Random Test NBSTSA 1
In an inguinal herniorrhaphy the spermatic cord is?
Retracted with a Penrose drain. When an inguinal herniorrhaphy is being performed, the spermatic cord is identified, freed, and a Penrose drain is placed around it for traction, and to prevent injury.
Polyglycolic acid sutures are
absorbed by the process of hydrolysis. Polyglycolic acid is a synthetic absorbable suture that is not affected by enzymes but rather by the process of hydrolysis, whereby water in the body acts to break down the polymeric constituents
The pounds of pressure necessary in a flash steam sterilizer set at 270 F is
27 pounds. 27 pounds of pressure is necessary for the steam autoclave set at 270 F. The high speed is the flash sterilizer.
A patient is having elective surgery. The nurse notes that her white cell count is 14,000 cu mm. That would indicate that
There may be an inflammation or infection present. The leukocytes normally range between 5000 and 10,000 cells in each cu mm of whole blood. High white counts may be indicative of an unsuspected inflammatory process that could contraindicate surgery.
Distal refers to
Away from the body. The term distal refers to an area away from the point of origin (body). The hand is distal to the elbow.
Meckel's diverticulum is found in the
Ileum. Meckel's diverticulum is a congenital sac or blind pouch sometimes found in the lower portion of the ileum. Strangulation may cause an intestinal obstruction.
In which case would a Frazier suction be used?
Ear. A Frazier suction would be found on an otologic setup
Airborne contamination is reduced by recirculation of filtered outside air at a rate of
25 air exchanges per hour. Recirculation of filtered air at a rate of no less than 25 air exchanges per hour is considered safe and economical
The purpose of OSHA is to
Ensure safe and healthful working conditions. OSHA's main purpose is to ensure safe and healthful working conditions for employees.
The body heat in pediatric patients is controlled with all of the following EXCEPT
Hot water bottles. Body heat in pediatric patients is controlled by wrapping the child in plastic materials, a warming blanket, and increasing room temperature. Hot water bottles are not used because they are unsafe
If the family is contacted but cannot come in to sign a permission for emergency surgery, the surgeon should.
accept permission by phone, telegram, or in written communication. If by telephone, two people monitor the conversation and sign the permission form as witnesses
Unwrapped instruments are sterilized at 270 F for a minimum of-
A retention suture passes through all of the following EXCEPT
Mesentery tissue. The tissue through which retention sutures are passed includes the skin, subcutaneous tissue, fascia, and may include the rectus muscle and peritoneum of an abdominal incision
A hernia that passes through the inguinal ring into the inguinal canal is termed
Indirect. Indirect hernias leave the abdominal cavity through the inguinal canal. Consequently, the hernia can often be found in the scrotum.
Dead space is the space
caused by separation of wound edges that have not been closely approximated. Dead space is that space caused by separation of wound edges that have not been closely approximated by sutures.
Wrapped tubing can be sterilized at 250 F for a minimum of.
Funnel chest is also known as
Pectus excavatum. Pectus ecavatum (funnel chest) and pectus carinatum (pigeon chest) are chest congenital defects.
Which term denotes low or decreased blood volume?
Hypovolemia. means low or decreased blood volume.
Injection of contrast media into the brachial, carotid, or vertebral artery to study the intracranial vessels is called.
angiography. An angiogram is a test in which vessel size, location, and configuration can be studied by injecting dye into intracranial vessels. It is an x-ray procedure.
Instruments and other items sterilized together in the flash autoclave require.
30 minutes at 250 F. Instruments alone can be flashed at 270 F. The addition of other items makes the requirement 10 minutes at 270 F.
Suture material that becomes encapsulated with fibrous tissue during the healing process is
Nonabsorbable suture. Remain permanently embedded in the body. During the healing process, they become encapsulated with fibrous tissue.
A right hemicolectomy is performed to remove pathology of the
ascending colon. This procedure is performed to remove a malignant lesion of the right colon and, in some cases, to remove inflammatory lesions involving the ileum, cecum, or right colon
Dacryo refers to
Lacrimal glands. Dacryo pertains to tears. The lacrimal sac fills with tears secreted by the lacrimal glands via the lacrimal ducts
When transporting a patient, drainage systems should be placed.
below the stretcher level. Drainage tubing should be placed so that there is a downward gravity flow.
The maximum size of a linen pack must not exceed
12X12X20 inches. Linen packs must not exceed a maximum size of 12x12x20 inches. Linens are loosely criss-crossed so as not to form a dense mass
Another name for a stay suture is a
retention suture. A retention or stay suture provides a secondary suture line. The purpose is to relieve undue strain on the primary suture line and do help obliterate dead space.
Which two anatomic structures are ligated and divided to effect a cholecystectomy
cystic duct, cystic artery. After complete exposure of the biliary tract, the cystic artery is doubly ligated and divided. The cystic duct is identified, carefully dissected from the common bile duct to the gallbladder neck, then doubly ligated and divided.
When the patient is being transferred from the OR table after surgery, the action should be
gentle and slow in order to prevent circulatory depression. The patient should be lifted or rolled gently and slowly to prevent circulatory depression. A sudden or jarring movement is potentially dangerous to the patient.
In steam sterilization, the function of pressure is to
increase the temperature of the steam. Moist heat and steam under pressure destroy microbial life. Heat destroys microorganisms, but the process is hastened with steam. Pressure is necessary to increase the temperature of the steam for destruction of microbial life.
Which of the following suture materials is not generally used in the presence of infection?
silk. Silk suture is used only in the absence of infection
Radical surgery done for lower sigmoid of rectal malignancy is an
abdominal perineal resection. This surgery is performed for malignant lesions of the lower sigmoid colon, rectum, and anus. It is a two-part procedure that involves resecting the proximal disease-free sigmoid and pulling the diseased portion down through a widely excised anus with total, permanent closure of the anus.
The term for fluid or water in the ventericles of the brains is
Hyprocephalus. The increased accumulation of cerebrospinal fluid within the ventericles of the brain is hydrocephalus. It results from interference with normal circulation and absorption of fluid and may result from developmental anomalies, infection, injury, or brain tumors. Treatment may be surgical shunt through which cerebrospinal fluid flows from the ventricales of the brain to a cavity such as the peritoneum.
The patient may be left on the transport stretcher unattended.
under no circumstances. A patient should never be left on a stretcher or OR table unattended, even though appearing alert and responsible
212 F is equivalent to
100C. The boiling point for water is 212F. This is equal to 100C 1.0F is equal to .54C
An anti-inflammatory drug whose effect is useful in reversing early rejection of organ transplants is
Prednisone. has an anti-inflammatory effect useful in reversing early rejection syndrome
A congenital abnormality of the musculature between the stomach and the duodenum is called
pyloric stenosis. Congenital hypertrophic pyloric stenosis is an abnormality of the pyloric musculature in which there is alteration of fibrous, gristle-like tissue, causing mechanical obstruction of the distal stomach
A fossa is a
basin-like depression. A fossa is a basin-like depression, for example, liliac fossa
A procedure performed to treat myasthenia gravis is a
thymectomy. Removal of the non-neoplastic thymus gland seems to have equivocal effects on the progression of myasthenia gravis
The purpose of lidocaine installation during a tracheotomy is to
decrease coughing. Lidocaine is instilled into the trachea to decrease coughing immediately before insertion of the tracheotomy tube.
A procedure that is done to give the bowel a rest when there is advance inflammation is
A temporary colostomy is done to decompress the bowel or give the bowel a rest as in advance inflammation or trauma
A forceps used to grasp lung tissue is a
Duval. The Duval lung-grasping forceps is designed to grasp lung tissue firmly while producing minimal tissue trauma
Heat-sensitive items that can be completely immersed can be processed via the ______ in 30 minutes
STERIS. A sterile processing system that uses peracetic acid, the STERIS system, is appropriate for heat-sensitive items that can be cleaned and completely immersed. The cycle is less then 30 minutes and less damaging than steam.
The maximum recommended dosage of local anesthetic drug per hour is
50mL of 1% solution. A recommendation is that no more than 50mL of a 1% solution of an anesthetic drug such as Lidocaine be injected per hour for local anesthesia
Ischemia can be defined as
deficient blood supply to a part. Ischemia is a local or temporary deficiency of blood supply caused by obstruction of the circulation to a part. A transient ischemic attack (TIA) is a temporary interference with the blood supply to the brain lasting a few moments to several hours.
The person transporting the patient on a stretcher should
push the stretcher from the head. The transporter should be near the patient's head so that he or she can converse with the patient or be available to assist the patient in an emergency, such as vomiting. When the patient is on the stretcher, his or her feet should be pointed down the hallway first
can be reused. Activated glutaraldehyde penetrates into the crevices of items, is noncorrosive, does not damage lenses or cement on lensed instruments, is not absorbed by rubber and plastic, and can be reused throughout the effective activation period.
A Weitlaner is a
A Weitlaner is a self-retaining retractor
Which part of the pancreas is the most common site of malignant tumors?
The head of the pancreas is the most common site of a malignant tumor
The purpose of the two-way stopcock on a Verres needle is
To control gas flow. The Verres needle is used to produce pneumoperitoneum. The two way stopcock at the base controls gas flow
An abnormal communication between two parts occurring in the anorectal area is called
fistula in ano. A fistula in ano is an abnormal communication between two parts often developing after an I and D or spontaneous drainage of an anorectal absecess
Burn removal of tissue down to fascia where all superficial layers are denuded is called
escharectomy. Full thickness eschar is excised down to fascia when viable tissues in more superficial layers are not evident. All denuded areas created by the excision are covered with biologic dressing for 3-5 days
The method of sterilization used for liquids is
slow exhaust. Solutions are steam sterilized alone and on slow exhaust. This is used so that the solutions do not boil over.
Medullary canal reamers are used to insert
Kuntschner nails. A medullary canal reamer reams the medullary canal for insertion of a Kuntschner nail.
A protrusion of fat through an abdominal wall defect between the xiphoid process and umbilicus is a
epigastric hernia. Epigastric hernias are located where fatty tissue protrudes through an abdominal wall defect between the xyphoid process and the umbilicus. Surgical repair is simple and successful
The position frequently utilized in thyroid and gallbladder surgery is
Reverse Trendelenburg. In this postion, the entire table is tilted so that the head is higher that the feet. It is used in thyroid surgery to facilitate breathing and decrease blood supply to the operative area. It is used in gallbladder surgery to allow abdominal viscera to fall away from the epigastric area, thus giving better exposure and access
What part of the cell is destroyed in steam sterilization?
cell protein. Microbial destruction is via a denaturation and coagulation of enzyme-protein in the cell
Which scope has a trocar?
laparoscope. The laparoscope has a trocar that aids in its puncture through the abdominal wall.
Laminar air flow provides
Laminar air flow is an ultraclean air system that filters, dilutes, and distributes air via a controlled unidirectional positive-pressure steam of air. It is used in high-risk procedures to reduce airborne bacterial contamination
A rotator cuff tear would occur in the
Shoulder. Rotator cuff tears frequently follow trauma to the shoulder in patients with weakened tendinous fibers who have degenerative changes within the joint. They cannot abduct shoulder
Which position would be chosen for a pneumonectomy?
Lateral. For pneumonectomy, a posterolateral approach is used, and the patient is placed on the table in the lateral position. A pillow is placed under the head and also between the patient's legs. The bottom knee is padded. The upper arm is flexed slightly and raised armboard. Compression of lower arm must be avoided.
When preparing tubing or any item with a lumen for gas sterilization
The lumen should be blown out with air to force-dry before packaging. In gas sterilization, any tubing or other item with a lumen should be blown out with air to force-dry before packaging because the water combines with the (EO) gas to form a harmful acid, ethylene glycol
A rib raspatory is a
Alexander. The Doyen (AKA Alexander) is a rib raspatory
A right-angled gallbladder forceps is a
Mixter. Dissection of the gallbladder from the bed of the liver is accomplished by the use of right-angle (mixter) clamps, blunt peanut dissectors, and Metzenbaum scissors.
A self-retaining mouth gag is a
Jennings. A mouthgag used in tonsillectomy and adenoidectomy is a Jennings
The maximum storage life for a muslin-wrapped item on open shelving is
30 days. The storage life is 21 to 30 days for muslin-wrapped items. Its a longer if it is hermetically sealed in a plastic overwrap
How are the legs placed in the lateral position?
The lower leg is flexed with the upper leg straight. In kidney position, the knee of the unaffected side is flexed to aid in stabilization, and the upper leg is straight. Legs are separated with a pillow.
Which statement regarding the changing of a glove during an operation is TRUE.
open-glove and another team member assists in regloving. The closed glove technique cannot be used for glove change during a procedure without contamination of the new glove by the sleeve of the gown or hand by the gown cuff. Preferably another team member regloves another
Each statement regarding OR room ventilation is true EXCEPT
Humidity is kept at 20-30%. Humidity should be maintained between 50% and 60% never less than 45%. This is to reduce the possibility of explosion from static charges
How many thoracic vertebrae are there?
12. There are 12 thoracic, 7 cervical, 5 lumbar, 1 sacrum, and 1 coccyx
When moving a patient from lithotomy position
lower legs together slowly. When in lithotomy position, legs should be raised, positioned, and lowered at the same time slowly, with no sudden movement and good support. Raising the legs simultaneously also prevents strain on the back and possible dislocation of the hips. Slow movements prevent hypotension as blood reenters the legs.
If a sterile muslin package drops to the floor.
it may never be used again. A sterile muslin-wrapped pack that drops on the floor should be discarded because compression results from the fall and air and dust could enter the package. It can no longer be considered sterile.
A tonsil suction is a
Yankauer. A Yankauer suction tip is used in a T&A and has a small hole at the end for directed suctioning. It is frequently used in general surgery when a limited amount of suctioning is to be done.
The most susceptible organ to laser injury is the
Eyes. The eye is the most susceptible organ to laser injury, thus safety glasses or goggles must be worn. Each type of laser requires specific types of lenses
The principal hazard encountered in splenecotomy is
Hemorrhage. Great care must be taken in ligating the splenic artery and vein because they are friable. Hemorrhage is the principal hazard encountered in surgery
When assisting with a cast application one must
handle cast with flat open hands. One must handle the cast with flat, open hands, never the fingers, which would cause finger pressure areas. The plaster bandage is held under water vertically to allow bubbles to escape. Water is 70-75 degree so the patient will not be burned. Rolls are soaked one at a time, keeping just ahead to avoid plaster hardening and waste
The most common postoperative complication of orthopedic surgery is
thromboembolism. Is the most common postoperative complication of orthopedic surgery, particularly if a patient must be immobilized for an extended period.
Which is an acceptable means of pouring a sterile solution onto a sterile field?
If a solution must be poured into a sterile receptacle on a sterile field, the scrub nurse holds the receptacle away from the table or sets it near the edge of a waterproof-drape table. The circulating nurse may not pour by reaching over the sterile field. She also must be careful not to drip any solution from outside of bottle onto sterile field.
Which nerve is affected by pressure on the lower leg or knee?
Peroneal. concerns the fibula (bone in the lower leg) and the common peroneal (lateral popliteal) nerve. Inadequately padded or improperly placed legs can cause pressure on the peroneal nerve
What advantage is phacoemulsification for cataract removal?
The ultrasonic vibrating nature of irrigation with a phaecoemulsification unit may cause injury to cells because of the substantial amount of anterior chamber irrigation. Corneal cells are very sensitive to manipulation, The short convalescence and small incision are both advantages.
The structure that covers the entrance of the larynx when one swallows, thus preventing food from entering the airway (trachea) is called
Epiglottis. The epiglottis is the lid like cartilaginous structure overhanging the entrance to the larynx, guarding it during swallowing
Physiologic salt solution used intravenously when the body needs additional sodium, calcium, and potassium is
Ringer's lactate solution, a physiologic salt solution, may be infused when the body's supply of sodium, calcium, and potassium have been depleted or for the improvement of circulation and simulation of renal activity.
In the lateral chest position, a sandbag or padding is placed under the chest at axillary level to
Prevent pressure on the lower arm. A precautionary measure in the lateral chest position is to place a sandbag under the weight bearing thorax at axillary level to relieve pressure and ensure uninhibited infusion therapy
A viscous jelly used to occupy space, thus preventing damage, in anterior segment surgery of the eye is
Healon. A viscous jelly, occupies space to prevent damage and adhesion formation, when opening the anterior capsule of the eye
Which of the following is frequently used over an incision following pediatric surgery
Collodian. An adheasive spray or collodian is adequate over a small incision and is especially desirable under diapers, unless dressings are needed to absorb drainage.
An agent used for epidural, spinal, or local providing good relaxation is
Marcaine. a local anesthetic, is used for epidurals, spinals, or local infiltration. It is long acting and provides food relaxation
The instrument used to measure the depth of a uterus during a dilation and curettage is a
uterine sound. The direction of the cervical canal and the depth of the uterine cavity are determined by means of a graduated uterine sound
Vagotomy is performed for peptic ulcer disease to
decrease secretion of gastric acid. A popular method of treating patients with ulcers is by cutting the vagus nerve. The vagus nerve stimulates gastric acid. This procedure reduces gastric acid secretions.
Before surgery, elastic bandages or special stockings are sometimes applied to the lower extremities to.
prevent venous stasis. Antiembolic stockings or elastic bandages may be applied to the lower extremities to prevent embolic phenomena or venous stasis. It also helps maintain blood pressure
Surgical masks should be changed
after each case. The OR staff should remask between patients
Why would benzoin be applied to the skin before dressing application?
to increase adhesiveness. Benzoin may be sprayed on the skin before applying tape to increase its adhesion
Closing the internal os of an incompetent cervix with a ligature of tape is called.
Shirodkar. A Shirodkar operation is placement of a collar type ligature of mersilene or Dacron at the level of the internal os to close is and prevent premature cervical dilation in a pregnancy
Pneumoperitoneum is effected by instilling gas into the peritoneal cavity by way of a
Verres needle. To produce pneumoperitoneum, a Verres needle is introduced infraumbilically into the peritoneal cavity. The gas is slowly introduced into the cavity under controlled flow and pressure
In addition to providing bladder drainage following a suprapublic prostatectomy, a Foley catheter
exerts pressure to obtain hemostasis. Hemostatic agents usually are packed into extremely vascular prostatic fossa to help control bleeding. Pressure from the Foley catheter balloon inserted after the closure of the urethra also helps obtain hemostasis.
Electrical connection of the patient to the conductive floor is assured by
a conductive strap in direct contact with the patient's skin, with one end of the strap fastened to the OR table metal frame.
Safety during use of the defibrillator includes all of the following EXCEPT
Maintaining contact with OR table and the patient. Paddle switches are pressed simultaneouely. The operator should have dry hands and stand on dry floor. Operator should not touch the OR table or the patient while current is applied to prevent self-electrocution
A drug that may be used as an IV flush or as a flush for a blood vessel lumen is
Heparin. Given IV, heparin is effective immediately and is used as a flush to keep IV lines open or to flush blood vessels lumens, 1mL heparin in 100mL normal saline
Nipple reconstruction can be enhanced by the use of a
tattoo. Tattooing may complete the reconstruction of the nipple after breast reconstruction surgery. Tissue to create the new nipple is harvested from the groin, auricular area, or contralateral nipple
Where are the adrenal glands located?
Above the kidney. The adrenal glands are located above each kidney.
The following are all contraindications to vaginal hysterectomy EXCEPT
presence of a cystocele. Anterior-posterior repairs are more easily accomplished when done with a vaginal hysterectomy and are not contraindicated
Instruments used to close the vaginal vault in a abdominal hysterectomy must be.
considered contaminated after use. Potentially contaminated instruments used on the cervix and vagina are placed in a discard basin and removed from the field after surgery.
The addition of adrenalin to a local anesthetic provides
vasoconstriction, prolonged anesthesia, decreased bleeding. Adrenalin is a potent stimulant. When combined with an anesthetic agent, it causes vasoconstriction to slow the uptake and absorption, thus prolonging the anesthetic and decreasing bleeding.
During laser surgery, each of the following policies must be adhered to EXCEPT
prescription glasses are approved protection mechanisms. Prescription glasses are not considered appropriate aye protection because the lens material may not stop the transmission of the laser beam. Each of the other policies provides eye protection
There are _____ parathyroids
4. There are four parathyroid, tiny bodies located behind the thyroid gland, embedded in its capsule.
A constant closed suction that utilizes a plastic container serving as both a suction and a receptacle for blood is a
Hemovac. A Hemovac is used for constant closed suction. The suction is maintained by a plastic container with a spring inside that tries to force apart the lids, thereby producing suction that is transmitted through plastic tubing. It is left in for about 3 days
The sphincter at the junction of the small and large intestine is the
ileocecal sphincter or valve joins the large intestine to the small intestine
Which hepatitis poses a threat to health care workers?
B. HBV has a risk factor for physicians, nurses, dentists, medical technologists, and others who are in contact with blood daily
A dye used in gynecology to test tubal patency is
Methylene blue. is used for gynecologic diagnostic procedures such as to test tubal patency.
Which stage of wound healing takes place when there is tissue loss with an inability to approximate wound edge?
Second (granulation). When surgical wounds are characterized by tissue loss with an inability to approximate wound edges, healing occurs through secondary intention. The area of tissue loss gradually fills in with granulation tissue
An abnormal accumulation of fluid in the tunica vaginalis is referred to as a
hydrocele. Normally a small amount of clear fluid is contained in the tunica vaginalis, a sac in the scrotum. When the amount increases, it is known as a hydrocele. A varicocele is a congested vein; a cystocele is a herniation of the bladder through the vaginal mucosa of a female; a spermatocele is a cystic mass attached to the upper pole of the epididymis
Periosteum is lifted from the surface of the bone with an
Periosteal elevators are used to lift the periosteum from the surface of the bone. The size ranges in width and choice is dependent of the width of the surface to be removed
Repair of a cranial defect is surgically represented by the term
crainoplasty. is the repair of a skull defect resulting from trauma, malformation, or a surgical procedure
For surgery on a known AIDS patient, all of the following precautions should be followed EXCEPT
needles resheathed. To minimize the risk of needle stick, needles should not be resheathed and should be placed in a puncture-proof container for sterilization and disposal
Health care workers who are potentially exposed to blood, can be vaccinated to prevent
Hepatitis B is caused by a virus and a vaccination for it is available
An alternative indwelling urinary drainage system diverting urine away from the urethra is a
suprapubic cystostomy catheterization. Insertion of a cannula directly into the bladder through a suprapublic incision provides an alternative indwelling drainage system
A common radiopaque contrast medium used in the OR is
Renografin. Is a radiopaque contrast medium used intraoperatively
What is the purpose of a chest tube and water seal drainage
exacuate fluid and air. Chest drainage prevents outside air from being drawn into the pleural space during expiration. Water in the collection units seals off outside air to maintain a negative pressure within the pleural cavity. Fluids drain by gravity from the chest into the water. This system ensures complete lung expansion postoperatively
Extreme flexion of the thighs in the lithotomy position impairs
respiratory function. Extreme flexion of the thighs in lithotomy position impairs respiratory function by increasing intraabdominal pressure against the diaphragm
A femoral-popliteal bypass is scheduled. Which self-retaining retractor would be used to facilitate exploration of the femoral artery
Weitlaner. After a vertical incision is made and extended along the medial aspect of the thigh over the femoral artery, a Weitlaner retractor is inserted into the incision
A double-bowl -shaped glass evacuator used to irrigate the bladder during transurethral surgery is called an
Ellik. The Ellik evacuator is a double-bowl-shaped glass evacuator. It contains a trap for fragments so they cannot be washed back into the sheath of the endoscope while irrigating with pressure on the rubber-bulb attachment
An approach to infection control designed to prevent transmission of blood-borne disease in health care settings is called
Universal precautions are designed to prevent transmission of AIDS and hepatitis in health care settings
An elevated PSA test could be indicative of cancer of the
Prostate. A PSA test measures prostate-specific antigen in blood. The amount of PSA is elevated in cancer of the prostate
In which intention of healing is there a wide, fibrous scar?
secondary. Granulation tissue in third-intention healing usually forms a wide, fibrous scar. Suturing is delayed because of much tissue removal
Which Gram-positive bacteria can cause abscesses?
Staphylococcus aureus. is a cause of suppurative conditions. It is a pathogenic, Gram positive and is transmitted because of its presence on skin and mucous membrane. The others are Gram-negative
Mannitol is a
osmotic diuretic. Mannitol is a most effective osmotic diuretic and is valuable in reducing intercranial pressure or edema. It may be given prophylactically to prevent renal failure. It also reduces intraocular pressure.
The organism causing hepatitis B is
Virus. Hepatitis is an inflammation of the liver. Viral hepatitis is the second most frequently reported infectious disease in the US. There are at least five different viruses causing hepatitis
An example of an anti-inflammatory is
Cortisone. is used as an anti-inflammatory. It is used to reduce resistance to the invasion of bacteria
Hemorrhage is suspected if
The blood pressure drops and pulse rate rises. The clinical manifestations of hemorrhage are pulse increase, fall in temperature, rapid and deep respirations, and fall in blood pressure. The patient is apprehensive and restless. He or she may be thirsty. The skin is cold, moist, and pale.
How many feet above the ground is considered safe for electrical outlets and fixtures that are not explosion-proof>
5 feet. All flammable gases and vapors except ethylene are heavier than air and settle to the floor when released. Electrical fixtures and outlets located less than 5 feet above the ground must meet rigid explosion code requirement
Carpal tunnel syndrome affects the
wrist. Carpal tunnel syndrome is a disease of the hand resulting in compression of the median nerve within the carpal tunnel. The necessary surgery is release of the bound down nerve and relief of pressure.
Documenting, tracking, and registering are mandated for
implants. Strict guidelines regarding implants by the FDA include documentation, tracking, and registering (data returned to manufacturer includes lot, serial number, size, type, position of use)
When the foreskin of the penis cannot be retracted over the glans it is called
Phimosis is a condition in which the foreskin is narrowed so that it cannot be retracted over the glans
The burn characterized by blister formation pain, and a moist and mottled red appearance is
Second-degree burns include all epidermis and varying degrees or depths of corium. It is characterized by blister pain, and redness. Hair follicles and sebaceous glands may be destroyed.
Microorganisms that grow in the absence of oxygen are
Anaerobes are those microbes that prefer to live without oxygen
The islets of Langerhans are located in the
Pancreas. The islets of Langerhans are dispersed throughout the pancreas
The master gland is the
pituitary. The master gland is the pituitary located in the brain
A condition that can occur as a result of gross bone contamination or improper surgical technique is
Osteomyelitis develops from hematogenous spread, gross bone contamination, or improper technique. A breakdown in aseptic technique, sterility, or inappropriate traffic patterns may also result in osteomyelitis
Oxytocics are used to
Contract the uterus. Drugs that exert a selective action on the smooth muscled uterus to promote contractions are called oxytocics. They extert a stronger effect on the fundus than they do on the cervix
Which of the following instruments would be used to retract the bladder walls during a suprapubic prostatectomy?
Mason-Judd. After an opening is made into the anterior bladder and the opening is extended with scissors, a Mason-Judd self retaining bladder retractor is inserted and the bladder is explored.
Maintenance of bony exposure during a lumbar laminectomy is effected by the use of a
Beckman-Adson. During a lumbar laminectomy, one or two Beckman-Adson self retaining retractors are used to expose the bone structure of the spinal column.
A common abdominal complication caused by previous abdominal or pelvic surgery is
Adhesions are a common development after previous abdominal or pelvic surgery. Also acute appendicitis or peritonitis can cause adhesion formation
Which of the following shunts would be used surgically to correct hydrocephalus?
A Hakim valve system is used to direct the flow of cerebrospinal fluid and regulate ventricular fluid pressure by opening within a preset range and draining excess fluid into the atrium or the peritoneum
A spinal fusion is usually effected by autogenous grafts taken from the patients
Ilium. Spinal fusion may by effected by use of an autogenous graft from the crest of the patients ilium
A complication of orthopedic surgery is
thromboembolism, fat embolism, and infection
Nonunion of bone can be treated with
artificially applied electric current. Electrical stimulation can induce or influence osteogenesis for treatment of nonunion, delayed union, and bone defects
The word which best describes "staging" is
categorization and series. Repairs in certain cases may be done in stages or series, for example, hypospadias repair, reconstruction using expanders
Nosocomial infection refers to
hospital-acquired infection. Nosocomial infections are hospital acquired infections. These are infections the patient did not have before admission in the hospital
During a CPR effort in the OR, the scrub nurse
remains sterile and keeps tables sterile. The scrub nurse remains sterile and keeps tables sterile, keeping track of all surgical items being used, keeping his or her attention on sterile field, and also attending to surgeon's needs
The edges of a wrapper that enclose sterile contents are considered
nonsterile. The edges of anything that encloses sterile contents are considered unsterile
A ureteral stent catheter is used to
provide long-term drainage in ureteral obstruction. An indwelling stent catheter is inserted for long-term drainage in a wide variety of benign and malignant diseases causing ureteral obstruction.
Uterotubal insufflation is a
Rubin's test. may be used to test patency of the fallopian tubes
An infants average a rest heart rate is _____ beats per minute
Which of the following instruments is not found in a vaginal procedure?
Harrington retractor. Is used in deep abdominal surgery. All of the others can be found in a dilation and curettage.
The operation to correct prolapse of the anterior vaginal wall is
colporrhaphy. Anterior colporrhaphy is performed to correct prolapse of the anterior vaginal vault and repair herniation of the bladder into the vaginal canal.
Which nasal sinus can be approached only through an external eyebrow incision?
frontal. The frontal sinus is approached by making an incision above the eyebrow on the affected side. Diseased tissue is then removed, the sinus cavity is cleansed, and drainage is instituted
Which sinus is surgically opened in a Caldwell-Luc procedure.
maxillary. An incision is made under the upper lip in a Caldwell-Luc procedure. An opening is created into the maxillary sinus, after which the infected contents of the sinus are removed. To promote good drainage, a large nasoantral window is created
Which of the following pieces of hardware will be used in an intramedullary fixation of a fracture of an adult femoral shaft?
Kuntschner nail. A Kuntschenr or Schneider nail can be used to immobilize a fracture of the femoral shaft
The second cranial nerve is the
The normal body temperature in centigrade measurement is
What is the purpose of doing ABGs intraoperatively
to assess arterial gases. Arterial gas measurements are analyzed and measured when arterial or venous catheters are in place
Which tube is used for gastrointestinal decompression?
Levin. The Levin tube is a common rubber or plastic nasogastric tube. It is inserted through the nostril down into the stomach or small intestine to remove flatus, fluids, or other contents.
A tissue expander would be used for
Breast reconstruction. using tissue expanders stretches normal tissue by weekly injections into the expander until maximum stretch has been achieved.
Continuous irrigation of the bladder is necessary during cystoscopy to
distend the bladder walls for visualization. Continuous irrigation of the bladder is necessary during cystoscopy to distend the walls for visualization and to wash out blood, tissue, and stone fragments.
The excision and removal of diseased and necrotic tissue is termed.
Debridement, the excision of necrotic tissue, is accomplished with a scalpel, an electrosurgical knife, a dermatome, or a laser beam. After a good vascular supply is located, a full-thickness or split-thickness graft can be used to preserve and cover the area
The excision of loose skin and periorbital fat of the eyelids is called
blepharoplasty. The aging process causes a sagging or relaxation of eyelid skin and the orbital septum. As the latter becomes weaker, it allows periorbital fat to bulge. These changes are pereceived as baggy eyelids. The surgical repair of this condition is blepharoplasty
A fleshy encroachment onto the cornea is called
pterygium. A pterygium is a fleshy, triangular encroachment onto the cornea. It occurs nasally and tends to be bilateral. If it encroaches on the visual axis it is removed surgically
Mandibular fractures are treated by occlusion of the teeth effected by the use of an
arch bar. An arch bar treats a mandibular fracture by placing teeth in occlusion to achieve adequate immobilization for healing. Scissors or wire cutters stay with the patient to prevent aspiration should the patient vomit.
Which procedure would require the following instruments: Freer elevator, osteotome, Asch Forcep, Ballinger swivel knife, caliper?
Nasal. Nasal instrumentation would include these items
Lacrimal probes are called
Bowmans are lacramal duct probes that also may be used in fallopian tube reconstruction
The eardrum is also known as the
tympanic membrane. At the end of the auditory canal is the tympanic membrane
Which of the following appliances can be used for intramedullary fixation of a femur?
Sampson. An intramedullary nail, rod, or pin is driven into the medullary canal through the site of the fracture. Sampson rods, straight and curved, are a good choice for femurs. All of the others are used for intertrochanteric fractures of the head of the femur
heartbeat less then 60 beats per minute
If a needle punctures a sterile team member's gloves
discard the needle and change the glove.
A Tenckhoff catheter is placed into
peritoneal cavity. A Tenckhoff catheter is inserted into the peritoneal cavity for chemotherapeutic instillation or peritoneal dialysis
The needle uses for a liver biopsy is
Each of the following treats glaucoma EXCEPT
Keratoplasty. A keratoplasty is a corneal transplant for a diseased cornea. Iridectomy, iridotomy, trephining, and trabeculectomy are used to treat glaucoma. Cyclodialysis, cyclodiathermy, and cyclocryotherapy are used to diminish aqueous secretions. Optical lasers offer an alternative with laser trabeculoplasty.
An instrument used to incise the eardrum to relieve pressure is called a
myringotomy knife. Through microscopic visualization, the aural speculum is inserted in the canal. Using a sharp myringotomy knife, a small curved incision is made in the posteroingerior quadrant or the pars tina, and the thickened membrane is cut.
In which surgical specialty would a perfusionist be necessary
cardiac surgery. A perfusionist aids in temperature, arterial and venous pressure, and blood gas monitoring, as well as peripheral tissue perfusion (passing of fluid) monitoring during a cardiopulmonary bypass
The preferred method of gloving is _____. In changing during a case, this method _____ be used
closed, cannot. The closed glove method is preferred because it affords assurance against contamination. This technique cannot be safely used for glove change during an operation.
When a patient goes into hypovolemic shock in the OR, an immediate response would be
restore fluid volume quickly. Hypovolemic shock is the most common. Fluid volume must be restored quickly so that there can be a rapid return of oxygenated blood to the tissues. Supplemental oxygen should also be administered
In which surgical wound classification would an appendectomy for ruptured appendix fall?
Contaminated. Contaminated wounds occur in operations with major breaks in aseptic technique. An example is appendectomy for ruptured appendix.
The malleus, incus, and stapes are located in the
middle ear. The middle ear consists of an air-filled space in the temporal bone called the tympanic cavity. This separates the external and inner ears. Three small bones or auditory ossicles --- the malleus (hammer), incus (anvil), and stapes (stirrup) --- are attached to the wall of the tympanic cavity by tiny ligaments
Protective goggles are worn during CO2 laser surgery to
The prevent corneal damage. During CO2 laser use, goggles are worn to protect the cornea and resulting corneal opacification
When gloving a surgeon
Keep the palm of the glove facing the surgeon. The right glove is usually done first. The palm of the glove is held toward the person, stretching the cuff and holding thumbs out so as to avoid touching the hand. The everted cuff is unfolded over the cuff of the sleeve
After hip joint surgery, immobilization is aided by the use of
abduction pillow. Abduction pillow aids in immobilizing hip joints after surgery. This prevents leg adduction, internal rotation, and hip flexion
The blue-green wavelength produce by a laser that is capable of treating retinal detachment, diabetic retinopathy, and macular neovascular lesion is
argon. The color or wavelength of a laser determines which part of the eye it can best treat the blue-green argon laser is used for retinal detachment, diabetic retinopathy, and other retinal problems. All of the others treat various portions of the eye.
If the patient has a positive breast biopsy, and the surgeon proceeds to do a radical mastectomy.
The patient is reprepped, and new drapes and instruments are used. When a patient has a breast biopsy and immediate extended operation, two separate prepping, draping, and instrument set are necessary.
At which artery is the blood pressure taken?
brachial. Blood pressure sounds are heard over the brachial aretery. The bell of the stethoscope is placed over the brachial artery below the blood pressure cuff. The first sound heard is the systolic pressure. The time at which the sound is no longer heard is the diastolic
The action of white blood cells is to
destroy bacteria. Leukocytes are phagocytic, which is a response to tissue destruction by bacteria. They ingest bacteria and dispose of dead matter
The function of the endocrine glands is to?
produce hormones. Ductless glands or endocrine glands secrete hormones internally discharged into blood or lymph and are circulated to all parts of the body. Hormones, the active principals of the glands, produce effects on tissues
Oxygenated blood is returned to the left atrium of the heart from the lungs via the
pulmonary vein. One of the two pairs of large vessels that return oxygenated blood from each lung to the left atrium of the heart is the pulmonary vein
Bile is manufactured in the _____and stored in the ______.
liver, gallbladder. Bile is manufactured in the liver. One pint of bile is produced daily. The gallbladder stores and concentrates bile until it is needed in the small intestine
Entrapment of the _______ nerve is relieved by a carpal tunnel release.
median. Carpal tunnel syndrome results from entrapment of the median nerve of the volar surface of the wrist resulting in pain, tingling of the fingers, and weakness of the thumb muscles. This surgery relieves the compression of the median nerve
When intraoperative cultures are obtained, each of the following is true EXCEPT
tip of swab is placed of back table. Cultures should be refrigerated or sent to the lab immediately. They are obtained under sterile conditions. Tips of swabs must not be contaminated by any other source. The circulating nurse receives the tube in a bag or container.
separation of layers of surgical wound. Dehiscence is the separation of layers of a surgical wound. In evisceration, the internal organs protrude through the wound
During vascular surgery, an arteriotomy is executed with a 11 blade and extended by use of a
Potts-Smith. With vascular forceps and a 11 blade, and arteriotomy is effected and extended with a Potts-Smith vascular scissor
The first part of the small intestine is known as the
duodenum. The first 10 to 12 inches of the small intestine is called the duodenum. It joins with the jejunum, which is 8 feet long. The jejunum joins with the ileum, which is 12 feet long
What organisms are likely to be found in a surgical wound adjacent to a colostomy?
Escherichia coli. live in the colon or large intestine. A colostomy is an opening of some portion of the colon on the abdominal surface. An adjacent wound could be contaminated with E. coli.
During a CPR effort, which drug is given to combat metabolic acidosis?
Sodium bicarbonate reverses acidosis. It should not be mixed with any other drug in the IV line.
When inserting a Foley catheter, always
check the integrity of the balloon by inflating it with the correct amount of sterile water prior to insertion. Urinary catheterization requires aseptic technique. The integrity of the balloon is checked by inflating it with the correct amount of sterile water or air before insertion. After insertion, the bladder is drained, and the balloon is than inflated
The proper setting for a tourniquet applied to the thigh is about
350 mmHg The tourniquet pressure for the average adult arm is 250-300 mm Hg. An adult requires about 350 mm Hg on the thigh. Thin adults and children may require less; whereas, the muscular and obese may require more.
Crushing a urinary calculus in the bladder though the urethra is called.
litholapaxy. Crushing a urinary calculus with a lithotapaxy. A lithotrite is introduced thorugh the urethra, and the stone is crushed and removed. A cystoscope is introduced into the urethra for introduced into the urethra for introduction of the lithotrite
The surgical procedure performed electively as a permanent method of sterilization is
vasectomy. A vasectomy is the excision of the vas deferens performed electively as a permanent method of sterilization
When doing a skin prep, which includes a draining sinus, the contaminated area is
done last or separately. Draining sinuses, skin ulcers, vagina, anus, etc., are considered contaminated area. The general rule of scrubbing the most contaminated area last or with separate sponges is followed
The portion of the stomach located at the approach to the small intestine is the
pylorus. Below the fundus of the stomach, the region narrows as it approaches the junction to the small intestine. This is the pylorus or distal portion of the stomach
A commonly used diuretic is
Lasix (furosemide) is a diuretic. A diuretic increases the secretion of urine.
The normal bladder capacity is
700-800 mL The
Rectal surgery preparation is done
surrounding area first, anus last. The anus is considered a contaminated area. The prep is done of the surrounding area first. The anus itself is last.
When changing a gown during a case, the ____ is (are) removed first, the ____ second, and a rescrub is _____.
gown, gloves, not necessary. When changing a gown during and operation, the gown is always removed first with the circulator pulling the gown off inside out. The gloves are removed using glove-to-glove then skin-to-skin technique. A rescrub is not necessary.
Which piece of equipment is used to make a skin graft larger?
mesh dermatome. Skin meshers cut small slits in the graft. When expanded, slits become diamond shaped opening. This permits expansion of the graft to cover three times as large an area as the original graft obtained from the donor site
The item that provides internal drainage of an obstructed ureter is a
stent. A ureteral stent provides internal drainage of an obstructed ureter. It is attached to a sterile closed urinary drainage system, and an adapter must be used because they are small in diameter.
A way to alleviate a presurgical patient's anxiety is via
preoperative visit. The patient's level of anxiety and fear is reduced by the preoperative visit because it supplies the patient with factual information and allows the opportunity for him or her to express feelings and concerns
The kidneys are held in place by the
renal fascia and fat. The kidneys are held in position by connective tissue (renal fascia) and masses of adipose tissue (renal fat) that surrounds them. Indaequate renal fascia may cause ptosis or floating kidney
A culture and sensitivity is done to
Determine nature of organism and the susceptibility of that organism. A culture identifies the suspected organism causing infection. Sensitivity determines the susceptibility of patient's bacterial infection to antibiotics or antibacterials.
Which of the following is considered the most effective agent for scrubbing?
All of the following would be on the setup for an open thoracotomy EXCEPT
Joseph's saw. A Joseph's saw is a bayonet like in design and is used for nasal procedures. The Alexander, Duval, and Lebsche are used for chest procedures
Transcutaneous electric nerve stimulation (TENS) would be utilized for
urinary calculi. Transcutaneous electric nerve stimulation (TENS) is shockwave energy generated electromagnetically, which fragments calculi. It is verified by fluoroscopy or x-ray. It is tubeless lithotripsy
During a basic femoral fixation, the length and position of the implant is determined by the use of
guide wire. A guide wire or pin is placed in the neck and head of the proximal fragment of the fracture. This determines the final position and length of the implant to be used
Which of the following grafts is not a synthetic vascular graft
biologic vascular. Biologic or synthetic prosthetic grafts are required to bypass vascular obstruction. The biologic vascular is a natural graft and may be either an autograft, hormograft, or heterograft.
Fingerlike projections at the end of the Fallopian tubes are called
fimbriae. Fallopian tubes (oviducts) have a funnel shaped portion (infundibulum), which ends in a fringe of fingerlike projections called fimbriae.
All of the following are true of self-adhering plastic incision drapes EXCEPT
scrubbed area must be moist at application. The scrubbed area must be dried after application of iodophors. Alcohol may be used to hasten drying or excess can be blotted or wiped off with a sterile job
An abnormal deposition of collagen that occurs during the healing process is known as
Keloid formation, an abnormal deposition of collagen in healing skin wounds, presents a particularly difficult problem for plastic surgeons, Keloids may require excision and grafting
All of the following statements are true during deep vaginal procedures EXCEPT
count is eliminated. Sponges are secured on sponge forceps in deep areas. All counts are very important in these procedures. Suction and vaginal packing may be used
The gas introduced into the peritoneum during laparoscopy to create a pneumoperitoneum is
Crutchfield tongs produce skeletal traction to reduce fractures of the
cervical spine. Skeletal traction, applied by Crutchfield tongs inserted in the parietal eminence of the skull, is generally used for reduction of fractures and dislocations of the cervical vertevrae
Which disease could be transmitted via a blood transfusion?
Staphylococcus is usually transmitted by
upper respiratory tract.
A bacteria with a thick coat that protects it from temperature extremes or strong chemicals is a
Spore. remains dormant while the conditions for its growth are unfavorable. its thick coating protects it from temperature extremes or strong chemicals. Spores are extremely resistant to any disinfectant but are killed by steam and gas sterilization
When a three-way Foley catheter is used, the third lumen is for
If a towel clip must be removed during a procedure
discard it from the field and cover the area with another sterile drape. If a towel clip must be removed, discard it from the sterile setup without touching the points because they are considered contaminated. The area from which it was removed is covered with another sterile drape.
Constant monitoring of cardiac function, a requirement for vascular surgery is effected by the use of a
Swan-Ganz. Constant monitoring of cardiac function with a Swan-Ganz pulmonary artery catheter is important in vascular patients. Patients may require frequent blood gas determination. Doppler is an ultrasound. Greenfield is a vena caval device for catching venous emboli. Fogarty is for thrombectomy and embolectomy
What procedure is accomplished to relieve mayasthenia gravis?
Thymectomy without en bloc dissection may be done to relieve myasthenia gravis. It may be done through a median sternotomy incision or through a transverse cervical incision
Which specimen would be placed in formalin?
Tonsils. Brest biopsy usually requires frozen section that is not placed in formalin. Kidney stones are sent dry so the chemical composition is not altered. Bronchial washing are sent down in the specimen collection unit as soon as possible, and formalin is not used on them. Tonsils would be sent in formalin
A legal wrong committed by one person involving injury to another person is called a
Scoliosis is surgically treated by the implantation of
Harrington rods are implanted into the spine by clips that hold onto the laminae. They are used in combination with the external methods of scoliosis support
An intravenous agent used for anesthesia induction is
Pentothal sodium is a barbiturate. It is a short-acting drug for induction before administration of more potent anesthetics, such as inhalants. It can also be used for short procedures not requiring relaxation
A prosthetic implant that requires nonadherence to tissue for the sake of creating normal flexion and extension is
Nonconstrained. Silastic nonconstrained prosthetics allow for normal range of motion postoperatively
Unauthorized discussion of a patient's surgery outside of the OR constitutes a lawsuit for
invasion of privacy
When applying a sterile sheet on the patient,
Protect the gloved hands by cuffing the end of the sheet over them
A chronic granulomatous inflammation of a meibomian gland in the eyelid is a
chalazion. Located in the tarsal plate of the eyelid, the meibomian gland may inflame and require surgical removal. It is known as a chalazion.
A drug given preoperatively that enables the liver to produce clotting factors in blood is
When is bowel technique necessary?
When a contaminated area of the intestinal tract is entered. Bowel technique is utilized when a contaminated area of the intestinal tract is entered and may be discontinued when the bowel has been anastomosed.
A slowly progressive contracture of the palmar fascia is called
Duputren's contracture is a progressive contracture of the palmar fascia. It causes flexion of the little finger, the ring finger, and frequently the middle fingers, rendering them useless.
If rubber suction tubing is to be reused
the lumen must be flushed with a detergent-disinfectant before tubing is terminally sterilized.
Who is responsible for the final count when reliefs have taken place during the cases?
Scrub person and circulator who do final count
Which of the following statements is a contraindication to intraocular lens (IOL) implant?
children with congenital cataracts. Young patients with congenital cataracts present a condition that contraindicates the use of implants. Children with traumatic cataracts are good candidates for IOL's
mydriatic. It dilates the pupil thereby facilitating examination of the retina and also lens removal
The legal doctrine res ipsa loquitor applies to
injuries sustained by the patient in the OR due to negligence.
"the thing speaks for itself"
After a case is completed, the sterile team members.
discard gown, gloves, caps, masks, and shoe covers before leaving OR suite.
Pilocarpine is used to
constrict the pupil. Pilocarpine is used to constrict the pupil to reduce intraocular pressure. In cataract surgery, it is used to help prevent the loss of vitreous.