TEST BANK for Surgical Technology 8th Edition by Joanna Kotcher-Updated

TEST BANK

TEST BANK

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COMPLETE Elaborated Test Bank for

Surgical Technology 8th Edition Joanna Kotcher

Surgical Technology 8th Edition by R.N. Fuller & Joanna Kotcher.

ISBN-10 0323680186 ISBN-13 978-0323680189 Test bank for Surgical Technology 8th Edition by R.N. Fuller & Joanna Kotcher

ISBN-10 0323680186 ISBN-13 978-0323680189

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TABLE OF CONTENTS Chapter:1. Surgical Technology: The Profession and the Professional Chapter:2. Communication and Teamwork Chapter:3. Medicolegal Aspects of Surgical Technology Chapter:4. The Health Care Facility Chapter:5. Supporting the Psychosocial Needs of the Patient Chapter:6. Diagnostic and Assessment Procedures Chapter:7. Hazards in the Perioperative Environment Chapter:8. Microbes and the Process of Infection Chapter:9. Sterile Technique and Infection Control Chapter:10. Decontamination, Sterilization, and Disinfection Chapter:11. Surgical Instruments Chapter:12. Perioperative Pharmacology Chapter:13. Anesthesia, Physiological Monitoring and Post-Anesthesia Recovery Chapter:14. Death and Dying Chapter:15. Energy Sources in Surgery Chapter:16. Moving, Handling and Positioning the Surgical Patient Chapter:17. Surgical Skin Preparation and Draping Chapter:18. Surgical Skills I: Planning a Case, Opening, and Start of Surgery Chapter:19. Surgical Skills II: Intraoperative and Immediate Postoperative Period Chapter:20. Minimally Invasive Surgery Chapter:21. Robotic Surgery Chapter:22. General Surgery Chapter:23. Gynecological and Obstetrical Surgery Chapter:24. Genitourinary Surgery Chapter:25. Ophthalmic Surgery

Chapter:26. Surgery of the Ear, Nose, Pharynx and Larynx Chapter:27. Oral and Maxillofacial Surgery Chapter:28. Plastic and Reconstructive Surgery Chapter:29. Orthopedic Surgery Chapter:30. Peripheral Vascular Surgery Chapter:31. Thoracic and Pulmonary Surgery Chapter:32. Cardiac Surgery Chapter:33. Pediatric Surgery Chapter:34. Neurosurgery Chapter:35. Emergency Trauma Surgery Chapter:36. Disaster Preparedness and Response

Chapter 01: Surgical Technology: The Profession and the Professional Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The professional association for surgical technologists is the ________. a. Association of periOperative Registered Nurses b. American College of Surgeons c. Association of Surgical Technologists d. Accreditation Review Committee on Education in Surgical Technology ANS: C

The AST is the professional organization in surgical technology. The association supports students and graduate surgical technologists through its many services and publications.

DIF: 1

REF: p. 5

2. ________ demonstrates that a surgical technologist from an accredited program has

achieved a minimum level of knowledge and skills. a. Licensure b. An associate’s degree c. Graduation d. Certification ANS: D

Certification: Acknowledgment by a private agency that a person has achieved a stated level of knowledge and skill. Certification is usually established by graduation from an accredited institution and passing a written examination.

DIF: 1

REF: p. 1

3. Certification for the surgical technologist is ________. a. mandatory b. voluntary c. unnecessary d. invalid ANS: B

Important to know: Students who graduate from an accredited program are required to take the certification exam as a means of maintaining the school’s accreditation status.

DIF: 1

REF: p. 4

4. The profession of surgical technologist is defined today as a result of ____________. a. less demanding professional needs b. technological advances c. growing demands in the ancillary departments d. advances in digital technology ANS: B

Technological advances created a need for more trained personnel who could assist the surgeon.

DIF: 1

REF: p. 2

5. The need for assistive personnel in surgery did not arise until ____________. a. World War I b. Korean War c. Civil War d. World War II ANS: D

The need for other types of surgical assistants became critical during World War II. During World War I, Army corpsmen worked on the battlefield to offer aid and comfort to the wound-ed, but they had no role in surgery. World War II dramatically changed that.

The need for assistive personnel in surgery did not arise until World War II. DIF: 1

REF: p. 2

6. During World War I, _______ worked on the battlefield to offer aid and comfort to the

wounded. a. nurses b. assistants c. Corpsmen d. orderlies ANS: C

During World War I, Army corpsmen worked on the battlefield to offer aid and comfort to the wound-ed, but they had no role in surgery.

DIF: 1

REF: p. 2

7. A new profession was born in the Army for the Corpsman; it was named __________. a. Corpsman I b. nurse c. CST d. ORT ANS: D

When nurses were not available, such as on combat ships, corpsmen worked under the direct supervision of the surgeons. The Army referred to these corpsmen as operating room technicians (ORTs). Thereafter, the military played a significant role in defining the role of the ORT. Each branch of the military provided specific training for the ORT. DIF: 1

REF: p. 2

8. Registered nurses continued to fill the role of the scrub, or “instrument,” nurse until about

__________. a. 1970 b. 1965 c. 1966 d. none are correct

ANS: B

Registered nurses continued to fill the role of “instrument nurse” until about 1965, when the role changed to “circulating” or non-sterile nurse.

DIF: 1

REF: p. 2

9. The Association of periOperative Registered Nurses (AORN) published a book called

_______________. a. The Role of the Operating Room Technician b. Teaching in the Operating Room c. Teaching the Operating Room Technician d. Surgical Techniques for Operating Room Technician ANS: C

In 1967, prompted by the need for guidelines and standards in the training of paramedical surgical personnel, the Association of Operating Room Nurses (AORN) published a training manual called Teaching the Operating Room Technician.

DIF: 1

REF: p. 2

10. In _______ the AORN board of directors created the ________________. a. 1968, Association of Operating Room Technicians b. 1965, Association of Operating Room Technicians c. 1968, Association of Operating Room Nurses d. 1967, Association of Operating Room Nurses ANS: C

In 1968 the AORN board of directors created the Association of Operating Room Technicians (AORT), which led to formal training for the civilian ORT in proprietary schools across the United States.

DIF: 1

REF: p. 2

11. AORT stands for __________. a. Association of Operating Radiology Technician b. Association of Ophthalmic Register Technician c. Association of Operating Respiratory Technician d. Association of Operating Room Technicians ANS: D

AORT stands for Association of Operating Room Technicians.

DIF: 1

REF: p. 2

12. In an effort to formalize technologists’ education, AORT created two new committees,

which are the Joint Review Committee and the __________. a. AST b. LCC-ST c. CST d. CORT-ST ANS: B

The AORT created two new committees, the Liaison Council on Certification for the Surgical Technologist (LCC-ST) and the Joint Review Committee on Education.

DIF: 1

REF: p. 2

13. The surgical technologist’s professional organization that supports students and graduates

is __________. a. LCC b. CST c. AST d. NBSTSA ANS: C

The AST is the professional organization in surgical technology. The association supports students and graduate surgical technologists through its many services and publications.

DIF: 1

REF: p. 5

14. At the national level, AST provides the following support to students and graduates of

surgical technologist and teaching institutions and the public __________. a. maintains practice standards, code of ethics, and code of conduct for the surgical technologist b. publishes a professional journal, The Surgical Technologist c. holds annual conferences for surgical technologists and educators d. all are correct ANS: D

State assemblies, local chapters of AST, link surgical technologists to their national association and provide forums for learning, discussion, and advocacy. The association is actively involved in training and curriculum development. At the national level, AST supports student and graduate surgical technologists, the public, and teaching institutions.

DIF: 1

REF: p. 5

15. It is important for students to become active members of AST to promote __________. a. standards of the profession b. the Association of Surgical Technology c. the Accrediting Review Council on Education in Surgical Technology d. themselves ANS: A

It is important for surgical technology students to become active members of AST and to promote the standards of the profession DIF: 1

REF: p. 5

16. As a body of professionals, surgical technologists are supported by a number of key

organizations and partners. Each has a designated role in __________. a. certification, standards, continuing education, and promotion b. continuing education, promotion, standards, and accreditation c. standards, continuing education, accreditation, and promotion d. promotion, certification, accreditation, and continuing education

ANS: D

As a body of professionals, surgical technologists are supported by a number of key organizations. Each has a designated role in promotion, certification, accreditation, and continuing education.

DIF: 1

REF: p. 5

17. Which of the following organizations oversees certification and credentialing for the

surgical technologist? a. AORN b. AST c. NBSTSA d. CAAHEP ANS: C

The National Board of Surgical Technology and Surgical Assisting (NBSTSA) which provides credentialing services for surgical technology provides a Candidate Handbook for students.

DIF: 1

REF: p. 4

18. Surgical technologists are trained in __________. a. 2-year colleges b. military c. proprietary certificate programs d. all the above ANS: D

Surgical technologists may be trained in a short certificate programs (9 to 12 months), or a 2-year associate degree course.

DIF: 1

REF: p. 4

19. Certification demonstrates __________. a. a level of knowledge and skill b. advanced level competencies c. understanding of the principles and practices of surgery d. support for NBSTSA ANS: A

Certification: Acknowledgment by a private agency that a person has achieved a stated level of knowledge and skill.

DIF: 1

REF: p. 1

20. To be eligible to take the certification examination, the applicant must meet all

requirements EXCEPT __________. a. be a graduate of an accredited program (ABHES and CAAHEP) b. currently be a CST c. be a graduate of a military program d. have 7 of the last 10 years documented scrub experience

ANS: D

The National Board of Surgical Technology and Surgical Assisting (NBSTSA) which provides credentialing services for surgical technology provides a Candidate Handbook for students. The handbook covers eligibility to take the certification exam and other topics important to the process. The Handbook can be accessed at https://www.nbstsa.org/sites/nbstsa/files/pdf/2019_CSTrev2.pdf DIF: 1

REF: p. 4

21. Suzie has taken the CST examination and passed. For Suzie to keep her certification

without retaking the examination, she must do one of the following __________. a. attend the national conference b. maintain continuing education (CE) credits c. nothing d. attend all state meetings ANS: B

In order to maintain certification, practicing STs must earn continuing education credits.

DIF: 1

REF: p. 4

22. The nonsterile member of the surgical team is called __________. a. Assistant b. Scrub c. circulator d. Surgeon ANS: C

the circulator is a “nonsterile” team member who is responsible for many different tasks, including direct patient care.

DIF: 1

REF: p. 3

23. The surgical technologist who works in a hospital or other facility that provides 24-hour

care is usually required to __________. a. take a break every hour b. be on “call” c. do nothing d. none are correct ANS: B

The surgical technologist working in a hospital or other facility that provides 24-hour care is usually required to be on “call.”

DIF: 1

REF: p. 3

24. ___________ has particular attributes, attitude, and behavior that reflect a high standard of

accountability, ethics, honesty, and respect for people. a. Someone highly trained b. Someone who uses his or her skills c. Allied health professional

d. Surgical technologist ANS: C

Allied health professionals contribute to the well-being and health of the patient through technical expertise and patient care in line with the standards, guidelines and ethics of their profession.

DIF: 1

REF: p. 1

MATCHING

Match each item with the correct acronym. a. NBSTSA b. ABHES c. ARC/STSA d. CAAHEP e. AORN f. AST g. ORT h. CFA i. CST j. STCR Surgical Technologist Circulating Role Operating Room Technician National Board of Surgical Technology and Surgical Assisting Association of Operative Registered Nurses Accrediting Bureau of Health Education Schools Association of Surgical Technologists Commission on Accreditation of Allied Health Education Programs Certified surgical technologist Accreditation Review Council on Education in Surgical Technology and Surgical Assisting 10. Certified first assistant 1.

2.

3.

4.

5.

6.

7.

8.

9.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

ANS: J ANS: G ANS: A ANS: E ANS: B ANS: F ANS: D ANS: I ANS: C ANS: H

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 3 p. 2 p. 4 p. 2 p. 6 p. 5 p. 6 p. 3 p. 6 p. 6

Match the definition with the role of the surgical technologist. a. Scrub role b. Circulator

c. Second assistant d. Preceptor e. Leadership and management 11. Maintain retraction of tissue 12. Communicate effectively with surgeon to prevent errors, such as passing the wrong

instrument or passing it in the wrong position 13. Nonsterile team member who assists the RN 14. Teaching others while scrubbed 15. Pursue an advanced degree in hospital administration and management 11.

12.

13.

14.

15.

ANS: C ANS: A ANS: B ANS: D ANS: E

DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2

REF: REF: REF: REF: REF:

p. 3 p. 2 p. 3 p. 3 p. 3

Match the definition with the role of the surgical technologist. a. Scrub role b. Circulator c. Second assistant d. Central Sterile Processing specialist 16. Assist with hemostasis as directed by the surgeon 17. the preparation and care of medical instruments and equipment 18. Ensure patient chart, including results of diagnostic procedures, permits, and preoperative

checklist, accompanies the patient into surgery 19. Prepares instruments and supplies on the sterile field 16.

17.

18.

19.

ANS: C ANS: D ANS: B ANS: A

DIF: DIF: DIF: DIF:

2 2 2 2

REF: REF: REF: REF:

p. 3 p. 7 p. 3 p. 3

Match the definition with the role of the surgical technologist. a. Scrub role b. Circulator c. Second assistant d. Central Sterile Processing specialist 20. Irrigating the surgical wound, especially in microsurgery 21. Skills and knowledge required for this role are the processes of sterilization and

disinfection and sterilization processes, assembly of surgical instrument sets, and management of complex instrument systems.

22. Role is fulfilled by a registered nurse 23. Assist surgeon in specific, well-defined task as needed during the procedure 20. ANS: C 21. ANS: D 22. ANS: B

DIF: 2 DIF: 2 DIF: 2

REF: p. 3 REF: p. 7 REF: p. 3

23. ANS: A

DIF: 2

REF: p. 2

Match the definition with the role of the surgical technologist. a. Circulator b. Second assistant c. Preceptor d. Leadership and management 24. Maintain a “dry” surgical site by operating suction devices and appropriate use of surgical

sponge 25. A teacher 26. The nonsterile person who performs patient care procedures, obtains and delivers the equipment needed for a surgery case, opens sterile supplies, and assists in positioning the patient on the operating table 27. Facilitate and coordinate teams and to manage equipment 24.

25.

26.

27.

ANS: B ANS: C ANS: A ANS: D

DIF: DIF: DIF: DIF:

2 2 2 2

REF: REF: REF: REF:

p. 3 p. 3 p. 3 p. 3

Match the following definitions with the correct term. a. Military service b. Specialty practice c. CST-CFA d. Educator and clinical instructor e. Medical industry representative f. Materials management or central sterile processing 28. Implements the curriculum for the institution and manages departments 29. Assists in surgical procedures to retract tissue and aid in exposure, hemostasis, close tissue 30.

31.

32.

33.

28.

29.

30.

31.

32.

33.

planes, and other intraoperative techniques while under supervision of the surgeon Education program parallels civilian requirements, with additional training in combat and war surgery and in golden hour treatment The scope of duties and responsibilities includes disinfection and sterilization processes, assembly of surgical instrument sets, and management of complex instrument systems Promote the company’s equipment but also has the technical expertise to troubleshoot problems The hospital-based surgical technologist may specialize in one or more surgical specialties such as orthopedics, neurosurgery, cardiac surgery, obstetrics, or plastic surgery ANS: D ANS: C ANS: A ANS: F ANS: E ANS: B

DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2

REF: REF: REF: REF: REF: REF:

p. 6 p. 6 p. 5 p. 7 p. 7 p. 7

Chapter 02: Communication and Teamwork Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ____________ is one of the most important tools for health care professionals to acquire. a. Teamwork b. Professionalism c. Communication d. Skills ANS: C

Communication skills are among the most important tools for health care professionals to acquire.

DIF: 1

REF: p. 13

2. Surgery is performed by __________. a. surgeons b. nurses c. surgical technologists d. teams of health professionals ANS: D

Surgery is performed by teams of health professionals.

DIF: 1

REF: p. 13

3. ________ is a quality found in people with self-esteem. This type of behavior seeks to

protect one’s own rights while respecting those of others. a. Aggressiveness b. Offensiveness c. Assertiveness d. Emotion ANS: C

Assertiveness is the ability to express one’s own needs and rights while respecting the needs and rights of others. It demonstrates confidence without being confrontational.

DIF: 1

REF: p. 13

4. ________ are behaviors that are accepted as part of the environment and culture of a

group. a. Norms b. Laws c. Regulations d. Rules ANS: A

Norms are defined as behaviors that are accepted as part of the environment and culture of a group. Norms are usually established by custom and popular acceptance rather than by law, although the two may not be mutually exclusive.

DIF: 1

REF: p. 12

5. Communication is a two-way process between the ________. a. ST and patient b. sender and receiver c. surgeon and circulator d. accuser and accused ANS: B

The elements of communication are a sender, a receiver, the message, the means of communication, and feedback about the message.

DIF: 1

REF: p. 13

6. ________ is the expression of emotion or opinion contained in the delivery of a message. a. Expression b. Body language c. Sensitivity d. Tone ANS: D

The message also carries a tone which is determined by how the message is expressed.

Most people have experienced communication which is neutral in substance but delivered in a way that conveys an emotion or attitude for example. Examples include a tone which is negative, or positive, angry, respectful, or derisive.

DIF: 1

REF: p. 13

7. ________ is the response to a message and is a component of effective communication. a. Feedback b. Aggression c. Harassment d. Abuse ANS: A

Feedback is a response by the receiver who acknowledges receipt of the message and its content.

DIF: 1

REF: p. 13

8. The most important reason to increase ________ is to maintain patient safety and

teamwork. a. staff b. salaries c. communication skills d. gossip and rumors ANS: C

Effective communication skills are extremely important in the health care professions.

Patient safety and teamwork are based on the ability to deliver and receive information in all forms.

DIF: 1

REF: p. 13

9. Poor patient care, errors, conflict, and stress are results of ________. a. poor communication skills b. aggression c. lack of educated team members d. cultural differences ANS: A

Poor communication can result in serious errors, conflict, and stress.

DIF: 1

REF: p. 13

10. Many health care workers are surprised to find that the greatest challenge in their work is

not the work itself but the ________ of the workplace. a. stress b. acceptable social distance c. gender value d. interactions and social climate ANS: D

Many health care workers are surprised to find that the greatest challenge in their work is not the work itself but the interactions and social climate of the workplace.

DIF: 1

REF: p. 13

11. Even if the sender does not wish to express his or her true feelings about the message,

these feelings will probably be conveyed by ________. a. aggressive behavior b. assertiveness c. body language d. gossip or rumors ANS: C

The way we use posture, gestures, and expressions to convey ideas and messages is called body language. These cues can emphasize the message or convey a meaning that differs significantly from what was originally intended.

DIF: 1

REF: p. 14

12. Good communication clarifies relationships and helps establish professional and social

boundaries. It increases teamwork and goals, which will greatly increase the safety of the environment for the ________. a. surgeon b. management staff c. ancillary departments d. patient

ANS: D

Effective communication skills are extremely important in the health care professions.

Patient safety and teamwork are based on the ability to deliver and receive information in all forms.

DIF: 1

REF: p. 13

13. _________________is a response by the receiver acknowledging receipt of the message

and its content. a. Sender b. Receiver c. Feedback d. Message ANS: C

Feedback is a response by the receiver acknowledging receipt of the message and its content.

DIF: 1

REF: p. 13

14. _____________________ is the way we use posture, gestures, and expressions to convey

ideas or messages. a. Verbal communication b. Body language c. Neutral language d. All are correct ANS: B

The way we use posture, gestures, and expressions to convey ideas and messages is called body language DIF: 1

REF: p. 14

15. ____________________ is purposeful touch that conveys care and empathy. a. Medical touch b. Positive touch c. Engaging touch d. Therapeutic touch ANS: D

Therapeutic touch is a method of conveying care and empathy to others DIF: 1

REF: p. 15

16. _______________ is the ability to communicate effectively with people of different

cultures and subcultures within populations. a. Cultural competence b. Cultural reference c. Cultural guidelines d. Cultural difference ANS: A

Cultural competence (sometimes called cultural intelligence) is the skill and knowledge to communicate and integrate well with people from diverse backgrounds and cultures.

DIF: 1

REF: p. 17

17. Which of the following is a characteristic between the health professional and the public? a. The public looks to the professional for aggression. b. The public looks to the professional for perceptions. c. The public looks to the professional for gossip and rumors. d. The public looks to the professional for reassurance.

ANS: D

The health professional may be the only “emotionally neutral” person in the setting, and the family needs this neutrality for reassurance.

DIF: 1

REF: p. 18

18. Stressors in the operating room environment can block __________________. a. conflict resolution b. politeness c. good communication and teamwork d. conflicting priorities ANS: C

Stressors in the operating room can block good communication and teamwork.

DIF: 1

REF: p. 23

19. Which of the following causes of team conflict is an interpersonal conflict? a. Personality clash b. Role confusion c. Personal space d. Organizational skills ANS: A

Personality clashes, attempts to gain control of the group, and power plays are some causes of team conflict.

DIF: 1

REF: p. 20

MATCHING

Match the characteristics of good teamwork and team conflict with their most correct description. a. Yielding b. Change c. Politeness d. Collaboration e. Conflict 1. Saying “please” or “thank you.”

2. Accepting the fact that others have valid points of view and conceding when one has made

incorrect assumptions or conclusions.

3. Working together for a common purpose.

4. The ability to adjust to unfolding events during a surgical procedure.

5. Poor communication and role confusion.

1.

2.

3.

4.

5.

ANS: C ANS: A ANS: D ANS: B ANS: E

DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2

REF: REF: REF: REF: REF:

p. 20 p. 20 p. 20 p. 20 p. 23

Match the characteristics of good teamwork and team conflict with their most correct description. a. Yielding b. Change c. Politeness d. Collaboration e. Conflict 6. Speaking to others in a calm manner without sarcasm.

7. Cooperation and the ability to accept one another’s individual personalities.

8. A surgical technologist wants to show the student how much they know rather than allow

the student to participate.

9. Identifying new tasks or procedures and implementing them with as little disruption as possible.

10. Open minded and retains a sense of fairness during team interaction.

6.

7.

8.

9.

10.

ANS: C ANS: D ANS: E ANS: B ANS: A

DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2

REF: REF: REF: REF: REF:

p. 20 p. 20 p. 21 p. 19 p. 20

Match the following terms with their most correct description. a. Emotions b. Environmental barriers c. Lack of a desire to communicate d. Perceptions e. Bias f. Lack of understanding g. Social and cultural influences 11. One person may perceive an unemotional patient as a “stoic,” strong, brave person facing

illness. Another person may see the same patient as extremely anxious and fearful, speechless, and unable to express emotion because of the intensity of his or her emotions.

12. How we perceive a problem, situation, or action sometimes depends on our social and cultural background as much as our knowledge.

13. An effective communication stopper 14. How we feel at the time of communication

15. The receiver does not have sufficient knowledge to understand exactly what the sender is

trying to communicate.

16. Hearing is a particular problem in the operating room.

17. To be successful in sending and receiving information, a person must want to communicate.

11.

12.

13.

14.

15.

16.

17.

ANS: D ANS: G ANS: E ANS: A ANS: F ANS: B ANS: C

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF:

p. 18 p. 19 p. 18 p. 19 p. 19 p. 19 p. 19

Chapter 03: Medicolegal Aspects of Surgical Technology Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Health care professionals are guided in their practice by __________. a. standards b. laws c. policies and regulations d. all are correct ANS: D

Health care professionals are guided in their practice by standards, laws, regulations, and policies.

DIF: 2

REF: p. 26

2. Law in most society is intended to protect __________. a. government officials b. state officials c. individuals d. none are correct ANS: C

Law in most societies is intended to protect individuals from harm and promote a peaceful society.

DIF: 2

REF: p. 26

3. _____________ is the transfer of responsibility for a task from one person to another. a. Compensation b. Delegation c. Regulation d. Segregation ANS: B

Delegation is the transfer of duty to perform a task from one person to another.

DIF: 2

REF: p. 30

4. A set of rules or regulations that hospital employees are required to follow, created to

protect patients and employees from harm and to ensure the smooth operation of the hospital, is called ________. a. code of ethics b. operative consents c. hospital policy d. medical practice acts ANS: C

Hospital policy: Rules or regulations that hospital employees are required to follow. They are created to protect patients and employees from harm and to ensure smooth operation of the hospital.

DIF: 2

REF: p. 25

5. Negligence committed by a professional who deliberately acts outside of her or his scope

of practice, or while impaired, is known as ________. a. damages b. malpractice c. a sentinel event d. complaints ANS: B

Malpractice is also part of civil law. It is defined by the JC as “improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position.”

Cases of malpractice are brought about against professionals who do not practice their professional skills when these skills are required or expected.

DIF: 2

REF: p. 27

6. The circulator has transported the patient to the operating room but has forgotten the

patient’s chart. The circulator leaves the patient alone and returns to the preoperative area to get the chart. Upon returning, the circulator finds the patient lying on the floor. The circulator may be charged with ________. a. abandonment b. improper ethical choices c. sexual harassment d. forgetting the patient’s chart ANS: A

Abandonment is neglect of a patient or leaving a patient unattended while under the direct care of a health care professional. An abandoned patient can suffer a fall or other injury such as aspiration (breathing in fluid), choking, cardiac arrest, or other life-threatening events.

DIF: 2

REF: p. 30

7. A derogatory statement concerning other coworkers’ skills, character, or reputation is

unprofessional and known as a(n) _____________________. a. ethical dilemma b. tort c. sentinel event d. defamation ANS: D

Defamation: Deliberate efforts to erode the reputation of another person.

DIF: 2

REF: p. 27

8. Intentionally lying or falsifying information given during a court testimony after being

sworn to tell the truth is known as ________.

a. b. c. d.

a tort perjury libel a complaint

ANS: B

Perjury: The crime of intentionally lying or falsifying information during court testimony after a person has sworn to tell the truth.

DIF: 2

REF: p. 25

9. A legal document stating the patient’s wishes for refusing or limiting care if the patient

becomes incompetent is known as a(n) ____________. a. nurse practice act b. advance directive c. Informed consent d. code of ethics ANS: B

Advance directive: A document in which a person gives instructions about his or her medical care in the event that the individual cannot speak for himself or herself. Examples are a living will and a medical power of attorney.

DIF: 2

REF: p. 13

10. A(n) ___________ is an unexpected occurrence involving death or serious psychological

injury, or risk thereof. It is titled as such because it signals the need for immediate investigation and response. a. sentinel event b. medical practice act c. ethical dilemma d. recommended practice ANS: A

A sentinel event is a specific type of adverse event. It is defined by the JC as a Patient Safety Event. It is defined as an event which was “not related to the natural course of the patient’s illness or underlying condition” and results in: Death, Permanent harm, Severe temporary harm and intervention required to sustain life.

DIF: 2

REF: p. 33

11. A wrong, independent of contract law violations, perpetrated by one person against

another person or person’s property that can be compensable by money damages is known as ___________. a. a tort b. slander c. damages d. negligence ANS: A

Actions which result in physical or psychological harm or injury to another is called a tort.

A tort is classified as intentional (done on purpose with intent to harm) or as a result of negligence.

DIF: 2

REF: p. 27

12. Under the U.S. Constitution, each state has the power to pass laws that define and regulate

its health professions. These state laws are called _____________. a. surgical laws b. policies c. hospital policy d. practice acts ANS: D

Under the U.S. Constitution, each state has the power to pass laws that define and regulate its health professions. These state laws are called practice acts.

DIF: 2

REF: p. 26

13. ________ are performed by two people during any surgery in which an item can be lost

inside the patient. a. X-rays b. Extra precautions c. Negligent acts d. Surgical counts ANS: D

The scrub and the circulator are responsible for the surgical counts, which must be performed in an exact way at prescribed times during the surgery.

DIF: 2

REF: p. 29

14. Because of the legal implications of this document, it must be signed by the physician, the

patient, and a witness. This document is called a(n) __________________. Without this signed document, surgery cannot proceed. a. surgical count sheet b. informed consent c. advance directive d. operative record ANS: B

A patient’s operative consent form, or informed consent, is a process in which the risks, benefits, and alternatives of the surgery or treatment are communicated to the patient, who must sign the form.

DIF: 2

REF: p. 36

15. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), created by the

U.S. Department of Health and Human Services (HHS), outlines federal standards for the protection of _______________. a. criminal actions b. licensed personnel

c. operating room personnel d. a patient’s privacy ANS: D

The HIPAA protects the patient’s right to privacy concerning their medical care, past, present, and future.

DIF: 2

REF: p. 38

16. A mandated procedure for ensuring that surgery is performed on the correct patient, site,

and side is called __________________. a. timeout b. pause time c. recheck time d. time check ANS: A

The Universal Protocol or TIMEOUT is a verification procedure in which the team pauses just before surgery begins to acknowledge essential information about the operative site and side, patient identity, position, and other crucial information about the patient and procedure. Surgery may not proceed until the protocol is completed.

DIF: 2

REF: p. 29

17. The operating room ___________________ is distinct from the hospital policy. a. MSDS Manual b. AORN Guidelines c. Code of Ethics d. procedure manual ANS: D

The operating room procedure manual is distinct from the hospital policy.

DIF: 2

REF: p. 27

18. Patient falls are the ___________ cause of death in hospitalized people over 65. a. only b. last c. leading d. all the above ANS: C

Patient falls are the leading cause of death in hospitalized people older than 65 years.

DIF: 2

REF: p. 29

19. Choose the correct statement concerning common circumstances in which falls occur. a. The side rails on a stretcher are not kept raised. b. Safety strap is not secured on the operating room table. c. Unsafe transfer techniques are used. d. All are correct.

ANS: D

The following are examples of common circumstances in which falls occur in the perioperative environment: The side rails on a stretcher are not kept raised, or a safety strap is not secured on the operating room table, A sedated or disoriented patient climbs over the side rails or becomes entangled between the rails, Unsafe transfer techniques are used to move a patient to and from a wheelchair, resulting in a fall.

DIF: 2

REF: p. 29

20. The universal protocol or ____________ is a verification procedure in which the team

pauses just before surgery and begins to acknowledge essential information about the operative site and side, patient identity, position, and other crucial information about the patient and procedure. a. standards b. timeout c. guidelines d. viewed ANS: B

The Universal Protocol or TIMEOUT is a verification procedure in which the team pauses just before surgery begins to acknowledge essential information about the operative site and side, patient identity, position, and other crucial information about the patient and procedure.

DIF: 2

REF: p. 29

21. Any tissue or foreign object removed from the patient during surgery requires careful

handling and ____________. a. information b. diagnosis c. evidence d. documentation ANS: D

Any tissue or foreign object removed from the patient during surgery requires careful handling and documentation.

DIF: 2

REF: p. 30

22. Surgical technologists are required to ____________ medications on the field. a. mix b. label c. prepare d. all are correct ANS: D

Surgical technologists are required to transfer medicines to the surgical field, to mix solutions, and to prepare medicines for administration. They are also required to label medicines received on the sterile field, which is necessary when drugs are transferred from their original container into another container or delivery system for use in surgery.

DIF: 2

REF: p. 30

23. __________ errors are among the most prevalent and serious errors occurring during

surgery. a. Labeling b. Instrumentation c. Sterilization d. Calculation ANS: A

Studies in the past decade have shown that labeling errors are among the most prevalent and serious errors occurring during surgery.

DIF: 2

REF: p. 30

24. __________ is defined as neglecting a patient or leaving a patient unattended when the

patient requires the presence of a health care professional. a. Error b. Misleading c. Transferring d. Abandonment ANS: D

Abandonment is neglect of a patient or leaving a patient unattended while under the direct care of a health care professional.

DIF: 2

REF: p. 30

25. Failure to ____________ can occur when a member of the team neglects to pass on vital

information that requires action. a. care b. communicate c. touch d. all are correct ANS: B

Failures in communication can occur when a member of the team neglects to pass on vital in-formation that requires action.

DIF: 2

REF: p. 30

26. You are scrubbed with Dr. Jones on a laparoscopic cholecystectomy. Dr. Jones and Dr.

Adams start telling jokes in a sexual manner. These comments make you feel uncomfortable; you would consider this __________. a. verbal abuse b. horizontal abuse c. Disruptive behavior d. all are correct ANS: C

The American Medical Association in its Code of Medical Ethics defines disruptive behavior as “any abusive conduct, including sexual or other forms of harassment, or others forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care of patient safety could be compromised.” The following are listed in the code: Physically threatening anyone [in the hospital], Making threatening or intimidating physical contact with another person, Throwing things, Threatening violence or retribution, Sexual and other harassment, Persistent inappropriate behavior rising to the level of harassment.

DIF: 2

REF: p. 31

27. Tammy is a program director and is always talking about her supervisor. Tammy informs

the class that her supervisor is uneducated and does not know the standards and guidelines.

Because Tammy has made this statement verbally this is considered __________. a. libel b. negligent c. assault d. slander ANS: D

If the actions are verbal, it is slander.

DIF: 2

REF: p. 27

28. _____________ means deliberate efforts to erode the reputation of another person. a. Defamation b. Assault c. Battery d. Slander ANS: A

Deliberate efforts to erode the reputation of another person.

DIF: 2

REF: p. 27

29. _____________ is the threat or attempt to harm another person. a. Battery b. False imprisonment c. Assault d. Slander ANS: C

Assault: is the threat or attempt to harm another person, regardless of whether the threat is carried out.

DIF: 2

REF: p. 27

30. __________ involves harmful contact with another person with intention to harm such as a

physical attack on another person. a. Battery b. False imprisonment c. Assault

d. Slander ANS: A

Battery: Harmful contact with another person with intention to harm such as a physical attack on another person DIF: 2

REF: p. 27

31. HIPAA protects the patient’s __________________ concerning their medical care, past,

present and future. a. personal belongings b. family c. right to privacy d. treatment records ANS: C

The HIPAA protects the patient’s right to privacy concerning their medical care, past, present, and future.

DIF: 2

REF: p. 34

32. ____________is the means for making a permanent legal record of the patient’s

interaction with health care providers and services. a. Medical records b. Treatment records c. Documentation d. Forms ANS: C

Documentation is the means of making a permanent legal record of the patient’s interaction with health care providers and services.

DIF: 2

REF: p. 34

33. A patient’s operative consent form, or ____________________, is the process in which

the attending practitioner explains risks, benefits, and alternatives of the surgery to the patient. a. health literacy b. signed consent c. informed consent d. anesthesia consent ANS: C

A patient’s operative consent form, or informed consent, is a process in which the risks, benefits, and alternatives of the surgery or treatment are communicated to the patient, who must sign the form.

DIF: 2

REF: p. 36

34. The surgical consent is signed by the ________, __________, and a(n) ___________. a. nurse, surgeon, anesthesiologist b. surgeon, nurse, family member

c. patient, surgeon, nurse d. patient, surgeon, witness ANS: D

The consent is then signed by the patient or person authorized to give the consent and the surgeon. A witness signature to the consent is required in all cases.

DIF: 2

REF: p. 36

35. An ____________ is a legal document that specifically states the type of medical

intervention or treatment the patient wants. a. medical power of attorney b. advance directive c. DNR d. none are correct ANS: B

An advance directive is a document in which a patient gives instructions about his or her medical care in the event that the individual cannot speak for himself or herself because of incapacity.

DIF: 2

REF: p. 37

MATCHING

Choose from the terms listed and match them with their most correct description. a. Statutes b. Administrative law 1. Laws passed by federal or state legislative bodies 2. Laws created by an agency or a department of the U.S. government.

1. ANS: A 2. ANS: B

DIF: 3 DIF: 3

REF: p. 25 REF: p. 26

Choose from the terms listed and match them with their most correct description. a. Intentional tort b. Negligence tort 3. Injury as a result of improper positioning 4. Invasion of privacy 3. ANS: B 4. ANS: A

DIF: 3 DIF: 3

REF: p. 26 REF: p. 27

Choose from the terms listed and match them with their most correct description. a. Intentional tort b. Negligence tort 5. A derogatory statement made by one person about another 6. Negligence

5. ANS: A 6. ANS: B

DIF: 3 DIF: 3

REF: p. 27 REF: p. 26

Choose from the terms listed and match them with their most correct description. a. Intentional tort b. Negligence tort c. Criminal liability 7. Theft of hospital policy 8. HIPAA violation 9. Committed inadvertently, without intent to harm 7. ANS: C 8. ANS: A 9. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 27 REF: p. 27 REF: p. 26

Chapter 04: The Health Care Facility Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The surgical department is structured and engineered to provide a safe and efficient

environment for patients and staff members. Many different designs can be used, but all must achieve the following objective(s). a. infection control b. environmental safety c. efficient use of personnel, time, space, and resources d. all are correct ANS: D

The surgical department is structured and engineered to provide a safe and efficient environment for patients and staff members. Many different designs can be used, but all must achieve the following objectives: infection control, environmental safety, efficient use of personnel, time, space, and resources DIF: 2

REF: p. 41

2. __________ and __________ areas (those with the greatest potential sources of infection)

are physically separated when possible. a. Clean and contaminated b. Clean and dirty c. Clean and clean contaminated d. None are correct ANS: A

Clean and contaminated areas (those with the greatest potential sources of infection) are physically separated when possible.

DIF: 2

REF: p. 41|p. 42

3. ____________ engineering in the operating room (OR) follows national medical

engineering standards for electrical circuits, inline gases, lighting, and other utilities. a. Mechanical b. Physical c. Environmental d. All are correct ANS: C

Environmental engineering in the operating room follows national medical engineering standards for electrical circuits, inline gases, lighting, and other utilities.

DIF: 1

REF: p. 42

4. All of the following are core principles of operating room design EXCEPT

_____________. a. personnel policies

b. infection control c. environmental safety d. efficiency ANS: A

The surgical department is structured and engineered to provide a safe and efficient environment for patients and staff members. Many different designs can be used, but all must achieve the following objectives: infection control, environmental safety, efficient use of personnel, time, space, and resources.

DIF: 2

REF: p. 56

5. __________ create(s) boundaries between areas that carry the highest potential sources of

infection and those that are the cleanest. a. Airflow b. Traffic patterns c. Clean area d. Certain areas ANS: B

Traffic patterns create boundaries between areas that carry the highest potential sources of infection and those that are the cleanest (most aseptic).

DIF: 2

REF: p. 43

6. _______ is the area where instruments and equipment are cleaned and disinfected. a. Central core b. Restricted c. Storage d. Decontamination ANS: D

The decontamination area is where surgical instruments and equipment are disinfected after use.

DIF: 2

REF: p. 42

7. ___________ is the primary accreditation organization for all health care facilities. a. Occupational Safety and Health Administration b. The Joint Commission c. Association for Professionals in Agency for Healthcare Research and Quality d. None are correct ANS: B

The Joint Commission is the primary accreditation organization for all health care facilities (http://www.jointcommission.org).

DIF: 1

REF: p. 41

8. One of the main strategies in the floor plan of a surgical department is __________. a. work flow b. infection control

c. design d. corridor ANS: B

The surgical department (operating room) is structured and engineered to provide a safe and efficient environment for patients and staff members. Many different designs can be used, but all must achieve the following objectives: 1. Infection control 2. Environmental safety 3. Efficient use of personnel, time, space, and material resources.

DIF: 2

REF: p. 41

9. Modern surgical lighting is usually derived from _________________. a. LED sources and halogen b. energy saving sources and high-definition screens c. compressed air and gas d. LED sources and light-emitting diodes ANS: A

Modern surgical lighting is usually derived from LED (light-emitting diode) sources and halogen.

DIF: 1

REF: p. 44

10. All of the following are compressed gases EXCEPT _______________. a. oxygen b. suction c. nitrous oxide d. nitrogen ANS: B

Oxygen, compressed air, nitrous oxide, and nitrogen are available through inline systems in most hospitals and outpatient surgical centers.

DIF: 2

REF: p. 44

11. The strength of vacuum of the suction is measured in ____________________. a. pounds per square inch (psi) b. laminar airflow (LAF) c. light-emitting diode (LED) d. high-efficiency particulate air (HEPA) ANS: A

The strength of the vacuum is measured in pounds per square inch and is adjustable.

DIF: 1

REF: p. 44

12. Which piece of equipment is covered with a firm removable pad? a. Back table b. Operating table c. Mayo stand d. Prep table ANS: B

The table surface is covered with a firm removable pad.

DIF: 1

REF: p. 43

13. Which piece of equipment is the sterile pack opened onto that provides a sterile surface for

instruments and supplies? a. Back table b. Ring stand c. Operating table d. Mayo stand ANS: A

The back table is a large, stainless steel table on which all instruments and supplies except those in immediate use are placed (Figure 4.3). For some procedures, more than one back table may be needed. Just before surgery, a sterile pack (table cover with towels and drapes enclosed) is opened onto the table.

DIF: 1

REF: p. 43

14. Which piece of equipment is covered with a sterile drape and placed over the patient

during the procedure for quick access to instruments? a. Back table b. Mayo stand c. Ring stand d. All are correct ANS: B

The Mayo stand is placed over or alongside the patient for quick access to instruments.

DIF: 1

REF: p. 43

15. Which piece of equipment is designed to contain sterile basins that are used during

surgery? a. Kick bucket b. Prep table c. Mayo stand d. Ring stand ANS: D

The ring stand is used to contain one or two basins.

DIF: 1

REF: p. 43

MATCHING

Choose from the terms listed and match them with their most correct description. a. Surgical offices b. Locker room/lounge area c. Patient preoperative holding area d. Scrub sinks e. Substerile room

f. Sterile instrument room g. Equipment storage h. Utility workroom and decontamination area i. Clean processing area j. Anesthesia department k. Post anesthesia unit l. Surgery waiting area m. Integrated OR system

13.

Immediately outside the OR suite Contains clean respiratory equipment, anesthetic agents, and adjunctive drugs Patient’s family is located outside traffic areas A front office situated near the main entry doors serves as a reception and central communication area for the department Any instruments that are not sent out of the department for decontamination and sterilization are brought to this area for assembly after decontamination in the department Provides centralized control of surgical devices and equipment through a sterile remote or voice activated system A transitional area for those who need to change from street clothes to surgical attire Sterile wrapped supplies are stored in designated restricted areas adjacent to the operating suites nearby A patient emerging from anesthesia faces many physiological risks Check-in point where the surgeon, anesthesiologist, and circulating nurse can confirm that all documentation is in order Are located outside the surgical suites so that personnel can proceed directly to surgery immediately after hand antisepsis Large equipment, such as the operating microscope, operating table attachments, and other heavy equipment, is kept in clean designated storerooms Soiled instruments and equipment are decontaminated and washed in this area

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

ANS: E ANS: J ANS: L ANS: A ANS: I ANS: M ANS: B ANS: F ANS: K ANS: C ANS: D ANS: G ANS: H

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 43 p. 46 p. 47 p. 45 p. 46 p. 47 p. 45 p. 46 p. 47 p. 45 p. 45 p. 46 p. 46

Choose from the terms listed and match them with their most correct description. Some answers will not be used. a. Organizational chart b. Chain of command c. Personnel policy

d. Surgeon e. Assistant surgeon f. Anesthesia care provider g. Perioperative registered nurse h. Physician assistant i. Licensed practical nurse j. Certified surgical technologist k. Certified surgical technologist–certified first assistant l. Certified surgical assistant or nonphysician surgical assistant m. Certified anesthesia technologist n. OR educator o. Surgical orderly or aide p. Central sterile processing technician q. Patient care technician r. Radiology s. EEG technician t. Medical industry representative u. Cardiovascular perfusionist v. Administration personnel w. Health care facility management x. Chief operation officer y. Director of surgical services/OR z. Perioperative nurse manager 14. A hierarchy of personnel positions that establishes both vertical and horizontal 15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

relationships between positions Assists the OR director Establishes the relationships between management and staff. These are ranked by chain of command.

Is an MD, DO, or CRNA Has completed a 1- or 2-year program in a college or vocational or technical school A member of the anesthesia patient care team and department Transportation of the patient to and from the surgical department Specialist in measuring the brain’s activities Responsible for oversight of the health facility Employed by surgical equipment and instrument company Multidisciplinary nursing assistant Responsible for the safe management and sterilization of equipment Develops and implements educational programs Prepares equipment and instruments before surgery Responsibilities and functions of all employees in the surgical department Patient’s primary physician in the OR Is a CST who has completed an educational program in surgical assisting Medical and technical radiology professional Role is to provide extracorporeal oxygenation of the blood during CABG Responsible for overseeing all clinical and professional activities in the department Manages an institution, plan its activities, and provide oversight for day-to-day operations and employees

35. A medical doctor licensed to perform and assist in surgery 36. Is an RN and also may have advance certification in perioperative nursing 37. Is a medical professional who practices medicine under the supervision of a physician 14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

ANS: B ANS: Z ANS: A ANS: F ANS: I ANS: M ANS: O ANS: S ANS: X ANS: T ANS: Q ANS: P ANS: N ANS: J ANS: C ANS: D ANS: K ANS: R ANS: U ANS: Y ANS: V ANS: E ANS: G ANS: H

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 40 p. 56 p. 57 p. 54 p. 54 p. 55 p. 55 p. 56 p. 56 p. 56 p. 55 p. 55 p. 55 p. 55 p. 54 p. 54 p. 55 p. 56 p. 56 p. 56 p. 40 p. 54 p. 54 p. 54

Chapter 05: Supporting the Psychosocial Needs of the Patient Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. According to Maslow’s Hierarchy of Needs, physiological needs are all of the following

EXCEPT ________________. a. psychological b. biochemical c. mechanical d. physical ANS: A

According to Maslow’s Hierarchy, the most basic of human needs are physiological—those that involve the biochemical, mechanical, and physical processes of life.

DIF: 2

REF: p. 59

2. Self-actualization is one’s ability to express and achieve ________ goals. a. society b. financial c. professional d. personal ANS: D

Self-actualization is an individual’s ability to plan and achieve his or her life goals on the based on the physical, social, and psychological freedom (the lower levels of the pyramid) to pursue those achievements. Personal goals are whatever that person defines as a goal or an achievement.

DIF: 2

REF: p. 61

3. In patient-centered care, the surgical team bases assessment, planning, and intervention on

the unique needs of the ________. a. surgical technologist b. patient c. surgeon d. patient’s family members ANS: B

Patient-centered care: Therapeutic care, communication, and intervention provided according to the unique needs of the patient and centered on those needs. Every patient is unique, and a positive surgical outcome depends on holistic patient-centered care —which is based on many different dimensions of care according to the patient as an individual.

These unique needs are revealed through information from others, the patient’s records, accurate observation, and good communication with the patients themselves.

DIF: 2

REF: p. 64

4. Maslow’s Hierarchy of Needs is a model for meeting ________ and is used as a reference

point for patient care. a. the surgeon’s needs b. the patient’s family members’ needs c. the sterile team’s needs d. human needs ANS: D

In the 1970s, psychologist Abraham Maslow developed a theory about human needs. His model, known as Maslow’s hierarchy of human needs, is depicted as a triangular or hierarchy of needs (FIG 5.1) DIF: 2

REF: p. 64

5. Pediatric patient groups are defined according to approximate _____________ age ranges. a. physical b. physiological c. chronological d. astronomical ANS: C

Pediatric patient groups are defined according to approximate chronological age ranges.

The age group reflects the developmental stage, as shown in Table 5.2.

DIF: 2

REF: p. 62

6. Knowledge of the different __________ of children helps the surgical technologist

understand the behaviors exhibited by these patients in the operating room. a. cultures b. developmental stages c. childhood diseases d. family backgrounds ANS: B

Children of different developmental stages have predictable fears, responses, and reactions to unfamiliar environments such as the operating room. Knowledge of these stages can help the surgical technologist understand the behaviors exhibited by children in the operating room.

DIF: 2

REF: p. 62

7. ________ is a model of human needs. a. Maslow’s Hierarchy of Needs b. Developmental stages c. Therapeutic communication d. Social considerations ANS: A

Maslow’s hierarchy of human needs, is depicted as a triangular or hierarchy of needs (FIG 5.1) DIF: 2

REF: p. 58

8. Toddlers can experience frustration and ________ when separated from their primary

caregiver. a. comfort b. anxiety c. happiness d. reflexes ANS: B

Toddlers become frustrated and anxious when separated from their primary caretaker. The operating room environment can be terrifying to a toddler.

DIF: 2

REF: p. 62

9. Which is the highest level of Maslow’s Hierarchy of Needs? a. Love b. Belonging c. Acceptance d. Self-actualization ANS: D

Self-actualization features prominently in both humanistic theories presented by Maslow and Rogers. Self-actualization is an individual’s ability to plan and achieve his or her life goals on the based on the physical, social, and psychological freedom (the lower levels of the pyramid) to pursue those achievements. Personal goals are whatever that person defines as a goal or an achievement.

DIF: 2

REF: p. 61

MATCHING

Choose from the terms listed and match them with their most correct description. a. Spiritual need b. Psychological need c. Basic need 1. Belief in an energy or greater power 2. Respiration 3. Anxiety and fear 1. ANS: A 2. ANS: C 3. ANS: B

DIF: 2 DIF: 2 DIF: 2

REF: p. 64 REF: p. 58 REF: p. 59

Choose from the terms listed and match them with their most correct description. a. Spiritual need b. Psychological need c. Basic need 4. Practice of a particular faith 5. Loss of security

6. Biochemical needs 4. ANS: A 5. ANS: B 6. ANS: C

DIF: 2 DIF: 2 DIF: 2

REF: p. 64 REF: p. 61 REF: p. 60

Choose from the terms listed and match them with their most correct description. a. Spiritual need b. Psychological need 7. Fear of death 8. Rituals and ceremonies 7. ANS: B 8. ANS: A

DIF: 2 DIF: 2

REF: p. 64 REF: p. 64

Chapter 06: Diagnostic and Assessment Procedures Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Contrast media instilled into the urinary tract for visualization of the bladder, ureters, and

kidney is called ________________. a. myelography b. cholangiography c. angiography d. retrograde pyelography ANS: D

In retrograde pyelography, a contrast medium is instilled into the urinary tract for visualization of the bladder, ureter, and kidney. This procedure is used to identify stones, strictures, tumor, or other anomalies of the urinary system.

DIF: 2

REF: p. 75

2. Because ________ is found in contrast media, the patient must be evaluated for potential

hypersensitivity before administration. a. radioactive material b. penicillin c. iodine d. latex ANS: C

Contrast radiography carries a risk of allergy to the radiopaque medium, especially when the agent is injected. A careful patient history is used to determine whether the patient has had any previous reaction to contrast media. Allergy to iodine or agents containing iodophor may indicate sensitivity to contrast media.

DIF: 2

REF: p. 75

3. ________ is a radiopaque element that is used in the radiographic examination of the

gastrointestinal (GI) tract. a. Barium b. Optiray c. Conray d. Renografin ANS: A

In studies of the gastrointestinal system, barium, a radiopaque element, is used to fill and out-line the structures. An upper gastrointestinal study is used to identify problems in the esophagus, stomach, and small intestine. For a study of the large intestine, barium is instilled into the distal colon and rectum (FIG 6.10).

DIF: 2

REF: p. 75

4. ____________ uses radiofrequency signals and multiple magnetic fields to produce a

high-definition image. a. Fluoroscopy b. Computed tomography (CT) c. Positron emission tomography (PET) d. Magnetic resonance imaging (MRI) ANS: D

Magnetic resonance imaging (MRI) uses radiofrequency signals and multiple magnetic fields to produce a high-definition image (FIG 6.14). In this process, the patient is exposed to electromagnetic energy, which is emitted inside a closed body tube or an open platform.

MRI produces two- or three-dimensional digital images in cross section and is mainly used to detect structural abnormalities, including tumors.

DIF: 2

REF: p. 76

5. Intraoperative radiation therapy is used to deliver _____________ dose(s) of radiation to a

specific area of the body. a. multiple b. a single c. a weak d. a small ANS: B

Intraoperative radiation therapy is used to deliver a single dose of radiation to a specific area of the body.

DIF: 2

REF: p. 81

6. In assessment of blood pressure, the difference between diastolic and systolic pressure is

called the ________ pressure. a. pulse b. systolic c. mean arterial d. diastolic ANS: A

When the blood is forcefully pumped through the left ventricle, pressure is at its greatest.

This is called the systolic pressure. As the heart muscle relaxes between contractions, blood pressure is lowered. This is called diastolic pressure. When blood pressure is assessed, the difference between diastolic and systolic pressure can be a significant sign.

This is called the pulse pressure.

DIF: 2

REF: p. 70

7. The _________________ is a basic test used to evaluate the type and percentage of normal

components in the blood. a. arterial blood gases (ABCs) b. metabolic panel c. complete blood count (CBC) d. white blood count (WBC)

ANS: C

The CBC is a basic test used to evaluate the type and percentage of normal components in the blood. A blood sample is drawn from the vein and centrifuged. This separates it into cellular and liquid components for evaluation. The CBC is a basic blood test used for screening medical, infectious, and other types of diseases.

DIF: 2

REF: p. 77

8. ________ studies are used to measure blood flow. a. MRI b. X-ray c. Endoscopy d. Doppler ANS: D

Doppler studies use ultrasound to measure vascular flow.

DIF: 2

REF: p. 77

9. The ____________________ produces characteristic patterns indicating normal or

abnormal conduction impulses that stimulate heart action. a. electrocardiogram (ECG) b. neuromonitoring c. Doppler d. ultrasound ANS: A

The ECG measures the activity through the heart is graphed by time and strength of impulse. This produces characteristic patterns indicating normal or abnormal conduction, which are recognizable to trained personnel.

DIF: 2

REF: p. 72

10. A test that includes results of blood glucose, carbon dioxide, creatinine, urea nitrogen,

bicarbonate, and several important electrolytes is called a ____________. a. urinalysis b. differential leukocyte count c. coagulation test d. metabolic panel ANS: D

The metabolic panel includes a number of tests to determine the serum levels of substances that are crucial for metabolism. Many types of metabolic panels can be done.

The basic metabolic panel includes blood glucose, carbon dioxide, creatinine, urea nitrogen, bicarbonate, and several important electrolytes. The exact tests included in any metabolic panel are determined by health care regulatory agencies and may change with reimbursement regulations.

DIF: 2

REF: p. 78

11. _________________, or decreased serum potassium, can result from persistent and severe

vomiting and diarrhea, from extensive tissue trauma, or from shock.

a. b. c. d.

Hypokalemia Hyperkalemia Hyponaturemia Hypocalcemia

ANS: A

Hypokalemia (decreased serum potassium) can result from persistent and severe vomiting and diarrhea, extensive tissue trauma, or shock. Certain drugs can also cause a decrease in potassium.

DIF: 2

REF: p. 79

12. A ___________ is composed of disorganized tissue that exhibits uncontrolled growth. a. benign tumor b. malignant tumor c. tumor marker d. tumor growth ANS: B

A malignant tumor is composed of disorganized tissue that exhibits uncontrolled growth.

Malignant tissue has the potential to spread from the original site (called the primary tumor) to other parts of the body.

DIF: 2

REF: p. 80

13. __________________ has/have important functions in the blood-clotting mechanism,

including clot retraction and activation of coagulation factor. a. Platelets b. Hemoglobin c. Red blood cells d. White blood cells ANS: A

Platelets have important functions in the blood-clotting mechanism, including clot retraction and activation of coagulation factor.

DIF: 2

REF: p. 78

14. ________ is necessary for the transmission of nerve impulses to skeletal, smooth, and

cardiac muscle. a. Sodium b. Potassium c. Calcium d. Magnesium ANS: B

Potassium is mainly found in cells. It is necessary for the transmission of nerve impulses to skeletal, smooth, and cardiac muscle. It also functions in the conversion of carbohydrates for cellular energy and is critical in maintaining osmolality in cells.

DIF: 2

REF: p. 79

15. Molecules of inorganic substances that are essential for homeostasis and are capable of

splitting to yield a charged particle or substance are called _____________. a. electrolytes b. cardiac enzymes c. glucose levels d. sodium levels ANS: A

Body fluids contain both organic and inorganic substances. These substances are essential for homeostasis. Molecules of inorganic substances are capable of splitting to yield a charged particle or substance, called an electrolyte.

DIF: 2

REF: p. 79

16. Two primary tests that are performed on surgical patients to evaluate blood and blood cells

are ________________________. a. CBC and differential leukocyte count b. cardiac enzyme and glucose level studies c. urinalysis and electrolyte study d. type and cross-match and type and screen ANS: A

The CBC is a basic test used to evaluate the type and percentage of normal components in the blood (Table 6.3). The CBC is a basic blood test used for screening medical, infectious, and other types of diseases. Differential leukocyte count: White blood cells (leukocytes) are essential to the immune process. The differential count measures the number of each type of leukocyte by volume of blood. These are monocytes, macrophages, band neutrophils, eosinophils, basophils, and lymphocytes.

DIF: 2

REF: p. 77

17. Normal oral temperature in a person at rest is _________. a. 42° C b. 47° C c. 52° C d. 37° C ANS: D

The oral temperature is measured under the tongue (sublingually). The tongue is highly vascular and accurately reflects the core temperature. The normal oral temperature in a person at rest is 98.6° F (37° C). The normal range is 96.4° to 99.1° F (35.8° to 37.3° C).

DIF: 2

REF: p. 68

18. __________________ is/are the oxygen-carrying protein attached to RBCs. a. Platelets b. Hematocrit c. Leukocytes d. Hemoglobin ANS: D

Hemoglobin is oxygen-carrying protein attached to red blood cells (erythrocytes) and is measured in grams per deciliter (g/dL).

DIF: 2

REF: p. 77

19. _____________________ can result from parathyroid disease, vitamin D deficiency, and

specific drugs such as corticosteroids and some diuretics. a. Hypocalcemia b. Hyponaturemia c. Hematocrit d. Hemoglobin ANS: A

Hypocalcemia can result from parathyroid disease, vitamin D deficiency, and specific drugs such as corticosteroids and some diuretics.

DIF: 2

REF: p. 79

20. Basic diagnostic indicators that are used to evaluate the patient’s condition are

______________. a. vital signs b. x-rays c. imaging studies d. Doppler studies ANS: A

Taking a patient’s vital signs allows an overall evaluation of the person’s well-being. This is the most basic form of clinical assessment. In some facilities, the surgical technologist may be required to measure the patient’s vital signs.

DIF: 2

REF: p. 68

21. __________________ is measured with a sphygmomanometer and a stethoscope. a. Blood pressure b. Pulse by palpation c. Hemoglobin d. Metastasis ANS: A

Blood pressure is measured with an electronic (digital) sphygmomanometer or manual sphygmomanometer, which requires a stethoscope. The stethoscope method provides a more thorough assessment.

DIF: 2

REF: p. 68

22. The ________ measures hemoglobin, hematocrit, platelet, and leukocytes. a. metabolic panel b. CBC c. imaging study d. ABO ANS: B

The CBC is a basic test used to evaluate the type and percentage of normal components in the blood (Table 6.3). A blood sample is drawn from the vein and centrifuged. This separates it into cellular and liquid components for evaluation. The CBC is a basic blood test used for screening medical, infectious, and other types of diseases. When formulating a diagnosis, physicians always consider variations in normal blood values along with other signs and symptoms; they are never considered in isolation.

DIF: 2

REF: p. 78

23. ___________ tests and procedures are those that do not require an incision or the

perforation of intact tissues or structures. a. Invasive b. Noninvasive c. CBC d. Fluoroscopy ANS: B

Noninvasive procedures are limited to skin contact or no direct contact with the body.

DIF: 2

REF: p. 82

24. Cesium-137, iodine-125, and iridium-192 are ________________ that are implanted

directly into the tumor mass. a. contrast mediums b. radioactive seeds c. metabolic panels d. cardiac enzymes ANS: B

Radioactive seeds can be implanted directly into the tumor mass and may be left in the patient indefinitely. Cesium-137, iodine-125, and iridium-192 are used in this procedure.

Seeds are generally used in tumors that cannot be removed by surgical resection because of precarious location or size.

DIF: 2

REF: p. 81

25. Electrolytes are vital for _________________ and are responsible for nerve impulses,

fluid balance, transport of substances in and out of the cell, and balancing blood pH. a. homeostasis b. hemostasis c. staging d. systolic pressure ANS: A

Electrolytes are vital for homeostasis and are responsible for nerve impulses, fluid balance, the transport of substances into and out of the cell and for maintaining the blood pH. DIF: 2

REF: p. 82

26. The term ______________ refers to substances that the x-ray cannot penetrate. a. radiopaque b. radiolucent

c. fluoroscopy d. palpating ANS: A

The term radiopaque refers to substances that x-rays cannot penetrate.

DIF: 2

REF: p. 82

27. _______________ is/are the most basic form of assessment. a. CT scan b. Chest radiograph c. ECG d. Vital signs ANS: D

Taking a patient’s vital signs allows an overall evaluation of the person’s well-being. This is the most basic form of clinical assessment. In some facilities, the surgical technologist may measure the patient’s vital signs. These are documented and reported to the registered nurse or surgeon. The surgical technologist is not expected to interpret the measurements or make a diagnosis based on the results. However, accurate measurement is always required. The vital signs include temperature, pulse, respiration, and blood pressure.

DIF: 2

REF: p. 68

28. The body requires a core (deep) temperature of approximately 99° F, or __________. a. 37.2° C b. 38.2° C c. 40° C d. 42° C ANS: A

The body requires a core (internal) temperature of approximately 99° F (37.2° C) to maintain physiological functions.

DIF: 2

REF: p. 68

29. Axillary temperature readings are ____________________ than oral measurements. a. 0.3° to 0.6° C higher b. 0.5° to 1° F lower c. 0.5° and 1.5° C lower d. 0.6° and 1.6° C higher ANS: B

The axillary temperature is measured at the axilla. Readings are 0.5° to 1° F (0.3° to 0.6° C) lower than the oral value.

DIF: 2

REF: p. 68

30. ______________ varies with environmental changes. a. Forehead or skin temperature b. Blood pressure c. Pulse rate

d. Pulse oximetry ANS: A

The forehead, or skin, temperature varies with environmental changes.

DIF: 2

REF: p. 68

31. Which statement about the use of thermometers is true? a. The use of external thermometers, such as the tympanic thermometer, poses less

risk of infection for your patient. b. You do not need to wash your hands after taking a patient’s temperature with a

forehead or skin thermometer because it is not an invasive procedure. c. The rectal method is preferred over the tympanic method. d. Tympanic thermometers can harbor an infectious biofilm that may not be visible.

ANS: D

Always wear gloves when taking the patient’s temperature. Probe and tympanic thermometers can harbor an infectious biofilm that may not be visible.

DIF: 2

REF: p. 68

32. The pulse is a reflection of the stroke volume or _____________. a. amount of input b. amount of oxygen in the blood c. amount of blood pumped through the heart d. amount of blood pumped from the heart into the aorta ANS: C

The pulse is a reflection of the stroke volume (amount of blood pumped through the heart) of each beat. The pulse is felt in the artery as it expands with each heartbeat. The normal heart rate varies according to age, condition, and metabolic level.

DIF: 2

REF: p. 69

33. The normal pulse rate for an adult is ___________________. a. 40 to 60 beats per minute b. 60 to 100 beats per minute c. 75 to 100 beats per minute d. 80 to 120 beats per minute ANS: C

The normal pulse rate for an adult is 60 to 100 beats per minute.

DIF: 2

REF: p. 69

34. All the following are ways that malignancy causes specific injury to the body EXCEPT

__________. a. cachexia b. anemia c. no pain d. blood clot ANS: C

Malignancy causes specific injury to the body: • The risk of thrombosis (blood clot) is increased as a result of inappropriate production of clotting factors by the tumor itself. The tumor may also block blood vessels, resulting in clotting. • Pain is caused by direct injury to tissue or by pain mediators released by the tumor. As the tumor impinges on healthy tissue, the tissue dies, resulting in severe pain. • Cachexia (tissue and body wasting) is characteristic of malignancy. As the tumor destroys tissue, the patient’s metabolism is altered. Nutrients normally received by healthy tissue for growth and repair are captured by the malignant tissue, which continues to grow and spread. • Anemia occurs as a result of internal bleeding and the body’s inability to replace red blood cells. • As the malignancy spreads, changes occur in the function of the target tissue. This results in many different disease conditions, depending on the organ or tissue function.

DIF: 2

REF: p. 80

35. _______________ provides detailed information about heart conduction. a. ECG b. EEG c. Blood pressure d. Oximetry ANS: A

As a diagnostic tool, an ECG provides detailed information about heart conduction. Each phase of the cardiac conduction system is represented on the graph.

DIF: 2

REF: p. 72

36. The basic metabolic panel includes all of the following EXCEPT __________. a. blood glucose b. carbon dioxide c. creatinine d. oxygen ANS: D

The metabolic panel includes a number of tests to determine serum levels of substances that are crucial for metabolism. Many types of metabolic panels can be done. The basic metabolic panel includes blood glucose, carbon dioxide, creatinine, urea nitrogen, bicarbonate, and several important electrolytes.

DIF: 2

REF: p. 78

MATCHING

Choose from the terms listed and match them with their most correct description. a. Standard x-ray b. MRI c. Ultrasound

1. Produces two- or three-dimensional digital images in cross section 2. Taken when a surgical count cannot be resolved and there is risk of an item left in the

patient 3. A gel coating is used as an interface because the high-frequency waves cannot be precisely

tracked through air.

1. ANS: B 2. ANS: A 3. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 75 REF: p. 73 REF: p. 76

Choose from the terms listed and match them with their most correct description. a. MRI b. Ultrasound c. Contrast radiography 4. Any metal in range of the device may be drawn toward the source of emission.

5. Used in vascular surgery to track the movement of blood when combined with the Doppler 6. Cholangiography and angiography 4. ANS: A 5. ANS: B 6. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 75 REF: p. 76 REF: p. 74

Choose from the terms listed and match them with their most correct description. a. MRI b. Ultrasound c. Contrast radiography 7. Uses radiofrequency signals and multiple magnetic fields to produce a high-definition

image 8. Carries a risk of allergy to the radiopaque media 9. Uses high-frequency sound waves 7. ANS: A 8. ANS: C 9. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 75 REF: p. 74 REF: p. 76

Choose from the terms listed and match them with their most correct description. a. CBC b. Electrolyte c. Coagulation test d. Urinalysis 10.

11.

12.

13.

Inorganic substances essential for homeostasis Used to monitor patients who are receiving antiplatelet drugs The pH and specific gravity are assessed Measures hemoglobin and hematocrit

10. ANS: B 11. ANS: C

DIF: 3 DIF: 3

REF: p. 77 REF: p. 78

12. ANS: D 13. ANS: A

DIF: 3 DIF: 3

REF: p. 79 REF: p. 77|p. 78

Choose from the terms listed and match them with their most correct description. a. CBC b. Electrolyte c. Coagulation test d. Urinalysis 14.

15.

16.

17.

Potassium, sodium, and magnesium Measures the number of each type of leukocyte PT and PTT Assesses color, clarity, and odor

14.

15.

16.

17.

ANS: B ANS: A ANS: C ANS: D

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 79 p. 78 p. 78 p. 79

Choose from the terms listed and match them with their most correct description. a. CBC b. Electrolyte 18. Positively charged are called cations and negatively charged are called anions 19. A sample is drawn from the vein and centrifuged 18. ANS: B 19. ANS: A

DIF: 3 DIF: 3

REF: p. 79 REF: p. 77

Chapter 07: Hazards in the Perioperative Environment Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ________ is/are implemented to reduce the risk of infectious disease transmission that are

spread from the mouth, nose, oropharynx, and trachea to a susceptible host. a. Contact precautions b. Transmission-based precautions c. Face, eye, and body protection d. Droplet precautions ANS: D

Droplet precautions should be used when caring for patients who are known or suspected to be infected with microorganisms that can be transmitted by infectious large-particle droplets that generally travel short distances [i.e., 3 feet (0.9 m) or less]; diseases caused by such microorganisms include diphtheria, pertussis, influenza, mumps, and pneumonic plague.

DIF: 2

REF: p. 96

2. The most common source of electrical injury to the surgical patient is ______________. a. a bipolar b. the electrosurgical unit (ESU) c. the chemical telescope warmer d. the irrigating solutions ANS: B

The most common source of electrical injury to the surgical patient is the ESU. DIF: 2

REF: p. 99

3. __________ is the statistical probability of a harmful event and is defined as the number of

harmful events that occur in a given population over a stated period. a. Prevention b. Risk c. Awareness d. Recording ANS: B

Risk is the statistical probability of a harmful event and is defined as the number of harmful events that occur in a given population over a stated period.

DIF: 2

REF: p. 85

4. ____________ is/are a leading cause of hospital fires in the United States. a. Electrical malfunctions b. Smoking c. Laser malfunctions d. Arson

ANS: A

Electrical malfunctions are a leading cause of hospital fires in the United States.

DIF: 2

REF: p. 92

5. The characteristics of electricity are current, voltage, resistance, and grounding. The

discharge of electrical current from the source to ground, where it is dispersed and rendered harmless, is ________. a. current b. voltage c. grounding d. resistance ANS: C

Grounding is the discharge of electrical current from the source to ground, where it is dispersed and rendered harmless.

DIF: 1

REF: p. 93

6. The __________ zone is a hands-free space (designated receptacle) on the sterile field

where sharps can be placed and retrieved so that the surgical technologist and surgeon do not hand instruments to each other directly. a. scalpel b. sharps c. free zone d. neutral ANS: D

No-hands technique: A method of transferring sharp instruments on the surgical field with-out hand-to-hand contact. A neutral zone is identified, and sharps are exchanged in this zone.

DIF: 2

REF: p. 84

7. Immediate action taken during a fire is described by the acronym _____________. a. RACE b. ABC c. PASS d. MSDS ANS: A

If the fire extends beyond the immediate patient area, the surgical team must activate the hospital fire plan. This plan is based on four immediate actions, which are easily remembered by the acronym RACE:Rescue patients in the immediate area of the fire.

Alert other people to the fire so that they can assist in patient removal and response.

Activate the fire alert system. Contain the fire. Shut all doors to slow the spread of smoke and flame. Always shut off the zone valves controlling inline gases to the room.

Evacuate personnel in the areas around the fire.If the fire is limited to a small area, appropriate extinguishing agents may be used to put it out. Personnel should never let a fire get between them and the exit.

DIF: 2

REF: p. 88

8. _______________ solutions are common and frequent sources of fuel in surgical fires. a. Irrigation b. Antibiotic c. Prep d. Disinfecting ANS: C

After prepping, allow the prep solution to dry and the fumes to dissipate. Wet prep and fumes trapped beneath drapes can ignite.

DIF: 2

REF: p. 89

9. To lift or transfer a patient, use your ___________ muscles to hold the weight of your

upper body. a. arm b. back c. leg d. abdominal ANS: D

To lift an object, use your abdominal muscles to hold the weight of your upper body.

When the abdominal muscles are not engaged in exertion, the back muscles, especially those in the sacral and lumbar region, must support the entire trunk; this is a common cause of back injury.

DIF: 2

REF: p. 98

10. Clothing or equipment that prevents the wearer from direct contact with hazardous

chemicals or potentially infectious body fluids is called _______________. a. airborne transmission exposure precautions b. transmission-based precautions c. personal protective equipment d. post-exposure prophylaxis ANS: C

Personal protective equipment is clothing or equipment that prevents the wearer from direct contact with hazardous chemicals or potentially infectious body fluids.

DIF: 2

REF: p. 84

11. Compressed gases in steel cylinders are associated with serious accidents and fatalities

related to __________________ of the tank. a. opening and closing b. connecting and disconnecting c. transporting and storage d. explosion or rupture ANS: D

Compressed gases in steel cylinders are associated with serious accidents and fatalities related to explosion or rupture of the tank.

DIF: 2

REF: p. 99

12. All fires require three components: fuel, a source of ignition, and oxygen. __________

makes the operating room (OR) a high-risk environment for fire. a. A large amount of combustible material b. A high concentration of oxygen c. high-energy equipment d. Volatile prep solutions ANS: B

Oxygen-enriched atmosphere (OEA): An environment that contains a high percentage of oxygen and therefore presents a high risk for fire.

DIF: 2

REF: p. 84

13. ___________ is created during the use of a laser or electrosurgery. It contains harmful

toxins, such as benzene, hydrogen cyanide, formaldehyde, blood fragments, and viruses that are potentially harmful when inhaled. a. A smoke plume b. A chemical hazard c. Infectious waste d. Ionizing radiation ANS: A

A smoke plume is created during laser surgery and electrosurgery. It contains toxic chemicals, vapors, blood fragments, and diseases. Smoke plumes contain harmful toxins that must be removed from the immediate surgical environment, because they are known to contain benzene, hydrogen cyanide, formaldehyde, blood fragments, and viruses and are potentially harmful when inhaled.

DIF: 1

REF: p. 95

14. A naturally occurring sap obtained from rubber trees and used in the manufacture of

medical devices and other commercial goods is known as ______________. a. latex b. glutaraldehyde c. grounding d. volatile ANS: A

Latex is a naturally occurring sap obtained from rubber trees. It is used commercially in the manufacture of many products, including medical devices, supplies, and patient care items.

DIF: 2

REF: p. 95

15. Although ___________ are uncomfortable and heavy, team members should wear them

under their sterile gowns during any procedure that requires radiation. a. dosimeters b. lead aprons c. electrosurgical units

d. oxidizers ANS: B

Although lead aprons are uncomfortable and heavy, team members should wear them under their sterile gowns during any procedure that requires radiation. Many lead aprons shield only the front of the body; personnel should face the radiation source during exposure.

DIF: 2

REF: p. 93

16. _______________ are used with laser and electrosurgical equipment to prevent disease

transmission. a. Efficient evacuation and filtering systems b. Special filtered masks c. Post-exposure prophylaxis (PEP) d. Oxidizers ANS: A

All safety organizations, including the National Institute for Occupational Safety and Health (NIOSH), recommend an efficient evacuation and filtering system. A suction tip at the exact site where smoke is generated filters the smoke and absorbs minute toxic particles.

DIF: 2

REF: p. 95

17. The recommended procedure to help prevent the development of blood-borne diseases

after an exposure incident is ____________. a. standard precautions b. post-exposure prophylaxis (PEP) c. special filtered masks d. electrosurgical units ANS: B

Postexposure prophylaxis (PEP): Recommended procedures to help prevent the development of blood-borne diseases after an exposure incident such as a needle stick injury.

DIF: 2

REF: p. 84

18. Protective barriers must be used to reduce the risk of skin and mucous membrane exposure

to ___________. a. potentially infectious material b. foul odors c. latex d. oxidizers ANS: A

Protective barriers must be used to reduce the risk of skin and mucous membrane exposure to potentially infectious material. See Box 7.3 DIF: 1

REF: p. 96

19. Guidelines recommended to reduce the risk of transmission of blood-borne and other

pathogens are called ________ precautions. a. universal b. standard c. traditional d. limited ANS: A

The response to this problem was a set of practices for handling blood and body fluids called Universal Precautions.

DIF: 2

REF: p. 95

20. ____________________ affect muscle control, which can lead to injury. a. Temperature and humidity b. Fatigue and stress c. Sharps and latex d. Oxidizers and eschar ANS: B

Fatigue and stress affect muscle control, which can lead to injury. Standing and walking for long periods put extra stress on muscles, tendons, and joints.

DIF: 2

REF: p. 98

MATCHING

Choose from the terms listed and match them with their most correct descriptions. a. Standard precautions b. Contact precautions c. Airborne transmission precautions d. Droplet precautions e. Transmission-based precautions 1. Standards and precautions to prevent the spread of infectious disease by patients known to 2.

3.

4.

5.

1.

2.

3.

4.

5.

be infected Precautions to reduce the risk of transmission of blood-borne and other pathogens.

Implemented to reduce the risk of infectious by infectious large-particle droplets that generally travel short distances These precautions must be used with tuberculosis and smallpox patients.

Precautions used in providing care for patients who are known or suspected to be infected or colonized with microorganisms ANS: E ANS: A ANS: D ANS: C ANS: B

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 84 p. 95 p. 96 p. 96 p. 96

Choose from the terms listed and match them with their most correct description.

a. b. c. d.

Standard precautions Contact precautions Airborne transmission precautions Droplet precautions

6. Used when the patient is known to have an infection known to be transmitted by direct

contact or items and surfaces in the patients’ environments.

7. Reduces the risk of transmission of airborne agents by droplet nuclei 3 feet (0.9 m) or less.

8. Personnel must use these precautions when in contact with patients infected with

diphtheria, pertussis, influenza, mumps, and pneumonic plague.

9. All patients are considered potential carriers of diseases 6.

7.

8.

9.

ANS: B ANS: C ANS: D ANS: A

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 96 p. 96 p. 96 p. 96

Match the correct term about radiation to the correct definition. a. Ionizing radiation b. Magnetic resonance imaging 10. Lead aprons must be worn during fluoroscopy to prevent exposure to scatter radiation.

11. The primary risk is the presence of metal, which can be drawn from its source and into the

path of the powerful magnetic field. For this reason, absolutely no metal objects are permitted in the MRI environment and fringe areas.

10. ANS: A 11. ANS: B

DIF: 3 DIF: 3

REF: p. 93 REF: p. 94

Match the correct term about radiation to the correct definition. a. Ionizing radiation b. Magnetic resonance imaging 12. Lead aprons must be stored flat or hung in a manner that prevents bending of the material.

13. Personal items, such as scissors or jewelry 12. ANS: A 13. ANS: B

DIF: 3 DIF: 3

REF: p. 93 REF: p. 94

Chapter 08: Microbes and the Process of Infection Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ___________ provide a form of adaptive immunity. a. Antibiotics b. Allergies c. Vaccinations d. Resident flora ANS: C

Vaccination provides a form of adaptive immunity. Vaccines are modified forms of disease organisms that create immunological memory in the body. They produce the same immunological response as the disease itself, without the risks involved in the disease process. Vaccination pro-vides artificial immunity against specific organisms.

DIF: 2

REF: p. 122|p. 123

2. The human intestinal tract contains many different types of bacteria, such as __________,

which are essential for metabolism. a. Pseudomonas aeruginosa b. Streptococcus pyogenes c. Staphylococcus aureus d. Escherichia coli ANS: D

For example, the normal human intestinal tract contains many different types of bacteria, such as Escherichia coli. The bacteria survive in balance with the body as long as they remain in the intestine.

DIF: 2

REF: p. 107

3. ____________ is the movement of liquid through a semipermeable membrane according

to differences in the concentration of substances on either side. a. Mutualism b. Comensualism c. Diffusion d. Osmosis ANS: D

When the particles cross a permeable membrane, such as that of a cell, it is called osmosis.

DIF: 2

REF: p. 104

4. Microbes enter the body through a location called the _____________. a. portal of entry b. microbe host c. vaginal lactobacilli d. intestinal tract

ANS: A

In order for a microbe to cause disease, it must first enter the body. The entry site is called the portal of entry. Examples of portals of entry are the skin, respiratory tract, mucous membranes, and gastrointestinal tract.

DIF: 2

REF: p. 109

5. A wound is described as _______________ when exudate (accumulation of pus, drainage,

dead cells, and serum) may appear around the incision. a. suppurative b. abscessed c. necrotic d. dehisced ANS: A

Exudate (an accumulation of pus, drainage, dead cells, and serum) may appear around the incision. The wound then is described as suppurative.

DIF: 2

REF: p. 110

6. When organisms of two different species live together, this is called ________. a. symbiosis b. immunodeficiency c. host d. parasitism ANS: A

The biological relationship between organisms living together is called symbiosis.

DIF: 2

REF: p. 123

7. ______________________ is the most widespread cause of surgical site infections. a. Streptococcus pyogenes b. Pseudomonas aeruginosa c. Staphylococcus aureus d. Salmonella enterica ANS: C

Staphylococcus aureus (S. aureus) is the most widespread cause of surgical site infections.

It normally resides in healthy skin, but when transmitted to the surgical wound by direct or indirect contact, it can cause an infection.

DIF: 2

REF: p. 113

8. _______________ are single-celled prokaryotic organisms. a. Antigens b. Aerosol droplets c. Bacteria d. Droplet nuclei ANS: C

A prokaryote is one of a group of single-celled microbes that includes only bacteria and a smaller, primitive group of single-celled organisms called Archaea. In medicine, we are mainly concerned with bacteria, because they cause disease.

DIF: 2

REF: p. 111

9. The nature of the bacterial cell membrane determines a bacterium’s ________ and its

response to antibiotics. a. identity b. ability to invade the body’s defense system c. preexisting disease d. Gram stain classification ANS: D

Gram staining is routinely performed to differentiate bacteria into two primary groups, namely gram-positive and gram-negative bacteria.

DIF: 2

REF: p. 106

10. ________ is/are a long filament that is responsible for bacterial motility. a. Genetic material b. Flagellum c. Appendages d. Organelles ANS: B

A long filament extends from the surface of the cell. This structure may occur as a single strand (flagellum) or in small “tufts” (flagella). The flagella are used for movement.

DIF: 2

REF: p. 104

11. Bacteria that cannot live in the presence of oxygen are called __________. a. anaerobes b. aerobes c. spores d. endotoxins ANS: A

Others cannot live in the presence of oxygen; these are called strict anaerobes. Anaerobes are important in the process of infection, because they can proliferate in deep traumatic or surgical wounds.

DIF: 2

REF: p. 112

12. The ____________ of bacteria growth is characterized by active and sometimes rapid cell

division. a. stationary phase b. exponential (log) phase c. lag phase d. death phase ANS: B

The exponential (log) phase is characterized by active and sometimes rapid cell division.

The rate is usually constant and depends on the growth medium. This rate is often referred to as the doubling time or generation time of the bacteria.

DIF: 2

REF: p. 112

13. The laboratory test to determine the thickness of a microbe’s cell wall is

_______________. a. Gram staining b. acid-fast staining c. culture and sensitivity d. biochemical testing ANS: A

Gram staining is routinely performed to differentiate bacteria into two primary groups, namely gram-positive and gram-negative bacteria. Some bacterial cells have a very thin cell wall, whereas in others, it is thick. Gram staining reveals the thicker wall of the gram-positive bacteria.

DIF: 2

REF: p. 106

14. ________ is a potentially lethal pathogen that can cause surgical site infection and can

spread via the lymphatic system to other sites in the body, causing anaerobic cellulitis (infection of the subcutaneous tissue) and tissue necrosis (death). a. Staphylococcus epidermidis b. Pseudomonas aeruginosa c. Klebsiella d. Streptococcus pyogenes ANS: D

Many HAIs are caused by Streptococcus pyogenes (a group A beta-hemolytic streptococcus). This potentially lethal pathogen causes surgical site infection; it spreads via the lymphatic system to other sites in the body, causing anaerobic infection and tissue death.

DIF: 2

REF: p. 114

15. ____________________ is an anaerobic bacteria, referred to as “gas gangrene,” that

causes rapid tissue death in deep wounds deprived of oxygen. a. Clostridium perfringens b. Clostridium tetani c. Rickettsiae d. Mycobacterium ANS: A

Clostridium perfringens is an anaerobic bacterium that causes rapid tissue death in deep wounds deprived of oxygen. This is a relatively rare infection, but it does occur in health care settings. Historically, it has been a common infection of deep, penetrating combat wounds.

DIF: 2

REF: p. 114

16. _____________ is transmitted via blood-to-blood contact, sexual contact, and contact with

certain body fluids. a. CDC b. AIDS c. HPV d. HIV ANS: D

HIV is transmitted via blood-to-blood contact, sexual contact, and contact with certain body fluids. The following fluids are known to transmit HIV: • Blood • Semen • Vaginal secretions • Breast milk • Cerebrospinal fluid • Synovial fluid • Amniotic fluid • Any body fluid containing blood DIF: 2

REF: p. 117

17. ________ is not a separate disease organism but a syndrome that occurs because of

infection with the human immunodeficiency virus. a. AIDS b. HBV c. RNA d. Creutzfeldt-Jakob disease (CJD) ANS: A

AIDS is not a separate disease organism but a syndrome that results from infection with HIV. Patients with AIDS lack normal immune response, and certain diseases are common in these individuals.

DIF: 2

REF: p. 118

18. ______________ infection is a term for hospital-acquired infection (HAI). a. Nosocomial b. Community-acquired c. Vector d. Opportunistic ANS: A

A hospital-acquired infection (HAI), also called a nosocomial infection, is an infection acquired while the patient is in a health care institution.

DIF: 1

REF: p. 109

19. ___________ occurs in the period immediately after trauma. a. The inflammatory response b. Antimicrobial resistance c. Virulence

d. Aerosol acceptance ANS: A

The inflammatory response is the body’s innate immune response to injury. The four classic signs of inflammation are heat, redness, swelling (edema), and pain.

DIF: 1

REF: p. 122

20. When a pathogenic or nonpathogenic microorganism gains entry to a wound’s sterile

tissues and colonizes there, it is called ________. a. disease transmission b. surgical site infection c. antimicrobial resistance d. inflammatory response ANS: B

Surgical site infection begins when a pathogenic or nonpathogenic microorganism colonizes the sterile wound (incision tissues).

DIF: 1

REF: p. 109

21. Cellular organisms are divided into two types: _______________________, with each

descending from different groups. a. prokaryotes and eukaryotes b. cytoplasm and organelles c. contaminated and sterile d. diffused and cultured ANS: A

The cell is the basic unit of a living organism. Cellular organisms are divided into two types, prokaryotes and eukaryotes, each descended from different groups.

DIF: 1

REF: p. 102

22. _____________ is a rare transmissible disease that attacks the central nervous system, is

progressive, and is always fatal. a. Hepatitis A virus b. CJD c. Convalescence d. Helicobacter pylori ANS: B

CJD is a rare, transmissible disease of the nervous system that is progressive and always fatal. The disease may have an incubation period of up to 20 years. Although CJD is not contagious, it is transmissible. The mechanism of transmission is currently unknown.

DIF: 1

REF: p. 119

23. To perform chemical tests on bacteria, it is necessary to ________________. a. grow them in a laboratory environment b. diffuse them with droplets c. count them under a microscope

d. contaminate them with infection ANS: A

Chemical tests can be performed on bacteria only if they are grown in a laboratory environment (culturing). After culturing, the bacteria are tested for sensitivity to antimicrobial drugs (culture and sensitivity).

DIF: 1

REF: p. 123

24. __________ causes the greatest number of hospital-acquired infections in the United

States. a. Insufficient surgical hand scrub b. Urinary catheterization c. Genetic material d. Cross contamination ANS: B

Urinary catheterization causes the greatest number of hospital-acquired infections (HAIs) in the United States.

DIF: 1

REF: p. 124

25. Autoinfection is the spread of infection from one _________________. a. prion to a vector b. person to another c. virion to a culture d. part of the body to another location ANS: D

Introduction of an infection from one part of the body to another is called self-infection or auto-infection.

DIF: 1

REF: p. 109

26. Staining is a process of coloring microbial specimens so that they can be seen with the

_____________. a. optical microscope b. safety glasses c. naked eye d. surgical site ANS: A

Staining is used to prepare a microbial specimen for examination under the microscope.

DIF: 1

REF: p. 106

MATCHING

Choose from the terms listed and match them with their most correct description. a. Endotoxin b. Exotoxin

1. Chemicals contained within the cell wall of bacteria 2. Protein produced as a result of bacterial metabolism 1. ANS: A 2. ANS: B

DIF: 3 DIF: 3

REF: p. 113 REF: p. 113

Choose from the terms listed and match them with their most correct description. a. Endotoxin b. Exotoxin 3. Toxic effect includes fever, increased or decreased number of white blood cells, diarrhea,

shock, extreme weakness, or death.

4. Enters specific body cells and disrupts the cell’s chemical and physical structure 3. ANS: A 4. ANS: B

DIF: 3 DIF: 3

REF: p. 113 REF: p. 113

Choose from the terms listed and match them with their most correct description. a. Staphylococcus aureus b. Streptococcus pneumoniae c. Escherichia coli 5. Direct transmission occurs when the gastrointestinal tract is perforated and bowel contents

spill into the sterile peritoneal cavity.

6. Most widespread cause of surgical site infections 7. Most frequent cause of urinary tract infection 5. ANS: C 6. ANS: A 7. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 114 REF: p. 113 REF: p. 114

Chapter 09: Sterile Technique and Infection Control Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ___________ is a way of making decisions and acting on proven methods. It uses rational

decision-making rather than opinion or past practice. a. Aseptic technique b. Evidence-based practice c. Surgeons d. Surgical assistants ANS: B

Evidence-based practice is a way of making decisions and acting on proven methods. It uses rational decision-making rather than opinion or past practice. Methods derived through evidence-based practice can be traced to accepted authority (peer review) and the highest level of professional inquiry.

DIF: 2

REF: p. 161

2. _____________ is used in the health care setting for routine hand hygiene. a. Avaguard b. Alcohol foam c. Antiseptic liquid soap d. Living tissue ANS: C

Antiseptic liquid soap and hand rub gel is dispensed from wall-mounted containers is used in the health care setting for routine hand hygiene.

DIF: 2

REF: p. 130

3. Hand washing is the simplest and most important preventive measure for reducing

infection in the operating room (OR). Hand washing is ________. a. time related b. event related c. not necessary if gloves are worn d. only necessary if you come into contact with blood or bodily fluids ANS: B

All perioperative personnel must perform routine hand washing according to current guidelines. This is an event-related practice—performed before or after a specific task or event. It the most important tool for preventing infection in the health care setting.

DIF: 2

REF: p. 130

4. When supplies and instruments are opened for a case, for safety reasons ___________

should be passed directly to the surgical technologist or placed in an area on the sterile field where they are clearly visible. a. sponges

b. medications c. scalpel blades and other sharps d. delicate instruments ANS: C

Scalpel blades and other sharps should be passed directly to the sterile surgical technologist or unwrapped in an open area where they are in plain view. Blades, trocars, and other sharps should not be opened onto instrument trays, because the sharps can be hidden by other instruments.

DIF: 2

REF: p. 151

5. The _________________ is the center of the sterile field during surgery. a. gowned surgeon b. covered back table c. draped patient d. surgical technologist ANS: C

The sterile field is the area covered by sterile drapes. It includes scrubbed personnel who are gowned and gloved. The draped patient is the center of the sterile field.

DIF: 2

REF: p. 161

6. Nonsterile team members _________ lean over or reach over a sterile surface to distribute

sterile goods to the field. a. sometimes b. never c. always d. under certain conditions ANS: B

Nonsterile personnel in surgery, team members who remain outside the boundary of the sterile field and do not come in direct contact with sterile equipment, sterile areas, or the surgical wound.

DIF: 2

REF: p. 152

7. Tables draped with sterile drapes are considered sterile _______________. a. 2 inches below the top b. only at table height c. 2 inches from the lower edge of the drape d. only in the center ANS: B

Sterile drapes, including table covers must never be adjusted after they have been placed.

When draped, tables are only sterile at table height. Adjusting a drape brings a non-sterile surface into a sterile one. This rule also applies to the draped patient. Items that fall below the surface of the drape are considered contaminated.

DIF: 2

REF: p. 149

8. When water is exposed to a sterile drape or gown, it can cause ____________, which

occurs when moisture from either side of the drape serves as a vehicle for bacteria to infiltrate the drape from the nonsterile surface. a. resident flora b. transient flora c. airborne contamination d. strike-through contamination ANS: D

Strikethrough is a specific type of contamination of a sterile surface by penetration of a non-sterile fluid through its sterile covering.

DIF: 2

REF: p. 128

9. Sterile personnel must pass other sterile personnel ________. a. face to face or back to back b. right side to right side c. left side to left side d. right side to left side ANS: A

Turn back to back or face to face while maintaining distance from each other, the sterile field, and unsterile areas during position changes DIF: 2

REF: p. 157

10. Sterile gowns are considered sterile ________. a. on the entire outside b. in the entire front c. until they get blood or bodily fluids on them d. in the front of a sterile gown from the chest to the level of the sterile field ANS: D

Consider the following parts of the gown to be sterile: the front of a sterile gown from the chest to the level of the sterile field and the gowns sleeves from the cuff to 2 inches above the elbow, circumferentially [Recommendation] DIF: 2

REF: p. 145

11. Protective goggles, masks, or face shields are required during any procedure in which

there is _________________________________. a. a risk that blood, other body fluids, or particles of tissue could splash on the face b. a nonsterile team member present c. a sign indicating, they must be worn d. difficulty in the procedure ANS: A

Protective eyewear or face shields are required by OSHA as part of the Bloodborne Pathogens Precautions to protect workers exposed to splashing and splatter of blood and body fluids. They also provide physical protection during procedures in which bone is drilled or cut with power instruments. Perioperative personnel must wear eye protection when splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated, and eye contamination can be reasonably anticipated.

DIF: 2

REF: p. 135

12. Jewelry of any kind is a potential source of pathogens. The current recommendation is to

_____________. a. keep jewelry covered b. only wear earrings and necklaces c. remove all jewelry d. wear only clean jewelry ANS: C

Perioperative personnel must remove all hand jewelry before starting work. This includes bracelets, rings, and watches which increase the bacterial load on the hands and prevent effective hand antisepsis.

DIF: 2

REF: p. 130

13. The basis of ___________ is the concept of barriers between contaminated and sterile

surfaces. Sterile objects or surfaces are contained or confined to prevent contact with nonsterile objects. a. cross-contamination b. aseptic technique c. continuing education d. teamwork ANS: B

The basis of sterile technique is the concept of barriers between contaminated and sterile sur-faces. Sterile objects or surfaces are contained or confined to prevent their contact with non-sterile objects.

DIF: 2

REF: p. 161

14. If water is found in a basin when the sterile wrapper is opened, the basin is considered

_________________. a. sterile b. contaminated c. infectious d. contained ANS: B

Before opening any sterile package, always check the integrity of the outside of the package and the external chemical indicators that validate exposure to the sterilization process. Any packages with tears, holes, or water marks are contaminated and should be removed from the room for reprocessing.

DIF: 1

REF: p. 148

15. All nonsterile surfaces are considered potentially contaminated with ________

microorganisms. a. strike-through contamination b. pathogenic c. sterile d. chemical ANS: B

When a surface is sterile, it is completely free of all living microorganisms, including bacterial spores. A sterile surface is known to be sterile only after it has been proven to have been processed with a prescribed method of sterilization. Surgical contamination occurs when potentially pathogenic microorganisms are introduced into the surgical wound, or any sterile area of the sterile field, including surgical instruments, devices, supplies, and drugs used during surgery.

DIF: 1

REF: p. 127

16. _____________ infection is a postoperative infection of the surgical wound. a. Surgical-site b. Community-acquired c. Chemical barrier d. Physical barrier ANS: A

Surgical-site infection is often the result of contamination of the tissues by microorganisms during the intraoperative period.

DIF: 1

REF: p. 126

17. _______________ provide a barrier between a nonsterile surface and the working area of

the sterile field. a. Sterile drapes b. Sterilization containers c. Mayo stands d. Antiseptics ANS: A

Physical barrier: In surgery, a barrier that separates a sterile surface from a nonsterile surface. Examples are sterile surgical gloves, gowns, and drapes.

DIF: 1

REF: p. 125

18. The top ________ of a sterile table is the only part considered sterile. a. and 1 inch down the side b. only c. and bottom d. 3 inches ANS: B

Remember that sterile drapes, including table covers must never be adjusted after they have been placed. When draped, tables are only sterile at table height. Adjusting a drape brings a non-sterile surface into a sterile one. This rule also applies to the draped patient.

Items that fall below the surface of the drape are considered contaminated.

DIF: 9

REF: p. 149

19. _____________ is based on surgical conscience: that is, in surgery, the ethical motivation

to immediately report surgical errors including contamination of the sterile field. a. Evidence-based practice b. Surgical conscience c. Asepsis d. Aseptic technique ANS: D

Aseptic technique is based on surgical conscience: In surgery, the ethical motivation to immediately report surgical errors including contamination of the sterile field.

DIF: 2

REF: p. 126

20. ________________ is when the surgeon’s gloved hand accidentally touches the nonsterile

edge of the surgical drape. a. Contamination b. Surgical conscience c. Asepsis d. Aseptic technique ANS: A

The surgeon’s gloved hand accidentally touches the nonsterile edge of the surgical drape.

His glove is contaminated.

DIF: 2

REF: p. 128

21. The ___________ is/are worn by both sterile and nonsterile surgical personnel in the

perioperative environment. a. scrub suit b. body lotion c. leather shoes d. laboratory coat ANS: A

Perioperative personnel are required to wear scrub suit attire that has been freshly laundered and not previously worn.

DIF: 2

REF: p. 133

22. Before opening a sterile pack, the scrub should also check the outside package for the

__________. a. right size b. integrity c. right wrap d. all the above

ANS: B

Before opening any sterile package, always check the integrity of the outside of the package and the external chemical indicators that validate exposure to the sterilization process. Any packages with tears, holes, or water marks are contaminated and should be removed from the room for reprocessing.

DIF: 2

REF: p. 148

23. What OR furniture should the procedure pack be placed on before opening? a. Ring stand b. Mayo stand c. Back table d. Prep stand ANS: C

A basic pack also be called a procedure pack is opened in place on the back table.

DIF: 2

REF: p. 149

24. What OR furniture should the instrument tray be placed on before opening? a. Ring stand b. Mayo stand c. Back table d. Small table (prep stand) ANS: D

Heavy instrument trays which are not contained in a sterile barrier system must be opened on a small table. The wrapped tray is placed on the table and the wrapper opened to create a small sterile field. The scrubbed surgical technologist may move the tray onto the back table or leave it in place as part of the sterile field.

DIF: 2

REF: p. 150

25. What OR furniture should the basin set be placed on before opening? a. Ring stand b. Mayo stand c. Back table d. Prep stand ANS: A

This means that the wrapped sterile item is positioned on an instrument table, ring stand (for large basins) or small side table. Basins are used to hold large quantities of sterile water or saline may opened in place. Do not reach over the basin to open it. It is better technique to move around the sterile package and pull the flaps toward you.

DIF: 2

REF: p. 148

MATCHING

Choose from the terms listed and match them with their most correct description. a. Antiseptics

b. Asepsis c. Aseptic technique 1. Chemicals that reduce the number of microorganisms in body tissue or on skin 2. Takes time and practice to develop 3. In surgery, it is a state of the presence of no pathogens 1. ANS: A 2. ANS: C 3. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 128 REF: p. 126 REF: p. 128

Choose from the terms listed and match them with their most correct description. a. Antiseptics b. Asepsis c. Aseptic technique 4. Used for the surgical scrub 5. Methods or practices in health care that promote and maintain a state of asepsis 6. “Without infection” 4. ANS: A 5. ANS: C 6. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 128 REF: p. 129 REF: p. 128

Choose from the terms listed and match them with their most correct description. a. Antiseptics b. Asepsis 7. The absence of pathogenic microorganisms on an animate surface or on body tissue 8. May prevent recolonization for a limited period 7. ANS: B 8. ANS: A

DIF: 3 DIF: 3

REF: p. 128 REF: p. 125

Choose from the terms listed and match them with their most correct description. a. Sterile b. Contaminated 9. Draped back tabletop 10. Cuff of gown after donning gloves 9. ANS: A 10. ANS: B

DIF: 3 DIF: 3

REF: p. 149 REF: p. 141

Choose from the terms listed and match them with their most correct description. a. Sterile b. Contaminated 11. Armpits 12. Draped patient 11. ANS: B

DIF: 3

REF: p. 145

12. ANS: A

DIF: 3

REF: p. 161

Chapter 10: Decontamination, Sterilization, and Disinfection Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Sterile instruments and supplies are loaded onto the ___________ before surgery and

transported to the surgical suite. a. case cart b. elevator c. personnel d. conveyor ANS: A

Sterile instruments and supplies are loaded onto the case cart before surgery and transported to the surgical suite.

DIF: 2

REF: p. 168

2. ______________ items must be sterile. These items enter sterile tissue or the vascular

system. a. Semicritical b. Noncritical c. Critical d. Low critical ANS: C

Critical items are those that come in contact with sterile body tissues such as internal organ systems and the vascular system. Examples are surgical instruments, vascular cannulas, and hypodermic needles. All medical devices in this category must be sterile.

DIF: 2

REF: p. 165

3. Because paper products are difficult or impossible to decontaminate, patient’s charts,

x-rays, and laboratory documentation should be ________. a. left outside of the surgical suite b. kept free from contamination c. flash sterilized d. immediately placed in plastic bags ANS: B

Because paper products are difficult or impossible to decontaminate, every effort should be made to keep patients’ charts, laboratory slips, radiograph reports and radiographs, and any paper documentation free of contamination.

DIF: 2

REF: p. 187

4. The phrase flash sterilization has been replaced by _____________ sterilization, in which

unwrapped surgical equipment is sterilized by a high-vacuum steam sterilization method just before use. a. just-in-time

b. quick c. right on time d. immediate-use steam sterilization—IUSS ANS: D

A high-speed pre-vacuum sterilizer is used in the operating room and in other areas of the hospital to sterilize items for immediate use. The immediate-use steam sterilizer uses extremely high temperatures to achieve a short cycle. In the past, the term flash sterilization was used to describe this process. In 2010 standards agencies agreed that the term flash sterilization does not reflect the complexity of sterilization for immediate use.

Therefore, the term has been replaced with immediate-use steam sterilization (IUSS).

Standards for IUSS have been adapted by professional organizations, including AST. DIF: 2

REF: p. 179

5. ___________________ is used to sterilize objects that cannot tolerate the heat, moisture,

and pressure of steam sterilization. a. Glutaraldehyde solution b. Peracetic acid c. Gas plasma d. Ethylene oxide ANS: D

Ethylene oxide EO is used to sterilize items that are heat and moisture sensitive. It can be used for delicate instruments, including microsurgical instruments and those with optical systems. It is highly penetrating, which makes it ideal for complex instruments with delicate inner components.

DIF: 2

REF: p. 180

6. The temperature of the gas directly affects the penetration of items in the chamber.

Operating temperatures range from ____________ for a “cold” cycle and ________ for a “warm” cycle. a. 85° to 100° F and 130° to 145° F b. 75° to 79° F and 130° to 145° F c. 85° to 100° F and 100° to 125° F d. 85° to 95° F and 100° to 115° F ANS: A

The temperature of the gas directly affects the penetration of items in the chamber.

Operating temperatures range from 85° to 100° F (29° to 37.7° C) for a “cold” cycle and 130° to 145° F (54° to 63° C) for a “warm” cycle.

DIF: 2

REF: p. 180

7. The recommended practice to damp dust the surgical lights, furniture, and fixed equipment

in the operating suite is ___________. a. at the end of the day b. before the beginning of each shift c. before each case of the day d. before the first case of the day

ANS: D

The recommended practice before the first case of the day is damp dusting of surgical lights, furniture, and fixed equipment in the operating suite. A clean, lint-free cloth and a hospital-grade chemical disinfectant are used.

DIF: 2

REF: p. 186

8. Power-driven surgical instruments (e.g., drills and saws) should be disassembled before

________________. a. using them b. semi critical cleaning c. noncritical cleaning d. steam sterilization ANS: D

Power-driven surgical instruments (e.g., drills, reamers, and saws) should be disassembled before steam sterilization. Hoses can be coiled loosely during packaging, and all delicate switches and parts should be protected during preparation.

DIF: 2

REF: p. 172

9. The ultrasonic cleaner removes debris from instruments by a process called __________. a. cavitation b. agitation c. osculation d. cavitation and agitation ANS: A

The ultrasonic cleaner removes debris from instruments by a process called cavitation.

High-frequency sound waves are generated through a water bath, causing tiny air bubbles trapped within the debris to implode (explode inwardly); this releases the debris from the instrument.

DIF: 2

REF: p. 169

10. A _________________ is a paper strip or specially treated tape that changes color when

exposed to a specific temperature. a. wrapping paper b. litmus paper c. paper monitor d. chemical indicator ANS: D

A method of testing a sterilization parameter. Chemical strips sensitive to physical conditions, such as temperature, are placed with the item being sterilized and change color when the parameter is reached; sometimes called a chemical monitor.

DIF: 2

REF: p. 176

11. The Spaulding classification of reprocessing instruments and patient materials assigns

three risk levels based on the specific region of the body where the device will be used.

These levels are critical, semi critical, and ________.

a. b. c. d.

noncritical uncritical ultra-critical low-critical

ANS: A

The Spaulding category associates high risk with critical devices. Intermediate risk is assigned to semi critical devices, and low-risk devices are noncritical.

DIF: 2

REF: p. 165|p. 166

12. Which class includes indicators that are the most exacting and accurate of all indicators

and that react to all critical values over a specified range in the sterilization process? a. 5 b. 4 c. 3 d. 2 ANS: A

Class 5 (integrating parameters) includes indicators that react to all critical values over a specified range in the sterilization process. These are the most exacting and accurate of all indicators.

DIF: 2

REF: p. 178

13. Which class includes indicators that respond to only one critical parameter with an exact

value? a. 2 b. 5 c. 1 d. 3 ANS: D

Class 3 (single parameter) includes indicators that respond to only one critical parameter with an exact value. An example is a heat-sensitive pellet (encased in a glass tube) that melts only at a certain temperature that is consistent with the sterilization method. The pellet is placed in specific areas of the sterilization chamber.

DIF: 2

REF: p. 178

14. Class _______ indicators are used for internal pack control of each cycle run, not for the

overall performance of the sterilizer for all cycles. a. 2 b. 6 c. 4 d. 5 ANS: B

Class 6 indicators (emulating indicators) are used for internal pack control of each cycle run, not for the overall performance of the sterilizer for all cycles.

DIF: 2

REF: p. 178

15. Class ____ indicators measure parameters. Examples include the Bowie-Dick and daily

air-removal tests for the presence of pure air (no steam) in the sterilization chamber. a. 4 b. 2 c. G d. L ANS: B

Class 2 (specialty indicators) are used for specific tests that measure parameters. Examples include the Bowie-Dick and daily air-removal tests for the presence of pure air (no steam) in the sterilization chamber.

DIF: 1

REF: p. 178

16. Class ________ is represented by multivariable indicators that react to two or more

parameters. An example is internal chemical indicators printed on a paper strip. a. 4 b. 2 c. L d. G ANS: A

Class 4 (multiparameter) is represented by multivariable indicators that react to two or more parameters. An example is internal chemical indicators printed on a paper strip.

DIF: 1

REF: p. 178

17. There are three distinct phases in all types of steam sterilizers. __________ is when air is

removed from the chamber and replaced with steam. a. Conditioning b. Exposure c. Parameter d. Indication ANS: A

The phase of steam sterilization when air is removed from the chamber and replaced with steam is called conditioning (sometimes called preconditioning).

DIF: 1

REF: p. 178

18. Two types of steam sterilizers are used in the clinical setting: __________. a. gravity displacement and Sterrad b. gravity displacement and dynamic c. dynamic and internal d. preconditioned and unconditioned ANS: B

Two types of steam sterilizers are used in the clinical setting: gravity displacement and dynamic (also called prevacuum or high-vacuum sterilizers).

DIF: 1

REF: p. 178

19. The ______________ sterilizer operates on the principle that air is heavier than steam. a. dynamic b. gravity displacement c. unconditioned d. preconditioned ANS: B

The gravity displacement sterilizer: A type of steam sterilizer that removes air by gravity.

DIF: 1

REF: p. 163

20. The important factor to remember about ___________ is that they do not indicate sterility,

only that certain conditions for sterility have been met. a. indicators b. Bowie-Dick tests c. detergents d. case cart systems ANS: A

In this test, commercially prepared paper strips or tape are chemically treated to change color when exposed to specific parameters of the sterilization process such as temperature and concentration of chemical sterilant DIF: 1

REF: p. 176

21. ___________ is a skilled, certified profession that requires expertise in the science and

practice of materials management, decontamination, and sterilization. a. Certified Surgical Technologists b. Sterile Processing Technicians c. Enzymatic cleaner d. High vacuum sterilizer ANS: B

The personnel responsible for this are the Sterile Processing Technicians. This is a skilled, certifiable profession that requires expertise in the science and practice of materials management, decontamination, and sterilization.

DIF: 1

REF: p. 166

MATCHING

Choose from the terms listed and match them with their most correct description. a. Critical items b. Noncritical items c. Semi critical items 1. Stethoscopes, blood pressure, and tourniquet cuffs 2. Laryngoscopes, bronchoscopes, and endotracheal tubes 3. Objects that enter sterile tissue or the vascular system

1. ANS: B 2. ANS: C 3. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 166 REF: p. 162 REF: p. 162

Choose from the terms listed and match them with their most correct description. a. Critical items b. Noncritical items c. Semi critical items 4. Must be sterile 5. Can include bed linens, crutches, tables 6. Come into contact with mucous membranes or nonintact skin 4. ANS: A 5. ANS: B 6. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 162 REF: p. 162 REF: p. 162

Choose from the terms listed and match them with their most correct description. a. Critical items b. Noncritical items 7. Include vascular and urinary catheters 8. Not required to be sterile because they do not penetrate intact tissues 7. ANS: A 8. ANS: B

DIF: 3 DIF: 3

REF: p. 162 REF: p. 162

Choose from the terms listed and match them with their most correct description. a. Critical items b. Noncritical items 9. Must be sterilized before use on a patient 10. Exposed to the intact skin but not mucous membranes 9. ANS: A 10. ANS: B

DIF: 3 DIF: 3

REF: p. 162 REF: p. 166

Choose from the terms listed and match them with their most correct description. a. Disinfection b. Sterilization 11. Used for noncritical items 12. Uses steam, ethylene oxide, peracetic acid, or cobalt-60 11. ANS: A 12. ANS: B

DIF: 3 DIF: 3

REF: p. 186 REF: p. 188

Choose from the terms listed and match them with their most correct description. a. Disinfection b. Sterilization 13. Process by which all microorganisms, including spores, are destroyed

14. Uses isopropyl alcohol 70% to 90%, glutaraldehyde, and iodophor solution 13. ANS: B 14. ANS: A

DIF: 3 DIF: 3

REF: p. 161 REF: p. 185

Choose from the terms listed and match them with their most correct description. a. Disinfection b. Sterilization 15. Used for anesthesia equipment, gastrointestinal endoscopes, bronchoscopes 16. Monitored by chemical and biological methods to ensure patient safety 15. ANS: A 16. ANS: B

DIF: 3 DIF: 3

REF: p. 183 REF: p. 188

Chapter 11: Surgical Instruments Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. A ratchet mechanism that holds an instrument in a closed position is called the ________. a. clamp b. points c. shank d. box lock ANS: D

Box lock: A ratchet mechanism that holds the instrument in a closed position DIF: 2

REF: p. 189

2. A McPherson ____ lid speculum is used to retract the eyelids. a. handheld b. superficial c. malleable d. self-retaining ANS: D

A McPherson self-retaining lid speculum is used to retract the eyelids.

DIF: 2

REF: p. 198

3. A ________ is used to cut and extract tissue and is distinguished by having a

spring-loaded hinge. a. retractor b. clamp c. forcep d. rongeur ANS: D

A rongeur is used to cut and extract tissue and is distinguished by having a spring-loaded hinge.

DIF: 2

REF: p. 192

4. Fibrous connective tissue requires heavy scissors, such as the ________ scissors for

cutting. a. curved Mayo b. Metzenbaum c. Stevens tenotomy d. Castroviejo ANS: A

Fibrous connective tissue requires heavier scissors, such as the curved Mayo scissors.

DIF: 2

REF: p. 192

5. _______ blades and handles are smaller and more delicate than those used in general

surgery. a. Beaver b. Number 4 c. Amputation d. Smillie ANS: A

Beaver blades and handles are smaller and more delicate than those used in general surgery.

DIF: 2

REF: p. 192

6. A(n) _______ blade is detachable from the knife handle, although single-use scalpels are

available and these do not detach. a. scalpel b. electrocautery c. Metzenbaum d. harmonic ANS: A

A scalpel blade is detachable from the knife handle, although single-use scalpels are available and these do not detach.

DIF: 2

REF: p. 191

7. The Babcock clamp is a non-occlusive, delicate clamp used to manipulate the intestines

________ organs. a. reproductive b. intestinal c. kocher d. tissue ANS: A

The Babcock clamp is a non-occlusive, delicate clamp used to manipulate the intestines reproductive organs.

DIF: 2

REF: p. 196

8. Most ________ are power driven electrically or pneumatically with compressed air or

nitrogen. a. grasps b. saws c. tools d. rigids ANS: B

Most saws are power driven electrically or pneumatically with compressed air or nitrogen.

Smaller saws used in paranasal surgery are handheld.

DIF: 2

REF: p. 194

9. Strong dissecting scissors such as curved ______ scissors are used on fascia and large

tendons. a. Metzenbaum b. bandage c. Mayo d. tenotomy ANS: C

Strong dissecting scissors, such as curved Mayo scissors, are used on fascia and large tendons.

DIF: 2

REF: p. 204

10. Toothed ________ are used for suturing adipose tissue. a. specula b. needle holders c. forceps d. clamps ANS: C

Toothed forceps are used for suturing adipose tissue.

DIF: 2

REF: p. 204

11. The ___________, which has a T tip with fine serrations at the tip, often is used to clamp

or grasp adipose tissue. a. Doyen b. Satinsky c. Allis clamp d. bulldog ANS: C

The Allis clamp, which has a T-shaped serrated tip, is often used to clamp or grasp adipose tissue.

DIF: 2

REF: p. 202|p. 204

12. Skin is ________, relatively fibrous, and strong. a. semisolid b. elastic c. boggy d. intestinal ANS: B

Skin is elastic, relatively fibrous, and strong.

DIF: 2

REF: p. 202

13. The _______ carbide inserts in needle holders prevent the needle from slipping or rotating. a. ebonizing b. diamond

c. chromium d. tungsten ANS: D

The tungsten carbide inserts in needle holders prevent the needle from slipping or rotating.

DIF: 2

REF: p. 209

14. Only partially __________ clamps and smooth tissue forceps are used in the lungs, spleen,

liver, or thyroid. a. occluding b. atraumatic c. single-action rongeur d. double-action rongeur ANS: A

Only partially occluding clamps and smooth tissue forceps are used in the lungs, spleen, liver, or thyroid.

DIF: 2

REF: p. 202

15. Fine ________ are used in ear, nose, and throat surgery for the delicate bones and surfaces

of the nasal sinuses and ear. a. rasps b. osteotomes c. chisels d. anvils ANS: A

Fine rasps are used for delicate bones and surfaces such as the nasal sinuses.

DIF: 2

REF: p. 193

16. ______ are available in many widths and sizes that fit a particular specialty. a. Tools b. Chisels c. Tubular structures d. Alloys ANS: B

Chisels are available in many widths and sizes that fit a particular specialty.

DIF: 2

REF: p. 193

17. The ________ is a slender, tube-like instrument with rounded ends. a. dilator b. curette c. chisel d. stricture ANS: A

The dilator is a slender, tube-like instrument with rounded ends.

DIF: 2

REF: p. 200

18. The cutting assembly includes a(n) ________, which clamps the tissue against the staple

cartridge. a. anvil b. probe c. gouge d. anastomosis ANS: A

The cutting assembly includes an anvil, which clamps the tissue against the staple cartridge.

DIF: 2

REF: p. 199

19. A ________ is used to cut and extract tissue and is distinguished by having a

spring-loaded hinge. a. rongeur b. transector c. Babcock d. ratchet ANS: A

A rongeur is used to cut and extract tissue and is distinguished by having a spring-loaded hinge.

DIF: 2

REF: p. 192

20. A partial ________ or atraumatic clamp has locking ratchets, but the tips and shanks do

not fully lock down in a firm grip. a. occlusion b. smooth c. rough d. hinge ANS: A

A partial occlusion or atraumatic clamp has locking ratchets, but the tips and shanks do not fully lock down in a firm grip.

DIF: 2

REF: p. 195

21. A ________ is a graduated, smooth instrument that is used to increase the circumference

of an orifice. a. clamp b. dilator c. anvil d. ratchet ANS: B

A dilator is a graduated, smooth instrument that is used to increase the circumference of an orifice.

DIF: 2

REF: p. 189

22. A ________ is a grasping instrument with sharp pointed tips, generally used to manipulate

or grasp tissue such as the thyroid or cervix. a. tenaculum b. Babcock c. Kelly d. Lowman ANS: A

A tenaculum is a grasping instrument with sharp, pointed tips, generally used to manipulate or grasp tissue such as the thyroid or cervix.

DIF: 2

REF: p. 189

23. Suction (aspiration) is needed during a surgical procedure to clear blood, fluids, and small

bits of tissue debris from the surgical site and provide an unobstructed view of the ____________. a. poole b. fossil c. backside d. anatomy ANS: D

Suction (aspiration) is needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site and provide an unobstructed view of the anatomy.

DIF: 2

REF: p. 198

24. The center hinge screw of the ________ can become worn with time. a. scissors b. Mayo c. railing d. straightener ANS: A

The center hinge screw of the scissors can become worn with time.

DIF: 2

REF: p. 207

25. A ________ has two or four separate sharp teeth that mesh together while penetrating

tissue in a pincer hold. a. retractor b. clamp c. forcep d. tenaculum ANS: D

The tenaculum is a specific type of holding clamp whose tips contain very sharp teeth that mesh together while penetrating the tissue in a pincer hold. A tenaculum may have two or four separate teeth, which are extremely sharp.

DIF: 2

REF: p. 196

26. The Heaney clamp is used specifically in ________ surgery to grasp the uterine ligaments. a. orthopedic b. general c. urological d. gynecological ANS: D

Use strong ligament clamps, such as Heaney, for uterine ligaments DIF: 2

REF: p. 203

27. ____________ reduces glare but is also prone to staining. a. Highly polished or mirror finish b. Satin finish c. Black chromium d. Satin finish ANS: D

Satin finish reduces glare but is also prone to staining.

DIF: 2

REF: p. 190

28. __________ instruments resist staining. a. Highly polished or mirror finish b. Satin finish c. Black chromium d. Titanium anodizing ANS: A

Highly polished or mirror finish instruments resist staining.

DIF: 2

REF: p. 190

29. _______________ is a method that imparts color and hardness to the surface of titanium. a. Highly polished or mirror finish b. Satin finish c. Black chromium d. Titanium anodizing ANS: D

Titanium anodizing is a method that imparts color and hardness to the surface of titanium.

DIF: 2

REF: p. 190

30. _____________ finish is used on laser surgery instruments. a. Highly polished or mirror b. Satin c. Black chromium d. Titanium anodizing

ANS: C

Black chromium finish is used on laser surgery instruments.

DIF: 2

REF: p. 190

31. The __________ is a small cup with a sharpened, serrated, or smooth rim at the end of the

handle. a. rongeur b. osteotome c. curette d. shears ANS: C

The curette is a small cup with a sharpened, serrated, or smooth rim at the end of the handle.

DIF: 2

REF: p. 193

32. A(n) ____ is a V-shaped bone chisel. a. rongeur b. osteotome c. curette d. gouge ANS: D

A gouge is a V-shaped bone chisel.

DIF: 2

REF: p. 189

33. A(n) _________ is used to remodel bone. a. rasp b. curette c. chisel d. osteotome ANS: A

A rasp is used to remodel bone.

DIF: 2

REF: p. 193

MATCHING

Choose from the terms listed and match them with their most correct description. a. Grasping and holding b. Cutting and dissecting c. Retracting or exposing 1. Scalpel blades are numbered consistently among manufacturers, and the number indicates

their shape and size.

2. Holds tissue against the walls of the surgical wound by mechanical action

3. During suturing, the surgeon will use this in one hand and the needle holder with the

suture in the other.

1. ANS: B 2. ANS: C 3. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 191 REF: p. 197 REF: p. 191

Choose from the terms listed and match them with their most correct description. a. Grasping and holding b. Cutting and dissecting 4. The tenaculum contains one or more teeth in the jaws that can be delicate or heavy.

5. Beaver handle, commonly used in eye and ear surgery 4. ANS: A 5. ANS: B

DIF: 3 DIF: 3

REF: p. 196 REF: p. 192

Chapter 12: Perioperative Pharmacology Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ________ is used for augmentation of labor. a. Epinephrine b. Acetic acid c. Lugol’s solution d. Oxytocin ANS: D

Oxytocin is used for augmentation of labor.

DIF: 2

REF: p. 247

2. _______________ stimulate the production of urine by the kidneys. a. Ophthalmic drugs b. Colloids c. Diuretics d. Contrast mediums ANS: C

Diuretics stimulate the production of urine by the kidneys.

DIF: 2

REF: p. 246

3. Colored dyes are usually dispensed to the sterile field in glass vials. The most common

types are gentian violet, methylene blue, and ________. a. indigo carmine b. color codes c. abnormal shades d. performers ANS: A

Colored dyes are usually dispensed to the sterile field in glass ampoules. The most common types are: Gentian violet, Methylene blue, Indigo carmine DIF: 2

REF: p. 242

4. A(n) ________ is a drug that inhibits blood clot formation but does not dissolve clots. a. hemostatic agent b. absorbable collagen c. anticoagulant d. antineoplastic agent ANS: C

An anticoagulant is a drug that inhibits blood clot formation but does not dissolve clots.

DIF: 2

REF: p. 238

5. Angina, which is chest pain associated with decreased oxygen supply to the heart muscle,

is partly treated using ________ drugs. a. antianginal b. osmotic c. aminoglycosides d. antimicrobials ANS: A

Antianginal drugs are used to treat angina, which is chest pain associated with decreased oxygen supply to the heart muscle.

DIF: 2

REF: p. 245

6. Knowledge of nerve transmission is basic to an understanding of how anesthetics and

other _____ drugs work. a. CNN b. CBS c. ABC d. CNS ANS: D

Knowledge of nerve transmission is basic to an understanding of how anesthetics and another CNS drugs work.

DIF: 2

REF: p. 238

7. Only intravenous solutions are used to________ blood vessels or near open blood vessels. a. produce b. irrigate c. contrast d. direct ANS: B

Only intravenous solutions are used to irrigate blood vessels or near open blood vessels.

DIF: 2

REF: p. 245

8. A ________ tablet is placed between the gum and mucous membrane of the cheek. a. buccal b. topical c. oral d. sublingual ANS: A

A buccal tablet is placed between the gum and mucous membrane of the cheek.

DIF: 2

REF: p. 230

9. Exogenous ________ for injection is available in different strengths and differing duration

of action. a. tuberculin b. Luer-Lok

c. insulin d. catheter tip ANS: C

Exogenous insulin for injection is available in different strengths and differing duration of action.

DIF: 2

REF: p. 247

10. The movement of a drug through the tissues and cells of the body, including the processes

of absorption, distribution, and localization in tissues; biotransformation; and excretion by mechanical or chemical means is called _______________. a. pharmacodynamics b. pharmacokinetics c. metabolism d. absorption ANS: B

The movement of a drug through the tissues and cells of the body, including the processes of absorption, distribution, and localization in tissues; biotransformation; and excretion by mechanical and chemical means.

DIF: 2

REF: p. 213

11. Drug delivery devices such as ________ are calibrated in small increments to provide a

high level of accuracy. a. calibrated cups b. syringes c. calibrated basins d. spoons ANS: B

Drug delivery devices such as syringes are calibrated in small increments to provide a high level of accuracy.

DIF: 2

REF: p. 248

12. A drug applied to the skin or mucous membranes is _______. a. subcutaneous b. parenteral c. topical d. instill ANS: C

Topical refers to application of a drug to the skin or mucous membranes.

DIF: 2

REF: p. 213

13. To reduce drug error when drugs are being used in the sterile field, each and every drug

container and its delivery device must be ____________. a. used only once b. closely watched by the surgeon

c. sealed d. labeled ANS: D

All pharmaceutical products, including implants, are labeled with specific information mandated by the U.S. Food and Drug Administration.

DIF: 2

REF: p. 216

14. The ________ is the one that has been ordered by the surgeon or other health care

provider. a. concentration b. right drug c. wrong drug d. type ANS: B

The right drug is the one that has been ordered by the surgeon or other health care provider.

DIF: 2

REF: p. 232

15. The ________ identifies a drug by its molecular structure. a. generic name b. drug nomenclature c. trade name d. chemical name ANS: D

The chemical name of a drug is derived from its molecular formula.

DIF: 2

REF: p. 216

16. ____________ is an undesirable or intolerable reaction to a drug administered at the

normal dosage. a. Toxicity b. A side effect c. An adverse reaction d. Anaphylaxis ANS: C

An adverse reaction is an undesirable or intolerable reaction to a drug administered at the normal dosage.

DIF: 2

REF: p. 230

17. Following ________ of a drug, the patient is assessed for physiological changes, including

adverse reactions. a. absorption b. metabolism c. elimination d. administration

ANS: D

Following the administration of a drug, the patient is assessed for physiological changes, including adverse reactions.

DIF: 2

REF: p. 230

18. Changes (both intended and unintended) in the body as a result of a drug are called

___________________. a. pharmacokinetics b. pharmacodynamics c. physiodynamics d. physiokinetics ANS: B

Changes (both intended and unintended) in the body as a result of a drug are called pharmacodynamics.

DIF: 1

REF: p. 219

19. ___________ is the study of movement of drugs through the body and the changes that

occur in the drug. a. Pharmacokinetics b. Pharmacodynamics c. Physiodynamics d. Physiokinetics ANS: A

Pharmacokinetics is the study of the movement of drugs through the body and the changes that occur in the drug.

DIF: 2

REF: p. 217

20. Most drugs are eliminated or cleared from the body mainly through the __________. a. lungs b. kidneys c. skin d. urinary tract ANS: B

Most drugs are eliminated through the urinary tract.

DIF: 2

REF: p. 219

21. The ________ is required to handle and deliver a number of different categories of drugs

used on the sterile field. a. anesthesia provider b. surgical technologist c. contrast medium d. apothecary ANS: B

The surgical technologist is required to handle and deliver a number of different categories of drugs.

DIF: 2

REF: p. 233

22. The ________ is a clear, injectable liquid that is radiopaque (opaque on radiographs). a. iodinated contrast medium b. diagnostic dye c. intrathecal d. topical ANS: A

An iodinated contrast medium (ICM) is a clear, injectable liquid that is radiopaque (opaque on radiographs).

DIF: 2

REF: p. 241

23. A(n) ________ is used as a diagnostic tool to differentiate normal cells from abnormal

ones. a. milliliter b. stain c. number system d. irrigation ANS: B

A stain is used as a diagnostic tool to differentiate normal cells from abnormal ones.

DIF: 2

REF: p. 242

24. Irrigation solutions are maintained at body temperature to prevent ________. a. hypothermia b. sickness c. waste d. excess ANS: A

Irrigation solutions are maintained at body temperature to prevent hypothermia.

DIF: 2

REF: p. 227

25. The most extreme form of ________ is anaphylactic shock, which can lead to death. a. uterotropics b. pitressin c. sensitivity d. isoproterenol ANS: C

The most extreme form of sensitivity is anaphylactic shock, which can lead to death.

DIF: 2

REF: p. 231

26. The ________ has/have developed a list of abbreviations that can lead to drug errors.

a. b. c. d.

agents drug administration medical offices Joint Commission

ANS: D

The Joint Commission has developed a list of abbreviations that can lead to drug errors.

DIF: 2

REF: p. 232

27. The patient may be started on _______ antibiotics a few hours before surgery, to prevent

postoperative infection. a. scheduled b. intravenous c. solid d. liquid ANS: B

The patient may be started on intravenous antibiotics a few hours before surgery, to prevent postoperative infection.

DIF: 2

REF: p. 242

28. Penicillin was developed during the early ________. a. 1940s b. 1950s c. 1960s d. 1970s ANS: A

Penicillin was developed during the early 1940s.

DIF: 2

REF: p. 242

29. Macrolides are ________ at low levels and bactericidal in high doses. a. stimulant b. liquidity c. bacteriostatic d. chemicals ANS: C

Macrolides are bacteriostatic at low levels and bactericidal in high doses.

DIF: 2

REF: p. 243

30. ________ is/are effective against gram-negative bacteria, in which they inhibit protein

synthesis. a. Aminoglycosides b. Ancef c. Transdermal d. Heparin ANS: A

Aminoglycosides are effective against gram-negative bacteria, in which they inhibit protein synthesis.

DIF: 2

REF: p. 243

31. Whole blood contains serum and blood cells plus anticoagulant and ___________. a. gelfoam b. preservative c. thrombin d. bone wax ANS: B

Whole blood contains serum and blood cells plus anticoagulant and preservative.

DIF: 2

REF: p. 234

32. One method of blocking ________ is to administer a competitive antagonist drug that has

an affinity for the postsynaptic receptor. a. absorption b. distribution c. metabolism d. neurotransmission ANS: D

One method of blocking neurotransmission is to administer a competitive antagonist drug that has an affinity for the postsynaptic receptor.

DIF: 2

REF: p. 238

33. ___________ is/are among the most common drugs used for moderate and severe pain

control. a. Peaks b. Distribution c. Opiates d. Metabolism ANS: C

Opiates are among the most common drugs used for moderate and severe pain control.

DIF: 2

REF: p. 240

34. True allergy to a drug is mediated by the __________. a. immune system b. cooling system c. liquid system d. allergy system ANS: A

True allergy to a drug is mediated by the immune system and requires previous exposure to substances in the drug or a genetic predisposition to allergy.

DIF: 2

REF: p. 231

35. Antifungal drugs are used for ________ and systemic fungal disease. a. anaphylactic b. superficial c. antibiotics d. tuberculin ANS: B

Antifungal drugs are used for treating superficial and systemic fungal diseases.

DIF: 2

REF: p. 243

36. Antacids reduce gastric fluid ________ and volume. a. patients b. acidity c. diabetes d. adolescents ANS: B

Antacids reduce gastric fluid acidity and volume.

DIF: 2

REF: p. 246

37. A specific protocol (method) is used to receive and deliver drugs to the ________ field. a. bleeding b. hemorrhage c. closure d. sterile ANS: D

A specific protocol (method) is used to receive and deliver drugs to the sterile field.

DIF: 2

REF: p. 248

38. One of the most common sources of drug error is failure to correctly label syringes and

other drug _________ devices. a. delivery b. routine c. traveler d. ringer ANS: A

One of the most common sources of drug error is failure to correctly label syringes and other drug delivery devices.

DIF: 2

REF: p. 248

MATCHING

Choose from the terms listed and match them with their most correct description. a. Adverse reactions b. Toxicity

1. An undesirable or intolerable reaction to a drug administered at the normal dosage 2. Occurs when the therapeutic dosage of a drug is exceeded 1. ANS: A 2. ANS: B

DIF: 3 DIF: 3

REF: p. 230 REF: p. 219

Choose from the terms listed and match them with their most correct description. a. Adverse reactions b. Toxicity 3. Not expected but may be predictable in some individuals 4. The therapeutic window is the highest and lowest amount of a drug needed to produce the

desired effect without causing 3. ANS: A 4. ANS: B

DIF: 3 DIF: 3

REF: p. 230 REF: p. 219

Choose from the terms listed and match them with their most correct description. a. Antibiotic b. Hemostatic 5. Bacitracin 6. Used as a direct topical application to areas of active bleeding to control the bleeding 5. ANS: A 6. ANS: B

DIF: 3 DIF: 3

REF: p. 242 REF: p. 235

Choose from the terms listed and match them with their most correct description. a. Antibiotic b. Hemostatic 7. Used to prevent postoperative wound infections 8. Gelfoam 7. ANS: A 8. ANS: B

DIF: 3 DIF: 3

REF: p. 242 REF: p. 236

Choose from the terms listed and match them with their most correct description. a. Hemostatic b. Anticoagulant 9. Heparin 10. Thrombin 9. ANS: B 10. ANS: A

DIF: 3 DIF: 3

REF: p. 238 REF: p. 237

Choose from the terms listed and match them with their most correct description. a. Parenteral b. Oral c. Topical

11. Sublingual 12. Intravenous 13. Vaginal 11. ANS: B 12. ANS: A 13. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 230 REF: p. 230 REF: p. 230

Choose from the terms listed and match them with their most correct description. a. Parenteral b. Oral c. Topical 14. Intraosseous (IO) 15. Transdermal 16. Ingestion 14. ANS: A 15. ANS: C 16. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 230 REF: p. 230 REF: p. 230

Choose from the terms listed and match them with their most correct description. a. Parenteral b. Oral c. Topical 17. Subcutaneous (SQ) 18. Inhalant 19. Buccal 17. ANS: A 18. ANS: C 19. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 230 REF: p. 230 REF: p. 230

Choose from the terms listed and match them with their most correct description. a. Parenteral b. Topical 20. Intradermal (ID) 21. Instillation 20. ANS: A 21. ANS: B

DIF: 3 DIF: 3

REF: p. 230 REF: p. 230

Choose from the terms listed and match them with their most correct description. a. Parenteral b. Topical 22. Rectal 23. Intraperitoneal

22. ANS: B 23. ANS: A

DIF: 3 DIF: 3

REF: p. 230 REF: p. 230

Choose from the terms listed and match them with their most correct description. a. Parenteral b. Topical 24. Intramuscular (IM) 25. Nasal 24. ANS: A 25. ANS: B

DIF: 3 DIF: 3

REF: p. 230 REF: p. 230

Chapter 13: Anesthesia, Physiological Monitoring and Post Anesthesia Recovery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. __________________ measures the electrical activity of the heart, which is projected into

a waveform. a. Electrocardiography (ECG) b. Temperature monitoring c. Neuromuscular monitoring d. Electroencephalogram ANS: A

ECG measures the electrical activity of the heart, which is projected into a waveform.

DIF: 2

REF: p. 265

2. ________ is a digital sensor that detects oxygen saturation in the hemoglobin by

spectrometry. a. Capnography b. Vascular monitoring c. Pulse oximeter d. Temperature monitoring ANS: C

The pulse oximeter detects oxygen saturation in the hemoglobin by spectrometry.

DIF: 2

REF: p. 265

3. Laryngospasm constitutes an emergency when an airway cannot be immediately

established by _________ ventilation. a. positive-pressure b. spontaneous c. full oxygen d. reversal ANS: A

Laryngospasm constitutes an emergency when an airway cannot be immediately established by positive-pressure ventilation.

DIF: 2

REF: p. 274

4. Administering _____________________ requires that the AP administer sedative and

anxiolytic (antianxiety) drugs as needed and manage any anesthetic or physiological emergencies. a. general anesthesia care b. monitored anesthesia care (MAC) c. anxiolysis d. homeostasis ANS: B

Monitored anesthesia care (MAC) is a specific service provided by an AP. If a patient is considered high risk, the surgeon may request monitored anesthesia care by an AP who is qualified to “rescue” a patient who has entered an unintended (deeper) level of sedation or requires emergency, life-saving interventions.

DIF: 2

REF: p. 267

5. ______________ anesthesia is the injection of anesthetic into superficial tissues to

produce a small area of anesthesia. a. Local infiltration b. Regional infiltration c. General d. Saddle block ANS: A

Local infiltration is injection of an anesthetic into superficial tissues to produce a small area of anesthesia.

DIF: 2

REF: p. 268

6. Spasm of the larynx usually is associated with airway secretions or stimulation of the

laryngeal nerve during intubation or _______. a. administration b. induction c. extubation d. amnesia ANS: C

Spasm of the larynx is usually associated with airway secretions or stimulation of the laryngeal nerve during intubation or extubation.

DIF: 2

REF: p. 274

7. Adequate _________________ is necessary during general anesthesia to manipulate the

body wall and other tissues within the operative site. a. cardiac relaxation b. local anesthesia c. personnel d. muscle relaxation ANS: D

Without adequate muscle relaxation or paralysis, retraction of the body wall and other tissues is difficult, and this prevents adequate exposure of the operative site.

DIF: 2

REF: p. 267

8. Termination of anesthesia and the process of regaining consciousness are called

____________. a. conclusion b. ending c. waking d. emergence

ANS: D

Termination of anesthesia and the process of regaining consciousness are called emergence.

DIF: 2

REF: p. 264

9. A _____________________ is a type of anesthesia in a specific area of the body by

injection of anesthetic around a major nerve or group of nerves. a. topical anxiolytic b. topical anesthetic c. peripheral nerve block d. regional block ANS: D

Regional block is anesthesia in a specific area of the body, achieved by injection of an anesthetic around a major nerve or group of nerves.

DIF: 2

REF: p. 251

10. ________ anesthesia can be provided to a single nerve, to a group of nerves, or to an area

of the spinal cord. a. Regional b. Epidural c. Continuous d. Nerve ANS: A

Regional anesthesia can be provided to a single nerve, to a group of nerves, or to an area of the spinal cord.

DIF: 2

REF: p. 268

11. ________ is a state in which the patient can respond to verbal commands. a. Thoracotomy b. Performance c. Sedation d. Administer resuscitative ANS: C

Sedation is a state of consciousness described along a continuum. At one end, a person is fully aware of their surroundings and able to respond to stimuli.

DIF: 2

REF: p. 252

12. __________________ anesthesia is induced with the drug ketamine, which blocks sensory

neurotransmission and associative pathways. a. Sedation b. Regional c. General d. Dissociative ANS: D

Dissociative anesthesia is induced with the drug ketamine, which blocks sensory neurotransmission and associative pathways.

DIF: 2

REF: p. 267

13. ________ is treated with mechanical ventilation or, in severe cases, administration of

succinylcholine to paralyze the muscles. a. Pancuronium b. Laryngospasm c. Rocuronium d. Mivacurium ANS: B

Laryngospasm is treated with mechanical ventilation or, in severe cases, administration of succinylcholine to paralyze the muscles.

DIF: 2

REF: p. 274

14. Preoperative ________ is required to minimize aspiration (inhalation) of gastric contents

during general anesthesia. a. apnea b. bronchial c. fasting d. crisis ANS: C

Preoperative fasting is required to minimize aspiration (inhalation) of gastric contents during procedural sedation or general anesthesia.

DIF: 2

REF: p. 256

15. In a state of well-being, the body responds readily to ________ to maintain life. a. stimuli b. analgesics c. narcotics d. barbiturates ANS: A

In a state of well-being, the body responds to specific stimuli in the environment to maintain life.

DIF: 2

REF: p. 264

16. In anesthesia, ________ is the patient’s inability to recall events that occur after the

administration of specific drugs. a. pain relief b. hallucinations c. amnesia d. relief from nausea ANS: C

Amnesia: In anesthesia, the patient’s inability to recall events that occur after the administration of specific drugs. After the drug is metabolized and cleared from the body, normal recall returns.

DIF: 2

REF: p. 250

17. The levels of consciousness, analgesia, and sedation are continually ________ monitored,

along with physiological parameters. a. continually b. generally c. carefully d. minimally ANS: A

The levels of consciousness, analgesia, and sedation are continually monitored, along with physiological parameters.

DIF: 2

REF: p. 264

18. ______ is a rare physiological response to all volatile anesthetic agents and

succinylcholine. a. Malignant hyperthermia (MH) b. Anaphylactic shock c. Coma d. Hemolytic reaction ANS: A

Malignant hyperthermia (MH) is a rare physiological response to all volatile anesthetic agents and succinylcholine.

DIF: 2

REF: p. 275

19. The capture and safe removal of anesthetic gas that escapes from the anesthesia machine is

accomplished with a ________ system. a. circular b. gas scavenging c. intubation d. regional block ANS: B

Gas scavenging: The capture and safe removal of extraneous anesthetic gases from the anesthesia machine.

DIF: 2

REF: p. 250

20. The circulation of blood to specific tissue, organ, system, or the whole body is called

_____________. a. perfusion b. transfer c. intubation d. sedation

ANS: A

Perfusion: Circulation of blood to specific tissue, organ, system, or the whole body.

Perfusion is necessary to maintain life in the cells.

DIF: 2

REF: p. 251

21. Topical anesthesia is used on skin, ________, and on superficial eye tissues. a. red cells b. mucous membranes c. subcutaneous tissue d. superficial nerves ANS: B

Topical anesthesia is used on skin, mucous membranes, and on superficial eye tissues.

DIF: 2

REF: p. 268

22. A ________ nerve block provides anesthesia to a specific area of the body supplied by a

major nerve or nerve plexus (group). a. peripheral b. constant c. intermittent d. intravenous ANS: A

A peripheral nerve block provides anesthesia to a specific area of the body supplied by a major nerve or nerve plexus (group).

DIF: 2

REF: p. 269

23. ______________ is the immediate harvesting of blood on the surgical field and reinfusion

to the patient. a. Blood transfusion b. Intraoperative cell salvage c. Extubation d. Gas scavenging ANS: B

Intraoperative cell salvage (autotransfusion) is the immediate harvesting of blood on the surgical field and reinfusion into the patient.

DIF: 2

REF: p. 275

24. ________ is a state of balance in physiological functions. a. Homeostasis b. Hemostasis c. Emergence d. Perfusion ANS: A

Homeostasis is a state of balance in physiological functions.

DIF: 2

REF: p. 251

25. A pulse ________ is a monitoring device that measures the patient’s hemoglobin oxygen

saturation by means of spectrometry. a. hemostasis b. balancer c. oximeter d. anesthesia ANS: C

A pulse oximeter is a monitoring device that measures the patient’s hemoglobin oxygen saturation by means of spectrometry.

DIF: 2

REF: p. 251

26. Deep unconsciousness, such as that achieved during general anesthesia, results in the

absence of protective mechanisms such as swallowing, coughing, blinking, and ________. a. recall b. cessation c. shivering d. capacity ANS: C

Deep unconsciousness, such as that achieved during general anesthesia, results in the absence of protective mechanisms, such as swallowing, coughing, blinking, and shivering.

DIF: 2

REF: p. 352

27. Central nervous system depression refers to ________ mental, sensory, and physical

capacity. a. changed b. instant c. peristalsis d. diminished ANS: D

Central nervous system (CNS) depression refers to a decrease in sensory awareness caused by drugs or a pathological condition.

DIF: 2

REF: p. 250

28. The __________ assistant assists the anesthesia care provider in tasks that are delegated

according to the AA’s practice skills and knowledge. a. surgical b. ACP c. nursing d. certified anesthesia ANS: D

The certified anesthesia assistant (CAA) assists the AP in tasks that are delegated according to the individual’s practice skills and knowledge.

DIF: 2

REF: p. 252

29. Hospitals have individual ________ protocols; however, specific details are always

verified. a. identity b. check-in c. consent forms d. religious preferences ANS: B

Hospitals and other surgical facilities have individual check-in protocols. However, specific de-tails are always verified.

DIF: 2

REF: p. 256

30. Diagnostic testing to determine the patient’s ________ level has been routine for many

decades. a. risk b. sedative c. prophylactic d. inhalation ANS: A

Diagnostic testing to determine the patient’s risk level has been routine for many decades.

DIF: 2

REF: p. 255

31. Preoperative medications are documented in the patient’s medical and ________ records. a. anxiety b. preoperative c. gastric d. general ANS: B

Preoperative medications are documented in the patient’s medical and preoperative records.

DIF: 2

REF: p. 256

32. Any medication ordered but not yet given may be administered in the holding area as

directed by the surgeon or ________. a. CPA b. BIT c. AP d. EAP ANS: C

Any medication ordered but not yet given may be administered in the holding area as directed by the surgeon or AP. DIF: 2

REF: p. 256

33. In the past, ________ drugs were given routinely, while the patient was awaiting surgery

on the hospital ward. a. backspace b. preoperative c. preventive d. patient ANS: B

In the past, preoperative drugs were given routinely while the patient was awaiting surgery in the hospital ward.

DIF: 2

REF: p. 257

34. Normal body temperature is _______. a. 94° to 99.5° C b. 95° to 97° C c. 97° to 99.5° F d. 36° to 37.5° F ANS: C

The normal body temperature is 97° to 99.5° F (36° to 37.5° C).

DIF: 2

REF: p. 265

35. Toxic reactions to local anesthetics arise most often during _______ block and epidural

anesthesia. a. specific b. injection c. regional d. postoperative ANS: C

Toxic reactions to local anesthetics arise most often during regional block and epidural anesthesia.

DIF: 2

REF: p. 271

36. A coma is the deepest state of _______, in which most brain activity ceases. a. anesthesia b. Esmarch concentration c. sleep d. unconsciousness ANS: D

A coma is the deepest state of unconsciousness, in which most brain activity ceases.

DIF: 2

REF: p. 250

37. The PACU is staffed by ______________ trained in postoperative recovery and

emergency treatment. a. certified surgical technologists b. certified registered nurse anesthetists

c. critical care nurses d. anesthesiologists ANS: C

The PACU is staffed by critical care nurses who are trained in postoperative recovery and emergency medicine.

DIF: 2

REF: p. 276

38. The PACU is close to the surgical suites for _______ transfer of patients after surgery. a. lounge b. changing c. central d. rapid ANS: D

The PACU is close to the surgical suites for rapid transfer of patients after surgery.

DIF: 2

REF: p. 276

39. Drugs given during the preoperative and intraoperative phase have a direct

pharmacological effect on those administered ____________. a. by anesthesia b. postoperatively c. for pain d. by injection ANS: B

Drugs given during the preoperative and intraoperative phase have a direct pharmacological effect on those administered postoperatively.

DIF: 2

REF: p. 277

40. ______________ is necessary to determine the need for further action, such as transfusion. a. Type of anesthesia administered b. Surgical procedure performed c. Estimated blood loss d. Patient age ANS: C

The estimated blood loss is necessary to determine the need for further action, such as transfusion.

DIF: 2

REF: p. 277

41. Malignant __________ (MH) is a rare condition that results in an extremely high core

body temperature, cardiac dysrhythmia, tachypnea (increased respiratory rate), hypoxia, and hypercarbia. a. hypoventilation b. hypothermia c. hyperthermia d. hypoxia

ANS: C

Malignant hyperthermia (MH) is a rare condition that results in an extremely high core body temperature, cardiac dysrhythmia, tachypnea (increased respiratory rate), hypoxia, and hypercarbia.

DIF: 2

REF: p. 281

42. A standardized method of measuring the patient’s response to external stimuli is known as

_____________. a. patient assessment b. focus assessment c. Glasgow Coma Scale (GCS) d. head to toe assessment ANS: C

GCS is a standardized method of measuring a patient’s response to external stimuli.

DIF: 2

REF: p. 251

43. During surgery preparation, the patient’s ____________ is continually monitored. a. code status b. nutritional status c. family support system d. physiological status ANS: D

The circulating nurse or the AP communicates all information needed to update the PACU nurse on the patient’s physiological status before and during surgery.

DIF: 2

REF: p. 277

44. _____________ is a term used to describe a clinical scenario in which patients are

prescribed many different medications. a. Polypharmacy b. ADL c. Discharge orders d. Care plan ANS: A

Polypharmacy is a clinical scenario in which patients are prescribed many different medications, sometimes by different primary health care providers who have no knowledge of other drugs the patient is taking.

DIF: 2

REF: p. 284

45. Patient ________ to home or another care facility is arranged before surgery whenever

possible. a. transport b. delivery c. provider d. schedule

ANS: A

Patient transport to home or another care facility is arranged before surgery whenever possible.

DIF: 2

REF: p. 283

46. ___________ problems are the most frequent life-threatening postoperative complication. a. Wound hemorrhage b. Pain management c. Respiratory d. Anesthetic agent ANS: C

Respiratory problems are the most frequent life-threatening postoperative complication.

DIF: 2

REF: p. 280

47. Although _______ is expected in the postsurgical phase, not all patients respond to pain in

the same way. a. pain b. neurological function c. mental status d. level of consciousness ANS: A

Although pain is expected in the postsurgical phase, not all patients respond to pain in the same way.

DIF: 2

REF: p. 278

48. Pain at the operative site is another cause of ______, resulting in low oxygen saturation. a. consciousness b. hypoxia c. imbalances d. hypoventilation ANS: D

Pain at the operative site is another cause of hypoventilation, resulting in low oxygen saturation.

DIF: 2

REF: p. 280

49. Discharge planning and implementation follow established roles and tasks according to

hospital ______. a. policy b. assessment c. focus d. ASA ANS: A

Discharge planning and implementation follow established roles and tasks according to hospital policy.

DIF: 2

REF: p. 282

50. Patient teaching is the responsibility of ________ nursing personnel. a. prepared b. ready c. trained d. experienced ANS: C

Patient teaching is the responsibility of trained nursing personnel.

DIF: 2

REF: p. 284

51. In the event of impending ________ or a rapidly deteriorating patient, surgery may be

terminated and the patient taken to the PACU. a. order b. stop c. death d. discharge ANS: C

In the event of impending death or a rapidly deteriorating patient, surgery may be terminated and the patient taken to the PACU. DIF: 2

REF: p. 284

52. A potentially fatal syndrome of hypermetabolism resulting in extremely high body

temperature, cardiac dysrhythmia, and respiratory distress is known as __________. a. hypoventilation b. hypoxia c. hypothermia d. malignant hyperthermia (MH) ANS: D

Malignant hyperthermia (MH) is a rare condition that causes an extremely high core body temperature, cardiac dysrhythmia, tachypnea (increased respiratory rate), hypoxia, and hypercarbia. The condition is potentially fatal and occurs most commonly at the time of administration of the anesthetic.

DIF: 2

REF: p. 281

53. Wound ______ and care are of primary importance during the postoperative period. a. department b. suspension c. inputs d. assessment ANS: D

Wound assessment and care are of primary importance during the postoperative period.

DIF: 2

REF: p. 277

54. The ______ is assessed for distention (which may indicate the presence of fluid, including

blood) or air. a. abdomen b. operatives c. volume d. treatment ANS: A

The abdomen is assessed for distention (which may indicate the presence of fluid, including blood) or air.

DIF: 2

REF: p. 278

55. The _______ staff provides continual emotional support to the patient. a. ICU b. PACU c. USP d. CBC ANS: B

The PACU staff provides continual emotional support to the patient.

DIF: 1

REF: p. 278

56. Both ________ and bronchospasm can be caused by particular anesthetic agents. a. laryngospasm b. perfusion c. auscultation d. arterial blood gases ANS: A

Both laryngospasm and bronchospasm can be caused by particular anesthetic agents.

DIF: 1

REF: p. 280

57. Perfusion or oxygen saturation of the blood is measured by ______________. a. arterial blood gases b. pulse oximeter c. Glasgow Coma Scale d. ADLs ANS: B

Perfusion (flow of blood to tissue) is measured by pulse oximeter.

DIF: 1

REF: p. 277

58. The __________ assessment is used by the PACU nurse to concentrate on a specific organ

system or region of the body. a. head to toe b. focused c. accepted

d. fluid ANS: B

The focused assessment is used by the PACU nurse to focus on a specific organ system or region of the body.

DIF: 1

REF: p. 277

59. Fluid shifts from the vascular space to the intracellular space can occur after surgery, and

the patient must be _________ carefully. a. evaluated b. accelerated c. focused d. dehydrated ANS: A

Fluid shifts from the vascular space to the intracellular space can occur after surgery, and the patient must be evaluated carefully.

DIF: 1

REF: p. 278

60. Assessment for _________ includes physical signs and symptoms. a. dehydration b. hyperthermia c. perfusion d. auscultation ANS: A

Assessment for dehydration includes physical signs and symptoms.

DIF: 1

REF: p. 278

61. Patients often need reassurance and orientation to their ________ while emerging from

general anesthesia or heavy sedation. a. environment b. education c. perfusion d. hydration ANS: A

Patients often need reassurance and orientation to their environment while emerging from general anesthesia or heavy sedation.

DIF: 1

REF: p. 278

62. Pulmonary ____________ is blockage of a pulmonary vessel by air, a blood clot, or other

substance (e.g., fragments of atherosclerotic plaque). a. embolism b. clotting c. dehydration d. irritation ANS: A

Pulmonary embolism is blockage of a pulmonary vessel by air, a blood clot, or other substance (e.g., fragments of atherosclerotic plaque).

DIF: 1

REF: p. 280|p. 281

63. Many anesthetic agents are cardiac irritants that can sensitize the _________ muscle to

disturbances in rhythm, rate, and cardiac output. a. transport b. cardiac c. heart d. patient’s ANS: C

Many anesthetic agents are cardiac irritants that can sensitize the heart muscle to disturbances in rhythm, rate, and cardiac output.

DIF: 2

REF: p. 281

64. Patients are informed and educated about their own care so that they can fully participate

in their _____________. a. recovery b. pain assessment c. social assessment d. wound assessment ANS: A

Patients are informed and educated about their own care so that they can fully participate in their recovery.

DIF: 2

REF: p. 282

65. The ______ provides specific orders for continuation of care and a smooth recovery. a. NBA b. AP c. PTA d. CPR ANS: B

The AP provides specific orders for continuation of care and a smooth recovery.

DIF: 2

REF: p. 277

66. Partial or complete closure of the bronchial tubes is ____________. a. bronchospasm b. percussion c. perfusion d. hypoxia ANS: A

Bronchospasm is the partial or complete closure of the bronchial tubes.

DIF: 2

REF: p. 280

67. The estimated blood loss is needed to determine the need for further action, such as

_______________. a. rhythm b. palpation c. transfusion d. auscultation ANS: C

The estimated blood loss is needed to determine the need for further action, such as transfusion.

DIF: 2

REF: p. 277

68. The heart is monitored for rate and rhythm using ______ leads and a cardiac monitor,

which produces a digital waveform. a. EKG b. BBC c. KRG d. ECG ANS: D

The heart is monitored for rate and rhythm using ECG leads and a cardiac monitor, which produces a digital waveform.

DIF: 2

REF: p. 278

69. The central ______ pressure may be measured with an inline catheter or by observing the

jugular veins. a. nervous b. venous c. digestion d. tension ANS: B

The central venous pressure may be measured with an inline catheter or by observing the jugular veins.

DIF: 2

REF: p. 278

70. _________________ can occur during surgery or in the postoperative period. a. Hemorrhage b. Change c. Standards d. Normotensive ANS: A

Hemorrhage can occur during surgery or in the postoperative period.

DIF: 2

REF: p. 281

71. Patients and family receive referral numbers for ______ care or further information.

a. b. c. d.

transportation PACU assistance emergency

ANS: D

Patients and family receive referral numbers for emergency care or further information.

DIF: 2

REF: p. 284

72. In the event the patient has no assistance available, community resources, including

______________ services and professional home nursing services, must be brought in. a. technology b. surgeon c. social d. personnel ANS: C

In the event the patient has no assistance available, community resources, including social services and professional home nursing services, must be brought in.

DIF: 2

REF: p. 283|p. 284

73. Physiological objectives that are necessary to ensure patient safety outside the critical care

unit are called _______________. a. discharge scores b. discharge criteria c. discharge planning d. discharge signs ANS: B

Discharge criteria are primarily physiological objectives, which are necessary to ensure patient safety outside the critical care unit.

DIF: 2

REF: p. 282

74. Aspiration or inhalation of secretions or stomach contents is associated with a weak gag

______________ related to use of narcotics, sedatives, and anesthetic agents. a. level of consciousness b. cardiopulmonary status c. reflex d. mental status ANS: C

Aspiration or inhalation of secretions or stomach contents is associated with a weak gag reflex related to use of narcotics, sedatives, and anesthetic agents.

DIF: 2

REF: p. 280

75. __________ (hand-off) is a verbal and written report from one nurse to another to provide

updated patient information. a. Hypoxia

b. Handover c. Hyperoxygenation d. Hypovolemia ANS: B

Handover (hand-off) is a verbal and written report from one nurse to another to provide updated patient information.

DIF: 2

REF: p. 282

MATCHING

Choose from the terms listed and match them with their most correct description. a. Analgesia b. Anesthesia c. Anesthetic 1. A drug that reduces or blocks sensation 2. The absence of pain caused by specific drugs 3. Without sensation 1. ANS: C 2. ANS: A 3. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 268 REF: p. 250 REF: p. 251

Choose from the terms listed and match them with their most correct description. a. Anesthesia provider b. PACU nurse c. Surgical patient 4. Communicates specific orders for continuation of care and a smooth recovery 5. Performs duties in the postanesthesia care area 6. May sign out of the health care facility AMA 4. ANS: A 5. ANS: B 6. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 277 REF: p. 276 REF: p. 284

Choose from the terms listed and match them with their most correct description. a. PACU nurse b. Surgical patient 7. Accountable for ensuring that the family members are alerted and kept up to date 8. Informed and educated to fully participate in the recovery phase 7. ANS: A 8. ANS: B

DIF: 3 DIF: 3

REF: p. 276 REF: p. 252

Choose from the terms listed and match them with their most correct description. a. PACU nurse b. Surgical patient

9. Arrangements for discharge 10. ADLs often determine their quality of life 9. ANS: A 10. ANS: B

DIF: 3 DIF: 3

REF: p. 282 REF: p. 284

Choose from the terms listed and match them with their most correct description. a. Glasgow Coma Scale b. Aldrete scale 11. Based on psychosocial and physiological criteria 12. A standardized method of measuring the patient’s response to external stimuli 11. ANS: B 12. ANS: A

DIF: 3 DIF: 3

REF: p. 282 REF: p. 252

Choose from the terms listed and match them with their most correct description. a. Glasgow Coma Scale b. Aldrete scale 13. Often used to determine whether a patient is ready for discharge from the PACU area 14. Used to assess motor response to verbal commands 13. ANS: B 14. ANS: A

DIF: 3 DIF: 3

REF: p. 282 REF: p. 254

Chapter 14: Death and Dying Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Physical care of the body to prepare it for viewing by the family and for mortuary

procedures is called _____________. a. morgue care b. postmortem care c. premortem care d. mortuary ANS: B

Physical care of the body to prepare it for viewing by the family and for mortuary procedures is called postmortem care.

DIF: 2

REF: p. 287

2. Support and care across different cultures is called _____________. a. cultural competence b. culture knowledge c. culture acceptance d. culture awareness ANS: A

Support and care across cultures is called cultural competence. It is learned through experience and active learning. It begins with acceptance and respect.

DIF: 2

REF: p. 290

3. Medical and supportive care provided to the dying patient is called __________ care. a. premortem b. comfort c. dignity d. palliative ANS: D

Palliative care is the medical and supportive care provided to the dying patient. Numerous types of surgical intervention may be included as a component of palliative care, such as debulking of a tumor or debridement of a pressure wound.

DIF: 2

REF: p. 290

4. When death occurs in surgery, the surgeon and the anesthesia care provider must verify

that brain death has occurred; this is called ___________ of death. a. proclamation b. certificate c. announcement d. determination ANS: D

When death occurs in surgery, the surgeon and the anesthesia care provider must verify that brain death has occurred; this is called determination of death. Death is determined by specific medical criteria, which have legal implications.

DIF: 2

REF: p. 290

5. Rigor mortis, the natural stiffening of the body, begins approximately ______ after death

and peaks at 8 to 10 hours. a. 15 minutes b. 30 minutes c. 1 hour d. 1.5 hours ANS: A

Rigor mortis, the natural stiffening of the body, begins approximately 15 minutes after death and peaks at 8 to 10 hours. The exact time depends on the tissues and environmental temperature. At 18 hours, the process regresses, and the body usually is relaxed after 24 hours. Rigor mortis begins at the head (eyelids) and progresses to the feet. When relaxation begins, it follows the reverse order of progression.

DIF: 2

REF: p. 291

6. After death, the collection of fluid that turns the ears and cheeks red or purple is called

_______ mortis. a. rigor b. post c. livor d. pooled ANS: C

Dependent areas of the body (those under pressure from body weight or gravity) begin to collect fluid, and the areas around the ears and cheeks may turn purple or red (a condition called livor mortis). The pooling of blood in these regions cannot be reversed in the embalming process.

DIF: 2

REF: p. 291

7. A structured response may be required to help health care workers cope with death. This

may involve planned _______ periods, or spontaneous expressions of support and acknowledgment by individual team members. a. vacation b. reassignment c. debriefing d. distracting ANS: C

A structured response may be required to help health care workers cope with death. This may involve planned “debriefing” periods, or spontaneous expressions of support and acknowledgment by individual team members.

DIF: 2

REF: p. 293

8. Because death in the operating room ________, the circulator must initiate all forms as for

any sentinel event. a. is a sentinel event b. is unusual c. is uncommon d. does not happen ANS: A

Because death in the operating room is a sentinel event, the circulator must initiate all forms as for any sentinel event. If death was pronounced in the operating room, members of the surgical team are named in the sentinel event documentation.

DIF: 2

REF: p. 291

9. Communication with the dying patient requires ___________. a. avoidance of the subject b. keen listening and observation skills c. assurance that all will be okay d. refusal to listen ANS: B

Communication with the dying patient requires keen listening and observation skills. It is important to recognize and acknowledge the fact of death and what this means to the patient in that moment and time.

DIF: 2

REF: p. 288

10. The circumstances of the patient’s death determine whether the coroner must investigate

the death; this process includes mandatory autopsy, and such a case is called a(n) __________. a. supervisor's case b. administrator’s case c. medical staff case d. coroner’s case ANS: D

The circumstances of the patient’s death determine whether the coroner must investigate the death; this process includes mandatory autopsy, and such a case is called a coroner’s case.

DIF: 2

REF: p. 291

11. Reactions and coping skills available to health care professionals are influenced by the

following factors, EXCEPT __________. a. lack of support b. the health care professional’s beliefs and values c. previous experience with death d. emotional well-being ANS: A

Emotional and psychological events triggered by the sudden death of a patient vary in health care workers. The reactions and coping skills available to these professionals often are influenced by the following factors: • Previous experience with death • Support available in the environment • The health care professional’s beliefs and values • Knowledge about the process of death • The health care professional’s emotional well-being DIF: 2

REF: p. 292|p. 293

12. If no decision has been made by the patient, the attending ______ must, by law, ask the

patient and family to consider organ donation. a. physician b. family c. chaplain d. nurses ANS: A

Many cultures and faiths forbid organ removal after death, and these cases are usually straightforward for the family and patient. However, individuals often leave the question unresolved at the time of death. If no decision has been made by the patient, the attending physician must, by law, ask the patient and family to consider organ donation. In cases of sudden death without clear directives, conflicting views may be held by family members about organ donation.

DIF: 2

REF: p. 292

13. The _______ theory of death is considered by some too constricting and does not allow for

individualism in the experience of death. a. stage b. end of life c. spiritual d. psychological ANS: A

Critics of Kübler-Ross’s model believe that the stage theory is too constricting and does not allow for individualism in the experience of death. However, the stages model provided a framework for psychologists and social workers to look at the process of dying in a way that had not been previously studied.

DIF: 2

REF: p. 288

14. Effective and compassionate communication with the family and the patient is enhanced

by understanding some of the more common problems families face. These not only include the _________ effects of grief but can also be related to the patient’s medical care, or to the practical aspects of finances and estate issues. a. physical b. physiological c. psychological

d. pathological ANS: C

The families of dying patients face many challenges and difficulties in the end-of-life period. Effective and compassionate communication with the family and the patient is enhanced by understanding some of the more common problems that families face. These not only include the psychological effects of grief, but can also be related to the patient’s medical care or to the practical aspects of finances and estate issues.

DIF: 2

REF: p. 293

15. Assisted suicide is perceived by many as an intent to ______. a. help b. cure c. harm d. heal ANS: C

Assisted suicide is perceived by many as intent to harm and is rejected on that basis.

Assisted suicide is intentional harm to a person, at their request, to promote or cause death.

DIF: 2

REF: p. 289

16. Decisions about end-of-life care fall to the ___________ when the patient is not able to

communicate his or her wishes. a. friends b. family c. hospital administrator d. clergy ANS: B

Ethical issues arise when the patient is not competent to communicate. Decisions about end-of-life care fall to the family when the patient is not able to communicate his or her wishes.

DIF: 2

REF: p. 289

17. Many cultures and faiths forbid organ removal after death, and these cases are usually

_______________. a. difficult to persuade the patient and family b. straightforward for the family and patient c. confusing for the family and patient d. decided by the physician ANS: B

Many cultures and faiths forbid organ removal after death, and these cases are usually straightforward for the family and patient. However, individuals often leave the question unresolved at the time of death.

DIF: 1

REF: p. 292

18. Although grief and other deep emotions are present in all families at the time of death,

these feelings are often mitigated by ritual and ceremony that ________________. a. comfort as well as heal the living b. allow the families to forget c. let families pretend nothing happened d. allow families to think about their grief ANS: A

Although grief and other deep emotions are present in all families at the time of death, these feelings often are mitigated by ritual and ceremony, which comfort as well as heal the living. In many cultures, they also are believed to comfort the dead.

DIF: 1

REF: p. 290

19. To determine brain death, specific medical assessment may be carried out on the patient to

determine absence of breathing, the response to painful stimuli, and the presence of ______________. a. cranial reflexes b. acuity response c. respiratory reflexes d. cardiac response ANS: A

Death is determined by specific medical criteria, which have legal implications. To determine brain death, specific medical assessment may be carried out on the patient to determine the absence of breathing, response to painful stimuli, and the presence of cranial reflexes.

DIF: 1

REF: p. 290

20. During the aftercare procedure, the body is always handled _________ and with _______

at all times. a. slowly; care b. gently; respect c. quickly; care d. leisurely; worry ANS: B

During the aftercare procedure, the body is handled gently and with respect at all times.

DIF: 1

REF: p. 291

21. Once the decision has been made for organ recovery, exacting clinical protocols are

followed to ensure __________________. a. there are no mistakes b. the vitality of the organs c. permission is not withdrawn d. respect is given ANS: B

Once the decision has been made for organ recovery, exacting clinical protocols are followed to ensure the vitality of the organs.

DIF: 1

REF: p. 292

22. Health care workers often face personal conflict about the decisions made by their patients

or the families of patients. They may not agree with the decisions, but they are obliged to ________________. a. propose a different outcome b. honor the decisions c. change the mind of the patient d. share an opinion ANS: B

Health care workers often face personal conflict about the decisions made by their patients or the families of patients. They may not agree with the decisions, but they are obliged to honor them. In extreme cases of ethical conflict, the health care professional may ask to be excused from participation in the care of the patient.

DIF: 1

REF: p. 290

23. A _____________ is one in which tissue perfusion can be maintained during and

immediately after death to preserve the life of the tissue. a. heart-beating cadaver b. non-heart-beating cadaver c. breathing cadaver d. non-breathing cadaver ANS: A

A heart-beating cadaver is one in which tissue perfusion can be maintained during and immediately after death to preserve the life of the tissue. Cardiopulmonary support provides intact circulation to organs suitable for recovery.

DIF: 1

REF: p. 292

24. The order to not resuscitate is made official by signing a DNR (do not resuscitate) order,

which is ___________________________________. a. sent to the hospital attorney b. charted in the patient’s medical record c. kept secret d. shared only with the hospital administrator ANS: B

Request not to resuscitate is made official when the patient signs a DNR order, which is charted in the patient’s medical record. Exacting forms that define precisely the procedures that can and cannot be performed during resuscitation have been designed to alleviate ambiguity.

DIF: 1

REF: p. 290

25. Tissues that are harvested from non-heart-beating cadavers include _________________. a. cornea, blood vessels, heart valves, bone, and skin b. lungs, kidneys, liver, and intestines c. stomach, bladder, pancreas, gall bladder

d. kidneys, gall bladder, heart valves, bone ANS: A

Tissues from a non-heart-beating cadaver are restricted to those that do not need perfusion to sustain viability for later transplantation. These include the cornea, blood vessels, heart valves, bone, and skin.

DIF: 1

REF: p. 292

MATCHING

Choose from the terms listed and match them with their most correct description. a. Stages of grief and dying b. Natural changes in the body after death c. Advanced directive 1. DNR or DNAR (do not attempt resuscitation) 2. Rigor mortis 3. Patients feel great anger and remorse that they did not heed warnings to change lifestyle

habits they knew were harmful.

1. ANS: C 2. ANS: B 3. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 290 REF: p. 291 REF: p. 288

Choose from the terms listed and match them with their most correct description. a. Stages of grief and dying b. Natural changes in the body after death c. Advanced directive 4. All sphincter muscles immediately lose tone 5. An inner attempt to bargain with God or another spiritual entity 6. The patient may refuse treatment in order to fulfill the right to die.

4. ANS: B 5. ANS: A 6. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 291 REF: p. 288 REF: p. 289

Choose from the terms listed and match them with their most correct description. a. Stages of grief and dying b. Natural changes in the body after death c. Advanced directive 7. Areas of the body begin to collect fluid and the areas around the ears and cheeks may turn

purple or red.

8. Living will 9. Patients express anger; feelings of anger may be projected at family, self, health workers, or God. 7. ANS: B 8. ANS: C

DIF: 3 DIF: 3

REF: p. 291 REF: p. 290

9. ANS: A

DIF: 3

REF: p. 288

Choose from the terms listed and match them with their most correct description. a. Denial b. Bargaining c. Acceptance 10. “If I pray daily, maybe God will allow me to live.”

11. Is a defense mechanism 12. The idea that death is no longer a source of psychological conflict 10. ANS: B 11. ANS: A 12. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 288 REF: p. 288 REF: p. 288

Chapter 15: Energy Sources in Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. During surgery, the perioperative team must suspect a problem if the surgeon repeatedly

requests _________________ of the ESU. a. increases in power b. increases in sound level c. relocation d. decrease in power ANS: A

During surgery, the perioperative team must suspect a problem if the surgeon repeatedly requests increases in power of the ESU. DIF: 2

REF: p. 297

2. During surgery, the active electrode pencil must be kept _____________ on the surgical

field. a. close to the surgical wound b. on the front edge of the Mayo stand c. on the patient’s legs d. in a nonconductive safety holster ANS: D

During surgery, the active electrode pencil must be kept in a nonconductive safety holster on the surgical field. The holster must be in plain sight of the team, and the ESU pencil must be replaced in it after each use.

DIF: 2

REF: p. 498

3. ______________ materials are used to insulate the conductive material carrying electricity

to prevent injury and maintain the flow of electricity within its circuit. a. Conductive b. Nonconductive c. Sterile d. Nonsterile ANS: B

Insulate is to cover or surround a conductive substance with nonconductive material.

DIF: 2

REF: p. 295

4. During the use of electrosurgery or laser surgery, tissue is destroyed or incised, and this

process creates toxic smoke called smoke _________, which is known to be highly toxic. a. stream b. hazard c. toxicity d. plume

ANS: D

During monopolar electrosurgery and laser surgery, tissue is subjected to high temperatures. This process creates toxic smoke called smoke plume. Smoke plume contains about 95% water and 5% other products, which include chemicals, blood cells, and intact or fragmented bacteria and viruses. The potential hazards of these substances are infectious disease transmission, toxicity from chemicals, and allergy.

DIF: 2

REF: p. 299

5. The force or power that pushes or drives electrons through the conductive material is

called __________. a. current b. resistance c. conductivity d. voltage ANS: D

Voltage is the pressure that pushes the flow of charged electrons through its circuit.

DIF: 2

REF: p. 297

6. ________________ energy is created when electricity is transformed into mechanical

energy to high-frequency vibration and friction. a. Ultrasonic b. Laser c. Cold thermal d. Electromagnetic ANS: A

Ultrasonic energy is created when electricity is transformed into mechanical energy to high-frequency vibration and friction. The ultrasonic instrument simultaneously cuts and coagulates tissue by transmitting ultrasonic wave energy through specially designed forceps, scissors, or blades.

DIF: 2

REF: p. 302

7. The patient-return electrode must be placed close to the surgical site over

_____________________. a. implants b. small muscle mass c. large bony protuberance d. large muscle mass ANS: D

The patient-return electrode must be placed close to the surgical site over a large muscle mass. Muscle has low impedance and is the best conductor.

DIF: 2

REF: p. 300

8. ____________ coupling is a specific burn hazard of monopolar endoscopic surgery when

current passes inadvertently through instrument insulation and adjacent conductive material into tissue.

a. b. c. d.

Direct Capacitive Negative Loop

ANS: B

Capacitive coupling is a specific burn hazard of monopolar endoscopic surgery. It occurs when current passes inadvertently through instrument insulation and adjacent conductive material into tissue. Burns resulting from capacitive coupling are particularly dangerous in minimally invasive surgery because the injury most often occurs outside the viewing area of the endoscope.

DIF: 2

REF: p. 302

9. In laser surgery a method of intermittent application of the laser light on the target tissue is

called __________. a. laser medium b. pulsed wave c. parallel d. wavelength ANS: B

Pulsed-wave lasers are lasers that apply the laser light intermittently to the target tissue.

DIF: 2

REF: p. 296

10. When the path of electricity is interrupted by a nonconductive material, this is called

________________. a. voltage b. current c. frequency d. impedance ANS: D

Impedance is the constriction of electrical current by a nonconductive material DIF: 2

REF: p. 295

11. A __________________ is required to manage laser risks and define safety protocols. a. licensed staff member b. laser safety officer c. committee d. patient advocate ANS: B

The laser safety officer is required to manage laser risks and define safety protocols.

DIF: 2

REF: p. 305

12. All personnel entering a room in which a laser is in use must ________. a. wear the appropriate eye protection b. sign the laser log

c. wear a lead apron d. sign the laser log; wear a lead apron ANS: A

All personnel entering a room in which lasers are in use must wear protective eyewear.

DIF: 2

REF: p. 305

13. Protection of the patient during laser surgery would include ________. a. wet towels b. wet eye pads or eye cups c. matte-finish metal airways d. wet towels; wet eye pads or eye cups ANS: D

All patients undergoing laser surgery while awake wear protective eyewear. Wet towels are placed around the operative site to prevent burns at the operative site.

DIF: 2

REF: p. 306

14. The ________ determines the degree of thermal damage from the laser. a. sensitivity of the irradiated tissue b. amount of tissue affected c. length of time tissue is exposed d. all are correct ANS: D

The following criteria determine the degree of thermal damage: The sensitivity of the irradiated tissue, the amount of tissue affected, the wavelength of the laser beam, the energy level of the laser beam, the amount of time the tissue is exposed.

DIF: 2

REF: p. 306

15. The two most common injuries associated with unintentional laser exposure are

____________________________________. a. eye injury and tissue burn b. infertility and genetic mutation c. infection and allergies d. infection and wound dehiscence ANS: A

The two most common injuries associated with unintentional laser exposure are eye injury and skin burn. Lasers in the ultraviolet and infrared areas of the spectrum are the most damaging.

DIF: 2

REF: p. 305

16. Cryosurgery is the use of an extremely ________ instrument or substance to destroy

tissue. a. heavy b. bright c. hot

d. cold ANS: D

Cryosurgery is performed with an extremely cold probe or substance to destroy tissue.

Cryosurgery has been used for many years to remove small skin lesions using liquid nitrogen.

DIF: 2

REF: p. 302

17. _______________ uses an intensely hot, precisely focused light beam to cut and coagulate

tissue. a. Electrosurgery b. Laser surgery c. Cryosurgery d. Argon surgery ANS: B

Laser is an acronym for light amplification by stimulated emission of radiation.

DIF: 2

REF: p. 302

18. ______________ is a characteristic of laser light when all the waves are exactly the same

length and they waves are lined up so that their peaks and troughs are in exactly the same location. a. Monochromatic b. Monopolar circuit c. Excimer d. Coherency ANS: D

All the waves in the laser light are exactly the same length and they waves are lined up so that their peaks and troughs are in exactly the same location, a quality called coherency.

DIF: 2

REF: p. 303

19. The grounding pad that is applied to the patient to carry electrical current flow from the

patient back to the power unit is known as the ________ electrode. a. dispersive b. active c. bovie d. ESU ANS: A

Patient return electrode (PRE) used in monopolar electrosurgery. The PRE is also known as a patient grounding pad, dispersive electrode, or inactive electrode.

DIF: 2

REF: p. 299

20. _____________________ is the term for complete destruction of tissue. a. Alternative site burn b. Ablation c. Fulguration

d. Coagulation ANS: B

Ablation is the complete destruction of tissue.

DIF: 2

REF: p. 301

21. The gas, liquid, or solid through which light energy is passed to create a laser beam,

contained within the optical resonant chamber, is known as ________. a. the laser medium b. solid state c. capacitive coupling d. coherency ANS: A

The distinctive characteristics of laser energy are created when light is pumped into a sealed chamber and filled with a laser medium (i.e., a gas, solid, or liquid). The chamber is called the optical resonant cavity.

DIF: 2

REF: p. 303

22. In laser technology, a series of mirrors that reflects photons or free electrons within the

optical resonant chamber and causes emission of more photons and the creation of laser energy is known as _____________. a. radiant exposure b. amplification c. selective absorption d. coherency ANS: B

When photons of a specific energy enter the chamber, they stimulate the high-energy atoms in the chamber to vibrate or resonate in duplicate wave patterns. Mirrors in the laser system bounce the photons back and forth through the laser medium in the chamber. This increases the number of resonating parallel photons and is called amplification.

DIF: 2

REF: p. 303

23. The destruction of cataracts using ultrasound technology is called ______________. a. ablation b. phacoemulsification c. coagulation d. fulguration ANS: B

Phacoemulsification is a process employing a delicate ophthalmological instrument (phacoemulsifier) that uses ultrasonic energy for the destruction of cataracts.

DIF: 2

REF: p. 302

24. In electrosurgery, _______ electromagnetic waves are used to produce the desired surgical

effect. a. amplitude

b. radiofrequency c. wavelength d. current ANS: B

Radiofrequency is electromagnetic energy in which the frequency is in the area of radio transmission. In electrosurgery, radiofrequency electromagnetic waves are used to produce the desired surgical effect.

DIF: 2

REF: p. 296

25. ___________ energy is created when electricity is transformed into mechanical energy to

high-frequency vibration and friction. a. Ultrasonic b. Kinetic c. Cold thermal d. Magnetic ANS: A

Ultrasonic energy is created when electricity is transformed into mechanical energy to high-frequency vibration and friction. The ultrasonic instrument simultaneously cuts and coagulates tissue by transmitting ultrasonic wave energy through specially designed forceps, scissors, or blades.

DIF: 2

REF: p. 302

26. All of the waves in laser light have exactly the same wavelength and therefore are

___________________. a. colorless b. monochromatic c. red d. white ANS: B

It is monochromatic (all waves are of the same wavelength).

DIF: 2

REF: p. 305

27. Lasers are distinguished by the functional or biophysical reaction of the ________. a. target tissue b. laser energy c. radiant exposure d. delivery system ANS: A

Lasers are distinguished by the functional or biophysical reaction of the target tissue.

DIF: 2

REF: p. 304

28. ___________ is a characteristic of laser energy in which some cells absorb the lasing

medium whereas others do not. This characteristic prevents the spread of heat (and damage) outside the target tissue.

a. b. c. d.

Radiant exposure Selective absorption Direct coupling Capacitive coupling

ANS: B

Selective absorption is an important characteristic of laser energy. This means that some cells absorb the lasing medium whereas others do not. This characteristic prevents the spread of heat (and damage) outside the target tissue.

DIF: 2

REF: p. 304

MATCHING

Choose from the terms listed and match them with their most correct description. a. Active electrode b. Patient return electrode 1. To prevent alternate site burns, the current exits the body through this highly conductive

electrode.

2. Electrosurgical handpiece or pencil 1. ANS: B 2. ANS: A

DIF: 3 DIF: 3

REF: p. 296 REF: p. 297

Choose from the terms listed and match them with their most correct description. a. Active electrode b. Patient return electrode 3. It may be activated by a switch located on the pencil or by a foot pedal 4. Its function is to capture electrical current from the active electrode and transmit it back to

the power unit.

3. ANS: A 4. ANS: B

DIF: 3 DIF: 3

REF: p. 297 REF: p. 307

Choose from the terms listed and match them with their most correct description. a. Active electrode b. Patient return electrode 5. Current must exit the body to complete the electrical circuit 6. Monopolar endoscopic procedures require metal cannulas and a type of monitoring to

prevent capacitive coupling.

5. ANS: B 6. ANS: A

DIF: 3 DIF: 3

REF: p. 299 REF: p. 302

Chapter 16: Moving, Handling, and Positioning the Surgical Patient Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Moving the arms away from the body is called _______________. a. adduction b. hyperextension c. abduction d. hyperflexion ANS: C

Movement of a joint or body part away from the body.

DIF: 2

REF: p. 309

2. The ________ position is a modification of prone position in which the patient lies on his

or her abdomen with the middle section of the table is flexed at a slight angle. a. Fowler b. prone c. jackknife or Kraske d. dorsal recumbent ANS: C

Also called jackknife position, the patient lies prone with the middle section of the table flexed at a slight angle.

DIF: 2

REF: p. 309

3. Injuries are reduced when health care providers use _____________. a. proper body mechanics b. restraints c. lower back muscles when lifting patients d. the stretcher to open a door ANS: A

Injuries are reduced when health care providers use proper body mechanics.

DIF: 2

REF: p. 311

4. To assist the patient when falling, ______________________. a. try to hold the patient up b. keep your feet close together and knees straight c. ease the patient to the floor, while protecting his or her head d. once the patient is on the floor, seek help ANS: C

To assist the falling patient, do not try to support the patient’s weight. Instead, ease the patient to the floor while protecting the person’s head.

DIF: 2

REF: p. 319

5. ____________________ must be lower than the patient’s body at all times. a. Bed rails b. The head of the bed c. The extension boot on an orthopedic table d. Drainage collecting units ANS: D

Drainage collecting units (e.g., urinary or chest units) must remain lower than the patient’s body at all times, and IV lines should be higher than the patient’s body.

DIF: 2

REF: p. 313

6. ______________________ must be higher than the patient’s body. a. Drainage bags b. Intravenous (IV) lines and fluid c. The room temperature d. Intravenous (IV) lines, fluid and the room temperature ANS: B

Drainage collecting units (e.g., urinary or chest units) must remain lower than the patient’s body at all times, and IV lines should be higher than the patient’s body. Secure IV bags and other drainage units to the gurney before moving the patient over.

DIF: 2

REF: p. 313

7. When passing through manually operated doors while transporting a patient,

___________________. a. push the foot of the stretcher forward against the door to open it b. open the doors first and secure them open c. always wait for someone to come through the door to help you d. shout for someone to help you ANS: B

When passing through manually operated doors, open the doors first and secure them open.

DIF: 2

REF: p. 315

8. Caregivers may accompany a(n) ________ patient to the surgical suite and stay through

anesthesia induction. a. combative b. trauma c. unresponsive d. pediatric ANS: D

Health care facilities allow caregivers to accompany the child to the holding area, and in many hospitals, a parent or other caregiver is permitted to stay in the operating suite during the induction of anesthesia.

DIF: 2

REF: p. 319

9. The developmental age of the ________ is critical for communication to be effective. a. child b. child’s caregiver c. anesthesia care provider d. person transporting the child ANS: A

Remember that children understand the meanings of words in their most literal sense. The child’s developmental age is critical to communication.

DIF: 2

REF: p. 319

10. An important element for the safety of the patient during positioning is ________. It is

necessary to provide smooth, step-by-step coordination. a. spur-of-the-moment decision making b. teamwork c. to always make the patient move herself or himself d. music ANS: B

Teamwork and clear communication are needed to create a safe, purposeful result.

DIF: 2

REF: p. 322

11. Sequential compression devices are used on patients having surgery to prevent ________. a. blood flow b. nerve damage c. muscle cramps d. blood pooling ANS: D

Antiembolism stockings or an SCD is placed on patients’ legs before long procedures or on patients predisposed to clot formation. This reduces the risk of blood pooling (stasis) and thrombus formation.

DIF: 2

REF: p. 326

12. The use of a footboard for the patient in the reverse Trendelenburg position may prevent

the patient from sliding downward, which can cause ______________. a. shearing injury b. vascular shift c. compartmental syndrome d. hypotension ANS: A

Shearing takes place when the patient is pulled over a high friction surface such as a bed sheet or blanket.

DIF: 2

REF: p. 323

13. The surgical team may begin positioning the patient only after the ________ gives his or

her permission. a. anesthesia provider b. surgeon c. surgical technologist d. perioperative nurse ANS: A

Positioning begins when the anesthesia provider states that it is safe to do so. He or she is in the best position to determine when it is safe to start positioning.

DIF: 2

REF: p. 323

14. The ________ position, or foot-down position, is used when the surgeon requires

unobstructed access to the upper abdominal cavity and lower esophagus. a. reverse Trendelenburg b. Trendelenburg c. Fowler’s d. semi-Fowler’s ANS: A

Reverse Trendelenburg is a foot-down variation on the supine position. It is used for procedures of the upper abdomen and neck.

DIF: 2

REF: p. 329

15. Lying with the abdomen downward, the patient is in the ________ position. a. supine b. prone c. lithotomy d. lateral ANS: B

In prone position the patient lies recumbent with the front of the body in contact with the operating table. Prone position provides exposure to the perianal region, buttocks, posterior spine, and posterior lower legs. A foam or gel chest lift may be used for access to the spine.

DIF: 2

REF: p. 334

16. A sitting position used for breast, shoulder, posterior cranium, and posterior spine

procedures is called the ________ position. a. Fowler b. semi-Fowler c. Trendelenberg d. reverse Trendelenberg ANS: A

Fowler is the sitting, reclining, or beach chair position is used for procedures of the breast, shoulder, posterior cranium, and posterior spine.

DIF: 2

REF: p. 332

17. A safety strap should be placed __________________ between the patient and the strap. a. directly on the patient’s skin with two finger’s space b. on top of a blanket or sheet with three finger’s space c. directly on the patient’s skin with three finger’s space d. on top of the blanket or sheet with four finger’s space ANS: B

The safety strap is placed 2 to 3 inches above the patient’s knees on top of the blanket or sheet. It is secured with three finger’s space between the patient and the strap.

DIF: 2

REF: p. 312

Chapter 17: Surgical Skin Preparation and Draping Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The ________ drape is used for procedures of the face, nose and throat. a. lithotomy b. extremity c. head d. incise ANS: C

The head drape is used for exposure of the face, nose, and throat.

DIF: 2

REF: p. 362

2. Surgeons use ________ to hold the towels in place when draping the patient. a. nonpenetrating towel clamps b. surgical tape c. penetrating towel clamps d. Esmarch bandages ANS: A

Use only nonpenetrating towel clamps for securing drapes. A hole in a drape creates a passageway for bacteria to contaminate the sterile field.

DIF: 2

REF: p. 357

3. When draping the patient for surgery, once a towel or drape has been placed on the patient,

________________. a. do not shift or move it b. it may be moved once c. it must be secured d. the skin prep is then performed ANS: A

After a drape has been placed, do not shift or move it.

DIF: 2

REF: p. 357

4. When prepping the abdomen for surgery, what should you do first? a. Prep the incision site. b. Start at the nipple line and work downward. c. Square the abdomen with sterile towels. d. Clean the umbilicus with swabs, and then begin at the incision site.

ANS: C

1. Square the abdomen with sterile towels. The upper towel is placed at the nipple line and the lower towel at the pubis. 2. Begin the prep at the umbilicus. Cleanse the umbilicus using cotton-tipped applicators dipped in prep solution to remove loose dead skin. 3. Prep the abdomen, starting at the incision site and moving to the periphery. 4. If soap solution is used, blot dry and then apply antiseptic paint. Allow the prep liquid to dry before applying drapes.

DIF: 2

REF: p. 349

5. A(n) ________ requires a preparation boundary that encompasses the neck, shoulder of the

affected side, thorax to the operating table surface, and mid-pelvic region. a. appendectomy b. radical mastectomy c. pelvic laparoscopy d. shoulder procedure ANS: B

A radical mastectomy requires a prep boundary that encompasses the neck, shoulder of the affected side, thorax to the operating table surface, and midpelvic region.

DIF: 2

REF: p. 347

6. In cardiac cases, the saphenous vein is often removed and used to replace the coronary

vessel. How is the patient prepped for this procedure? a. The leg and thorax are prepped at the same time. b. It depends on the prep solution used. c. A complete body prep is necessary including the full circumference of the legs bilaterally. d. Only the thorax is prepped.

ANS: C

In cardiac cases in which a saphenous graft is taken from one or both legs, a complete body prep is necessary, including the full circumference of the legs bilaterally.

DIF: 2

REF: p. 352

7. The purpose of draping is to provide ______________ around the surgical site. a. exposure b. a wide sterile area c. a protective barrier d. warmth for the patient ANS: B

The purpose of draping is to provide a wide sterile area around the surgical site.

DIF: 2

REF: p. 352

8. ________ result(s) when preparation solutions are allowed to pool underneath the patient. a. Nosocomial infections b. Contaminated areas c. Residual activity d. Chemical burns

ANS: D

Chemical burns can occur when the prepping agent is allowed to pool between the patient and the operating table linens, padding under the pneumatic tourniquet, or beneath the dispersive electrode.

DIF: 2

REF: p. 344

9. The most common prep solution for ophthalmic procedures is _______________. a. chlorhexidine b. duraprep c. dilute povidone-iodine d. alcohol ANS: C

Among approved preoperative skin antiseptics, only one is approved for use around the eyes and ears: dilute povidone-iodine.

DIF: 2

REF: p. 346

10. Urinary catheterization is a sterile procedure. Contaminants introduced by catheterization

increase the risk of _____________. a. urinary retention b. urinary tract infection c. bladder distension d. mucosal abrasions ANS: B

Urinary catheterization is a sterile procedure. The urinary bladder and proximal urethra are sterile, and contaminants introduced by catheterization increase the risk of urinary tract infection.

DIF: 2

REF: p. 342

11. _____________ is/are generally not removed from the surgical patient but will require a

surgeon’s order if it needs to be done. a. Body piercings b. Hair c. Makeup d. Medical alert bracelets ANS: B

Hair clipping requires a verbal or written order by the surgeon.

DIF: 2

REF: p. 339

12. ________ is the body’s primary defense against infection. a. Skin b. Immune system c. Hair d. Hygiene ANS: A

Skin is the body’s primary defense against infection.

DIF: 2

REF: p. 338

13. A cause of ________ is the normal skin bacteria of the patient and the surgical team

members being introduced into the incision. a. chemical burns b. desiccation c. strike-through contamination d. surgical site infections (SSI) ANS: D

When normal or transient bacteria are introduced into the surgical wound, they can cause a surgical site infection (SSI).

DIF: 1

REF: p. 338

14. A ________ catheter is the most common catheter used during a surgical procedure for

continuous drainage of the bladder. a. Foley b. straight c. intravascular d. suprapubic ANS: A

The most common method of continuous drainage is a Foley urinary catheter.

DIF: 1

REF: p. 339

15. Before surgery, the skin must be washed or painted with a(n) ________ to reduce the

number of transient and normal microorganisms to an absolute minimum. a. disinfectant b. antiseptic solution c. sterile solution d. hand soap ANS: B

Before surgery, the incision site and a wide area around it are cleansed or painted with an antiseptic to reduce the number of transient and normal microorganisms to an absolute minimum.

DIF: 1

REF: p. 338

16. ________ must never be shaved because of the failure to regrow or abnormal regrowth. a. Eyebrows b. Facial hair c. Arm hair d. Pubic hair ANS: A

Eyebrows and eyelashes are never or removed by other means because they may fail to regrow or may grow abnormally after removal.

DIF: 1

REF: p. 399

17. When the skin is prepped correctly the area is antiseptically cleansed in what manner? a. Incision site to periphery b. Periphery to incision site c. Top of incision to bottom of incision line d. Bottom of incision line to top of incision line ANS: A

When the skin is prepped correctly, the area is antiseptically cleaned from the center of the incisional site to the periphery.

DIF: 1

REF: p. 365

18. Only ________ are approved for use on skin and may be used for the surgical skin prep. a. antiseptics b. disinfectants c. sterile solutions d. betadine solutions ANS: A

Only antiseptic agents approved by the FDA for use on skin may be used for the prep.

Antiseptics used for surgical prep are mainly evaluated according to the following criteria: 1. Effectiveness on microbes, especially gram-negative and -positive bacteria 2. Toxicity 3. Ability to be used in or around the eyes, ears, mucous membranes, and neural tissue 4.

Flammability 5. Residual antimicrobial action after application and drying.

DIF: 1

REF: p. 342|p. 343

19. _____________ drapes are used whenever laser surgery is planned. a. Water-soaked b. Aluminum-coated c. Flame retardant d. light-reflecting ANS: B

Aluminum-coated drapes are used whenever laser surgery is planned. These deflect laser energy and prevent ignition in an oxygen-rich environment, especially in head and neck surgery.

DIF: 1

REF: p. 357

20. If an area of the drape is suspected of being contaminated, the area may be ___________. a. covered with another impervious drape b. removed by the sterile person c. ignored if 1/2 inch away from incision site d. removed by a nonsterile person ANS: A

Strike-through contamination occurs when a drape becomes soaked during surgery and solution penetrates to a nonsterile surface. Whenever possible, use only impervious drapes on areas likely to become soaked during surgery.

DIF: 1

REF: p. 357

21. Uncontrolled or unmonitored systems create a risk of __________. a. allergies b. chemical burn c. fire d. thermal burn ANS: D

Uncontrolled or unmonitored systems create a risk of thermal burns because the exact temperature is not known.

DIF: 2

REF: p. 344

22. Surgical prep agents can cause skin irritation, rash, or other __________. a. allergies b. chemical burn c. fire d. thermal burn ANS: A

Allergy to the prep solution may occur. Always check the patient chart for allergies before the surgical prep.

DIF: 2

REF: p. 344

23. Alcohol and alcohol-based prep solutions are volatile and flammable. When alcohol

solution or volatile fumes come in contact with heat sources, they can easily cause __________. a. allergies b. chemical burn c. fire d. thermal burn ANS: C

As stated above, alcohol prepping agents are highly flammable and create a risk of fire. In the presence of concentrated oxygen in an oxygen-enriched environment such as the operating room, the risk is even greater. Ignition can occur during electrosurgery or laser surgery. Closed cavities, such as the throat, are particularly at risk. Fumes from alcohol-based prep solutions can settle in spaces created by drapes and ignite in these areas.

DIF: 2

REF: p. 344

24. Serious _________ can occur when prep solutions are allowed to pool under the patient

during surgery. a. allergies b. chemical burns

c. fires d. thermal burns ANS: B

Chemical burns can occur when the prepping agent is allowed to pool between the patient and the operating table linens, padding under the pneumatic tourniquet, or beneath the dispersive electrode.

DIF: 2

REF: p. 344

25. During the cleansing process, the surgeon removes all foreign material and trims away

devitalized tissue called __________. a. trauma b. cardiovascular c. autograft d. debridement ANS: D

Trauma procedures may require debridement and removal of embedded foreign material as part of the prep or just before it with the patient under sedation.

DIF: 2

REF: p. 351

26. ______________ is a type of tissue that is removed from one site on the patient and

grafted to another site. a. Trauma b. Cardiovascular c. Autograft d. Debridement ANS: C

A tissue autograft is a graft that is removed from one site on the patient and grafted to another site.

DIF: 2

REF: p. 351

27. ____________ wounds are almost always contaminated because they are caused by

external forces and often occur in environments that are mildly or grossly contaminated. a. Trauma b. Cardiovascular c. Autograft d. Debridement ANS: A

Trauma wounds are almost always contaminated because they are caused by external forces and often occur in environments that are mildly or heavily contaminated.

DIF: 2

REF: p. 351

28. ____________ are folded in a specific way before sterilization so that they can be

positioned over the operative site and unfolded in a way that prevents contamination. a. Prep

b. Gowns c. Drapes d. All are correct ANS: C

Drapes are folded in a specific way before sterilization so that they can be positioned over the operative site and unfolded in a way that prevents their contamination.

DIF: 2

REF: p. 352

29. A retention catheter with a small, inflatable balloon at the tip is called a ______ catheter. a. Robinson b. Malcot c. Fogarty d. Foley ANS: D

Retention catheter is a type of urinary catheter that remains in place. Also called an indwelling or Foley catheter.

DIF: 2

REF: p. 338

30. Selection of the correct catheter is based on the patient’s __________. a. age, mental development, and sexual preference b. age, size, and the type of procedure c. age, size, and gender d. size, grade in school, and gender ANS: C

Prepackaged sterile catheterization kits contain the supplies needed for catheterization.

The correct catheter is selected based on the patient’s age, size, and gender.

DIF: 2

REF: p. 340

31. Catheterization of a female surgical patient requires the ______________ position. a. supine b. prone c. lithotomy d. knees slightly flexed ANS: D

A female patient is positioned with the knees slightly flexed and the hips externally rotated. The male patient is placed in the supine position.

DIF: 2

REF: p. 340

32. Which of the following statements is true regarding the sterile technique for placing a

Foley catheter? a. the dominant hand is to remain sterile while the non-dominant hand is nonsterile. b. Both hands must remain sterile for the procedure. c. If the catheter is placed before the prep has been done, it is not done using aseptic technique.

d. The insertion hand does not contact sterile supplies.

ANS: A

The sterile technique required for catheterization requires the dominant hand to remain sterile while the non-dominant hand is nonsterile. The non-dominant hand is used to stabilize the genitalia and expose the urethral meatus. The dominant hand remains sterile and contacts only the sterile supplies and catheter.

DIF: 2

REF: p. 340

Chapter 18: Surgical Skills I: Planning a Case, Opening, and Start of Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The ____________ containing towels, drapes, and gowns is centered on the back table and

opened using aseptic technique. a. wrapped basin b. instrument tray c. basic pack d. surgical drape ANS: C

The basic pack containing basic linens (towels, drapes, and surgeons’ gowns) is centered on the back table and opened using sterile technique.

DIF: 2

REF: p. 374

2. Using a(n) _____________ approach to all setups improves efficiency. a. nonstressful b. educated c. surgical d. methodical ANS: D

Using a methodical method for all setups improves efficiency and greatly decreases stress and errors in the learning stages.

DIF: 2

REF: p. 377

3. Before organizing and preparing supplies during setup, ___________ the sterile area. a. dry top b. increase the size of c. decrease the size of d. remove supplies from ANS: B

Before organizing and preparing supplies, increase the size of the sterile area.

DIF: 2

REF: p. 377

4. Avoid shifting items around from one place to another during setup. Try to handle an item

only once. Shifting items from one location to another without purpose increases the chance of ________________ and is not productive. a. injury b. confusion c. contamination d. missing items ANS: C

Avoid shifting the same items around from one place to another during the setup. Try to handle an item only once or twice. Shifting items from one location to another without purpose is not productive.

DIF: 2

REF: p. 378

5. You may have up to 10 trays on a complex case. This is why it is important to think about

what you need, locate it among all the supplies, and then put it in a specific place. If instrument trays must be stacked, place the ___________ ones on the bottom. a. least-used b. heavier c. empty d. large ANS: B

If instrument trays must be stacked, place heavier ones on the bottom. Heavier trays are stacked on the bottom.

DIF: 2

REF: p. 379

6. _________________ is/are responsible for ensuring that no item is left in a patient. a. Licensed professionals only b. The certified surgical technologist c. The surgeon d. All team members ANS: D

All team members are responsible for ensuring that no items are left in a patient. The scrubbed technologist or nurse and circulator normally perform the count together. In turn, they report the count to the surgeon, whether it is correct or incorrect.

DIF: 2

REF: p. 381

7. The count is performed by two people. Professional standard for counts as published by

AORN requires a _____________ and another health care worker such as the surgical technologist to perform the count. a. circulator b. surgeon c. surgical assistant d. licensed practical nurse ANS: A

The scrubbed technologist or nurse and circulator normally perform the count together.

DIF: 2

REF: p. 381

8. All sharps should be passed with ____________________. If hospital policy or an

individual surgeon has not implemented this technique, the scrub must pass sharps in the traditional manner. a. the technique requested on surgeon’s preference card b. care c. the left hand

d. a neutral zone (no-hands) technique ANS: D

The neutral zone is a physical location on the sterile field designated and understood by the surgical team as a physical space (shallow basin or magnetic board) where sharps are placed and retrieved. This prevents hand-to-hand contact with the surgical knife, suture needles, and other devices that can cause injury.

DIF: 2

REF: p. 386

9. The surgical technologist must keep track of the amount of _____________ used in the

wound so that estimated blood loss can be calculated. a. lap sponges b. Raytec c. irrigation fluid d. local anesthetic ANS: C

All irrigation fluid must be measured by the surgical technologist and recorded as it is used so that total blood loss can be calculated accurately.

DIF: 2

REF: p. 380

10. The process preceded by patient verification process detailed by The Joint Commission is

called ______. a. assignment board b. TIMEOUT c. sentinel event d. assessment ANS: B

The surgical TIMEOUT (universal protocol) has been developed in response to the high rate of wrong site and wrong patient surgeries. The protocol is specific, precise, and mandatory in all accredited health facilities.

DIF: 1

REF: p. 386

11. A tissue implant derived from another person, animal, or the patient is called a(n)

____________. a. graft b. implant c. dissection d. section ANS: A

A graft is tissue taken from a distant site on the patient, another person, or animal and used to replace tissue lost from disease or injury.

DIF: 1

REF: p. 371|p. 372

12. A method used for gathering supplies for a case is referred to as a(n) _________ system. a. assignment board

b. case cart c. protocol d. event related ANS: B

The method used to gather supplies for a case depends on the system established by the health care facility. The process is called “picking a case” or “pulling a case.” The case cart method is most commonly used.

DIF: 1

REF: p. 373

13. A(n) __________________________ is a database containing each surgeon’s particular

routines for specific instruments for a particular surgery. a. surgeon’s preference card b. assignment board c. case plan d. Universal Protocol ANS: A

Each surgeon’s preference card contains a list of the specific instruments, equipment, drugs, suture, and other items that a particular surgeon uses on a specific surgery.

DIF: 2

REF: p. 374

Chapter 19: Surgical Skills II: Intraoperative and Immediate Postoperative Period Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. A ________ suture is a suture-needle combination designed to discharge the suture easily. a. double-armed b. spring-eye needle c. swaged suture-needle combination d. control-release ANS: D

A detachable suture is one in which the suture detaches from the needle by pulling it straight back from the swage. These are referred to by their proprietary names such as De-tach or Control-release.

DIF: 2

REF: p. 405

2. The ________ needle has a round body that narrows to a sharp point. It punctures tissue,

making an opening for the body of the needle to follow. Its primary use is for suturing soft tissue. a. blunt b. tapered c. cutting d. spatula ANS: B

The tapered needle has a round body that tapers to a sharp point. It punctures tissue, making an opening for the body of the needle to follow. Its primary use is for suturing soft tissue, such as muscle, subcutaneous fat, peritoneum, dura, and gastrointestinal, genitourinary, biliary, and vascular tissue.

DIF: 2

REF: p. 410

3. The process of suturing two tissue edges together is called __________. a. approximation b. ligation c. stitching d. locking ANS: A

The primary use of sutures is to bring tissue edges together. The process of suturing two opposing tissue edges together is called approximation. Suture is also used to tie, or ligate, bleeding vessels.

DIF: 2

REF: p. 412

4. A(n) ________ suture is a continuous suture used to approximate the open ends of a

lumen. It is traditionally used during an appendectomy to close the base of the appendix after the distal portion is removed.

a. b. c. d.

interrupted running mattress purse-string

ANS: D

The purse-string suture is a special continuous suture technique for closing the end of a tubular structure (lumen), such as the appendix, its most common application. In this technique, one end of the suture is anchored, and stitches are placed around the periphery of the open lumen.

DIF: 2

REF: p. 413

5. In areas where great strength is required, such as abdominal incisions, ________ sutures

are used in conjunction with routine abdominal suture layers to add support to the closure. a. retention b. continuous c. horizontal mattress d. vertical mattress ANS: A

Retention sutures are a type of interrupted technique used to provide additional support to wound edges in abdominal surgery. In this technique, heavy sutures are placed though all the tissue layers of the body wall several centimeters from the primary suture line.

DIF: 2

REF: p. 414

6. When cutting sutures, use only ________ scissors. To cut the suture, open the scissors

slightly. Use only the tips of the scissors to cut; never the midportion of the blades. Cut only when you can see what you are cutting. a. tissue b. bandage c. sharp suture d. Potts ANS: C

1. Use only sharp suture scissors; never use tissue scissors on suture material.

2. To cut the suture, open the scissors slightly. Use the tip of the scissors to cut.

3. Hold the scissors as shown in FIG 19.34.

4. Place your index finger over the top of the scissors to steady the blades. Turn the scissors at a 45-degree angle. This creates a small “whisker.” Cut the suture ends while keeping the scissors at an angle.

5. When cutting sutures and performing other tasks at the same time, it is convenient to “palm” the scissors in one hand (FIG 19.35).

6. Remove any cut suture ends from the wound area to prevent them from falling into the wound.

DIF: 2

REF: p. 421

7. The ability of suture material to absorb fluid is called _______. a. inert

b. tensile strength c. enzymatic action d. capillary action ANS: D

Sutures made of multifilament strands absorb moisture and hold body fluids (called wicking or capillary action).

DIF: 2

REF: p. 404

8. The ________ phase of wound healing is the proliferative stage. During this phase,

fibroblasts synthesize collagen and other cell matrices. a. substrate b. lag c. remodeling d. second ANS: D

The proliferative phase begins on about day 4 or 5 and continues for approximately 2 weeks. During this phase, fibroblasts synthesize collagen and other cell matrices. These form the ground substance of the new tissue, providing support and strength.

DIF: 2

REF: p. 430

9. Excess inflammation and serous discharge from the wound is a sign of surgical

__________________. a. site infection b. incision healing c. site dehiscence d. site drainage ANS: A

The first signs of infection are excess inflammation and serous discharge from the wound.

DIF: 2

REF: p. 431

10. ______________ will contribute to the healing process of the surgical incision. a. Surgical technique b. Chronic disease c. Nutritional status d. All are correct ANS: D

Factors that affect wound healing are immune system, chronic disease, fluid and electrolyte balance, nutritional status, obesity, age, and surgical technique.

DIF: 2

REF: p. 431

11. Surgical gut sutures are packaged in a(n) ______________ solution. a. alcohol b. saline c. sterile water

d. polybutelate ANS: A

Gut requires special handling to preserve its strength and pliability. The sutures are packaged in an alcohol and water solution, which can be a source of fire on the surgical field.

DIF: 2

REF: p. 406

12. _______________ is/are tubing through which retention sutures are threaded to prevent

them from cutting into the patient’s skin. a. Penrose drain b. Bolsters c. Binders d. Montgomery straps ANS: B

As each suture is drawn tight, it pulls the edges of the incision into approximation without cutting into the tissue. Plastic or rubber bolsters, or small lengths of tubing, are threaded through the suture to distribute the tension and prevent it from cutting into the patient’s skin.

DIF: 2

REF: p. 414

13. A free-tie suture attached to the end of a clamp is called a _________. a. deep tie b. clamp tie c. tie on a passer d. suture on a clamp ANS: C

When suture ties (without a needle) are required deep in the wound, they must be passed on a right-angle or curved clamp. The tip of the suture tie is grasped by the tip of the clamps. This allows the surgeon to slip the instrument tip under the vessel or other structure to be ligated.

DIF: 2

REF: p. 415

14. A monofilament suture is extruded from the package and _________. a. stretched slightly b. soaked in saline c. soaked in antibiotic solution d. coiled to increase tensile strength ANS: A

A monofilament is a single continuous fiber made by extruding and stretching a synthetic material.

DIF: 2

REF: p. 403

15. Load the needle holder ________ removing the entire needle suture combination from the

package.

a. b. c. d.

after before while never

ANS: B

Load the needle holder before removing the entire needle-suture from its package.

DIF: 2

REF: p. 417

16. Most commercial needles are now manufactured with the suture preattached. This is called

a ________________ suture. a. Swage b. French eye c. monofilament d. braided ANS: A

Most commercial needles are now manufactured with the suture pre-attached. This is called a swaged or atraumatic suture. During manufacturing, the suture is inserted into the hollow lumen of the needle, and the area is crimped and sealed.

DIF: 2

REF: p. 405

17. A suture that causes little or no bioactivity is said to be ________. a. inert b. control-released c. active d. bio-balanced ANS: A

Sutures that cause little or no bioactivity are said to be highly inert, causing little or no inflammation.

DIF: 2

REF: p. 404

18. A suture-needle combination containing a needle at each end of the suture is called a

__________ suture. a. double-armed b. double-needle c. double-threaded d. double-hooked ANS: A

A double-armed suture is one with a needle swaged to each end. This type of suture is used for circular incisions, such as in ophthalmic surgery, or for hollow lumens, such as blood vessels or the intestine DIF: 2

REF: p. 405

19. A ____________ suture with long suture length is anchored at one end of the tissues, and

the needle alternated from one side of the tissue edge to the other the entire length of the wound. a. simple or interrupted b. continuous or running c. swaged d. braided ANS: B

The continuous or running suture has a knot at the beginning and at the end. It is composed of one continuous strand of suture. The needle is alternated from one side of the tissue edge to the other, as one would when sewing.

DIF: 2

REF: p. 412

20. How to position the needle holder in relation to the suture needle depends on whether the

________ is right-handed or left-handed. a. surgeon b. surgical technologist c. circulator d. anesthesiologist ANS: A

The position of the needle holder in relation to the suture needle depends on: • Whether the surgeon is right-handed or left-handed • Whether the surgeon stands opposite the ST or next to the ST • Whether the suture is requested as “back-handed” DIF: 2

REF: p. 418

21. Surgeons are accustomed to receiving sutures from the scrub in a prescribed manner for

__________. a. better utilization of the suture b. safety and efficiency of movement c. adhering to policy d. increasing infection control ANS: B

One of the primary skills of the surgical technologist is the management of sutures during surgery. Surgeons are accustomed to receiving sutures from the ST in a prescribed manner for safety and efficiency of movement.

DIF: 2

REF: p. 415

MATCHING

Choose from the terms listed and match them with their most correct description. a. Wound complications b. Wound healing c. Wound classification

1. Seroma and hematoma 2. Inflammatory phase 3. Clean contaminated wound 1. ANS: A 2. ANS: B 3. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 431 REF: p. 430 REF: p. 429

Choose from the terms listed and match them with their most correct description. a. Wound complications b. Wound classification 4. Evisceration 5. Contaminated wound 4. ANS: A 5. ANS: B

DIF: 3 DIF: 3

REF: p. 431 REF: p. 429|p. 430

Choose from the terms listed and match them with their most correct description. a. Wound complications b. Wound healing 6. Remodeling phase 7. Adhesions 6. ANS: B 7. ANS: A

DIF: 3 DIF: 3

REF: p. 430 REF: p. 431

Choose from the terms listed and match them with their most correct description. a. Wound complications b. Wound healing c. Wound classification 8. Proliferative phase 9. Clean wound 10. Surgical site infection 8. ANS: B 9. ANS: C 10. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 430 REF: p. 429 REF: p. 431

Choose from the terms listed and match them with their most correct description. a. Suture material b. Surgical needle characteristic c. Suturing technique 11. Tapered 12. Running or continuous 13. Vicryl 11. ANS: B

DIF: 3

REF: p. 410

12. ANS: C 13. ANS: A

DIF: 3 DIF: 3

REF: p. 412 REF: p. 406

Choose from the terms listed and match them with their most correct description. a. Suture material b. Surgical needle characteristic c. Suturing technique 14. Conventional cutting 15. Polypropylene 16. Interrupted 14. ANS: B 15. ANS: A 16. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 410 REF: p. 408 REF: p. 412

Choose from the terms listed and match them with their most correct description. a. Suture material b. Suturing technique 17. Stainless steel 18. Subcuticular 17. ANS: A 18. ANS: B

DIF: 3 DIF: 3

REF: p. 421 REF: p. 413

Choose from the terms listed and match them with their most correct description. a. Surgical needle characteristic b. Suturing technique 19. French eye 20. Suture ligature 19. ANS: A 20. ANS: B

DIF: 3 DIF: 3

REF: p. 405 REF: p. 414

Chapter 20: Minimally Invasive Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. After precleaning, a flexible endoscope must be _______________. a. flushed with saline b. sterilized c. soaked in enzymatic cleaner d. leak tested ANS: D

After precleaning, a flexible endoscope must be leak tested.

DIF: 2

REF: p. 453

2. A _______________________ is used to assess the regional anatomy, to obtain tissue

biopsies, and to perform minor surgical procedures. a. laparoscope b. rigid endoscope c. flexible endoscope d. rigid telescope ANS: C

A flexible endoscope is used to assess the regional anatomy, to obtain tissue biopsies, and to perform minor surgical procedures.

DIF: 2

REF: p. 451

3. The flexible tip of the endoscope is operated at the control head to obtain ________. a. direct views b. rotational views c. biopsies d. washings ANS: B

The flexible tip of the endoscope is operated at the control head to obtain rotational views.

DIF: 2

REF: p. 451

4. Surgical _________ are used in place of suture ligatures to occlude blood vessels or other

types of hollow structures, such as the bile ducts. a. suture b. sponges c. clips d. clamps ANS: C

Surgical clips are used in place of suture ligatures to occlude blood vessels or other types of hollow structures, such as the bile ducts.

DIF: 2

REF: p. 443

5. While cleaning, look for defects in the surface of the instrument. Look for any signs of

instrument housing and ____________ damage that may cause accidental burns to the patient. a. insulation b. working tips c. finger rings d. grip mechanisms ANS: A

While cleaning, look for defects in the surface of the instrument. Look for any signs of instrument housing and insulation damage that may cause accidental burns to the patient.

DIF: 2

REF: p. 453

6. To prevent damage to a telescope, you should never carry or hold it ________________. a. without a container b. with one hand c. by the head d. by the shaft ANS: D

To prevent damage to a telescope, you should never carry or hold it by the shaft.

DIF: 2

REF: p. 438

7. The clarity of an image that the camera provides depends on ________. a. how many pixels or silicon units the camera chip contains b. the user’s knowledge and experience c. the quality of the video system d. the quality of overhead lighting ANS: A

The clarity of an image that the camera provides depends on how many pixels or silicon units the camera chip contains.

DIF: 2

REF: p. 438

8. The __________________ connects the camera to the telescope and is specific to the type

of camera and scope in use. a. hard coupler b. endocoupler c. camera coupler d. duocoupler ANS: B

The endocoupler connects the camera to the telescope and is specific to the type of camera and scope in use.

DIF: 2

REF: p. 438

9. When a fiberoptic cable is in use, it must not be activated until it is attached to the system.

The intense light rays can ________. a. cause serious eye damage to surgical personnel b. easily ignite the patient’s drapes c. restrict the surgical team member’s view d. cause the longitudinal fibers to break ANS: B

When a fiberoptic cable is in use, it must not be activated until it is attached to the system.

The intense light rays can easily ignite the patient’s drapes.

DIF: 2

REF: p. 435

10. When the telescope is introduced into the body, the temperature difference creates

_______ on the telescope lens. a. clearness b. crystals c. cracks d. fogging ANS: D

When the telescope is introduced into the body, the temperature difference creates fogging on the telescope lens.

DIF: 2

REF: p. 438

11. The proximal section of a flexible endoscope where the controls are located is called the

___________________. a. capacitator b. focus ring c. trocar d. control head ANS: D

The proximal section of a flexible endoscope where the controls are located is called the control head.

DIF: 2

REF: p. 434

12. A(n) ________ is used to create ports or channels through the body wall for the insertion

of MIS instruments. a. trocar-cannula system b. insufflator c. uterine manipulator d. Veress needle ANS: A

A trocar and cannula system are used to create ports or channels through the body wall for the insertion of MIS instruments.

DIF: 2

REF: p. 440

13. MIS is performed with the use of a ________ and ________, which are introduced into the

body through small incisions at the operative site. a. long surgical instrument; audio b. lensed telescope; long instruments c. short surgical device; open drainage d. no surgical; open drainage ANS: B

MIS is performed with the use of a lensed telescope and long instruments, which are introduced into the body through very small incisions at the operative site.

DIF: 2

REF: p. 435

14. A traditional surgical procedure that includes a large incision and wide access to the

targeted tissue is a(n) ________ procedure. a. open b. minimally invasive c. closed d. reduced ANS: A

Open surgery requires a larger incision and is performed directly on the tissues through that incision, without an interface.

DIF: 2

REF: p. 435

15. A ______________ is needed to create a pneumoperitoneum. a. distractor b. Veress needle c. uterine sound d. dilator ANS: B

To create a pneumoperitoneum, the surgeon inflates the abdomen with CO2 through a large-bore needle called a Veress needle or trocar fitted for CO2 insufflation.

DIF: 2

REF: p. 441

16. When passing an instrument to the surgeon, you should always orient the instrument so

that the working tip points __________. a. downward b. upward c. away from the surgeon and d. away from the technologist and ANS: A

When passing an instrument to the surgeon, always orient the instrument so that the working tip points downward.

DIF: 2

REF: p. 449

17. During MIS, the room lights are usually ________.

a. b. c. d.

left on as brightly as possible dimmed or powered off adjusted per surgeon preference adjusted per circulator preference

ANS: B

During MIS, the room lights usually are dimmed or powered off.

DIF: 2

REF: p. 449

18. Integrated or hybrid operating rooms provide the most advanced computer and digital

technologies, including data management, storage, and transfer required for MIS and _________ procedures. a. robotic b. remote c. computer-assisted d. technology-enhanced ANS: A

The integrated or hybrid operating room provides a method for the delivery and integration of digital technologies to the surgical suite. It provides the most advanced computer and digital technologies, including data management, storage, and transfer required for MIS and robotic procedures.

DIF: 2

REF: p. 440

19. In minimally invasive surgery, the abdominal cavity is filled with carbon dioxide, which

provides a clear view of the anatomy. This process is called _________. a. insufflation b. arthroscopy c. inflation d. filing ANS: A

Insufflation is a process in which the abdominal and sometimes the thoracic cavities are filled with carbon dioxide (CO2) gas. This provides a clear view of the anatomy and permits safe entry of the rigid telescope and other instruments during the procedure.

DIF: 2

REF: p. 441

20. Each silicon element in the chip represents one _________. a. dimmer b. pixel c. meter d. resolution ANS: B

Each silicon element in the chip represents one pixel.

DIF: 2

REF: p. 438

21. _________ systems can be disposable, reusable, or reposable.

a. b. c. d.

Trocar-cannula Specimen retrieval Fenestrated lumen Open drainage

ANS: A

Trocar-cannula systems can be disposable, reusable, or reposable.

DIF: 2

REF: p. 440

22. _________ frequency bipolar electrosurgery is used to coagulate and cut through tissue. a. Highb. Lowc. Moderated. QuickANS: A

High-frequency bipolar electrosurgery is used to coagulate and cut through tissue.

DIF: 2

REF: p. 448

23. _________ and_________ modalities have replaced traditional sutures in many

endoscopic procedures. a. Electrosurgical; ultrasound b. Electrocardio; static c. Antistatic; static d. Septic; adaptive ANS: A

Electrosurgical and ultrasound modalities have replaced traditional sutures in many procedures.

DIF: 2

REF: p. 443

24. After the leak test, the _________ is cleaned manually. a. camera b. endoscope c. camera lens d. camera and endoscope case ANS: B

After the leak test, the endoscope is cleaned manually.

DIF: 2

REF: p. 453

25. Among the new skills that surgeons must learn when using robotic surgery is the loss of

_________ feedback. a. haptic b. septic c. hepatic d. aseptic ANS: A

Haptic feedback: Tactile feedback, conveyed from tissue to the hand when a surgical instrument is used.

DIF: 2

REF: p. 434

MATCHING

Choose from the terms listed and match them with their most correct description. a. Minimally invasive surgery b. Flexible endoscopy 1. Primary benefits include less tissue trauma and postoperative pain and a shorter recovery

time 2. Primary use is in diagnostic procedures 1. ANS: A 2. ANS: B

DIF: 3 DIF: 3

REF: p. 454 REF: p. 455

Choose from the terms listed and match them with their most correct description. a. Minimally invasive surgery b. Flexible endoscopy 3. Surgical specialties where used would include abdominal, gynecological, orthopedic,

thoracic, and genitourinary surgery 4. Must be leak tested after precleaning 3. ANS: A 4. ANS: B

DIF: 3 DIF: 3

REF: p. 445 REF: p. 453

Choose from the terms listed and match them with their most correct description. a. Instrument b. Technique c. Imaging d. Insufflation 5.

6.

7.

8.

Trocar placement Probe Accomplished through a Veress needle Fiberoptic light cord

5.

6.

7.

8.

ANS: B ANS: A ANS: D ANS: C

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 440 p. 445 p. 442 p. 448

Choose from the terms listed and match them with their most correct description. a. Instrument b. Imaging c. Insufflation 9. High-resolution monitor

10. Suction/irrigator 11. Introduction of CO2 9. ANS: B 10. ANS: A 11. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 439 REF: p. 450 REF: p. 441

Choose from the terms listed and match them with their most correct description. a. Imaging b. Insufflation 12. Tissue expansion 13. Camera control unit 12. ANS: B 13. ANS: A

DIF: 3 DIF: 3

REF: p. 455 REF: p. 439

Chapter 01: The Surgical Technologist Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The professional association for surgical technologists is the . a. Association of periOperative Registered Nurses b. American College of Surgeons c. Association of Surgical Technologists d. Accreditation Review Committee on Education in Surgical Technology ANS: C The AST is the surgical technologists’ professional organization. The association promotes professional standards by providing services to its members as well as legislative support to promote and formalize the status of surgical technologists.

DIF:

1

2.

REF: p. 3 demonstrates that a surgical technologist from an accredited program has achieved a minimum level of knowledge and

skills. a. Licensure b. An associate’s degree c. Graduation d. Certification ANS: D Certification is a demonstration of competency to a particular standard, usually set by the professional organization.

DIF:

1

REF: p. 4

3. Certification for the surgical technologist is a. mandatory b. voluntary c. unnecessary d. invalid

.

ANS: B Certification is mandatory in some states for an individual to work in the profession. However, in most states certification is voluntary. Note: All graduates from a CAAHEP-accredited program are required to take the CST examination before graduation.

DIF:

1

REF: p. 4

4. Certification differs from licensure in that certification . a. does not require continuing education credits b. allows employers to evaluate prospective employees by one verifiable national standard c. is not currently mandatory to practice in all 50 states d. is a no-cost examination ANS: C Licensure is a process in which the state government issues registration and the right to practice. Certification is mandatory in some states for an individual to work in the profession. This requirement is the national trend because it provides a demonstrable standard of knowledge. At the time of this writing, mandatory graduation from an accredited surgical technology program and certification is required in the states of Idaho, Indiana, Massachusetts, New Jersey, New York, South Carolina, Tennessee, and Texas. Two other states—Colorado and Washington—require formal registration of the individual’s legal name and place of residence.

DIF:

1

REF: p. 4

5. The profession of surgical technologist is defined today as a result of a. less demanding professional needs b. rapid monumental developments in technology in general c. growing demands in the ancillary departments d. advances in digital technology ANS: B Rapid monumental developments in technology help define the role of the surgical technologist.

DIF:

1

REF: p. 2

6. The need for assistive personnel in surgery did not arise until a. World War I b. Korean War c. Civil War d. World War II ANS: D The need for assistive personnel in surgery did not arise until World War II. DIF:

1

REF: p. 2

.

7. During World War I, a. nurses b. assistants c. Corpsmen d. orderlies

worked on the battlefield to offer aid and comfort to the wounded.

ANS: C During World War I, Corpsmen worked on the battlefield to offer aid and comfort to the wounded.

DIF:

1

REF: p. 2

8. A new profession was born in the Army for the Corpsman; it was named a. Corpsman I b. nurse c. CST d. ORT

.

ANS: D ORT, operating room technician, was a new profession born in the Army for the Corpsman.

DIF:

1

REF: p. 2

9. Registered nurses continued to fill the role of the scrub, or “instrument,” nurse until about a. 1970 b. 1965 c. 1966 d. none of the above

.

ANS: B RNs continued to fill the role of the scrub, or instrument, nurse until 1965.

DIF:

1

REF: p. 2

10. The Association of periOperative Registered Nurses (AORN) published a book called a. The Role of the Operating Room Technician b. Teaching in the Operating Room c. Teaching the Operating Room Technician d. Surgical Techniques for Operating Room Technician

.

ANS: C The Association of periOperative Registered Nurses (AORN) published a book called Teaching the Operating Room Technician.

DIF: 11. In a. b. c. d.

1

REF: p. 2

the AORN board of directors created the 1968, Association of Operating Room Technicians 1965, Association of Operating Room Technicians 1968, Association of Operating Room Nurses 1967, Association of Operating Room Nurses

.

ANS: C In 1968, the AORN board of directors created the Association of Operating Room Nurses.

DIF:

1

REF: p. 2

12. AORT stands for . a. Association of Operating Radiology Technician b. Association of Ophthalmic Register Technician c. Association of Operating Respiratory Technician d. Association of Operating Room Technicians ANS: D AORT stands for Association of Operating Room Technicians.

DIF:

1

REF: p. 2

13. In an effort to formalize technologists’ education, AORT created two new committees, which are the Joint Review Committee and the . a. AST b. LCC-ST c. CST d. CORT-ST ANS: B In an effort to formalize technologists’ education, AORT created two new committees, the Joint Review Committee and the Liaison Council on Certification for the Surgical Technologist (LCC-ST).

DIF:

1

REF: p. 2-3

14. The surgical technologist’s professional organization that supports students and graduates is a. LCC b. CST c. AST d. NBSTSA

.

ANS: C The surgical technologist’s professional organization that supports students and graduates is the Association of Surgical Technologists (AST).

DIF:

1

REF: p. 3

15. At the national level, AST provides the following support to students and graduates of surgical technologist and teaching institutions and the public . a. maintains practice standards, code of ethics, and code of conduct for the surgical technologist b. publishes a professional journal, The Surgical Technologist c. holds annual conferences for surgical technologists and educators d. all of the above ANS: D At the national level, AST provides the following support to students and graduates of surgical technologist and teaching institutions and the public: maintains practice standards, code of ethics, and code of conduct for the surgical technologist; publishes a professional journal, The Surgical Technologist; and holds annual conferences for surgical technologists and educators.

DIF:

1

REF: p. 3

16. It is important for students to become active members of AST to promote a. standards of the profession b. the Association of Surgical Technology c. the Accrediting Review Council on Education in Surgical Technology d. themselves

.

ANS: A It is important for surgical technology students to become active members of the AST to promote the standards of the profession.

DIF:

1

REF: p. 3

17. As a body of professionals, surgical technologists are supported by a number of key organizations and partners. Each has a designated role in . a. certification, standards, continuing education, and promotion b. continuing education, promotion, standards, and accreditation c. standards, continuing education, accreditation, and promotion d. promotion, certification, accreditation, and continuing education ANS: D As a body of professionals, surgical technologists are supported by a number of key organizations and partners. Each has a designated role in promotion, certification, accreditation, and continuing education.

DIF:

1

REF: p. 3

18. The Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA) provides educational recommendations and required for accreditation of programs in surgical technology and surgical first assisting. a. guidelines b. rules c. standards d. grades ANS: C The Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA) provides educational standards and recommendations required for accreditation of programs in surgical technology and surgical first assisting.

DIF:

1

REF: p. 3

19. Which of the following organizations oversees certification and credentialing for the surgical technologist? a. AORN b. AST c. NBSTSA d. CAAHEP ANS: C The National Board of Surgical Technology and Surgical Assisting (NBSTSA) oversees certification and credentialing of surgical technologists and surgical assistants.

DIF:

1

REF: p. 3

20. Accreditation is granted to a school only after a. review of curriculum b. full on-site visit c. council review at the end of the year d. curriculum is submitted

.

ANS: B Accreditation is granted to a school only after a full on-site evaluation of the program and its facilities to ensure compliance with ARC/STSA standards.

DIF:

1

REF: p. 3

21. Surgical technologists are trained in a. 2-year colleges b. military c. proprietary certificate programs d. all the above

.

ANS: D Surgical technologists are trained in 2-year colleges, the military, and proprietary certificate programs.

DIF:

1

REF: p. 4

22. The Accrediting Bureau of Health Education Schools (ABHES) is another a. for-profit b. nonprofit c. semiprofit d. none of the above

accrediting body.

ANS: B ABHES is another nonprofit accrediting body.

DIF:

1

REF: p. 3

23. Certification through the Association of Surgical Technologists requires a. graduation from an ABHES-accredited school b. graduation from an Armed Forces program c. graduation from a CAAHEP-accredited school d. all of the above

.

ANS: D Certification through the Association of Surgical Technologists requires graduation from an CAAHEP-accredited school, ABHES-accredited school, and federally sponsored Armed Forces program.

DIF:

1

REF: p. 3

24. Certification demonstrates . a. standard of knowledge b. advanced level competencies c. understanding of the principles and practices of surgery d. support for NBSTSA ANS: A Certification demonstrates a standard of knowledge and understanding of the principles of surgical technology.

DIF:

1

REF: p. 4

25. To be eligible to take the certification examination, the applicant must meet all requirements EXCEPT a. be a graduate of an accredited program (ABHES and CAAHEP) b. currently be a CST c. be a graduate of a military program d. have 7 of the last 10 years documented scrub experience

.

ANS: D Individuals must be a graduate of an accredited program (CAAHEP and ABHES), currently a CST, and a graduate of a military program.

DIF:

1

REF: p. 4

26. The National Center for Competency Test requires applicants to have the following a. high school diploma or GED b. be a graduate of a formal operating room technician (ORT) training program c. A and B d. none of the above

.

ANS: C NCCT applicants must have a high school diploma or GED, be a graduate of an ORT training program, and have 7 years of validated scrub experience within the past 10 years.

DIF:

1

REF: p. 4

27. Suzie has taken the CST examination and passed. For Suzie to keep her certification without retaking the examination, she must do one of the following . a. attend the national conference b. maintain continuing education (CE) credits c. nothing d. attend all state meetings ANS: B CE credits provide an opportunity for professionals to improve their knowledge and competency.

DIF:

1

REF: p. 4-5

28. The stated goals of a career ladder are primarily to do all the following EXCEPT a. improve patient care b. promote accountability c. encourage employer recognition of the surgical technologist d. encourage experienced surgical technologists to contribute to the professional growth of their own career

.

ANS: D The stated goals of a career ladder are primarily to improve patient care, encourage employer recognition of the surgical technologist, promote accountability, increase the visibility of the surgical technologist’s role in the health care facility, and encourage experienced surgical technologists to contribute to the professional growth of others.

DIF:

1

REF: p. 5

29. The nonsterile member of the surgical team is called a. assistant b. scrub c. circulator d. surgeon

.

ANS: C The circulator is a nonsterile team member.

DIF:

1

REF: p. 6

30. The surgical technologist who works in a hospital or other facility that provides 24-hour care is usually required to a. take a break every hour b. be on “call” c. do nothing d. none of the above

.

ANS: B The surgical technologist who works in a hospital or other facility that provides 24-hour care is usually required to be on “call.”

DIF:

1

REF: p. 6

31. The larger picture casts the surgical technologist’s role as a combination of four main areas of health care and technology EXCEPT . a. educator and preceptor b. participant in leadership and management c. patient care provider in the perioperative setting d. specialist in sterilization ANS: D The larger picture casts the surgical technologist’s role as a combination of four main areas of health care and technology: assistant in surgical procedures as part of the surgical team; specialist in the preparation, handling, and use of surgical devices, equipment, and instruments; patient care provider in the perioperative setting; participant in leadership and management, and educator and preceptor.

DIF:

1

REF: p. 7

32. James is a new graduate, and he is looking for a job in surgical technology. Career services has met with him and had him fill out applications for the following jobs. Of the following job fields, which one does James NOT qualify for as a new graduate? a. CST b. Central processing manager c. VA hospital, ST position d. Educator ANS: D Public trust means that patients, their families, and others in the care environment maintain a high level of confidence in the professionals who care for them. Entry-level certification and at least 2 years of experience in surgery are the minimum requirements for an educator position.

DIF:

1

REF: p. 8

33.

has particular attributes, attitude, and behavior that reflect a high standard of accountability, ethics, honesty, and respect for people. a. Someone highly trained b. Someone who uses his or her skills c. A professional d. Surgical technologist ANS: C Professionals have particular attributes, attitude, and behavior that reflect a high standard of accountability, ethics, honesty, and respect for people.

DIF:

1

REF: p. 9

MATCHING Match each item with the correct acronym. a. NBSTSA b. ABHES c. ARC/STSA d. CAAHEP e. AORN f. AST g. ORT h. CFA i. ACS j. RN k. CST l. NCCT m. STCR n. LPN 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

Surgical Technologist Circulating Role Operating Room Technician National Board of Surgical Technology and Surgical Assisting Association of Operative Registered Nurses Licensed practical nurse Accrediting Bureau of Health Education Schools Registered nurse Association of Surgical Technologists Commission on Accreditation of Allied Health Education Programs American College of Surgeons Certified surgical technologist Accreditation Review Council on Education in Surgical Technology and Surgical Assisting Certified first assistant National Center for Competency Testing

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS:

M G A E N B J F D I K C H L

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 6 p. 2 p. 3 p. 2 p. 4 p. 3 p. 4 p. 3 p. 3 p. 4 p. 3 p. 3 p. 8 p. 4

Match the definition with the role of the surgical technologist. You may use the same answer more than once. a. Scrub role b. Circulator c. Second assistant d. Preceptor e. Instrumentation specialist f. Leadership and management 15.

16.

17.

18.

19.

20.

21.

Maintain retraction of tissue Communicate effectively with surgeon to prevent errors, such as passing the wrong instrument or passing it in the wrong position Nonsterile team member who assists the RN Assist with hemostasis as directed by the surgeon Specialist in the preparation, handling, and use of instruments Irrigating the surgical wound, especially in microsurgery Teaching others while scrubbed

22. Pursue an advanced degree in hospital administration and management 23. Skills and knowledge required for this role are the processes of sterilization and disinfection, inspection of and troubleshooting equipment, and assembly of instrument tray 24. Maintain a “dry” surgical site by operating suction devices and appropriate use of surgical sponge 25. Ensure patient chart, including results of diagnostic procedures, permits, and preoperative checklist, accompanies the patient into surgery 26. Prepares instruments and supplies on the sterile field 27. Role is fulfilled by a registered nurse 28. A teacher 29. The nonsterile person who performs patient care procedures, obtains and delivers the equipment needed for a surgery case, opens sterile supplies, and assists in positioning the patient on the operating table 30. Facilitating safety and emergency protocols 31. Assist surgeon in specific, well-defined task as needed during the procedure 15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS:

C A B C E C D F E C B A B D B F A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 6 p. 5 p. 6 p. 6 p. 6 p. 7 p. 6 p. 7 p. 7 p. 7 p. 6 p. 6 p. 6 p. 6 p. 7 p. 6 p. 7

Match the following definitions with the correct term. a. Facility-based ST b. Military service c. Specialty practice d. CST-CFA e. Educator and clinical instructor f. Medical industry representative g. Central processing management h. Research product and development 32. Work in research product and development in the area of surgical instruments, supplies, and devices 33. Designs and develops the curriculum for the institution and manages departments 34. Assists in surgical procedures to retract tissue and aid in exposure, hemostasis, close tissue planes, and other intraoperative techniques while under supervision of the surgeon 35. Education program parallels civilian requirements, with additional training in combat and war surgery and in golden hour treatment 36. The scope of duties and responsibilities includes disinfection and sterilization processes, assembly of surgical instrument sets, and management of complex instrument systems 37. Promote the company’s equipment but also has the technical expertise to troubleshoot problems 38. The hospital-based surgical technologist may specialize in one or more surgical specialties such as orthopedics, neurosurgery, cardiac surgery, obstetrics, or plastic surgery 32.

33.

34.

35.

36.

37.

38.

ANS: ANS: ANS: ANS: ANS: ANS: ANS:

H E D B G F C

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF:

p. 6 p. 8 p. 8 p. 8 p. 7 p. 8 p. 8

Chapter 21: Robotic-Assisted Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The working tip on the tip of robotic instruments is called a. yaw. b. pitch. c. end effector. d. roll.

ANS: C

The working tip on the tip of the robotic instruments is called end effector.

DIF: 2

REF: p. 459

2. The tips of robotic instruments allow for _____________ degree rotation. a. 90 b. 120 c. 180 d. 360 ANS: A

The tips of robotic instruments allow for 90 degree rotation.

DIF: 2

REF: p. 459

3. Which of the following is a robotic operating room table developed to operate with the da

Vinci Xi robotic system to allow repositioning of the patient? a. Andrews b. Halo c. Amsco d. Trumpf ANS: D

The Trumpf Medical TraSystem 7000dv is integrated with the Xi system to allow repositioning the patient allowing the table to move with the instrument arms without undocking the robot.

DIF: 2

REF: p. 469

4. Which system is a robotically controlled bronchoscope with a high degree of flexibility

and HD 3-Division? a. Mako b. Monarch Platform c. da Vinci d. Versius ANS: B

The Monarch Platform (Auris Health) is a robotically controlled bronchoscopy system with a high degree of flexibility and HD 3-Division.

DIF: 2

REF: p. 465

5. Which of the following robotic systems is used in orthopedic surgery for partial or total

joint replacements? a. Mako b. Monarch Platform c. da Vinci d. Versius ANS: A

The Mako Robotic Arm Interactive System (Stryker) is a robotic system that is used for partial or total knee and hip joint replacements.

DIF: 2

REF: p. 463|p. 464

6. The tips of robotic instruments contribute to the maneuverability of the instruments in

small spaces. The movement of the tips to perform right and left turns is called ______. a. end effector b. pitch c. yaw d. roll ANS: C

The tips of robotic instruments contribute to the maneuverability of the instruments in small spaces the movement of the tips to perform right and left turns is called yaw.

DIF: 2

REF: p. 459

7. The tips of robotic instruments contribute to the maneuverability of the instruments in

small spaces the movement of the tips similar to the movement of an airplane that dips its wings in either direction is called ______. a. end effector b. pitch c. yaw d. roll ANS: D

The tips of robotic instruments contribute to the maneuverability of the instruments in small spaces the movement of the tips similar to the movement of an airplane that dips its wings in either direction is called roll.

DIF: 2

REF: p. 459

8. The tips of robotic instruments contribute to the maneuverability of the instruments in

small spaces the movement of the tips of the instruments in a nose up or nose down position is called ____________. a. end effector b. pitch c. yaw d. roll

ANS: B

The tips of robotic instruments contribute to the maneuverability of the instruments in small spaces the movement of the tips of the instruments in a nose up or nose down position is called pitch.

DIF: 2

REF: p. 459

9. Robotic instruments are maneuvered from the console. Who is responsible for attaching

and detaching the instruments from the arm using the clutch controls on the arm? a. Assistant surgeon and surgical technologist b. Anesthesia care provider and assistant surgeon c. Circulator and surgical technologist d. Surgeon and assistant surgeon ANS: A

The surgeon is working remotely at the surgeon’s console. The assistant surgeon and surgical technologist both work together to attach and detach the instruments from the arm of the robot.

DIF: 2

REF: p. 459

10. The closed system surgeon console design is sometimes referred to as _________. a. submersive b. submissive c. immersive d. dispersive ANS: C

The closed system surgeon console design is sometimes referred to as immersive. This type of system features a cockpit style viewer. The surgeon activates the unit by positioning their head within the console which displays the endoscopic camera video feed on a stereo viewer.

DIF: 2

REF: p. 458

11. Which governmental agency is responsible for regulation of robotic-assisted devices? a. OSHA b. DEA c. FDA d. AAMI ANS: C

The US Food and Drug Administration is responsible for regulation of robotic-assisted devices.

DIF: 2

REF: p. 457

12. The sense of touch and pressure in which cues are transmitted to the surgeon’s hand. a. Scaled movement b. Hand controller c. Wristed instrument d. Haptic feedback

ANS: D

Haptic feedback provides the sense of touch and pressure and cues that are transmitted to the surgeon’s hand.

DIF: 2

REF: p. 459

13. Translation of the surgeon’s normal hand movement to smaller ratios from 1:2 to 1:5 is a. scaled movement. b. hand controller. c. wristed instrument. d. haptic feedback.

ANS: A

Scaled movement is the translation of the surgeon’s normal hand movement to a smaller ratios from 1:2 to 1:5.

DIF: 2

REF: p. 457

14. Devices located in the surgeon console for manipulating surgical instruments: a. Scaled movement b. Hand controller c. Wristed instrument d. Haptic feedback ANS: B

The hand controllers located in the surgeon console are used for manipulating the surgical instruments.

DIF: 2

REF: p. 456

15. A feature which allows 7 degrees of freedom allowing for opening and closing the jaws of

the instruments enabling for very fine movement in all directions is called a. scaled movement. b. hand controller. c. wristed instruments. d. haptic feedback.

ANS: C

Wristed instruments have a feature which provides 7 degrees of freedom allowing for opening and closing the jaws of the instruments enabling for very fine movement in all directions.

DIF: 2

REF: p. 459

16. Which robotic system uses a single bedside (patient) cart with multiple instrument arms

mounted on a boom? The surgeon console is a closed unit with 3-D viewing. a. da Vinci b. Monarch Platform c. Mako d. Versius ANS: A

The da Vinci robotic system uses a single bedside (patient) cart with multiple instrument arms mounted on a boom. The surgeon console is a closed unit with 3-D viewing.

DIF: 2

REF: p. 463

17. Which of the following should be positioned where the surgeon can see the sterile field to

observe for unintended movements or events with a clear path to the door, so the surgeon has access to get to the scrub sink and scrub in case of emergency? a. Bedside unit b. Docking station c. Vision tower d. Surgeon console ANS: D

The surgeon console should be positioned so the surgeon can see the sterile field to observe for unintended movements or events with a clear path to the door, so the surgeon has access to get to the scrub sink and scrub in case of emergency.

DIF: 2

REF: p. 468

18. Which robotic system does not feature haptic feedback causing the surgeon to rely on

visual 3-D imaging alone? a. da Vinci b. Monarch Platform c. Mako d. Versius ANS: A

The da Vinci robotic system does not feature haptic feedback the surgeon relies on visual 3-D imaging.

DIF: 2

REF: p. 459

19. The most common rigid endoscopes used in robotic-assisted procedures are the a. 0 degree. b. 30 degrees. c. 15 degrees. d. A and B. ANS: D

The most common rigid endoscopes used in robotic-assisted procedures are the 0 degree and 30 degrees scopes.

DIF: 2

REF: p. 460

20. Which of the following holds the energy modalities, system electronics, video controller,

and touch screen? a. Console b. Vision tower c. Bedside unit d. Docking station

ANS: B

The vision tower holds the energy modalities, system electronics, video controller, and touch screen components.

DIF: 2

REF: p. 458

21. Which component of the robotic-assisted surgical system holds the instruments and

receives signals from the surgeon? a. Console b. Vision tower c. Bedside unit d. Hand controller ANS: C

The bedside unit is the unit that holds the instruments and receives signals from the surgeon.

DIF: 2

REF: p. 456

22. In an open method of establishing a pneumoperitoneum the _________ trocar is used. a. Veress needle b. Hassan c. 12 mm sharp d. 11 mm sharp ANS: B

The Hassan trocar is a blunt trocar used in minimally invasive procedures when a small incision is made.

DIF: 2

REF: p. 462

23. In a closed method of establishing pneumoperitoneum a _____________ is used. a. Veress needle b. Hassan c. 12 mm trocar d. 11 mm trocar ANS: A

A Veress needle is used to establish pneumoperitoneum in a closed method of creating a pneumoperitoneum.

DIF: 2

REF: p. 462

24. Which of the following is used to establish pneumoperitoneum for minimally invasive

procedures? a. Nitrous b. CO2 c. H2O d. NPO ANS: B

CO2, carbon dioxide is used to establish pneumoperitoneum for minimally invasive procedures.

DIF: 2

REF: p. 462

25. Which of the following trocars is sutured into place during the procedure? a. Veress needle b. Hassan c. 12 mm sharp d. 11 mm sharp ANS: B

The Hassan trocar is sutured in place during open robotic and minimally invasive procedures.

DIF: 2

REF: p. 462

Chapter 22: General Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The organs and organ systems that are included in general surgery are the following

EXCEPT __________. a. spleen b. pancreas c. femur d. breast ANS: C

The organs and organ systems involved include the following: abdominal wall, gastrointestinal (GI) system, biliary system (the gallbladder and associated structures), spleen, pancreas, hepatic system, breast, and thyroid.

DIF: 2

REF: p. 476

2. RLQ refers to what part of the abdominal section? a. Right lower quality b. Right lower quadrant c. Right labile quality d. Right labile quadrant ANS: B

RLQ stands for right lower quadrant.

DIF: 2

REF: p. 476

3. LLQ refers to what part of the abdominal section? a. Left labile quadrant b. Left lower quadrant c. Left labile quality d. Left lower quality ANS: B

LLQ stands for left lower quadrant.

DIF: 2

REF: p. 476

4. The abdomen is divided into nine regions; the organs located in the rib area is in the

__________. a. left and right lumbar regions b. left and right iliac regions c. umbilical region d. left and right hypochondriac regions ANS: D

The rib area is located in the left and right hypochondriac regions.

DIF: 2

REF: p. 477

5. The abdomen is divided into nine regions; the organ located in the inguinal area is in the

__________. a. left and right lumbar regions b. left and right iliac regions c. umbilical region d. left and right hypochondriac regions ANS: B

The inguinal area is located in the left and right iliac regions.

DIF: 2

REF: p. 477

6. The abdomen is divided into nine regions; the organ located in the umbilicus area is in the

__________. a. left and right lumbar regions b. left and right iliac regions c. umbilical region d. left and right hypochondriac regions ANS: C

The umbilicus is located in the umbilical region.

DIF: 2

REF: p. 477

7. All of the following are distinct tissue layers that support the abdominal organs, EXCEPT

__________. a. fascia b. skin c. subcutaneous adipose tissue d. umbilicus ANS: D

Tissue layers comprise the following: skin, subcutaneous, fascia, muscle, and peritoneum.

DIF: 2

REF: p. 477

8. The spermatic cord in the male follows the inguinal canal and contains the following

structures, EXCEPT __________. a. ductus deferens b. ilioinguinal nerve c. testicular veins d. sympathetic & visceral nerve fibers ANS: B

The spermatic cord in the male follows the inguinal canal and contains the following structures: ductus deferens, artery to the ductus deferens, testicular artery, pampiniform plexus (testicular veins), cremasteric artery and vein, sympathetic and visceral nerve fibers, lymphatics, remnants of the processus vaginalis.

DIF: 2

REF: p. 478|p. 479

9. A midline incision is used for surgical procedures of the ___________. a. liver b. sigmoid colon c. appendix d. uterus ANS: A

A midline incision is made for surgical procedures of the lower esophagus, stomach, small intestine, liver, biliary system, spleen, pancreas, and proximal colon.

DIF: 2

REF: p. 480

10. A subcostal incision is used for surgical procedures of the _____________. a. spleen b. pancreas c. appendix d. uterus ANS: A

A subcostal incision is used for surgical procedures of the right biliary system, spleen, and bilateral (chevron): liver transplantation.

DIF: 2

REF: p. 480

11. A McBurney incision is used for surgical procedures of the ____________. a. spleen b. pancreas c. appendix d. uterus ANS: C

A McBurney incision is used for surgical procedures of the appendix.

DIF: 2

REF: p. 480

12. An inguinal (oblique) incision is made for surgical procedures of the _____________. a. appendix b. spleen c. liver d. spermatic cord ANS: D

An inguinal incision is made for surgical procedures of the muscle and fascia of the inguinal abdominal wall, spermatic cord, inguinal ring, abdominal ring, and inferior epigastric artery and vein.

DIF: 2

REF: p. 480

13. A lower transverse abdominal incision is made for surgical procedures of the __________. a. spleen b. pancreas

c. appendix d. uterus ANS: D

A lower transverse abdominal incision is made for surgical procedures of the uterus, adnexa, bladder, and access for cesarean sections.

DIF: 2

REF: p. 480

14. Protrusion of abdominal tissue through one or more abdominal layers is a(n) __________. a. strangulated hernia b. direct inguinal hernia c. Spigelian hernia d. incisional hernia ANS: D

Incisional hernia is a protrusion of abdominal tissue through one or more abdominal layers.

DIF: 2

REF: p. 487

15. In a(n) _____________ hernia, tissue protruding from the hernia may be swollen and

squeezed. a. strangulated b. direct inguinal c. Spigelian d. incisional ANS: A

In a strangulated hernia, tissue protruding from the hernia may become swollen and squeezed. This may result in local ischemia or other complications.

DIF: 2

REF: p. 487

16. A hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal

ring is a(n) __________. a. strangulated hernia b. direct inguinal hernia c. indirect inguinal hernia d. incisional hernia ANS: C

An indirect inguinal hernia is a hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring.

DIF: 2

REF: p. 487

17. Protrusion of abdominal or inguinal tissue directly through the transversalis fascia is a(n)

__________. a. strangulated hernia b. direct inguinal hernia c. indirect hernia

d. incisional hernia ANS: B

A direct inguinal hernia is a protrusion of abdominal or inguinal tissue directly through the transversalis fascia.

DIF: 2

REF: p. 487

18. A hernia arising from a weakness in the transverse fascia below the inguinal ligament is

a(n) __________. a. umbilical hernia b. direct inguinal hernia c. Spigelian hernia d. femoral hernia ANS: D

A femoral hernia is a hernia arising from a weakness in the transversalis fascia below the inguinal ligament.

DIF: 2

REF: p. 487

19. An abdominal wall defect occurring in the linea alba at the umbilical ring is a(n)

__________. a. umbilical hernia b. direct inguinal hernia c. Spigelian hernia d. femoral hernia ANS: A

An umbilical hernia is an abdominal wall defect occurring in the linea alba at the umbilical ring; occurring in the linea alba at the umbilical ring; seen in infants and adults. Rarely requires surgery. Incarceration is more common in obese adults.

DIF: 2

REF: p. 487

20. A rare hernia occurring between the transverse abdominis and rectus muscles is a(n)

__________. a. umbilical hernia b. direct inguinal hernia c. Spigelian hernia d. femoral hernia ANS: C

A Spigelian hernia is a rare hernia occurring between the transverse abdominis and rectus muscles.

DIF: 2

REF: p. 487

21. The spermatic cord is retracted with a small _________________. a. red robinson b. JP drain c. ortho drain

d. Penrose drain ANS: D

The spermatic cord is retracted with a small Penrose drain.

DIF: 2

REF: p. 488

22. Special equipment may be needed for a GI surgery, EXCEPT __________. a. bowel bag b. vessel loops c. raney clips d. Ultrasonic coagulation and cutting systems ANS: C

Special equipment that might be required during GI surgery includes the following: ultrasonic coagulation and cutting systems, vessel loops for large vessel dissection, ultrasound probe, bowel bag (a plastic bag used to enclose the bowel during open surgery to prevent tissue dehydration), temporary ostomy bag, wound protector—used for isolation technique to isolate the bowel when it is surgically opened and during resection of metastatic tumor resection.

DIF: 2

REF: p. 496

23. To place one or more clamps at a right angle to a tube or vessel is __________. a. to cross-clamp b. to double-clamp c. resection d. anastomosis ANS: A

To cross-clamp is to place one or more clamps at a right angle to a tube or vessel.

DIF: 2

REF: p. 496

24. To place two clamps over a section of tissue to prevent bleeding when the tissue is severed

is __________. a. to cross-clamp b. to double-clamp c. resection d. anastomosis ANS: B

To double-clamp is to place two clamps over a section of tissue to prevent bleeding when the tissue is severed.

DIF: 2

REF: p. 496

25. A procedure in which a section of an organ is divided or removed is __________. a. to cross-clamp b. anastomosis c. to double-clamp d. resection

ANS: D

Resection is a procedure in which a section of an organ is divided or removed.

DIF: 2

REF: p. 496

26. A procedure in which two hollow structures are joined surgically is __________. a. to cross-clamp b. anastomosis c. to double-clamp d. resection ANS: B

Anastomosis is a procedure in which two hollow structures are joined surgically.

DIF: 2

REF: p. 496

27. The freeing up of tissue from its attachments before anastomosis or resection is

__________. a. division b. mobilization c. to cross-clamp d. to clamp and divide ANS: B

Mobilization is the freeing up of tissue from its attachments before anastomosis or resection.

DIF: 2

REF: p. 496

28. A procedure in which one section of tissue is cut away from another is __________. a. division b. mobilization c. cross-clamp d. clamp and divide ANS: A

Division is a procedure in which one section of tissue is cut away from another.

DIF: 2

REF: p. 496

29. Approximately 400,000 people die annually as a result of __________. a. SSI b. wrong surgical site c. HAI d. obesity ANS: D

Approximately 400,000 people die annually as a result of obesity.

DIF: 2

REF: p. 505

30. This occurs most often as a postoperative complication or a result of pelvic or back injury

and peritonitis __________. a. paralytic ileus b. volvulus c. strangulation d. intussusception ANS: A

Paralytic ileus is the paralysis of the ileum; this occurs most often as a postoperative complication following abdominal surgery.

DIF: 2

REF: p. 509

31. Telescoping of the intestines, occurring mainly in children and resulting in ischemia and

necrosis of the bowel is __________. a. paralytic ileus b. volvulus c. strangulation d. intussusception ANS: D

Intussusception is a telescoping of the intestine (this occurs mainly in children and results in ischemia and necrosis of the bowel).

DIF: 2

REF: p. 509

32. Twisting of the bowel on itself is __________. a. paralytic ileus b. volvulus c. strangulation d. intussusception ANS: B

Volvulus is twisting of the bowel on itself.

DIF: 2

REF: p. 509

33. What type of suture will be placed around the neck of the hernia sac? a. Interrupted b. Horizontal c. Purse-string d. None are correct ANS: C

The hernia sac is ligated with ties or a purse-string suture.

DIF: 2

REF: p. 488

34. During a laparoscopic cholecystectomy, which two structures are occluded? a. Cystic duct and common bile duct b. Common bile duct and artery c. Cystic duct and cystic artery

d. Cystic artery and common bile duct ANS: C

During a laparoscopic cholecystectomy, the cystic duct and cystic artery are occluded.

DIF: 2

REF: p. 521

35. During a splenectomy, what four major requirements must be met to stop bleeding? a. Access, visualization, good lighting, retractors b. Access, visualization, temperature, clamps c. Access, visualization, time, clamps d. Access, visualization, good lighting, clamps ANS: D

During a splenectomy, four major requirements must be met to stop bleeding: access, visualization, good lighting, and clamps.

DIF: 2

REF: p. 524

36. A range of procedures are available for surgical management of a non-metastatic breast

tumor. All of the following are available, EXCEPT __________. a. needle aspiration biopsy b. fine-needle insertion c. sentinel node detection d. mastectomy ANS: D

A range of procedures are available for surgical management of a breast tumor: needle aspiration biopsy, fine-needle insertion, and sentinel node detection and biopsy.

DIF: 2

REF: p. 530

37. During this procedure, a gamma ray detecting probe is used to determine which lymph

nodes are affected. a. excisional biopsy b. wire localization c. sentinel lymph node biopsy d. none are correct ANS: C

The procedure for sentinel lymph node biopsy (SLNB) involves injection of isosulfan blue dye, radioactive material (technetium-99), or both directly into the breast mass or nearby.

Both materials may be used to track the lymph nodes visually (dye) and by gamma ray emission (technetium-99).

DIF: 2

REF: p. 531

Chapter 23: Gynecological and Obstetrical Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The cervix is the lower neck of the ______________. a. bladder b. pelvic c. uterus d. canal ANS: C

The cervix is the lower neck of the uterus.

DIF: 2

REF: p. 542

2. The vaporization or destruction of tissue is called ___________. a. supination b. tracheation c. lacrimation d. ablation ANS: D

To remove or destroy tissue is to ablate.

DIF: 2

REF: p. 541

3. ______________ is a fibrous, benign tumor of the uterus that usually arises from the

myometrium. a. Leiomyoma b. Trocar c. Expulsion d. Insufflation ANS: A

Leiomyoma is a fibrous, benign tumor of the uterus that usually arises from the myometrium.

DIF: 2

REF: p. 541

4. The anatomical area between the posterior vestibule and the anus is the ____________. a. fibrous b. oophorectomy c. perineum d. salpingectomy ANS: C

The anatomical area between the posterior vestibule and the anus is the perineum.

DIF: 2

REF: p. 541

5. Excessive bleeding during menses is ____________. a. conception b. fimbriae c. menorrhagia d. expulsion ANS: C

Excessive bleeding during menses is menorrhagia.

DIF: 2

REF: p. 541

6. _____________ focuses on the treatment and prevention of diseases affecting the female

reproductive system. a. Physiology b. Obstetrics c. Gynecology d. Surgery ANS: C

Gynecology focuses on the treatment and prevention of diseases affecting the female reproductive system.

DIF: 2

REF: p. 542

7. ________ relates to the process of pregnancy and birth (parturition). a. Endometrium b. Specialty c. Fetal d. Obstetrics ANS: D

Obstetrics relates to the process of pregnancy and birth (parturition).

DIF: 2

REF: p. 542

8. The ________ is/are small projection(s) that extend from the end of the tube. a. placenta b. amniotic c. fimbriae d. eclampsia ANS: C

The fimbriae are small projections that extend from the end of the tube.

DIF: 2

REF: p. 542

9. The structures that together make up the external genitalia are called the _________. a. vulva b. cervix c. ova d. eclampsia ANS: A

The structures that together make up the external genitalia are called the vulva.

DIF: 2

REF: p. 544

10. The __________ is a raised mound of tissue that protects the symphysis pubis. a. sterile water b. electrolytic media c. vestibule d. mons pubis ANS: D

The mons pubis is a raised mound of tissue that protects the symphysis pubis.

DIF: 2

REF: p. 544

11. The ________ is a highly vascular organ that contains sensitive erectile tissue. a. pelvic b. incision c. clitoris d. pregnancy ANS: C

The clitoris is a highly vascular organ that contains sensitive erectile tissue.

DIF: 2

REF: p. 544

12. The ________ glands lie on both sides of the vestibule and secrete mucus during sexual

intercourse. a. salpingectomy b. tubal c. Bartholin d. oophoroplasty ANS: C

The Bartholin glands lie on both sides of the vestibule and secrete mucus during sexual intercourse.

DIF: 2

REF: p. 544

13. The term ___________ refers collectively to all the structures located within the labia

minora. a. myometrium b. endometrium c. vestibule d. fimbria ANS: C

The term vestibule refers collectively to all the structures located within the labia minora.

DIF: 2

REF: p. 544

14. Most ______________ procedures are performed with the patient in the supine or

lithotomy position. a. follicular b. gynecological c. luteal d. menstruation ANS: B

Most gynecological procedures are performed with the patient in the supine or lithotomy position.

DIF: 2

REF: p. 546

15. _______________ instruments are specialized for reproductive structures. a. Lateral b. Laparoscopic c. Supine d. Lithotomy ANS: B

Laparoscopic instruments are specialized for reproductive structures.

DIF: 2

REF: p. 547

16. _____________ pelvic procedures require vaginal speculums and long instruments,

including uterine clamps and heavy dissecting scissors. a. Cystocele b. Transvaginal c. Dermoid d. Rectocele ANS: B

Transvaginal pelvic procedures require vaginal speculums and long instruments, including uterine clamps and heavy dissecting scissors.

DIF: 2

REF: p. 547

17. Surgical blockage prevents implantation (pregnancy) and development of a ________. a. fetus b. uterine cyst c. uterine fibroid d. uterine tumor ANS: A

Surgical blockage prevents implantation (pregnancy) and development of a fetus.

DIF: 2

REF: p. 562

18. Continuous irrigation may be used to locate microscopic _________. a. hernias b. bleeders c. veins

d. arteries ANS: B

Continuous irrigation may be used to locate microscopic bleeders.

DIF: 2

REF: p. 566

19. LAVH is the removal of the uterus by a combined ________ and vaginal approach. a. peritoneal b. laparoscopic c. periscopic d. microscopic ANS: B

LAVH is the removal of the uterus by a combined laparoscopic and vaginal approach.

DIF: 2

REF: p. 567

20. _______________ includes removal of the uterus and cervix. a. LSH b. TAH c. TUH d. FSU ANS: B

TAH includes removal of the uterus and cervix.

DIF: 2

REF: p. 568

21. In total abdominal hysterectomy, the surgeon uses _____ scissors and long tissue forceps

to separate the bladder and the uterus. a. Metzenbaum b. Masterson c. Mayo d. Heaney ANS: A

Using Metzenbaum scissors and long tissue forceps, the surgeon separates the two structures by dissecting the peritoneal covering away from the bladder.

DIF: 2

REF: p. 569

22. A _________ hysterectomy is performed to treat pelvic malignancy. a. radical b. primary c. partial d. tubal ANS: A

A radical hysterectomy is performed to treat pelvic malignancy.

DIF: 2

REF: p. 572

23. During _________ a fiberoptic hysteroscope is inserted through the cervix and into the

uterus. a. distention b. hysteroscopy c. D&C d. cystoscopy ANS: B

During hysteroscopy a fiberoptic hysteroscope is inserted through the cervix and into the uterus.

DIF: 2

REF: p. 554

24. _________ is absorption of fluid into the vascular system, leading to increased blood

pressure and possible death related to fluid overload. a. Intravasation b. Micturition c. Insufflation d. Effusion ANS: A

Intravasation is the absorption of the fluid into the vascular system, leading to increased blood pressure and possible death related to fluid overload.

DIF: 2

REF: p. 541

25. The hysteroscope is inserted into the uterus with the _________ in place. a. medium b. monitor c. sheath d. laser ANS: C

The hysteroscope is inserted into the uterus with the sheath in place.

DIF: 2

REF: p. 555

26. The _________ is equipped with an outer sheath that allows fluid outflow and an inner

sheath for continuous irrigation. a. electrode b. resectoscope c. endometrial scope d. retriever ANS: B

The resectoscope is equipped with an outer sheath that allows for fluid outflow and an inner sheath for continuous irrigation.

DIF: 2

REF: p. 555

27. A(n) _________ is a benign, fibrous tumor of the uterus that usually arises from the

myometrium.

a. b. c. d.

ablation leiomyoma amenorrhea impinge

ANS: B

A leiomyoma is a fibrous, benign tumor of the uterus that usually arises from the myometrium.

DIF: 2

REF: p. 541

28. ________ is a nearly sterile fecal waste that accumulates while the fetus is in the uterus. a. Meconium b. Muscle c. Cervical mucus d. Vernix ANS: A

Meconium is a nearly sterile fecal waste that accumulates while the fetus is in the uterus.

DIF: 2

REF: p. 542

29. The ________ is a thick organ that adheres to the uterus on the maternal side. a. embryo b. placenta c. gland d. fallopian tube ANS: B

The placenta is a thick organ that adheres to the uterus on the maternal side.

DIF: 2

REF: p. 575

MATCHING

Choose from the terms listed and match them with their most correct description. a. Abdominal procedure b. Transcervical procedure c. Transvaginal procedure 1. Repair of vesicovaginal fistula 2. Hysteroscopy 3. Tubal ligation 1. ANS: C 2. ANS: B 3. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 559 REF: p. 554 REF: p. 562

Choose from the terms listed and match them with their most correct description. a. Abdominal procedure b. Transcervical procedure

c. Transvaginal procedure 4. Removal of cystic Bartholin gland 5. TAH 6. Resectoscope myomectomy 4. ANS: C 5. ANS: A 6. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 560 REF: p. 568 REF: p. 555

Choose from the terms listed and match them with their most correct description. a. Transcervical procedure b. Transvaginal procedure 7. Repair of cystocele 8. Dilation and curettage 7. ANS: B 8. ANS: A

DIF: 3 DIF: 3

REF: p. 558 REF: p. 557

Choose from the terms listed and match them with their most correct description. a. Placental abruption b. Placenta previa c. Nuchal cord d. Cord prolapsed 9.

10.

11.

12.

An umbilical cord wrapped one or more times around the baby’s neck When the cord precedes the fetal head When the placenta implants completely or partially over the cervical os Can be caused by abdominal trauma, abnormalities of the uterus, a short umbilical cord, and hypertension

9.

10.

11.

12.

ANS: C ANS: D ANS: B ANS: A

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 576 p. 577 p. 575 p. 575

Choose from the terms listed and match them with their most correct description. a. Placental abruption b. Placenta previa c. Nuchal cord 13. Seldom diagnosed before labor 14. Usually identified on routine ultrasound in the prenatal period 15. Premature separation of the placenta from the uterine wall 13. ANS: C 14. ANS: B 15. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 576 REF: p. 575 REF: p. 575

Choose from the terms listed and match them with their most correct description.

a. Placental abruption b. Cord prolapsed c. Nuchal cord 16. Usually occurs with an active baby in the early months of pregnancy 17. Fetal demise results if the entire placenta separates from the uterus 18. This condition more likely with breech presentation 16. ANS: C 17. ANS: A 18. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 576 REF: p. 575 REF: p. 577

Chapter 24: Genitourinary Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Stones caused by the precipitation of minerals, such as calcium, and other substances from

the urine or kidney filtrate are ________________. a. uterine b. dilators c. calculi d. phila ANS: C

Stones caused by the precipitation of minerals, such as calcium, and other substances from the urine or kidney filtrate are calculi.

DIF: 2

REF: p. 585

2. A urethral or ureteral catheter that is left in place is a(n) ________ catheter. a. inguinal b. indwelling c. reverse d. permanent ANS: B

A urethral or ureteral catheter that is left in place for continuous drainage.

DIF: 2

REF: p. 585

3. Backward (opposite of its normal direction) flow of a body fluid is _______. a. reflux b. epispadias c. undescended d. hydrocele ANS: A

Reflux is the flow of a body fluid in the direction opposite its normal path.

DIF: 2

REF: p. 585

4. ____________ is a device that puts pressure on tissue, usually to stop bleeding. a. McBurney b. Transurethral c. Epigastric d. Tamponade ANS: D

Tamponade is a device that puts pressure on tissue to control bleeding.

DIF: 2

REF: p. 585

5. Twisting of an organ or a structure on itself is ________. a. fiberoptic b. torsion c. residual d. hemorrhage ANS: B

Torsion is the twisting of an organ or a structure on itself. Torsion may cause local ischemia and necrosis.

DIF: 2

REF: p. 585

6. The ________ cavity lies posterior to (behind) the peritoneal cavity. a. retroperitoneal b. electrolytic c. abdominal d. thoracic ANS: A

The retroperitoneal cavity (also referred to as the retroperitoneal space) lies posterior to (behind) the peritoneal cavity.

DIF: 2

REF: p. 586

7. The ________ are the primary organs for filtration of the blood. a. kidneys b. fascia c. prostatectomy d. cortex ANS: A

The kidneys are the primary organs for filtration of the blood.

DIF: 2

REF: p. 586

8. The _____________ is composed of a vast system of microscopic tubules that

communicate directly with the capillaries to filter the blood. a. glomerulus b. absorption c. ultrasound d. osmolality ANS: A

The glomerulus is composed of a vast system of microscopic tubules that communicate directly with the capillaries to filter the blood.

DIF: 2

REF: p. 586

9. ________ stones (calculi) are formed by the precipitation of specific salts from filtrate that

becomes supersaturated. a. Kidney b. Supine

c. Lateral d. Crystalline ANS: A

Kidney stones (calculi) are formed by the precipitation of specific salts from kidney filtrate that has become supersaturated.

DIF: 2

REF: p. 591

10. The ________ glands are paired organs that lie on the medial side of the upper kidney. a. phrenic b. adrenal c. segmental d. muscular ANS: B

The adrenal glands are paired organs that lie on the medial side of the upper kidney.

DIF: 2

REF: p. 588

11. The ________ communicates with the lower bladder to enable excretion of urine from the

body. a. bladder b. secreting c. urethra d. cancerous ANS: C

The urethra communicates with the lower bladder to enable excretion of urine from the body.

DIF: 2

REF: p. 588

12. The _____________ is a layered tissue sac that encases the testicles. a. pelvis b. sperm c. scrotum d. tunica ANS: C

The scrotum is a layered tissue sac that encases the testicles.

DIF: 2

REF: p. 588

13. The ________ gland surrounds the urethra and secretes an alkaline fluid that contributes to

seminal fluid. a. Cowper b. lactated c. prostate d. sterile ANS: C

The prostate gland surrounds the urethra and secretes an alkaline fluid that contributes to seminal fluid.

DIF: 2

REF: p. 589

14. _____________ patients are extremely protective of their AV access sites and need to take

precautions to prevent injury at the site. a. Adrenalectomy b. Nephrectomy c. Prostatectomy d. Hemodialysis ANS: D

Hemodialysis patients are extremely careful of their AV access sites and need to take precautions to prevent injury at the site.

DIF: 2

REF: p. 591

15. A(n) ________ may be used to outline structures of the urinary system, including any

stones larger than 2 mm. a. KUB b. epididymis c. necrosis d. mass ANS: A

A KUB may be used to outline structures of the urinary system, including any stones larger than 2 mm.

DIF: 2

REF: p. 591

16. The ________ connects the sheath to the telescope and has one or two working channels

for carrying wires, stents, and other instruments. a. bridge b. gap c. filter d. bladder ANS: A

The bridge connects the sheath to the telescope. It also has one or two working channels for carrying wires, stents, and other instruments discussed below.

DIF: 2

REF: p. 593

17. During __________ procedure, a rigid or flexible scope is positioned in the renal pelvis

and advance into the calyces. a. Cystoscopy b. Ureteroscopy c. Colporrhaphy d. Arthodesis ANS: B

The ureteroscope is used to perform endoscopic procedures of the ureter. A flexible ureteroscope range in size from 6.9 to 9 Fr. The flexible tip allows the scope to be positioned in the renal pelvis and advanced into the calyces.

DIF: 2

REF: p. 594

18. Whenever electrosurgical instruments are used, the irrigation fluid must ___________. a. contain electrolytes b. not contain electrolytes c. be chilled d. be warmed ANS: B

Whenever electrosurgical instruments are used, the irrigation fluid must not contain electrolytes.

DIF: 2

REF: p. 592

19. In adult circumcision, a ________ incision is made in the skin and carried

circumferentially. a. dorsal b. dextran c. ventral d. lateral ANS: A

A dorsal incision is made in the skin and carried circumferentially.

DIF: 2

REF: p. 615

20. A ___________ is a benign, fluid-filled sac that develops in the anterior testis. a. varicocele b. hydrocele c. spermatocele d. chordee ANS: B

A hydrocele is a benign, fluid-filled sac that develops in the anterior testis.

DIF: 1

REF: p. 617

21. Patients are ________ closely for organ rejection, hemorrhage, and infection in the

immediate postoperative period. a. Monitored b. Surveyed c. queried d. prepped ANS: A

Patients are monitored closely for acute organ rejection, hemorrhage, and infection in the immediate postoperative period.

DIF: 1

REF: p. 608

22. A(n) ________ implant is surgically is placed to treat impotence caused by organic

disease. a. penile b. epididymal c. testicular d. prostatic ANS: A

A testicular prosthesis is placed into the scrotal sac after orchiectomy.

DIF: 1

REF: p. 616

23. In robotic-assisted prostatectomy, the patient is prepped and draped for an abdominal

laparoscopic procedure in the ________ position. a. prone b. lithotomy c. supine d. jack-knife ANS: B

The patient is placed in low lithotomy using a non-skid padding system or vacuum positioning device and prepped from nipple line to pubic symphysis.

DIF: 1

REF: p. 612

24. Kidney transplantation is performed for acute and chronic ________. a. ESRD b. QAQC c. KBU d. PKU ANS: A

Kidney transplantation is performed for acute and chronic ESRD. DIF: 1

REF: p. 606

MATCHING

Choose from the terms listed and match them with their most correct description. a. Kidney b. Ureter c. Bladder 1. Anastomosed to the ilium when creating an ileal conduit 2. Renal calculi 3. Contains a region called the trigone 1. ANS: B 2. ANS: A

DIF: 3 DIF: 3

REF: p. 601 REF: p. 591

3. ANS: C

DIF: 3

REF: p. 588

Choose from the terms listed and match them with their most correct description. a. Kidney b. Urethra c. Bladder 4. Meatotomy 5. Composed of four tissue layers: the outer serosa, the muscular layer, the submucosa, and

the inner mucosa 6. Have two main tissue layers, an outer cortex and the inner medulla 4. ANS: B 5. ANS: C 6. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 585 REF: p. 588 REF: p. 588

Choose from the terms listed and match them with their most correct description. a. Ureter b. Urethra c. Bladder 7. Communicates with the lower bladder for excretion of urine from the body 8. Distended with fluid to enhance visualization during cystoscopic procedures 9. Moves urine along by peristalsis 7. ANS: B 8. ANS: C 9. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 588 REF: p. 592 REF: p. 588

Choose from the terms listed and match them with their most correct description. a. Open procedure b. Transurethral procedure 10. Cystoscopy 11. Insertion of penile implant 10. ANS: B 11. ANS: A

DIF: 3 DIF: 3

REF: p. 592 REF: p. 616

Choose from the terms listed and match them with their most correct description. a. Open procedure b. Transurethral procedure 12. Kidney transplant 13. TURP 12. ANS: A 13. ANS: B

DIF: 3 DIF: 3

REF: p. 605 REF: p. 608

Choose from the terms listed and match them with their most correct description. a. Open procedure

b. Transurethral procedure 14. Ureteral stent placement 15. Suprapubic prostatectomy 14. ANS: B 15. ANS: A

DIF: 3 DIF: 3

REF: p. 608 REF: p. 609

Chapter 25: Ophthalmic Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ________________ is a procedure performed to treat glaucoma. a. Keratoplasty b. Iridectomy c. Vitrectomy d. Trabeculectomy ANS: D

A trabeculectomy is performed to create a channel from which the aqueous humor may drain from the anterior chamber. This procedure is performed for the treatment of glaucoma.

DIF: 2

REF: p. 645

2. Surgical removal of the eyeball after the eye muscles and optic nerve have been severed is

called _____________. a. enucleation b. evisceration c. exenteration d. keratoplasty ANS: A

Enucleation is complete removal of the eyeball (globe) while the eye muscles are left intact. Evisceration is a similar procedure in which the contents of the eye are removed, but the outer shell of the sclera and the muscle attachments are left intact.

DIF: 2

REF: p. 647

3. A condition in which the crystalline lens of the eye or its capsule, or both, becomes

opaque, with consequent loss of vision, is known as ________. a. capsulorhexis b. a cataract c. glaucoma d. enucleation ANS: B

A cataract is the clouding of vision caused by a disease in which the crystalline lens of the eye, its capsule, or both become opaque. This prevents light from focusing on the retina, resulting in visual distortion.

DIF: 2

REF: p. 621

4. ___________________ is performed to create a permanent opening in the tear duct for the

drainage of tears. a. Lacrimal duct probing

b. Dacryocystorhinostomy c. Dacryocystitis d. Dacryocystocele ANS: B

Dacryocystorhinostomy is the creation of a permanent opening in the tear duct for the drainage of tears.

DIF: 2

REF: p. 636

5. Ophthalmic muscle surgery is performed to correct deviation of the eye caused by

______________. a. blunt trauma b. paralysis of the levator palpebrae muscle c. deficient nerve stimulation d. strabismus ANS: D

Muscle resection and muscle recession are performed to correct deviation of the eye caused by strabismus. In this procedure, the affected muscles are detached and reattached at the correct location.

DIF: 2

REF: p. 638

6. Entropion is the abnormal inversion of the ________. a. eyelashes b. bilateral upper eyelids c. upper eyelid d. lower eyelid ANS: D

Entropion is an abnormal inversion of the lower eyelid. The goal of surgery is to restore the eyelid to correct anatomical position by resection.

DIF: 2

REF: p. 649

7. ______________ is performed to treat an intraocular malignancy such as retinoblastoma

and melanoma. a. Exenteration b. Blepharoplasty c. Enucleation d. Evisceration ANS: C

Enucleation is performed to treat intraocular malignancy (e.g., retinoblastoma, melanoma), a penetrating ocular wound, a painful blind eye, or an eye that is blind and painless but disfigured.

DIF: 2

REF: p. 647

8. A common technique to repair a retinal detachment is to produce ________ between the

detached layers.

a. b. c. d.

vitreous adhesions blood supply nervous intervention

ANS: B

A common technique is to produce adhesions between the layers with cryotherapy (freezing of the tissue) or diathermy (mild heat created by a diathermy unit or laser).

DIF: 2

REF: p. 644

9. _______________ is/are made of lint-free cellulose or similar material. a. Sutures b. Eye sponges c. Implants d. Gauze ANS: B

Eye sponges are made of lint-free cellulose or similar material.

DIF: 2

REF: p. 634

10. Which of the following statements regarding ophthalmic sutures is true? a. Sutures are available in sizes 0 to 6–0. b. Single-armed sutures are used. c. Sutures should be handled as little as possible. d. Double-armed sutures are used to close puncture wounds.

ANS: C

Sutures should be handled as little as possible, and the points of the needles should be protected from damage.

DIF: 2

REF: p. 634

11. A process in which the lens continually changes shape to maintain the focus of an image

on the retina is ________. a. anatomy b. ophthalmic c. accommodation d. traction ANS: C

Accommodation is a process in which the lens continually changes shape to maintain the focus of an image on the retina.

DIF: 2

REF: p. 621

12. Clear, watery fluid that fills the anterior and posterior chambers in the front of the eye is

called ________. a. vitreous humor b. choroid c. aqueous humor

d. enucleation ANS: C

A clear fluid produced by the ciliary epithelium, called aqueous humor, fills the anterior and posterior chambers.

DIF: 2

REF: p. 624

13. An operation performed when the sensory layer of the retina and the pigment epithelium

layer become separated from each other is called ________. a. scleral buckling b. cataract extraction c. vitreous replacement d. keratoplasty ANS: A

Scleral buckling surgery is performed when the sensory layer of the retina becomes separated from the pigment epithelial layer.

DIF: 2

REF: p. 644

14. The tissue that refracts light rays as they enter the eye is called the ________. a. Retina b. crystalline lens c. Iris d. Cornea ANS: D

The light rays are refracted as they pass through the cornea, aqueous humor, lens, and vitreous. The rays converge at the focal point.

DIF: 2

REF: p. 625

15. A pigmented contractile membrane composed mainly of muscle tissue is known as the

_______________. a. Pupil b. palpebral conjunctiva c. lacrimal caruncle d. Iris ANS: D

The iris is a pigmented membrane composed mainly of muscle tissue that surrounds the pupil.

DIF: 2

REF: p. 623

16. Surgery in which the eye muscle is moved back to release the globe is muscle ________. a. aqueous b. choroid c. recession d. Ciliary ANS: C

Muscle recession is a surgery in which the eye muscle is moved back to release the globe.

DIF: 2

REF: p. 621

17. The anterior space in front the lens and iris is called the __________. a. anterior chamber b. posterior chamber c. posterior cavity d. anterior cavity ANS: A

The anterior chamber lies in front of the iris, whereas the posterior chamber lies behind the iris but in front of (anterior to) the lens.

DIF: 2

REF: p. 624

18. ________ is the inability to coordinate the extraocular muscles, which prevents binocular

vision. a. Strabismus b. Ophthalmic c. Keratoconus d. Conjunctivitis ANS: A

Strabismus is the inability to coordinate the extraocular muscles, which prevents binocular vision.

DIF: 2

REF: p. 621

19. When the surgeon is required to look away from the field, he or she ______________. a. is able to take questions and discuss the next step b. loses concentration and the rhythm of the surgery c. is refocusing in order to carry on d. is allowing the eyes and mind a short break ANS: B

When required to look away from the field, the surgeon loses concentration and the rhythm of the surgery.

DIF: 2

REF: p. 634

20. A(n) _______ is an outwardly turned eyelid. a. ectropion b. ptosis c. canthus d. presbyopia ANS: A

An ectropion is an outwardly turned eyelid.

DIF: 2

REF: p. 651

21. Following a cataract extraction, a(n) ________ vitrectomy may be indicated, which is

considered a complication of the surgery. a. anterior b. posterior c. ventral d. dorsal ANS: A

Many surgeons groove the nucleus of the cataract and separate it into four quadrants before proceeding. This is a complication of the surgery and may necessitate an anterior vitrectomy.

DIF: 2

REF: p. 642

22. An intravitreous gas injection is done to create pressure on the retina. The gases used

include ________. a. sulfur hexafluoride and perfluoropropane b. carbon dioxide and ethylene oxide c. glutaraldehyde d. nitrous oxide ANS: A

The gas infusion exerts pressure on the retina while subretinal fluid is reabsorbed and scarification takes place. The gases include sulfur hexafluoride (SF6) and perfluoropropane (C3F8).

DIF: 2

REF: p. 645

23. Glaucoma is a group of diseases characterized by ________________________ and visual

field loss. a. a tear in the retina b. optic nerve damage c. pterygium d. dacryocyctitis ANS: B

Glaucoma is a group of diseases characterized by optic nerve damage and visual field loss.

DIF: 2

REF: p. 645

24. Fluorescein angiography is used extensively in the diagnosis and evaluation of

____________ disease. a. retinal and choroid b. corneal and Graves c. keratoconus d. right and left angle glaucoma ANS: A

Fluorescein angiography is used extensively in the diagnosis and evaluation of retinal and choroid diseases.

DIF: 2

REF: p. 626

25. The ________ is a thick, white, fibrous tissue that encloses about three fourths of the

eyeball. a. sclera b. cornea c. pupil d. iris ANS: A

The sclera is a thick, white, fibrous tissue that encloses about three fourths of the eyeball.

DIF: 2

REF: p. 623

26. The lens lies directly behind the iris in the ________ chamber. a. projected b. dorsal c. posterior d. anterior ANS: D

The lens lies directly behind the iris in the anterior chamber.

DIF: 2

REF: p. 623

27. _____________ is the bending of light rays through a transparent medium. a. Irritation b. Infraction c. Refraction d. Reflection ANS: C

Refraction is the bending of light rays through a transparent medium.

DIF: 2

REF: p. 625

28. The eyelid margins are cleaned using cotton-tip ________. a. applicators b. sponges c. Q-tips d. 4 x 4’s ANS: A

The eyelid margins are cleaned using cotton-tip applicators.

DIF: 2

REF: p. 627

29. Most ophthalmic surgery is performed using a regional anesthetic with monitored

________. a. sleeping b. position c. sedation d. breathing

ANS: C

Most ophthalmic surgery is performed using a regional anesthetic with monitored sedation.

DIF: 2

REF: p. 627

30. A soft dressing or hard______ may be used to protect the eye after surgery. a. shield b. scope c. patch d. sponge ANS: A

A soft dressing or hard shield may be used to protect the eye after surgery.

DIF: 2

REF: p. 634

31. _______________ requires dexterity and a steady hand. a. Positioning b. Microsurgery c. X-raying d. Scrubbing ANS: B

Microsurgery requires dexterity and a steady hand.

DIF: 2

REF: p. 635

32. A ________ is an inflammatory, benign growth that originates in a sebaceous gland of the

eyelid. a. chalazion b. cyst c. pterygium d. strabismus ANS: A

A chalazion is an inflammatory, benign growth that originates in a sebaceous gland of the eyelid.

DIF: 2

REF: p. 636

MATCHING

Choose from the terms listed and match them with their most correct description. a. Enucleation b. Evisceration 1. Complete removal of the eyeball 2. Leaves the outer shell of the sclera with its muscle attachments intact 1. ANS: A 2. ANS: B

DIF: 3 DIF: 3

REF: p. 647 REF: p. 647

Choose from the terms listed and match them with their most correct description. a. Enucleation b. Evisceration c. Enucleation and Evisceration 3. Surgical removal of the eyeball after the eye muscles and optic nerve have been severed 4. A transitional implant is inserted to shape the orbital cavity 5. The removal of the contents of the eye, with the sclera left intact 3. ANS: A 4. ANS: C 5. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 647 REF: p. 621 REF: p. 621

Choose from the terms listed and match them with their most correct description. a. Enucleation b. Exenteration 6. Performed to treat intraocular malignancy, such as retinoblastoma and melanoma 7. Removal of the entire contents of the orbit 6. ANS: A 7. ANS: B

DIF: 3 DIF: 3

REF: p. 647 REF: p. 648

Choose from the terms listed and match them with their most correct description. a. Anterior chamber b. Soft tissue c. Posterior cavity 8. Repair of entropion 9. Performed using a phacoemulsifier 10. Scleral buckling 8. ANS: B 9. ANS: A 10. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 649 REF: p. 642 REF: p. 644

Choose from the terms listed and match them with their most correct description. a. Anterior chamber b. Soft tissue c. Posterior cavity 11. Dacryocystorhinostomy 12. Performed when the sensory layer of the retina becomes separated 13. Cataract 11. ANS: B 12. ANS: C 13. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 636 REF: p. 644 REF: p. 644

Choose from the terms listed and match them with their most correct description.

a. Anterior chamber b. Posterior cavity 14. Vitreous humor 15. Aqueous humor 14. ANS: B 15. ANS: A

DIF: 3 DIF: 3

REF: p. 644 REF: p. 645

Chapter 26: Surgery of the Ear, Nose, Pharynx, and Larynx Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Which of the following instruments would be used to remove nasal polyps? a. Wilde forceps b. Crowe-Davis c. Bayonette forceps d. Jansen forceps ANS: A

Under direct visualization with the nasal endoscope, the surgeon uses either a Wilde forceps or micro debrider to remove the nasal polyps.

DIF: 2

REF: p. 685

2. At what age is a cochlear implant contraindicated in children? a. Under 2 years old b. Under 3 years old c. More than 5 years old d. Not contraindicated in children, regardless of their age ANS: A

Congenital deafness in the child can be treated with a cochlear implant, but surgery is delayed until the age of 2 years.

DIF: 2

REF: p. 676

3. Earwax is known as ________. a. cerumen b. keratin c. cholesteatoma d. epistaxis ANS: A

The lateral one third of the external auditory canal is surrounded with cartilage and is lined with glands that secrete a waxy substance called cerumen.

DIF: 2

REF: p. 655

4. The __________ transmits the vibrations of the tympanic membrane (TM) and the other

ossicles to the inner ear via the oval window. a. stapes b. malleus c. incus d. anvil ANS: A

The stapes (stirrup) transmits the vibrations of the TM and the other ossicles to the inner ear via the oval window.

DIF: 2

REF: p. 655

5. Reconstruction of the _______ and oropharynx, or uvulopalatopharyngoplasty, is

performed to reduce and tighten oropharyngeal tissue. a. eyelid b. polyps c. uvula d. ear ANS: C

Reconstruction of the uvula and oropharynx, or uvulopalatopharyngoplasty (UPP), is performed to reduce and tighten oropharyngeal tissue.

DIF: 2

REF: p. 693

6. A _______ suction device is used to remove the morcellated tissue. a. #9 Yankauer b. #10 Poole c. #12 Frazier d. #11 Taylor ANS: C

A #12 Frazier suction device is used to remove the morcellated tissue.

DIF: 2

REF: p. 685

7. The primary reasons for performing an adenoidectomy are________ infection and

obstruction caused by hypertrophy of the tissue. a. chronic b. mild c. high d. low ANS: A

The primary reasons for an adenoidectomy are chronic infection and obstruction caused by hypertrophy of the tissue.

DIF: 2

REF: p. 691

8. During a tracheostomy, the ________ is kept with the patient in his or her room. a. obturator b. primary tube c. balloon syringe d. universal connector ANS: A

The obturator of the tracheostomy tube is kept with the patient as long as the tracheal tube is in place.

DIF: 2

REF: p. 695

9. Myringoplasty is performed to close a small, nonhealing hole in the _____________. a. RW b. TM c. OV d. ME ANS: B

A myringoplasty is performed to close a small nonhealing hole in the TM. DIF: 2

REF: p. 672

10. The _______________extends from the posterior choanae of the nose to the palate. a. pharynx b. oropharynx c. nasopharynx d. hypopharynx ANS: C

The nasopharynx extends from the posterior choanae of the nose to the palate. The nasopharynx is situated behind the nasal cavity and above the oral cavity.

DIF: 2

REF: p. 680

11. Turbinectomy may be performed at the same time as __________. a. septoplasty b. deformities c. increases d. airflow ANS: A

Turbinectomy may be performed during septoplasty.

DIF: 2

REF: p. 686

12. The ______ glands are situated within the lobes of the thyroid. a. parathyroid b. sphenoid c. paralysis d. magnesium ANS: A

The parathyroid glands are situated within the lobes of the thyroid.

DIF: 2

REF: p. 698

13. The paired ________ sinuses are the large sinuses below the ocular orbits. a. sphenoid b. maxillary c. frontal d. ethmoid ANS: B

The paired maxillary sinuses are the large sinuses below the ocular orbits.

DIF: 2

REF: p. 679

14. An incision is made in the __________ below the obstruction with a #15 blade. a. nasopharynx b. oropharynx c. hypopharynx d. nasal septum ANS: D

An incision is made in the nasal septum below the obstruction with a #15 blade.

DIF: 2

REF: p. 687

15. Most endoscopic procedures of the nose are performed to treat ________. a. cancerous neoplasms b. benign disease c. congenital polyps d. inflammatory or infectious diseases ANS: D

Most endoscopic procedures of the nose are done to treat inflammatory or infectious diseases.

DIF: 2

REF: p. 685

16. A cochlear implant is used to transmit external sound directly to the _______________. a. eighth cranial nerve b. semicircular canals c. tenth cranial nerve d. twelfth cranial nerve ANS: A

A cochlear implant is used to transmit external sound directly to the eighth cranial nerve. It is used in the treatment of sensorineural deafness.

DIF: 2

REF: p. 675

17. Cholesteatoma, eustachian tube dysfunction, neoplasm, or congenital malformation of the

middle ear may block airflow to the mastoid and cause chronic ________. a. mastoiditis b. labyrinthitis c. cholestasis d. otitis media ANS: A

Cholesteatoma, eustachian tube dysfunction, neoplasm, or congenital malformation of the middle ear may block airflow to the mastoid and cause chronic mastoiditis.

DIF: 2

REF: p. 673

18. The medical abbreviation TM stands for ________.

a. b. c. d.

temporomandibular joint disease tympanic membrane transcendental meditation transverse myelitis

ANS: B

The medical abbreviation TM stands for tympanic membrane.

DIF: 2

REF: p. 654

19. The 30-degree scope is used for maxillary, sphenoid, and __________ sinus procedures. a. thyroid b. ethmoid c. lacrimal d. palatine ANS: B

The 30-degree scope is used for maxillary, sphenoid, and ethmoid sinus procedures.

DIF: 2

REF: p. 685

20. The submandibular duct, or Wharton duct, emerges from the deep anterior portion of the

gland and drains into the_______________ floor of the mouth. a. anterior b. parotid and hypoglossal c. dorsal d. posterior ANS: A

The submandibular duct, or Wharton duct, emerges from the deep anterior portion of the gland and drains into the anterior floor of the mouth.

DIF: 2

REF: p. 697

21. Thyroid hormones (THs) are necessary for regulating _________________. a. cell metabolism and growth b. digestion and temperature c. estrogen and progesterone d. gastrin and glucagon ANS: A

These thyroid hormones (THs) are necessary for regulating cell metabolism and growth.

DIF: 2

REF: p. 698

22. A ___________ is almost always combined with a total laryngectomy to treat laryngeal

metastasis or problems with aspiration. a. glossectomy b. arthroscopy c. turbinectomy d. tonsillectomy ANS: A

A total glossectomy is almost always combined with a total laryngectomy to treat laryngeal metastasis or problems with aspiration.

DIF: 2

REF: p. 700

MATCHING

Choose from the terms listed and match them with their most correct description. a. Ear b. Neck c. Nose d. Oropharynx and larynx 1.

2.

3.

4.

Anatomically divided into triangles Contains the ossicles Contains the adenoids Formed by two U-shaped cartilaginous structures called the lower lateral cartilages

1.

2.

3.

4.

ANS: B ANS: A ANS: D ANS: C

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 696 p. 655 p. 680 p. 679

Choose from the terms listed and match them with their most correct description. a. Ear b. Nose c. Oropharynx and larynx 5. Otitis media 6. Maxillary sinus is approached through this 7. Uvulopalatopharyngoplasty (UPP) 5. ANS: A 6. ANS: B 7. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 655 REF: p. 679 REF: p. 693

Choose from the terms listed and match them with their most correct description. a. Ear b. Nose c. Oropharynx and larynx 8. Contains the turbinates 9. Contain the arytenoid cartilages 10. Anatomy is divided into three regions 8. ANS: B 9. ANS: C 10. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 679 REF: p. 680 REF: p. 655

Choose from the terms listed and match them with their most correct description.

a. External ear b. Middle ear c. Internal ear 11. Crista ampullaris 12. Proximal eustachian tube 13. Contains cerumen 11. ANS: C 12. ANS: B 13. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 655 REF: p. 655 REF: p. 655

Choose from the terms listed and match them with their most correct description. a. External ear b. Middle ear c. Internal ear 14. Intratympanic portion of the facial nerve 15. Auricle or pinna 16. Responsible for equilibrium 14. ANS: B 15. ANS: A 16. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 655 REF: p. 655 REF: p. 655

Choose from the terms listed and match them with their most correct description. a. External ear b. Middle ear c. Internal ear 17. Examined with an otoscope 18. Ossicular reconstruction 17. ANS: A 18. ANS: B

DIF: 3 DIF: 3

REF: p. 655 REF: p. 675

Choose from the terms listed and match them with their most correct description. a. Middle ear b. Internal ear 19. Cochlear implant 20. Stapedectomy 19. ANS: B 20. ANS: A

DIF: 3 DIF: 3

REF: p. 675 REF: p. 675

Chapter 27: Oral and Maxillofacial Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Procedures involving the __________ are performed primarily by an oral-maxillofacial

surgeon. a. eyes b. brain c. teeth d. maxillary sinuses ANS: C

Procedures involving the teeth are performed primarily by an oral-maxillofacial surgeon.

DIF: 2

REF: p. 709

2. The face is divided into which of the following three regions? a. Medial face, distal face, and proximal face b. Superior face, inferior face, and medial face c. Upper face, midface, and lower face d. Superior face, midface, and inferior face ANS: C

The face is divided into three regions: upper face, midface, and lower face.

DIF: 2

REF: p. 709

3. _________________ maintains stability of the upper and lower jaws during procedure or

for extended use while a facial fracture heals. a. Dental implants b. Arch bars c. Miniplates d. Bone grafts ANS: B

The purpose of arch bars is to maintain stability of the upper and lower jaws during the procedure or for extended use while a facial fracture heals.

DIF: 2

REF: p. 714

4. Le Fort ____ is a horizontal fracture of the maxilla that causes the hard palate and alveolar

process to become separated from the remainder of the maxilla. The fracture extends into the lower nasal septum, lateral maxillary sinus, and palatine bones. a. II b. III c. IV d. I ANS: D

Le Fort I is a horizontal fracture of the maxilla that causes the hard palate and alveolar process to become separated from the rest of the maxilla. The fracture extends into the lower nasal septum, lateral maxillary sinus, and palatine bones.

DIF: 2

REF: p. 708

5. ________________ fractures usually include a portion of the globe displaced posteriorly

or extrude into the nasal sinuses. a. orbital floor b. dental implants c. arch bar applications d. bone graft ANS: A

Fractures of the orbital floor usually result from the increased orbital pressure caused by the impact on the globe. A portion of the globe may extrude into the nasal sinus (enophthalmos), or the globe can be displaced posteriorly.

DIF: 2

REF: p. 712

6. ___________________ involves the bones of the face, repairing fractures and

reconstructing congenital anomalies. a. Odontectomy surgery b. Oromaxillofacial surgery c. TMJ arthroplasty d. Dental implantation surgery ANS: B

Oromaxillofacial surgery involves the bones of the face, primarily for repair of fractures and reconstruction of congenital anomalies.

DIF: 2

REF: p. 708

7. _________________ dictate(s) that wires on arch bars be tightened in a clockwise fashion

so that any other surgeon knows to remove them in a counterclockwise direction. a. Operating room policy b. AORN c. Surgeon’s preference cards d. Standard protocol ANS: D

Standard protocol dictates that wires be tightened in a clockwise fashion so that any other surgeon knows to remove them in a counterclockwise direction.

DIF: 2

REF: p. 716

8. ____________________ are performed primarily by oromaxillofacial, plastic, or

otorhinolaryngology surgeons. a. Dental implants b. Maxillofacial procedures c. Odontectomies d. CT scans

ANS: B

Maxillofacial procedures are performed primarily by surgeons specializing in oromaxillofacial, plastic, or otorhinolaryngology surgery.

DIF: 2

REF: p. 708

9. In the Le Fort _____ fracture, there is a separation of all the facial bones from their cranial

base. It includes fracture of the zygoma, maxilla, and nasal bones. The fracture line extends through the ethmoid bone and bony orbit with severe facial flattening and swelling. a. II b. IV c. III d. I ANS: C

The Le Fort III fracture involves separation of all the facial bones from their cranial base.

It includes fracture of the zygoma, maxilla, and nasal bones. The demarcation line extends through the ethmoid bone and bony orbit, with severe facial flattening and swelling.

DIF: 2

REF: p. 709

10. ___________________ of injury or congenital anomalies can affect speech, mastication

(chewing), and development of the teeth. a. Applying arch bars for the repair b. Using dental implants for the repair c. The repair d. Long-term physiological effects ANS: D

The long-term physiological effects of injury or congenital anomalies can affect speech, mastication (chewing), and tooth development.

DIF: 2

REF: p. 708

11. The Le Fort ______ fracture is pyramidal in shape. It extends from the nasal bone to the

frontal processes of the maxilla, lacrimal bones, and inferior orbital floor and may extend into the orbital foramen. Inferiorly, it extends into the anterior maxillary sinus and the pterygoid plates. a. II b. IV c. III d. I ANS: A

The Le Fort II fracture is pyramidal in shape. It extends from the nasal bone to the frontal processes of the maxilla, lacrimal bones, and inferior orbital floor and may extend into the orbital foramen. Inferiorly, it extends into the anterior maxillary sinus and the pterygoid plates. This type of fracture also is associated with leakage of cerebrospinal fluid (CSF) into the nasal sinuses.

DIF: 2

REF: p. 709

12. The _________ forms the bridge of the nose and articulates with the ethmoid and maxilla. a. zygoma b. nasal bone c. arch bar d. temporal bone ANS: B

The nasal bone forms the bridge of the nose and articulates with the ethmoid and the maxilla. Fractures of the nasal ethmoid area may injure the lacrimal apparatus, including the ducts and lacrimal glands.

DIF: 2

REF: p. 709

13. The ________________ is the only movable bone of the face. a. mandible b. zygomatic arch c. nasal bone d. maxilla ANS: A

The lower face contains the mandible, which is the only movable bone of the face. It is a U-shaped bone suspended from the temporal bone.

DIF: 2

REF: p. 709

14. _______________ are the basic instruments required for facial fractures. a. Miniplates and screws b. Dental implants and bone grafts c. Skin grafts and bone grafts d. Gingival grafts and bone grafts ANS: A

Basic instruments required for facial fractures are miniplates and screws, which are available as a commercial set along with the instruments required to install them.

DIF: 2

REF: p. 719|p. 720

15. _____________ is the number, type, and pattern of the teeth. a. Mastication b. Dentition c. Micturition d. Occlusion ANS: B

Dentition is the number, type, and pattern of the teeth.

DIF: 2

REF: p. 708

16. A screw that penetrates both cortical layers and the intervening spongy layer of the bone is

called a _________ screw.

a. b. c. d.

bicortical cannulated bicoronal subciliary

ANS: A

A bicortical screw that penetrate both cortical layers and the intervening spongy layer of the bone.

DIF: 2

REF: p. 708

17. Also called application of arch bars, a procedure in which the maxilla and mandible are

placed in their normally closed position and fixed with wires is called ______________. a. maxillomandibular fixation (MMF) b. reconstructive surgery c. sternocleidomastoid surgery d. mandibular joint fixation ANS: A

Maxillomandibular fixation (MMF) is a procedure to wire the jaws in a closed position.

The hardware used in this technique is the arch bar. The jaw is then closed, and wires used to bind the maxilla and mandible together.

DIF: 2

REF: p. 714

18. The _________ forms the lateral walls and floor of the bony orbit, which houses the

eyeball. a. zygoma b. ethmoid c. sphenoid d. maxilla ANS: A

The zygoma forms the lateral walls and floor of the bony orbit, which houses the eyeball.

DIF: 2

REF: p. 709

MATCHING

Choose from the terms listed and match them with their most correct description. a. Upper face b. Midface c. Lower face 1. Fractures in this area are important in their association with injury to the eye, especially in

displaced fractures.

2. The mandible is the only movable bone of the face. It is a U-shaped bone that is suspended from the temporal bone.

3. The frontal bone is part of the cranium but forms the forehead and contains portions of the nasal sinuses.

1. ANS: B 2. ANS: C 3. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 709 REF: p. 709 REF: p. 709

Choose from the terms listed and match them with their most correct description. a. Midface b. Lower face 4. The bony orbit is formed by the frontal bone, but also contains portions of other bones of

the face. These include the zygoma, maxilla, lacrimal, ethmoid, sphenoid, and palatine bones.

5. The ramus extends inferiorly from the condyle to the angle, where it joins the body of the mandible and extends anteriorly and medially to join the other half of the mandible.

4. ANS: A 5. ANS: B

DIF: 3 DIF: 3

REF: p. 709 REF: p. 709

Choose from the terms listed and match them with their most correct description. a. Midface b. Lower face 6. The ethmoid bone is a complex structure that contributes to the floor of the cranium and

contains a number of sinus cavities.

7. The condyles insert into the glenoid fossa of the temporal bones to form the temporomandibular joints.

6. ANS: A 7. ANS: B

DIF: 3 DIF: 3

REF: p. 709 REF: p. 709

Choose from the terms listed and match them with their most correct description. a. Maxillomandibular fixation (MMF) or arch bars b. Open reduction internal fixation 8. In this procedure, fractures are reduced and fixated. The buttressing structures are

reinforced.

9. Implanted to realign dentition of the mandible and midface.

8. ANS: B 9. ANS: A

DIF: 3 DIF: 3

REF: p. 716 REF: p. 714

Choose from the terms listed and match them with their most correct description. a. Maxillomandibular fixation (MMF) or arch bars b. Open reduction internal fixation 10. If kept in place postoperatively, wire cutters are kept with the patient at all times during

the postoperative period to allow for immediate access to the mouth in the event of an airway emergency.

11. The surgeon chooses the size and type of plate to be used.

10. ANS: A 11. ANS: B

DIF: 3 DIF: 3

REF: p. 716 REF: p. 716

Choose from the terms listed and match them with their most correct description. a. Maxillomandibular fixation (MMF) or arch bars b. Open reduction internal fixation 12. The appropriate drill bit is loaded into a small power drill, and the screw holes are drilled.

13. To prevent the suture ends from injuring the soft tissues, a “rosebud” is made in the suture

ends by grasping the wire with a hemostat and crimping it inward. The end may be buried in the patient’s gingiva.

12. ANS: B 13. ANS: A

DIF: 3 DIF: 3

REF: p. 716 REF: p. 716

Choose from the terms listed and match them with their most correct description. a. Maxillomandibular fixation (MMF) or arch bars b. Open reduction internal fixation 14. If a drill guide is used, a depth gauge is used to measure the screw length required.

15. A wire is clamped with a Rubio needle holder, threaded between the teeth, wrapped

around the bar, and twisted to tighten.

14. ANS: B 15. ANS: A

DIF: 3 DIF: 3

REF: p. 718 REF: p. 716

Chapter 28: Plastic and Reconstructive Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Skin grafts that consist of the epidermis and a portion of the papillary dermis are called

________ grafts. a. pedicle b. split-thickness c. full-thickness d. composite ANS: B

A graft that contains epidermis and papillary dermis, which is a highly bioactive portion of the dermis, is a split-thickness graft (STSG).

DIF: 2

REF: p. 731

2. ____________ are grafts that were harvested from donors and preserved by the tissue bank

until needed. a. Allografts b. Autografts c. Composite grafts d. Xenografts ANS: A

A graft transferred from one individual to another. An allograft, also called homograft, are harvested from donors and preserved by the tissue bank until needed. Skin, bone, and cartilage are commonly used allografts.

DIF: 2

REF: p. 731

3. A rhytidectomy is performed to __________. a. reduce a scar/keloid b. increase size and shape of breast c. remodel the skin & underlying tissue d. remodel the nose ANS: C

Rhytidectomy is performed to remodel the skin and underlying tissue.

DIF: 2

REF: p. 755

4. Protecting underlying tissues and organs, excreting organic waste, and storing of nutrients

are functions of ________________. a. adipose tissue b. scar formation c. mammary system d. the integumentary system ANS: D

The skin, or integumentary system, performs numerous vital functions: • Protects underlying tissues and organs.

• Excretes organic waste and stores nutrients.

• Excretes water and dissipates heat as a means of thermoregulation.

• Contains sensory nerves that inform the individual about the environment.

DIF: 2

REF: p. 724

5. Third-degree burns develop _________, which is devitalized, nonelastic tissue adhering to

the wound site. a. bilobate b. eschar c. plicate d. imbricate ANS: B

Third-degree burns develop eschar, which is devitalized, nonelastic tissue adhering to the wound site.

DIF: 2

REF: p. 729

6. A surgical technique in which a plane of tissue is created or an existing tissue plane is

lifted, such as skin from the fascia, is called _______________. a. stent b. plicate c. undermine d. debridement ANS: C

Undermine is a surgical technique in which a plane of tissue is created or an existing tissue plane is lifted, such as skin from the fascia.

DIF: 2

REF: p. 723

7. The most superficial layer of the epidermis is called the stratum _________. a. corneum b. granulosum c. spinosum d. germinativum ANS: A

The stratum corneum is the most superficial layer of the epidermis.

DIF: 2

REF: p. 724

8. A graft derived from live tissue—human or animal—is called a(n) __________________. a. autograft b. allograft c. biological graft d. synthetic graft ANS: C

A biological graft are grafts derived from live tissue, either human or animal.

DIF: 2

REF: p. 723

9. During a lower lid blepharoplasty, the initial incision is made in the ________. a. canthi of the eye b. cornea of the eye c. supraciliary region d. subciliary region ANS: D

The surgeon makes the incision in the subciliary region, 2 to 3 mm below the lower lash line.

DIF: 2

REF: p. 741

10. Mentoplasty is the augmentation of the _________. a. cheeks b. forehead c. chin d. lips ANS: C

Mentoplasty is one of many different facial augmentation procedures in which synthetic implants are used. Surgery to place a chin implant is called mentoplasty.

DIF: 2

REF: p. 743

11. When performing an otoplasty, the incision is made in the _______ area. a. lower jaw b. temporal c. postauricular d. preauricular ANS: C

Otoplasty is surgical modification of the external ear. With the ear held forward, an incision is made in the postauricular skin with a #15 blade to expose the cartilage.

DIF: 2

REF: p. 744|p. 745

12. When performing a breast augmentation with an implant, the surgeon creates a pocket

under the __________________ to receive the implant. a. trapezius b. rectus c. pectoralis minor d. pectoralis major ANS: D

A pocket is created under the pectoralis major muscle.

DIF: 2

REF: p. 747

13. The procedure performed to remove excess skin and adipose tissue from the abdominal

wall is called a _________. a. rhytidectomy b. panniculectomy c. blepharoplasty d. mentoplasty ANS: B

Panniculectomy (abdominoplasty) is performed for cosmetic reduction of abdominal fat.

An “apron” of tissue is removed in severe cases to improve the patient’s quality of life.

DIF: 2

REF: p. 755

14. A malar augmentation is a procedure used to enlarge the __________. a. lips b. eyebrows c. cheeks d. chin ANS: C

Malar augmentation is an operative procedure to increase the height of the cheekbone for aesthetic improvement.

DIF: 2

REF: p. 744

15. During malar augmentation, the incision is ________. a. intraoral b. intranasal c. in the subcuticular space d. in the supratarsal crease ANS: A

A buccal incision is made. An intraoral incision is made at the junction of the gum and soft tissue of the upper lip using a #15 knife or needlepoint ESU. DIF: 2

REF: p. 744

16. During removal of a superficial lesion, the skin edges are retracted with a(n)

_______________________. a. Army-Navy retractor b. Beckman self-retaining retractor c. double- or single-prong skin hook d. Gelpi self-retaining retractor ANS: C

Lesions are usually removed using a no. 15 knife blade. The assistant or ST may use double- or single-prong skin hooks to retract the skin edges during excision.

DIF: 2

REF: p. 739

17. Grafts that are raised from the donor site but are not severed free are called ________

grafts.

a. b. c. d.

pedicle free split-thickness progressive

ANS: A

A pedicle graft (also called a flap graft) is raised from the donor site but not immediately severed free.

DIF: 2

REF: p. 737

18. Full-thickness skin graft (FTSG) contains ____________. a. only the dermis b. both dermis and epidermis c. one remodeled structure d. two or more types of tissues ANS: B

A full-thickness skin graft (FTSG) is composed of both dermis and epidermis.

DIF: 2

REF: p. 736

19. The ____________ is the outer layer of the skin. a. eschar b. epidermis c. keloid d. dermis ANS: B

The epidermis is the outer layer of the skin. The primary tissue cells of the epidermis are the keratinocytes.

DIF: 2

REF: p. 724

20. Aesthetic surgery, also called ____________ surgery, is performed to improve the

appearance but does not always address function. a. cosmetic b. basic c. Mohs d. synthetic ANS: A

Aesthetic surgery, also called cosmetic surgery, is performed to improve an individual’s appearance but does not necessarily address function.

DIF: 2

REF: p. 724

21. A dermatome is used to harvest a large _____ skin graft. a. full thickness b. split-thickness c. composite d. biosynthetic

ANS: B

The split-thickness graft can be harvested using a dermatome or graft knife.

DIF: 2

REF: p. 732

22. ____________ is the surgical removal of dead skin, debris, and infection material from a

wound. a. Debridement b. Escharotomy c. Fasciotomy d. Allograft ANS: A

Debridement is the removal of nonviable tissue from a nonhealing or traumatic wound.

DIF: 2

REF: p. 729

23. Sharp dissection is performed with _______ or fine Metzenbaum scissors and toothed

tissue forceps. a. very fine b. dull c. mayo scissors d. elevator ANS: A

Sharp dissection is performed with very fine, sharp scissors and toothed tissue forceps.

DIF: 2

REF: p. 725

MATCHING

Choose from the terms listed and match them with their most correct description. a. Liposuction b. Mesher c. Dermatome 1. Used to take autograft skin 2. Aspiration of adipose tissue 3. Used to increase the surface area of grafted skin by puncturing holes into the skin graft 1. ANS: C 2. ANS: A 3. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 732 REF: p. 754 REF: p. 732

Choose from the terms listed and match them with their most correct description. a. Mesher b. Brow lift 4. The corneal, pretrichial, or direct approach may be used 5. Used to aerate a skin graft

4. ANS: B 5. ANS: A

DIF: 3 DIF: 3

REF: p. 741 REF: p. 732

Choose from the specialty procedures and match them with their most correct description. a. Mammoplasty b. Rhytidectomy 6. Performed to change the size & shape of the breast 7. Performed to provide a more aesthetic appearance 6. ANS: A 7. ANS: B

DIF: 3 DIF: 3

REF: p. 747 REF: p. 742

Choose from the terms listed and match them with their most correct description. a. Mammoplasty b. Panniculectomy 8. Performed to reconstruct the breast without the use of implants 9. Performed to excise the excess abdominal wall skin 8. ANS: A 9. ANS: B

DIF: 3 DIF: 3

REF: p. 747 REF: p. 754

Choose from the terms listed and match them with their most correct description. a. Mammoplasty b. Panniculectomy 10. Usually performed after significant weight loss 11. Requires the use of a tissue expander under certain conditions 10. ANS: B 11. ANS: A

DIF: 3 DIF: 3

REF: p. 754 REF: p. 747

Choose from the terms listed and match them with their most correct description. a. Mammoplasty b. Skin graft 12. Performed to treat macromastia 13. A stent dressing is used 12. ANS: A 13. ANS: B

DIF: 3 DIF: 3

REF: p. 747 REF: p. 731

Chapter 29: Orthopedic Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The middle shaft of the long bone is called the ________. a. diaphysis b. epiphysis c. periosteum d. crest ANS: A

Long bones are characterized by a middle shaft, called the diaphysis.

DIF: 2

REF: p. 759

2. The patella is an example of a ________ bone. a. sesamoid b. long c. short d. flat ANS: A

The patella is an example of a sesamoid bone.

DIF: 2

REF: p. 760

3. The ________ part of a long bone is very dense and is found in the shaft of long bones, at

the ends of joints, and vertebrae where it surrounds the softer cancellous bone. a. cortical b. cancellous c. bone marrow d. periosteum ANS: A

Cortical bone which is also known as compact bone is the denser of the two types. It is found in the shaft of long bones, and at the ends of joints, and vertebrae where it surrounds the softer cancellous bone.

DIF: 2

REF: p. 758

4. A rounded orifice in bone or a passageway for blood vessels or nerves is known as a

_____________. a. foramen b. tuberosity c. spine d. process ANS: A

A rounded orifice in bone or a passageway for blood vessels or nerves is known as a foramen.

DIF: 2

REF: p. 761

5. ________ protect(s) the bone surface and provide(s) attachment for tendons. a. The endosteum b. The periosteum c. The marrow d. Red blood cells ANS: B

The function of the periosteum is to protect the bone surface and provide attachment for tendons.

DIF: 2

REF: p. 758

6. A knuckle-shaped portion of bone, generally found in association with a joint, is called a

_____________. a. condyle b. crest c. spine d. process ANS: A

A knuckle-shaped portion of bone, generally found in association with a joint, is called a condyle.

DIF: 2

REF: p. 761

7. During _______________________, the glenoid rim is reattached to the joint capsule with

a biosynthetic or other anchoring device or with heavy sutures. a. plating of the proximal humerus b. shoulder arthroscopy c. the Bankart procedure d. carpal tunnel release ANS: C

In the Bankart procedure, the glenoid rim is reattached to the joint capsule with a biosynthetic or other anchoring device or with heavy sutures.

DIF: 2

REF: p. 785|p. 786

8. The surgical goal of a Bankart procedure is to ________. a. restore stability to the shoulder joint and to alleviate pain b. surgically repair a fracture of the distal humerus c. correct the metacarpophalangeal (MCP) joint that has deteriorated because of

rheumatic arthritis d. correct a recurrent glenohumeral dislocation of the shoulder is the tearing or

separation of the labrum from the joint capsule.

ANS: D

An important cause of recurrent glenohumeral dislocation is the tearing or separation of the labrum (the rim of the glenoid capsule) from the joint capsule.

DIF: 2

REF: p. 786

9. ________ fractures are fractures in which the bone penetrates the skin. a. Greenstick b. Open c. Spiral d. Transverse ANS: B

Open: A fracture in which the fractured end penetrates the skin.

DIF: 2

REF: p. 763

10. A fracture caused by disease is called a(n) _____________. a. pathological fracture b. metastatic fracture c. bone tumor d. open fracture ANS: A

Pathological fracture: A fracture caused by disease such as osteoporosis which is caused by calcium deficiency.

DIF: 2

REF: p. 763

11. The _________ is the most complicated joint of the body, vulnerable to a variety of

injuries. a. wrist b. elbow c. hip d. knee ANS: D

The knee is the most complicated joint of the body. It is vulnerable to a variety of injuries, which are caused mainly by sports and motor vehicle accidents.

DIF: 2

REF: p. 808

12. A(n) ____________ blade is fixed at a right angle (90 degrees) to the handpiece and

moves along a perpendicular axis. a. reamer b. reciprocating saw c. sagittal saw d. oscillating saw ANS: C

Sagittal saw: The blade is fixed at a right angle (90 degrees) to the handpiece and oscillates in the perpendicular axis.

DIF: 2

REF: p. 769

13. K-wires and Steinmann pins are inserted directly into the tissue using ____________. a. a hammer b. a drill c. a screwdriver d. IM rodding ANS: B

Kirschner wires (K-wires) and Steinmann pins are thick wires that are inserted with a drill.

DIF: 2

REF: p. 779

14. __________________ requires the use of orthopedic implants. a. Open reduction internal fixation b. Closed reduction c. Closed reduction with plaster casting d. Application of a hip spica ANS: A

•Open reduction and internal fixation (ORIF): This procedure requires open surgery to expose the bone and reduce the fracture. Internal orthopedic implants are used to achieve fixation.

DIF: 2

REF: p. 764

15. An orthopedic drill is similar to a ______________ drill. a. carpenter’s b. dental c. miner’s d. construction ANS: A

An orthopedic drill is similar to a carpenter’s drill.

DIF: 2

REF: p. 768

16. Elevators are used to lift the ______________. a. bone marrow away from the compact bone b. periosteum from the surface of the bone c. cartilage from surface to bone d. muscle from the surface of bone ANS: B

Although it has many uses, its main function is to remove the periosteum (the tough outer membrane of the bone) from the bone surface.

DIF: 2

REF: p. 770

17. Whenever power-driven instruments are in use, the tip of the instruments must be

continuously ________. a. irrigated using an Asepto or bulb syringe b. wiped with a dry lap sponge c. cleaned

d. wiped with a wet lap sponge ANS: A

Whenever power instruments that cut bone are in use, such as drills, reamers, and saws, the tip of the instrument must be continuously irrigated to prevent the buildup of heat and prevent excess friction. Irrigation can be delivered using a bulb syringe or Asepto syringe (see Chapter 12).

DIF: 2

REF: p. 822

18. During arthroscopy, ________ tubing and ______ tubing are required to maintain

continuous flushing of the joint. a. inflow; outflow b. external; internal c. small; big d. backflow; inflow ANS: A

Inflow tubing and outflow tubing are required to maintain continuous flushing of the joint.

DIF: 2

REF: p. 784

19. ________ and ______ cutters are used for trimming and modeling bone and cartilage. a. Rongeurs; bone b. Elevators; bone c. Rasps; bone d. Bone hooks; bone ANS: A

Rongeurs and bone cutters are used for trimming and modeling bone and cartilage.

DIF: 2

REF: p. 770

20. Cancellous bone ______________________________________________. a. is found on the surface of bones and is organized by tubular units called osteons b. resembles a sponge and the spaces are filled with red or yellow marrow, a soft

connective tissue c. is stronger than cortical bone d. serves to support and protect ANS: B

Cancellous bone (also called spongy or trabecular bone) is softer than cortical bone found at the ends of the long bones, within the ribs, flat bones of the cranium, the scapula, and other smaller flat bones of the body. Cancellous bone is less dense than cortical bone and has no geometric structure. Instead, the structure resembles a sponge, and the spaces are filled with red or yellow marrow, a soft connective tissue.

DIF: 2

REF: p. 758

MATCHING

Choose from the terms listed and match them with their most correct description.

a. Hand instrument b. Power equipment c. Joint replacement implant 1. Made from ceramic material 2. Sagittal saw 3. Rongeurs and bone cutters 1. ANS: C 2. ANS: B 3. ANS: A

DIF: 3 DIF: 3 DIF: 3

REF: p. 780 REF: p. 769 REF: p. 770

Choose from the terms listed and match them with their most correct description. a. Hand instrument b. Orthopedic implant c. Joint replacement implant 4. Used to scrape away periosteum from bone surface 5. Screws made of titanium or stainless steel 6. Components used to replace the diseased or injured tissue 4. ANS: A 5. ANS: B 6. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 770 REF: p. 773 REF: p. 780

Choose from the terms listed and match them with their most correct description. a. Hand instrument b. Orthopedic implant 7. Devices used to attach or fix bone and other connective tissue 8. Bone-holding clamp 7. ANS: B 8. ANS: A

DIF: 3 DIF: 3

REF: p. 772 REF: p. 770

Choose from the terms listed and match them with their most correct description. a. Process b. Sinus c. Fossa d. Spine e. Tubercle f. Crest g. Neck h. Sulcus i. Foramen j. Tuberosity k. Condyle 9. A knuckle-shaped portion of bone generally found in association with a joint 10. A ridge of bone (e.g., iliac crest)

11. A rounded orifice in a bone (e.g., olfactory foramen); usually a passageway for blood

14.

15.

16.

17.

18.

19.

vessels or nerves A depression in a bone (e.g., iliac fossa) A narrow bridge of bone between two other structures (e.g., neck of the femur, neck of the humerus) A projection of bone (e.g., coracoid process) A cavity within a bone (e.g., nasal sinus) A sharp, narrow projection (e.g., spinous process) A groove in a bone A small, rounded projection (e.g., deltoid tubercle) A large, rounded projection (e.g., ischial tuberosity)

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

ANS: K ANS: F ANS: I ANS: C ANS: G ANS: A ANS: B ANS: D ANS: H ANS: E ANS: J

12.

13.

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 761 p. 761 p. 761 p. 761 p. 761 p. 761 p. 761 p. 761 p. 761 p. 761 p. 761

Choose from the terms listed and match them with their most correct description. a. Impacted b. Transverse c. Oblique d. Spiral e. Greenstick f. Open g. Comminuted 20. The fracture line is perpendicular to the long axis of the bone 21. A type of transverse fracture that occurs at an angle 22. A fracture of the long bone that occurs in a spiral pattern as the result of twisting or torsion 23.

24.

25.

26.

on the bone A fracture in which bone fragments are driven into each other or into another bone A fracture with two or more pieces A fracture in which the fractured end penetrates the skin A fracture of immature bone that is soft and less brittle than mature bone

20.

21.

22.

23.

24.

25.

26.

ANS: B ANS: C ANS: D ANS: A ANS: G ANS: F ANS: E

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 763 p. 763 p. 763 p. 763 p. 763 p. 763 p. 763

Chapter 30: Vascular and Microvascular Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. During ________ hemodialysis, the patient’s blood is shunted outside the body through an

artery. a. etiology b. parenchyma c. in situ d. extracorporeal ANS: D

During extracorporeal hemodialysis, the patient’s blood is shunted outside the body through an artery.

DIF: 2

REF: p. 846

2. An incision made in the artery is called an ________. a. arteriovenous (AV) fistula b. arteriotomy c. arteriotomy d. arteriogram ANS: B

Arteriotomy is an incision into the artery.

DIF: 2

REF: p. 823

3. A blood clot, air, atherosclerotic plaque, or fat that is a moving substance in the vascular

system is known as a(n) ________. a. thrombus b. infarction c. embolus d. ischemia ANS: C

Embolus: A moving substance in the vascular system. An embolus may consist of air, a blood clot, atherosclerotic plaque, or fat.

DIF: 2

REF: p. 823

4. A reduction in the patient’s total blood volume is called ____________. a. hyperthermia b. hypocoagulation c. hypervolemia d. hypovolemia ANS: D

A decrease in blood pressure (hypotension) can be caused by hypovolemia (a precipitous drop in blood or fluid volume), fluid shifts between the spaces in the body, shock, or infection.

DIF: 2

REF: p. 828

5. Which of the following anatomical structures make up the peripheral vascular system? a. Arteries, veins, and lymphatic vessels b. Heart, lungs, arteries, and veins c. Heart, arteries, veins, and capillary networks d. Arteries and veins ANS: A

Peripheral vascular surgery is a specialty of the arteries, veins, and lymphatic vessels lying outside the immediate area of the heart.

DIF: 2

REF: p. 824

6. _____________ is administered to reverse the effects of systemic heparin. a. Neostigmine b. Vasopressin c. Protamine sulfate d. Premarin ANS: C

Systemic heparin is reversed with protamine sulfate, which is administered by the anesthesia care provider.

DIF: 2

REF: p. 823

7. Ischemia of tissue may be caused by ________________________. a. loss of sensation to the tissue b. loss of blood to the tissue c. pain originating from dead tissue d. death of the tissue ANS: B

Ischemia: The decrease in or absence of blood supply to a localized area, usually related to vascular obstruction.

DIF: 2

REF: p. 823

8. The injection of contrast media into a selected artery and its branches to determine the

exact location of strictures, occlusion, or malformation is called ________. a. angioplasty b. angiography c. venotomy d. arteriotomy ANS: B

Angiography refers to imaging of arteries or veins.

DIF: 2

REF: p. 833

9. A direct anastomosis between an artery and a vein is called a(n) ________. a. hemodialysis fistula b. arteriovenous graft c. hemodialysis graft d. AV fistula ANS: D

An AV fistula is a direct anastomosis between an artery and a vein.

DIF: 2

REF: p. 847

10. A metal, umbrella-shaped filter is inserted into the ________ to prevent emboli from

entering the pulmonary system. a. inferior vena cava b. ascending aorta c. descending aorta d. superior vena cava ANS: A

A vena cava filter is a metal, umbrella-shaped filter inserted into the inferior vena cava to prevent emboli from entering the pulmonary system.

DIF: 2

REF: p. 845

11. ______________ is the removal of atherosclerotic plaque that develops inside of the

artery. a. Endarterectomy b. Embolectomy c. Thrombectomy d. Angioplasty ANS: A

Many vascular procedures require removal of atherosclerotic plaque from the inside of an artery (endarterectomy).

DIF: 2

REF: p. 839

12. The medical term that means “in its natural position or normal place” is ________. a. in situ b. emboli c. ischemia d. thromboembolic ANS: A

In situ: A term meaning “in the natural position or normal place, without disturbing or invading surrounding tissues.”

DIF: 2

REF: p. 823

13. A bifurcated graft is ________________.

a. b. c. d.

Y-shaped straight not used in vascular surgery rarely used in vascular surgery

ANS: A

Bifurcation: The Y-shape of an artery or graft.

DIF: 2

REF: p. 823

14. A(n) ________ is any organic or nonorganic material blocking an artery. a. embolus b. plaque c. thrombus d. thrombin ANS: C

Thrombus: Any organic or nonorganic material blocking an artery; generally, refers to a blood clot or atherosclerotic plaque but also includes fat or air.

DIF: 2

REF: p. 823

15. Pulse volume recording (arterial plethysmography) requires ________ blood pressure cuff

reading(s). a. one b. two c. three d. four ANS: C

A pulse volume recorder is used to measure the arterial pulse waveform during systole.

For this test, three blood pressure cuffs are placed on the leg and inflated to 65 mm Hg. Each cuff reading produces a waveform, which is compared with the waveforms from the other two cuffs.

DIF: 2

REF: p. 831

16. The largest vein of the body is the ___________. a. iliac vein b. renal vein c. portal vein d. vena cava ANS: D

The largest vein of the body is the vena cava, which is divided into inferior and superior segments.

DIF: 2

REF: p. 828

17. The elastic nature of the arteries allows them to _____ during systole and _____ during

diastole to maintain vascular pressure. a. relax; contract

b. contract; relax c. collapse; relax d. contract; collapse ANS: B

The elastic nature of arteries allows them to contract during systole (ventricular contraction) and relax during diastole (the resting phase of the heart) to maintain vascular pressure.

DIF: 2

REF: p. 824

18. The tunica externa (also called the _________), which is composed of connective tissue,

protects the vessel from injury and provides structural strength. a. adventitia b. externa c. adnexa d. media ANS: A

The tunica externa (also called the adventitia), which is composed of connective tissue, protects the vessel from injury and provides structural strength.

DIF: 2

REF: p. 824

19. Arterial plaque is identified as a thick, yellow, rubbery material that adheres to the lumen

(__________ layer) of the artery. a. media b. intimal c. interstitial d. enteric ANS: B

Arterial plaque is identified as a thick, yellow, rubbery material that adheres to the lumen (intimal layer) of the artery.

DIF: 2

REF: p. 850

20. Obstruction or stenosis of an artery commonly forms at the ________. a. bifurcations b. origins c. anomalies d. intima ANS: A

In peripheral atherosclerosis, fatty plaque and calcium are deposited on the tunica intima, causing stenosis and poor circulation. Areas of plaque are most dense near arterial bifurcations.

DIF: 2

REF: p. 832

21. In situ saphenous vein bypass is a surgical alternative to using a ________ to bypass a

diseased femoral artery.

a. b. c. d.

synthetic graft stent balloon catheter

ANS: A

In situ saphenous vein bypass is a surgical alternative to the use of a synthetic graft to bypass a diseased femoral artery.

DIF: 2

REF: p. 856

22. Abdominal aortic aneurysm is a condition in which a section of the abdominal aorta

becomes ____________. a. thickened and structured b. weakens and bulges c. thin and flaky d. thick and hard ANS: B

An abdominal aortic aneurysm is a condition in which a section of the abdominal aorta wall weakens and bulges.

DIF: 2

REF: p. 851

MATCHING

Choose from the terms listed and match them with their most correct description. a. Arteriotomy b. Endarterectomy c. Angioplasty 1. An incision made in the artery 2. The surgical removal of plaque from inside an artery 3. May use a vascular stent 1. ANS: A 2. ANS: B 3. ANS: C

DIF: 3 DIF: 3 DIF: 3

REF: p. 823 REF: p. 823 REF: p. 844

Choose from the terms listed and match them with their most correct description. a. Arteriotomy b. Atherosclerosis c. Endarterectomy d. Angioplasty 4.

5.

6.

7.

May use a vascular shunt Most common form of arteriosclerosis Made with a #11 scalpel blade Performed during angiography

4. ANS: C

DIF: 3

REF: p. 849

5. ANS: B 6. ANS: A 7. ANS: D

DIF: 3 DIF: 3 DIF: 3

REF: p. 823 REF: p. 849 REF: p. 844

Choose from the terms listed and match them with their most correct description. a. Vein b. Lymphatic c. Artery 8. Carries oxygenated blood from the heart 9. Carries nutrients from the digestive system into the liver 10. Produces lymphocytes 8. ANS: C 9. ANS: A 10. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 824 REF: p. 831 REF: p. 832

Choose from the terms listed and match them with their most correct description. a. Vein b. Lymphatic c. Artery 11. Inferior vena cava 12. Thick-walled and highly elastic 13. Occurs in groups or chains 11. ANS: A 12. ANS: C 13. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 844 REF: p. 824 REF: p. 832

Choose from the terms listed and match them with their most correct description. a. Vein b. Artery 14. Blood pumped by skeletal muscles 15. Common carotid 14. ANS: A 15. ANS: B

DIF: 3 DIF: 3

REF: p. 825 REF: p. 828

Choose from the terms listed and match them with their most correct description. a. Vein b. Lymphatic 16. Composed of ducts 17. Carries blood back to the heart 16. ANS: B 17. ANS: A

DIF: 3 DIF: 3

REF: p. 831 REF: p. 825

Chapter 31: Thoracic and Pulmonary Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Thoracic and _____________ surgery includes procedures of the _________ system and

thoracic cavity, excluding those that involve the heart and cardiac vessels. a. pulmonary, endocrine b. cardiac, respiratory c. pulmonary, respiratory d. none are correct ANS: C

Thoracic and pulmonary surgery includes procedures of the respiratory system and thoracic cavity, excluding those that involve the heart and cardiac vessels.

DIF: 2

REF: p. 865

2. ______________________ is bloody sputum or bleeding arising from the respiratory tract. a. Empyema b. Hemoptysis c. Hypoxia d. Pleuritis ANS: B

Hemoptysis: Bloody sputum or bleeding arising from the respiratory tract.

DIF: 2

REF: p. 865

3. With the patient in the ___________ position, it is necessary to position a magnetic

instrument pad over the top drape to serve as a neutral zone and to retain any instruments that are placed on the drape. a. prone b. lateral c. supine d. dorsal recumbent ANS: B

With the patient in a lateral position, it is necessary to position a magnetic instrument pad over the top drape to serve as a neutral zone and also to retain any instruments that are placed on the drape.

DIF: 2

REF: p. 870

4. ____________ of one or both lungs is performed to remove a diseased lung and replace it

with a donor lung. a. Donors b. Transplantation c. Transferred d. A and B

ANS: B

Transplantation of one or both lungs is performed to remove a diseased lung and replace it with a donor lung.

DIF: 2

REF: p. 891

5. The surgical removal of a fibrous tissue overlying the lung is called ________________. a. lung volume reduction b. pneumonectomy c. decortication of the lung d. lobectomy ANS: C

Decortication of the lung is the surgical removal of fibrous tissue overlying the lung.

DIF: 2

REF: p. 891

6. The procedure that removes an entire lung to debulk (reduce the size of) a malignant tumor

is called a _______________________. a. lobectomy b. pneumonectomy c. decortication of the lung d. lung volume reduction ANS: B

Pneumonectomy is the removal of the entire lung.

DIF: 2

REF: p. 889

7. The ________ nerves are carefully preserved during pneumonectomy. a. vagus, left recurrent laryngeal, and phrenic b. vagus, pneumatic, and phrenic c. phrenic, pneumatic, and epigastric d. pneumatic, vagus, and left recurrent laryngeal ANS: A

The vagus, recurrent laryngeal (left side only), and phrenic nerves are retracted with vessel loops or moist umbilical tapes.

DIF: 2

REF: p. 891

8. The ________ begin(s) at the larynx and branch(es) into two main airways. a. bronchi b. hilum c. trachea d. pharynx ANS: C

The trachea begins at the larynx and branches into two main airways, the right and left primary bronchi and bronchial tree.

DIF: 2

REF: p. 866

9. During a pulmonary function test, the total volume of air is exhaled after maximum

inspiration. This is called ____________________. a. tidal volume b. vital capacity c. total lung capacity d. minute volume ANS: B

Vital capacity is the total volume of air exhaled after maximum inspiration.

DIF: 2

REF: p. 870

10. Bronchoscopy is the insertion of a bronchoscope through the _________. a. trachea & bronchial tree b. mediastinum c. pleura d. thoracic cavity ANS: A

The surgeon inserts the bronchoscope and advances the endoscope through the trachea and bronchial tree.

DIF: 2

REF: p. 876

11. When a thoracotomy is performed, the edges of the wound are covered with laparotomy

sponges to protect the wound edges from ____________. a. hemorrhaging b. sticking c. drying d. bruising ANS: D

The edges of the wound are covered with laparotomy sponges to protect them from bruising.

DIF: 2

REF: p. 888

12. _____________ is defined as difficulty in breathing. a. Hypoxia b. Empyema c. Dyspnea d. Pleuritis ANS: C

Dyspnea is difficulty in breathing.

DIF: 2

REF: p. 865

13. __________________ is the loss of elasticity and distention of the alveoli. a. Emphysema b. Fibrosis

c. Pleural effusion d. Sarcoidosis ANS: A

Diseases that constrict the alveoli, such as emphysema, cause loss of alveolar elasticity.

The result is inability to exchange oxygen with carbon dioxide.

DIF: 2

REF: p. 869

14. __________________ requires 10-mm lenses in sizes 0 and 30 degrees. a. Rigid bronchoscopy b. Mediastinoscopy c. Thoracoscopy d. Flexible bronchoscopy ANS: C

Thoracoscopy in an adult requires 10-mm lenses in sizes 0 and 30 degrees.

DIF: 2

REF: p. 882

15. _____________ is the distribution of oxygen to the tissue. a. Diffusion b. Ventilation c. Respiration d. Perfusion ANS: D

Perfusion (oxygen) is the distribution of oxygen to tissues.

DIF: 2

REF: p. 865

16. ________________ is generally used only for the removal of large tissue or a foreign

body. a. Rigid or flexible bronchoscopy b. Pleuroscopy c. Mediastinoscopy d. Thoracoscopy ANS: A

Interventional procedures such as foreign body removal, biopsy, and removal of small tumors can be performed through the flexible endoscope, especially the rigid bronchoscope, which has a larger diameter than the flexible scope.

DIF: 2

REF: p. 865

17. With a thoracotomy, the shoulder muscles are retracted using a __________. a. wide Deaver b. scapular retractor c. ribbon retractor d. Finochietto retractor ANS: B

During a thoracotomy, the surgeon inserts a scapular retractor beneath the shoulder muscles and elevates the scapula.

DIF: 2

REF: p. 888

18. Pulmonary angiography is performed when computed tomography (CT) scans are

inconclusive for diagnosis of __________. a. pulmonary infusion b. obstructive pulmonary disease c. pulmonary embolism d. spontaneous pneumothorax ANS: C

Pulmonary angiography is performed when CT scans are inconclusive for the diagnosis of pulmonary embolism.

DIF: 2

REF: p. 870

19. A pneumothorax is air in the chest cavity that prevents the lungs from expanding and may

____________________. a. displace the mediastinal structures b. collapse the contralateral lung c. inflate the contralateral lung d. cause bilateral lung inflation ANS: A

A pneumothorax is air in the chest cavity, which prevents the lungs from expanding and may displace the mediastinal structures.

DIF: 2

REF: p. 865

20. The reason inhaled foreign material is more likely to enter the right lung is because the

right bronchus is _______ than the left. a. larger b. straighter c. smaller d. longer ANS: B

Because the right bronchus is straighter than the left, inhaled foreign material is more likely to enter the right lung.

DIF: 2

REF: p. 866

21. When the diaphragm __________, the potential space between the two pleural membranes

is decreased and air is pulled into airways and lungs. a. expands b. contracts c. closes d. opens ANS: B

When the diaphragm contracts during inhalation, the potential space between the two pleural membranes decreases, and air is pulled into the airways and lungs.

DIF: 2

REF: p. 868

22. The lung is divided into anatomical regions. The right lung has ____ lobes and the left

lung has _____ lobes. a. two, three b. three, two c. four, three d. three, four ANS: B

The lung is divided into anatomical regions. The right lung has three lobes, and the left lung has two lobes.

DIF: 2

REF: p. 867

23. Diffusion is the transfer of oxygen from the __________________. a. bronchi in the lungs to the alveoli b. alveoli in the lungs to the bloodstream c. capillaries to the alveoli in the lungs d. alveoli in the lungs to the capillaries ANS: B

Diffusion is the transfer of oxygen from the alveoli in the lungs to the bloodstream.

DIF: 2

REF: p. 866

24. An arterial blood gas test assesses the arterial blood for ___________. a. red and white blood cells and platelets b. oxygen and carbon dioxide levels, as well as pH c. pH of blood only d. number of red and white blood cells and platelets ANS: B

In this test, the arterial blood is assessed for oxygen levels, carbon dioxide levels, and pH (acid-base balance).

DIF: 2

REF: p. 870

25. The patient is placed in semi-Fowler position to perform a _____ bronchoscopy. a. rigid b. flexible c. laparoscopic d. open ANS: B

In a flexible bronchoscopy, the patient is placed in a semi-Fowler position.

DIF: 2

REF: p. 876

MATCHING

Choose from the terms listed and match them with their most correct description. a. Bronchoscopy b. Mediastinoscopy c. Thoracoscopy 1. A small portion of lung tissue is removed for pathological assessment 2. Used to remove foreign body from airway 3. Uses a stainless steel endoscope inserted through a small incision at the suprasternal notch 1. ANS: C 2. ANS: A 3. ANS: B

DIF: 3 DIF: 3 DIF: 3

REF: p. 883 REF: p. 876 REF: p. 881

Choose from the terms listed and match them with their most correct description. a. Mediastinoscopy b. Thoracoscopy 4. Uses a 10-mm, 0-degree, and 30-degree lens 5. Lymph node biopsy is performed routinely during the procedure 4. ANS: B 5. ANS: A

DIF: 3 DIF: 3

REF: p. 882 REF: p. 881

Choose from the terms listed and match them with their most correct description. a. Bronchoscopy b. Thoracoscopy 6. Inserts a scope into the trachea 7. Used to perform a lung biopsy 6. ANS: A 7. ANS: B

DIF: 3 DIF: 3

REF: p. 880 REF: p. 881

Choose from the terms listed and match them with their most correct description. a. Bronchoscopy b. Thoracoscopy 8. Can be either rigid or flexible 9. Uses trocars and cannulas 8. ANS: A 9. ANS: B

DIF: 3 DIF: 3

REF: p. 881 REF: p. 883

Choose from the terms listed and match them with their most correct description. a. Hemothorax b. Emphysema 10. Loss of elasticity and destruction of lung tissue 11. Blood in the pleural cavity

10. ANS: B 11. ANS: A

DIF: 3 DIF: 3

REF: p. 892 REF: p. 869

Choose from the terms listed and match them with their most correct description. a. Pneumothorax b. Emphysema 12. Air enters the pleural cavity 13. Lung volume reduction surgery is used to treat 12. ANS: A 13. ANS: B

DIF: 3 DIF: 3

REF: p. 869 REF: p. 885

Chapter 32: Cardiac Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The heart is contained within a closed cavity called the ________. a. mediastinum b. pleural space c. chest cavity d. thoracic outlet ANS: A

The heart is contained within a closed cavity called the mediastinum.

DIF: 2

REF: p. 895

2. The sinoatrial (SA) node initiates the cardiac cycle and is sometimes called the heart’s

_____________. a. electrode b. pacemaker c. generator d. alligator clamp ANS: B

The SA node initiates the cardiac cycle and is sometimes called the heart’s pacemaker.

DIF: 2

REF: p. 896

3. Fibrillation is _________________. a. a disturbance to the heartbeat b. a heart valve that is unable to close tightly c. a fast heart rate d. uncoordinated muscular activity in the heart muscle, which results in “quivering”

rather than pumping action ANS: D

Fibrillation is uncoordinated muscular activity in the heart muscle, which results in “quivering” rather than pumping action.

DIF: 2

REF: p. 894

4. Chaotic, disorganized stimulation of one or both ventricles that does not pump the blood is

called __________. a. ventricular fibrillation. b. tachycardia. c. bradycardia. d. atrial septal defect.

ANS: A

Chaotic, disorganized stimulation of one or both ventricles that does not pump the blood is called ventricular fibrillation.

DIF: 2

REF: p. 925

5. ____________________ demonstrates the movement of blood through the valves and can

be used to measure the ejection fraction and end-systolic and end-diastolic volumes. a. Ventricular angiography b. Electrophysiology c. Mediastinoscopy d. Computed tomography (CT) scan ANS: A

Ventricular angiography demonstrates the movement of blood through the valves and can be used to measure the ejection fraction (the amount of blood pumped from the ventricles) and end-systolic and end-diastolic volumes.

DIF: 2

REF: p. 898

6. The coronary artery is opened with a #11 knife blade (or Beaver blade), and the incision is

extended with _______ coronary scissors. a. Potts b. Metz c. tenotomy d. micro ANS: A

The coronary artery is opened with a #11 knife blade (or Beaver blade), and the incision is extended with Potts coronary scissors.

DIF: 2

REF: p. 911

7. _______________ inadequate blood supply to a localized area related to blockage of

vessels leading to that area. a. Ischemia b. Infarction c. Mediastinum d. Stenosis ANS: A

Ischemia is inadequate blood supply to a localized area related to blockage of vessels leading to that area.

DIF: 2

REF: p. 894

8. A pacemaker is a device that produces electrical impulses that stimulate the heart. This

process is called _____________. a. pacing the heart b. stabilizing the heart c. decreasing a high heart rate d. repairing a non–life-threatening dysrhythmia ANS: A

A pacemaker is a device that produces electrical impulses that stimulate the heart muscle.

This process is called pacing the heart.

DIF: 2

REF: p. 905

9. Bradycardia is a heart rate _______ beats per minute. a. below 40 to 60 b. of 70 to 100 c. of 60 to 120 d. higher than 120 ANS: A

A heart rate below 40 to 60 beats per minute is bradycardia.

DIF: 2

REF: p. 925

10. __________________ is the most common incision used for surgical procedures of the

heart and great vessels in the thoracic cavity. a. Transverse sternotomy b. Median sternotomy c. Anterior lateral thoracotomy d. Posterior lateral thoracotomy ANS: B

A median sternotomy is a midline incision used for surgical procedures of the heart and large vessels in the thoracic cavity.

DIF: 2

REF: p. 905

11. Cardioplegia solution is used to ________. a. intentionally interrupt the heart’s pumping action b. reverse the effect of heparin c. prevent blood clots from forming d. treat ventricular arrhythmias ANS: A

Cardioplegia is the intentional interruption of the heart’s pumping action. A cardioplegic solution contains various additives, the most important being potassium chloride. The solution may be cooled or warmed for administration.

DIF: 2

REF: p. 905

12. The aortic valve maintains one-way blood flow from the ________ to the aorta. a. right ventricle b. left atrium c. right atrium d. left ventricle ANS: D

The aortic valve maintains one-way blood flow from the left ventricle to the aorta. The valve is replaced when it has lost function due to disease.

DIF: 2

REF: p. 915

13. During an aortic valve replacement, a _____________ incision is most commonly made to

open the aorta. a. transverse b. brachial c. median sternotomy d. lateral thoracotomy ANS: A

During an aortic valve replacement, the surgeon opens the aorta with a transverse incision or, occasionally, a vertical incision.

DIF: 2

REF: p. 916

14. The mitral valve is located between the _______________. a. left atrium and the aorta b. right atrium and vena cava c. left atrium and left ventricle d. right atrium and right ventricle ANS: C

The mitral valve is situated between the left atrium and left ventricle.

DIF: 2

REF: p. 918

15. During coronary artery bypass surgery, the surgeon occludes the ascending aorta and

inserts the indwelling catheter for ______________. a. infusion of cardioplegic solution and venting of air b. infusion of heparin solution and injection of air c. infusion of anesthetic solutions and injection of air d. infusion of potassium solution and injection of air ANS: A

The surgeon then occludes the ascending aorta and inserts the indwelling catheter for infusion of cardioplegic solution and venting of air.

DIF: 2

REF: p. 911

16. Removal of the native heart and replacement with a donor heart is indicated for patients

with ______ cardiac disease. a. end-stage b. chronic c. continuous d. early-stage ANS: A

Heart transplantation may be performed in suitable patients with end-stage cardiac disease.

DIF: 2

REF: p. 928

17. Two classifications of aneurysms are ____________.

a. b. c. d.

saccular and fusiform stenotic and syncope aortic and ventricular cranial and caudal

ANS: A

Aneurysms can be classified as saccular or fusiform. A saccular aneurysm is the ballooning out of a localized area in the artery. A fusiform aneurysm involves the entire circumference of the artery.

DIF: 2

REF: p. 919

18. An artificial pacemaker is implanted in the body to correct cardiac arrhythmia caused by

_______________. a. stenosis of the great vessels b. disease of the conduction system c. hardening of heart vessels d. hardening of the heart valves ANS: B

An artificial pacemaker is implanted in the body to correct cardiac arrhythmia caused by a disease of the conduction system.

DIF: 2

REF: p. 925

19. Tachycardia is a fast heart rate, usually more than ________ beats per minute. a. 90 b. 80 c. 65 d. 120 ANS: D

Tachycardia is a fast heart rate usually more than 120 beats per minute.

DIF: 1

REF: p. 894

20. The three layers tissue layers of the heart wall are the outer epicardium, the middle

myocardium, and the inner _________. a. pericardium b. endocardium c. cryocardium d. intracardium ANS: B

Three tissue layers make up the heart wall: the outer epicardium, middle myocardium, and inner endocardium.

DIF: 1

REF: p. 895

21. Cardiac catheterization is a(n) ___________ procedure and involves insertion of a cardiac

catheter into the heart chambers and large vessels via a peripheral artery or vein. a. open operative

b. interventional radiology c. noninvasive d. difficult ANS: B

Cardiac catheterization is an interventional radiology procedure that involves the insertion of a cardiac catheter into the heart chambers and large vessels via a peripheral artery or vein.

DIF: 2

REF: p. 896|p. 897

22. The Rumel tourniquet, commonly used in cardiovascular surgery, is a short length of

rubber tubing either commercially prepared or cut from a(n) _____________. a. Penrose drain b. T-tube drain c. straight (Robinson) urinary catheter d. unused section of suction tubing ANS: C

The Rumel tourniquet, commonly used in cardiovascular surgery, is a short length of synthetic tubing either commercially prepared or cut from a straight (Robinson) urinary catheter.

DIF: 1

REF: p. 903

23. A midline incision from the sternal notch 2 to 3 inches below the xiphoid is called a(n)

______ sternotomy. a. median b. paramedian c. anterolateral d. transverse ANS: A

A midline incision from the sternal notch to 2 to 3 inches below the xiphoid is called a median sternotomy.

DIF: 1

REF: p. 906

MATCHING

Match the following dysrhythmias with the best description of the anomaly. a. Ventricular fibrillation b. Atrial flutter c. Bradycardia d. Ventricular tachycardia e. Atrial fibrillation 1. Heart rate over 120 beats per minute 2. Heart rate of 240 to 450 beats per minute 3. Chaotic, disorganized stimulation of the ventricle(s) that does not pump the blood

4. Chaotic, disorganized stimulation of the atrium (atria) that prevents atrial contraction

(which helps fill the ventricle with blood) 5. Abnormally slow heartbeat below 60 beats per minute 1.

2.

3.

4.

5.

ANS: D ANS: B ANS: A ANS: E ANS: C

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 925 p. 925 p. 925 p. 925 p. 894

Choose from the terms listed and match them with their most correct description. a. Right ventricle b. Right atrium c. Bicuspid (mitral) valve d. Left ventricle e. Left atrium f. Tricuspid valve 6.

7.

8.

9.

10.

11.

Located on the right side of the heart between the ventricle and the atrium Receives deoxygenated blood from the right atrium Pumps oxygenated blood to the body Between the left atrium and left ventricle A diseased mitral valve is replaced to prevent blood from regurgitating here Receives deoxygenated blood from the body

6.

7.

8.

9.

10.

11.

ANS: F ANS: A ANS: D ANS: C ANS: E ANS: B

DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3

REF: REF: REF: REF: REF: REF:

p. 895 p. 896 p. 896 p. 895 p. 918 p. 931

Choose from the terms listed and match them with their most correct description. a. Right ventricle b. Bicuspid (mitral) valve c. Left ventricle d. Tricuspid valve 12.

13.

14.

15.

Replaced with a prosthetic valve through a right atriotomy Connected to the pulmonary artery by the pulmonary valve Disease may be caused by rheumatic heart disease Connects to the aorta by the aortic valve

12.

13.

14.

15.

ANS: D ANS: A ANS: B ANS: C

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 919 p. 896 p. 918 p. 930

Chapter 33: Pediatric Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. Pediatric surgery is a multidisciplinary field that encompasses many surgical specialties.

Most procedures can be classified into one of three groups, including all of the following, EXCEPT __________. a. trauma surgery b. treatment of disease c. treatment of PID d. treatment of congenital anomalies ANS: C

Pediatric surgery is a multidisciplinary field that encompasses many surgical specialties.

Most procedures can be classified in one of three groups: Surgery for treatment of congenital anomalies, Procedures for treatment of diseases, Trauma surgery.

DIF: 2

REF: p. 937

2. During surgery, the prewarmed operating room (OR), warm air blanket, and overhead

lighting contribute to __________. a. OR environment b. intraoperative procedure c. intraoperative warming d. all are correct ANS: C

During surgery, several methods are used to maintain the core temperature.

DIF: 2

REF: p. 938

3. Infants and children can become rapidly dehydrated. Before surgery begins, a(n)

______________ line is inserted to maintain access to the circulatory system. a. IV b. endotracheal tube c. catheter d. tube ANS: A

Infants and children can become rapidly dehydrated. Before surgery begins, an IV line is inserted to maintain access to the circulatory system.

DIF: 2

REF: p. 938

4. The causative agent of measles is __________. a. Treponema pallidum b. varicella-zoster virus c. rubella virus d. herpesvirus

ANS: C

Rubella virus—the causative agent of measles (cataract, glaucoma, deafness, heart defects, retinal defects).

DIF: 2

REF: p. 939

5. The causative agent of cerebral calcifications, microcephaly, and heart defects is

__________. a. Toxoplasma gondii b. varicella-zoster virus c. rubella virus d. herpesvirus ANS: A

Toxoplasma gondii (cerebral calcifications, microcephaly, heart defects).

DIF: 2

REF: p. 939

6. The causative agent of syphilis is __________. a. Treponema pallidum b. varicella-zoster virus c. rubella virus d. herpesvirus ANS: A

Treponema pallidum—the causative agent of syphilis (hydrocephalus, deafness, bone defects).

DIF: 2

REF: p. 939

7. The causative agent of chickenpox is __________. a. Treponema pallidum b. varicella-zoster virus c. rubella virus d. herpesvirus ANS: B

Varicella-zoster virus—the causative agent of chickenpox (muscle atrophy, mental retardation).

DIF: 2

REF: p. 939

8. The causative agent of hydrocephalus and deafness is __________. a. cytomegalovirus b. varicella-zoster virus c. rubella virus d. herpesvirus ANS: A

Cytomegalovirus (hydrocephalus, deafness).

DIF: 2

REF: p. 939

9. The causative agent of retinal defect, microcephaly, and microphthalmia is __________. a. cytomegalovirus b. varicella-zoster virus c. rubella virus d. herpesvirus ANS: D

Herpes virus (microcephaly, microphthalmia, retinal defect).

DIF: 2

REF: p. 939

10. The method of induction depends on all the following EXCEPT __________. a. child’s age b. presence of a parent c. whether there is IV access d. sex of child ANS: D

The method of induction depends on the following conditions: the child’s age, whether there is IV access, the presence of a parent, the preference and skill of the anesthesia care provider, the American Society of Anesthesiologists (ASA) case classification (see Chapter 13).

DIF: 2

REF: p. 943

11. Pediatric medications are prescribed according to the child’s __________. a. developmental stage b. age c. weight d. all are correct ANS: C

Pediatric medications are prescribed according to the child’s weight in kilograms, and the correct dose must be verified by the surgeon, circulating registered nurse, and surgical technologist.

DIF: 2

REF: p. 943

12. Neonates and infants usually are transported to the OR in a __________. a. small stretcher b. heated Isolette c. large crib d. parent’s arms ANS: B

Neonates and infants are usually transported to the operating room in a heated Isolette.

DIF: 2

REF: p. 943

13. What size are pediatric instruments? a. Same as adults

b. Micro instrument c. Smaller in dimension d. All are correct ANS: C

The instruments themselves may be smaller in all dimensions, or only the tips (working ends) may be smaller.

DIF: 2

REF: p. 944

MATCHING

Match the congenital and genetic abnormalities with the definition. a. Anencephaly b. Atrial septal defect c. Branchial cleft cysts and clefts d. Chest wall deformities e. Choanal atresia f. Cleft lip or palate g. Coarctation of the aorta h. Esophageal atresia i. Gastroschisis j. Hirschsprung disease k. Infantile hypertrophic l. Omphalocele m. Patent ductus arteriosus n. Pulmonary valve stenosis o. Spina bifida p. Syndactyly q. Tetralogy of Fallot r. Tracheoesophageal fistula s. Ventricular septal defect t. Wilms tumor 1. Congenital narrowing of the thoracic aorta that restricts blood flow to the lower body 2. A congenital anomaly that includes several types of neural tube defects, including 3.

4.

5.

6.

7.

8.

9.

10.

incomplete closure of the bony spinal column around the spinal cord Congenital anomaly in which large parts of the brain fail to develop Is a congenital anomaly characterized by a stricture or blockage of the passage between the nasal sinus and the pharyngonasal airways The most common primary renal malignancy of children A combination of congenital defects Congenital absence of ganglion cells, which control the relaxation and contraction that occur in peristalsis These are embryonic remnants or slits in the neck region that persist as cysts or fistulas after birth Webbing of the fingers or toes as a result of incomplete separation of the digits in embryonic life Is a fetal heart structure that shunts blood from the right ventricle into systemic circulation

11. Congenital cardiac defect 12. An abdominal wall defect in which the viscera form outside the body 13. Congenital cardiac defect in which a hole in the interatrial septum allows blood from the 14.

15.

16.

17.

18.

19.

20.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

left atrium to flow into the right atrium Complete or partial absence of the esophagus Also called pyloric stenosis Partial or complete division of the lip or palate prevents the infant from sucking effectively A fistula connecting the esophagus with the trachea Pectus excavatum or pectus carinatum Congenital cardiac defect in which the pulmonary valve leaflets are fused, restricting circulation of the blood from the right ventricle to the lungs A type of abdominal wall deformity in which the viscera develop outside the body, contained within a peritoneal sac ANS: G ANS: O ANS: A ANS: E ANS: T ANS: Q ANS: J ANS: C ANS: P ANS: M ANS: S ANS: I ANS: B ANS: H ANS: K ANS: F ANS: R ANS: D ANS: N ANS: L

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 940 p. 940 p. 940 p. 940 p. 941 p. 941 p. 940 p. 940 p. 941 p. 940 p. 941 p. 940 p. 940 p. 940 p. 940 p. 940 p. 941 p. 940 p. 940 p. 940

Chapter 34: Neurosurgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. The neuron is the primary _____ type of the nervous system and is located throughout the

body. a. soma b. axon c. dendrites d. cell ANS: D

The neuron is the cell type of the nervous system located throughout the body.

DIF: 2

REF: p. 965

2. The ____________ acts as the sending and receiving area for nerve impulses and is the

energy center of the cell. a. soma b. axon c. dendrites d. cell ANS: A

The soma acts as the sending and receiving area for nerve impulses and is the energy center of the cell.

DIF: 2

REF: p. 966

3. The ______ carry/carries nerve impulses toward the cell. a. soma b. axon c. dendrites d. cell ANS: C

The dendrites carry nerve impulses toward (afferent) the cell.

DIF: 2

REF: p. 966

4. The ___________ carry/carries nerve impulses away from the cell. a. soma b. axon c. dendrites d. cell ANS: B

The axon carries nerve impulses away (efferent) from the cell.

DIF: 2

REF: p. 966

5. Two __________ bones are on either side of the skull, which contribute to the structure for

the sides of the cranium. a. frontal b. temporal c. occipital d. parietal ANS: B

Two temporal bones on either side of the skull, which contribute to the structure for the sides of the cranium.

DIF: 2

REF: p. 966

6. One _______ bone provides structure for the forehead and orbits. a. frontal b. temporal c. occipital d. parietal ANS: A

One frontal bone, which provides structure for the forehead and orbits.

DIF: 2

REF: p. 966

7. One _____ bone provides structure to the back of the skull and a portion of the floor of the

cranium. a. frontal b. temporal c. occipital d. parietal ANS: C

One occipital bone, which provides structure to the back of the skull and a portion of the floor of the cranium.

DIF: 2

REF: p. 966

8. Two _________ bones on either side of the skull provide structure for the sides and roof of

the cranium. a. frontal b. temporal c. occipital d. parietal ANS: D

Two parietal bones on either side of the skull, which provide structure for the sides and roof of the cranium.

DIF: 2

REF: p. 966

9. The pericranium is the periosteal layer of the skull bones. It is covered with all of the

following EXCEPT __________. a. muscle b. galea c. dura d. skin ANS: C

The pericranium is the periosteal layer of the skull bones. It is covered by muscle and the galea, a tough, fibrous tissue sheet. The skin of the scalp is very thick and highly vascular and contains numerous hair follicles.

DIF: 2

REF: p. 966

10. The brain is divided into three main sections, including all of the following EXCEPT

__________. a. cerebrum b. pericranium c. cerebellum d. brainstem ANS: B

The brain is divided into three main sections: the cerebrum, cerebellum, and brainstem.

DIF: 2

REF: p. 966

11. The _______ is also known as the forebrain. a. cerebrum b. cerebellum c. brainstem d. pericranium ANS: A

The cerebrum, or forebrain, controls all motor activity and sensory impulses.

DIF: 2

REF: p. 966

12. The __________ is also known as the hindbrain. a. cerebrum b. cerebellum c. brainstem d. pericranium ANS: B

The cerebellum, or hindbrain, lies under the posterior cerebrum and is the second largest area of the brain.

DIF: 2

REF: p. 966

13. The major structures of the midbrain include all of the following EXCEPT __________. a. thyroid gland b. hypothalamus

c. thalamus d. pituitary gland ANS: A

The major structures of the midbrain are the thalamus, hypothalamus, posterior pituitary gland, and pineal gland.

DIF: 2

REF: p. 966

14. There are __________ cervical vertebrae. a. 12 b. 5 c. 1 d. 7 ANS: D

There are 7 cervical vertebrae.

DIF: 2

REF: p. 969

15. There are ___ lumbar vertebrae. a. 12 b. 5 c. 1 d. 7 ANS: B

There are 5 lumbar vertebrae.

DIF: 2

REF: p. 969

16. There are ____ sacral vertebrae. a. 12 b. 5 c. 1 d. 7 ANS: B

There are 5 sacral vertebrae.

DIF: 2

REF: p. 969

17. There are _______ thoracic vertebrae. a. 12 b. 5 c. 1 d. 7 ANS: A

There are 12 thoracic vertebrae.

DIF: 2

REF: p. 969

18. The _________ nerves that originate in the brain are responsible for the sensory and motor

functions of the body. a. spinal b. cranial c. peripheral d. thoracic ANS: B

The cranial nerves are 12 pairs of nerves that originate in the brain and are responsible for the sensory and motor functions of the body.

DIF: 2

REF: p. 971

19. ____________ nerves are composed of small bundles of nerve fibers, called fascicles,

which are surrounded by a sheath called the endoneurium. a. Spinal b. Cranial c. Peripheral d. Thoracic ANS: C

Peripheral nerves are composed of small bundles of nerve fibers, called fascicles, which are surrounded by a sheath called the endoneurium.

DIF: 2

REF: p. 974

20. The _______ nerves occur in pairs and originate from the spinal cord near their

corresponding vertebra. a. spinal b. cranial c. peripheral d. thoracic ANS: A

The spinal nerves occur in pairs and originate from the spinal cord near their corresponding vertebra.

DIF: 2

REF: p. 971

21. Small, square, felt sponges made of cotton or rayon to control bleeding on neural and

vascular tissue are referred to as __________. a. 4 4s b. laps c. Kittners d. cottonoids ANS: D

The neurosurgeon uses small, square, felted sponges made of cotton or rayon to control bleeding on neural and vascular tissue. These are commonly referred to as “patties” or “cottonoids.”

DIF: 2

REF: p. 981

22. What type of dressing would be placed on a spinal incision? a. Radiopaque sponge b. Tegaderm c. ABD pads d. Telfa ANS: D

Spinal incisions are dressed with nonadherent Telfa and absorbent gauze pads secured with tape.

DIF: 2

REF: p. 982

23. Gardner-Wells tongs may be used to secure __________. a. patient’s arms b. patient’s head c. patient’s spine d. patient’s legs ANS: B

Skull tongs (e.g., Gardner-Wells tongs) may also be used to secure the patient’s head in a particular position and as a means for attaching traction devices.

DIF: 2

REF: p. 982

24. All of the following are patient position devices EXCEPT __________. a. headrest b. Telfa c. Operating room (OR) table d. Wilson frame ANS: B

Headrest, OR table, and Wilson frame are all used for patient position.

DIF: 2

REF: p. 982

25. During a craniotomy, the patient is positioned using a __________ headrest or pin

fixation. a. round b. oval c. horseshoe d. oblong ANS: C

During a craniotomy, a padded horseshoe headrest may also be used.

DIF: 2

REF: p. 984

26. What type of ESU is used during a craniotomy? a. Disposable b. Harmonic c. Needle

d. Bipolar ANS: D

The bipolar ESU is also used for hemostasis.

DIF: 2

REF: p. 984

27. During a microdiscectomy, what type of retractor is used? a. Weitlaner b. Ragnell c. Senns d. Tubular ANS: D

The scrub places a long electrode on the monopolar ESU, and the surgeon uses it through the tubular retractor to remove any remaining muscle or soft tissue overlying the lamina.

DIF: 2

REF: p. 1006

28. During a microdiscectomy, the wound edges are approximated with __________. a. Steri-Strips. b. Dermabond. c. suture. d. A and B. ANS: D

The wound edges are approximated with Steri-Strips or Dermabond glue.

DIF: 2

REF: p. 1008

29. During a microdiscectomy, Gelfoam pledgets are soaked in __________. a. lidocaine. b. topical thrombin. c. saline. d. none are correct.

ANS: B

Any necessary hemostasis is accomplished with the bipolar ESU and Gelfoam pledgets soaked in topical thrombin.

DIF: 2

REF: p. 1008

MATCHING

Match the cranial nerves with the definition. a. I (olfactory) b. II (optic) c. III (oculomotor) d. IV (trochlear) e. V (trigeminal) f. VI (abducens) g. VII (facial)

h. i. j. k. l.

VIII (vestibulocochlear) IX (glossopharyngeal) X (vagus) XI (accessory) XII (hypoglossal)

12.

Controls lateral movement of the eye Innervates the muscle of the tongue Responsible for the sense of smell Innervates the pharyngeal and laryngeal muscles, heart, pancreas, lungs, and digestive systems Controls the oblique muscle of the eye Controls the sense of taste Has two parts, a cranial portion and a spinal portion Conveys impulses for sight A motor nerve that controls the muscle in the face and scalp Controls muscle that moves the eye and iris A sensory nerve that controls the sensation of the face, forehead, mouth, nose, and top of head Controls hearing and equilibrium

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

ANS: F ANS: L ANS: A ANS: J ANS: D ANS: I ANS: K ANS: B ANS: G ANS: C ANS: E ANS: H

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 971 p. 971 p. 971 p. 971 p. 971 p. 971 p. 971 p. 971 p. 971 p. 971 p. 971 p. 971

Chapter 35: Emergency Trauma Surgery Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ___________ is/are the leading cause(s) of death among individuals between the ages of 1

and 45 and the third leading cause of death in all age groups. a. Motorcycle accidents b. Motor vehicle accidents c. Boating accidents d. Trauma ANS: D

Trauma is the leading cause of death among individuals between the age of 1 and 45 years and the third leading cause of death in all age groups.

DIF: 2

REF: p. 1014

2. During a true surgical emergency, more so than in any other scenario, ___________ is key

to a successful outcome for the patient. a. teamwork b. preparation c. counting d. instruments ANS: A

During a true surgical emergency, more so than in any other scenario, teamwork is key to a successful outcome for the patient.

DIF: 2

REF: p. 1015

3. Although the ability to respond quickly to the demand of surgery is important, so is

_______________. a. teamwork b. accuracy c. preparation d. instruments ANS: B

Accuracy in emergency terms means “getting it right the first time.”

DIF: 2

REF: p. 1015

4. Clear _____________ is the pivot point of team efforts in an emergency. a. teamwork b. accuracy c. preparation d. communication ANS: D

Clear communication is the pivot point of team efforts in an emergency. There may be many people attending the patient at one time during the emergency.

DIF: 2

REF: p. 1015

5. ATLS is __________. a. Advanced Trauma Life System b. Advanced Trauma Limited Support c. Advanced Trauma Life Support d. Advanced Trauma Limited System ANS: C

Physician certification in trauma care is achieved through the American College of Surgeon’s Advanced Trauma Life Support (ATLS) course, which is globally recognized.

DIF: 2

REF: p. 1016

6. ____________ is/are treatment pathways in trauma surgery. a. Signs and symptoms b. Algorithms c. Hemorrhagic shock d. None are correct ANS: B

Algorithms are treatment pathways established to allow systematic and consistent methods of medical and surgical management.

DIF: 2

REF: p. 1014

7. Subnormal core body temperature for an extended period of time is known as

__________. a. metabolic acidosis b. coagulopathy c. hypothermia d. hyperthermia ANS: C

Hypothermia is subnormal core body temperature for an extended period of time.

DIF: 2

REF: p. 1016

8. Lower-than-normal blood pH is what condition? a. Metabolic acidosis b. Coagulopathy c. Hypothermia d. Hyperthermia ANS: A

Metabolic acidosis is lower than normal blood pH. DIF: 2

REF: p. 1016

9. ____________, a vascular failure caused by prolonged, severe blood loss, is the most

common cause of mortality in trauma. a. Hypothermia b. Coagulopathy c. Hemorrhagic shock d. Metabolic acidosis ANS: C

A vascular failure, caused by prolonged, severe blood loss, is the most common cause of mortality in trauma and is called hemorrhagic shock.

DIF: 2

REF: p. 1016

10. The compensatory mechanisms in acute injury can lead to the condition called

__________. a. compartment syndrome b. metabolic acidosis c. hemorrhagic shock d. hypothermia ANS: A

The compensatory mechanisms in acute injury can lead to the condition called compartment syndrome. In simple terms, this is tissue swelling within a closed area such as muscle bundles (surrounded by sheets of fascia and encased by superficial tissues) or the abdomen.

DIF: 2

REF: p. 1018

11. ____________ is the process of restoring physiological balance in injury. a. Metabolic acidosis b. Hypothermia c. Hyperthermia d. Resuscitation ANS: D

Resuscitation is the process of restoring physiological balance in injury. In the context of trauma, resuscitation refers to treatment for the effects of hemorrhagic shock, including establishing normal circulating blood volume (hemodynamics), tissue perfusion, and vascular tone.

DIF: 2

REF: p. 1019

12. The secondary survey is also known as __________. a. occult injury b. hospital care c. clinical care d. emergency care ANS: B

The secondary survey is performed once the patient is stable enough to be moved.

However, a patient requiring immediate, lifesaving surgery may be transported directly to the operating room after the primary assessment.

DIF: 2

REF: p. 1019

13. Consent for invasive procedures, including emergency surgery, is obtained from the

patient if he or she is able, or from _____________________, according to hospital policy. a. another person b. responsible individuals c. the parents d. none are correct ANS: B

Consent for invasive procedures, including emergency surgery, is obtained from the patient if he or she is able, or from responsible individuals, according to hospital policy.

DIF: 2

REF: p. 1023

14. Death from ______ is the second leading cause of mortality in the United States, and

approximately 115,000 cases of _______ injury are treated each year. a. firearms; firearm b. stabbing; stabbing c. trauma; trauma d. motor vehicle accident; motor vehicle accident ANS: A

Death from firearms is the second leading cause of mortality in the United States.

Approximately 115,000 cases of firearm injury are treated each year. The most common firearm used in personal violence is the handgun.

DIF: 2

REF: p. 1022

15. When passing any instrument that will come in contact with a bullet, fragments, shrapnel,

or other ballistic item, ensure that the _______ of the instrument are protected with rubber shod or completely covered with a sponge. a. finger hold b. ratchets c. serrations d. tips ANS: D

When passing any instrument that will come in contact with a bullet, fragments, shrapnel, or other ballistic item, ensure that the tips of the instrument are protected with rubber shod or completely covered with a sponge. Markings on the fragment or bullet may not be visible without magnification but are nevertheless present on all weapons.

DIF: 2

REF: p. 1022

16. One goal of damage control surgery is to focus solely on lifesaving maneuvers, including

all of the following EXCEPT __________. a. control of feeding b. control of hemorrhage c. control of fecal spillage d. relief of compartment syndrome

ANS: A

The goal of damage control surgery is to focus solely on lifesaving maneuvers: Control of hemorrhage, Control of fecal spillage (abdominal and pelvic injury), Packing a body cavity, Delayed or phased closure of the wound, Relief of compartment syndrome, Splinting or external fixation to prevent extension of injuries.

DIF: 2

REF: p. 1020

17. If the patient is stabilized in 12 to 48 hours, he or she can then be returned to surgery for a

____________ procedure. a. follow-up b. emergency c. schedule d. definitive ANS: D

If the patient is stabilized in 12 to 48 hours, he or she can then be returned to surgery for a definitive procedure (surgical treatment using a planned method and techniques intended to provide a lasting repair).

DIF: 2

REF: p. 1020

18. Hospitals should have basic setups for __________. a. craniotomy b. bowel resection c. replantation d. vasovasostomy ANS: A

All health care facility surgical departments prepare emergency case carts in preparation for specific emergencies likely to arrive for treatment. These include basic setups for craniotomy, cesarean section, and abdominal aneurysm.

DIF: 1

REF: p. 1020

19. To avoid having instrument sets opened but not used, specialty instruments can be placed

on a __________ the operating room (OR) in the sterile core. a. cart inside b. cart outside c. sterile uncovered Mayo stand in d. sterile covered Mayo stand in ANS: B

To avoid having instrument sets opened but not used, specialty instruments can be placed unopened on a cart outside the operating room in the sterile core.

DIF: 1

REF: p. 1020

20. Copious amounts of _________ solution are often needed during trauma surgery. a. drug b. irrigation

c. heparin d. coagulation ANS: B

Copious amounts of irrigation solution are often needed during trauma surgery. These are used to flush and clean the wound of tissue debris and foreign objects.

DIF: 1

REF: p. 1020

21. ____________-based tissue sealants are used only if there is no coagulopathy present

because these depend on an intact coagulation response. a. Thrombin b. Lidocaine c. Heparin d. Warfarin ANS: A

Thrombin-based tissue sealants are used only if there is no coagulopathy present because these depend on an intact coagulation response.

DIF: 1

REF: p. 1021

22. Postoperative serosanguinous pooling is controlled with wound _________. a. drains b. dressings c. clamps d. pins ANS: A

Postoperative serosanguinous pooling is controlled with wound drains, whereas fluid and electrolyte imbalance is managed through systemic resuscitative measures.

DIF: 1

REF: p. 1021

23. The real potential for extending the patient’s injuries exists during ___________ and

_____________. a. positioning; skin prep b. moving; handling c. induction; wake up d. preoperative preparations; postoperative preparation ANS: B

The real potential for extending the patient’s injuries exists during moving and handling.

DIF: 1

REF: p. 1022

24. Normothermia is maintaining core body temperature __________. a. at the absolute minimum that supports life. b. as close to normal as possible. c. as close to maximum as possible. d. at 25 degrees Celsius.

ANS: B

Maintaining the patient’s core temperature as close to normal as possible is a major goal of emergency treatment.

DIF: 1

REF: p. 1022

25. You are called in on a motor vehicle accident; the patient is disoriented and scared. As a

health care professional, it is important to provide some measure of _______ for the patient. a. emotional comfort b. distress relief c. safety education d. standard precaution ANS: A

In a severe emergency, all activity is focused on lifesaving measures. However, whenever possible, it is important to provide some measure of emotional comfort.

DIF: 1

REF: p. 1023

26. You are scrubbed in on an emergency case when the circulator tells you that all

standardized ____________ procedures may be suspended in life-threatening situations. a. surgical b. count c. aseptic d. anesthetic ANS: B

In emergency circumstances, some of the usual routines are abbreviated. This includes sponge and instrument counts. Although this is not an ideal situation, the American College of Surgeons has stated that standardized counting procedures may be suspended in life-threatening situations.

DIF: 1

REF: p. 1023

27. The term “up” means what during an emergency case? a. Items are sterile and ready for use b. On the Mayo ready for use c. The patient’s blood pressure is too high d. The patient’s heart rate is too high ANS: B

The term up means “up on the Mayo, ready to use.”

DIF: 1

REF: p. 1023

MATCHING

Match the terms with the definitions. Not all answers will be used. a. Blunt injury b. Cardiac rupture c. Cardiac tamponade

d. Coagulopathy e. Compartment syndrome f. Contusion g. Damage control surgery h. Definitive diagnosis i. Definitive procedure j. Exsanguinating k. Flail chest l. FAST m. Hemorrhagic shock n. Hemothorax o. Metabolic acidosis p. Occult injury q. Penetrating injury r. Pneumothorax 1. Pressure on the heart causing restriction and damage to the conduction system 2. Injury that results in air in the pleural space causing displacement or collapse of the 3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

respiratory structures Bruising Trauma that results in deep tissue injury without rupture of the skin A protocol of ATLS in which ultrasound is used in a focus area to diagnose severe trauma Condition in which the body’s normal blood clotting mechanism ceases to function; characteristic in severe multitrauma Tearing of the atria or ventricles as a result of trauma Evidence-based diagnosis of a medical problem using normal investigative procedures, such as imaging studies A type of shock characterized by vascular failure resulting from severe bleeding Hemorrhage with the potential to deplete the patient’s total blood volume Surgery whose objective is to stop hemorrhage and prevent sepsis without attempting reconstruction or anatomical continuity Increased pressure in any compartment of the body A planned surgical procedure, usually with specific objectives for reconstruction or restoring continuity of anatomical structures ANS: C ANS: R ANS: F ANS: A ANS: L ANS: D ANS: B ANS: H ANS: M ANS: J ANS: G ANS: E ANS: I

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014 p. 1014

Chapter 36: Disaster Preparedness and Response Fuller: Surgical Technology: Principles and Practice, 8th Edition MULTIPLE CHOICE 1. ________ is a catastrophic event that poses a large-scale risk to human life and property. a. Tornado b. Disaster c. Hurricane d. Earthquake ANS: B

Disaster is a catastrophic event that poses a large-scale risk to human life and property.

DIF: 2

REF: p. 1041

2. ___________ is a localized emergency, such as a transportation accident, explosion, or

structural collapse, in which the number of victims overwhelms local health care services. a. An emergency b. A national incident c. A mass casualty event d. None are correct ANS: C

A mass casualty event (MCE) is a localized emergency, such as a transportation accident (e.g., major air crash), explosion, or structural collapse in which the number of victims overwhelms local health care services.

DIF: 2

REF: p. 1041

3. _________ or ____________ disasters are unintentional events caused by human activity,

compounded by error or negligence. a. War, technology b. Technology, chemical c. Chemical, war d. Technological, industrial ANS: D

Technological or industrial disasters are unintentional events caused by human activity, compounded by error or negligence.

DIF: 2

REF: p. 1044

4. Large-scale _____________ can occur where flammable materials are used in

manufacturing or in large storage facilities, including oil refineries, chemical plants, and manufacturing facilities. a. Hazardous material accident b. Radiation accident c. Explosions d. Transportation accident

ANS: C

Large-scale explosions can occur where flammable materials are used in manufacturing or in large storage facilities, including oil refineries, chemical plants, and manufacturing facilities.

DIF: 2

REF: p. 1044

5. ___________________ occur in similar conditions as explosions, with greater risk in

refineries and other locations where large amounts of hazardous materials are stored or manufactured. a. Hazardous material accidents b. Radiation accidents c. Explosions d. Transportation accidents ANS: A

Hazardous material accidents occur in similar conditions as explosions, with greater risk in refineries and other locations where large amounts of hazardous materials are stored or manufactured.

DIF: 2

REF: p. 1044

6. _______________________ such as the Fukushima nuclear crisis and Chernobyl are

uncommon but devastating to communities. a. Hazardous material accidents b. Radiation accidents c. Explosions d. Transportation accidents ANS: B

Radiation accidents such as the Fukushima nuclear crisis and Chernobyl are uncommon but devastating to communities.

DIF: 2

REF: p. 1044

7. _________________ are large-scale aviation, vehicle, and train accidents, which often

result in mass casualty events. a. Hazardous material accidents b. Radiation accidents c. Explosions d. Transportation accidents ANS: D

Transportation accidents are large-scale aviation, vehicle, and train accidents, which often result in mass casualty events.

DIF: 2

REF: p. 1044

8. ___________ is/are a wide-scale, rapidly contagious infectious disease. a. Acts of terrorism b. Bioterrorism c. Chemical terrorism

d. A pandemic ANS: D

A pandemic is a wide-scale, rapidly contagious infectious disease.

DIF: 2

REF: p. 1044

9. What is the intentional release of harmful biological agents into the environment? a. Acts of terrorism b. Bioterrorism c. Chemical terrorism d. Pandemic ANS: B

Bioterrorism is the intentional release of harmful biological agents into the environment.

DIF: 2

REF: p. 1045

10. What is the use of chemical agents for intentional harm in the population? a. Acts of terrorism b. Bioterrorism c. Chemical terrorism d. Pandemic ANS: C

Chemical terrorism is the use of chemical agents for intentional harm in the population.

DIF: 2

REF: p. 1045

11. A(n) __________ is a more geographically isolated event that can be handled by local

services. a. emergency b. mass casualty event c. disaster d. medical facility evacuation ANS: A

An emergency is more geographically isolated event that can be handled by local emergency services, such as ambulances, the fire department, or paramedics.

DIF: 2

REF: p. 1041

12. A level _____ disaster is classified by statewide and federal assistance being required

because the effects of the disaster have overwhelmed local and regional resources. a. I b. II c. III d. IV ANS: C

Level III; statewide and federal assistance are required because the effects of the disaster have overwhelmed local and regional resources.

DIF: 2

REF: p. 1041

13. ______________, or risk reduction, is a process or activity that minimizes the impact of an

event. a. Response b. Coordination c. Mitigation d. Logistics and supply chains ANS: C

Mitigation, or risk reduction, is a process or activity that minimizes the impact of an event.

DIF: 2

REF: p. 1049

14. ______________ is a process in which casualties are given emergency medical treatment

according to the probability of their survival. a. Triage b. Local incidence command system c. Recovery d. Morgue ANS: A

Triage is a process in which casualties are given emergency medical treatment according to the probability of their survival.

DIF: 1

REF: p. 1053

15. ________________ are those with a particularly high risk for injury or harm as a result of

a disaster. a. US Navy Seals b. FEMA workers c. American Red Cross workers d. Vulnerable populations ANS: D

Vulnerable populations are those with a particularly high risk for injury or harm as a result of a disaster.

DIF: 1

REF: p. 1055

MATCHING

Match each term with the correct definition. a. CDC b. DHHS c. DHS d. DHSES e. EMA f. EOP g. HazMat h. MCE

i. j.

NIMS NWS

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Emergency operations center National Weather Service Mass casualty event Hazardous materials National Incident Management System Emergency Management Agency Department of Homeland Security Centers for Disease Control and Prevention Department of Health and Human Services Division of Homeland Security and Emergency Services

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

ANS: F ANS: J ANS: H ANS: G ANS: I ANS: E ANS: C ANS: A ANS: B ANS: D

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040

Match each term with the correct definition. a. AHRQ b. DMAT c. FCC d. FEMA e. HICS f. HRSA g. NDMS h. NRF i. START j. WHO 11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Disaster Medical Assistance Team World Health Organization Health Resources and Services Administration Hospital incident command system Simple triage and rapid treatment Federal Communications Commission National Response Framework Federal Emergency Management Agency National Disaster Medical System Agency for Healthcare Research and Quality

11. ANS: B

DIF: 2

REF: p. 1040

12.

13.

14.

15.

16.

17.

18.

19.

20.

ANS: J ANS: F ANS: E ANS: I ANS: C ANS: H ANS: D ANS: G ANS: A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040 p. 1040

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Test Bank - Surgical Technology 8th Edition by R.N. Fuller & Joanna Kotcher - Complete Elaborated and Latest Test Bank. ALL Chapters(1-36)Included and Updated.

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