NBSTSA Surgical Instrumentation & Equipment 4 — Questions and Answers
Question 1: Which type of needle holder is specifically designed to prevent suture damage when working with delicate, fine suture material?
- Hegar needle holder
- Castroviejo needle holder (Correct answer)
- Crile-Wood needle holder
- Mayo-Hegar needle holder
Correct answer: Castroviejo needle holder
The Castroviejo needle holder has fine, smooth jaws designed for ophthalmic and microsurgical procedures where delicate suture material must not be damaged.
Question 2: A Weitlaner retractor is classified as what type of retractor?
- Hand-held retractor
- Self-retaining retractor (Correct answer)
- Ribbon retractor
- Malleable retractor
Correct answer: Self-retaining retractor
The Weitlaner is a self-retaining retractor with sharp or blunt prongs that lock open to maintain tissue retraction without requiring a hand to hold it.
Question 3: When passing a scalpel to the surgeon during a procedure, the correct technique is to:
- Place it on the sterile field and let the surgeon pick it up
- Hand it handle-first with the blade facing away from both parties
- Pass it blade-down in a kidney basin (Correct answer)
- Place it in the surgeon's hand blade-up to allow grip adjustment
Correct answer: Pass it blade-down in a kidney basin
The safest method is the neutral zone or hands-free technique—placing the scalpel in a basin or designated area rather than hand-to-hand transfer to prevent sharps injury.
Question 4: A Bookwalter retractor system is most commonly used for which type of surgery?
- Cranial surgery
- Abdominal and pelvic surgery (Correct answer)
- Thoracic surgery
- Orthopedic extremity surgery
Correct answer: Abdominal and pelvic surgery
The Bookwalter is a table-mounted, self-retaining ring retractor system designed to provide wide exposure during open abdominal and pelvic procedures.
Question 5: Which instrument is used to crush and occlude the cystic duct before it is ligated and divided during an open cholecystectomy?
- Rochester-Pean clamp
- Mixter right-angle clamp (Correct answer)
- Kelly clamp
- Ochsner clamp
Correct answer: Mixter right-angle clamp
A Mixter (right-angle) clamp is passed around the cystic duct to encircle it, allowing a tie or clip to be placed before transection.
Question 6: The Kerrison rongeur is most frequently used in which surgical specialty?
- General surgery
- Neurosurgery and spine surgery (Correct answer)
- Plastic surgery
- Vascular surgery
Correct answer: Neurosurgery and spine surgery
The Kerrison rongeur is used in neurosurgery and spinal procedures to remove small pieces of bone and ligament, such as during laminectomy.
Question 7: During a laparoscopic procedure, a 10 mm port becomes contaminated. The scrub tech should:
- Continue using the port and decontaminate at case end
- Replace with a new sterile port and re-establish pneumoperitoneum (Correct answer)
- Irrigate the port with saline and continue
- Downsize to a 5 mm port to avoid disruption
Correct answer: Replace with a new sterile port and re-establish pneumoperitoneum
Any contaminated instrument or device must be removed from the sterile field and replaced with a sterile equivalent to maintain aseptic technique.
NBSTSA Surgical Instrumentation & Equipment 4
Which type of needle holder is specifically designed to prevent suture damage when working with delicate, fine suture material?