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Quiz Session - Attempts With Random Questions

NBSTSA CST Exam Questions

Page 8 of 25

141.

For instruments that are sensitive to high temperatures, which sterilization method and packaging combination is preferred?

  • Ethylene oxide sterilization with Tyvek pouches

  • Steam sterilization with muslin wrapping

  • Dry heat sterilization with aluminum foil

  • Hydrogen peroxide plasma sterilization with paper-plastic pouches

Correct answer: Ethylene oxide sterilization with Tyvek pouches

Ethylene oxide sterilization with Tyvek pouches is preferred for temperature-sensitive instruments because it operates at lower temperatures, and Tyvek pouches provide effective barrier protection while allowing the sterilant to penetrate.

Steam sterilization with muslin wrapping is not suitable for high-temperature-sensitive instruments due to the high heat of steam sterilization. 

Dry heat sterilization with aluminum foil is used for heat-resistant items, not for temperature-sensitive instruments. 

Hydrogen peroxide plasma sterilization with paper-plastic pouches is suitable for some temperature-sensitive items, but ethylene oxide with Tyvek offers better material compatibility and penetration for a wider range of instruments.

142.

A patient is undergoing a laparoscopic cholecystectomy. Which structure is MOST at risk during the surgical dissection of the cystic duct?

  • Common bile duct

  • Hepatic duct

  • Pancreatic duct

  • Spleen

Correct answer: Common bile duct

The common bile duct is anatomically close to the cystic duct and can be accidentally damaged during the dissection or clipping of the cystic duct.

The hepatic duct is at risk but less so than the common bile duct, as it branches farther away from the site of dissection. The pancreatic duct is not in the immediate vicinity of the cystic duct and is therefore less at risk during a cholecystectomy. The spleen is located far from the gallbladder and cystic duct and is not typically at risk during a cholecystectomy.

143.

Before the initiation of a procedure requiring the use of a surgical microscope, what is the MOST important action to ensure its proper functioning?

  • Checking the clarity and focus of the microscope

  • Confirming the operating room temperature

  • Ensuring the microscopic blade is sharp

  • Reviewing if the surgeon's vision requires correction

Correct answer: Checking the clarity and focus of the microscope

Ensuring the microscope's clarity and focus is crucial for high precision and to avoid errors during surgery, directly impacting the success of the procedure.

While maintaining an appropriate operating room temperature is important for overall equipment function and patient safety, it is not directly related to the functioning of the surgical microscope itself. 

Surgical microscopes do not include a microscopic blade. 

Reviewing if the surgeon's vision requires correction may be relevant to the surgeon's overall ability to use the microscope effectively but does not address the immediate functionality of the surgical microscope.

144.

Which part of the gastrointestinal tract is primarily involved in a Whipple procedure?

  • Duodenum

  • Esophagus

  • Stomach

  • Jejunum

Correct answer: Duodenum

The Whipple procedure is a complex surgical operation that removes the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, and a portion of the bile duct to treat pancreatic cancer. It involves the resection of the duodenum, which is part of the small intestine and closely involved with pancreatic functions.

The esophagus is not involved in a Whipple procedure, which focuses on the lower parts of the gastrointestinal tract and the pancreas. While the stomach may be partially resected in a Whipple procedure, the duodenum is a more primary focus. The jejunum is another part of the small intestine but is not involved in a Whipple procedure.

145.

In a carpal tunnel release surgery, the transverse carpal ligament is cut to relieve pressure on which nerve?

  • Median nerve

  • Ulnar nerve

  • Radial nerve

  • Axillary nerve

Correct answer: Median nerve

The median nerve is compressed within the carpal tunnel. Releasing the transverse carpal ligament relieves this pressure by allowing more room for the nerve to pass through without constriction.

The ulnar nerve is not typically compressed in the carpal tunnel; it travels in a separate path. The radial nerve is primarily involved in the posterior aspect of the forearm and not affected by the carpal tunnel. The axillary nerve is not related to the wrist area and is unaffected by carpal tunnel syndrome.

146.

A surgical technologist notices that the insulation on a bipolar electrocautery cable is slightly damaged. What is the MOST appropriate action to take to ensure electrical safety?

  • Remove the cable from service and report it according to hospital protocol

  • Continue using the cable as long as it will not be in direct contact with the patient.

  • Wrap the damaged area with medical tape as a temporary fix then address following the conclusion of the procedure

  • Monitor the cable closely for further damage during the procedure

Correct answer: Remove the cable from service and report it according to hospital protocol

Removing the damaged cable from service and reporting it prevents potential electrical safety hazards, ensuring a safe environment for both patients and staff.

Continuing to use the cable, even with no direct contact with the patient, risks electrical safety and is not in line with best practice. 

Wrapping the damaged area with medical tape is a temporary and unsafe solution that does not address the underlying risk of electrical hazards. 

Monitoring the cable for further damage does not eliminate the immediate risk presented by the damaged insulation and could lead to safety incidents.

147.

What is the MOST appropriate action if a surgical technologist notices a small tear in their glove during a procedure?

  • Immediately change the glove using proper aseptic technique

  • Continue the procedure without changing the glove to avoid delay

  • Cover the tear with another glove and continue the procedure

  • Apply a sterile adhesive bandage over the tear and continue

Correct answer: Immediately change the glove using proper aseptic technique

Changing the glove immediately, using aseptic technique ensures maintenance of a sterile environment and adherence to universal precautions.

Continuing with a torn glove risks contamination and breaches universal precautions. 

Covering the tear with another glove does not adequately address the risk of contamination; replacing the glove is best practice. 

Applying a sterile adhesive bandage does not provide a sterile barrier or adhere to standard precautions.

148.

A patient scheduled for a nephrectomy due to renal carcinoma would require careful monitoring of which postoperative parameter to assess for potential complications?

  • Serum creatinine levels

  • Liver enzyme levels

  • Amylase levels

  • Blood glucose levels

Correct answer: Serum creatinine levels

Creatinine is eliminated by the kidney and provides a direct insight into kidney function. Monitoring serum creatinine levels post-nephrectomy is crucial to assess kidney function and detect renal impairment.

Liver enzyme levels are not directly relevant to kidney function and are not the primary concern post-nephrectomy. Amylase levels are related to pancreatic function and are not a focus post-nephrectomy. Blood glucose levels, while important, are not the primary monitoring focus after a kidney removal.

149.

During a thyroidectomy, careful consideration must be given to the preservation of the parathyroid glands due to their role in which of the following?

  • Regulating calcium levels in the blood

  • Controlling the rate of metabolism

  • Regulating blood sugar levels

  • Producing adrenaline in response to stress

Correct answer: Regulating calcium levels in the blood

The parathyroid glands are crucial in regulating calcium levels in the blood through the secretion of parathyroid hormone. This hormone increases the release of calcium from bones, absorption of calcium in the intestines, and reabsorption of calcium in the kidneys, thereby balancing calcium levels in the blood.

Controlling the rate of metabolism is primarily the function of the thyroid gland, not the parathyroids. 

Regulating blood sugar levels is primarily the function of the pancreas through insulin and glucagon, not the parathyroids. 

Producing adrenaline in response to stress is the function of the adrenal glands, not the parathyroids.

150.

Before assembling a laparoscopic instrument set, what is the FIRST step to ensure the equipment's functionality?

  • Inspect for physical damage

  • Sterilize the instruments

  • Lubricate the moving parts

  • Test any electrical components

Correct answer: Inspect for physical damage

The first step before assembling a laparoscopic instrument set is to inspect for physical damage to ensure all components are in proper working condition. This is crucial for the functionality and safety of the equipment.

Sterilizing the instruments before inspection might lead to sterilizing damaged or malfunctioning equipment, wasting resources and potentially compromising patient safety. 

Lubricating moving parts before ensuring the equipment is damage-free could mask problems or interfere with a thorough inspection. 

Testing the electrical components is important but should follow an initial physical inspection to identify any visible damage or defects.

151.

A patient presents with a swollen, painful knee and history of a sports injury. What pathology is MOST likely for this patient?

  • Meniscal tear

  • Osteoporosis

  • Tendonitis

  • Bursitis

Correct answer: Meniscal tear

Meniscal tears are common knee injuries in sports and typically present with pain, swelling, and difficulty moving the knee, aligning well with the patient’s symptoms.

Osteoporosis is a generalized bone density loss, more likely leading to fractures than localized pain and swelling in the knee from a sports injury. 

Tendonitis could cause pain and swelling but is usually associated with tendon overuse or strain rather than a direct injury from sports, making it less likely than a meniscal tear. 

Bursitis is inflammation of the bursae and could cause knee swelling; however, it's less likely to produce severe pain and movement difficulty after an acute sports injury when compared to a meniscal tear.

152.

During a major abdominal surgery, the surgical technologist notices that the estimated blood loss (EBL) is approximately 1,500 mL. What is the MOST appropriate blood product to administer initially?

  • Packed red blood cells

  • Fresh frozen plasma

  • Platelet concentrate

  • Cryoprecipitate

Correct answer: Packed red blood cells

Packed red blood cells are the most appropriate choice for replacing significant blood loss, as they increase oxygen-carrying capacity and maintain hemoglobin levels.

Fresh frozen plasma is used for replacing clotting factors, not primarily for volume expansion or red cell replacement. 

Platelet concentrate is used when there is a specific need for platelets, such as in thrombocytopenia or active bleeding due to a platelet function defect. 

Cryoprecipitate is used for specific factor deficiencies like fibrinogen, factor VIII, and von Willebrand factor, not for general blood volume replacement.

153.

When using a Finochietto rib spreader during a thoracotomy, what is the MOST important action to ensure patient safety and optimal surgical exposure?

  • Incrementally adjusting the spreader to avoid rib fractures

  • Spreading the ribs as far apart as possible to maximize visibility

  • Ensuring that steady traction is applied using the spreader for the entire duration of the procedure

  • Using the spreader for less than one hour at a time

Correct answer: Incrementally adjusting the spreader to avoid rib fractures

Incrementally adjusting the Finochietto rib spreader helps to prevent rib fractures by gradually increasing the space within the thoracic cavity, thereby ensuring patient safety while still providing optimal surgical exposure.

Spreading the ribs as far apart as possible can lead to excessive strain on the ribs and surrounding tissues, increasing the risk of rib fractures and tissue damage, which is counterproductive to patient safety. 

While steady traction is important, the key to safety and effectiveness is not the constant application of force but the careful and gradual adjustment of the spreader to prevent damage to the ribcage and surrounding tissues. 

The duration of use for the spreader is less important than the method of its application.

154.

During the time out process, which of the following is essential to verify FIRST?

  • Correct patient identity

  • Patient's position on the operating table

  • The presence of a signed patient consent

  • Allergy status of the patient

Correct answer: Correct patient identity

Verifying the correct patient identity is the first and most critical step during the time out to prevent wrong person surgery.

While verifying the patient's position is important, it is not the first priority during the time out process. The presence of a signed patient consent is important but is also not the first priority during this process. Allergy status is important but is verified after confirming the patient's identity as part of the comprehensive time out process.

155.

If a high-level disinfection unit displays a "low temperature" error, what is the FIRST action to take?

  • Check the unit's temperature calibration

  • Increase the disinfection time

  • Increase the temperature setting

  • Decrease the load size

Correct answer: Check the unit's temperature calibration

Temperature calibration issues can lead to inaccurate readings and are a common cause of low temperature errors. If the calibration is off, the unit might incorrectly register a lower temperature than it is actually operating at, potentially leading to ineffective disinfection. Checking the calibration is a good first action, as it is most likley to resolve the issue.

Increasing disinfection time does not address the root cause of a temperature error. 

Increasing the temperature setting may not be effective if the unit is not accurately calibrated. Calibration should be checked first prior to increasing the temperature setting. 

Decreasing the load size does not directly address a temperature-related issue.

156.

When inspecting a sterile package before a procedure, which of the following is the MOST critical indicator that the package may have been compromised after sterile?

  • The package is wet, but the sterilization indicator has changed to the correct color

  • The package is dry and intact but past its expiration date

  • There is a small, non-discolored area where the package is slightly indented

  • The sterilization indicator has not changed color, but the package is intact

Correct answer: The package is wet, but the sterilization indicator has changed to the correct color

A wet package, regardless of the sterilization indicator's color change, is considered contaminated because moisture can act as a conduit for bacteria, potentially compromising the sterility of the contents.

While an expired package should not be used, expiration does not immediately indicate a breach in sterility.  

A small, non-discolored indentation may not affect the sterility of the package, especially if the package is otherwise intact and the sterilization indicators show appropriate changes. 

If the sterilization indicator has not changed color, this suggests the sterilization process may not have been effective. This would not, however, be considered a compromise that occurred after sterilization.

157.

During a laparoscopic cholecystectomy, what is the MOST appropriate next step after the introduction of the trocar and insufflation of the abdomen?

  • Insertion of the laparoscope

  • Application of surgical clips to the cystic artery

  • Removal of the gallbladder

  • Closure of the port sites

Correct answer: Insertion of the laparoscope

The laparoscope is inserted immediately after trocar insertion and insufflation to allow visualization of the abdominal cavity, which is the logical next step.

Surgical clips are applied to the cystic artery later in the procedure, after the laparoscope has been inserted and the cystic duct and artery have been identified. 

Removal of the gallbladder is the main objective of the procedure but only occurs after identification and clipping of the cystic duct and artery. 

Closure of the port sites is the final step of the procedure after the gallbladder has been removed and all instruments have been withdrawn.

158.

You observe that the grounding pad for the electrocautery unit has become partially detached during a procedure. What action should you take FIRST to ensure patient safety?

  • Reattach the grounding pad securely to the patient

  • Disconnect the electrocautery unit immediately

  • Alert the anesthesia team about the need for them prepare to apply a new grounding pad

  • Alert the anesthesia team about the potential for cardiac disturbances

Correct answer: Reattach the grounding pad securely to the patient

Ensuring the grounding pad is securely attached to the patient is the first and immediate action to prevent any potential burns or electrical injuries, as it safely completes the electrical circuit used during electrocautery, minimizing the risk to the patient.

While disconnecting the electrocautery unit might seem like a preventive measure, doing so could interrupt the surgical procedure unnecessarily and is unnecessary if the grounding pad is securely reattached. 

It is not the responsible of the anesthesia team to prepare a new grounding pad or reattached the current grounding pad. 

A partially detached grounding pad increases the risk of electrical burns or injury. Alerting the surgical team about any associated risks is not as important as immediately addressing the detachment issue.

159.

A patient is undergoing a retinal tear repair. Which surgical technique is commonly used for sealing a retinal tear?

  • Laser photocoagulation

  • Trabeculectomy

  • Keratoplasty

  • Phacoemulsification

Correct answer: Laser photocoagulation

Laser photocoagulation involves using a laser to create burns around the retinal tear, which leads to scarring that effectively seals the tear and prevents further detachment of the retina.

Trabeculectomy is a surgical procedure used to treat glaucoma by creating an alternative pathway for aqueous humor to drain from the eye, reducing intraocular pressure. This procedure is not related to retinal tear repair. 

Keratoplasty, also known as corneal transplant surgery, replaces part of the cornea with corneal tissue from a donor and is unrelated to treating retinal tears. 

Phacoemulsification is a technique used in cataract surgery where an ultrasonic device breaks up and removes the lens. It is unrelated to sealing retinal tears.

160.

During an emergency appendectomy, the surgeon requests quick estimation of the patient's blood loss (EBL). Which of the following abbreviations correctly denotes the measurement the surgical technologist should report?

  • mL

  • L

  • mg

  • g

Correct answer: mL

Milliliters (mL) is the correct unit for measuring and reporting Estimated Blood Loss (EBL) in a surgical setting, providing a precise and practical measure for blood volume lost.

Liters (L) is too large a unit for the practical measurement of blood loss in most surgical scenarios, as blood loss is usually measured in smaller quantities.

Milligrams (mg) is a unit of mass, not volume, and is therefore inappropriate for measuring blood volume. 

Grams (g) is also a unit of mass and not suitable for estimating blood loss, which is measured in terms of volume.

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