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Quiz Session - Attempts With Random Questions

NBSTSA CST Exam Questions

Page 10 of 25

181.

The primary function of a Gelpi retractor falls into which instrument classification?

  • Retracting or exposing

  • Clamping or occluding

  • Cutting or dissecting

  • Suturing or stapling

Correct answer: Retracting or exposing

Gelpi retractors are used to hold back the edges of a surgical incision or wound, thus retracting or exposing the surgical site.

Gelpi retractors are not used for clamping or occluding vessels, they do not have cutting capabilities, and they are not used for suturing or stapling tissues.

182.

For a patient undergoing a dental bone graft with an allograft, what is the MOST critical factor to ensure successful grafting?

  • The sterilization method used on the allograft

  • The patient's age

  • The match of blood type between donor and recipient

  • The amount of time the graft is stored before use

Correct answer: The sterilization method used on the allograft

The sterilization method is crucial to ensure the allograft is free from pathogens while maintaining its structural and biological properties.

While age can influence healing times, it's not the most critical factor for graft success. Blood type matching is not necessary for allograft bone grafting, as the graft is decellularized. While prolonged storage can affect graft quality, the sterilization method has a more direct impact on the success of the graft.

183.

A surgical technologist notices that the sharps container is almost full while disposing of contaminated sharps. What is the MOST appropriate action to take?

  • Securely close the container and replace it with a new one

  • Use the container until there is no more space, then seal the top

  • Inform the cleaning staff and use a different container

  • Push down on the contents to make more room for additional sharps

Correct answer: Securely close the container and replace it with a new one

This is the safest and most appropriate action to take because overfilled sharps containers pose a risk for needle-stick injuries, and securely closing and replacing the container minimizes this risk.

Using the container until there is no more space and then sealing the top increases the risk of overfilling, which can lead to sharps injuries. 

While informing the cleaning staff is a proactive step, relying on them to address the situation does not immediately mitigate the risk of a sharps injury. 

The primary responsibility for managing sharps disposal ultimately falls on the person using the container. Pushing down on the contents to make more room is extremely dangerous because it significantly increases the risk of needle-stick injuries.

184.

In a procedure requiring precise skin incision and minimal trauma, which instrument would be the surgeon's BEST choice?

  • Scalpel with a #15 blade

  • Mayo scissors

  • Rongeur

  • Scalpel with a #22 blade

Correct answer: Scalpel with a #15 blade

A scalpel with a #15 blade is designed for precision and control in small, delicate surgeries or procedures, making it the ideal choice for precise skin incisions with minimal trauma.

Mayo scissors are designed for cutting thick tissues but are less precise than scalpels. Their design is not suited for delicate work that requires minimal tissue damage. 

A rongeur is a heavy-duty instrument used for removing bone. Its use would result in significant trauma to soft tissues, making it an inappropriate choice for procedures requiring minimal trauma. 

The #22 blade is larger and has a more curved cutting edge compared to smaller, more precise blades like the #15. This design allows for efficient cutting through tough tissue but does not offer the same level of precision for delicate or fine incisions.

185.

A surgical procedure involves opening the stomach and removing a section of the intestine. How should this wound be classified?

  • Clean-contaminated

  • Clean

  • Contaminated

  • Dirty

Correct answer: Clean-contaminated

A clean-contaminated wound is one that occurs in an operative environment where there is controlled entry into a hollow organ, like the stomach or intestine, expected to contain microbes without unusual contamination.

A clean wound is one where there is no entry into an organ that typically harbors bacteria; the described surgery does not fit this category because it involves the gastrointestinal tract. 

Contaminated wounds are typically open, accidental wounds or from surgeries with major breaks in sterile technique or gross spillage from the organ. 

Dirty wounds involve old traumatic wounds with retained devitalized tissue and those with existing clinical infection or perforated organs.

186.

In assessing a patient with a suspected abdominal aortic aneurysm, which of the following findings would MOST likely be observed?

  • Hypotension and tachycardia

  • Bradycardia and fever

  • Lower extremity paralysis

  • Weight loss and malaise

Correct answer: Hypotension and tachycardia

Hypotension and tachycardia are common findings in a patient with a ruptured abdominal aortic aneurysm due to significant blood loss leading to shock. This rapid heartbeat and low blood pressure are the body's response to try and maintain adequate blood flow.

Bradycardia (slow heart rate) and fever are not typically associated with an abdominal aortic aneurysm. Bradycardia would be unusual in the setting of hypovolemia caused by a rupture, and fever is not a direct symptom of aneurysms. 

Lower extremity paralysis could occur in specific and severe cases where the aneurysm interrupts blood flow to the spinal cord or peripheral nerves, but this is not a common or primary symptom of an abdominal aortic aneurysm. 

Weight loss and malaise are very non-specific symptoms and are unlikely to be directly associated with an abdominal aortic aneurysm.

187.

A surgical team is performing a low anterior resection for colorectal cancer. Which stapling device should the surgical technologist ensure is available for creating the distal anastomosis?

  • Circular stapler

  • Hemorrhoidal stapler

  • Skin stapler

  • Linear cutter stapler

Correct answer: Circular stapler

Circular staplers are ideal for creating secure, end-to-end anastomoses in colorectal surgeries, particularly in the distal rectum.

Hemorrhoidal staplers are specifically designed for hemorrhoid surgery, not for anastomoses in colorectal surgery. Skin staplers are used for closing skin incisions and are not suitable for internal anastomoses. Linear cutter staplers can be used for resection but are not the best choice for creating circular anastomoses required in low anterior resections.

188.

During a lumbar laminectomy, the surgical team is cautious to avoid damage to the spinal nerve roots. What is the PRIMARY reason for preserving the integrity of these structures?

  • To maintain sensory and motor function in the lower extremities

  • To prevent postoperative cerebrospinal fluid leak

  • To ensure the stability of the vertebral column

  • To avoid disruption of the sympathetic nervous system

Correct answer: To maintain sensory and motor function in the lower extremities

Preserving the integrity of the spinal nerve roots during lumbar laminectomy is crucial for maintaining sensory and motor functions in the lower extremities, as these nerves provide these signals.

While a cerebrospinal fluid leak could be a concern with this surgery, it is not the primary reason for preserving spinal nerve roots. 

Stability of the vertebral column is more directly related to structural elements like bones and ligaments, not to nerve roots. 

Disruption of the sympathetic nervous system is a concern but is not the primary focus in preserving nerve roots in this context.

189.

In a procedure where significant blood loss is anticipated, what is the key consideration when selecting a sponge for the operative site?

  • The absorbency of the sponge

  • The sponge's thickness

  • The size of the sponge

  • The sponge's texture

Correct answer: The absorbency of the sponge

The absorbency of the sponge is critical in procedures with significant blood loss to efficiently manage and minimize the loss.

While the size and thickness of the sponge are important and can impact absorbency, the primary concern is how much blood the sponge can absorb to maintain a clear operative field. Texture may affect tissue interaction, but absorbency is most important for managing blood loss effectively.

190.

In monitoring blood loss during a surgical procedure, which of the following is MOST indicative of significant blood loss?

  • The collection of 500 mL of blood in the suction canister

  • A 10% increase in heart rate

  • A slight decrease in blood pressure

  • Bright red blood on the surgical drapes

Correct answer: The collection of 500 mL of blood in the suction canister

The collection of a significant volume of blood, like 500 mL, provides a clear, measurable estimate of blood loss during surgery. This measurement is particularly useful for quantifying blood loss accurately due to the ability to measure it directly, allowing healthcare providers to respond appropriately.

While blood loss will lead to an increase in heart rate, a 10% increase in heart rate can be due to various factors, not specifically indicating significant blood loss. 

A slight decrease in blood pressure needs to be considered with other signs; it's not a definitive indicator alone. 

While bright red blood may indicate arterial bleeding, it doesn’t quantify the loss, which is crucial for determining significance.

191.

During a mastectomy, care must be taken to manage the lymphatic vessels to prevent postoperative complications. Which complication is most directly related to damage or removal of lymphatic vessels during surgery?

  • Lymphedema

  • Hemorrhage

  • Surgical site infection

  • Deep vein thrombosis

Correct answer: Lymphedema

Lymphedema is a common complication arising from the damage or removal of lymphatic vessels during surgeries like a mastectomy, as these vessels are involved in fluid balance and removal from tissues.

Hemorrhage is more directly related to blood vessel injury rather than lymphatic vessels. 

Surgical site infections are generally associated with microbial invasions and less directly related to lymphatic vessel management. 

Deep vein thrombosis is primarily related to venous thrombosis and not directly linked to lymphatic vessel management.

192.

During a lumbar laminectomy, which structure is primarily being removed to relieve pressure on the spinal cord or nerve roots?

  • Lamina

  • Vertebral body

  • Intervertebral disc

  • Spinous process

Correct answer: Lamina

The lamina forms part of the vertebral arch and its removal during lumbar laminectomy directly decompresses the spinal cord or nerve roots.

The vertebral body is the anterior portion of the vertebra and is not typically removed in a laminectomy. 

The intervertebral disc is between vertebrae, and although it can be involved in spinal surgeries, it is not the primary structure removed in a laminectomy. 

The spinous process could be removed but is not the primary focus of a lumbar laminectomy aimed at relieving pressure on the spinal cord or nerve roots.

193.

For the application of a surgical dressing following a skin graft, which instrument is preferred to gently manipulate the delicate tissue?

  • Skin hook

  • Kocher forceps

  • Allis clamp

  • Toothed forceps

Correct answer: Skin hook

The skin hook is specifically designed to handle delicate tissues with minimal trauma. Its design allows for the gentle manipulation of fragile tissue such as that involved in skin grafts. This instrument is preferred because it can lift and move tissue without causing significant damage or compression, which is crucial for the success of procedures involving skin grafts.

Kocher forceps are designed for holding heavy tissue or for use in procedures where a firm grip on the tissue is required. They are typically too traumatic for delicate tissues like skin grafts because their design can cause significant compression and damage to the tissue. 

Allis clamps are used to grasp tissue firmly but are not ideal for handling delicate tissues like those involved in skin grafts. The Allis clamp can cause significant trauma to the tissue due to its tight gripping mechanism, which can lead to tissue damage. 

Toothed forceps, while used in surgical settings for gripping tissue, are not the best choice for handling very delicate tissues such as skin grafts. The teeth can cause puncture wounds or tears in the graft, which can compromise the integrity of the delicate tissue and affect healing.

194.

During a surgical procedure using a microscope, the surgeon complains of a blurry image. What should the surgical technologist do FIRST?

  • Adjust the focus controls on the microscope

  • Clean the external lenses of the microscope

  • Check the power supply to the microscope

  • Inform the circulating nurse to document the issue

Correct answer: Adjust the focus controls on the microscope

The first and most direct action to correct a blurry image is adjusting the focus, as it's often the cause of such issues.

Cleaning the lenses may be necessary if adjusting the focus does not resolve the issue, making it a secondary step. 

Checking the power supply is unlikely to resolve a blurriness problem, which is more likely to be related to image focusing. 

Documentation is important but does not directly address the immediate issue of image quality.

195.

What is the PRIMARY reason for using a trocar during laparoscopic surgery?

  • To provide an entry point for endoscopic instruments

  • To aspirate fluids from the abdominal cavity

  • To measure the intra-abdominal pressure

  • To enable pneumoperitoneum

Correct answer: To provide an entry point for endoscopic instruments

Trocars are used in laparoscopic surgery to create an entry point through the abdominal wall, allowing endoscopic instruments to be inserted into the abdominal cavity for performing surgical procedures.

While aspiration of fluids can be a component of laparoscopic surgery, it is not the primary function of a trocar; aspiration is typically achieved using specific suction instruments that can be inserted through a trocar. 

Measuring intra-abdominal pressure is not the primary purpose of a trocar. 

Enabling pneumoperitoneum, the process of insufflating the abdominal cavity with gas to create a working space for surgery, is achieved using a Veress needle or a trocar with an insufflation port. However, the primary reason for using a trocar is to provide an entry point for instruments, not specifically to enable pneumoperitoneum.

196.

During a total knee arthroplasty, which draping technique is MOST appropriate to ensure optimal surgical site exposure and sterility?

  • Using a stockinette over the foot and lower leg, followed by an extremity drape

  • Placing a large impervious U-drape over the leg and securing it with adhesive strips

  • Draping with a standard sheet drape secured with towel clips

  • Applying a transparent adhesive drape directly to the skin around the surgical site

Correct answer: Using a stockinette over the foot and lower leg, followed by an extremity drape

Using a stockinette over the foot and lower leg, followed by an extremity drape, is the most appropriate technique for a total knee arthroplasty. This method provides secure coverage, conforms to the shape of the leg, and allows for optimal surgical site exposure while maintaining sterility.

A large impervious U-drape is typically used for procedures requiring broader coverage and might not provide the conforming fit needed for a knee arthroplasty. 

A standard sheet drape secured with towel clips may not provide the snug fit and precise exposure required for knee arthroplasty, potentially compromising sterility. 

A transparent adhesive drape is often used as an adjunct to other draping materials to secure the edges and prevent fluid seepage but is not sufficient on its own for the comprehensive coverage needed in knee arthroplasty.

197.

During a thoracic surgery requiring lung resection, the surgeon requests a stapling device. Which device should be prepared to ensure airtight closure of the lung tissue?

  • Linear stapler

  • Circular stapler

  • Skin stapler

  • Intraluminal stapler

Correct answer: Linear stapler

Linear staplers are versatile and can provide the long, continuous closures needed for lung resection, ensuring an airtight seal.

Circular staplers are primarily used in gastrointestinal surgeries and are not suitable for lung tissue closure. Skin staplers are for external use and cannot provide the airtight closure required for lung resection. Intraluminal staplers are used within tubular structures of the gastrointestinal tract, not for lung tissue.

198.

After an orthopedic surgery, which of the following is the MOST appropriate method for handling the removal of heavy drapes used to cover the C-arm fluoroscope?

  • Ask for assistance to gently lift the drapes off, ensuring not to disturb the surgical site

  • Pull the drapes as quickly as possible to provide efficient postoperative care

  • Cut the drapes off using scissors to prevent movement of the equipment

  • Leave the drapes for the radiology department to handle due to the sensitive nature of the equipment

Correct answer: Ask for assistance to gently lift the drapes off, ensuring not to disturb the surgical site

Asking for assistance to gently lift heavy drapes ensures that the equipment is not disturbed, minimizing the risk of injury or contamination.

Pulling the drapes quickly can disturb or damage the equipment. Cutting the drapes is not a standard practice and can lead to unnecessary contamination of the equipment. It is the responsibility of the surgical team to ensure that all equipment is properly processed, not the radiology department.

199.

Which of the following is an essential safety consideration when handling an endoscopic electrocautery device?

  • Using the device only within the visual field provided by the endoscope

  • Ensuring the device is always kept in direct line of sight

  • Maintaining the device at the highest power setting to ensure efficacy

  • Applying pressure to the patient's abdomen to enhance the device's effectiveness

Correct answer: Using the device only within the visual field provided by the endoscope

For safety and precision, it is crucial to use electrocautery devices only within the visual field provided by the endoscope to avoid unintended injury to tissues.

While maintaining visibility is important, the direct line of sight of the device itself is less critical than its visibility within the endoscopic view. 

Using the highest power setting is not always safe or effective; power settings should be adjusted based on the surgical task and tissue type. 

Applying external pressure is not related to the safe use of an endoscopic electrocautery device and could potentially cause harm.

200.

Before the procurement of organs for transplantation, what is the MOST critical step that must be confirmed by the surgical technologist?

  • Confirming the donor's consent for organ donation has been properly documented and authorized

  • Ensuring that the potential recipients are ready to begin surgery immediately following organ procurement

  • Verifying the compatibility of the donor organs with the potential recipients

  • Checking that the operating room temperature is appropriate for organ preservation

Correct answer: Confirming the donor's consent for organ donation has been properly documented and authorized

Confirming documented and authorized consent is crucial to ensuring ethical and legal compliance with organ donation procedures.

Ensuring readiness of potential recipients may be important but is secondary to confirming the legal and ethical foundation of consent for donation. Organ procurement will also typically not be timed based on recipient readiness. 

Verifying organ compatibility is a medical necessity but follows the ethical prerequisite of confirmed consent. 

While maintaining appropriate environmental conditions is important, it is not as critical as confirming consent for the donation process and is not typically a primary consideration during organ procurement.

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