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Which of the following chemicals used in the Peri-Operative Department is non-
carcinogenic?
A. polymethlymethacrylate
B. formalin
C. ethylene oxide
D. Monsel's
- answer-D. Monsel's
Rationale: Polymethlymethacrylate, formalin and ethylene oxide are all chemical
hazards and are considered carcinogenic. Monsel's is a hemostatic agent and is
non-carcinogenic.
For which of the following drains is a sterile safety pin used?
A. Penrose
B. Pleur-evac
C. closed vacuum
D. red Robinson
- answer-A. Penrose
Rationale: A Penrose comes with a safety pin that can be attached at the end of the
drain to the dressing sponge that keeps both the drain and sponge in place.
Which of the following instruments should be passed to the surgeon to achieve
hemostasis at the beginning of an operative procedure? (Select the three (3) correct
answers.)
A. electrosurgical pen
B. sponge
C. scalpel
D. suction device
E. sponge forceps
- answer-A. electrosurgical pen
B. sponge
D. suction device
,Rationale: To achieve hemostasis, a sponge can be used to clear the area to see
where the bleeding is coming from. An electrosurgical pen can be used to stop
bleeding because the thermal heat will disperse to stop bleeding. The suction
device is used to provide visualization so that the bleeding can be stopped. A
scalpel is used to make an incision. Sponge forceps would not be used to control
superficial bleeding at the beginning of the case.
When disinfecting a flexible endoscope used on a patient with TB, which of the
following sterilization methods should be employed?
A. steris
B. bleach
C. steam
D. enzymatic
- answer-A. steris
Rationale: The Steris is the machine used to clean and rid microorganisms from
flexible endoscopes. Steam sterilization is not compatible with endoscopes because
it will damage the endoscope. Bleach and enzymatic are both disinfectants.
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.
- answer-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 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.
- answer-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.
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.
- answer-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.
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.
- answer-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.
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.
- answer-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.
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.
- answer-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.