Ch 14 General Surgery

The total volume in a 30 cc syringe is: a. 1 ounce b. 2 ounces c. 3 ounces d. 4 ounces

1 ounce

One gram equals: a. 100 mg b. 1000 mg c. 100 mL d. 1000 mL

1000 mg

How many milliliters are in 1 ounce? a. 10 b. 30 c. 75 d. 100

30

During a laparoscopic inguinal hernia repair, the size of the laterally placed trocars is: a. 5 mm b. 10 mm c. 12 mm d. 14 mm

5 mm

A cystocele is: a. a herniation of the urinary bladder b. an accumulation of fluid in any sac-like cavity c. a congenital herniation of intra-abdominal viscera through a defect in the abdominal wall d. a dilation of the spermatic cord

A herniation of the urinary bladder

The term chyme refers to: a. bile b. a mixture of partially digested food c. lymphatic fluid d. a sac or bladder

A mixture of partially digested food

Blood gas analysis is called: a. BGA b. SAT rate c. ABG d. ABO

ABG

If a patient falls because he or she was left unattended, the OR team member could be cited in a lawsuit for: a. misconduct b. assault c. doctrine of respondeat superior d. abandonment

Abandonment

Which procedure is used to treat cancer of the rectum? a. colporrhaphy b. rectouterine evacuation c. billroth I d. abdominoperineal resection

Abdominoperineal resection

In which way could a patient's response to impending surgery exhibit itself? a. tension and anxiety b. fear and suspicion c. anger and hostility d. all of the above

All of the above

Intra-abdominal pressure during the instillation of CO2 for the creation of pneumoperitoneum is 8-10 mm Hg. A pressure reading higher than this may indicate that the needle may be: a. buried in fatty tissue b. buried in the omentum c. in a lumen of intestines d. all of the above

All of the above

The proper method of removing the gallbladder specimen after complete dissection and irrigation of the operative site in a laparoscopic cholecystectomy is to: a. utilize an endobag b. pull gallbladder through the largest port c. decompress the gallbladder by suctioning bile before removal d. all of the above

All of the above

The terminal portion in the lower colon is called the: a. sigmoid b. rectum c. anus d. anal canal

Anal canal

The correct procedure for sterile dressing application is: a. apply dressing after drape removal b. apply dressing before drape removal c. apply raytec sponges in thick layer d. apply dressing in recovery room

Apply dressing before drape removal

Cultures obtained during surgery: a. are handled as any other specimen b. are passed off the field into a bag or container held by the circulator c. should be kept warm or sent to the lab immediately d. should be handled only by the scrub nurse

Are passed off the field into a bag or container held by the circulator

A patient signs a permission form for surgery, but because of a language barrier he or she does not fully understand what she or he has signed. This could constitute a liability case for: a. assault and battery b. lack of accountability c. improper documentation d. invasion of privacy

Assault and battery

The instrument used to grasp the appendix during an open appendectomy is: a. kocher forceps b. pean clamp c. babcock forceps d. allis forceps

Babcock forceps

The instrument used for common duct exploration during an open cholecystectomy is: a. fogarty catheter b. schnidt forceps c. bakes dilator d. ochsner trocar

Bakes dilator

The surgical consent is signed: a. before induction b. in the holding area c. the morning of surgery d. before administration of preoperative medications

Before administration of preoperative medications

In addition to a major general surgical instrumentation set, which of the following will also be needed for a cholecystectomy? a. rib resection instruments b. thoracic instruments c. CBD exploration instruments d. genitourinary instruments

CBD exploration instruments

Defogging the video camera is usually the responsibility of the: a. circulator b. surgeon c. scrub person d. camera operator

Camera operator

Insufflation of the abdomen is achieved with the use of: a. nitrous oxide b. oxygen c. carbon dioxide d. nitrogen

Carbon dioxide

The procedure performed for decompression of the cecum due to colonic obstruction is: a. gastrotomy b. colostomy c. cecostomy d. ileostomy

Cecostomy

The appendix is attached to the: a. ascending colon b. transverse colon c. cecum d. descending colon

Cecum

Intraoperative cholangiograms can be performed either through an open abdominal or laparoscopic procedures using a contrast medium directly into the common bile duct through a: a. cystocath b. cholangiocath c. t-tube d. red rubber catheter

Cholangiocath

Direct visualization of the common bile duct is accomplished with a: a. cholangiocath b. cholangiogram c. choledochoscope d. trocar

Cholangiogram

Which gallbladder procedure always requires intraoperative x-rays? a. choledochoscopy b. cholelithotripsy c. choledochoduodenostomy d. cholangiogram

Cholangiogram

The condition of gallstones is called: a. pyelolithiasis b. cholelithiasis c. cystolithiasis d. ureterolithiasis

Cholelithiasis

The commercial name for glutaraldehyde is: a. peracetic acid b. phenol c. quats d. cidex

Cidex

Drainage of an incision following a simple or modified radical mastectomy is accomplished by a: a. penrose b. sump c. closed-wound drainage d. cigarette drain

Closed-wound drainage

Irrigating fluid used to flush the organ between harvest and transplantation of a liver is known as: a. lactated ringers b. physiosol c. collin's d. normal saline

Collin's

Omental flaps, falciform ligament, or Gerota's fascia flaps may be used to: a. repair abdominal defects b. control liver hemorrhage c. repair pelvic ducts d. control splenic hemorrhage

Control liver hemorrhage

Gastrotomy is the: a. resection of the portion of the stomach b. repair of a stomach ulcer c. removal of a bezoar d. creation of an opening from the stomach to the skin

Creation of an opening from the stomach to the skin

Tracheotomy is the: a. creation of a tracheal stoma b. creation of an opening into the trachea c. removal of the trachea d. repair of a crushed trachea

Creation of an opening into the trachea

The structures that must be ligated prior to removal of the gallbladder are the: a. common bile duct; cystic duct b. common bile duct; hepatic duct c. cystic artery; hepatic duct d. cystic artery; cystic duct

Cystic artery; cystic duct

A hernia that occurs within Hesselbach's triangle and does not have a sac is called a/an --- hernia. a. direct b. indirect c. femoral d. hiatal

Direct

In which hernia does the herniation protrude into the inguinal canal but not the cord? a. incisional b. femoral c. direct d. indirect

Direct

Which type of hernia is located within Hesselbach's triangle? a. indirect b. congenital c. epigastric d. direct

Direct

A Meckel's diverticulum occurs on the: a. distal ileum b. cecum c. sigmoid d. duodenum

Distal ileum

While a surgical case is in progress: a. doors remain open so staff can easily move in or out b. doors should remain closed c. doors remain open to circulate air d. doors may be opend or closed

Doors should remain closed

Choledochotomy is performed to: a. visualize the common bile duct b. drain the common bile duct c. excise the common bile duct d. bypass the common bile duct

Drain the common bile duct

How is a frozen section sent to the lab? a. in formalin b. in saline c. in water d. dry

Dry

The three portions of the small intestine are the: a. mesentery, duodenum, and appendix b. cecum, mesentery, and ileum c. ileum, sigmoid, and jejunum d. duodenum, ileum, and jejunum

Duodenum, ileum, and jejunum

A device that may obviate the need for an abdominoperineal resection because a low anterior anastomosis can be performed is a(n): a. end-to-end anastomosis (EEA) b. GIA c. TA 55 d. LDS

End-to-end anastomosis (EEA)

During a laparoscopic Nissen fundoplication, the instrument used to grasp the upper portion of the fundus of the stomach is: a. endo-babcock b. endograsper c. endo-allis d. endo retractor

Endo-babcock

During a laparoscopic appendectomy, what instrument is commonly used to dissect free the appendix from its attachment to the mesoappendix? a. endoscopic linear stapler b. endoscissors c. endo-ligaclip applier d. endo-dissecting forceps

Endoscopic linear stapler

The Heller procedure is performed to correct: a. gastroesophageal reflux b. esophageal diverticulum c. esophageal obstruction d. gastric acidosis

Esophageal obstruction

A surgical procedure performed to relieve esophageal obstruction by cardiospasm is an: a. esophagectomy b. esophagogastrectomy c. esophagomyotomy d. esophagogastrotomy

Esophagomyotomy

Fogarty biliary catheters are used to: a. drain the gallbladder b. drain the common bile duct c. instill contrast media d. facilitate stone removal

Facilitate stone removal

A post-op complication attributed to glove powder entering a wound is: a. granulomate b. infection c. inflammation d. keloid formation

Granulomate

Pathologic enlargement of the male breast is called: a. subcutaneous adenoma b. gynecomastia c. hypoplasia d. cystic mastitis

Gynecomastia

A type of deep retractor commonly used during an open cholecystectomy is a/an: a. US army b. harrington c. green d. gelpi

Harrington

Whipple pancreaticoduodenectomy involves the removal of the ---. a. head of the pancreas, distal one-third of the stomach, duodenum, proximal 10 cm of jejunum, gallbladder, cystic and common bile ducts, and peripancreatic and hepatoduodenal lymph nodes b. tail of the pancreas, proximal one-third of the stomach, duodenum, distal 10 cm of jejunum, gallbladder, cystic and hepatic ducts, and peripancreatic and hepatoduodenal lymph nodes c. pancreas, stomach, cecum, ileum, bladder, hepatic and cystic ducts, and periaortic lymph nodes d. islets of langerhans, spleen, stomach, duodenum, colon, cystic and common bile ducts, and peripancreatic and hepatoduodenal lymph nodes

Head of the pancreas, distal one-third of the stomach, duodenum, proximal 10 cm of jejunum, gallbladder, cystic and common bile ducts, and peripancreatic and hepatoduodenal lymph nodes

Thrombosed vessels of the rectum are known surgically as: a. polyps b. hemorrhoids c. fistulas d. anorectal tumors

Hemorrhoids

Nissen fundoplication is the procedure performed to correct a(n): a. gastric ulcer b. inguinal hernia c. hiatal hernia d. ruptured tubal pregnancy

Hiatal hernia

Liability is a legal rule that: a. applies only in criminal actions b. holds the hospital responsible for its personnel c. holds each individual responsible for his or her own acts d. has no significance in malpractice suits

Holds each individual responsible for his or her own acts

Which bone is transected with bone-cutting forceps before removal of a thyroglossal cyst? a. ethmoid b. hyoid c. pterygoid d. zygomatic process

Hyoid

A common complication of extubation is: a. hypotension b. tachypnea c. hypoxia d. hypercapnia

Hypoxia

Which procedure would not require a pressure dressing? a. plastic surgery b. knee surgery c. radical mastectomy d. hysterectomy

Hysterectomy

In which situation should sterility be questioned? a. if a sterilized pack is found in an unsterile workroom b. if the surgeon turns away from the sterile field for a brow wipe c. if the scrub drapes a non-sterile table, covering the edges nearest the body first d. if the lip of a pour bottle is held over the basin as close to the edge as possible

If a sterilized pack is found in an unsterile workroom

The type of ostomy established when a total colectomy is performed is: a. ileostomy b. colostomy c. rectosigmoidostomy d. jejunostomy

Ileostomy

At the completion of the anastomosis of an intestine, the instruments used on the bowel are placed: a. on the back table b. in separate basin c. on mayo tray d. off the sterile field

In seperate basin

A diaphragmatic hernia is located: a. on the ventral body surface b. around the umbilicus c. in the diaphragm d. in the groin

In the diaphragm

Which hernia leaves the abdominal cavity at the internal inguinal ring and passes with the cord structures down the inguinal canal? a. direct b. umbilical c. spigelian d. indirect

Indirect

In laparoscopy, tubal patency is checked by: a. irrigating with normal saline b. injecting renografin into the tube c. injecting methylene blue into the cervical canal d. irrigating the tube with lugol's solution

Injecting methylene blue into the cervical canal

A dissecting sponge that is a small roll of heavy cotton tape is a: a. kitner b. peanut c. tonsil d. tape

Kitner

Which of the following is a function of the omenta? a. synthesize vitamins b. limit peritoneal infection c. aid in digestion d. synthesize blood clotting factors

Limit peritoneal infection

A Silverman biopsy needle is used for a/an --- biopsy. a. lung b. cervical c. liver d. kidney

Liver

A subphrenic abscess occurs in the: a. pancreas b. spleen c. lung d. liver

Liver

Bile is produced by the: a. gallbladder b. spleen c. common bile duct d. liver

Liver

In an extreme patient emergency, a sponge count: a. may be omitted b. may be done by the scrub alone c. must be done before the case is allowed to begin d. must be done before closure

May be omitted

During an appendectomy, the structure that must be dissected free from its attachment to the cecum is the: a. omentum b. peritoneum c. taenia d. mesoappendix

Mesoappendix

Which of the following describes the anatomic area that will be prepped for a laparotomy? a. mid-chest to mid-thighs and bilaterally b. chin to knees and bilaterally c. shoulder to hips and bilaterally d. mid-chest to iliac crests and bilaterally

Mid-chest to mid-thighs and bilaterally

Before handing a Penrose drain to the surgeon: a. place it on an allis clamp b. attach a safety pin to it c. cut it to the desired length d. moisten it with saline

Moisten it with saline

Peanuts and dissecting sponges are generally: a. used dry b. moistened with saline c. moistened with water d. moistened with antibiotic solution

Moistened with saline

Once the peritoneum is entered, lap sponges should be: a. removed from the field b. counted c. moistened with warm saline d. mounted on ring forceps

Moistened with warm saline

Tissue death is called a. necrosis b. necatoriasis c. nematodiasis d. neoteny

Necrosis

The lack of care or skill that anyone in the same situation would be expected to use is the legal definition of: a. assault b. abandonment c. negligence d. default

Negligence

A Kocher-type incision is: a. vertical b. transverse c. paramedian d. oblique

Oblique

The abbreviation ung refers to: a. tincture b. ointment c. as directed d. spirits

Ointment

A thoracoabdominal incision is used when performing a/an: a. partial gastrectomy b. open hiatal hernia repair c. pancreatic procedure d. cholecystectomy

Open hiatal hernia repair

A specially treated form of surgical gauze that has a hemostatic effect when buried in tissue is: a. topical thrombin b. gelfoam c. human fibrin foam d. oxycel

Oxycel

Which gland has both exocrine and endocrine functions? a. liver b. spleen c. pancreas d. gallbladder

Pancreas

Which organ is removed either because of trauma, a blood condition, or as a staging procedure for malignancy? a. adernals b. spleen c. liver d. pancreas

Pancreas

What type of hernia is a combination of direct and inguinal hernia? a. hypogastric b. pantaloon c. sliding d. ventral

Pantaloon

The instrument commonly used to provide traction on the gallbladder during an open cholecystectomy is: a. mixter forceps b. deaver retractor c. kocher clamp d. pean forceps

Pean forceps

Blunt dissection of the gallbladder from the sulcus of the liver requires the use of a: a. metzenbaum b. kelly c. tampon d. peanut

Peanut

Which item retracts the spermatic cord structure in herniorrhaphy? a. army-navy retractor b. penrose drain c. green retractor d. silk suture

Penrose drain

Following hemorrhoidectomy, a: a. a dry dressing of 4 by 4's is packed in the rectum b. petroleum gauze packing is placed in the anal canal c. stent dressing is applied d. steri-strip dressing is used

Petroleum gauze packing is placed in the anal canal

The passageway for foods and liquids into the digestive system, and for air into the respiratory system, is the: a. trachea b. larynx c. epiglottis d. pharynx

Pharynx

Which of the following are functions of the liver? a. produces bile b. produces fat-soluble vitamins c. produces insulin d. produces glucagon

Produces bile

Which suture technique is applied when closing the indirect hernia sac? a. interrupted b. subcuticular c. purse-string d. continuous

Purse-string

The flow of foods and liquids from the stomach to the small intestine is controlled by the: a. ileocecal valve b. cardiac sphincter c. pyloric sphincter d. sphincter of oddi

Pyloric sphincter

Surgical enlargement of the passage between the prepylorus of the stomach and the duodenum is a: a. pyloromyotomy b. pyloroplasty c. billroth I d. billroth II

Pyloroplasty

What other procedure is performed with a vagotomy? a. pyloroplasty b. gastrectomy c. ileostomy d. colostomy

Pyloroplasty

A forcep commonly used to remove gallstones from the common bile duct during an open cholecystectomy is: a. potts-smith b. randall c. babcock d. kelly

Randall

Each of the following actions by a scrub person to prevent wounds and punctures, according to CDC guidelines, except: a. use an instrument to remove blades b. recap injection needles c. account for each needle as surgeon finishes with it d. protect sharp blades, edges, and tips

Recap injection needles

During a thyroidectomy, the nerve that must be preserved is the: a. bagus b. hypoglossal c. recurrent laryngeal d. glossopharyngeal

Recurrent laryngeal

An important consideration during cholangiogram is to: a. irrigate with distilled water b. remove all bubbles from the cholangiocath c. flash sterilize the choledoscope d. dip the catheter into lubricating jelly

Remove all bubbles from the cholangiocath

The procedure to follow if a hair is found on the operative field is to: a. notify circulator b. complete an incident report c. remove it with a clamp, cover over area d. no action is necessary

Remove it with a clamp, cover over area

Sutures placed in a wound to prevent wound evisceration are called: a. stent b. fixation c. retention d. traction

Retention

The use of a Penrose drain is often employed during inguinal herniorrhaphy to: a. remove purulent drainage b. retract the spermatic cord c. provide hemostasis d. support the repair

Retract the spermatic cord

Which of the following conditions is not an acceptable aseptic technique? a. scrub nurse standing on a platform or step stool b.scrub nurse keeps hands below shoulder level c. scrub nurse folds arms with hands at axillae d. scrub nurse's hands are at or above waist level

Scrub nurse folds arms with hands at axillae

If breast reconstruction is being performed, two setups may be required immediately following, to prevent: a. infection b. abscess c. dimpling and edema d. seeding

Seeding

A common post-op patient complaint following a laparoscopic procedure is: a. headache b. diarrhea c. gastric upset d. shoulder pain

Shoulder pain

The s-shaped bend in the lower colon is the: a. hepatic flexure b. splenic flexure c. rectum d. sigmoid

Sigmoid

The breast procedure performed to remove extensive benign disease is a(n): a. axillary node dissection b. simple mastectomy c. radical mastectomy d. modified radical mastectomy

Simple mastectomy

The biliary tract terminates at the: a. bladder b. sphincter of oddi c. common hepatic duct d. cystic duct

Sphincter of oddi

A left subcostal incision indicates surgery of the: a. gallbladder b. spleen c. pancreas d. liver

Spleen

During a mastectomy, which irrigating solution is used on the muscle layer due to its hypotonic properties? a. saline b. ringer's lactate c. sterile water d. glycine

Sterile water

In a thyroidectomy, a loop retractor retracts the: a. platysma muscle b. cervical fascia c. thyroid veins d. sternocleidomastoid muscle

Sternocleidomastoid muscle

What chemical system uses peracetic acid as the sterilant? a. ozone gas sterilization b. steris c. sterrad d. vapor phase sterilizer

Sterris

Which of the following specimens is not placed in preservative solution? a. stones b. curettings c. tonsils d. uterus

Stones

An irreducible hernia in which the abdominal contents have become necrotic is called: a. strangulated b. incarcerated c. sliding d. ventral

Strangulated

Which muscles are incised in the midline of the neck once the skin flaps are completed during a thyroidectomy? a. sternocleidomastoid b. strap c. sternohyoid d. sternoclavicular

Strap

The incision used for splenectomy is: a. midline transverse b. thoracoabdominal c. subcostal d. lower paramedian

Subcostal

An advanced inflammation of the bowel could be conservatively treated with which procedure? a. temporary colostomy b. anterior resection c. hemicolectomy d. abdominal perineal resection

Temporary colostomy

An end ileostomy is created from the: a. transverse colon b. descending colon c. terminal ileum d. sigmoid colon

Terminal ileum

All of the following statements refer to pilonidal cyst surgery except: a. it is performed with an elliptical incision b. the wound frequently heals by granulation c. probes are required on setup d. the cyst is removed, but the tract reamins

The cyst is removed, but the tract remains

A patient was burned on the lip with a hot mouth gag. What action would have prevented this incident? a. the circulator cooled the item in the sterilizer b. the scrub nurse warned the surgeon that the item was hot c. the scrub nurse cooled the item in a basin with sterile water d. the surgeon had checked the item before using it

The scrub nurse cooled the item in a basin with sterile water

When performing an esophagectomy, which instrumentation should be added to the basic instrument set? a. thoracotomy tray b. tracheotomy tray c. plastic/reconstructive set d. minor tray

Thoracotomy tray

An enzyme extract from bovine blood used as a topical hemostatic agent is: a. oxytocin b. tannic acid c. thrombin d. collagen

Thrombin

Why are bumpers or bolsters used on retention sutures? a. to prevent the suture from cutting into the skin surface b. to facilitate easy removal c. to identify the order of suture removal d. to prevent unequal tension on the wound edges

To prevent the suture from cutting into the skin surface

A purse-string is used: a. as a retention suture b. for ligation c. to provide traction d. to tighten or close an opening

To tighten or close an opening

The defect in an inguinal hernia occurs in the --- muscle. a. scarpa's fascia b. internal oblique c. transversalis d. cremaster

Transversalis

Indicates for a cholecystostomy include all except: a. acute pancreatitis b. traumatic rupture of the gallbladder c. chronic calculous cholecystitis d. acute cholecystitis with gallstones

Traumatic rupture of the gallbladder

What position is used to displace the abdominal contents to enhance the surgeons view of the lower abdominal region? a. trendelenburg b. lateral c. fowler's d. reverse trendelenburg

Trendelenburg

The laparoscope with attached video camera is inserted through the --- port during a laparoscopic cholecystectomy. a. xiphoid b. lateral c. mediolateral d. umbilicul

Umbilical

In which incision could retention sutures be used? a. vertical midline b. mcburney c. transverse d. thoracoabdominal

Vertical midline

The simplest abdominal incision offering good exposure to any part of the abdominal cavity is the: a. right subcostal b. kocher's c. mid-abdominal transverse d. vertical midline

Vertical midline