CHAP 2 PREOPERATIVE PREPARATION
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Room temp for infants and children shoud be maintained as warm as | 85oF
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| Areas needing special cleaning attention on a weekly or monthly routine would include | ceiling and wall mounted fixtures and tracks
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| A glass suction bottle should ideally be | cleaned with a disinfectant solution and autoclaved before reuse
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| Storage shelves must be cleaned with a germicide | each week
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| While a surgical case is in progress | doors should remain closed
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| When cleaning the floor between cases | a clean mop head must be used each time, a two-bucket system, one detergent and one clear water, is used, buckets must be empited and cleaned between ea case, ALL OF THE ABOVE
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| A dropped sterile item may only be used if the | wrapper is imprevious and contact area is dry
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| In the event that a child needs emergency surgery, and the parents cannot be located to sign the permission | a written consultation by two physicians other than the surgeon will suffice
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| The surgical concent form can be witnessed by ea of the following EXCEPT | the surgeon, the nurse, an authorized hospital employee, THE PATIENT'S SPOUSE
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| A general concent form is | a form authorizing all treatments or porcedures
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| The ultimate responsibility for obtaining consent lies with the | surgeon
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| The surgical consent is signed | before administration of preoperative medications
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| an informed consent | protects patient from unratified or unwanted procedures and preotects the surgeon and the hospital from claims of an unauthorized operation
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| Implied consent | is allowed by law in emergencies when no other authorized person may be contacted
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| Which position would be the most desirable for a pilonidal cystectomy or an hemorrhoidectomy | Kraske
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| a postition often used in cranial procedures is called | Fowler's
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| in positioning for laminectomy, rolls or bolsters are placed | longitudinally to support the chest from axilla to hip
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| the position used for a patient in hypovolemic shock is | modified Trendelenbrug
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| A Mayfield table would be used for which type of surgery | neurologic
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| Good exposure for thyroid surgery is ensured by all of the following EXCEPT | modified dorsal recumbent with shoulder roll, hyperextension of the neck, utilization of skin-stay
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| A procedure requiring the patient to be positioned supine in modified lithotomy is | Abdominoperineal resection (APR)
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| In which procedure may the patient be placed in a supine position with the right side slightly elevated by a wedge to tilt the patient to the left | Cesarean section
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| The position for most open bladder surgery would be | supine, bolster under pelvis
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| In which circumstance could the patient sustain injury to the pudendal nerves | positioned on the fracture table
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| Which factor is important to consider when positioning the aging patient | skeletal changes, limited range of motion of joints, tissue fragility, ALL OF THE ABOVE
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| When positioning the patient for a procedure, which of the following provides maximum patient safety and maximum surgical site exposure | patient;s body doesn't touch metal on table, equipment, Mayo stand, and personnel are not resting on pt, bony prominences are padded, ALL OF THE ABOVE
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| When preparing a patient for a breast biopsy, a breast scrub is either eliminated or done very gently because of | dispersal of cancer cells
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| The ideal place to do the shave prep is in the | holding area of the OR
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| Any area that is considered contaminated | should be scrubbed last or separately
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| In preparation for surgery, skin should be washed and painted | from the incision site to the periphery in a cirucular motion
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| Preliminary preparation of the patient's skin begins | with a preoparative shower
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| Suction tubing is attached to the drapes with a | nonperforating clamp
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| When draping a table, the scrub nurse shoud drape | front to back
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| A seamless, stretchable material often used to cover extremities during draping | stockinette
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| Drapes are | placed on a dry area
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| which statement demostrates a break in technique during the draping process | gloved hands may touch the skin of the patient
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| A head drape consists of | medium sheet, towel, towel clip
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| Gowns are considered sterile only from | chest to sterile field level, and sleeves from elbow to cuffs
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| An acceptable action when drying the hands and arms after the surgical scrub is to | dry thoroughly, cleanest area first
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| Which statement regarding the scrub procedure is not true | renders the skin aseptic
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| If the scrub nurse needs to change a glove during an operation | the circulator pulls the glove off
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| Which statement regarding the removal of gown and gloves doesn't meet safe criteria | The gloves are removed before the gown
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| An effective surgical scrub procedure is | time method and brush-stroke method
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| Regarding the surgical scrub, which statement would violate acceptable practice | nail polish may be worn if freshly applied
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| Eyewear, goggles and/or facesshields should be worn | on every case
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| the surgical scrub is | mechanical washing and chemical antisepsis of the skin
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| Scrub technique endos | 2 inches above the elbow
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| Which statement reagarding the surgical scrub indicates INAPPROPRIATE preparation by the scrub | nail polish may be worn, if not chipped
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| Which statement best decribes an effective surgical hand scrub | time or number of strokes, ahnd to elbow sequence
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| The brush-stroke method of scrubbing prescribes the number of strokes required. Indicate the number for ea: nails, fingers, hand and arms | 30,20,20,20
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| A surgical treatment for scoliosis (is a lateral deviation of the spine) could employ the use of | Harington rods (are internal splints that help maintain the supine as straight as possible)
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| What is a lebsche used for | A Lebsche sternum knife is used in chest surgery to open the sternum
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| A rongeur used extensively in surgery of the spine and in neurosurgery is the | Kerrison rongeur (available in several angles)
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| Bakes are | common duct dilators and have maleable shafts in sizes 3-11mm. they are used to explore the common bile duct
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| A rib retractor is a | Finochietto
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| A Doyen is a | rib raspatory
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| The instrument used to enlarge the burr hole made during a craniotomy is | Rongeur. (an electric drill or a hand perforator is used to make the burr holes. a rongeur is used to enlarge the burr hole)
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| Wescott scissors are used in | ophtalmic surgery
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| The instrument used in a splenectomy is a | pedicle clamp (For splenectomy prepare a basic laparotomy set plus two large right angled pedicle clamps and long instruments and hemostatic material)
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| Bowman probes are used in | to probe the lacrimal duct in a dacrocystorhinostomy and in lacrimal probing to open a closed lacrimal drainage system
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| A Hurd dissector and pillar retractor is used in | tonsillectomy to free the tonsil lobe from its attachments to the pillars
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| The lempert elevator is used in surgery of the | delicate ear surgery
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| A Scoville retractor is used in a | laminectomy
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| A Bailey is a | rib approximator and is used to approximate the ribs for closure of the thoracic incision before closure of the chest
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| A Sauerbruch is a | rib rongeur used to resect a rib and is found in a thoracotomy rib instrument bone set
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| An Auvard is a | speculum that is weighted fro use in the bagina
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| A babcock is used to | grasp delicate structures
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| Nasal cartilage is incised with | Ballenger swivel knife
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| A self-retracting retractor is a | Weitlaner
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| A rectal speculum is a | Hill
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| A small fine needle holder used in plastic surgery is a | Webster
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| A kidney pedicle clamp is a | Herrick
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| Uterine dilators are | Hanks
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| On which set would a Jenning's mouth retractor be found | tonsillectomy set
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| An instrument used to retrieve a needle biopsy from either thyroid, liver, kidney or prostate is | Silverman biopsy needle
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| The instrument used for a corrective rhinoplasty is | a freer elevator to undermine the skin of the nose and free the periosteum and perichondrium
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| The instruments found on an intestinal set up are | The Doyen clamps that come straight or curved
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| The retractor in a thorocotomy set to separate the ribs is | the Bailey rib retractor
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| What is the Green retractor | It is a goiter retractor also known as a loop retractor. It is used to retract the sternocleidomastoid muscle during thyroidectomy
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| An instrument found in a major bone set is a | Stille-Luer Duckbill rongeur. It is used to bite off sharp, irregular bone edges
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| What is a Davidson | A Davidson is a scapula retractor. It is found in a thoracotomy set
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| The instrument used to grasp lung tissue is | the Duval forceps is alung-grasping forcep and is included in the instrumentation for lobectomy and pheumonectomy
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| The instruments found on a vascular set up are | The stinsky and DeBakey are vascular clamps, and the Pott Smith is an angled or straight vascular scissors. The DeBakey cross action bulldog is a clamping instrument
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| The instrument known as bulldog is | A DeBakey bulldog is a cross action clamp, straight or curved. It is used for occlusion of major perpheral arteries.
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| What is a Heaney | A Heaney is a hysterectomy forceps. It has double serrated jaws with cross grooves
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| What is a Potts-Smith instrument | is a vascular scissors that is angled to the side
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| The instrument used to clamp the aorta in an AAA surgery is | The satinsky aortic clamp
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| The Castroviejo needle holder is | used in both eye and plastic surgery as well as other surgeries requiring fine, delicate suture
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| What is a kidney instrument | Randall stone forceps
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| What is a Harrington | it is a retracting instrument frequently used for gallbladder surgery. Its tip is heart-shaped, thus it is sometimes called the sweetheart
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| A techinique utilizing the insertion of a needle or wire thorugh a needle in order to identify suspicious breast tissue is a | wire localization
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| a forceps used to remove stones in billiary surgery is a | Randall stone forcpes
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| Which procedure may require the preparation of a skin graft setup | In a total radical mastectomy, the surgeon may prapare the anterior surface of the thight in the venet a skin graft is needed
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| Right angled pedicle clamps would be found on a setup for | splenectomy
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| Blunt nerve hooks are selected for a | vagotomy setup
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| In which procedural setup would a T-tube be found | exploration of the common bile duct
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| Stapedectomy requires all of the followning EXCEPT | small microsuction, speculum, prothesis, AUTOGRAFT
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| Cochlear implants utilize an electode device | to restore hearing
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| all of the following are required for repair of a nasal fracture | bayonet forceps, splint and Asch forceps
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| A forceps used in nasal surgery is a | Bayonet
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| All of the following instruments can be forund on a nasal setup EXCEPT | Freer elevator, bayonet forceps, POTTS FORCEPS Frazier suction tube
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| On which setup would bougies be found | esophagoscopy (they're esophageal dilators)
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| All of the following can be found on a tonsillectomy setup | yankauer suction, Hurd dissector and pillar retractor and tongue depressor
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| Tissue expanders are used in | breast reconstruction
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| The fracture trated with arch bars is | mandibular and maxillary fractures reductions
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| Rib removal for surgical exposure of the kidney requires all of the following | alexander periosteotome, Doyen raspatory and Sille shears
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| Stone forceps on a kidney set are | Randall
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| A Sarot is a | bronchus clamp
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| Which item would not be included on a setup for a transvenous (endocardial) pacemaker | intra-aortic balloon pump
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| The most frequent conditions requiring the use of a permanent pacemaker are | heart block and bradyarrhythmia
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| Which setup would include distraction and copression components | Harrington rods are internal splints -- the distraction rods placed concave to the curve and the compression rods on the convex side
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| Traction applied directly on bone via pins, wires, or tongs is | Skeletal
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| skeletal traction of a lower leg is accomplished with the use of a | Kirschner wire
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| In orthopedic surgery, the viewing of the progression of the procedure on a television screen is known as | image intensification (flouroscopy)
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| A neurologic study in chich a radiopaque substance is injected into the subarachnoid space through a lumbar puncture is called | Myelogram
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| A neuro headrest skull clamp is called a | Mayfield
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| Maintenance of acceptable blood pressure and prevention of the development of air emboli in the neurosurgical patient can be effected by preoprative utilization of | an antigravity suit
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| A _________ is a mouth gag | Dingman
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| Specialized instruments for a cleft lip rapair would include | Logan's bow (it is applied to the cheeks with tape strips to relieve tension on the incision and to splint the lip. it is a curved metal frame)
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| Cloward instrumentation would be included for suregery of the | cervical spine
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| On which setup would a Bever knife handle be found | eye surgery
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| Which procedure requiers a sterile setup | skeletal traction (traction bow, pins and drills)
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| A craniotomy may employ the use of a ______ for exposure | Leyla-Yasargil self-retracting retractor
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| On which setup would either a Pereyra or a Stamey needle be found | urologic surgery (it is used for bladder neck suspension. it is a ligature carrier
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| Disintegration of kidney stones thorugh a liquid medium is accomplished with an | extracorporeal shock wave lithotriptor
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| A urology perineal retractor system is called | Omni-Tract
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| Which procedure would utilize a Mason-Judd retractor | bladder surgery
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| A Furlow inserter is used in | Penile implantation
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| On which case would a boomerang be found | Prostate surgery
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| A millin is a(n) | retropubic bladder retractor
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| which setup would include a Gomco clamp | circumcision (infants)
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| In which surgical specialty would a HUMI cannula be used | gynecologic
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| an instrument used in laparoscopy to manipulate the uterus for increased structure visibility is the | Hulka Forceps
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| A central venous pressure (CVP) catheter insertion requires | a sterile set up
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| The purpose of a set of Bakes would be | common duct dilation
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| A Steffee plate is a | spinal implant for tx of fractures, spondylolishtesis and idiopathic scoliosis of the thoracolumbar column
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| Skeletal traction is accomplished with | Cruthcfield tongs
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| The Bookwalter is a _______ instrument | retracting
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| Which instrument is a retractor | harrington
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| A long thoracic forceps is a | Schnidt
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| A bougie is a | esophageal dilator
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| Which graft must be obtained with a dermatome | split-thickness mesh graft
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| A Cavitron unit is used for | phacoemulsification
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| The power source for Hall pover equipment is | nitrogen
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| A neurosurgical drill used for precision cutting, shaping, and repari of bone is the | Air Drill 100
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| In what surgery would a small fragment compression set be used | olecranon fracture
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| A permanent pacemaker operates on a pulse generator powered by | lithium
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| Which item is an air drill | Hall power equipment
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| Hypothermia is employed in cardiac surgery | to reduce oxygen consumption
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| which item is not a comp9onent of a cardiopulmonary bypass system | oxygenator, hear exchanger, VENTRICULAR FIBRILLATOR, pump
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| which movement iin a power instrument drills holes or inserts screws, wires or pins | rotary movement
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| The power instrument that is small, lighweight, free of vibration, and easy to handle for pinpoint accuracy at high speed is | air-powered
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| The power source for the Air Drill 100 is | compressed nitrogen
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| the power source for air-powered dermatomes is | compressed nitrogen and air
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| Suction tubing should be processed in the following way | residual of distilled water in lumen, steam sterilize, tubing coiled
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| The suction tip that is right angled and is used for small amounts of fluid such as in brain surgery is | Ferguson-Frazier suction tip
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| Which suction tip has an angle and is used in the mouth or throat | yankauer
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| When using a cellsaver for autologous blood transfusion, the blood is suctioned through a double lumen tubing and is | heparinized (heparinized saline or citrated dextrose mixes with blood at the tip of the tubing. it is filtered and separated and RBC are washed, infused with saline, and go into a reinfusion bag
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| During orthopedic surgery, the suction tubing shoud be | cleared frequently
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| which type of surgery would require several patent suction cannulas and sucction often controlled by a foot-pedal | ear, nose and throat (ENT)
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| when suctioning in neruosurgery a precaution taken is to | avoid applying vacuum directly on brain or neural tissue
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| A tourniquet is utilized | only when hemorrhage is not contrelled by other methods
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| The proper setting for a tourniquet applied to an arm is | 250-300 mmHg
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| Exsanguination of a limb before tourniquet inflation is accomplished with wrapping the elevated extremity with | Esmarch
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| The amount of pressure used to inflate a tourniquet depends on all of the following EXCEPT | patient's age, size of extremity, DEPTH OF SURGICAL INCISION, systolic blood pressure
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| A regional block that uses the tourniquet is a | Bier block
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| The tourniquet is contraindicated if | a patient's circulation to distal part of extremity is poor
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| Which action drains venous blood during tourniquet application | elevate extremity before thightening tourniquet
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| At what point should the surgeon be informed of the time of tourniquet application | after 1 hour, then every 15 minutes
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| When would the use of Esmarch be contraindicated | when patient has had recent injury and has had recent cast
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| Which agent is NOT used to inflate a pneumatic tourniquet | nitrous oxide
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| A precaution necessary when using a pneumatic tourniquet is | solutions must be prevented from pooling under tourniquet
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| In which procedure would a tourniquet be contraindicated | gangrenous toe amputation
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| A grounding pad is not required for the electrocautery in | a bipolar unit
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| The inactive electrode of the cautery is the | ground pad
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| The electrical circuit of the electrocautery when | current flows to generator to active electrode, through tissue, and back to generator via the inactive electrode
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| why must the electrocautery tip be kept clean | to ensure electrical contract effectiveness
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| in electrocautery "buzzing" refers to | coagulation of vessel via a metal instrument touching the active electrode
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| which electrosurgical unit provides precise control of the coagulated area | bipolar
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| which condition is MOST acceptable when using electrocautery | ground pad placed close to operative site
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| the active electrode on the electrocautery is the | tip
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| A cautery would not be used | in neck or nasopharynx surgery if nitrous oxide is used
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| why are only moist sponges utilized during electrocautery use | to prevent fire
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| if the electrocautery is used through the colonoscope, CO2 should be available to flush out the colon because | gases normally in colon could cause explosion
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| Fulguration is utilized primarily in _________surgery | transurethral resection and prostate operations (TURP)
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| When working in the bladder why is more or higher electrical current necessary during cautery use | more current is needed when working in solution
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| Fulguration via the resectoscope is accpomplished by the use of an ____tip | electrode
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| a direct visualization of the common bile duct is done by means of a | choledochoscope
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| Fiberoptic lighting is | an intense cool light that illuminates body cavities via a bundle of thousands of coated glass fibers.
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| Complications can occur during endoscopy such as | bleeding and perforation
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| an endoscopy procedure that does not requiere a steril set up is | a bronchoscopy
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| Fiberoptic cable integrity is questionable when | dark spots are evident
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| when using a fiberoptic, burns and fires are prevented by | cable is kept away from drapes when disconnected from endoscope; personnel should not lean on cable endo that is disconnected but is still on ; cable end is kept on a moist
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| An economical, practical, and effective way to clean reusable channeled endocsopic instruments initially is with the | endoflush
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| a sterilant that is used on endoscopes that is bactricidal, fungicidal, and sporricidal in 20-30 minutes processing time is | peracetic acid
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| which statement is true regarding a STERIS system for endoscope sterilization | only one scope or a few instruments can be processed in a cycle
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| The endoscope that provides aview of the middle of the thorax, between the two pleural sacs is | mediastinoscope
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| Loupes are used for | magnification
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| Resolving power of an operating microscope means | the ability to discern detail
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| Which item in the optical lens system is responsible for magnification | oculars and objective lens
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| The range of focal lenghts of the objective lenses in the operating microscope is | 100-400mm
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| A continuously variable magnification system is afforded to the eye surgeon by the | zoom lens with foot control
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| The purpose of the "slit" lamp in eye surgery is | defining depth perception
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| The operating microscope that visually employs fiberoptics for its light source is | coaxial illuminators provides intense, cool light
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| Care of the microscope would include | damp dust external surfaces with detergent-disinfectant before use; enclose in an antistatic plastic cover when not in use and clean casters before each use
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| The purpose of the beam splitter in an operating microscope is to | coincide the assistant's field of view with the suregon's
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| The colpomicroscope affords a view of the | cervix
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| The procedure employing the use of a self retaining laryngoscope and microscope is called a | suspension microlaryngoscopy
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| The binocular microscope provides stereoscopic vision. This refers to | the view afforded by double eyepieces
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| Which magnifying powers are available for the microscope eye piece | 10X, 12.5X, 16X and 20X
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| Which procedure is inappropriate when caring for optic lenses | oil or fingerprints are removed by soaking in solvent for 10 minutes and drying with a cotton ball, (correct: they should be removed with a solvent or lens-cleaning solution or 50% denatured alcohol not immersed)
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| The OR bed may have a metal crossbar between the two upper sections which may be raised to elevate the | kidney and gallbladder
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| Which item is also known as an "airplane support" | double arm board
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| Operative accessibility in thyroid surgery may be aided by the use of a | shoulder bridge
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| In which position would shoulder braces be indicated | extreme Trendelenburg
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| A precaution necessary when using the kidney rests is | to press firmly but not too tightly against body, to pad well and to place the longer rest beneath iliac crest
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| Chest rolls (bolsters) | facilitate respiration
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| Bakelite orthopedic table attachments are sometimes used because | the do not interfere with radiographic studies
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| Sponges and towels used near the laser tissue impact site are kept wet in order to | prevent ignition of these materials by reflected beam
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| A laser plume is composed of | carbonized particles, water and odor
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| When using lasers, nonreflective instrumentation | decreases accidental direct reflection of the laser beam to another area
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| Which laser emission is primarily absorbed in tissue by hemoglobin or melanin | Argon (operates in the visible light region in the blue-green spectrum)
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| The fire extinguisher of choice for a laser fire is a | Halon (consists of hudrogenated halocarbons and doesnt produce a residue and has low toxicity)
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| In surgical precodure employing the use of the laser, prep solution on the patient's skin should be pat-dried because | pooled fluids can retain laser heat and subsequently burn tissue
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| Laser surgery performed in the rectal area shoud be preceded by | suctioning of lower bowel to remove methane gas, and packing in the rectum with wet, counted sponges
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| Ebonization refers to | coating of instruments to decrease reflectivity
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| The use of each of the following items are measures employed to readuce laser induce injuries | ebonized instruments, anodized instruments and reflective drapes
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| When utilizing the laser, occupational exposure to suergical smoke via the skin, eye and mucous memebranes is best minimized by the use of | universal precautions
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| Which specialty would employ the use of slit lamp and laser | ophthalmic
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| The laser used primarily for port-wine stain lessons of the skin is the | Ruby
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| People who are near the CO2 laser impact area cna guard against corneal injuries by | wearing amber-tinted lenses
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| Each of the following are measures used to control the effects of the laser plume | smoke evacuators, suctions and high filtration masks
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| wich endotrachal tube is contraindicated during laser suergery | PVC tube
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| what item should be on the scrub person's instrumentation table while the laser is in use | a basin with sterile water or saline (in case of fire)
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| The laser used most commonly for retinal detachment, tear or hole is | argon
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| The tunable dye laser used to disintegrate kidney stones is the | Candela
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| A device used to correct and counteract internal bleeding conditions and hypovolemia is | MAST (medical antishock trouser)
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| Placement of a Levin tube would be in the | stomach
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| a sponge used in brain surgery is a | cottonoid patty
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| The dressing used after nasal surgery is | moustache dressing
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| Seemless tubular cotton that stretches to fit a contour and is used for padding is called a | stockinette
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| Which case would require the use of cottonoid strips | laminectomy
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| An item used for padding that has smooth and clingy layers is called | Webril is a soft, lint-free, cotton bandage
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| Rectal packing is made of | petroleum-treated gauze
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|
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