Final's Technique Questions Flashcards
Seamless tubular cotton that stretches to fit a contour and is used for padding is called a(n)
stockinette
An informed consent
. protects the surgeolL and the hospital from claims of an unauthorized operation
. authorizes routine duties carried out at the hospital
The surgical consent form can be witnessed by each of the following EXCEPT
the patient’s spouse
Which position would be the most desirable for a pilonidal cystectomy or a hemorrhoidectomy?
Kraske
In positioning for laminectomy, rolls or bolsters are placed
longitudinally to support the chest from axilla to hip
The ultimate responsibility for obtaining consent lies with the
surgeon
A position often used in cranial procedures is called
Fowler’s
Any area that is considered contaminated
should be scrubbed last or separately
Good exposure for thyroid surgery is ensured by all of the following EXCEPT
Answer: firm retraction of the laryngeal nerve and surrounding structures
Correct other options:
. utilization of skin-stay sutures
. hyperextension of the neck
. modified dorsal recumbent with shoulder rol
Which factor is important to consider when positioning the aging patient?
. skeletal changes
. limited range of motion of joints
. tissue fragility
The surgical consent is signed
before administration of preoperative medications
All of the following statements regarding sterility are true EXCEPT
Answer: a sterile person faces a nonsterile person when passing
. instruments or sutures hanging over the table edge are discarded
. sterile persons pass each other back to back
. wrapper edges are unsterile
In which position would shoulder braces be indicted?
extreme Trendelenburg
The patient is premedicated and brought to the operating room for a cystoscopy and an open reduction of the wrist. Upon arrival in the operating room, it is observed that the patient has only signed for the cystoscopy. The correct procedure would be to
Answer: cancel surgery until a valid permission can be obtained
. let the surgeon make the decision as to whether surgery could be done
. ask the patient verbally for consent and have witnesses attest to it
. have the patient sign for the additional procedure in the operating room
A grounding pad is not required for the electrocautery in
a bipolar unit
The ideal place to do the shave prep is in the
holding area of the OR
While a surgical case is in progress
doors should remain closed
The patient is scheduled for an appendectomy. After completing this procedure the surgeon decides to remove a mole from the shoulder while the patient is still under anesthesia. No permission was obtained for this. The circulating nurse should
report it to the supervisor or proper administrative authority
Which statement demonstrates a break in technique during the draping process?
gloved hands may touch the skin of the patient
Drapes are
placed on a dry area
Not:
. unfolded before being carried to OR table
. passed across the table to surgeon along with towel clips
. adjusted after placement for correct position
The active electrode on the electrocautery is the
tip
When positioning the patient for a procedure, which of the following provides maximum patient safety and maximum surgical site exposure?
patient’s body does not touch metal on table
equipment, Mayo stand, or personnel are not resting on the patient
bony prominences are padded
A seamless, stretchable material often used to cover extremities during draping is
stockinette
In preparation for surgery, skin should be washed and painted
from the incision site to the periphery in a circular motion
At what point should the surgeon be informed of the time of tourniquet application?
after 1 hour, then every 15 minutes
The following statements regarding a grounding plate for electrosurgery are true EXCEPT
Answer: the plate must be placed directly over a bony prominence
. the plate must be lubricated with electro surgical gel
the plate must have good contact with the patient’s skin
the grounded pathway returns the electrical current to the unit after the surgeon delivers it to the operative
Site
The proper setting for a tourniquet applied to an arm is
250-300 mm Hg
Suction tubing should be processed in the following way
residual of distilled water in lumen, stearn sterilize, tubing coiled
The inactive electrode of the cautery is the
ground pad
In electrosurgery, “buzzing” refers to
coagulation of vessel via a metal instrument touching the active electrode
Which statement regarding the withdrawal of a consent by a patient is NOT true?
Answer: the surgeon may do the procedure if he documents that it is necessary as a lifesaving measure
. the surgeon obtains a written refusal from the patient
You Answered
the surgeon informs the patient of the dangers if the procedure is not carried out
the surgeon informs the hospital administration of the patient’s refusal
Why are only moist sponges utilized during electrocautery use?
to prevent fire
Exsanguination of a limb before tourniquet inflation is accomplished with wrapping the elevated extremity with
Esmarch
Which suction tip has an angle and is used in the mouth or throat?
Yankauer
A dropped sterile item may only be used if the
wrapper is impervious and contact area is dry
When using lasers, nomeflective instrumentation
decreases accidental direct reflection of the laser beam to another area
Chest rolls (bolsters)
facilitate respiration
Not:
. minimize pressure on abdominal organs
secure position
minimize pressure on bony prominences
Sponges and towels used near the laser tissue impact site are kept wet in order to
prevent ignition of these materials by reflected beam
Which statement is true regarding a STERIS system for endoscope sterilization?
Answer: only one scope or a few instruments can be processed in a cycle
not:
. it is not sporicidal
it is very costly
the processing time is lengthy
Ebonization refers to
coating of instruments to decrease reflectivity
A Babcock is used to
grasp delicate structures
In which procedural setup would aT-tube be found?
exploration of the common bile duct
The Bookwalter is a _______________ instrument.
retracting
A small fine needle holder used in plastic surgery is a
Webster
A sponge used in brain surgery is a(n)
cottonoid patty
Placement of a Levin tube would be in the
stomach
Which case would require the use of cottonoid strips?
laminectomy
A dissecting sponge that is a small roll of heavy cotton tape is a
Kitner
A stab wound is a separate small incision
close to operative site
A dissecting sponge made of gauze that is used to dissect or absorb fluid is called a
peanut
Which of the following can be a supplement to a subcuticular closure?
skin closure tape
A dressing that is held in place by long suture ends crisscrossed and tied is called a
stent
An Auvard is a
speculum
A catheter commonly used in a gastrostomy is a
mushroom
Patties are
moistened with saline
The drain that has a reservoir creating negative pressure to facilitate drainage is a
hemovac
All of the following statements are true of ureteral catheters EXCEPT that they
Answer: provide direct visualization of the bladder
range in caliber from size 3 to 14 French
have graduated markings in centimeters
are made of flexible woven nylon or plastic
A closed-wound suction system works by
negative-pressure vacuum
A Pezzer is a
mushroom catheter
The following statements regarding counts are true EXCEPT
Answer: the relief scrub or circulator does not need to repeat count if only one of them is relieved
. persons taking final count must sign the count record
persons taking final count are held accountable
all counts are verified before person being relieved leaves room
Which factor is not accomplished by chest drainage?
Answer: positive pressure re-establishmen
Other Right Answers:
. suction controlled by level of water
. drains fluid and air from pleural cavity
. provides water seal for gravity drainag
The initial count requires
that the count be done aloud by circulator and scrub
The three lumens of a Foley are used for inflation, drainage, and
continuous irrigation
If a sponge is intentionally left in the patient
a notation is placed on the operative record
If a sponge pack contains an incorrect number of sponges, the circulating nurse should
isolate the pack, do not use it
Which of the following statements concerning sponges are true EXCEPT
Answer: a count is unnecessary in a vaginal procedure
Other Correct Options:
. only radiopaque sponges should be used on the sterile field
. a pack containing an incorrect number of sponges is discarded
. sponges should be counted from the folded edge
During the closure count a discrepancy
is reported to surgeon
The following statements regarding counting sponges are true EXCEPT
Answer: an incorrect number of sponges in a pack should be compensated for on count sheet with a notation
Other Correct Options:
. separate each sponge and number aloud while placing it in a pile on table
. shake pack to separate sponges
. sponges are counted at folded edge
In an instrument count
all instruments and parts must be counted
During the sponge count procedures, which action would constitute an UNACCEPTABLE technique?
soiled sponges used for prep remain in kick bucket and are not part of count
Maslow’s hierarchy is important because it establishes a hierarchy of ____.
needs
Omission or commission of an act that is related to normal patient care is the most common cause of a charge of ____.
negligence
If a patient asks what you do, you should ____.
explain in simple factual language
The number of microbes or organic debris that exist at a given time is referred to as ____.
bioburden
Methods used to prevent contamination of the sterile field are referred to as ____.
sterile technique
What dormant structure can some bacteria form to survive adverse environmental conditions?
spore
Most surgical infections occur because of ____.
contamination during the procedure
The primary source of airborne bacteria transmission in the operating room is the ____.
surgical team
A surgical procedure involving perforated viscera is classified as a ____.
class IV, dirty wound
Infection contracted within the health care setting is known as ____.
nosocomial
Fluid bottles may be recapped and reused under what conditions?
may NOT be recapped
The process that assures that all microorganisms including spores are killed is called ____.
sterilization
A catalyst used to aid in the breakdown of organic material such as blood and tissue is a/an ____.
enzyme
The basis for the practice of strict adherence to sterile technique is called ____.
surgical conscience
Which of the following tasks is not assigned to adolescence?
Answer: select life-long partner
Other Options:
. establish sex role behavior with peers of both sexes
form a new sense of identity
separate from parents emotionally
The informed consent cannot be signed by the patient after ____.
taking preoperative medications
Why should saline NOT be used to clean stainless steel surgical instruments?
salt will pit the stainless steel
The ultrasonic washer is an example of a/an
mechanical decontamination unit
The ____ is used to remove small organic particles and soil from areas of instruments that are difficult to clean manually.
ultrasonic washer
To prevent the formation of condensate in nested basins (double basin) what must be done?
separate with towel
In many instances a patient may be given a preoperative medication to ____.
reduce anxiety and nausea
The presence of food or fluid in the stomach during surgery increases the danger of ____.
aspiration
Which of the following must be performed in order for the patient to sign the informed consent?
risks and benefits described
When identifying a patient, the patient’s verbal identification is compared to the ____.
patient’s identification band
Patients should be transported slowly and ____.
feet first
Approximately 60% of all surgical patients are affected by ____.
hypothermia
When transporting a patient on a stretcher or in a bed, the side rails should be ____.
up and locked
When moving an unconscious patient to the lateral position, how many individuals should be used to turn the patient?
four
The first patient complaint about the operating room is the ____.
room is cold
Once placed on the operating table, the patient may never be ____.
left alone
In the prone position, the safety belt should be over the ____.
thighs
The Trendelenburg position is often used for surgery on the ____.
lower abdomen and pelvis
Plain gut, chromic gut, PDS II, and Monocryl are examples of ____.
monofilament absorbable sutures
Perineal, rectal, and vaginal surgery is usually performed with the patient in what position?
lithotomy
Fowler’s position can be used for surgical procedures on the ____.
shoulder
During urethral catheterization, which hand is used to expose the meatus?
the nondominant hand
To prevent bladder distension during long procedures, the surgical patient may receive a(n) ____.
indwelling urinary catheter
Which of the following is considered a contaminated area when performing the skin prep?
vagina
What is the general rule for prepping contaminated areas?
contaminated area las
What is the most commonly used hemostatic device?
electrocautery
During a cardiac arrest in the operating room, the primary role of the STSR is to ____.
protect the sterile field
NPO can be defined as
Patient must refrain from eating
Patient must refgrain from drinking
Nothing by mouth
All of the following can be used to identify a patient except?
Answer: OR personnel
Other correct options:
Patient’s chart
Checking wristband
Verbally asking the patient
A vasoconstrictor that is often mixed with local anesthetics is ____.
epinephrine
A minor may sign his or her operative consent form is he or she is:
Emancipated
Adult patients are most commonly transported to the OR by which of the following?
Guerney
Which of the following might the patient be allowed to wear to OR before being administered anesthesia?
Dentures
Eye glasses
Hearing aid
If significant blood loss is expected to occur during surgery, when might a patient avoid doing typing & cross matching?
. When cellsaver is used.
. When family members donate blood in the patient’s name.
A sedated patient may sign for his operative consent if:
He may never sign.
About 40% of nosocomial infections are caused by:
Contamination of an inserted catheter
Drapes that have an adhesive backing that can be impregnated with an antimicrobial iodine agent are called ____.
incise
What item disperses the current and heat generated by the electrosurgical unit in tissue?
grounding pad
Drapes that have openings for exposure of the area to be incised are ____.
fenestrated
All of the following are purposes of the preoperative patient routine except?
To intimidate the patient
General abdominal procedures typically require a(an) ____ instrument set.
laparotomy
The type of surgical dressing that eliminates dead space and prevents edema or postoperative bleeding is called ____.
pressure
Which of the following is used for wounds that require frequent dressing changes?
Montgomery strap
Healing where the wound is left open and allowed to heal from the inner layer to the outside surface is ____.
second intention
Which of the following is used to irrigate wounds, aspirate fluids, or inject medications?
syringe
What machine infuses CO2 gas into the abdominal cavity?
insufflator
The partial or total separation of a layer or layers of tissue after closure is called ____.
dehiscence
Which of the following is used on a wound that has been primarily closed and from which little or no drainage is expected?
one-layer dressing
The suture diameter is referred to as the ____ .
gauge
Surgical silk is a ____
multifilament nonabsorbable suture
How much fluid is required to inflate the indwelling Foley catheter 5-cc balloon?
10-cc
Occlusive adherent polyurethane, liquid collodion, and aerosol adhesive sprays are examples of ____.
one-layer dressings
Which of the following sutures is absorbable?
Dexon
A stapler used to insert two straight, evenly spaced, side-by-side rows of staples into tissue is a/an ____ stapler.
linear
The rupture of a wound with spilling of contents is known as:
Evisceration
Evisceration is the rupture of a wound with the spilling of contents.
Which suture is a monofilament?
Maxon
Pieces of plastic or rubber tubing threaded over the retention suture ends prior to tying are called ____.
bolsters
Which synthetic mesh may be used in the presence of infection?
Prolene
The EEA surgical stapler is used for:
Anastomosis of proximal colon to rectum
The EEA surgical stapler is used for anastomosis of the proximal colon to rectum.
Which factor is not accomplished by chest drainage?
positive pressure re-establishment
Which suture absorbs the fastest?
chromic gut
A characteristic of polyglycolic acid sutures is they are:
Absorbable
Polyglycolic acid suture is treated with a salt solution to decrease its absorbability.
The final wound classification is assigned when ____.
the procedure is finished
