NBSTSA Surgical Instrumentation and Equipment 2 — Questions and Answers
Question 1: Electrosurgical units (ESU) use which principle to cut and coagulate tissue?
- Direct current to stimulate muscle contraction
- High-frequency alternating current to generate heat in tissue (Correct answer)
- Laser energy converted to electrical impulses
- Low-voltage DC applied through bipolar forceps only
Correct answer: High-frequency alternating current to generate heat in tissue
ESUs use high-frequency alternating current (radiofrequency energy) that generates heat within tissue for cutting and coagulation without stimulating neuromuscular tissue.
Question 2: What is the correct placement of the dispersive electrode (patient return electrode) during monopolar electrosurgery?
- Over a bony prominence closest to the surgical site
- On a well-vascularized, fleshy muscle mass away from implants and ECG leads (Correct answer)
- Anywhere on the patient's back for convenience
- Directly under the operative site to minimize current travel distance
Correct answer: On a well-vascularized, fleshy muscle mass away from implants and ECG leads
The dispersive electrode must be placed on a well-vascularized, large muscle mass to ensure uniform current dispersal and avoid burns; bony prominences reduce contact and increase risk.
Question 3: A powered surgical drill used in orthopedic surgery must be inspected before use for which of the following?
- Battery charge, chuck integrity, and sterility of the handpiece and attachments (Correct answer)
- Only the battery charge level
- The brand name to confirm compatibility with the surgeon's preference
- Color-coding of the attachment to match the surgical set
Correct answer: Battery charge, chuck integrity, and sterility of the handpiece and attachments
Before use, orthopedic power equipment must be checked for adequate power, secure chuck function, and confirmed sterility of the handpiece and all attachments.
Question 4: Which suction device is preferred for removing blood and fluid from a deep abdominal cavity?
- Frazier suction tip
- Yankauer suction tip
- Poole suction tip (Correct answer)
- Baron suction tip
Correct answer: Poole suction tip
The Poole suction tip has a large-bore outer guard with multiple perforations, making it ideal for evacuating large volumes of fluid from the peritoneal cavity.
Question 5: Metzenbaum scissors are most appropriately used for which of the following?
- Cutting heavy fascia and sutures
- Delicate tissue dissection and cutting fine sutures (Correct answer)
- Trimming bone during orthopedic procedures
- Cutting staple lines in bowel anastomosis
Correct answer: Delicate tissue dissection and cutting fine sutures
Metzenbaum scissors are lightweight, fine-tipped scissors intended for blunt dissection and cutting delicate tissue, not for heavy materials.
Question 6: A Penrose drain is classified as which type of wound drain?
- Active closed-suction drain
- Passive open drain (Correct answer)
- Trocar-placed closed drain
- Sump drain with double lumen
Correct answer: Passive open drain
A Penrose drain is a passive, open drain — a soft latex tube that allows fluid to flow by gravity and capillary action without suction.
Question 7: When handing a scalpel to the surgeon using the neutral zone (hands-free) technique, the scrub tech should:
- Hand the scalpel directly handle-first to the surgeon's dominant hand
- Place the scalpel in a designated neutral zone container or basin for the surgeon to retrieve (Correct answer)
- Pass the scalpel blade-first to improve grip during transfer
- Announce the pass verbally and hand it directly to avoid delay
Correct answer: Place the scalpel in a designated neutral zone container or basin for the surgeon to retrieve
The neutral zone technique requires placing the sharp instrument in a designated container or zone so the surgeon and scrub never handle it simultaneously, reducing sharps injury risk.
NBSTSA Surgical Instrumentation and Equipment 2
Electrosurgical units (ESU) use which principle to cut and coagulate tissue?