Certified Surgical Technologist Intraoperative Procedures Questions and Answers — Questions and Answers
Question 1: A surgical technologist is preparing a specimen of a breast biopsy for permanent section. Which of the following is the MOST appropriate action for preserving the specimen?
- Place it in a dry, sterile container.
- Immerse it in normal saline.
- Send it immediately to pathology without any solution.
- Place it in a container with formalin. (Correct answer)
Correct answer: Place it in a container with formalin.
For a permanent section, tissue specimens are typically placed in a preservative solution, most commonly 10% formalin, to prevent autolysis and preserve the cellular architecture for later histopathological examination. Dry containers are used for specimens like stones or when special studies are needed. Saline is used for keeping tissue moist for a short period, such as for a frozen section, but not for long-term preservation.
Question 2: During a laparotomy, the surgeon requests irrigation. The surgical technologist has 1,000 mL of sterile normal saline on the back table. After pouring some into a basin, 300 mL remains in the original bottle. The surgeon uses an unmeasured amount from the basin. Later, the circulator adds another 500 mL to the back table supply. At the end of the case, 600 mL is left on the back table. How much irrigation was used?
- 400 mL
- 700 mL
- 900 mL (Correct answer)
- 1,100 mL
Correct answer: 900 mL
To calculate the amount of irrigation used, track the total amount delivered to the sterile field and subtract the amount remaining. Initial amount: 1,000 mL. Added amount: 500 mL. Total on field: 1,000 + 500 = 1,500 mL. Amount remaining: 600 mL. Amount used: 1,500 mL (total) - 600 mL (remaining) = 900 mL.
Question 3: A patient begins to exhibit muscle rigidity, tachycardia, and a rapid rise in end-tidal CO2 shortly after the administration of succinylcholine and sevoflurane. Which of the following is the primary pharmacological agent required to treat this condition?
- Sodium bicarbonate
- Dantrolene (Correct answer)
- Atropine
- Epinephrine
Correct answer: Dantrolene
The patient's symptoms are classic signs of a Malignant Hyperthermia (MH) crisis, a rare but life-threatening reaction to certain anesthetic agents. Dantrolene sodium is the specific antidote for MH, as it works by inhibiting calcium ion release from the sarcoplasmic reticulum of muscle cells, thereby reversing the hypermetabolic state. Sodium bicarbonate may be used to treat metabolic acidosis associated with MH, but it is not the primary treatment.
Question 4: Which of the following describes the correct procedure for the surgical technologist when passing a medication to the surgeon?
- State the medication's name and strength after passing the syringe.
- Announce the medication's name and strength as it is being passed. (Correct answer)
- Assume the surgeon knows the medication requested and pass it silently.
- Only label the syringe and hand it to the surgeon.
Correct answer: Announce the medication's name and strength as it is being passed.
To ensure patient safety and prevent medication errors, the surgical technologist must clearly state the name and strength of the medication aloud as it is being passed to the surgeon. This verbal confirmation is a critical step in the medication administration process on the sterile field, reinforcing the visual label on the syringe or container.
Question 5: When performing the closing count for sponges and sharps, the surgical technologist and the circulator discover a discrepancy. A laparotomy sponge is missing. What is the immediate, primary action that should be taken?
- Document the discrepancy in the patient's chart.
- Begin closing the surgical wound.
- Immediately notify the surgeon. (Correct answer)
- Order an intraoperative X-ray.
Correct answer: Immediately notify the surgeon.
Patient safety is the absolute priority. If a count is incorrect, the surgeon must be notified immediately. The surgeon will then typically direct a systematic search of the wound, sterile field, and surrounding area. Documenting and ordering an X-ray are subsequent steps, but the first action is to inform the surgeon so the search can begin without delay.
Question 6: To maintain sterile technique when opening a wrapped sterile package, which flap should the surgical technologist open LAST?
- The flap furthest away.
- The right-side flap.
- The left-side flap.
- The flap closest to the body. (Correct answer)
Correct answer: The flap closest to the body.
When opening a wrapped sterile package, the flaps should be opened in a specific order to avoid reaching over the sterile contents. The furthest flap is opened first, followed by the side flaps. The final flap, the one nearest to the individual's body, is opened last. This technique prevents the non-sterile arm and body from passing over the exposed sterile field, minimizing the risk of contamination.
Certified Surgical Technologist Intraoperative Procedures Questions and Answers
A surgical technologist is preparing a specimen of a breast biopsy for permanent section.
Which of the following is the MOST appropriate action for preserving the specimen?