CRNFA Surgical Instrumentation and Equipment 1 — Questions and Answers
Question 1: Which type of needle holder is most appropriate when suturing delicate cardiovascular tissue?
- Hegar needle holder
- Castroviejo needle holder (Correct answer)
- Mayo-Hegar needle holder
- Crile-Wood needle holder
Correct answer: Castroviejo needle holder
The Castroviejo needle holder is a fine, spring-loaded instrument designed for delicate cardiovascular and ophthalmic suturing.
Question 2: The CRNFA identifies a Metzenbaum scissors on the instrument table. Its PRIMARY use is for:
- Cutting heavy fascia and tissue
- Cutting suture material
- Dissecting delicate tissue (Correct answer)
- Opening skin incisions
Correct answer: Dissecting delicate tissue
Metzenbaum scissors have long, slender blades designed for dissecting and cutting delicate tissue, not for cutting suture.
Question 3: A Bookwalter retractor system is best classified as which type of retractor?
- Hand-held retractor
- Self-retaining retractor (Correct answer)
- Malleable retractor
- Vein retractor
Correct answer: Self-retaining retractor
The Bookwalter is a self-retaining retractor system that attaches to the OR table and holds tissue without requiring manual assistance.
Question 4: When using a monopolar electrosurgical unit (ESU), the dispersive electrode (grounding pad) should be placed:
- On a bony prominence near the operative site
- Over a large muscle mass with good vascularity, as close to the site as practical (Correct answer)
- On the patient's chest regardless of operative site
- On any dry, clean skin surface chosen for convenience
Correct answer: Over a large muscle mass with good vascularity, as close to the site as practical
The dispersive electrode must be placed over a large, well-vascularized muscle mass near the operative site to ensure complete current return and prevent burns.
Question 5: Which instrument is specifically designed to clamp the cystic duct during laparoscopic cholecystectomy?
- Hem-o-lok clip applier
- Ligaclip applier
- Endoloop ligature
- Both A and B are correct (Correct answer)
Correct answer: Both A and B are correct
Both Hem-o-lok clip appliers and Ligaclip appliers are used laparoscopically to occlude the cystic duct and cystic artery during cholecystectomy.
Question 6: The CRNFA is assisting with a bowel resection and selects a GIA stapler. GIA stands for:
- Gastrointestinal anastomosis (Correct answer)
- Gastric intestinal approximation
- General incision apparatus
- Gastrointestinal insertion apparatus
Correct answer: Gastrointestinal anastomosis
GIA stands for gastrointestinal anastomosis; this linear stapler simultaneously places two double rows of staples and cuts between them.
Question 7: A Weitlaner retractor is best described as:
- A hand-held, smooth-tipped retractor for superficial wounds
- A self-retaining retractor with sharp or blunt rake-like prongs (Correct answer)
- A deep pelvic retractor requiring an assistant
- A ribbon/malleable retractor shaped by the surgeon
Correct answer: A self-retaining retractor with sharp or blunt rake-like prongs
The Weitlaner is a self-retaining retractor with outward-spreading ratcheted arms tipped with blunt or sharp prongs, commonly used in small incisions.
CRNFA Surgical Instrumentation and Equipment 1
Which type of needle holder is most appropriate when suturing delicate cardiovascular tissue?