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Quiz Session - Attempts With Random Questions

NBSTSA CST Exam Questions

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21.

A 55-year-old smoker with chronic cough undergoes a chest X-ray, which shows a mass. What is the most probable diagnosis?

  • Lung carcinoma

  • Bronchial asthma

  • Pulmonary edema

  • Pneumothorax

Correct answer: Lung carcinoma

Lung carcinoma is likely in a smoker with a chronic cough and a newly identified chest mass; this condition aligns well with the risk factors and presentation.

Bronchial asthma is a chronic inflammatory disease of the airways that does not typically present with a mass on chest X-ray. 

Pulmonary edema involves fluid accumulation in the lungs and would appear as diffuse shadowing rather than a localized mass on a chest X-ray. 

Pneumothorax involves the presence of air in the pleural space and would show as an area of clear space rather than a mass on chest X-ray.

22.

Which principle of tissue handling BEST minimizes tissue trauma and promotes healing by avoiding unnecessary tension on wound edges?

  • Handling tissues with minimal force and using proper instruments

  • Using the sharpest possible instrument for dissection

  • Applying traction and countertraction slowly and carefully

  • Irrigating the surgical site frequently

Correct answer: Handling tissues with minimal force and using proper instruments

Minimizing force during tissue handling and using appropriate instruments are crucial to avoid damaging tissues, which helps reduce trauma and promote faster and more effective healing. Gentle manipulation of tissues not only reduces mechanical damage but also limits the inflammatory response, enhancing the overall recovery process.

Using the sharpest possible instrument for dissection is important, but sharpness alone does not ensure minimal tissue trauma; technique and handling are also important. 

Applying traction and countertraction can be useful in some surgical procedures but must be done judiciously to prevent tissue trauma. 

Frequent irrigation can be beneficial in certain contexts to clear debris and contaminants, but it does not directly minimize tissue trauma as effectively as gentle handling.

23.

What is the FIRST step in troubleshooting an autoclave that is not reaching the correct sterilization temperature?

  • Check the door seal for leaks

  • Increase the sterilization time

  • Decrease the load size

  • Replace the chemical indicator strips

Correct answer: Check the door seal for leaks

A compromised door seal can allow steam to escape, preventing the autoclave from reaching the necessary sterilization temperature.

Increasing sterilization time does not address the underlying issue affecting temperature achievement. 

Decreasing the load size may improve steam circulation but does not directly address issues with reaching sterilization temperature. 

Replacing chemical indicator strips does not influence the autoclave's ability to reach the correct sterilization temperature.

24.

What is the PRIMARY reason for using a synthetic graft in vascular surgery?

  • To reduce the risk of disease transmission

  • To promote osteogenesis

  • To provide immediate structural support

  • To encourage angiogenesis

Correct answer: To reduce the risk of disease transmission

Synthetic grafts eliminate the risk of disease transmission associated with biological grafts, making them a safer alternative in many cases.

Synthetic grafts are not used for osteogenesis, as they do not contain biological components necessary for bone growth. While synthetic grafts can provide structural support, it's not the primary reason for their use in vascular surgery. Angiogenesis is more closely associated with biological grafts; synthetic grafts do not inherently encourage new blood vessel formation.

25.

When is the INITIAL count of instruments and sponges typically performed?

  • Before the surgery begins

  • After the first incision is made

  • As they are used during surgery

  • Prior to closing the surgical site

Correct answer: Before the surgery begins

The initial count of instruments and sponges is typically performed before the surgery begins to ensure all items are accounted for, which helps prevent the retention of foreign objects in the patient. This is a critical step in maintaining patient safety and adhering to standard operating procedures in the surgical setting.

Waiting until after the first incision is made to perform the initial count could compromise patient safety by increasing the risk of leaving items inside the surgical site, as it bypasses the opportunity to establish a baseline count before the procedure starts. 

Counting instruments and sponges for the first time as they are used during surgery is impractical and does not provide a reliable method for tracking items, potentially leading to inaccuracies and increased risk of retained surgical items. 

While counts are also performed prior to closing the surgical site, the initial count must occur before the surgery begins to establish a baseline, ensuring all items are accounted for from the start of the procedure.

26.

Which material is preferred for wrapping instruments for steam sterilization to ensure proper sterilization and storage?

  • Muslin

  • Polyethylene film

  • Heavy-duty aluminum foil

  • Waxed paper

Correct answer: Muslin

Muslin is a breathable fabric that allows steam penetration and is commonly used for wrapping instruments for steam sterilization, ensuring proper sterilization and storage.

Polyethylene film is not suitable for steam sterilization, as it does not allow steam penetration. Heavy-duty aluminum foil is impermeable to steam and therefore not suitable for steam sterilization. Waxed paper is not ideal for steam sterilization because it may not allow adequate steam penetration and could compromise sterility.

27.

For a patient scheduled for a below-the-knee amputation due to chronic osteomyelitis, which method of anesthesia is MOST appropriate?

  • Spinal block

  • General anesthesia

  • Local infiltration around the surgical site

  • Topical anesthesia

Correct answer: Spinal block

A spinal block is suitable for below-the-knee amputation, as it provides effective regional anesthesia, minimizing pain while allowing the patient to remain awake, which can be preferable for monitoring and recovery.

General anesthesia could be used but is not necessary for such a procedure and comes with higher risks of complications and longer recovery times. 

Local infiltration around the surgical site may not provide adequate pain control for the intensity of a below-the-knee amputation. 

Topical anesthesia is not nearly strong enough for such an invasive procedure as an amputation.

28.

Which stage of wound healing involves collagen synthesis, granulation tissue formation, and re-epithelialization?

  • Proliferative phase

  • Hemostasis

  • Inflammatory phase

  • Maturation phase

Correct answer: Proliferative phase

The proliferative phase of wound healing is when collagen synthesis, granulation tissue formation, and re-epithelialization occur, crucial for building new tissue and covering the wound.

Hemostasis is the initial phase of wound healing, focusing on stopping bleeding through clot formation, not tissue rebuilding. The inflammatory phase is characterized by swelling, redness, and inflammation, preparing the wound for the healing phases but does not involve proliferation. The maturation phase involves the remodeling of collagen and strengthening of the tissue; this phase occurs after the proliferative phase.

29.

A surgical technologist notices that the sterile field has been compromised during a procedure. What is the MOST appropriate immediate action?

  • Notify the surgeon and the rest of the team about the breach

  • Continue the procedure until given further direction by the surgeon

  • Cover the compromised area with sterile drapes

  • Replace all instruments and supplies with new sterile items

Correct answer: Notify the surgeon and the rest of the team about the breach

Notifying the team allows for a collective decision on how to proceed, whether that involves reinforcing the sterile field, replacing compromised items, or taking other corrective actions.

Ignoring a breach in sterility can lead to infection and compromises patient safety; the surgical technologist is responsible for notifying the team. 

Simply covering the compromised area may not address the underlying issue; the rest of the team should be notified prior to determining the next steps. 

While replacing compromised items may be necessary, the first step is to notify the team to assess the situation and decide on the appropriate response.

30.

Which hemostasis method is preferred for controlling capillary bleeding in a highly vascularized tissue during a thyroidectomy?

  • Bipolar electrocautery

  • Application of a hemostatic agent

  • Suture ligation

  • Direct pressure with a surgical sponge

Correct answer: Bipolar electrocautery

Bipolar electrocautery allows for precise application of energy, minimizing thermal spread and damage to surrounding tissues, making it ideal for controlling bleeding in delicate areas like the thyroid gland.

While hemostatic agents can be useful for managing capillary bleeding, they may not provide the immediate and targeted control required in a highly vascularized area. 

Suture ligation is more suited for larger vessels and may not be practical or effective for widespread capillary bleeding. 

Direct pressure can help control bleeding but may not be sufficient alone for the diffuse capillary bleeding seen in thyroid surgery.

31.

What is the MOST likely cause of a steam sterilizer's printout indicating a failed sterilization cycle?

  • Overloading of the sterilizer chamber

  • Insufficient steam supply

  • Use of expired sterilization pouches

  • Incorrect loading of the sterilization chamber

Correct answer: Overloading of the sterilizer chamber

Overloading can prevent proper steam circulation and penetration, leading to failed sterilization cycles. When items are densely packed or incorrectly arranged, steam cannot reach all surfaces equally, affecting the efficacy of the sterilization process. This is the most likely of the options provided.

While a potential cause, insufficient steam supply is less likely than overloading to be a cause of failed sterilization cycles. Use of expired sterilization pouches is not likely to cause a failed cycle printout directly. Incorrect loading can impact effectiveness, but overloading is a more direct cause of failed sterilization.

32.

Which of the following outcomes is the PRIMARY focus of a postoperative debrief session?

  • Identifying opportunities for improving surgical efficiency

  • Allocating blame for any complications that occurred during surgery

  • Planning the next day's surgical schedule

  • Reviewing the financial cost of the surgery

Correct answer: Identifying opportunities for improving surgical efficiency

The primary focus of a postoperative debrief is to identify opportunities for improving surgical efficiency, enhancing team performance, and ensuring patient safety.

Allocating blame is counterproductive and does not foster a culture of safety or continuous improvement. Planning the next day's surgical schedule is not the purpose of a postoperative debrief session. Reviewing the financial cost of the surgery is not the primary focus of a debrief, which centers on clinical outcomes and process improvement.

33.

After a surgical procedure, which of the following steps should be taken FIRST in the process of room cleanup?

  • Disposing of all sharps in the designated sharps container

  • Mopping the floor with an approved disinfectant

  • Disposing of any drapes or materials contaminated with biohazardous materials

  • Wiping down the operating table with a sterilizing agent

Correct answer: Disposing of all sharps in the designated sharps container

Ensuring that all sharps are immediately disposed of in the designated sharps container minimizes the risk of needle-stick injuries and the potential spread of infection. 

Mopping the floor with an approved disinfectant, while important for infection control, is not the first step in the cleanup process. Addressing sharps and contaminated materials directly impacting staff safety takes precedence. 

Disposing of any drapes or materials contaminated with biohazardous materials is crucial for infection prevention but follows the disposal of sharps to first eliminate this risk. 

Wiping down the operating table with a sterilizing agent is an important step in room cleanup for the next procedure but is not the first step, as the immediate management of sharps and biohazardous waste takes priority for staff and patient safety.

34.

During an abdominal surgery, the surgeon asks for suture material that minimizes the risk of infection. Which suture feature should the surgical technologist prioritize?

  • Monofilament structure

  • Braided structure

  • Color-coded structure

  • Coated structure

Correct answer: Monofilament structure

Monofilament sutures are less likely to harbor bacteria than braided sutures, making them a better choice for minimizing the risk of infection.

Braided sutures have interstices that can harbor bacteria, potentially increasing the risk of infection. The color-coding of sutures is used for identification and has no impact on the risk of infection. While coating can reduce tissue drag, it does not primarily affect the suture's ability to minimize infection risk compared to the structural difference of being monofilament.

35.

When preparing cultures from a surgical site infection, it's important to distinguish between bacterial types for targeted treatment. Which of the following culture results would indicate a Gram-positive bacterial infection?

  • Purple clusters under a microscope after Gram staining

  • Pink rods under a microscope after Gram staining

  • Blue spheres under a microscope after Gram staining

  • Red rods under a microscope after Gram staining

Correct answer: Purple clusters under a microscope after Gram staining

Gram-positive bacteria retain the crystal violet dye used in Gram staining, appearing purple under a microscope. The description of clusters suggests the presence of bacteria such as Staphylococcus, which forms clusters.

Pink rods under a microscope indicate Gram-negative bacteria, as they do not retain the crystal violet dye and are counterstained pink with safranin. 

Blue spheres under a microscope after Gram staining are not a standard result in Gram staining, suggesting a misunderstanding or misapplication of the staining technique. 

Red rods indicate Gram-negative bacteria stained with safranin, which counterstains cells that do not retain the primary dye, crystal violet.

36.

During a laparoscopic cholecystectomy, the gallbladder is removed without any spillage of bile or breach of aseptic technique. How should this wound be classified?

  • Clean

  • Clean-contaminated

  • Contaminated

  • Dirty

Correct answer: Clean

A clean wound classification applies to an operation on a non-infected area where no inflammation is encountered, and respiratory, alimentary, genital, or uninfected urinary tracts are not entered, such as in a laparoscopic cholecystectomy without bile spillage.

Clean-contaminated involves controlled opening of respiratory, alimentary, genital, or uninfected urinary tracts with minimal spillage. This is not applicable here as there was no spillage. Contaminated would involve gross spillage or major breaks in technique, which did not occur in this procedure. Dirty wounds involve existing infection or visible contamination, which is not the case in this situation.

37.

When preparing an arterial line for insertion, what is the MOST important step to prevent complications?

  • Calibrating the pressure transducer system

  • Wrapping the line with a heating pad to prevent coagulation

  • Ensuring the flush bag under pressure exceeds the patient’s diastolic blood pressure

  • Applying a topical vasoconstrictor to the insertion site

Correct answer: Calibrating the pressure transducer system

Calibrating the pressure transducer system is crucial, as it ensures accurate blood pressure readings, which is essential for monitoring the patient accurately and preventing complications associated with inaccurate blood pressure monitoring.

Wrapping the line with a heating pad is not the most critical step for preventing complications during arterial line insertion. 

The flush bag should be under pressure exceeding the patient’s systolic blood pressure, not their diastolic blood pressure, to ensure that the bag will flush into the patient’s arteries when used. 

Applying a topical vasoconstrictor to the insertion site is not a step in preventing complications associated with the arterial line.

38.

In cataract surgery, it is important to know that which part of the eye is responsible for focusing light onto the retina?

  • Lens

  • Cornea

  • Sclera

  • Iris

Correct answer: Lens

The lens of the eye focuses light onto the retina. This effect is crucial for clear vision, and the sense is the part of the eye altered during cataract surgery to restore vision.

While the cornea also plays a role in focusing light, it is not the primary focus of cataract surgery, which targets the lens. The sclera provides structural support and protection for the eye but does not focus light. The iris controls the size of the pupil and does not focus light onto the retina.

39.

When disassembling a surgical microscope after use, what is the FIRST step to ensure safety and maintenance?

  • Turning off the power and unplugging the microscope

  • Wiping the lenses with an approved cleaning solution

  • Removing the microscope from the sterile field

  • Documenting the usage in the equipment log

Correct answer: Turning off the power and unplugging the microscope

Turning off and unplugging the microscope is the first step to ensure electrical safety and to prepare for safe disassembly.

While cleaning the lenses is important, it should not precede ensuring the equipment is powered down for safety. 

Removing the microscope from the sterile field is important but is not as important for safety as ensuring the device is powered down. 

Documentation is crucial but is a post-procedural step following physical disassembly and safety checks.

40.

When preparing for a laparoscopic procedure, which step is MOST crucial in ensuring the endoscopic equipment is functioning correctly before surgery?

  • Verifying the video monitor displays a clear image

  • Confirming the availability of backup surgical instruments

  • Ensuring a grounding pad is available

  • Ensuring there is an adequate supply of surgical sutures

Correct answer: Verifying the video monitor displays a clear image

Ensuring the video monitor displays a clear and accurate image is crucial for laparoscopic procedures because it provides the surgeon with a visual of the patient's internal structures, which is essential for guiding the surgery.

While confirming the availability of backup surgical instruments is important for preparedness, it does not directly impact the ability to perform the laparoscopic procedure or the functionality of the endoscopic equipment. 

Ensuring a grounding pad is available is important for patient safety to prevent electrical injuries, but it is not directly related to the endoscopic equipment's functionality. 

Having an adequate supply of surgical sutures is necessary for the completion of the surgery, but it is not the most crucial step in ensuring the endoscopic equipment, specifically, is functioning correctly before surgery.

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