intra-operative procedures

Question 1

How much 0.25% bupivacaine (marcaine) should be mixed with 1 mL of 1.0% lidocaine (xylocaine) to make the solution equal strengths of both medications?
A. 2.0 mL
B. 4.0 mL
C. 5.0 mL
D. 10.0 mL

Answer 1

4.0 mL

The correct calculation is 4 mL of marcaine to every 1 mL of xylocaine. This will make the solution equal strengths of both medications.

Question 2

During a transurethral resection of the prostate, bleeding is controlled by: 
A. irrigation
B. gelfoam
C. cauterization
D. suture ligature

Answer 2

cauterization

Cauterization is the method for controlling bleeding during a TURP. Gelfoam is a hemostatic agent used in open procedures. Bleeding is not controlled with irrigation. Suture ligature can control bleeding during an open or laparoscopic procedure.

Question 3

Which of the following procedures is used for removal of an embolus?
A. fasciotomy
B. endarterectomy
C. balloon catheterization
D. aneurysmectomy

Answer 3

balloon catheterization

Balloon catheterization is a common method using a fogarty catheter to remove an embolus. An endarterectomy restores circulation by removing plaque from the intima of an artery. Aneurysmectomy is the removal of an abnormal dilation of a blood vessel. Fasciotomy is the surgical incision of fascia.

Question 4

A three-way Foley catheter is inserted following a transurethral resection of the prostate (TURP) in order to:
A. keep the perineal area dry
B. irrigate and facilitate hemostasis
C. prevent the patient from getting out of bed
D. keep accurate input and output records

Answer 4

irrigate and facilitate hemostasis

A three-way Foley catheter is used for irrigation and drainage of the bladder. The inflated balloon helps with hemostasis. It is beneficial for patients to be ambulatory to facilitate recovery. Record-keeping is not the reason for insertion of the three-way Foley catheter. Keeping the perineal area dry is not a factor for insertion of the Foley. However, keeping any skin surface clean and dry is an important consideration.

Question 5

When assisting with the closure of a skin incision and operating the skin stapler, the surgical technologist in the scrub role is placing staples through which two layers?
A. cuticular and subcuticular 
B. subcutaneous and fascia
C. subicular and subcutaneous
D. subcuticular and subcutaneous

Answer 5

cuticular and subcuticular

The cuticular and subcuticular layers are the two most outer layers of the skin and are closed together by the skin stapler. The subcutaneous and fascia layers are not closed together as the subcuticular layer lays on top of the subcutaneous layer. To close the skin with a stapler, the outermost layer must be included. The subcutilar and subcutaneous layers are located deep to the skin and would not be closed by a skin stapler.

Question 6

A surgeon is performing a procedure to repair damage from a gunshot wound to the chest. Which of the following types of drains should the surgical technologist have available at the end of the procedure?
A. gravity
B. passive
C. suction
D. underwater

Answer 6

underwater

An underwater drain is used to pull fluid or air from the thoracic cavity after surgery or trauma to the thorax. It is used to restore negative pressure to the thoracic cavity. A passive drain is used whenever drainage is minimal, such as in surgeries of the biliary system and genitourinary tract. Examples are penrose, T-tube, and Foley catheter. A suction drain is negative pressure device that pulls fluids from the wound by suction. Examples include the Jackson-Pratt and Hemovac. Suction drains are used primarily in abdominal procedures. A gravity drain is a type os passive drain. Examples are a Foley catheter, Pezzer, T-tube, and Malecot.

Question 7

During an open repair of an indirect hernia, which of the following drains should a surgical technologist have available to pass the surgeon once the spermatic cord has been dissected?
A. T-tube
B. Malecot
C. Jackson-Pratt
D. Penrose

Answer 7

Penrose

A small Penrose drain is used to retract the spermatic vessels and vas deferens (spermatic cord). A surgical technologist should moisten the drain before passing it to the surgeon. The Malecot drain provides continuous drainage after genitourinary surgery. The T-tube is used specifically for bile duct drainage. The Jackson-Pratt drain is a suction drain that pulls serum and blood from a wound by a negative pressure device.