CST Perioperative Patient Care 3 — Questions and Answers
Question 1: What is the correct sequence for surgical hand antisepsis using a brush-stroke method?
- Nails, fingertips, hands, wrists, forearms (Correct answer)
- Forearms, wrists, hands, fingertips, nails
- Hands, forearms, wrists, fingertips, nails
- Nails, hands, wrists, forearms, fingertips
Correct answer: Nails, fingertips, hands, wrists, forearms
Surgical scrubbing proceeds from most contaminated (nails/fingertips) to least contaminated (forearms) to prevent recontamination of cleaner areas.
Question 2: Foley catheter insertion in the perioperative setting is primarily performed to:
- Measure urine output and decompress the bladder during lengthy procedures (Correct answer)
- Prevent urinary tract infections in surgical patients
- Administer irrigation fluids directly to the bladder
- Detect renal artery injury during abdominal surgery
Correct answer: Measure urine output and decompress the bladder during lengthy procedures
Indwelling urinary catheters allow continuous monitoring of urine output and prevent bladder distension during prolonged surgeries.
Question 3: Which patient position places the greatest risk for brachial plexus injury?
- Prone
- Supine with arms tucked
- Supine with arms abducted more than 90 degrees (Correct answer)
- Lateral decubitus with axillary roll in place
Correct answer: Supine with arms abducted more than 90 degrees
Abducting the arm beyond 90 degrees stretches the brachial plexus, leading to potential nerve injury during surgery.
Question 4: A patient's preoperative checklist reveals they took their daily aspirin this morning. This is most significant because aspirin:
- Interacts with anesthetic gases causing hypotension
- Inhibits platelet aggregation and increases bleeding risk (Correct answer)
- Elevates heart rate and may cause intraoperative tachycardia
- Reduces the effectiveness of neuromuscular blocking agents
Correct answer: Inhibits platelet aggregation and increases bleeding risk
Aspirin irreversibly inhibits cyclooxygenase, impairing platelet function and increasing intraoperative and postoperative bleeding risk.
Question 5: When counting sponges intraoperatively, the scrub and circulator should:
- Count silently to avoid distracting the surgeon
- Count together aloud, with the scrub separating each sponge (Correct answer)
- Have only the circulator count since they are unsterile
- Count only at the end of the procedure to save time
Correct answer: Count together aloud, with the scrub separating each sponge
Two-person simultaneous counting with audible verbalization and physical separation of each sponge ensures an accurate and accountable count.
Question 6: Which of the following is a sign of air embolism during a surgical procedure?
- Gradual rise in blood pressure
- Sudden decrease in end-tidal CO2 with hypotension (Correct answer)
- Elevated core body temperature
- Muscle fasciculations
Correct answer: Sudden decrease in end-tidal CO2 with hypotension
Air embolism causes a sudden drop in end-tidal CO2 as air obstructs pulmonary circulation, accompanied by cardiovascular collapse.
Question 7: The scrub technologist's primary role during patient positioning is to:
- Operate positioning devices and direct team members
- Maintain sterility of the surgical field while assisting positioning as needed (Correct answer)
- Document all positional aids used in the intraoperative record
- Assess pressure points and neurovascular status postoperatively
Correct answer: Maintain sterility of the surgical field while assisting positioning as needed
The scrub technologist must remain focused on maintaining sterile field integrity while supporting team positioning efforts without contaminating sterile items.
CST Perioperative Patient Care 3
What is the correct sequence for surgical hand antisepsis using a brush-stroke method?