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Quiz Session - Attempts With Random Questions

NBSTSA CST Exam Questions

Page 7 of 25

121.

A surgeon requests heparin to be added to the irrigation solution during a vascular surgery. What is the purpose of adding heparin?

  • To prevent blood clotting

  • To prevent infection

  • To reduce post-operative pain

  • To reduce bleeding-associated risks

Correct answer: To prevent blood clotting

Heparin is added to the irrigation solution during vascular surgeries specifically to prevent blood clotting by inhibiting thrombin and other clotting factors, which is crucial in maintaining patency in the vascular system being operated on.

Heparin does not have antibacterial properties; its primary function is as an anticoagulant, meaning it helps to prevent blood clots from forming. 

Heparin's role is not to reduce post-operative pain; instead, it is used to prevent blood clotting during procedures that might involve a risk of thrombosis. 

While reducing bleeding-associated risks is important in surgery, the direct purpose of adding heparin is not to reduce bleeding but rather to prevent the formation of blood clots, which can indirectly contribute to safer surgical outcomes by ensuring unobstructed blood flow. Heparin will ultimately increase the risk of bleeding during surgery.

122.

For a patient with a known allergy to ester-type local anesthetics undergoing a minor surgical procedure, which of the following agents should be considered?

  • Bupivacaine

  • Procaine

  • Tetracaine

  • Chloroprocaine

Correct answer: Bupivacaine

Bupivacaine is an amide-type local anesthetic, appropriate for patients with allergies to ester-type anesthetics. It does not cross-react with antibodies targeting ester-type anesthetics, making it a safe alternative for patients with such allergies.

Procaine is an ester-type anesthetic and should be avoided in patients with known allergies to this class. Tetracaine is also an ester-type anesthetic, making it unsuitable for someone with an ester allergy. Chloroprocaine is another ester-type anesthetic and should be avoided for the same reasons as procaine and tetracaine.

123.

A patient underwent an appendectomy and received a total of 20ml of bupivacaine for local anesthesia. In documenting this for the postoperative report, what detail is MOST critical to include about the bupivacaine used?

  • The concentration of the bupivacaine solution

  • The expiration date of the bupivacaine solution

  • The temperature at which the bupivacaine solution was stored

  • Whether the bupivacaine solution was used during or prior to the initiation of general anesthesia

Correct answer: The concentration of the bupivacaine solution

The concentration of the bupivacaine solution is crucial to document because it has the potential to have a direct physiological impact on the patient.

While the expiration date of the bupivacaine solution is important for safety, it does not directly impact the anesthetic effect or dosage as critically as the concentration does. 

The temperature at which the bupivacaine solution was stored is not particularly relevant to the immediate postoperative outcome and drug efficacy compared to its concentration. 

Although it could be useful to know when the bupivacaine was administered in relation to the general anesthesia, it is not as critical as knowing the concentration for determining the drug's immediate effect on the patient.

124.

In an anterior cruciate ligament (ACL) repair, which structure is primarily involved?

  • Tibia

  • Humoral head

  • Patella

  • Fibula

Correct answer: Tibia

The tibia, along with the femur, is one of the bones connected by the Anterior Cruciate Ligament (ACL), which is primarily repaired in ACL surgeries. The ACL is crucial for knee stability, connecting the tibia (shinbone) to the femur (thighbone).

The humoral head, or humerus head, is part of the upper arm and is not involved in ACL repairs, which focus on the knee joint. 

The patella, or kneecap, is close to the ACL but not the primary structure involved in ACL repair. The ACL connects the tibia and femur beneath the patella. 

The fibula is a bone in the lower leg but does not connect directly with the ACL; it is adjacent to the tibia but not primarily involved in ACL surgery.

125.

During a laparotomy, the surgeon notes an unexpected mass on the patient's liver. Which of the following is the MOST likely diagnosis?

  • Hepatocellular carcinoma

  • Renal cyst

  • Spleen enlargement

  • Pancreatic pseudocyst

Correct answer: Hepatocellular carcinoma

Hepatocellular carcinoma typically presents as a mass in the liver and is a common primary liver cancer, especially in patients with underlying liver disease. The presence of a mass in the liver during surgery strongly points toward this diagnosis.

Renal cysts are fluid-filled sacs within the kidneys and would not be located on the liver, making this option irrelevant to the described scenario. 

Spleen enlargement, or splenomegaly, would be noted on the spleen itself, not as a mass on the liver; thus, it is not a potential diagnosis in this case. 

Pancreatic pseudocysts are fluid-filled sacs arising due to pancreatitis and are located near or around the pancreas, not on the liver.

126.

A preceptor notices that a student surgical technologist consistently struggles with maintaining the sterile field. What is the MOST effective way to address this issue?

  • Discuss the observations privately with the student, providing specific examples and ways to improve

  • Report the student to the educational program for not meeting the required competencies

  • Assign the student to less complex cases until they improve their skills

  • Encourage the student to practice more on their own time

Correct answer: Discuss the observations privately with the student, providing specific examples and ways to improve

A private discussion allows for constructive feedback focused on specific issues and improvement strategies, supporting the student's learning without causing embarrassment or discouragement.

Reporting to the educational program before providing direct feedback and an opportunity to improve can undermine the student's confidence and the learning process. 

Assigning them to less complex cases may reduce immediate pressure but does not directly address the need for skill development in maintaining sterility. 

Encouraging practice on their own time could be helpful but should be accompanied by specific guidance and support to address the identified issues effectively.

127.

Which of the following steps is MOST important when troubleshooting poor image quality from an endoscopic camera during a procedure?

  • Checking the connection between the camera and the video monitor

  • Increasing the intensity of the operating room lights

  • Adjusting the patient's position on the operating table

  • Replacing the endoscopic instrument entirely

Correct answer: Checking the connection between the camera and the video monitor

Poor image quality often results from issues with the connection between the camera and the monitor, making this the first step in troubleshooting.

Operating room light intensity has no direct effect on the quality of the image produced by the endoscopic camera. 

The patient's position may affect surgical access but not the quality of the image from the endoscopic camera. 

Replacing the instrument is a more drastic step and should be considered only after simpler troubleshooting steps have been attempted.

128.

If a surgical sponge count at the end of an operative procedure is incorrect, what is the MOST appropriate initial action?

  • Stop and perform a recount of all sponges

  • Proceed with closing the patient and recounting sponges concurrently

  • Prepare the patient for post-operative imaging

  • Notify the surgeon that the patient may become hemodynamically unstable

Correct answer: Stop and perform a recount of all sponges

Stopping to perform a recount of all sponges is the most appropriate initial action because it directly addresses the issue at hand and can quickly resolve discrepancies.

Proceeding with closing the patient before ensuring all surgical materials are accounted for increases the risk of leaving a foreign object inside the patient, which can lead to serious complications. 

Preparing the patient for post-operative imaging as an initial step is premature and inefficient before a thorough manual recount is attempted, as imaging might not be necessary if the recount clarifies the discrepancy or if the sponge can be retrieved while the surgical site is still open. 

Notifying the surgeon that the patient may become hemodynamically unstable is not directly related to the issue of an incorrect sponge count.

129.

A surgical patient is at increased risk for post-operative venous thromboembolism (VTE). Which medication is MOST commonly administered prophylactically to prevent this condition?

  • Enoxaparin

  • Warfarin

  • Amoxicillin

  • Metoprolol

Correct answer: Enoxaparin

Enoxaparin is commonly used as a prophylactic agent against Venous ThromboEmbolism (VTE) in the postoperative setting due to its effectiveness and ease of use in preventing deep vein thrombosis and pulmonary embolism.

Warfarin is used for long-term anticoagulation but is not typically used for immediate post-operative VTE prophylaxis due to its slower onset of action and the need for monitoring. 

Amoxicillin is an antibiotic and does not have anticoagulant properties; it does not prevent VTE. 

Metoprolol is a beta-blocker used to manage hypertension and other cardiac conditions, not for VTE prophylaxis.

130.

For a patient with a known allergy to bovine products, which hemostasis method is MOST likely to need to be avoided?

  • Topical thrombin

  • Gelatin sponge

  • Oxidized regenerated cellulose

  • Polyglycolic acid suture

Correct answer: Topical thrombin

Topical thrombin is often derived from bovine sources. Patients with allergies to bovine products may have an adverse reaction to topical thrombin derived from bovine sources.

Gelatin sponges, while derived from collagen, are typically well-tolerated, but the provider should verify the source if bovine allergy is a concern. Oxidized regenerated cellulose is a synthetic product and does not pose a risk to patients with bovine allergies. Polyglycolic acid sutures are synthetic and do not pose a risk to patients with bovine allergies.

131.

During the sterilization process, you notice the sterilizer's pressure gauge reading is lower than expected. What is the MOST likely cause?

  • There is an obstruction in the steam supply

  • The load is too small

  • The temperature is set too high

  • The drying phase is malfunctioning

Correct answer: There is an obstruction in the steam supply

An obstruction in the steam supply during the sterilization process can significantly impact the functionality of the sterilizer. Sterilizers operate by using steam under pressure to achieve the high temperatures necessary for sterilization. If there is an obstruction in the steam supply line, it can hinder the flow of steam into the sterilizer chamber. As a result, the pressure gauge, which measures the pressure inside the chamber, will show a reading that is lower than expected. This is the most likely cause of the low pressure gauge reading.

A small load size does not typically cause a decrease in pressure gauge readings. Setting the temperature too high would not directly result in lower pressure readings. Malfunctioning of the drying phase does not typically affect the pressure readings during the sterilization process.

132.

During an emergency surgery, it's critical to maintain sterile techniques. If a sterile package is found to be wet, what is the MOST appropriate action?

  • Consider the contents contaminated and obtain a new sterile package

  • Dry the package before attempting to open it

  • Open the package and use the instrument only if the inside of the package is dry

  • Inspect the contents through the package for any visible contamination prior to making a decision

Correct answer: Consider the contents contaminated and obtain a new sterile package

If a sterile package is wet, the sterility is compromised, as moisture can allow microbial migration through microscopic pores in the packaging. The safest action is to consider it contaminated and replace it.

Drying the package does not restore its sterility, as the contents inside may already be contaminated by the moisture penetration. 

Opening the package to use the instrument, even if the inside appears dry, is risky because the sterility of the contents cannot be assured once the exterior packaging is compromised. 

Inspecting the contents through the package does not ensure sterility. Visual inspection cannot detect microbial contamination.

133.

During a lengthy abdominal surgery, you note the patient's estimated blood loss (EBL) is 1500 mL. Which action is most appropriate for the surgical technologist to take FIRST?

  • Alert the surgeon and anesthesia provider to the EBL

  • Request immediate cessation of the surgery

  • Prepare for immediate blood transfusion

  • Increase the IV fluid rate substantially

Correct answer: Alert the surgeon and anesthesia provider to the EBL

The surgical technologist plays a vital role in the operating room by ensuring that significant findings, such as a high Estimated Blood Loss (EBL), are communicated promptly to the surgical and anesthesia teams. This allows for immediate assessment and the implementation of necessary interventions to ensure patient safety.

Cessation of surgery is a decision for the surgeon based on the necessity of the procedure versus the risk. 

Preparation for blood transfusion is a potential next step, but the first action is to communicate the finding. 

Adjusting IV fluid rates is within the purview of the anesthesia provider, who should be informed of the EBL first.

134.

After the use of an oscillating saw in an orthopedic surgery, what is the MOST important action for ensuring the saw's longevity and readiness for future use?

  • Disassembling and cleaning the saw according to manufacturer's instructions

  • Immediately rinsing the saw under running water

  • Placing the saw in a high-temperature autoclave for sterilization

  • Oscillating saws cannot be reused

Correct answer: Disassembling and cleaning the saw according to manufacturer's instructions

Following the manufacturer’s instructions for disassembly and cleaning is critical to remove biological debris and prevent corrosion, ensuring the tool's longevity.

Rinsing the saw under running water might not be recommended for certain components and could cause damage. High-temperature autoclaving may not be suitable for all power equipment components and could cause damage. Oscillating saws can be reused if they are cleaned according to manufacturer's instructions.

135.

During an orthopedic surgery, the surgeon needs to remove a small piece of bone by gouging it out. Which instrument should the surgical technologist hand to the surgeon?

  • Rongeur

  • Osteotome

  • Curette

  • Hemostat

Correct answer: Rongeur

The Rongeur is designed for gnawing away bone, making it the ideal instrument for removing a small piece of bone as requested by the surgeon.

An osteotome is used for cutting or shaping bone, not specifically for removing small pieces. An osteotome would provide a chiseling mechanism, not a gouging mechanism. 

A curette is used for scraping the surface of bone or other tissues, not for removal of bone pieces. 

A hemostat is primarily used for controlling bleeding by clamping blood vessels, not for bone removal.

136.

If a surgical instrument washer-disinfector is leaving residue on instruments, what should be the FIRST action?

  • Check and clean the spray arms

  • Manually wash all instruments

  • Use a different detergent

  • Reduce the load size

Correct answer: Check and clean the spray arms

Clogged or dirty spray arms can prevent effective cleaning and lead to residue on instruments. Cleaning them should be the first action, as this is the most likely cause of the residue.

Manually washing all instruments does not address the root cause of the residue issue. Using a different detergent may not solve the problem if the issue is mechanical, such as with the spray arms. Reducing the load size does not directly address the cause of residue on instruments.

137.

A surgical technologist is assisting in a procedure where a sterile field must be maintained. Which action is MOST likely to compromise the sterile field?

  • Allowing sterilized instrument slightly off the sterile field as long as the surface is sanitized

  • Using sterile drapes to cover the operating table

  • Passing instruments above the waist level

  • Wearing single use sterile gloves for over an hour

Correct answer: Allowing sterilized instrument slightly off the sterile field as long as the surface is sanitized

Allowing sterilized instruments off the sterile field, even on a sanitized surface, risks contamination, as the sterility of the surface cannot be guaranteed to the standards required for a sterile field.

Using sterile drapes properly does not compromise the sterile field; it is a standard procedure to maintain sterility at the operating table. 

Passing instruments above the waist level is a standard procedure in maintaining a sterile field, ensuring that the instruments stay within the sterile zone. 

Wearing single-use sterile gloves for an extended period is not ideal but does not necessarily compromise the sterile field as long as the gloves remain intact and clean.

138.

If a power failure happens during surgery, what is the MOST critical action for the surgical technologist to take?

  • Maintain the sterile field until power is restored

  • Immediately check the status of backup power systems

  • Ensure that all surgical instruments are accounted for

  • Assist in manual ventilation if required by the anesthesia provider

Correct answer: Maintain the sterile field until power is restored

Keeping the sterile field intact is crucial to prevent contamination and ensure patient safety during unexpected interruptions.

While backup power is important, the surgical technologist's primary responsibility is to the sterile field and patient safety. 

Instrument accountability is vital, but maintaining the sterile field is the immediate priority during a power outage. 

Assisting in manual ventilation may be necessary, but it falls under the anesthesia provider's purview; maintaining the sterile field is the technologist's primary responsibility.

139.

After a short-cycle sterilization process, how should the sterilized instruments be handled?

  • Immediately used or transferred to a sterile field

  • Left inside the sterilizer for cooling

  • Placed on a drying rack

  • Wrapped in a sterile cloth

Correct answer: Immediately used or transferred to a sterile field

After short-cycle sterilization, instruments should be immediately used or transferred to a sterile field to maintain sterility and for immediate use in surgical procedures.

Leaving instruments inside the sterilizer for cooling is not recommended, as it could compromise sterility and delay their availability for use. 

Placing on a drying rack is not necessary for items sterilized in a short-cycle process, as they should be dry upon completion and ready for immediate use. 

Wrapping in a sterile cloth post-sterilization is not recommended for instruments intended for immediate use, as it could introduce contaminants and is not necessary if the instrument is going to be used immediately.

140.

What is the CORRECT action if a surgical technologist accidentally touches the faucet with their scrubbed hands?

  • Dry the hands and start the scrub process over from the beginning

  • Continue with the scrub, as the faucet is considered clean

  • Rinse the hands thoroughly with water, then continue scrubbing for an additional minute

  • Report the incident to the surgical supervisor immediately

Correct answer: Dry the hands and start the scrub process over from the beginning

If contamination occurs, the appropriate action is to dry the hands and restart the scrub process to ensure hands are properly decontaminated.

The faucet is not considered sterile, and touching it compromises the scrub. 

Simply rinsing and continuing scrubbing may not adequately address the contamination. 

While reporting safety incidents can be important, the best action is to remedy the breach in aseptic technique by restarting the scrub. Taking this action will render the need to report the incident irrelevant.

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