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Quiz Session - Attempts With Random Questions

NBSTSA CST Exam Questions

Page 3 of 25

41.

For a surgical incision that is expected to have minimal drainage and is located in an area of high mobility, such as the knee, which of the following dressing choices is the MOST appropriate?

  • A flexible, thin film dressing to accommodate movement

  • A rigid, non-flexible dressing for strong protection while kneeling

  • A hydrocolloid dressing to maintain a moist environment

  • An alginate dressing with high absorbency properties

Correct answer: A flexible, thin film dressing to accommodate movement

Flexible, thin film dressings can move with the body and provide a barrier to external contaminants, making them ideal for areas of high mobility with minimal drainage.

A rigid, non-flexible dressing could restrict movement and may not adhere well to areas of high mobility like the knee. While hydrocolloid dressings maintain a moist healing environment, their bulkiness might limit movement in areas like the knee. Alginate dressings are used for wounds with heavy exudate, which is not expected in this situation.

42.

A surgeon needs to perform a procedure that requires the suturing of a highly vascular area. Which characteristic of the needle should the surgical technologist consider MOST important when preparing the suture?

  • Tapered point

  • Blunt tip

  • Cutting edge

  • Large eye

Correct answer: Tapered point

A tapered point is designed to pierce and spread tissue without cutting it, making it ideal for suturing highly vascular areas with minimal trauma and reduced risk of bleeding.

A blunt tip is typically used for friable tissue and may not be suitable for penetrating highly vascular areas. 

A cutting edge can cause more trauma to the tissue, potentially leading to increased bleeding in a highly vascular area. 

The size of the needle's eye is less relevant to its ability to suture a highly vascular area than the shape of the needle tip.

43.

In a repair of a rotator cuff tear, which muscle is MOST commonly affected and repaired?

  • Supraspinatus

  • Deltoid

  • Biceps

  • Pectoralis major

Correct answer: Supraspinatus

The supraspinatus muscle is the most commonly affected muscle in rotator cuff tears and is most frequently repaired. It sits on top of the shoulder blade and is crucial for lifting the arm and moving it away from the body.

The deltoid muscle, although a major shoulder muscle, is not a part of the rotator cuff. Rotator cuff repairs specifically address the smaller muscles and tendons encircling the shoulder joint. The biceps muscle is in the front of the upper arm and is not part of the rotator cuff group. The pectoralis major is a large chest muscle that does not form part of the rotator cuff.

44.

When preparing a set of instruments for autoclaving, what is the MOST important factor to consider to ensure proper sterilization?

  • The instruments are arranged in a single layer in the sterilization tray

  • The instruments are all of the same material

  • The sterilization tray is filled to capacity

  • The instruments are all used in the same type of surgery

Correct answer: The instruments are arranged in a single layer in the sterilization tray

Arranging instruments in a single layer in the sterilization tray allows steam or sterilizing gas to circulate freely around each instrument, ensuring that all surfaces are exposed to the sterilizing agent. This is crucial for achieving proper sterilization by allowing heat and steam to penetrate every part of each instrument.

While having instruments made of the same material can help ensure uniform heating and reduce the risk of damage, it is not the most important factor for sterilization effectiveness. 

Filling the sterilization tray to capacity can actually hinder the sterilization process by restricting the flow of steam or gas around and through the instruments, potentially leaving some areas unsterilized.  

The type of surgery the instruments are used for is irrelevant to the sterilization process.

45.

Which instrument would be most suitable for manipulating or holding bowel tissue during a laparotomy?

  • DeBakey forceps

  • Bulldog clamp

  • Rongeur

  • Trocar

Correct answer: DeBakey forceps

DeBakey forceps are designed with atraumatic teeth, making them suitable for gently grasping delicate tissues like the bowel without causing significant damage.

Bulldog clamps are used to clamp blood vessels and are not effective for holding or manipulating bowel tissues effectively. 

Rongeurs are used for removing bony structures and are not appropriate for tissue manipulation. 

Trocars are used to create pathways for the insertion of tubes or other instruments into body cavities and are not used for tissue manipulation.

46.

During an emergency laparotomy for a patient with a perforated bowel, the anesthesiologist decides to administer anesthesia that will provide a rapid onset and short duration of action. Which of the following is the MOST appropriate choice?

  • General anesthesia using a volatile agent

  • Topical anesthesia to the abdominal wall

  • Local infiltration with lidocaine

  • Nerve block at the T10 level

Correct answer: General anesthesia using a volatile agent

General anesthesia with a volatile agent allows for swift adjustments in the depth of anesthesia, which is crucial when managing the physiological fluctuations often encountered during emergency surgeries such as a laparotomy. These agents are easily titrated, making them ideal for maintaining patient stability throughout the procedure.

Topical anesthesia to the abdominal wall is inadequate for the depth of surgery required in a laparotomy. Local infiltration with lidocaine is insufficient for the extensive and deep surgical interventions involved in a laparotomy. A nerve block at the T10 level does not provide comprehensive anesthesia required for a laparotomy.

47.

If a patient exhibits signs of anaphylaxis during surgery, what is the MOST appropriate action for the surgical technologist to take?

  • Prepare to assist in providing epinephrine to the anesthesia provider

  • Administer an antihistamine to the patient immediately

  • Increase the rate of IV fluids as a first response

  • Apply a cold compress to the patient’s forehead

Correct answer: Prepare to assist in providing epinephrine to the anesthesia provider

Epinephrine is the first-line treatment for anaphylaxis, and preparing it for administration by the anesthesia provider is appropriate and within the scope of practice for a surgical technologist if necessary.

While antihistamines are used in the treatment of allergic reactions, the administration of these medications is not within the surgical technologist’s scope of practice. 

Adjusting the rate of IV fluids is a medical decision to be made by the anesthesia provider or surgeon, not the surgical technologist. 

A cold compress does not address the systemic nature of anaphylaxis and is not a relevant action in this situation.

48.

A surgical technologist is preparing the operating room and realizes that the biohazard waste bin is nearly full. What is the most appropriate next step?

  • Replace the biohazard waste bin with an empty one before starting the procedure

  • Continue with the preparation, and deal with the biohazard waste bin after the surgery

  • Ask a colleague to empty the bin while continuing with the room preparation

  • Ignore the bin’s status, as it is not part of the surgical technologist's responsibilities

Correct answer: Replace the biohazard waste bin with an empty one before starting the procedure

Replacing the biohazard waste bin before the procedure ensures the operating room remains organized and complies with standard precautions for handling potentially infectious materials.

Leaving the biohazard waste bin nearly full can lead to improper disposal of potentially infectious materials, violating standard precautions. 

While asking a colleague to assist is proactive, directly ensuring that the bin is replaced avoids any delay or oversight in handling biohazardous waste. 

It is part of the surgical technologist's responsibilities to maintain a safe and sanitary operating environment, which includes managing biohazard waste.

49.

A surgical technologist is setting up a computer navigation system for a neurosurgical procedure. What is the MOST important factor to ensure system reliability throughout the surgery?

  • Continuous monitoring of the system’s power supply

  • Regular updates of the navigation software

  • The surgeon’s experience with the system

  • Proper sterilization of the navigation equipment

Correct answer: Continuous monitoring of the system’s power supply

A stable power supply is crucial to prevent system failures during critical surgical procedures. This helps avoid any interruptions or malfunctions in the computer navigation system, which could lead to critical failures at crucial moments. This stability is not merely about preventing the system from shutting down entirely but also about ensuring that there are no fluctuations or surges in power that could cause the system to malfunction or provide inaccurate information.

Software updates are important but typically done before the surgery. They are not typically a factor to monitor continuously during the procedure. 

While the surgeon's experience is important for the overall success, it does not directly ensure the system's reliability. 

Sterilization is critical for preventing infection but does not affect the reliability of the navigation system’s technical performance.

50.

When preparing to enter the operating room for a procedure that involves a high risk of fluid splash, which of the following pieces of personal protective equipment should be donned LAST?

  • Sterile gloves

  • Surgical gown

  • Protective eyewear

  • N95 respirator mask

Correct answer: Sterile gloves

Sterile gloves are typically donned last in the sequence of putting on personal protective equipment to ensure the hands remain sterile after gowning, thus minimizing the risk of contaminating sterile surfaces.

The surgical gown is usually donned before sterile gloves to ensure the gown's sleeves are covered by the gloves, maintaining sterility. 

Protective eyewear is generally donned before sterile gloves to ensure the face and eyes are protected without contaminating the hands after gowning. 

An N95 respirator mask is typically donned before sterile gloves and usually before entering the operating room as part of protecting the respiratory tract from airborne particles.

51.

A patient is undergoing aortic valve replacement surgery for aortic stenosis. What is the PRIMARY function of the aortic valve being replaced?

  • To regulate blood flow from the left ventricle into the aorta

  • To prevent backflow of blood into the left atrium

  • To regulate blood flow from the right ventricle to the lungs

  • To prevent backflow of blood into the right ventricle

Correct answer: To regulate blood flow from the left ventricle into the aorta

The primary function of the aortic valve is to regulate blood flow from the left ventricle into the aorta, ensuring forward flow and preventing backflow into the ventricle.

Preventing backflow into the left atrium is the function of the mitral valve, not the aortic valve. Regulating blood flow from the right ventricle to the lungs is the function of the pulmonary valve. Preventing backflow into the right ventricle is the function of the tricuspid valve.

52.

A patient scheduled for elective surgery has noted a latex allergy in their medical history. What is the FIRST step in preparing the operating room?

  • Replace all latex-containing items with latex-free alternatives

  • As standard surgical supplies are latex-free, no changes are necessary

  • Administer antihistamines to the patient preemptively, as completely avoiding latex is not feasible

  • Evaluate the type of latex allergy, as the surgery may need to be postponed depending on the allergy type

Correct answer: Replace all latex-containing items with latex-free alternatives

The safety of the patient with a latex allergy requires replacing all potential latex-containing items with latex-free alternatives to prevent potential allergic reactions.

Assuming that standard surgical supplies are latex-free is dangerous; specific measures must be taken to ensure a latex-free environment for allergic patients. 

Preemptive antihistamines do not eliminate the risk of a severe allergic reaction and are not a substitute for creating a safe environment. It is feasible to ensure that all equipment is latex-free and to address a known allergy. 

While it is important to understand the severity of the patient’s allergy, it is unlikely that the surgery would need to be postponed.

53.

After connecting a surgical drain to the suction apparatus, you notice there is no fluid being collected in the suction reservoir. What should you do FIRST?

  • Check for kinks or obstructions in the drainage system

  • Increase the suction pressure to the maximum level

  • Replace the suction apparatus with a new one

  • Immediately inform the surgeon about the malfunction

Correct answer: Check for kinks or obstructions in the drainage system

The most common reason for lack of drainage is a physical obstruction or kink in the system, which should be addressed first. Identifying and rectifying any obstructions ensures that the drainage system can function effectively, preventing the accumulation of fluid at the surgical site. 

Increasing the suction pressure without checking for obstructions could damage tissues or the drainage system. 

Replacing the suction apparatus without troubleshooting could be unnecessary and time consuming. 

While communication with the surgical team is important, the first step is to troubleshoot the issue at hand.

54.

A surgical patient exhibits a sudden decrease in blood oxygen saturation. The blood visible in the surgical field turns from bright red to dark red. What does this change MOST likely indicate?

  • Decreased oxygenation

  • Increased oxygenation

  • Serious bleeding

  • Allergic reaction

Correct answer: Decreased oxygenation

The change in blood color from bright red to dark red signifies that the blood is carrying less oxygen, as hemoglobin without oxygen (deoxyhemoglobin) is darker in color than oxygenated hemoglobin, indicating decreased oxygenation.

Increased oxygenation would cause the blood to appear brighter red because oxygenated hemoglobin is brighter due to the oxygen bound to it; darkening of the blood suggests the opposite. 

Serious bleeding could lead to a decrease in blood pressure or volume but would not directly cause the blood in the surgical field to change color. 

An allergic reaction might cause various systemic responses, including changes in blood pressure, hives, or anaphylaxis, but it would not directly result in the blood changing from bright red to dark red.

55.

When treating a pneumothorax, which technique is essential to re-expand the collapsed lung and remove air from the pleural space?

  • Chest tube insertion

  • Pericardial window

  • Mediastinoscopy

  • Pulmonary artery ligation

Correct answer: Chest tube insertion

Chest tube insertion is essential in managing a pneumothorax, as it helps re-expand the collapsed lung and remove air from the pleural space. This procedure involves inserting a tube into the pleural cavity to evacuate air, allowing the lung to reinflate and restoring normal respiratory function.

A pericardial window is used to relieve pressure from fluid around the heart and is not relevant for a pneumothorax. Mediastinoscopy is a diagnostic procedure and does not address lung re-expansion in pneumothorax. Pulmonary artery ligation is a severe measure not typically used in the management of a simple pneumothorax.

56.

For a surgical procedure requiring the use of a suction drain, what is the MOST critical preparation step to ensure effectiveness?

  • Testing the suction functionality before surgery

  • Coiling the drain tubing neatly on the sterile field

  • Flushing the tubing of the suction drain

  • Lubricating the exterior of the drain tubing

Correct answer: Testing the suction functionality before surgery

Ensuring the suction functionality works properly before surgery is crucial to avoid intraoperative complications and to ensure that the drain can effectively remove fluids or air from the surgical site.

While coiling the drain tubing neatly on the sterile field is important for organization and preventing contamination, it does not directly impact the effectiveness of the suction drain. 

Flushing the tubing of the suction drain may be necessary in some situations, but it is not as critical as testing the functionality of the suction mechanism itself. 

Lubricating the exterior of the drain tubing may facilitate the placement of the drain but does not directly ensure the effectiveness of the suction capability.

57.

After an appendectomy, which type of dressing is MOST appropriate for the surgical wound?

  • A dry sterile gauze dressing to absorb minimal exudate

  • A transparent film dressing to allow for continuous observation

  • A hydrocolloid dressing to support a moist healing environment

  • An alginate dressing for heavy exudate management

Correct answer: A dry sterile gauze dressing to absorb minimal exudate

Dry sterile gauze dressings are commonly used for clean, closed surgical incisions due to their ability to absorb minimal exudate and protect the wound site.

While transparent film dressings allow for observation, they are not typically used for incisions with minimal exudate like an appendectomy. 

Hydrocolloid dressings are used for wounds requiring a moist environment but are not the standard choice for clean, closed surgical incisions. 

Alginate dressings are highly absorbent and best suited for wounds with heavy exudate, not typical of an appendectomy wound.

58.

During a cholecystectomy, the surgeon requests an injection of 0.5% Marcaine into the gallbladder bed. What is the primary reason for using this medication?

  • To reduce post-operative pain

  • To induce systemic anesthesia

  • To provide muscle relaxation

  • To control bleeding

Correct answer: To reduce post-operative pain

Marcaine (Bupivacaine) is a local anesthetic used to reduce post-operative pain by blocking nerve impulses.

Marcaine is used for local anesthesia, not systemic. Marcaine does not provide muscle relaxation; it blocks nerve conduction to reduce pain. While Marcaine has vasoconstrictive properties, its primary use in this context is for pain control, not hemostasis.

59.

A DeBakey forceps is BEST classified under which of the following categories?

  • Grasping or holding

  • Clamping or occluding

  • Cutting or dissecting

  • Suturing or stapling

Correct answer: Grasping or holding

DeBakey forceps are primarily used for grasping and holding delicate tissues, offering precise control without causing damage.

DeBakey forceps are not designed for clamping or occluding vessels, do not have cutting edges so are not used for cutting or dissecting, and are not used for suturing or stapling tissues.

60.

During a surgical procedure, the surgeon needs to expose a deep surgical site. Which method of tissue manipulation minimizes the risk of tissue damage?

  • Application of blunt dissection techniques where appropriate

  • Reliance primarily on electrocautery for dissection

  • Frequent changing of gloves to reduce microbial contamination

  • Only providing traction without countertraction

Correct answer: Application of blunt dissection techniques where appropriate

Blunt dissection minimizes tissue damage by separating tissues along natural lines of division rather than cutting them. This reduces the risk of tissue damage.

Reliance on electrocautery can be beneficial for controlling bleeding but can also cause thermal damage to tissues, which might increase the risk of impair healing. 

While changing gloves frequently can reduce microbial contamination, this action alone does not directly influence the method of tissue manipulation or its risk of causing tissue damage. 

Providing traction without countertraction can increase the risk of tissue damage, as it puts undue stress on the tissues, potentially tearing them rather than exposing the surgical site gently.

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