefore, the term "retention" accurately describes the purpose and function of sutures in this scenario.
49.
Surgical enlargement of the passage between the prepylorus of the stomach and the duodenum is a
Correct Answer
B. Pyloroplasty
Explanation
Pyloroplasty is the correct answer because it refers to the surgical enlargement of the passage between the prepylorus of the stomach and the duodenum. This procedure is performed to treat conditions such as pyloric stenosis, where the pylorus (the opening between the stomach and the small intestine) becomes narrowed and obstructs the flow of food. Pyloroplasty involves making an incision in the pylorus to widen the passage and improve the movement of food from the stomach into the small intestine.
50.
A Whipple operation is surgically termed a
Correct Answer
B. Pancreatoduodenectomy
Explanation
A Whipple operation, also known as a pancreatoduodenectomy, is a surgical procedure that involves the removal of the head of the pancreas, part of the small intestine, the gallbladder, and sometimes a portion of the stomach. This procedure is commonly used to treat pancreatic cancer, as well as other conditions such as chronic pancreatitis and tumors in the pancreas or bile ducts. It is considered a complex and extensive surgery that requires a skilled surgeon and a multidisciplinary team.