CST Perioperative Patient Advocacy 3 — Questions and Answers
Question 1: A patient who speaks only Spanish is about to be transferred into the OR. No interpreter is present and the consent form is in English only. What is the appropriate action?
- Proceed because the surgeon verbally explained the procedure
- Delay transport until a qualified interpreter and translated consent are obtained (Correct answer)
- Use a bilingual staff member from another department as a temporary interpreter
- Ask a Spanish-speaking family member in the waiting room to translate the form
Correct answer: Delay transport until a qualified interpreter and translated consent are obtained
Informed consent requires that the patient fully understands the procedure in their own language; surgery should be delayed until a qualified medical interpreter and properly translated consent are secured.
Question 2: The surgical technologist witnesses the surgeon make a derogatory comment about the unconscious patient's appearance. What is the best course of action?
- Ignore it since the patient cannot hear and no harm is done
- Report the incident to the charge nurse or supervisor after the case (Correct answer)
- Laugh along to maintain team rapport
- Confront the surgeon loudly in the OR to make a point
Correct answer: Report the incident to the charge nurse or supervisor after the case
Disrespectful comments about anesthetized patients violate professional and ethical standards and should be reported to supervisory staff after the case.
Question 3: Which action BEST demonstrates the scrub tech's role as a patient advocate during the intraoperative phase?
- Completing the instrument count quickly to reduce case time
- Voicing concern when a sponge count discrepancy is not immediately resolved (Correct answer)
- Following the surgeon's preference card without deviation
- Positioning the Mayo stand to maximize the surgeon's comfort
Correct answer: Voicing concern when a sponge count discrepancy is not immediately resolved
Speaking up when a count discrepancy is unresolved directly protects the patient from a retained surgical item, which is a core advocacy function.
Question 4: A patient in pre-op tells the circulating nurse she wants to remove her hearing aids but is worried she will not be able to communicate her pain after surgery. The scrub tech hears this concern. What is the best response?
- Assure the patient her hearing aids will be labeled and returned post-op, and document the communication need (Correct answer)
- Tell the patient that nursing staff in PACU will manage her needs
- Advise her to keep her hearing aids in during the entire procedure
- Suggest she write down her concerns on a notepad before surgery
Correct answer: Assure the patient her hearing aids will be labeled and returned post-op, and document the communication need
Documenting the patient's communication need and ensuring proper labeling and return of her devices directly addresses her concern and supports continuity of patient-centered care.
Question 5: A surgeon asks the scrub tech to hand off a surgical specimen to an unlabeled container. What action best protects the patient?
- Hand off the specimen and label the container after the case
- Refuse the handoff until the specimen container is properly labeled with required patient identifiers (Correct answer)
- Ask the circulator to label it while the handoff occurs simultaneously
- Accept the specimen and inform pathology verbally of the patient's identity
Correct answer: Refuse the handoff until the specimen container is properly labeled with required patient identifiers
Specimens must be transferred only to labeled containers with two patient identifiers to prevent misidentification, which could result in wrong diagnosis or treatment.
Question 6: While preparing the sterile field, the scrub tech learns the patient is a Jehovah's Witness who has refused blood products. The surgeon has not updated the preference card to reflect this. What should the scrub tech do?
- Proceed with a standard setup since the surgeon manages intraoperative decisions
- Notify the circulator and surgeon so the team can plan for blood conservation techniques and confirm the patient's wishes are documented (Correct answer)
- Set up blood products on standby in case of emergency
- Assume the anesthesiologist has already addressed the blood refusal
Correct answer: Notify the circulator and surgeon so the team can plan for blood conservation techniques and confirm the patient's wishes are documented
The scrub tech must communicate the blood refusal to the team so bloodless surgery techniques can be prepared and the patient's documented wishes are respected intraoperatively.
Question 7: During a procedure, the scrub tech notices an incorrect implant size has been opened compared to what is documented in the patient's chart. The surgeon has not yet requested it. What is the priority action?
- Wait for the surgeon to request the implant before raising a concern
- Immediately notify the circulator and surgeon of the discrepancy before the implant is used (Correct answer)
- Use the opened implant since it is already sterile and on the field
- Document the discrepancy and proceed at the surgeon's discretion
Correct answer: Immediately notify the circulator and surgeon of the discrepancy before the implant is used
Identifying an implant size discrepancy before it is used prevents a wrong-size implant event; immediate notification allows the team to obtain the correct implant.
CST Perioperative Patient Advocacy 3
A patient who speaks only Spanish is about to be transferred into the OR.
No interpreter is present and the consent form is in English only.
What is the appropriate action?