CST Postoperative Duties 3 — Questions and Answers
Question 1: A needle is discovered missing during the closing needle count. What is the FIRST action the scrub ST should take?
- Inform the surgeon and circulator immediately and search the sterile field (Correct answer)
- Complete the closure and search after the patient is transferred
- Notify the charge nurse but continue the case quietly
- Recount only the sponges to rule out a mix-up
Correct answer: Inform the surgeon and circulator immediately and search the sterile field
An unresolved needle count discrepancy must be reported immediately so the surgical team can search the field and wound before closure is completed.
Question 2: Which postoperative task is the scrub ST responsible for regarding sharps disposal?
- Placing all sharps in an approved puncture-resistant sharps container (Correct answer)
- Recapping needles with one hand and discarding in regular waste
- Passing uncapped sharps back to the circulator for disposal
- Leaving sharps on the Mayo stand for instrument processing staff
Correct answer: Placing all sharps in an approved puncture-resistant sharps container
All sharps must be disposed of in approved puncture-resistant containers to comply with OSHA bloodborne pathogen standards.
Question 3: What is the correct order of postoperative counts for a laparotomy?
- Sharps, sponges, instruments — performed before closing each layer (Correct answer)
- Instruments only, performed once at the very end of the case
- Sponges first at closure, then instruments after the patient leaves
- Counts are only required when a discrepancy is suspected
Correct answer: Sharps, sponges, instruments — performed before closing each layer
Sharps, sponges, and instruments are counted before closing each anatomical layer per AORN guidelines to ensure nothing is retained.
Question 4: After a postoperative case, the scrub ST notices a suture needle is unaccounted for. An X-ray is taken and the needle is NOT visible. What is the appropriate next step?
- Document the incident and complete an occurrence report per facility policy (Correct answer)
- Assume the count was wrong and proceed without further action
- Re-scrub the ST and restart the counts from the beginning
- Discharge the patient immediately to avoid liability
Correct answer: Document the incident and complete an occurrence report per facility policy
An unresolved count discrepancy requires an occurrence/incident report and full documentation regardless of X-ray results.
Question 5: Which of the following is the scrub ST's role during dressing application?
- Pass dressing materials to the surgeon in the correct order while maintaining sterility (Correct answer)
- Apply the dressing directly to the wound without surgeon involvement
- Hand non-sterile supplies from the circulator to the surgeon
- Document dressing type in the electronic health record
Correct answer: Pass dressing materials to the surgeon in the correct order while maintaining sterility
The scrub ST passes sterile dressing materials (e.g., telfa, gauze, tape) to the surgeon in the correct sequence while maintaining sterile technique.
Question 6: How should the scrub ST handle a knife blade after the skin is closed?
- Remove the blade with a needle holder and dispose in a sharps container (Correct answer)
- Leave the blade on the scalpel handle for decontamination staff
- Recap the blade with the original plastic sheath and discard
- Pass the loaded scalpel to the circulator for disposal
Correct answer: Remove the blade with a needle holder and dispose in a sharps container
Knife blades must be removed using a needle holder (never by hand) and discarded directly into a sharps container to prevent injury.
Question 7: When transferring a postoperative patient from the OR table, the scrub ST should:
- Assist with the transfer while protecting IV lines, drains, and the surgical site (Correct answer)
- Remain scrubbed and stationary at the back table during the transfer
- Operate the OR table controls while anesthesia manages the patient
- Remove all monitoring equipment before the transfer begins
Correct answer: Assist with the transfer while protecting IV lines, drains, and the surgical site
The ST assists in safe patient transfer by helping protect tubes, drains, and the wound site while coordinating with the team.
CST Postoperative Duties 3
A needle is discovered missing during the closing needle count.
What is the FIRST action the scrub ST should take?