To Practice For  National Certification Exam

EXPLANATIONS:
(u) A. The main concern is to get the patient back into normal rhythm, not to get the wound closed up. If the patient's heart doesn't begin beating again, there will be no use of finishing the surgery.
(u) B. The circulator can call for help. The surgical technologist in the scrub role should remain sterile.
(c) C. The surgical technologist in the scrub role should remain sterile and maintain the sterile field unless otherwise directed by the surgeon.
(u) D. The ESU is not a primary concern in this emergency. The surgical technologist in the scrub role should maintain the sterile field.should remain sterile and maintain the sterile field unless otherwise directed by the surgeon.
(u) D. The ESU is not a primary concern in this emergency. The surgical technologist in the scrub role should maintain the sterile field.

(c) A. Heaney clamps are used to clamp the uterine ligaments during a hysterectomy.
(u) B. Heaney clamps would traumatize lung tissue during a lobectomy.
(u) C. A cystectomy (removal of the bladder) does not require the use of Heaney clamps.
(u) D. A gastrectomy (removal of the stomach) does not require the use of Heaney clamps.

EXPLANATIONS:
(u) A. Pathogenic organisms cause or are able to cause disease.
(u) B. Nonpathogenic organisms are not disease forming.
(c) C. Aerobic organisms require an oxygen-rich environment to survive.
(u) D. Anaerobic organisms do not require oxygen to survive.

(u) A. Antiseptics destroy most but not all pathogens and are not typically used on inanimate objects.
(u) B. Decontamination is a process of disinfection and does not render an instrument sterile.
(c) C. Sterilization is the destruction of all microorganisms.
(u) D. Reduction implies the destruction of some or most bacteria. Sterilization requires the destruction of ALL bacteria.

EXPLANATIONS:
(u) A. Adjusting the stirrups based on the height of the first assistant may contribute to patient injury.
(u) B. The manufacturer's recommendations would not necessarily address the proper height for any given patient.
(u) C. The surgeon's height has nothing to do with correct placement of the stirrups. This must be calibrated to the patient's height.
(c) D. The stirrup height is adjusted to the length of the patient's legs so that nerve pressure and damage are prevented.

EXPLANATIONS:
(u) A. Osteomyelitis is an infection of the bone and bone marrow.
(u) B. Sepsis is an inflammatory response that causes a high fever but does not result from an injection of succinylcholine.
(c) C. Succinylcholine is a anesthetic muscle relaxant that can trigger malignant hyperthermia.
(u) D. Appendicitis is an inflammation of the appendix that can cause a high fever but does not result from an injection of succinylcholine.

c) A. Glutaraldehyde is used for devices that can withstand complete immersion in liquid. To render an item sterile it must be immersed for 10 hours.
(u) B. Sodium hypochlorite is an effective disinfectant for surfaces, floors, and equipment but not instruments.
(u) C. Aqueous formaldehyde is a preservative not a sterilizing agent.
(u) D. Methyl phenol is used to disinfect large areas such as floors and countertops.

The Jorgenson scissor is most likely found in a basic hysterectomy set-up.

(c) A. A quiet, dimly lighted room will facilitate the effects of the preoperative medications administered to patients to relieve anxiety and promote drowsiness.
(u) B. A brightly lighted room would not have a calming effect.
(u) C. A warm, busy room negates the effect of preoperative medication and promotes patient preoperative anxiety.
(u) D. A cool, busy room will negate the effects of the preoperative medication and the lower temperature could contribute to potential hypothermia of the patient.

EXPLANATIONS:
(u) A. The assistant's PPE should be placed at the top of the stack since the assistant scrubs in first. According to the preference card, the assistant prefers size 8 gloves not size 7.5.
(u) B. The assistant's PPE should be placed at the top of the stack since the assistant scrubs in first. According to the preference card, the assistant prefers size 8 gloves not size 7.5.
(c) C. The assistant's PPE should be placed at the top of the stack since the assistant scrubs in first. Additionally, the towel should be on top of the gown, with the gloves beneath the gown.
(u) D. The assistant's PPE should be placed at the top of the stack since the assistant scrubs in first. According to the preference card, the assistant prefers an XL cloth gown not a large paper gown.

Padding is applied to an extremity before applying a tourniquet to avoid skin injuries. This is because the tourniquet, when tightened, can put pressure on the skin and potentially cause damage such as bruising, abrasions, or even cuts. By using padding, the pressure is distributed more evenly and reduces the risk of skin injuries.

EXPLANATIONS:
(u) A. The periosteum is the outer layer covering of the bone and is present during all stages of bone growth.
(u) B. The diaphysis is the shaft of the long bone and is not where growth takes place.
(u) C. The medullary canal is the innermost part of the bone that contains bone marrow which supplies the bone with nutrients but does not determine if a long bone is still growing.
(c) D. The epiphyseal plate, also known as the growth plate, is the center for ossification at each extremity of a long bone.

EXPLANATIONS:
(c) A. The bursa is pad-like sac or cavity found in connective tissues, usually in the vicinity of joints.
(u) B. A fossa is a furrow or shallow depression.
(u) C. A ganglion is a fluid-filled sac that can arise from almost any tendon sheath or joint in the hand or wrist.
(u) D. A ligament is a band or sheet of strong fibrous tissue connecting the articular ends of bones, serving to bind them together and to facilitate or limit motion.

EXPLANATIONS:
(u) A. The insertion of the drainage tube is performed near the end of the procedure.
(u) B. Cerumen is removed prior to the incision of the tympanic membrane.
(u) C. Removal of fluid from the middle ear is performed following the incision of the tympanic membrane.
(c) D. Removal of cerumen is done after the ear speculum is inserted for visualization of the tympanic membrane.

Rhytidectomy is a surgical procedure that involves removing excess skin from the face and neck. It is commonly known as a facelift and is performed to reduce the signs of aging, such as wrinkles and sagging skin. Rhinoplasty, cheiloplasty, and blepharoplasty are all different procedures that involve modifying the nose, lips, and eyelids respectively, but they do not address excess skin on the face and neck.

(u) A. Drapes should not be applied over the unprepped skin because it would not effectively address the contamination of the operative site.
(u) B. Drapes applied should NEVER be repositioned because it is a break in aseptic technique.
(c) C. This is the correct procedure because it adheres to aseptic technique and best addresses contamination on the operative site.
(u) D. Adhesive drapes do not adequately address operative site skin preparation.

(u) A. A Bartholin's cyst is caused by one of the vestibular glands filling with clear fluid and becoming blocked.
(u) B. An ectopic pregnancy occurs in a Fallopian tube instead of the uterus.
(c) C. A circlage procedure is performed to prevent spontaneous abortion and preterm delivery by placing a purse-string suture around the cervix.
(u) D. Placenta previa is a condition in which the placenta is attached near the cervix and ruptures prematurely.

(u) A. Gastrostomy is used to treat patient with esophageal disease or stricture.
(u) B. Nissen fundoplication is performed to reduce the fundus for the treatment of persistent gastroesophageal reflux disease (GERD).
(u) C. Heller myotomy is a surgical procedure in which the muscles of the lower esophageal sphincter are cut, allowing food and liquids to pass to the stomach.
(c) D. Infantile pyloric stenosis is relieved by removing the congenital obstructive lesion in the pylorus of the stomach. This procedure is called pyloromyotomy.

EXPLANATIONS:
(c) A. Adaptic is a nonadherent dressing placed directly on the wound.
(u) B. Collodion is a liquid adhesive which seals the wound.
(u) C. Steri-strips are adhesive tape-like dressings.
(u) D. Elastoplast is adhesive tape.

c) A. Reabsorbing water is a primary function of the colon, along with elimination of digestive wastes.
(u) B. Secreting hormones is a function of the small intestine.
(u) C. Secreting digestive hormones is a function of the parietal cells of the stomach.
(u) D. Absorbing the products of digestion is a function of the small intestine.

(c) A. 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.
(u) B. When removing drapes from the patient, the surgical technologist should remain protected with PPE (personal protective equipment) before handling the drapes.
(u) C. When removing drapes from the patient, the surgical technologist should remain protected with PPE (personal protective equipment) before handling drapes. The second pair of sterile gloves is unnecessary to remove drapes.
(u) D. Sterile gloves are not necessary for the clean-up process, as supplies, instruments, and equipment are no longer considered to be sterile during this procedure.

EXPLANATIONS:
(c) A. The internal mammary artery is the preferred vascular conduit to revascularize the myocardium.
(u) B. The subclavian artery is distal to the internal mammary artery and would not be long enough to reach the affected coronary artery.
(u) C. The internal mammary artery anastomosed to the aorta would not revascularize the affected heart muscle.
(u) D. The subclavian artery anastomosed to the aorta would not revascularize the affected heart muscle.

EXPLANATIONS:
(u) A. Simms is a vaginal retractor for gynecological procedures.
(u) B. Auvard is a weighted vaginal retractor used for gynecological procedures.
(c) C. Schroeder is a tenaculum with a single tooth or a vulsellum with a double tooth.
(u) D. Bozeman is a long dressing forceps for packing the vagina.

(u) A. A McBurney's incision is most commonly used for an appendectomy.
(u) B. A Pfannenstiel incision is most commonly used for a hysterectomy or cesarean section.
(u) C. A lower midline incision is used for uterine adnexa or urinary bladder surgery.
(c) D. A subcostal incision is preferred for an open cholecystectomy.

c) A. A myelogram is injection of contrast media into the spine subarachnoid space.
(u) B. An arteriogram is the injection of contrast media into the arteries.
(u) C. A lumbar puncture is a procedure that allows access to the subarachnoid space for removal of cerebrospinal fluid for diagnostic purposes.
(u) D. A pneumography is an anatomical illustration of the lung.

A. They are not exactly the same.
(u) B. Rectal temperatures are 1 degree higher than oral temperatures. Axillary temperatures are 1 degree lower.
(c) C. Rectal temperatures are 1 degree higher than oral temperatures.
(u) D. Rectal temperatures are not 2 degrees higher than oral Fahrenheit temperatures.

u) A. Gown and gloves should be kept on to remove the soiled drapes.
(u) B. Gloves should be removed after all other drapes and supplies are properly disposed of and bagged but before the mask is removed.
(c) C. The surgical mask should not be touched by soiled gloves, and in many areas must remain on until the room is exited.
(u) D. Gown and gloves should be kept on until the removal of the soiled Mayo drape.

(u) A. Epinephrine is a cardiac stimulant.
(u) B. Nitroglycerin is a vasodilator that lowers the blood pressure.
(c) C. Lidocaine is an antiarrhythmic.
(u) D. Norepinephrine is a cardiac stimulant.

u) A. Tachycardia (rapid pulse) is a symptom of shock.
(c) B. Hypertension is NOT a symptom of shock. Hypotension is a symptom.
(u) C. Cold, clammy skin is a result of shock due to peripheral shutdown.
(u) D. Respirations increase due to tachycardia.

EXPLANATIONS:
(u) A. Intravenously injected bupivacaine is associated with cardiac arrest.
(u) B. Lidocaine containing epinephrine can cause convulsions and tachycardia when injected into the peripheral vascular system.
(u) C. Intravascular injection of bupivacaine with epinephrine is associated with convulsions, tachycardia, and cardiac arrest.
(c) D. Lidocaine (Xylocaine) when utilized for regional Bier block anesthesia does not carry as significant a risk for anesthetic agent toxicity as bupivacaine (Marcaine).

EXPLANATIONS:
(c) A. The Sterrad system is a plasma sterilization system that uses hydrogen peroxide in plasma form.
(u) B. Glutaraldehyde is a cold sterilant and is not used in the Sterrad sterilization system.
(u) C. Peracetic acid is typically used in the Steris sterilization system not the Sterrad sterilization system.
(u) D. Carbon dioxide is not utilized for the sterilization process.