Certified Surgical Technologist Intraoperative Procedures 2 — Questions and Answers
Question 1: When using the Bovie electrosurgical unit, the dispersive electrode (grounding pad) should be placed:
- Over a bony prominence close to the operative site
- On a well-vascularized muscle mass as close to the operative site as possible (Correct answer)
- On the patient's back regardless of surgical site
- Over scar tissue for better adhesion
Correct answer: On a well-vascularized muscle mass as close to the operative site as possible
The dispersive electrode must be placed on a well-vascularized muscle mass close to the operative site to ensure safe current return and prevent burns.
Question 2: During a laparoscopic procedure, CO2 insufflation is used primarily to:
- Reduce the risk of gas embolism
- Create pneumoperitoneum for visualization and instrument access (Correct answer)
- Cool the abdominal organs during surgery
- Prevent bacterial contamination of the peritoneal cavity
Correct answer: Create pneumoperitoneum for visualization and instrument access
CO2 insufflation creates pneumoperitoneum, expanding the abdominal cavity to allow visualization and manipulation of organs during laparoscopic surgery.
Question 3: The scrub technologist notices the surgeon has perforated the bowel during dissection. The FIRST priority is to:
- Immediately close the wound
- Notify the circulator and contain contamination with wet sponges (Correct answer)
- Change all instruments and drapes immediately
- Document the incident in the operative record
Correct answer: Notify the circulator and contain contamination with wet sponges
Containing contamination by isolating the perforated bowel with wet sponges and alerting the circulator is the immediate priority to prevent further peritoneal soiling.
Question 4: Which suture material is MOST appropriate for closing fascia in abdominal procedures?
- Plain gut
- Chromic gut
- Polyglactin 910 (Vicryl)
- Polypropylene (Prolene) (Correct answer)
Correct answer: Polypropylene (Prolene)
Polypropylene is a non-absorbable monofilament suture ideal for fascial closure because it maintains tensile strength permanently and resists infection.
Question 5: When performing a sponge count, the scrub tech and circulator discover a discrepancy. The surgeon should be notified BEFORE:
- The first closing count
- Wound closure begins (Correct answer)
- The final skin closure
- The patient leaves the OR
Correct answer: Wound closure begins
The surgeon must be notified of any sponge count discrepancy before wound closure begins so the wound can be thoroughly explored.
Question 6: During a total hip arthroplasty, the scrub tech should have pulse lavage irrigation ready primarily to:
- Cool the bone cement during polymerization
- Remove bone debris and reduce infection risk in the bone cavity (Correct answer)
- Increase cement adhesion to the prosthesis
- Hydrate the surrounding soft tissue
Correct answer: Remove bone debris and reduce infection risk in the bone cavity
Pulse lavage removes bone debris, fat, and marrow elements from the medullary canal, reducing infection risk and improving cement or press-fit fixation.
Question 7: A Jackson-Pratt (JP) drain is classified as which type of drainage system?
- Passive gravity drain
- Active closed-suction drain (Correct answer)
- Penrose open drain
- Sump drain
Correct answer: Active closed-suction drain
The Jackson-Pratt is an active closed-suction drain that uses negative pressure from a compressed bulb reservoir to remove fluid from the wound.
Certified Surgical Technologist Intraoperative Procedures 2
When using the Bovie electrosurgical unit, the dispersive electrode (grounding pad) should be placed: