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Quiz Session - Attempts With Random Questions

NBSTSA CST Exam Questions

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1.

During preoperative preparation for a total knee arthroplasty, which equipment should the surgical technologist prioritize to reserve?

  • Bone cement mixer

  • High-frequency ventilator

  • Microsurgical needle holder

  • Fiberoptic bronchoscope

Correct answer: Bone cement mixer

Bone cement is often used in total knee arthroplasty to adhere the artificial joint to the bone, making the bone cement mixer crucial for this surgery.

High-frequency ventilators are critical in specific respiratory treatments, not typically required for a total knee arthroplasty. 

Microsurgical needle holders are used in procedures requiring fine suturing, such as microvascular surgery, not typically in knee arthroplasty. 

Fiberoptic bronchoscopes are used for examining the airways and are not relevant equipment for a knee arthroplasty procedure.

2.

When choosing a waterless surgical scrub product, what is the MOST important factor to consider?

  • The product's efficacy in reducing microbial flora

  • The product's efficacy in eliminating all microbial flora

  • The duration of the scrub process needed

  • The moisturizing properties of the product to ensure the skin barrier remains intact

Correct answer: The product's efficacy in reducing microbial flora

The most important factor is the product’s ability to effectively reduce microbial flora on the skin.

Eliminating all microbial flora is not something that can be achieved using any surgical scrub product or handwashing technique. 

While the duration of the scrub process is important, the primary consideration should be the product's efficacy. 

Moisturizing properties are secondary to the product's antimicrobial effectiveness.

3.

During the inspection process, a surgical technologist notices that a pair of hemostats does not close properly. The appropriate action is to do which of the following?

  • Tag the hemostats for repair and remove them from service

  • Tag the hemostats to only be used for non-critical tasks

  • Attempt to repair the hemostats immediately

  • Continue to use the hemostats until a replacement can be found

Correct answer: Tag the hemostats for repair and remove them from service

Tagging the hemostats for repair and removing them from service ensures that defective equipment does not compromise patient safety or surgical outcomes.

Tagging the hemostats to only be used for non-critical tasks still poses a risk, as malfunctioning equipment can unexpectedly fail and complications cannot necessarily be predictable. 

Attempting to repair the hemostats immediately is not advisable without the proper tools, skills, or environment, as this could further damage the instrument. 

Continuing to use the hemostats until a replacement can be found compromises patient safety and surgical integrity.

4.

Before starting an x-ray during a surgical procedure, what is the MOST important safety device to apply to the patient to minimize radiation exposure?

  • Lead apron or shields

  • Reflective blanket

  • Thermal insulation pad

  • Gel padding to prevent pressure ulcers

Correct answer: Lead apron or shields

Lead aprons or shields are specifically designed to protect patients (and staff) from unnecessary radiation exposure, making them the most important safety device in this context.

Reflective blankets are used for temperature regulation, not radiation protection. 

Thermal insulation pads are also used for maintaining body temperature, not for radiation shielding. 

Gel padding may help prevent pressure ulcers but does not offer protection against radiation exposure.

5.

In preparing a specimen obtained during a thyroidectomy, what is the MOST appropriate preparation to ensure its preservation until analysis?

  • Placement in a formalin-filled container

  • Immediate freezing at -20°C

  • Submersion in a saline solution

  • Air drying on a sterile surface

Correct answer: Placement in a formalin-filled container

Formalin fixation is standard for preserving tissue specimens, ensuring cellular detail is maintained for accurate pathology.

Immediate freezing is not typically required for thyroid specimens and could damage tissue integrity. Saline keeps the specimen moist but does not preserve tissue for histological examination. Air drying could lead to desiccation and tissue distortion, compromising histological evaluation.

6.

Before the start of a surgical procedure, the surgical technologist notices that the patient’s consent form is missing. What is the MOST appropriate action?

  • Inform the surgeon, so they can ensure the consent form is signed before proceeding

  • Recognize that obtaining consent is the role of the surgeon and that it is ultimately their responsibility

  • Have the patient complete the consent form prior to proceeding

  • Document the absence of the consent form and proceed with the setup

Correct answer: Inform the surgeon, so they can ensure the consent form is signed before proceeding

Ensuring that all necessary documentation, especially the consent form, is in place before surgery is crucial. It is a legal requirement and critical for patient safety and autonomy.

While obtaining consent is the role of the surgeon, the surgical technologist should still address this deficiency in documentation. 

Obtaining consent is the role of the surgeon and having the patient complete the consent form without the surgeon’s involvement is incorrect. 

Merely documenting the absence of the consent form without taking action to rectify the situation is not adequate to meet legal and ethical standards. Proceeding with surgery without written consent is against legal and ethical standards.

7.

In an appendectomy, the removal of which structure is the PRIMARY focus?

  • Appendix

  • Colon

  • Small intestine

  • Gallbladder

Correct answer: Appendix

The appendix is the primary focus of an appendectomy. This surgical procedure specifically involves the removal of the appendix, a small pouch attached to the large intestine, which, when inflamed, necessitates removal to prevent rupture and serious complications.

The colon is related to the appendix but is not the primary focus of an appendectomy. The small intestine connects to the large intestine at a location distant from the appendix and thus remains unaffected in this procedure. The gallbladder, located in the upper right quadrant of the abdomen and involved in bile storage, is unrelated to the appendix.

8.

Which of the following patient positions is most appropriate for a posterior surgery?

  • Prone position on chest rolls

  • Supine position

  • Spinal position

  • Fowler's position

Correct answer: Prone position on chest rolls

The prone position on chest rolls allows for optimal exposure of the lumbar spine while ensuring adequate ventilation and reducing abdominal pressure.

The supine position is primarily for anterior access surgeries, not suitable for posterior lumbar spine surgery. 

The spinal position is not the name of a recognized surgical position. 

Fowler's position, where the patient is seated in a semi-upright position, is primarily used for procedures involving the head, neck, and shoulders, not the lumbar spine.

9.

When assisting with the application of a plaster cast for a fractured forearm, which of the following steps is MOST important to prevent thermal injury to the patient?

  • Dipping the plaster rolls in lukewarm water before application

  • Applying the cast as tightly as possible to immobilize the fracture

  • Using minimal padding under the plaster to ensure firm support

  • Ensuring the patient's forearm is positioned above heart level

Correct answer: Dipping the plaster rolls in lukewarm water before application

Dipping plaster rolls in lukewarm water controls and slows the exothermic reaction during setting, minimizing the risk of thermal injury. This precaution is important for patient safety, ensuring the setting process does not cause discomfort or burns to the skin.

Applying the cast too tightly can cause circulatory and nerve compression; it does not reduce the risk of thermal injury. Insufficient padding can lead to pressure sores and discomfort but does not directly relate to thermal injury. Positioning the forearm above heart level helps reduce swelling but is unrelated to preventing thermal injury.

10.

In a split-thickness skin graft procedure, which layer of the skin is PRIMARILY harvested along with the epidermis?

  • Part of the dermis

  • Dermis

  • Subcutaneous tissue

  • Part of the hypodermis

Correct answer: Part of the dermis

A split-thickness skin graft involves harvesting the epidermis and a part of the dermis, not the entire dermis. This partial thickness of the dermis is chosen because it contains enough of the essential structures of the skin, such as blood vessels and collagen, which are vital for the survival and integration of the graft on the recipient site. Taking only part of the dermis increases preservation of the donor site. 

The entire dermis is not taken in a split-thickness graft—only a part of it is. Subcutaneous tissue is below the dermis and not typically included in a split-thickness skin graft. The hypodermis, or subcutaneous layer, is not included in a split-thickness skin graft.

11.

During a lengthy procedure, how should a surgical technologist manage skin-edge retractors to minimize the risk of tissue necrosis?

  • By frequently releasing and reapplying the retractors

  • By applying constant pressure throughout the procedure

  • By using additional padding under the retractor edges

  • There is no risk of tissue necrosis when using skin-edge retractors

Correct answer: By frequently releasing and reapplying the retractors

Periodically releasing and reapplying retractors helps to maintain blood flow and minimize pressure necrosis.

Constant pressure can impair blood flow, increasing the risk of tissue necrosis. While padding may reduce direct pressure, it does not address the underlying issue of impaired blood flow due to constant tension. There is a risk of tissue necrosis when using skin-edge retractors for a lengthy procedure.

12.

Following a surgical procedure, a wound that heals by primary intention is characterized by which of the following?

  • Immediate closure of the wound edges with sutures or staples

  • Natural closure of the wound without any intervention

  • Formation of granulation tissue that fills the wound space before closure

  • Secondary closure after the wound has been left open for drainage

Correct answer: Immediate closure of the wound edges with sutures or staples

Wounds that heal by primary intention are those where the wound edges are surgically closed immediately, typically with sutures or staples, facilitating faster and usually neater healing.

Natural closure without any intervention describes healing by secondary intention, where the wound is left open and heals naturally from the base up. The formation of granulation tissue before closure characterizes secondary intention, not primary intention healing. Secondary closure after open drainage is also a feature of healing by secondary intention, not primary intention.

13.

A surgical technologist notices a discrepancy in a patient’s medication list in the electronic health record (EHR) while preparing for a procedure. Who should the technologist immediately communicate this discrepancy to using the hospital’s interdepartmental communication system?

  • The patient’s assigned nurse to verify the medication list

  • The hospital pharmacy to cross-check the medication inventory

  • The operating room (OR) manager to document the discrepancy

  • All surgical team members scheduled for the procedure

Correct answer: The patient’s assigned nurse to verify the medication list

Communicating with the assigned nurse is the most direct and efficient way to verify and correct the medication list, ensuring patient safety.

The hospital pharmacy's role is to dispense medications, not to verify discrepancies in the Electronic Health Record (EHR) against a patient's current medication regimen. 

The Operating Room (OR) manager oversees operational aspects of the OR and is not typically involved in direct patient care or medication management. 

Alerting all surgical team members does not directly address the need to verify and correct the medication list.

14.

A surgical technologist notices tension between two scrub nurses arguing over the correct procedure during a surgery. What is the MOST appropriate action for the surgical technologist to take to maintain a positive and productive work environment?

  • Remain neutral and suggest discussing the procedure with the surgeon for clarification

  • Take a side with the scrub nurse who is correct to quickly resolve the argument

  • Suggest taking a short break to allow everyone to calm down before continuing

  • Report the argument to a supervisor immediately without further involvement

Correct answer: Remain neutral and suggest discussing the procedure with the surgeon for clarification

Suggesting a discussion with the surgeon for clarification maintains neutrality and seeks to resolve the conflict based on accurate procedural knowledge.

Taking sides can escalate tension and does not contribute to a constructive resolution or a positive work environment. 

Suggesting a break might temporarily ease tension but does not address the underlying disagreement or the need for procedural clarification. 

Immediate reporting to a supervisor without attempting to resolve the issue may not be necessary and could escalate the situation unnecessarily. This approach also does not foster a collaborative team environment.

15.

A patient undergoing a bowel resection is to be started on IV antibiotics for prophylaxis against surgical site infections. Which class of antibiotics is commonly chosen for its broad-spectrum activity in this scenario?

  • Cephalosporins

  • Aminoglycosides

  • Fluoroquinolones

  • Macrolides

Correct answer: Cephalosporins

Cephalosporins are a broad-spectrum class of antibiotics often chosen for prophylaxis in abdominal surgeries due to their efficacy against a wide range of bacterial pathogens commonly encountered in such procedures.

Aminoglycosides have broad-spectrum activity but are less frequently used as prophylactic agents due to their potential for nephrotoxicity and ototoxicity. 

Fluoroquinolones also have broad-spectrum activity but are generally reserved for specific infections due to concerns about resistance and side effects. 

Macrolides are not typically the first choice for surgical prophylaxis due to their narrower spectrum of activity against common surgical pathogens.

16.

In a surgical procedure for an AAA repair, which major vessel is primarily involved and at risk?

  • Abdominal aorta

  • Inferior vena cava

  • Superior mesenteric artery

  • Renal artery

Correct answer: Abdominal aorta

In a Abdominal Aortic Aneurysm (AAA) repair, the primary vessel involved is the abdominal aorta. This major artery runs through the abdomen, and the procedure focuses on repairing the weakened area of the aorta to prevent rupture.

The inferior vena cava, though a major vein in the abdomen, is not the focus of an AAA repair. 

The superior mesenteric artery, important for supplying blood to the intestines, is not directly involved in an AAA repair. The focus of AAA repair is the aorta, not its branches unless they are directly affected by the aneurysm. 

The renal artery, supplying blood to the kidneys, is also not the primary focus of an AAA repair. Although it can be affected if the aneurysm extends near the renal arteries, the main concern remains the aorta itself.

17.

When transferring a patient from the operating table to a stretcher, what is the MOST important factor to consider for patient safety?

  • Coordination among team members during the transfer

  • Having a smooth, fast transfer to minimize the time the patient is exposed to risks during transfer

  • Ensuring the patient is fully awake before transferring

  • The type of operating table and stretcher

Correct answer: Coordination among team members during the transfer

Effective coordination among team members ensures that the patient is supported adequately and securely during the transfer, minimizing the risk of falls or injury, which is crucial for patient safety.

While minimizing the time of exposure to risks is theoretically important, haste can lead to mishandling and increased risk of accidents. 

Ensuring the patient is fully awake before transferring may not always be applicable or the most critical factor, especially in cases where the patient needs to remain sedated or requires immediate postoperative care that does not allow for awakening. 

Although the compatibility and functionality of the operating table and stretcher are important to facilitate a smooth transfer, the key factor for patient safety is the coordination and communication among the healthcare professionals involved in the transfer.

18.

During a laparoscopic cholecystectomy, the surgeon requests irrigation to clear the operative site of small gallstones and debris. Which solution is MOST appropriate for this procedure?

  • Sterile saline solution

  • Hydrogen peroxide

  • Povidone-iodine solution

  • Distilled water

Correct answer: Sterile saline solution

Sterile saline solution is isotonic and safe for irrigation in a laparoscopic cholecystectomy, as it does not provoke tissue reaction and effectively clears the site.

Hydrogen peroxide can cause air embolisms when used in laparoscopic procedures and is cytotoxic, making it inappropriate for this use. 

Povidone-iodine solution is antiseptic and may be toxic if introduced into the peritoneal cavity, leading to complications. 

Distilled water is hypotonic and can cause cell lysis if used for irrigation in the abdominal cavity.

19.

When monitoring the use of irrigating solutions during an abdominal surgery, which solution is PREFERRED to minimize cellular swelling?

  • 0.9% saline

  • Distilled water

  • Dextrose 5% in water

  • 0.45% saline

Correct answer: 0.9% saline

0.9% saline is isotonic, meaning it has the same osmolality as body fluids, thus minimizing the risk of cellular swelling or shrinking during its use in abdominal surgery.

Distilled water is hypotonic compared to body fluids, which can lead to cellular swelling as water moves into cells to balance the osmotic pressure. 

Dextrose 5% in water is initially isotonic, but once dextrose is metabolized, it effectively becomes hypotonic, potentially leading to cellular swelling. 

0.45% saline is hypotonic compared to body fluids, increasing the risk of cellular swelling, as it causes water to move into cells to equalize osmotic differences.

20.

Which action is MOST appropriate when labeling a specimen container for a segment of bowel resected for obstruction?

  • Labeling with the patient's name and site of the specimen

  • Labeling with the surgeon’s name

  • Labeling with the patient’s diagnosis

  • Labeling with the patient's name and type of surgery being performed

Correct answer: Labeling with the patient's name and site of the specimen

Labeling the specimen container with the patient's name and the specific site of the specimen ensures accurate identification and correlation with the patient’s medical records.

Labeling with the surgeon’s name does not provide specific information about the patient or the specimen. 

Labeling with the patient’s diagnosis is not specific enough for identifying the specimen, especially in cases where a patient might have multiple issues or a diagnosis might not be fully established before the examination of the specimen. 

Labeling with the patient's name and type of surgery being performed does not provide specific information about the exact site of the specimen.

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