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Stack #26033
CHAP 2 PREOPERATIVE PREPARATION
| PART 2 PREOP PREP | ANSWER |
|---|---|
| Room temp for infants and children shoud be maintained as warm as | 85oF |
| Areas needing special cleaning attention on a weekly or monthly routine would include | ceiling and wall mounted fixtures and tracks |
| A glass suction bottle should ideally be | cleaned with a disinfectant solution and autoclaved before reuse |
| Storage shelves must be cleaned with a germicide | each week |
| While a surgical case is in progress | doors should remain closed |
| When cleaning the floor between cases | a clean mop head must be used each time, a two-bucket system, one detergent and one clear water, is used, buckets must be empited and cleaned between ea case, ALL OF THE ABOVE |
| A dropped sterile item may only be used if the | wrapper is imprevious and contact area is dry |
| In the event that a child needs emergency surgery, and the parents cannot be located to sign the permission | a written consultation by two physicians other than the surgeon will suffice |
| The surgical concent form can be witnessed by ea of the following EXCEPT | the surgeon, the nurse, an authorized hospital employee, THE PATIENT'S SPOUSE |
| A general concent form is | a form authorizing all treatments or porcedures |
| The ultimate responsibility for obtaining consent lies with the | surgeon |
| The surgical consent is signed | before administration of preoperative medications |
| an informed consent | protects patient from unratified or unwanted procedures and preotects the surgeon and the hospital from claims of an unauthorized operation |
| Implied consent | is allowed by law in emergencies when no other authorized person may be contacted |
| Which position would be the most desirable for a pilonidal cystectomy or an hemorrhoidectomy | Kraske |
| a postition often used in cranial procedures is called | Fowler's |
| in positioning for laminectomy, rolls or bolsters are placed | longitudinally to support the chest from axilla to hip |
| the position used for a patient in hypovolemic shock is | modified Trendelenbrug |
| A Mayfield table would be used for which type of surgery | neurologic |
| Good exposure for thyroid surgery is ensured by all of the following EXCEPT | modified dorsal recumbent with shoulder roll, hyperextension of the neck, utilization of skin-stay |
| A procedure requiring the patient to be positioned supine in modified lithotomy is | Abdominoperineal resection (APR) |
| In which procedure may the patient be placed in a supine position with the right side slightly elevated by a wedge to tilt the patient to the left | Cesarean section |
| The position for most open bladder surgery would be | supine, bolster under pelvis |
| In which circumstance could the patient sustain injury to the pudendal nerves | positioned on the fracture table |
| Which factor is important to consider when positioning the aging patient | skeletal changes, limited range of motion of joints, tissue fragility, ALL OF THE ABOVE |
| When positioning the patient for a procedure, which of the following provides maximum patient safety and maximum surgical site exposure | patient;s body doesn't touch metal on table, equipment, Mayo stand, and personnel are not resting on pt, bony prominences are padded, ALL OF THE ABOVE |
| When preparing a patient for a breast biopsy, a breast scrub is either eliminated or done very gently because of | dispersal of cancer cells |
| The ideal place to do the shave prep is in the | holding area of the OR |
| Any area that is considered contaminated | should be scrubbed last or separately |
| In preparation for surgery, skin should be washed and painted | from the incision site to the periphery in a cirucular motion |
| Preliminary preparation of the patient's skin begins | with a preoparative shower |
| Suction tubing is attached to the drapes with a | nonperforating clamp |
| When draping a table, the scrub nurse shoud drape | front to back |
| A seamless, stretchable material often used to cover extremities during draping | stockinette |
| Drapes are | placed on a dry area |
| which statement demostrates a break in technique during the draping process | gloved hands may touch the skin of the patient |
| A head drape consists of | medium sheet, towel, towel clip |
| Gowns are considered sterile only from | chest to sterile field level, and sleeves from elbow to cuffs |
| An acceptable action when drying the hands and arms after the surgical scrub is to | dry thoroughly, cleanest area first |
| Which statement regarding the scrub procedure is not true | renders the skin aseptic |
| If the scrub nurse needs to change a glove during an operation | the circulator pulls the glove off |
| Which statement regarding the removal of gown and gloves doesn't meet safe criteria | The gloves are removed before the gown |
| An effective surgical scrub procedure is | time method and brush-stroke method |
| Regarding the surgical scrub, which statement would violate acceptable practice | nail polish may be worn if freshly applied |
| Eyewear, goggles and/or facesshields should be worn | on every case |
| the surgical scrub is | mechanical washing and chemical antisepsis of the skin |
| Scrub technique endos | 2 inches above the elbow |
| Which statement reagarding the surgical scrub indicates INAPPROPRIATE preparation by the scrub | nail polish may be worn, if not chipped |
| Which statement best decribes an effective surgical hand scrub | time or number of strokes, ahnd to elbow sequence |
| The brush-stroke method of scrubbing prescribes the number of strokes required. Indicate the number for ea: nails, fingers, hand and arms | 30,20,20,20 |
| A surgical treatment for scoliosis (is a lateral deviation of the spine) could employ the use of | Harington rods (are internal splints that help maintain the supine as straight as possible) |
| What is a lebsche used for | A Lebsche sternum knife is used in chest surgery to open the sternum |
| A rongeur used extensively in surgery of the spine and in neurosurgery is the | Kerrison rongeur (available in several angles) |
| Bakes are | common duct dilators and have maleable shafts in sizes 3-11mm. they are used to explore the common bile duct |
| A rib retractor is a | Finochietto |
| A Doyen is a | rib raspatory |
| The instrument used to enlarge the burr hole made during a craniotomy is | Rongeur. (an electric drill or a hand perforator is used to make the burr holes. a rongeur is used to enlarge the burr hole) |
| Wescott scissors are used in | ophtalmic surgery |
| The instrument used in a splenectomy is a | pedicle clamp (For splenectomy prepare a basic laparotomy set plus two large right angled pedicle clamps and long instruments and hemostatic material) |
| Bowman probes are used in | to probe the lacrimal duct in a dacrocystorhinostomy and in lacrimal probing to open a closed lacrimal drainage system |
| A Hurd dissector and pillar retractor is used in | tonsillectomy to free the tonsil lobe from its attachments to the pillars |
| The lempert elevator is used in surgery of the | delicate ear surgery |
| A Scoville retractor is used in a | laminectomy |
| A Bailey is a | rib approximator and is used to approximate the ribs for closure of the thoracic incision before closure of the chest |
| A Sauerbruch is a | rib rongeur used to resect a rib and is found in a thoracotomy rib instrument bone set |
| An Auvard is a | speculum that is weighted fro use in the bagina |
| A babcock is used to | grasp delicate structures |
| Nasal cartilage is incised with | Ballenger swivel knife |
| A self-retracting retractor is a | Weitlaner |
| A rectal speculum is a | Hill |
| A small fine needle holder used in plastic surgery is a | Webster |
| A kidney pedicle clamp is a | Herrick |
| Uterine dilators are | Hanks |
| On which set would a Jenning's mouth retractor be found | tonsillectomy set |
| An instrument used to retrieve a needle biopsy from either thyroid, liver, kidney or prostate is | Silverman biopsy needle |
| The instrument used for a corrective rhinoplasty is | a freer elevator to undermine the skin of the nose and free the periosteum and perichondrium |
| The instruments found on an intestinal set up are | The Doyen clamps that come straight or curved |
| The retractor in a thorocotomy set to separate the ribs is | the Bailey rib retractor |
| What is the Green retractor | It is a goiter retractor also known as a loop retractor. It is used to retract the sternocleidomastoid muscle during thyroidectomy |
| An instrument found in a major bone set is a | Stille-Luer Duckbill rongeur. It is used to bite off sharp, irregular bone edges |
| What is a Davidson | A Davidson is a scapula retractor. It is found in a thoracotomy set |
| The instrument used to grasp lung tissue is | the Duval forceps is alung-grasping forcep and is included in the instrumentation for lobectomy and pheumonectomy |
| The instruments found on a vascular set up are | The stinsky and DeBakey are vascular clamps, and the Pott Smith is an angled or straight vascular scissors. The DeBakey cross action bulldog is a clamping instrument |
| The instrument known as bulldog is | A DeBakey bulldog is a cross action clamp, straight or curved. It is used for occlusion of major perpheral arteries. |
| What is a Heaney | A Heaney is a hysterectomy forceps. It has double serrated jaws with cross grooves |
| What is a Potts-Smith instrument | is a vascular scissors that is angled to the side |
| The instrument used to clamp the aorta in an AAA surgery is | The satinsky aortic clamp |
| The Castroviejo needle holder is | used in both eye and plastic surgery as well as other surgeries requiring fine, delicate suture |
| What is a kidney instrument | Randall stone forceps |
| What is a Harrington | it is a retracting instrument frequently used for gallbladder surgery. Its tip is heart-shaped, thus it is sometimes called the sweetheart |
| A techinique utilizing the insertion of a needle or wire thorugh a needle in order to identify suspicious breast tissue is a | wire localization |
| a forceps used to remove stones in billiary surgery is a | Randall stone forcpes |
| Which procedure may require the preparation of a skin graft setup | In a total radical mastectomy, the surgeon may prapare the anterior surface of the thight in the venet a skin graft is needed |
| Right angled pedicle clamps would be found on a setup for | splenectomy |
| Blunt nerve hooks are selected for a | vagotomy setup |
| In which procedural setup would a T-tube be found | exploration of the common bile duct |
| Stapedectomy requires all of the followning EXCEPT | small microsuction, speculum, prothesis, AUTOGRAFT |
| Cochlear implants utilize an electode device | to restore hearing |
| all of the following are required for repair of a nasal fracture | bayonet forceps, splint and Asch forceps |
| A forceps used in nasal surgery is a | Bayonet |
| All of the following instruments can be forund on a nasal setup EXCEPT | Freer elevator, bayonet forceps, POTTS FORCEPS Frazier suction tube |
| On which setup would bougies be found | esophagoscopy (they're esophageal dilators) |
| All of the following can be found on a tonsillectomy setup | yankauer suction, Hurd dissector and pillar retractor and tongue depressor |
| Tissue expanders are used in | breast reconstruction |
| The fracture trated with arch bars is | mandibular and maxillary fractures reductions |
| Rib removal for surgical exposure of the kidney requires all of the following | alexander periosteotome, Doyen raspatory and Sille shears |
| Stone forceps on a kidney set are | Randall |
| A Sarot is a | bronchus clamp |
| Which item would not be included on a setup for a transvenous (endocardial) pacemaker | intra-aortic balloon pump |
| The most frequent conditions requiring the use of a permanent pacemaker are | heart block and bradyarrhythmia |
| Which setup would include distraction and copression components | Harrington rods are internal splints -- the distraction rods placed concave to the curve and the compression rods on the convex side |
| Traction applied directly on bone via pins, wires, or tongs is | Skeletal |
| skeletal traction of a lower leg is accomplished with the use of a | Kirschner wire |
| In orthopedic surgery, the viewing of the progression of the procedure on a television screen is known as | image intensification (flouroscopy) |
| A neurologic study in chich a radiopaque substance is injected into the subarachnoid space through a lumbar puncture is called | Myelogram |
| A neuro headrest skull clamp is called a | Mayfield |
| Maintenance of acceptable blood pressure and prevention of the development of air emboli in the neurosurgical patient can be effected by preoprative utilization of | an antigravity suit |
| A _________ is a mouth gag | Dingman |
| Specialized instruments for a cleft lip rapair would include | Logan's bow (it is applied to the cheeks with tape strips to relieve tension on the incision and to splint the lip. it is a curved metal frame) |
| Cloward instrumentation would be included for suregery of the | cervical spine |
| On which setup would a Bever knife handle be found | eye surgery |
| Which procedure requiers a sterile setup | skeletal traction (traction bow, pins and drills) |
| A craniotomy may employ the use of a ______ for exposure | Leyla-Yasargil self-retracting retractor |
| On which setup would either a Pereyra or a Stamey needle be found | urologic surgery (it is used for bladder neck suspension. it is a ligature carrier |
| Disintegration of kidney stones thorugh a liquid medium is accomplished with an | extracorporeal shock wave lithotriptor |
| A urology perineal retractor system is called | Omni-Tract |
| Which procedure would utilize a Mason-Judd retractor | bladder surgery |
| A Furlow inserter is used in | Penile implantation |
| On which case would a boomerang be found | Prostate surgery |
| A millin is a(n) | retropubic bladder retractor |
| which setup would include a Gomco clamp | circumcision (infants) |
| In which surgical specialty would a HUMI cannula be used | gynecologic |
| an instrument used in laparoscopy to manipulate the uterus for increased structure visibility is the | Hulka Forceps |
| A central venous pressure (CVP) catheter insertion requires | a sterile set up |
| The purpose of a set of Bakes would be | common duct dilation |
| A Steffee plate is a | spinal implant for tx of fractures, spondylolishtesis and idiopathic scoliosis of the thoracolumbar column |
| Skeletal traction is accomplished with | Cruthcfield tongs |
| The Bookwalter is a _______ instrument | retracting |
| Which instrument is a retractor | harrington |
| A long thoracic forceps is a | Schnidt |
| A bougie is a | esophageal dilator |
| Which graft must be obtained with a dermatome | split-thickness mesh graft |
| A Cavitron unit is used for | phacoemulsification |
| The power source for Hall pover equipment is | nitrogen |
| A neurosurgical drill used for precision cutting, shaping, and repari of bone is the | Air Drill 100 |
| In what surgery would a small fragment compression set be used | olecranon fracture |
| A permanent pacemaker operates on a pulse generator powered by | lithium |
| Which item is an air drill | Hall power equipment |
| Hypothermia is employed in cardiac surgery | to reduce oxygen consumption |
| which item is not a comp9onent of a cardiopulmonary bypass system | oxygenator, hear exchanger, VENTRICULAR FIBRILLATOR, pump |
| which movement iin a power instrument drills holes or inserts screws, wires or pins | rotary movement |
| The power instrument that is small, lighweight, free of vibration, and easy to handle for pinpoint accuracy at high speed is | air-powered |
| The power source for the Air Drill 100 is | compressed nitrogen |
| the power source for air-powered dermatomes is | compressed nitrogen and air |
| Suction tubing should be processed in the following way | residual of distilled water in lumen, steam sterilize, tubing coiled |
| The suction tip that is right angled and is used for small amounts of fluid such as in brain surgery is | Ferguson-Frazier suction tip |
| Which suction tip has an angle and is used in the mouth or throat | yankauer |
| When using a cellsaver for autologous blood transfusion, the blood is suctioned through a double lumen tubing and is | heparinized (heparinized saline or citrated dextrose mixes with blood at the tip of the tubing. it is filtered and separated and RBC are washed, infused with saline, and go into a reinfusion bag |
| During orthopedic surgery, the suction tubing shoud be | cleared frequently |
| which type of surgery would require several patent suction cannulas and sucction often controlled by a foot-pedal | ear, nose and throat (ENT) |
| when suctioning in neruosurgery a precaution taken is to | avoid applying vacuum directly on brain or neural tissue |
| A tourniquet is utilized | only when hemorrhage is not contrelled by other methods |
| The proper setting for a tourniquet applied to an arm is | 250-300 mmHg |
| Exsanguination of a limb before tourniquet inflation is accomplished with wrapping the elevated extremity with | Esmarch |
| The amount of pressure used to inflate a tourniquet depends on all of the following EXCEPT | patient's age, size of extremity, DEPTH OF SURGICAL INCISION, systolic blood pressure |
| A regional block that uses the tourniquet is a | Bier block |
| The tourniquet is contraindicated if | a patient's circulation to distal part of extremity is poor |
| Which action drains venous blood during tourniquet application | elevate extremity before thightening tourniquet |
| At what point should the surgeon be informed of the time of tourniquet application | after 1 hour, then every 15 minutes |
| When would the use of Esmarch be contraindicated | when patient has had recent injury and has had recent cast |
| Which agent is NOT used to inflate a pneumatic tourniquet | nitrous oxide |
| A precaution necessary when using a pneumatic tourniquet is | solutions must be prevented from pooling under tourniquet |
| In which procedure would a tourniquet be contraindicated | gangrenous toe amputation |
| A grounding pad is not required for the electrocautery in | a bipolar unit |
| The inactive electrode of the cautery is the | ground pad |
| The electrical circuit of the electrocautery when | current flows to generator to active electrode, through tissue, and back to generator via the inactive electrode |
| why must the electrocautery tip be kept clean | to ensure electrical contract effectiveness |
| in electrocautery "buzzing" refers to | coagulation of vessel via a metal instrument touching the active electrode |
| which electrosurgical unit provides precise control of the coagulated area | bipolar |
| which condition is MOST acceptable when using electrocautery | ground pad placed close to operative site |
| the active electrode on the electrocautery is the | tip |
| A cautery would not be used | in neck or nasopharynx surgery if nitrous oxide is used |
| why are only moist sponges utilized during electrocautery use | to prevent fire |
| if the electrocautery is used through the colonoscope, CO2 should be available to flush out the colon because | gases normally in colon could cause explosion |
| Fulguration is utilized primarily in _________surgery | transurethral resection and prostate operations (TURP) |
| When working in the bladder why is more or higher electrical current necessary during cautery use | more current is needed when working in solution |
| Fulguration via the resectoscope is accpomplished by the use of an ____tip | electrode |
| a direct visualization of the common bile duct is done by means of a | choledochoscope |
| Fiberoptic lighting is | an intense cool light that illuminates body cavities via a bundle of thousands of coated glass fibers. |
| Complications can occur during endoscopy such as | bleeding and perforation |
| an endoscopy procedure that does not requiere a steril set up is | a bronchoscopy |
| Fiberoptic cable integrity is questionable when | dark spots are evident |
| when using a fiberoptic, burns and fires are prevented by | cable is kept away from drapes when disconnected from endoscope; personnel should not lean on cable endo that is disconnected but is still on ; cable end is kept on a moist |
| An economical, practical, and effective way to clean reusable channeled endocsopic instruments initially is with the | endoflush |
| a sterilant that is used on endoscopes that is bactricidal, fungicidal, and sporricidal in 20-30 minutes processing time is | peracetic acid |
| which statement is true regarding a STERIS system for endoscope sterilization | only one scope or a few instruments can be processed in a cycle |
| The endoscope that provides aview of the middle of the thorax, between the two pleural sacs is | mediastinoscope |
| Loupes are used for | magnification |
| Resolving power of an operating microscope means | the ability to discern detail |
| Which item in the optical lens system is responsible for magnification | oculars and objective lens |
| The range of focal lenghts of the objective lenses in the operating microscope is | 100-400mm |
| A continuously variable magnification system is afforded to the eye surgeon by the | zoom lens with foot control |
| The purpose of the "slit" lamp in eye surgery is | defining depth perception |
| The operating microscope that visually employs fiberoptics for its light source is | coaxial illuminators provides intense, cool light |
| Care of the microscope would include | damp dust external surfaces with detergent-disinfectant before use; enclose in an antistatic plastic cover when not in use and clean casters before each use |
| The purpose of the beam splitter in an operating microscope is to | coincide the assistant's field of view with the suregon's |
| The colpomicroscope affords a view of the | cervix |
| The procedure employing the use of a self retaining laryngoscope and microscope is called a | suspension microlaryngoscopy |
| The binocular microscope provides stereoscopic vision. This refers to | the view afforded by double eyepieces |
| Which magnifying powers are available for the microscope eye piece | 10X, 12.5X, 16X and 20X |
| Which procedure is inappropriate when caring for optic lenses | oil or fingerprints are removed by soaking in solvent for 10 minutes and drying with a cotton ball, (correct: they should be removed with a solvent or lens-cleaning solution or 50% denatured alcohol not immersed) |
| The OR bed may have a metal crossbar between the two upper sections which may be raised to elevate the | kidney and gallbladder |
| Which item is also known as an "airplane support" | double arm board |
| Operative accessibility in thyroid surgery may be aided by the use of a | shoulder bridge |
| In which position would shoulder braces be indicated | extreme Trendelenburg |
| A precaution necessary when using the kidney rests is | to press firmly but not too tightly against body, to pad well and to place the longer rest beneath iliac crest |
| Chest rolls (bolsters) | facilitate respiration |
| Bakelite orthopedic table attachments are sometimes used because | the do not interfere with radiographic studies |
| Sponges and towels used near the laser tissue impact site are kept wet in order to | prevent ignition of these materials by reflected beam |
| A laser plume is composed of | carbonized particles, water and odor |
| When using lasers, nonreflective instrumentation | decreases accidental direct reflection of the laser beam to another area |
| Which laser emission is primarily absorbed in tissue by hemoglobin or melanin | Argon (operates in the visible light region in the blue-green spectrum) |
| The fire extinguisher of choice for a laser fire is a | Halon (consists of hudrogenated halocarbons and doesnt produce a residue and has low toxicity) |
| In surgical precodure employing the use of the laser, prep solution on the patient's skin should be pat-dried because | pooled fluids can retain laser heat and subsequently burn tissue |
| Laser surgery performed in the rectal area shoud be preceded by | suctioning of lower bowel to remove methane gas, and packing in the rectum with wet, counted sponges |
| Ebonization refers to | coating of instruments to decrease reflectivity |
| The use of each of the following items are measures employed to readuce laser induce injuries | ebonized instruments, anodized instruments and reflective drapes |
| When utilizing the laser, occupational exposure to suergical smoke via the skin, eye and mucous memebranes is best minimized by the use of | universal precautions |
| Which specialty would employ the use of slit lamp and laser | ophthalmic |
| The laser used primarily for port-wine stain lessons of the skin is the | Ruby |
| People who are near the CO2 laser impact area cna guard against corneal injuries by | wearing amber-tinted lenses |
| Each of the following are measures used to control the effects of the laser plume | smoke evacuators, suctions and high filtration masks |
| wich endotrachal tube is contraindicated during laser suergery | PVC tube |
| what item should be on the scrub person's instrumentation table while the laser is in use | a basin with sterile water or saline (in case of fire) |
| The laser used most commonly for retinal detachment, tear or hole is | argon |
| The tunable dye laser used to disintegrate kidney stones is the | Candela |
| A device used to correct and counteract internal bleeding conditions and hypovolemia is | MAST (medical antishock trouser) |
| Placement of a Levin tube would be in the | stomach |
| a sponge used in brain surgery is a | cottonoid patty |
| The dressing used after nasal surgery is | moustache dressing |
| Seemless tubular cotton that stretches to fit a contour and is used for padding is called a | stockinette |
| Which case would require the use of cottonoid strips | laminectomy |
| An item used for padding that has smooth and clingy layers is called | Webril is a soft, lint-free, cotton bandage |
| Rectal packing is made of | petroleum-treated gauze |
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