Ch 12 Surgical Case Management

With what amount and which fluid is a 16 French, two way Foley catheter with 5 CC balloon filled? 5 ml of sterile water, 10 ml of sterile normal sailing, 5 ml of sterile normal sailing, 10 ml of sterile water

10 ml of sterile water

Up to what area of the arms does a surgical technologist scrub? 2" below the elbows, 2" above the elbows, 1" below the elbows, 1" above the elbows

2" above the elbows

Where is the safety belt or strap placed on a patient in supine position on the OR table? 2" proximal to the knees, 2" proximal to the ankles common 2" distal to the knees, 2" distal to the perineal

2" proximal to the knees

How many individuals are required to safely transfer a recently anesthetized patient from the OR table to the stretcher? 4, 2, 3, none; wait until patient can move him or herself

4

Which of the following is/are not included in operative vital sign measurements? Blood pressure, pulse, height and weight, all of the above

All of the above

Referring to the Apex of the heart, used as a method of reading a pulse rate

Apical

The act of listening to sounds within organs or areas of the body

Ausculation

What is the term used when a surgical team member who is on stand by must return to the facility to do a case? Pulled up, called up, pulled in, called in

Called in

Which 2 members of the surgical team are responsible for performing the counts to prevent retained items? Circulator and surgeon, surgeon and first assistant, surgeon and surgical Tech, circulator and surgical Tech

Circulator and surgical Tech

Which gloving method should be performed by the surgical technologist after donning a sterile gown and before setting up the back table? Assisted gloving, triple gloving, open gloving, closed gloving

Close gloving

Which of the following describes the configuration of a Mayo stand cover? Wrap-around, flat, rigid, cylindrical

Cylindrical

Type of cream used as a hair removal method that does not cause micro abrasions

Depilatory

Which type of sterile gown uses battery power ventilation for the wearer? Full coverage system, reusable cloth, impervious backed, disposable fluid resistant

Disposable fluid resistant

Which component of personal protective equipment has shown the ability to decrease disease transmission from needle punctures? Full coverage system, lead aprons/Shields, double gloving, splash guard mask

Double Gloving

When turning the sterile gown, what is handed to the circulator that completes the gowning process? Gown wrapper, gloved hand, gown tab or card, glove wrapper

Down tab or card

Which of the following are not considered countable items for potential of retained foreign objects? Instruments, sharps, dressings, sponges

Dressings

Which of the following is not an example of Blunt dissection of tissue? Surgeon and assistant pull open peritoneum bilaterally, Gloved finger against tissue Endo-sheers are used through laparoscopic trocar to separate tissue, Dissection sponge (peanut)

Endo-sheers are used through laparoscopic trocar to separate tissue

What is the term for the normal resident microbial population found on human skin? fomites, biologicals, Flora, bioburden

Flora

The patient undergoing laparotomy should be prepped: In vertical strokes from superior prep margins to inferior prep margins, From the incision site outward towards the periphery in a circular motion From the periphery inward towards the incision site in a circular motion, In a side to side motion from bedside level

From the incision site outward toward the periphery in a circular motion

Which of the following statements regarding hair removal is INcorrect? Hair removal using a razor can result in micro abrasions, and increased microbial count, Hair must be shaved from every incision and and ECG leads site, Hair removal should be performed as close to the time of the procedure as possible, Hair removal is dependent upon surgeon's preference, patient factors, and surgical site

Hair must be shaved from every incision will and ECG leads site

If a pack of sponges is found to have an incorrect number during the count process and the patient is on the OR table what should be done? Hand off the pack to the circulator who will bag, label as incorrect, and isolate off field until case completion, Discard the sponge pack into the trash hamper, Hand off the pack to the circulator who will remove it from the Room, Ask the circulator to record the actual number on the count board for closing count verification

Hand off the pack to the circulator who will bag, label as incorrect, and isolate off field until count completion

Which of the following descriptions of how to pour liquids into a container on the sterile field is correct? Hold the bottle 6" above but with only the lid of the bottle over the basin, Hold of the bottle 12" above and with only the lid of the bottle over the basin, Hold the bottle 12" above and over the basin, Hold the bottle 6" above and over the basin

Hold the bottle 12" above and with only the lid of the bottle over the basin

What would be the likely result of positioning the patient's arms on armboards at a greater than 90ﾟ angle from the torso? Hyper-extensive nerve damage, hamstring strain common foot drop comet restriction of respiratory freedom

Hyper - extensive nerve damage

The ability to prevent penetration of fluid through materials resulting in contamination

Impervious

The position in which an individual is lying on his or her side, also called decubitas

Lateral recumbent

Radiation, convection, conduction, and evaporation are examples of: Methods of thermal hemostasis, surgical suite ventilation controls, instrument sterilization methods, of intraoperative heat loss

Mechanisms of intra operative heat loss

Which of the following would not be an appropriate method of performing a surgical scrub/skin preparation? Brushless/waterless, counted strokes, anatomical timed, medical hand wash

Medical hand wash

During the process of setting up the sterile field, efficiency and economy of motion recommended that the surgical technologist: Move items only once if possible, Request that circulating RN open all supplies for case after ST has gloved and gowned, Position back table close to door, Place as many instruments on Mayo stand as possible

Move items only once if possible

In preparing a patient for surgery which of the following should be removed to facilitate oxygen blood level assessment? Nail Polish, dentures, make up, hearing aids

Nail polish

Area designates for placement of sharps to prevent intraoperative injury to sterile team members

Neutral zone

Which method of gloving is appropriate for placement of a urinary catheter as part of the skin prep? Double gloving, open gloving, unsterile gloving, closed loving

Open gloving

What should the surgical technologist do with his or her gown and gloves in preparation for dawning after scrubbing? Open and toss gown and gloves onto the back table, Open and toss gown and gloves into the basin set, Open and toss gown and gloves into an sterile Mayo stand, Open gown wrapper on an unsterile Mayo stand and open and toss gloves onto gown

Open gown wrapper on an unsterile Mayo stand and open and toss gloves onto gown

What is the appropriate method for delivering a sterile item to the back table from a peel package? Open peel pack away from self, using top flap to cover hand and arm, open item over center of back table, Open package toward self, then project item into air, aiming for back table, Open package laterally, and carefully slide item over glued edge on to top of back table, Open package laterally and completely, gently toss item without touching glued edge or going over back table

Open package laterally and completely gently toss item without touching glued edge or going over back table

Before opening any supplies for delivery to the sterile field, what must be verified? Initials of person who prepared item, removal of charge sticker, length of time item has been stored, package integrity being intact and not violated

Package integrity being intact and not violated

Which table attachment is required to safely maintain a patient in the reverse trendelenburg position? Patted footboard, kidney braces, anesthesia screen, shoulder braces

Patted footboard

The passage of fluid through the lymphatic system or blood vessels to an organ or tissues

Perfusion

When transporting a patient on a stretcher through the OR sweet corridors which method should be followed? Push the stretcher with the patient facing feet 1st in the position most comfortable for the patient, Pull the stretcher with the patient facing feet 1st and the patient flat and restrained, Pull the stretcher with the patient facing head 1st and the patient flat and restrained, Push the stretcher with the patient facing head 1st in the position most comfortable for the patient

Push the stretcher with the patient facing feet first in the position most comfotable for the patient

What is the purpose of a radio frequency tracking system in the operating Room? Prevent potential for patient mis identification, Assist CSPD personnel in locating instruments raise, Aid in chargeable items being input into the system, Reduce possibility of retained foreign object

Reduce possibility of retained foreign object

The main purpose of the surgical scrub prep is to: Provide a visible area of paint where the incision will be made, Remove all resident and transient Flora from the planned incision site, Reduce the microbial count on the skin to an irreducible minimum, Sterilize the patient's skin to prevent post op surgical site infections

Reduce the microbial count on the skin to an irreducible minimum

Which of the following techniques of counting sponges on this sterile field is an example of best practice? Remove paper bands around sponges, hold pack in hand and fan out to separate, and then count aloud while touching each sponge, Count packages, leaving paper bands around an intact to prevent mixing of sponges before use, Count quietly into yourself, and record totals with a skin marker on the back table cover, Remove paper bands around sponges, separate each sponge into separate piles while counting aloud with the circulator

Remove paper bands around sponges, separate each sponge into separate piles while counting aloud with the circulator

Which position would facilitate exposure of the operative site during a laparoscopic cholecystectom? Reverse trendelenburg With slight tilt to the left, Reverse trendelenburg with slight tilt to the right, trendelenburg with slight tilt to the right, trendelenburg with slight tilt to the left

Reverse trendelenburg with slight tilt to the left

Which towel is 1st when squaring off the operative site? Same side as person applying towels, opposite side from person applying towels, inferior margin, superior margin

Same side as person applying towels

During the surgical skin prep, areas that are considered contaminated should: Be scrubbed vigorously and 1st, need no special attention, should not be scrubbed at all, should be scrubbed separately or last

Should be scrubbed separately or last

Which position is routinely used for flexible colonoscopy procedures and may be performed on the patient's stretcher? Sims, Krasky, Fowler's, Lithotomy

Sims

To secure the Mayo stand from moving during draping what should be done? Push the Mayo stand against the wall, have the circulator hold the Mayo stand post, grasp the back side of the tray with one hand, step on one leg of the Mayo

Step on one leg of the Mayo stand

Best practice States that all of the following items remained sterile until the patient leaves the room, except the: Mayo stand, back table, basin set, surgical drapes

Surgical drapes

Which term describes the condition of a surgical technologist skin followed skin prep? Sterile, debrided, medically clean, surgically clean

Surgically clean

Rapid breaths that rise with body temperature

Tachypnea

What does the circulator verify before the surgical technologist places the basket of instruments on the table? The filter on the container lid has changed color, The number of instruments in the tray are correct on the count sheet from CSPD, The filters on the bottom of the container are intact and the container is dry, The internal indicator has changed color

The filters on the bottom of the container are intact and the container is dry

Which of the following statements about lateral kidney positioning is incorrect? The patients flank is positioned over the kidney lift to provide greater exposure of the operative area, The lower leg is flexed, the upper leg is straight, and a pillow is between them, The lower leg is straight and the upper leg is flexed comment with a pillow under the lower leg, A small role is placed under the non operative site axillary area to facilitate respiration

The lower leg is straight and the upper leg is flexed, with a pillow under the lower leg

Which of the following statements regarding transfer of an awake, mobile patient from stretcher to OR table is incorrect? Both table and stretcher must be locked to prevent movement during transfer, The safety strap is secured tightly across the patient's waist to prevent possible fall due to narrow our table, One staff member is positioned on table side to receive patient and one on stretcher side to stabilize, Instruct patient to keep the blanket on during transfer, preventing hypothermia and for privacy

The safety strap is secured tightly across patient's waist to prevent possible fall due to narrow OR table

Which statement regarding instrument counts is correct? They should be counted while all still on back table, They are unnecessary if only one tray is opened for use, They are required by state law for every surgical procedure, They have been replaced by routine practice of post op X-ray to verify no retained instruments

They should be counted while all still on back table

They act or process of being twisted or rotated around and access

Torsion

The proper sequence for performing intra operative and closing counts is operative site, Mayo stand, back table, basins comet kick bucket or off field. T/F

True

What is the name of the common disposable surgical gowns style? Circumferential, wrap-around, turn around, cylindrical

Wrap-around

Which member of the surgical team gives permission for the patient to be positioned or transferred? CST, circulator, CSFA, anesthesia provider

anesthesia provider

An assistant may be needed to properly perform which type of surgical skin prep? Midline vertical abdominal, two-step prep with scrub and paint, circumfrential extremity, vaginal/perineal prep in lithotomy position

circumfrential extremity

The purpose of the preoperative skin prep is to sterilize the patient's skin to prevent surgical site infections. T/F

false

What is the temporary position for a female patient for placement of urinary catheter prior to abdominal hysterectomy? Jack-knife, semi Fowler's, frog legged, low-lithotomy

frog-legged

For which position would the head of the OR table be moved to the foot before the patient is placed on the table? Jackknife, trendelenburg, lateral kidney, lithotomy

lithotomy

The area between the anus and scrotum in males or between the anus and volva in females

perineum

Which position requires anesthesia administration and integration to be performed on the patient's stretcher prior to final positioning? lithotomy, prone, lateral, supine

prone

What is the name of the device used to manually assessed blood pressure? sphygmomanometer, glucometer, electrocardiograph, pulse oximeter

sphygmomanometer

What is the term used for the area beneath the finger nail that is cleaned with a pick during the surgical scrub? Sublingual, subungle, subdermal, subacromial

subungal

Trendelenburg, reverse trendelenburg, Fowler's, and lithotomy are variants of which basic position? Prone, supine, lateral, decubitus

supine

Suction to be and ESU cords are attached to the sterile drape with perforating towel clips to prevent contamination T/F

true

The ability to anticipate the needs of the sergeant is one of the most important skills for an ST to develop. T/F

true

The legs of a patient being placed in the lithotomy position should be raised and lowered slowly and simultaneously by 2 and sterile personnel. T/F

true

What is the proper way to open a small sterile I wrapped item for delivery on to the sterile field? First flap is pulled and opened away from self and tucks into Palm, side flaps are pulled and tucked into Palm, and last flat is pulled towards self and secured before tossing item on to field

true