1.
During which of the following surgeries is a Meckel's diverticulum typically discovered?
Correct Answer
B. Appendectomy
Explanation
A Meckel's diverticulum is found on the bowel. During an appendectomy, bowel is examined and can lead to the discovery of a Meckel's diverticulum.
2.
Which of the following solutions can be used to disinfect endoscopic instruments?
Correct Answer
D. Activated glutaraldehyde
Explanation
Iodophors are primarily used as a skin antiseptic.
Alcohol can damage the glue holding the lens inside the endoscope.
Pure phenols are too caustic and cannot be used in the operating room. Phenol derivatives can be used as a low-level housekeeping disinfectant.
Activated glutaraldehyde is a high-level disinfectant widely used for disinfection of endoscopes.
3.
Which of the following is the administration route for thrombin?
Correct Answer
B. Topical application
Explanation
Thrombin should never be introduced into a large blood vessel because significant intravascular clotting and death may result. Thrombin may be applied topically, in a solution or as a powder.
4.
Glove powder is normally wiped from the gloved hand because it has the potential to cause
Correct Answer
C. Granulomas.
Explanation
Glove powder is sterile, so it is not considered a contaminant to the wound. Glove powder is a sterile foreign body whose reaction with tissue can cause granulomas. Dehiscence is caused by a breakdown of the wound closure. Pathogenic organisms cause infections.
5.
Which of the following procedures is the removal of the entire orbital content, including the periosteum?
Correct Answer
D. Exenteration
Explanation
A recession cuts the eye muscles and reattaches it posteriorly to lengthen it.
Resection is removal of a section of the eye muscle and reattaching it where the incision was made to shorten it.
Evisceration is removal of the contents of the eye, leaving muscle and sclera.
Exenteration removes everything in the global orbit due to malignancies.
6.
Which of the following is MOST commonly used for wound closure in the presence of infection?
Correct Answer
A. Stainless steel
Explanation
Stainless steel suture is recommended for use in infected areas because it is non-absorbable with indefinite tensile strength.
Polyglactin-910 and silk are multifilament and would harbor or transfer microorganisms.
Plain gut has limited tensile strength with faster absorption in the presence of infection.
7.
When preparing the Sterrad sterilization system for use in the surgical area, which of the following outlets must be available?
Correct Answer
D. Electrical
Explanation
The Sterrad sterilization system requires electricity to operate.
A suction outlet is used by the surgical team to suction body fluids away from the surgical site and the patient's airway.
An oxygen outlet is used by anesthesia personnel to provide oxygen to the patient during surgery.
A nitrogen outlet is used for power equipment.
8.
When can instrument counts be omitted?
Correct Answer
A. If the incision is too small for an instrument to become buried.
Explanation
The count can be deleted if significant risk for a retained item is unlikely and falls within hospital protocols.
The circulator's activities should not affect count procedures.
Instruments should not be sent to another OR prior to completion of the final count.
Inpatient or outpatient status does not affect count procedures.
9.
When assisting with the closure of a skin incision and operating the skin stapler, the surgical technologist in the scrub role is placing the staples through which two layers?
Correct Answer
A. Cuticular and subcuticular
Explanation
The cuticular and subcuticular are the two most outer layers of the skin and are closed together by the skin stapler.
10.
Which of the following is the definition of instrument sterilization?
Correct Answer
C. Destruction of microorganisms
Explanation
Sterilization is the destruction of all microorganisms.
Antiseptics destroy most but not all pathogens and are not typically used on inanimate objects.
Decontamination is a process of disinfection and does not render an instrument sterile.
Reduction implies the destruction of some or most bacteria. Sterilization requires the destruction of ALL bacteria.
11.
When a cholecystectomy is performed, which of the following anatomical structures must be preserved?
Correct Answer
C. Common duct
Explanation
The common duct is preserved in order to drain bile.
The cystic duct and cystic vein are ligated.
The cystic artery is dissected in a cholecystectomy.
12.
Which of the following instruments is used for placement of cottonoid strips during a craniotomy?
Correct Answer
A. Bayonet forceps
Explanation
Bayonet forceps are used as the primary forceps for neurosurgical procedures, and are used to place cottonoids and Gelfoam for hemostasis.
Russian forceps are tissue forceps used primarily for grasping.
A Kelly clamp is used for hemostasis or grasping.
An angled DeBakey clamp is used to occlude vessels.
13.
When donning gloves using the open-gloving technique, the ungloved hand will touch the
Correct Answer
D. Folded edge of the cuff of the glove.
Explanation
Contamination will occur when the ungloved hand touches a sterile part of the glove. Grasp the folded edge of the cuff of the glove to maintain sterility. The inverted cuff permits a person to touch the glove's inner side.
14.
Which of the following is reshaped during a total hip arthroplasty?
Correct Answer
B. Acetabulum
Explanation
The acetabulum is deepened during a total hip arthroplasty. The fibula and tibia are in the lower leg and are not involved in total hip arthroplasty. The iliac crest is not affected by this procedure.
15.
A scleral buckle procedure repairs
Correct Answer
B. Detached retinas.
Explanation
A scleral buckle procedure is used to repair a retinal detachment. A keratotomy corrects astigmatism. Corneal transplantation and keraplasty repairs corneal scarring. Strabismus surgery corrects eye muscles.
16.
Anterior and posterior knee stability is influenced by the dynamics of the
Correct Answer
A. Cruciate ligaments.
Explanation
Knee stability is influenced by the dynamics of the anterior and posterior cruciate ligaments. The anterior and posterior joint capsule assists in movement. The patellar tendon encloses the patella and secures it in the front of the knee joint. The collateral ligaments provide medial and lateral stability to the knee joint.
17.
During a craniotomy, removal of the bone flap is followed by
Correct Answer
A. Incision of the dura mater.
Explanation
The skin flap follows incision of the galea aponeurotica which is closely connected to the integument by the firm, dense, fibro-fatty layer which forms the superficial fascia of the scalp. Raney clips are clamped on the skin flap for hemostasis before removal of the bone flap. The dura mater is the first protective membranous layer over the brain which lies immediately beneath the bone (cranium). Suturing of the dura mater is conducted after its incision and the exposure of the brain.
18.
Which of the following suturing techniques features short lateral stitches that are taken beneath the epithelial layer of skin?
Correct Answer
D. Subcuticular
Explanation
A subcuticular stitch is a type of continuous stitch placed beneath the epidermis.
A purse-string suture encircles a circular wound and is a continuous stitch running parallel to the edges.
A traction suture is used to retract tissue for better exposure of the operative field.
A mattress stitch is a type of continuous stitch that is used to reapproximate wound edges.
19.
A specimen obtained for frozen section is generally removed from the sterile field intraoperatively because it
Correct Answer
B. Is sent to pathology immediately.
Explanation
The specimen will not contaminate the sterile field. Special preparation and examination of the tissue can determine whether it is malignant, if nodes are involved, and if margins are clear of malignant cells. Sending a frozen section will give the physician an immediate diagnosis and will allow him/her to treat the patient correctly. If the specimen is placed in formalin solution, the pathologist will not be able to do specific testing to determine a diagnosis. The circulator places the patient sticker on the specimen whenever it is handed off intraoperatively.
20.
In a sterilized package, a chemical indicator is used to
Correct Answer
D. Confirm that the package was exposed to sterilization.
Explanation
A chemical indicator is not activated by moisture alone.
A chemical indicator (internal) verifies exposure to a sterilization process but does not ensure sterility of the package.
A chemical indicator can not verify the appropriateness of a package wrapping.
21.
Which of the following statements regarding surgical scrubbing is NOT true?
Correct Answer
C. Prolonging a scrub beyond the standard scrub length is effective in decreasing microbe counts.
Explanation
The timed method and the counted brush-stroke method are the 2 methods of scrubbing.
The vigorous 5-minute scrub will remove the transient flora as effectively as a 10-minute scrub. A 10-minute scrub breaks down the skin's integrity and thus is discouraged.
The hand scrub is done to decrease the number of microorganisms to an irreducible minimum and prolonging the surgical scrub will NOT decrease the microbe count beyond that. It is NOT a sterile procedure as skin cannot be sterilized.
The hands are contaminated through the microscopic tears and breakdown of the gloves during the procedure and as soon as the gloves are removed, thus should be washed with soap and water thoroughly.
22.
Which of the following is the best sequence for cleaning the operating room after placement of the dressings?
Correct Answer
A. Remove sterile drapes, remove gown and gloves, don a pair of unsterile gloves to clean the back table.
Explanation
PPE (personal protective equipment) will protect surgical personnel from coming in contact with body fluids on the drapes. After the drapes are removed, the surgical technologist can safely remove the gown and gloves to complete clean-up with a pair of unsterile exam gloves. Note: The surgical technologist may be required to remain sterile until the patient leaves the room in some circumstances.
23.
A Pereyra needle is used for which of the following types of surgery?
Correct Answer
C. Bladder neck suspension
Explanation
The Pereya needle is utilized only in urology procedures for urinary incontinence and is ONLY used in the Pereya procedure to treat incontinence. This is a type of bladder neck suspension procedure.
24.
Which of the following conditions should be treated FIRST?
Correct Answer
A. Obstructed airway
Explanation
The first priority is to have an unobstructed airway. Although treatment of the other conditions is important, early recognition of airway obstruction is the key to a successful outcome.
25.
Which of the following procedures treats a congenital obstructed lesion found at the distal end of an infant's stomach?
Correct Answer
D. Pyloromyotomy
Explanation
Infantile pyloric stenosis is relieved by removing the congenital obstructive lesion in the pylorus of the stomach.
Gastrostomy is used to treat patients with espohageal disease or stricture.
Nissen fundoplication is performed to reduce the fundus for the treatment of persistend gastroespohageal reflux disease (GERD).
Heller myotomy is a surgical procedure in which the muscles of the lower espohageal sphincter are cut, allowing food and liquids to pass to the stomach.
26.
The surgeon asks a surgical technologist to place a drop of a mydriatic solution in OD. As a result of this medication, the pupil of the
Correct Answer
A. Right eye will dilate.
Explanation
OD is the abbreviation for the right eye - OS is the abbreviation for the left eye
A mydriatic solution will dilate the pupil, not constrict it.
27.
A Balfour is used in which of the following procedures?
Correct Answer
B. Sigmoid resection
Explanation
A Balfour is a large, self-retaining abdominal retractor.
28.
Which of the following is a contrast media?
Correct Answer
B. Hypaque
Explanation
Marcaine is a local anesthetic.
Depo-Medrol is a steroid.
Lymphazurin is a dye used for sentinel node biopsy.
29.
Which of the following is the most common complication of a strangulated hernia?
Correct Answer
B. Necrosis
Explanation
The blood supply of the trapped sac becomes compromised and eventually the sac contents necrose. Infection and hemorrhage can be secondary complications of a strangulated hernia. Shock rarely becomes a secondary complication of a strangulated hernia.
30.
Which of the following structures is behind and below the base of the penis?
Correct Answer
A. Scrotum
Explanation
The scrotum is located behind and below the base of the penis. The seminal vesicles lie on the fundus of the bladder and are superior to the base of the penis. The vas deferens extend from the epididymis, lie within the spermatic cord and lie superior to the base of the penis. The prepuce is located at the distal end of the penis.
31.
In a steam autoclave set on pre-vacuum, the minimum temperature that must be reached is
Correct Answer
D. 270 degrees
Explanation
This temperature combined with the pressure in an autoclave is required to destroy microbial life.
32.
Hepatitis B is caused by a
Correct Answer
B. Virus.
Explanation
Hepatitis B is a generalized inflammation of the liver caused by one of several viral agents.
33.
If two basins are wrapped together for sterilizing, how should they be packaged?
Correct Answer
D. With one basin stacked inside the other and separated by a towel
Explanation
Nested basins must be separated by a porous material such as a towel to allow the sterilizing agent to permeate and contact all surface areas of the basins. Basins and trays should be place vertically in the autoclave to allow moisture to run out of them.
34.
A resectoscope is used to resect the
Correct Answer
B. Prostate.
Explanation
A resectoscope is used to resect the prostate.
35.
Which of the following wounds is most likely in the inflammatory phase of wound healing?
Correct Answer
D. An abdominal incision, 20 minutes post-closure
Explanation
The inflammatory phase is the first phase of wound healing and begins within minutes of injury and lasts for 3 to 5 days. The proliferation phase occurs beginning approximately with the 3rd post-operative day continuing to the 20th post-operative day. A cicatrix indicates scar formation and occurs during the maturation phase of wound healing.
36.
How must basins be positioned for sterilization in the autoclave?
Correct Answer
C. On their sides
Explanation
The autoclave should be loaded to facilitate removal of air and aid in the flow of the sterilizing agent. Placing basins on their sides helps remove air and exposes all surfaces to the sterilizing agent. Steam sterilization cannot be guaranteed if the basins are tightly stacked as steam cannot penetrate all surfaces. If basins are placed right side up, water would collect in the basin due to condensation when the steam comes into contact with the cool metal surfaces. Air could be trapped inside the basin if the basins are placed upside down. All air must be removed to permit proper contact of steam on all surfaces.
37.
Which of the following vasoconstrictors is used to prolong the action of local anesthetics?
Correct Answer
D. Epinephrine
Explanation
Epinephrine is a vasoconstrictor used with a local anesthetic to prolong its action. Heparin is an anticoagulant. Ergonovine is used for uterine bleeding. Lidocaine is a local anesthetic.
38.
Which of the following surgical procedures may be used to remove a carcinoma from the head of the pancreas?
Correct Answer
B. Whipple
Explanation
A Heller is a myotomy procedure.
A Bankart procedure is done to repair stability of the shoulder.
A Billroth I is a partial gastrectomy procedure.
39.
Place the following phases of wound healing by first intention in correct order from first to last:
1. proliferation
2. remodeling
3. inflammatory
Correct Answer
C. 3, 1, 2
Explanation
The inflammatory phase begins within minutes of tissue trauma. The proliferation phase begins on the 3rd day following tissue trauma. The remodeling phase begins 14 days following tissue trauma.
40.
Which of the following is NOT an acceptable technique when placing a patient in lithotomy position?
Correct Answer
B. Legs placed in stirrups one at a time
Explanation
Legs should not be placed one at a time due to back, knee, and hip pain; also for pressure injury to skin, nerves, and blood vessels and blood pressure changes.
Both legs should be placed simultaneously to prevent hip and back pain, blood pressure changes, and to prevent pressure injury to the skin, nerves, and blood vessels. Arms are placed on arm boards to prevent a crushing or shearing injury to the hand. The hips should be placed at the break in the table so they are in the correct position when the lower portion of the table is removed.
41.
Which of the following characterizes bacteria of the genus Clostridium?
Correct Answer
B. Anaerobic
Explanation
The Clostridium species is anaerobic and can survive without oxygen. It is a Gram-positive bacteria that has the ability to produce spores.
42.
When performing a right hemicolectomy, the surgeon will most likely remove portions of which of the following?
Correct Answer
B. Ascending and transverse colon
Explanation
The ascending and transverse colon are portions of the large bowel found on the patient's right side. The descending colon, sigmoid and rectum are portions of the large bowel found on the patient's left side. The jejunum and duodenum are portions of the small bowel and not removed in a hemicolectomy.
43.
Retention sutures are advantageous when the patient is
Correct Answer
D. Obese.
Explanation
Retention sutures are used to reduce strain on the suture line due to obesity.
44.
In order to remove a portion of the kidney, the surgeon must enter which of the following?
Correct Answer
B. Gerota's fascia
Explanation
Gerota's fascia is also known as renal fascia. It encloses the suprarenal glands and separates them from the kidney. Hesselbach's triangle is located in the inguinal region and is made up of the abdominal muscle, inguinal ligament, and inferior epigastric artery. Synovial membrane is a membrane lining the capsule of a joint. The suprapleural membrane is an outer membrane covering the lung.
45.
A potential surgical complication of an inguinal herniorrhaphy is injury to the
Correct Answer
C. Spermatic cord.
Explanation
In both direct and indirect inguinal herniorrhaphy in males, both the spermatic cord and the blood supply to the testes must be protected from injury. The femoral artery is encountered in a femoral herniorrhaphy. The phrenic nerve innervates the diaphragm and is not involved in inguinal hernia repair. The sciatic nerve innervates the hip, or ischium, and is not involved in inguinal hernia repair.
46.
The diagnostic procedure that examines the interior of the respiratory structures is
Correct Answer
A. Bronchoscopy.
Explanation
Bronchoscopy is the viewing of the tracheobronchial tree. Culdoscopy is the viewing of the viscera of the female pelvic cavity. Esophagoscopy is the viewing of the esophagus. Mediastinoscopy examines the mediastinum.
47.
An inanimate object that harbors and transmits a disease is a
Correct Answer
A. Fomite.
Explanation
A carrier is one who harbors disease organisms in the body without visible symptoms. A vector is a carrier; an animal, usually an arthropod. An arthropod is an insect-carrier, such as a mosquito.
A fomite is an inanimate object or material.
48.
Which of the following is used to cross-clamp the intestine during a bowel resection?
Correct Answer
A. Allen
Explanation
The Allen clamp is an intestinal clamp.
Lahey clamps are used in thyroid surgery.
Heaney clamps are used in gynecological surgery.
Duval clamps are used in thoracic surgery.
49.
When utilizing a laparoscopic setup, potential hazards associated with the equipment include
Correct Answer
D. Fiberoptic beam fire.
Explanation
The intense fiberoptic beam can ignite the patient's drapes and cause fires. Therefore, cameras should be turned off when not in use and are appropriately placed during procedures.
Pneumoperitoneum is created with the insertion of a Verres needle into the abdominal cavity. This is needed for laparoscopic procedures and is not a hazard. There is no radiation involved when utilizing a laparoscopic set-up. Embolism in regards to laparoscopic procedures are caused by carbon dioxide and not nitrogen.
50.
When exposed to ionizing radiation, staff and patients should wear personal protective equipment containing
Correct Answer
B. Lead.
Explanation
Ionizing radiation may be stopped by lead or thick concrete. Lead a least 0.5 mm thick is the most effective protection against gamma rays. Alpha and beta particles do not require shielding.