NBSTSA Surgical Counts & Safety Protocols

Question 1

According to AORN guidelines, when should the initial (first) surgical count be performed?

Accepted Answer

Before the procedure begins as items are being opened onto the sterile field

Answer

The initial count is performed before the procedure starts, as items are opened onto the sterile field. This establishes the baseline. Subsequent counts occur before closure of a body cavity, before final wound closure, and at any personnel change.

Question 2

During an abdominal case, the scrub tech and circulator discover a discrepant sponge count at wound closure. What is the FIRST action to take?

Accepted Answer

Immediately notify the surgeon before closure proceeds

Answer

The surgeon must be notified immediately before closure proceeds. The surgeon then initiates a methodical search of the wound and room. Closing with an unresolved count discrepancy violates patient safety standards and risks leaving a retained surgical item.

Question 3

What is the primary purpose of the Universal Protocol (Time-Out) immediately before surgical incision?

Accepted Answer

To prevent wrong-site, wrong-procedure, and wrong-patient surgery

Answer

The Universal Protocol, developed by The Joint Commission, requires active verification of patient identity, surgical site (including laterality), and procedure immediately before incision. Its sole purpose is to prevent wrong-site, wrong-procedure, and wrong-patient errors — classified as 'never events.'

Question 4

Surgical sponges used inside body cavities must contain which feature to assist in detecting a retained item?

Accepted Answer

A radiopaque (X-ray detectable) strip

Answer

All surgical sponges intended for use in body cavities must contain a radiopaque marker (typically a barium sulfate-impregnated thread) visible on X-ray. If a count discrepancy cannot be resolved by recounting, an intraoperative radiograph can locate a retained sponge.

Question 5

Which of the following item categories must be counted on every surgical case?

Accepted Answer

Sponges, sharps, and instruments

Answer

Standard surgical counts always include three categories: sponges (all types), sharps (needles, blades, electrosurgical tips), and instruments. All three are counted at procedure start, before body cavity closure, before wound closure, and at any shift or personnel change.

NBSTSA - National Board of Surgical Technology and Surgical Assisting Practice Test

NBSTSA - National Board of Surgical Technology and Surgical Assisting Practice Test

NBSTSA Surgical Counts & Safety Protocols