NBSTSA Surgical Instrumentation & Equipment 5 — Questions and Answers
Question 1: Which electrosurgical unit (ESU) mode uses a continuous waveform to provide hemostasis through tissue coagulation?
- Cut mode
- Blend mode
- Coag mode (Correct answer)
- Bipolar mode
Correct answer: Coag mode
Coag mode delivers an intermittent, high-voltage waveform that desiccates and coagulates tissue proteins to achieve hemostasis.
Question 2: What is the primary purpose of a grooved director during surgery?
- To retract tendons away from the operative site
- To guide a scalpel when incising along a structure (Correct answer)
- To dilate a vessel before catheter insertion
- To measure wound depth prior to closure
Correct answer: To guide a scalpel when incising along a structure
A grooved director is placed under a structure (such as a sinus tract or fistula) to guide and protect underlying tissue while the overlying tissue is incised.
Question 3: A bipolar electrosurgical forceps differs from monopolar ESU because it:
- Uses alternating current instead of radio frequency
- Requires a dispersive (grounding) pad placed on the patient
- Passes current only between its two tips, limiting spread (Correct answer)
- Operates at a lower frequency to prevent tissue burns
Correct answer: Passes current only between its two tips, limiting spread
Bipolar ESU confines current between the two forceps tips, making it safer near delicate structures such as nerves and in patients with implanted electronic devices.
Question 4: The Penrose drain is categorized as which type of drain?
- Active closed-suction drain
- Passive open drain (Correct answer)
- Sump drain
- Closed-gravity drain
Correct answer: Passive open drain
The Penrose is a soft latex tube that drains passively by capillary action and gravity without any suction mechanism.
Question 5: When setting up a pneumatic tourniquet for an extremity procedure, the cuff should be placed:
- Distally, just above the joint
- At the widest circumference of the extremity, proximal to the operative site (Correct answer)
- Directly over a bony prominence to prevent slipping
- At the mid-shaft level regardless of anatomy
Correct answer: At the widest circumference of the extremity, proximal to the operative site
The cuff is placed at the widest part of the limb proximal to the surgical site to evenly distribute pressure and protect neurovascular structures.
Question 6: A Harrington retractor (sweetheart retractor) is primarily used to retract which structure?
- The kidney during nephrectomy
- The liver during upper abdominal surgery (Correct answer)
- The bladder during pelvic dissection
- The lung during thoracotomy
Correct answer: The liver during upper abdominal surgery
The curved, heart-shaped blade of the Harrington retractor is designed to gently retract the liver during upper abdominal procedures such as cholecystectomy or esophageal surgery.
Question 7: Which stapling device is used to create an anastomosis between two hollow viscera (e.g., bowel segments) in a circular, end-to-end fashion?
- Linear cutter (GIA stapler)
- Proximate skin stapler
- Circular (EEA) stapler (Correct answer)
- TA (thoracoabdominal) stapler
Correct answer: Circular (EEA) stapler
The EEA (end-to-end anastomosis) circular stapler simultaneously places two concentric rows of staples and cuts a circular core to create a lumen between two hollow structures.
NBSTSA Surgical Instrumentation & Equipment 5
Which electrosurgical unit (ESU) mode uses a continuous waveform to provide hemostasis through tissue coagulation?