NCCT CST Practice Exam

When steam sterilizing biological indicators, how long are they incubated before the reading is recorded? A. 12 hours B. 24 hours C. 48 hours D. 72 hours

B. 24 hours Rationale: Per CDC guidelines, steam sterilizer biological indicators must be incubated for 24 hours before the reading is recorded.

Which of the following is the minimum amount of time an unwrapped Kelly clamp needs to be flash sterilized for? A. 6 minutes B. 3 minutes C. 7 minutes D. 12 minutes

B. 3 minutes Rationale: The minimum amount of time is 3 minutes.

When sterilizing an unwrapped, non-porous item with no lumen in an immediate use sterilization unit, which of the following parameters must be met for sterilization with gravity displacement steam? (Select the two (2) correct answers.) A. 3-4 minute exposure time B. 270 F C. 10 minute exposure time D. 132o F E. 4 minute drying time

A. 3-4 minute exposure time B. 270 F Rationale: Per CDC guidelines, proper parameters for an unwrapped, non-porous item with no lumen in a gravity displacement sterilizer are 132 degrees Celsius, or 270F for 3 minutes.

The surgical technologist places the patient in Fowler position with head secured by craniotomy headrest. Which of the following locations indicates correct application of the safety strap? A. 2 inches above the knees B. 2 inches below the knees C. across the torso just below the sternum D. across the torso just above the sternum

A. 2 inches above the knees Rationale: Correct placement of the safety strap is two inches above the knees. Take care to make sure the strap is not too tight. You should be able to slip two fingers under the strap with ease. Placing the strap across the torso would not secure the legs to the bed. Placing the strap below the knees does not provide adequate safety support to the rest of the body.

In preparation for a carotid endarterectomy the surgical technologist should anticipate using which of the following sutures? A. 7-0 prolene B. 7-0 chromic C. 7-0 ethibond D. 7-0 silk

A. 7-0 prolene Rationale: The arteriotomy of a carotid endarterectomy is closed with Prolene. All vascular surgery utilizes non-absorbable suture such as Prolene.

The patient is scheduled to have a Meniscal repair done on his right knee. Which of the following best represents how the site should be marked in the preoperative holding area to verify correct surgical site? A. A "yes" written on the right knee, with a small line showing where the incision will be. B. An "X" marked on the right knee, with a small line showing where the incision will be. C. An "X" marked on the left knee, showing that this is not the correct surgical site. D. A "no" written on the left knee, showing that this is not the correct surgical site.

A. A "yes" written on the right knee, with a small line showing where the incision will be. Rationale: The operative site will be marked by the surgeon. Indelible marker should be used, so that prep solutions, drapes and tape do not inhibit the ability to read it clearly. The word "yes" or the surgeon's initials are commonly acceptable ways to mark the correct surgical site. "X" or "no" are not acceptable, as to it could lead to confusion or misunderstanding of whether site is correct or not.

A charge nurse has just notified the surgical technologist to be prepared for a post-operative emergency for a post salpingo-oophorectomy. Which of the following is the instrumentation needed? (Select the two (2) correct answers.) A. Bookwalter retractor B. C-section set C. dilation and curettage set D. major set E. Mayfield retractor

A. Bookwalter retractor D. major set Rationale: The incision for this emergent procedure will most likely be a midline vertical incision, which would require a larger self-retaining retractor such as a Bookwalter. A Major instrument set will also be needed because it will have all the basic instruments for incision, dissection and hemostasis. A C-section set does have several basic instrumentation, but a Major instrument tray will have more instruments to use. A dilation and curettage set only has vaginal instruments in it. A Mayfield retractor is used during craniotomy procedures to hold the head in place.

If the surgical technologist's request for an initial count is refused by the circulator due to emergent nature of a procedure, which of the following is the proper course of action? A. Continue with subsequent counts and follow procedure from that point on in the case. B. Do not proceed with the case until the initial count is completed. C. Perform the initial count independently, using the count sheet inside the tray. D. Ask a different member of the surgical team to assist in the initial count.

A. Continue with subsequent counts and follow procedure from that point on in the case. Rationale: Per AST guidelines, if an emergency procedure will not allow time for a pre-operative count, subsequent counts should be completed at the appropriate time. If there are any discrepancies in the number of items used during the case, an x-ray should be done at time of closing to ensure no items were left in the patient.

A vulva biopsy is to be conducted on a patient who is an observant Muslim. Which of the following should actions should be taken for this case? A. Enlist an all female surgical team. B. Use a towel to cover the patient's face. C. Enlist an all Muslim surgical team. D. Ensure that no blood products are used.

A. Enlist an all female surgical team. Rationale: A Muslim woman, in keeping with their cultural beliefs, would not be permitted to be seen by a member of the opposite sex, other than their husband. If a woman is young, and unmarried, they may request a chaperone escort her into the procedure room and stay with her until she is asleep. Under Joint Commission policy, accredited facilities must make efforts to adhere to the cultural or religious practices.

Which of the following retractors has sharp disposable inserts that must be disposed of in an appropriate sharps container following the end of the surgical case? A. Mayfield B. Cloward C. Bookwalter D. Greenfield

A. Mayfield Rationale: The Mayfield is a headrest that pins the head for stabilization. The pins used are very sharp and must be placed in the sharps container after the procedure. A Cloward is a hand held retractor used in an anterior cervical procedure. The Bookwalter is a self-retaining retractor used for open abdominal procedure. The Greenfield is a self-retaining retractor used on the brain.

The surgical team is at the surgical field and has just completed the time-out. The surgeon turns to the surgical technologist and asks for local. Which of the following actions should the surgical technologist take next before passing the local? A. Read aloud the medication label on the syringe. B. Pass the correctly labeled medication syringe. C. Confirm with the circulator the medication label on the syringe. D. Confirm with the anesthesiologist the medication on the syringe.

A. Read aloud the medication label on the syringe. Rationale: The medication has already been verified by the circulator and the surgical technologist upon placement on the sterile field. The surgical technologist needs to read aloud the syringe contents when handing the syringe to the surgeon. The anesthesiologist is not part of the sterile team environment.

A 21-year-old patient is rushed to the OR with a self-inflicted stab wound to the groin. The wound is an inch in length and the patient has flat lined with a steady flow of blood pumping from the small wound. Which of the following items should the surgical technologist have ready for the surgeon? (Select the three (3) correct answers.) A. Yankauer suction B. lap sponges C. Raytec sponges D. Frazier suction E. knife blade

A. Yankauer suction B. lap sponges E. knife blade Rationale: Laparotomy sponges are needed because of the steady flow of blood that is being lost. The yankauer suction is the appropriate suction to use because it can keep the incision clear and absorb more fluid. A knife blade would be needed to extend the incision to find out where the bleeding is coming from so it can be stopped. Raytec sponges cannot absorb substantial amounts of blood. A Frazier suction is not needed because it is used for smaller, precise suctioning.

An OB-GYN surgeon has posted a laparoscopic partial hysterectomy and has informed the surgical team that the ovaries are remaining. However, the fallopian tubes will require ligation involving the tubes being clipped and cauterized. Which of the following instruments should the surgical technologist open? A. a Filshie and a Kleppinger B. a harmonic scalpel and hemoclip applier C. a Filshie and hemoclip applier D. a Kleppinger and harmonic scalpel

A. a Filshie and a Kleppinger Rationale: A Filshie is a small titanium clip with a soft lining used specifically for female sterilization. The Kleppinger would be used next as a secondary measure to cauterize the exposed ends of the Fallopian tubes. A harmonic scalpel is used to cut and coagulate tissue, but the Kleppinger offers a smaller, more precise coagulation area. Hemoclip appliers are not used as a sterilization method.

The surgical technologist is preparing the OR suite for a patient's transurethral resection of the prostate (TURP). Which of the following supplies should the surgical technologist anticipate? A. continuous bladder irrigation solution B. minor instrument set C. red rubber catheter D. mineral oil

A. continuous bladder irrigation solution Rationale: A cystoscope will be used during the TURP, the resection needs to have continuous bladder irrigation solution. An incision will not be made so a minor instrument tray will not be needed. The patient does not need to be straight catheterized, so a red rubber catheter is not needed. Mineral oil is a lubricant used on a patient's skin to make a dermatome work better when performing a skin graft.

Which of the following must the surgical technologist verify before implants are opened during a total knee replacement? (Select the three (3) correct answers.) A. expiration date B. name of component C. lot number D. size E. manufacturer name

A. expiration date B. name of component D. size Rationale: Manufacturer name and lot number do not have to be verified by the surgical technologist, but are charted by the circulator for documentation. Always verify implant type, size, and expiration date, prior to opening.

In anticipation of a visually impaired patient's surgical procedure, the best practice in facilitating movement would be for the surgical technologist to A. explain the process of moving from stretcher to bed then guide the patient's hand to aid him while he moves. B. guide the patient by touching him then explain the process of moving from the stretcher to the operating bed. C. allow the patient to become familiar moving by feeling around on his own. D. explain the process of moving then allow the patient to move on his own.

A. explain the process of moving from stretcher to bed then guide the patient's hand to aid him while he moves. Rationale: Since the patient is visually impaired they cannot see that well what you are telling them to do. Someone should explain to the patient, what will be needed from them to move over to the operating room bed. The surgical technologist should guide the patient's hand and tell them where it is expected for them to move. The patient should be told what to do first ,and then have them move over to the correct position, with guidance as they move.

Which of the following substances used in the surgical environment is flammable? A. isopropyl alcohol B. silver nitrate C. acetic acid D. sorbitol solution

A. isopropyl alcohol Rationale: Silver nitrate is a hemostatic agent. Acetic acid is also known as vinegar and is not flammable. Sorbitol solution is a sugar alcohol and is not flammable. Isopropyl alcohol is highly flammable and can start a fire.

During a total abdominal hysterectomy, the surgeon has begun placing the Balfour retractor. In anticipation of bowel packing, the surgical technologist should moisten A. laparotomy sponges. B. Ray-Tec sponges. C. Kittner sponges. D. sterile blue towels.

A. laparotomy sponges. Rationale: Laparotomy sponges are the best choice for packing the bowel during an abdominal case because they are a large sponge used for larger incisions. Ray-tec sponges should never be used in the abdomen without a sponge stick because they can get lost very easily. Kittner sponges are only used for very small dissection or dabbing of blood. Blue towels should never be placed within an open incision because they do not have an x-ray detectable strip and they have not been counted like other sponges.

The surgical technologist observed a patient fall during the transfer from the gurney to the operating bed. Which of the following items are required in the incident report? (Select the three (3) correct answers.) A. patient's name B. personnel involved C. type of anesthesia used D. location of the incident E. patient's weight

A. patient's name B. personnel involved D. location of the incident Rationale: In completing an incident report for an occurrence such as this fall, all information regarding the patient and the circumstances around the occurrence should be included. In this case scenario, the patient had not had anesthesia yet so this did not play a factor, nor did the patient's weight. So the best choices for information that needed to be included in the incident report are the patient's name, the personnel involved, and the location of the incident

When cutting 7-0 nylon suture, which of the following is the best instrument to use? A. straight Iris scissors B. straight Mayo scissors C. curved Metzenbaum scissors D. curved Stevens tenotomy scissors

A. straight Iris scissors Rationale: Suture should always be cut with a straight scissor, and one that is compatible with the heaviness of the suture material being cut. The best choice is the straight Iris scissor, since it is a smaller, finer scissor than a Mayo.

After a tracheostomy procedure the surgical technologist should keep which of the following items sterile on the back table until the patient leaves the room? A. tracheostomy hook and spreader B. tracheostomy obturator C. tracheostomy inner cannula D. endotracheal tube

A. tracheostomy hook and spreader Rationale: The hook and spreader should remain sterile on the back table—in case there are any complications and the tracheotomy tube needs replaced or fixed; they will aid in fixing or replacing the tube. The obturator helps position the tube. An endotracheal tube is used for general anesthesia.

At the beginning of a carpal tunnel procedure the surgeon announces that he will use a Steven's scissor for every hand case he does from this day forward. After the case, which of the following is the most efficient way to make sure he has his Steven's scissor moving forward? A. Speak to the Sterile Processing manager, and ask that a Steven's scissor be added to every hand tray in the department. B. Add the Steven's scissor to every hand procedure preference card for the surgeon. C. Post a note in the supply room announcing the surgeon's request. D. Speak to the Materials Management department and ask they order additional Steven's scissors since the surgeon is going to use them more frequently.

B. Add the Steven's scissor to every hand procedure preference card for the surgeon. Rationale: Preference cards hold information for surgeon and case specific requirements. Putting the information on this card, will ensure that the scissor will be pulled, each time this surgeon does a hand case. Including the scissor in every hand tray is redundant, as all surgeons may not require its use. Notifying the Materials Management department of this request may be helpful, but will not be the best choice to ensure the surgeon has what he needs for future hand cases.

An alert, oriented, and mobile 300 lb. patient is brought into the OR on a transport cart. Which of the following is the best method of slowly transferring this patient to the OR bed? A. Align the beds together, lock the wheels, and use a roller board. B. Align the beds together, lock the wheels, and ask the patient to move himself. C. Use a mechanical lift to assist in moving the patient. D. Call for more lifting help to assist in moving the patient.

B. Align the beds together, lock the wheels, and ask the patient to move himself. Rationale: The mobile patient should be asked to move herself to the OR table independently. A minimum of two team members should be available to assist in any way possible. It is important to make sure all wheels are locked on both the gurney and the OR bed.

When breaking down the setup, which of the following steps should be completed first? A. The instruments are put back into the instrument tray and placed in/on the case cart. B. All sharps are contained and disposed of in the sharps container. C. Spray down the non-disposable instruments with cleaner. D. All disposable drapes are discarded into the trash receptacle.

B. All sharps are contained and disposed of in the sharps container. Rationale: At the end of every procedure the sharps need contained and put away first to prevent injuries. The other steps are done after the sharps are put away and disposed of in order to avoid getting stuck.

During an I&D of a back wound with the patient in the prone position the anesthesiologist announces that the patient is turning blue and calls a code. Which of the following actions should the surgical technologist take to assist? A. Assist the surgeon in closing the wound, remove the drapes, and flip the patient. B. Cover the wound and remove the Mayo and back table. C. Flip the patient immediately. D. Assist anesthesia with the patient while the surgeon continues surgery.

B. Cover the wound and remove the Mayo and back table. Rationale: The first thing that needs to be done is to maintain the patient's airway. The wound should be covered and the mayo should be removed so the patient can be flipped in order for anesthesia to take care of the airway, then assist anesthesia with the patient.

The surgical technologist is opening for a procedure and notices the wrapped item she just opened has a hole in the outer layer. Which of the following is the proper course of action? A. Open the inner layer onto the sterile field. B. Discard the item and retrieve a new one. C. Check the indicator to ensure the item has been sterilized. D. Place the package on a prep stand and open away from the sterile field.

B. Discard the item and retrieve a new one. Rationale: If the integrity of the package has been compromised, it should not be taken on the sterile field. When in doubt throw it out and get a new one. If the package has a hole it should never be used. If it was taken onto the sterile field it would contaminate the whole field.

A tornado warning is in effect and power has been switched to the generator due to downed electrical lines. The hospital's disaster triage protocol has been activated. A surgical procedure is in progress. Which of the following is the best course of action to ensure patient safety? A. Immediately evacuate the patient to the preoperative holding area. B. Finish the procedure and evacuate the patient. C. Place wet towels under door and finish the procedure. D. Cover the back table until the storm passes.

B. Finish the procedure and evacuate the patient. Rationale: Follow hospital's disaster plan for tornado preparedness and response. Under Joint Commissions standard codes, this would be categorized as a Code Brown, which is a weather related emergency. The best option in this instance is to complete the case, and then transfer the patient to a safe location for post-operative care.

The surgical team has just completed a radical mastectomy and the surgeon has left the room. While cleaning up the back table the surgical technologist notices the Jackson Pratt placed during this surgery is full with bright red fluid. Which of the following should the surgical technologist do next? A. Ask the anesthesiologist to remove the bulb. B. Inform the circulator that the drain is full and there is the potential for active bleeding in the surgical site. C. Immediately apply pressure over the site where the drain is inserted. D. Ask the circulator for a new bulb to replace the full one prior to the patient being sent to PACU.

B. Inform the circulator that the drain is full and there is the potential for active bleeding in the surgical site. Rationale: The circulator needs to be informed since there may be a potential active bleed and the surgeon has left the room. The surgical technologist should then remove the bulb and empty the contents in the appropriate container. The circulator should document the amount in the bulb. If the drain keeps filling up the surgeon would need to return to the room. The Jackson Pratt drain can be emptied since it has a removable bulb. A new one is not needed since it can be emptied and replaced. Since there is potential bleeding the surgical technologist should not cover it up.

The surgeon begins to close the uterus during a myomectomy. Which of the following actions should the surgical technologist take before continuing with the closure of the wound? A. Initiate the closing count. B. Initiate the cavity count. C. Obtain sterile wound dressing material. D. Weigh the myoma.

B. Initiate the cavity count. Rationale: Always count upon closing a cavity within a cavity, like the uterus within the abdomen. The final closing count is initiated at skin closure. Any dressing material should be opened after skin closure is completed. There is no need to weigh the myoma in the operating room.

The patient is undergoing cardiothoracic surgery, and placed in the Sims position. Which of the following actions prevents the likelihood of an intraoperative positioning injury to the brachial plexus? A. Apply flank padding and a head stabilizer. B. Place rolled towel padding beneath abducted down-side arm. C. Place lower leg stirrup sling directly over Achilles tendon. D. Apply pillows directly under the knee joint.

B. Place rolled towel padding beneath abducted down-side arm. Rationale: Placing a rolled towel, or gelpads under the down-side arm, will protect the brachial plexus during long surgical procedures. Extended time in the Sims position, can irritate this network of nerves, if not properly protected and padded while the patient is on the OR table.

The surgeon has removed a specimen for a fresh section and is sending it to the lab immediately for a diagnosis. How should the technologist prepare the specimen for retrieval? A. Remove all sutures attached to the specimen and place in a specimen container. B. Place the specimen in a dry specimen container. C. Place the specimen in a container with saline to maintain moisture during transport. D. Remove all sutures attached and place the specimen on Telfa in a dry specimen container.

B. Place the specimen in a dry specimen container. Rationale: A fresh specimen is one that has to be sent to the lab dry, and will then be fixed with a fixative solution upon arrival in the lab. Never remove any sutures the surgeon attached to the specimen which mark laterality.

While preparing the room for a surgical procedure using the laser, which of the following policies ensure the laser is being used correctly? (Select the three (3) correct answers.) A. Have laparotomy sponges available. B. Post warning signs outside the room C. Place the foot control next to the circulator. D. Do not use alcohol based preps. E. Wear safety goggles.

B. Post warning signs outside the room. D. Do not use alcohol based preps. E. Wear safety goggles. Rationale: Posting warning signs will prevent surgery doors from opening and causing unnecessary harm to co-workers outside the room. Not using alcohol based preps will decrease the risk of surgical fires. Safety goggles approved for that specific laser will prevent injury to the eye. Laparotomy sponges should be wet if available. The doctor should be in control of the foot control pedal to the laser.

The circulating nurse notices that the patient is actively bleeding from one of the operative sites and the surgeon has left the room. Which of the following actions should the surgical technologist take? A. Break scrub and inform the surgeon. B. Remain in gown and gloves and apply pressure. C. Break scrub and monitor the sterile field. D. Open a new sterile field for the patient.

B. Remain in gown and gloves and apply pressure. Rationale: The surgical technologist should remain sterile until the patient is out of the operating room and in PACU. If the surgical technologist has not broken scrub she can apply pressure until the surgeon is called back into the room. Since the field remains sterile it is not necessary to open a new sterile field.

The surgical technologist notices smoke and flames coming from the drape surrounding the surgical site. Which of the following actions should the surgical technologist take? A. Move away and protect the sterility of the back table. B. Smother the drape with a wet sterile towel. C. Place the flame retardant blanket over the patient. D. Disconnect the electrical surgical unit.

B. Smother the drape with a wet sterile towel. Rationale: The first thing the surgical technologist should do is to smother the drape with a wet sterile towel to contain the fire. The surgical technologist should not abandon the patient. The fire should be taken care of first, then someone can disconnect the electrical surgical equipment. The flame retardant blanket is placed on the patient as soon as the fire has been contained.

Which of the following actions by the surgical technologist reduces the risk of bioburden accumulation on serrated hemostatic forceps postoperatively? A. Soak in sterile saline within 24 hours. B. Soak in enzymatic solution within 20 minutes. C. Allow to dry completely prior to placing in autoclave. D. Sterilize with rings together.

B. Soak in enzymatic solution within 20 minutes. Rationale: Instruments are not soaked in saline because it will pit them. Instruments should not be sterilized with rings together, because they cannot be properly sterilized. The instruments dry in sterile processing prior to being placed in the autoclave.

While assisting the surgeon in draping a patient the surgical technologist is told that she has contaminated her gloves. Which of the following actions should the technologist take? A. Remove the contaminated drape, place a new drape, and re-glove. B. Step away from the field and re-glove. C. Place a new drape over the contaminated drape, and re-glove. D. Break from field, scrub and re-glove.

B. Step away from the field and re-glove. Rationale: The drape is not contaminated, making removal of the drape unnecessary. There is also no need to cover the drape with a new one. Breaking scrub completely is not necessary because re-gloving is adequate if the scrub is able to do this without contaminating the gown.

Prior to a case the surgical technologist determines the power saw is not functioning. Which of the following is the most likely cause? A. It is not plugged into the electrical outlet. B. The battery has not been adequately charged. C. It has not been attached to the foot pedal. D. The arthroscopy shaver is not connected.

B. The battery has not been adequately charged. Rationale: The battery should be tested prior to the start of the case. If the power saw does not work, it is more than likely because the battery is not charged. Because the power saw has a battery, it is not connected to a power cord and does not need a foot pedal to run. The arthroscopy shaver is not a type of power saw.

While cleaning the back table after a cystoscopy case, the tray of instruments accidentally falls on the floor. After retrieving all instruments, which of the following should the surgical technologist do before returning instruments to decontamination? A. Send the contents of the tray to Biomedical Engineering. B. Visually inspect the instruments. C. Inform Central Sterile that the instruments need inspection. D. Assemble the instruments that have not been used.

B. Visually inspect the instruments. Rationale: The first thing that needs to be done is to visually inspect the instruments for cracks or breakage. The case is over, so the instruments do not need assembled. Central Sterile can be notified also, but that occurs after the surgical technologist inspects them. The contents would not be sent to Bio Med.

Ten minutes into an automatic chemical washer cycle for an instrument string, the surgical technologist notices she has missed a few critical instruments. Which of the following should the technologist do? A. Immediately power down the washer and add the instruments. B. Wait until the washer stops and run a new cycle with the instruments. C. Open the washer door on the dirty side and add manually decontaminated instruments. D. Open the washer door on the clean side and add manually decontaminated instruments.

B. Wait until the washer stops and run a new cycle with the instruments. Rationale: The correct thing to do is wait until the cycle stops then add the instruments and start a new cycle. The instruments should not be added to the stringer until they have gone through the washer sterilizer. It is not good to abort the cycle.

A patient is undergoing a right partial pneumonectomy. Which of the following drains should the surgical technologist prepare for placement at the end of the case? A. Jackson Pratt B. chest tube C. Penrose D. Hemovac

B. chest tube Rationale: Any time the chest cavity is entered and the normally present negative intrapleural pressure is compromised, a chest tube must be placed to reestablish the negative pressure. A penrose is a passive drain that is partially placed within the wound allowing fluid to move out of the tube onto a dressing. The Jackson Pratt drain is commonly used for general and abdominal procedures for moderate drainage. The Hemovac drainage is commonly used for orthopedics for moderate drainage.

A surgical technologist is in the process of opening sterile supplies for an abdominal hysterectomy on a 300 lb. patient. After reviewing the preference card, which of the following items should the technologist hold in order to watch costs? (Select the three (3) correct answers.) A. long Bovie tip B. closing suture C. 11 knife blade D. extra laps E. extra Raytec

B. closing suture C. 11 knife blade E. extra Raytec Rationale: A long Bovie tip would need to be opened because the patient is 300 pounds. Also extra lap tapes would be needed because of the patient weight and the potential for bleeding. Suture should be held because it may not be the correct suture needed because of the patient's size. An 11 blade is used on laparoscopic cases and would not be necessary for an open procedure. Raytecs should not be opened or free on opened procedures

In a sterilized package, a chemical indicator is used to A. verify elimination of living flora on the package. B. confirm that the package was exposed to sterilization. C. show that no moisture entered the package. D. ensure that the package is sterile.

B. confirm that the package was exposed to sterilization. Rationale: The chemical indicator s are used internally and externally to show that the package has been exposed to the sterilization process. They do not verify the sterility of the items in the packages. They only mean that the package has had the right temperature, humidity, and sterilant. It will not verify elimination of living flora on the package or that moisture is in the package.

When being relieved for lunch during surgery, which of the following tasks is performed by the outgoing surgical technologist? A. removing supplies and equipment from the Mayo stand B. counting sharps and sponges C. adding gown and gloves to the back table for return to surgery D. placing all softs and sharps onto the back table

B. counting sharps and sponges Rationale: The surgical technologist should ensure that all sharps and sponges are accounted for prior to being relieved for lunch or break.

Which of the following are duties the surgeon may delegate to the surgical technologist? (Select the three (3) correct answers.) A. dissect tissue B. cut suture C. tie off suture D. remove clamps E. retract tissue

B. cut suture D. remove clamps E. retract tissue Rationale: Cutting suture, removing clamps, and retracting tissue can be done under the doctor's supervision. They are within the scope of practice a surgical technologist. However, surgical technologists cannot alter tissue, because they have not had the proper training and education.

During an abdominal hysterectomy, the surgeon found a lesion on the ovary. The surgeon excised the lesion and asked that the specimen be sent to the lab for immediate analysis. Which of the following types of specimen is this? A. permanent B. frozen C. partial D. fresh

B. frozen Rationale: A frozen specimen is sent to the lab dry for immediate analysis. It is useful for checking margins on the specimen. Permanent sections are placed in a fixative solution for further analysis later. A fresh specimen is one that has to be sent to the lab dry and then will be fixed with a fixative solution upon arrival in the lab.

Which of the following instruments can be decontaminated in a washer-sterilizer? A. power drill B. laser coated instrument set C. Phaco instrument set D. colonoscope

B. laser coated instrument set Rationale: The laser coated instrument set can be put in the washer-sterilizer. The power drill should not be submersed in liquid. The Phaco instrument set and the colonoscope should be hand washed since they are delicate and can be damaged.

Which of the following hemostatic agents must be handled dry? A. prothrombin/Thrombin B. microfibrillar collagen/Avitene C. gelatin sponge/Gelfoam D. bone wax

B. microfibrillar collagen/Avitene Rationale: Avitene must be handled dry because it will stick to wet surfaces. Prothrombin/ thrombin are enzymes that assist the blood in the clotting cascade. Bone wax is a waxy substance made from beeswax and can be handled with wet or dry hands.

Which of the following factors determine if a disposable sterile supply item is acceptable to use? A. package integrity and expiration date B. on the preference card and expiration date C. package integrity and on the case cart D. on the case cart and on the preference card

B. on the preference card and expiration date Rationale: The package should be checked for holes and the integrity should be good. The expiration date should be checked to make sure it has not expired. The expiration date is not on the case cart or preference card for the sterile supplies.

Which of the following items are needed for immediate use sterilization documentation? (Select the three (3) correct answers.) A. circulating nurse signature B. patient ID number C. item sterilized D. sterilizing parameters E. type of surgery

B. patient ID number C. item sterilized D. sterilizing parameters Rationale: The required data needed to log a flash sterilization cycle are patient ID number, the item being sterilized and the parameters of the sterilization (temperature, length of cycle, and type of sterilization used). This information is essential for tracking purposes in case a patient develops an infection. Documentation of use of a flash sterilizer should also be made in the patient's chart.

Which of the following is the best method of terminal sterilization? A. flash sterilizer B. prevacuum steam sterilizer C. washer sterilizer D. liquid sterilization

B. prevacuum steam sterilizer Rationale: Steam sterilization utilizes moist heat in the form of saturated steam under pressure within an enclosed environment and is the most dependable method of sterilization in which all microbes, including spores, are destroyed.

If a Frazier suction tip falls on the floor during a procedure the proper protocol for flash autoclaving the item in a gravity displacement sterilizer is to A. properly place it in the autoclave for 4 minutes at 270 degrees F. B. properly place it in the autoclave for 10 minutes at 270 degrees F. C. flush the lumen and autoclave for 4 minutes at 270 degrees F. D. flush the lumen and autoclave for 10 minutes at 270 degrees F.

B. properly place it in the autoclave for 10 minutes at 270 degrees F Rationale: Instruments with lumens must be autoclaved for 10 minutes. Prior to flash sterilizing a lumen, the inside of the lumen must be flushed. This allows residual water left in the lumen to become steam during the high temperature which will destroy the microbes present. 4 minutes would not be adequate time to achieve sterilization for an instrument with a lumen.

At the end of each case the surgical technologist should A. soak the instruments in normal saline. B. rinse blood from the instruments with sterile water. C. wipe the instruments off with a wet towel. D. have the circulator inspect the instruments.

B. rinse blood from the instruments with sterile water. Rationale: Instruments should only be wiped off and soaked in sterile water. Instruments should never be placed in saline because salt causes pitting and corrosion. The circulator would not inspect the instruments because she is taking care of the patient and doing charting. Wiping off instruments with a wet towel would help, but that is not the best action to take at the end of the case.

A pressure dressing is most likely applied over a A. fractured femur EX Fix. B. skin graft. C. cataract surgery. D. TURP.

B. skin graft. Rationale: The skin graft requires a pressure dressing—a three-layer dressing for the absorption of excessive drainage used to promote wound healing. The other surgeries do not require a pressure dressing.

When returning from lunch in the cafeteria and re-entering the surgical suite, the minimum amount of time for a surgical hand scrub should be A. 10 minutes. B. 3 minutes. C. 5 minutes. D. 6 minutes.

C. 5 minutes Rationale: The initial surgical scrub of the day is 5 minutes, but subsequent scrubs are required to be 3 minutes in duration - unless the surgical technologist leaves the surgical suite. Anytime the technologist leaves the suite the hand scrub is 5 minutes, as though it were the first scrub of the day.

The surgical technologist is scrubbed in on a scheduled breast biopsy with a frozen section. After removing the specimen the surgeon tags the specimen with suture at 6 o'clock and passes it to the technologist. Which of the following should the technologist do first? A. Label the specimen. B. Pass off the specimen to the nurse immediately. C. Ask the surgeon to identify the specimen. D. Place the specimen on a Raytec sponge.

C. Ask the surgeon to identify the specimen. Rationale: The specimen must always be verified by the surgeon before being passed off. Patient labels will be placed in the sterile, dry, container after verification and the specimen will be passed off to the circulator to be transported to the lab immediately. Specimens should never be placed on sponges.

The surgical technologist hears a patient entering the operating room state verbally that he doesn't want the surgery and fears he will not survive. The surgical technologist must inform the A. surgeon. B. anesthesiologist. C. circulating nurse. D. charge nurse.

C. Circulating nurse Rationale: Per the Joint Commission, informed consent is a process of communication between a clinician and a patient which results in the patient's authorization to undergo a specific surgical procedure. It is the surgical technologist's ethical responsibility to bring it to the attention of the circulator if there is evidence the patient has changed his mind, or needs more information to be able to understand the procedure he is scheduled for.

Which of the following is the minimum number of counts for a Cesarean section case? A. two B. seven C. four D. three

C. Four Rationale: There is always a minimum of four (4) counts on a C-section: one prior to the incision, one prior to closure of the uterus, one prior to closing the abdominal cavity, and one prior to closing the skin. Seven would be too excessive and unnecessary.

Which of the following resources should the surgical technologist use if a question arises concerning the correct use of a cleaning solution? A. OSHA regulations B. CDC guidelines C. MSDS D. Bowie-Dick test sheet

C. MSDS Rationale: OSHA is the Occupational Safety and Health Administration. CDC stands for the Centers for Disease Control and Prevention. Material Safety Data Sheets (MSDS) contains information on all hazardous chemicals: precautions for handling the chemicals, the hazards associated with chemicals, and the firefighting techniques--along with first aid for exposure. The Bowie-Dick test is used to test and monitor high vacuum steam sterilizer.

The patient has undergone cardiac bypass surgery. Protamine has been administered and the surgeon is preparing to close the sternotomy. Bleeding is a postoperative concern. Which of the following systems should the surgical technologist anticipate the surgeon will use? A. Jackson Pratt B. Hemovac C. Pleur-Evac D. Penrose

C. Pleur-Evac Rationale: The Pleur-Evac drain is used following thoracic or cardiothoracic procedures to reestablish negative pressure, assist in post-op drainage, and seal any air leaks in the pleura if present. The Jackson Pratt and Hemovac drains are used for moderate drainage in orthopedics or general procedures. A Penrose drain is a passive drain not intended for moderate or heavy drainage.

During a vaginal hysterectomy the surgical team noticed that the safety belt was left off the patient before the drape was applied and discovered after draping. How can the patient be secured to the OR bed without interrupting the sterile field or procedure? A. The surgical technologist can watch for movement of the patient and inform the circulator. B. The anesthesiologist can secure the head to prevent shifting. C. The circulator can reach under the sterile drape and apply the safety strap. D. The surgeon can request sterile coban to secure the patient.

C. The circulator can reach under the sterile drape and apply the safety strap. Rationale: The underside of the drape is not sterile, therefore, can be touched by the unsterile circulating nurse, while she secures the patient with the safety strap.

During surgery, the surgical technologist reaches for a supply item being handed by the circulator. The surgical technologist's left glove touches the outside of the package. Which of the following steps must be taken to correct the break in sterile technique? A. The surgical technologist must break, re-scrub, and re-gown and glove. B. The surgical technologist must remove the contaminated glove and re-glove herself. C. The circulator removes the contaminated glove and then the technologist re-gloves herself. D. The circulator removes the contaminated glove and re-gloves the surgical technologist away from field.

C. The circulator removes the contaminated glove and then the technologist re-gloves herself. Rationale: Because the surgery is already in progress, it is not necessary for the surgical technologist to re-scrub and re-gown. The circulator can remove the contaminated glove, and the surgical technologist can re-glove. The surgical technologist cannot remove their own glove, because the surgery is in progress. And the surgical technologist cannot leave the sterile field since the surgery is in progress.

The surgeon has just completed a right ankle fusion and decided to apply a cast after closing the skin. Which of the following materials should the surgical technologist have available for the surgeon to apply before the cast? A. Ace wrap B. Esmark C. Webril D. plaster strips

C. Webril Rationale: Webril is padding that is applied to an extremity before a cast is applied. Esmark is used to exsanguinate an extremity before a tourniquet is applied; an ace wrap is used to wrap an extremity after the dressing is applied, and plaster strips are used to immobilize an extremity.

The OR needs to be set up for a spinal laminectomy, where the surgeon has asked for a spinal positioner to arch the back in a prone position. Which of the following positioners should be chosen? A. Mayfield headrest B. MorphBoard positioning system C. Wilson frame D. Stulberg sliding bolster

C. Wilson frame Rationale: The Mayfield headrest is used to pin the head in neuro surgeries. A MorphBoard positioning device is a peg board used to position the hip in the lateral position. The Wilson frame is used to put the patient in the prone position to expose the back for an laminectomy. The Stulberg sliding bolster is used for knee surgery as a positioner.

The surgeon will be taking bilateral skin grafts from the patient's thighs for placement on a left lower leg fasciotomy. For both surgical sites, which of the following dressings should the surgical technologist anticipate the surgeon needing? A. Duoderm B. iodoform gauze C. Xeroform D. adhesive skin closure strips

C. Xeroform Rationale: Xeroform is an occlusive dressing and it would not stick to the sites. This allows for a painless removal of the dressing because it is non-adherent. Iodoform gauze would not be used because it would stick to the surgical site. Adhesive skin closure tapes are used to approximate the wound edges together. Duoderm is used to treat bed sores or pressure ulcers.

After a resident connects the Yankauer suction tip, it falls slightly below the edge of the sterile field. Which of the following should be considered contaminated? A. Yankauer suction tip and the resident's gown B. Yankauer suction tip and the drape C. Yankauer suction tip D. Yankauer suction tip, the drape, and the resident's gown

C. Yankauer suction tip Rationale: Anything below the level of the sterile field is considered unsterile. When the tip of the Yankauer falls below the edge of the sterile field, it is considered contaminated. Unless it comes in contact with the drapes, or the residents gown as it's being passed off - it would be all that is considered contaminated.

Which member of the surgical team is in charge of the transfer of an immobile or unconscious patient from the OR table to the stretcher? A. surgeon B. circulator C. anesthesia provider D. surgical technologist

C. anesthesia provider Rationale: The anesthesia provider is in control of the patient transfer and coordinates the move. They have control of the head and the patient's airway. The surgeon most likely has already left the room and cannot help with the transfer. The circulator is on the other side of the bed waiting on the transfer device when anesthesia gives the permission. The surgical technologist is on the other side waiting to help transfer the patient. There should always be 4 people to transfer a patient. Anesthesia is at the head of the bed and one person is on each side with one at the end of the bed to help transfer the feet.

When opening a sterile package at the back table, the package should be held A. close to the body. B. over the back table. C. away from the body. D. upside down.

C. away from the body Rationale: When opening the back-table package on the back table the package should be checked for integrity. The outer wrapper should be removed and the package should be opened away from the surgical technologist. The break or seal should be removed, the first flap is opened away from the surgical technologist and then the second flap is open towards you. Your hands never should be over the sterile field because skin could flake off the arms and contaminate the back table set up. The package would never be opened upside down.

The surgical team is in the process of moving a 79 lb patient from the OR table to the stretcher. The circulator has been called out of the room. The anesthesiologist tells the surgical technologist that between the two of them they can move a patient of this size. The surgical tech should A. move the patient with the anesthesiologist. B. allow the patient to move. C. call for moving help. D. look for the circulator.

C. call for moving help. Rationale: There should always be 4 individuals when transferring a patient from an operating room to a stretcher. Anesthesia is always at the head of the bed and gives the ok when the transfer can be completed. There should also be a person on each side of the bed and one at the bottom of the bed to move the patient in a safe manner.

When reviewing the autoclave log, the surgical technologist should confirm that which of the following items have been documented before using the instrumentation? A. expiration date B. Sterrad indicator C. exposure temperature D. gas volume

C. exposure temperature Rationale: Exposure temperature is one of the items of documentation that should be on the monitoring log. This will allow the ST to see if the sterilizer has reached the required temperature to deem the item or tray sterile.

Which of the following items should the surgical technologist have in the room for an ORIF of an ankle case? (Select the two (2) correct answers.) A. reciprocating saw B. laminectomy tray C. extremity pack D. vascular tray E. small fragment tray

C. extremity pack E. small fragment tray Rationale: The ORIF Open Reduction Internal Fixation involves the ankle fracture which is an extremity so an extremity pack will be needed. The Small fragment will also be need because it contains screws, plates and drill bits that will be needed for the fixation. The procedure does not need a laminectomy pack since we are not working on the spine. A vascular tray would not be needs because veins and arteries are not involved.

During a laparoscopic procedure, the screen on the monitor becomes darker and visualization is impaired. The surgeon discovers that carbon dioxide is escaping. Which of the following should the surgical technologist check first? A. light cord B. camera C. insufflation tubing D. ESU

C. insufflation tubing Rationale: Insufflation tubing is connected to the CO2 tank or gas line, and also is connected to the scope. The insufflator is set to a certain pressure to maintain visibility in the abdomen during laparoscopic surgery. Connection of the insufflation tubing can be checked by the ST at scope. Connection of the insufflation tubing at the insufflator itself, must be checked by a non-sterile team member.

Patient skin preparation for LAVH and abdominal to perineal procedures should be performed using which of the following solutions? A. chlorhexidine B. isopropyl alcohol C. iodophor paint D. ethyl alcohol

C. iodophor paint Rationale: Iodophor paint is less likely to cause irritation vaginal mucosa. Use of it is contraindicated if the patient has a sensitivity to povidone-iodine. Alcohol and chlorhexadine are not safe to use for skin prep in perineal procedures.

When preparing peel pack instruments for steam sterilization the surgical technologist should inspect the instrument, place an indicator in the package, and A. adjust the sterilizer temperature. B. use a Sterrad indicator. C. label the package. D. use a biological indicator.

C. label the package. Rationale: The last thing that needs to be done to the package is to label the contents. It is being steam sterilized so it does not need a Sterrad indicator. Since it is in a peel pack it does not need a biological indicator. The steam sterilizer temperature is already set.

During a laparoscopic procedure the surgeon decides to convert to open. Which of the following additional supplies and equipment need to be opened? A. insufflation tubing B. endo-pouch C. lap sponges D. Veress needle

C. lap sponges Rationale: When converting to an open case the incision will be extended. Laparotomy sponges will be needed because they are the largest and most absorbent in open cases. The insufflation tubing, endo-pouch, and Veress needle are part of a set-up for a laparoscopic procedure and are not used on open laparotomy surgeries.

The patient is scheduled for insertion of a permanent pacemaker at 0800. In addition to key surgical team members, the absence of which of the following individuals would cause the case to be delayed? A. unit coordinator B. internal hospital transporter C. manufacturer representative D. sterile processing personnel

C. manufacturer representative Rationale: The manufacturer representative should be present to calibrate the product for the surgeon's use and serve as a product expert to enhance patient safety. A unit coordinator, hospital transporter, or sterile processing personnel are not required to be present for surgical procedures.

During an open hernia procedure on adult male patient the surgeon requests assistance with retracting the spermatic cord. Which of the following should the surgical technologist provide? A. Army-Navy retractor B. vessel loop C. moist Penrose D. Weitlaner

C. moist Penrose Rationale: A moist Penrose drape is used with a Kelly clamp to retract and preserve the spermatic cord during an inguinal hernia. The Army Navy is a hand retractor which provides exposure to the operative site. A Weitlaner is a self-retaining retractor used to provide exposure to the operative site. Vessel loops are used to retract nerves, arteries, or veins.

A patient is having a laparoscopic assisted vaginal hysterectomy. If the surgeon is unable to extract the uterus vaginally, which of the following equipment should the surgical technologist have available to retrieve the uterus? A. harmonic scalpel B. ligasure C. morcellator D. enseal

C. morcellator Rationale: Morcellation, during gynecological procedures, means cutting the specimen into smaller pieces for easier removal. This has many benefits to the patient, including smaller incisions and shorter surgery time. The harmonic scalpel would not be helpful in retrieving the uterus because it is used to cut and coagulate tissue simultaneously. Ligasure and Enseal are used to help seal vessels.

The surgical technologist prepared a breast lump to send as a frozen section to pathology. The surgical technologist should pass off the specimen placed A. in normal saline. B. on a raytec sponge. C. on a telfa pad. D. in formalin.

C. on a telfa pad Rationale: A fresh frozen specimen means that the specimen is not in formalin, or any fixative agent. The STs responsibility is to place the specimen on a moist Telfa, which will allow it to be easily removed in the lab and not stick to an untreated surface. The ST should pass the specimen off on the Telfa to her circulator who will then place it in a clean specimen container and arrange for immediate transport to pathology.

Postoperatively a hernia repair patient complains of ulnar pain, numbness and tingling bilaterally. The most likely cause of the patient's discomfort is that the surgical technologist forgot to A. adduct the arm. B. place the axillary roll. C. place arm pads. D. abduct the arm.

C. place arm pads. Rationale: Adduction/abduction are motions performed during surgery. Axillary rolls are used during the lateral position. Arm pads are used throughout surgery to prevent damage to the ulnar nerve. The arms are placed on arm boards with the palm facing upwards.

A cardiac arrest occurs during a thoracotomy procedure, and the surgeon calls a CODE BLUE. The surgeon is attempting to resuscitate the patient using CPR. Which of the following is the responsibility of the surgical technologist in this situation? A. Hand the surgeon a loaded needle holder and forceps for closing. B. Break scrub and retrieve the code cart. C. Prepare internal defibrillator paddles. D. Prepare external defibrillator paddles.

C. prepare internal defibrillator paddles Rationale: The surgery is already in progress when the Code Blue is called the surgical technologist may be required to prepare the internal defibrillator paddles. The surgical technologist does not break scrub to get the crash cart the circulator will get any necessary equipment needed.

Which of the following areas of the surgical gown is considered sterile? A. the front of the gown from the neckline to the waist B. the cuffs and sleeves of both arms up to the shoulders C. the front of gown from the chest to the waist D. the back of the gown

C. the front of gown from the chest to the waist Rationale: The front of the gown from the mid-chest level to the waist and the sleeves circumferentially to 2 in proximal to the elbows is considered sterile.

Which of the following is correct technique for opening a sterilized instrument tray as a scrubbed surgical technologist using aseptic technique? A. Break the seal on the outer tray handles and lift the outer tray. B. Break the seal on the inner basket handles and lift the inner basket from the tray. C. After the seal is broken by circulator and the lid is removed, lift the outer tray. D. After the seal is broken by circulator and the lid is removed, lift inner the basket from the tray.

D. After the seal is broken by circulator and the lid is removed, lift inner the basket from the tray. Rationale: The outside of the container is unsterile, requiring it to be opened by the circulator. The inside of the tray is considered sterile, and its contents can only be lifted out by a team member that is scrubbed and sterile. Once the inner basket is lifted from the tray, it should be placed onto a sterile table or mayo stand.

The surgeon is performing an inguinal herniorraphy procedure and has made the incision and dissected down a short way into the underlying tissue. Which of the following retractors should the surgical technologist have ready to pass? A. Bookwalter B. Senn C. Harrington D. Army-Navy

D. Army-Navy Rationale: To facilitate proper exposure for length and depth of incision for hernia repair, Army-Navy retractors are best utilized for retraction needs of short depths, as is specified in this case description. A Bookwalter is a large self-retaining retractor used in larger abdominal procedures. A Senn is a small, hand-held retractor for superficial incisions. A Harrington is a larger hand-held retractor often used to retract the liver or spleen.

The surgeon is doing a laparoscopic procedure using an endo GIA stapler. He passes the stapler to the surgical technologist and asks him to reload. Which of the following should the technologist do to the stapler before passing back to the surgeon? A. Open the jaws. B. Pre-fire the jaws. C. Lubricate the jaws. D. Close the jaws.

D. Close the jaws. Rationale: The jaws must be closed to fit through the laparoscopic port. Each refill is single-use, therefore pre-firing the stapler will activate the staples, rendering the reload useless. There is no need to lubricate the jaws.

The surgeon requests a non-absorbable suture for skin closure. Which of the following sutures is non-absorbable? A. Vicryl B. Chromic C. Plain Gut D. Nylon

D. Nylon Rationale: Vicryl, Chromic and Plain Gut are all absorbable suture material. Nylon is the only option that is non-absorbable.

Which of the following is used to help maintain hemostasis intraoperatively in neurosurgery? A. skin stapler B. Indermil glue C. Dermabond glue D. Raney clips

D. Raney clips Rationale: Raney clips are used to control bleeding along scalp edges. A skin stapler is used only to close skin incisions. Indermil glue is a type of tissue adhesive for skin closure at the end of the surgery. Dermabond is a skin adhesive barrier used in addition to sutures to close incisions.

The surgical technologist is helping the surgeon complete a laparoscopic cholecystectomy and the surgeon has placed the dressing on the patient. Which of the following should the surgical technologist do next? A. Remove the top glove, hold the dressing in place, roll away the drape and discard. B. Remove Mayo stand, back table and top glove, hold the dressing in place, tear the drape off the patient and discard. C. Remove top glove, hold dressing in place, tear the drape off patient and discard. D. Remove the Mayo stand, back table and top glove, hold the dressing in place, roll away the drape and discard.

D. Remove the Mayo stand, back table and top glove, hold the dressing in place, roll away the drape and discard. Rationale: The Mayo stand and back table need to remain sterile until the patient is out of the room. The top gloves need replaced to prohibit any debris from getting the dressing dirty. By holding the dressing on with the clean gloves the drape can be removed so any biohazardous materials are contained within the drapes and discarded.

Upon opening a sterilized instrument tray, the surgical technologist finds bioburden inside the lumen of a metal suction. Which of the following actions should the surgical technologist take? A. Isolate the sterilized suction, then flush the bioburden with sterile water. B. Remove the sterilized suction from the sterile field. C. Isolate the sterilized suction on the sterile field with a sterile towel. D. Remove the sterilized instrument tray from the sterile field.

D. Remove the sterilized instrument tray from the sterile field. Rationale: The surgical technologist should check and inspect instruments. If bioburden is found, the whole tray should be discarded and handed off. (When in doubt throw it out.) The tray should not be left on the sterile field at all, or cleaned on the sterile field, because it would make the field contaminated.

Instruments and supplies have been opened by the surgical technologist for a case in Room 5. Soon after the surgical technologist was informed that the case has been moved to Room 1, but there is a similar case scheduled for Room 5 later that morning. Which of the following is the best course of action? A. Cover the back table with a sterile drape and leave it in Room 5. B. Leave the set-up in Room 5 to be used on the later case for no longer than one hour. C. Leave the case in Room 5 in order to save costs and alert the charge nurse about the move to Room 1. D. Take unopened supplies to Room 1, build a new set-up, and break down Room 5.

D. Take unopened supplies to Room 1, build a new set-up, and break down Room 5. Rationale: If a room is delayed or cancelled, there is no way to ensure the set up remains sterile, unless a staff member stays in the room and monitors. Facility policy may also dictate a time frame for use of opened sterile items.

The surgical technologist reviews the schedule for the following day and notices that an orthopedic surgeon has scheduled an ACL reconstruction with donor graft. Which of the following tissue implants is the correct term describing this graft? A. dermal graft B. epidermal graft C. autograft D. allograft

D. allograft Rationale: An allograft is taken from another person or cadaver. An autograft is taken from the patient's own tissue. Dermal and epidermal both refer to skin grafts.

When opening a wrapped item using aseptic technique, the proper sequence is to open the top flap A. away from operator, proximal flap opened, side flap opened last. B. toward operator, side flaps opened, distal flap opened last. C. toward operator, side flaps opened, proximal flap opened last. D. away from operator, side flaps opened, proximal flap opened last.

D. away from operator, side flaps opened, proximal flap opened last. Rationale: It is best to open the first flap away from while the remaining flaps are unfolded so the wrap is still covering the area closest to you. The side flaps will be opened next with the last flap opened away from you while not reaching over the sterile area.

When a surgical technologist is being relieved at end of shift during a myomectomy, she is required to A. conduct a soft and sharps count. B. initiate a time out. C. conduct a complete count. D. collect the specimen before leaving.

D. conduct a complete count. Rationale: The surgical technologist should ensure that all countables are accounted for prior to being relieved.

The surgical technologist is preparing for a myelography procedure. Which of the following items would definitely be on the preference card for this case? A. periosteal elevator B. Prolene mesh C. Williams retractor D. contrast medium

D. contrast medium Rationale: A myelogram is a diagnostic imaging procedure used to visualize the spinal column and any diseases surrounding the spinal column. Contrast medium is essential in a myelogram in order to see detail in the spinal column not visible by CT scan or MRI alone. A periosteal elevator is used in open orthopedic procedures to scrape periosteum off bone. Prolene mesh is commonly used to repair hernias. A Williams retractor is a self-retaining retractor used in lumbar discectomy procedures.

An OB/GYN surgeon has posted an emergent laparoscopic case and the surgical technologist notices that his reusable metal trocar has not been processed from the day before. Which of the following sterilization methods is the best choice for this scenario? A. ethylene oxide sterilization B. gas sterilization C. Steris D. flash sterilization

D. flash sterilization Rationale: Ethylene oxide is a type of gas sterilization that takes several hours to complete. Steris is used for endoscopic equipment. Flash sterilization is the best option in this scenario since the trocar is required for immediate use.

Which of the following procedures requires a surgical site dressing? A. myringotomy B. hysteroscopy C. ureteroscopy D. laparotomy

D. laparotomy Rationale: The laparotomy procedure is the only one that would have an incision big enough for a surgical site dressing. The myringotomy is a small incision in the ear to place a vent tube. A hysteroscopy is used for visualization of the uterus and uses a scope and no incisions are made. A ureteroscopy is also used for visualization, but of the ureters. No incision is made in a ureteroscopy either.

When the initial, proximal transectioning of the small bowel is done, in which of the following capacities should the GIA linear cutter be delivered to the surgeon? A. reloaded and clamped as one piece B. loaded and handed as one piece C. reloaded and clamped in two pieces D. loaded and handed in two pieces

D. loaded and handed in two pieces Rationale: The unit needs to be passed in two pieces, as that is the way it will be used. One over, one under the bowel then clipped together to allow for cutting and stapling.

The surgical technologist has just handed the surgeon a 2-0 Silk suture. Which of the following scissors should the surgical technologist have ready? A. curved Mayo scissors B. Metzenbaum scissors C. tenotomy scissors D. straight Mayo scissors

D. straight Mayo scissors Rationale: Selecting a straight scissor to cut suture with is imperative. The heaviness of the suture material should also gauge the size of the scissor the ST should select. The Metzenbaum is a slightly curved tissue scissor, and the tenotomy scissor is meant for finer, lighter cutting. Here the best choice is the straight Mayo scissor.

During a vascular procedure a vessel is ligated. The surgeon states that she will repair the vessel after bleeding is controlled. Which needle type would she most likely require to complete this task? A. French eyed needle B. control release needle C. cutting needle D. tapered needle

D. tapered needle Rationale: A tapered needle is often used for vascular, GI, and most soft tissue. A cutting needle penetrates through tougher tissue, such as skin. A control release needle is better for placing interrupted sutures or when there's a need for rapid release of the needle. Use of a French eye needle results in greater tissue damage than an eyeless needle, like the tapered needle.

An emaciated patient is scheduled for an abdominal hysterectomy with removal of excessive skin on bilateral thighs. The circulator has opted to place the ESU grounding pad on the patient's forearm. The surgical technologist should suggest that the ESU pad be removed and placed on A. either thigh. B. either ankle. C. the clavicle. D. the buttocks.

D. the buttocks. Rationale: It is essential that the grounding pad be completely in contact with the patient's skin. In this case, the patient is emaciated, so the forearm would likely be too small to facilitate the full size of the grounding pad. Placement on the buttock allows for the complete pad to be in contact with the patient's skin.

When transferring a patient to the operation room table, the surgical technologist should A. power off any medical equipment during the transfer. B. ensure that the O.R table remains unlocked in order to position the table to the surgeon's preference. C. allow 5-6 fingerbreadths between the safety strap and the patient. D. transfer medical equipment first and then move the patient.

D. transfer medical equipment first and then move the patient. Rationale: Powering off medical equipment could harm the patient. Unlocked operating room tables increase the patients risk for injury. The safety strap should be snug for the safety of the patient without causing injury. Transferring medical equipment first ensures the equipment remains functional throughout the transfer.