JCAHPO Assisting with Interventions & Procedures 4 — Questions and Answers
Question 1: After application of cryotherapy for retinal tears, the expected immediate tissue response observed by the surgeon is:
- Blanching and whitening of the treated retinal tissue (Correct answer)
- Hemorrhage at the site of application
- Immediate adhesion of the detached retina
- Bubble formation in the vitreous cavity
Correct answer: Blanching and whitening of the treated retinal tissue
Cryotherapy causes immediate blanching and whitening (ice ball formation) of the retinal and choroidal tissue at the treatment site, confirming adequate freeze application.
Question 2: Which of the following best describes the assistant's responsibility when handling intraocular lenses (IOLs) during cataract surgery?
- Loading the IOL into the injector using bare hands for speed
- Following the manufacturer's guidelines for loading and handling to avoid contamination or damage (Correct answer)
- Storing the IOL in normal saline for at least 30 minutes before use
- Inspecting the IOL optic by touching the central optical zone to check clarity
Correct answer: Following the manufacturer's guidelines for loading and handling to avoid contamination or damage
IOLs must be handled strictly per manufacturer instructions using appropriate instruments to avoid contamination of the optic or haptics, which could lead to complications.
Question 3: During a trabeculectomy, a mitomycin C-soaked sponge is placed on the sclera. What special handling precaution must the surgical assistant observe?
- Sponge should be applied with bare fingers to the episcleral tissue
- Sponge should be handled with forceps and all MMC-saturated materials must be safely discarded per hazardous waste protocols (Correct answer)
- MMC sponge should be rinsed with BSS and reused for the fellow eye
- The sponge does not require special handling as MMC is non-toxic at ophthalmic concentrations
Correct answer: Sponge should be handled with forceps and all MMC-saturated materials must be safely discarded per hazardous waste protocols
Mitomycin C is a cytotoxic chemotherapeutic agent; all MMC-soaked materials must be handled with instruments (not bare hands) and disposed of as hazardous/chemotherapy waste.
Question 4: When assisting with laser photocoagulation for diabetic retinopathy, which contact lens is commonly used to provide a wide-field view of the retina?
- Goldmann three-mirror lens
- Panfunduscope or wide-field lens such as the Mainster or Volk lens (Correct answer)
- Koeppe goniolens
- Humphrey central field analyzer lens
Correct answer: Panfunduscope or wide-field lens such as the Mainster or Volk lens
Wide-field contact lenses such as the Mainster or Volk panfunduscope provide a broader view of the peripheral retina needed for panretinal photocoagulation in diabetic retinopathy.
Question 5: A patient undergoing a dacryocystorhinostomy (DCR) will have a silicone tube placed. What is the purpose of this tube?
- To drain the aqueous humor from the anterior chamber
- To stent the newly created opening between the lacrimal sac and nasal cavity, keeping it patent during healing (Correct answer)
- To deliver antibiotic medication directly to the lacrimal gland
- To measure tear production during the postoperative period
Correct answer: To stent the newly created opening between the lacrimal sac and nasal cavity, keeping it patent during healing
Silicone stenting tubes maintain patency of the surgically created dacryocystorhinostomy opening during the healing period to prevent scarring and closure.
Question 6: Before assisting with Botox (onabotulinumtoxinA) injections for blepharospasm, what is the most important documentation the assistant should verify?
- That the patient has not eaten for six hours
- That informed consent has been signed and the correct dilution and dosage are confirmed (Correct answer)
- That the patient's pupils have been dilated
- That a topical steroid has been applied to the injection sites
Correct answer: That informed consent has been signed and the correct dilution and dosage are confirmed
Informed consent and verification of the correct dilution and unit dosage of botulinum toxin are mandatory safety steps before injection to ensure safe and appropriate treatment.
Question 7: During probing and irrigation of the nasolacrimal duct in an infant, the assistant's primary role is to:
- Perform the probing independently while the physician observes
- Swaddle or restrain the infant safely and pass instruments to the physician as needed (Correct answer)
- Administer general anesthesia to the infant
- Irrigate the nasolacrimal system using a Yankauer suction tip
Correct answer: Swaddle or restrain the infant safely and pass instruments to the physician as needed
The assistant safely restrains or ensures the infant is swaddled and immobile during the procedure and provides instruments to the physician on demand.
JCAHPO Assisting with Interventions & Procedures 4
After application of cryotherapy for retinal tears, the expected immediate tissue response observed by the surgeon is: