VTNE Surgical Nursing 4 — Questions and Answers
Question 1: What does the term 'first-intention healing' refer to in wound management?
- Healing by granulation tissue filling an open wound
- Healing of a wound closed primarily with sutures where edges are apposed (Correct answer)
- Delayed primary closure after contamination resolves
- Healing via skin grafting
Correct answer: Healing of a wound closed primarily with sutures where edges are apposed
First-intention (primary) healing occurs when wound edges are surgically apposed with sutures, staples, or adhesive, minimizing scar formation.
Question 2: Which of the following is a correct aseptic technique when opening a sterile package onto the sterile field?
- Drop the item from 12 inches above the field
- Reach across the sterile field to place the item
- Peel back the wrapper and flip the item onto the field without touching the sterile interior (Correct answer)
- Place the entire package on the field and let the scrub tech open it
Correct answer: Peel back the wrapper and flip the item onto the field without touching the sterile interior
The circulating nurse peels back the outer wrapper and presents or drops the sterile item onto the field without touching the sterile interior or reaching over the field.
Question 3: Which of the following is the MOST important factor in preventing surgical site infections (SSI)?
- Using colored suture material
- Proper patient skin preparation and aseptic technique (Correct answer)
- Keeping OR temperature below 60°F
- Administering post-operative antibiotics for 14 days
Correct answer: Proper patient skin preparation and aseptic technique
Rigorous pre-operative skin antisepsis and strict intraoperative aseptic technique are the most critical factors in SSI prevention.
Question 4: During ophthalmic surgery on a dog, the anesthetist observes sudden severe bradycardia. The MOST likely cause is:
- Hyperthermia
- Oculocardiac reflex triggered by traction on the globe or extraocular muscles (Correct answer)
- Hyperkalemia from IV fluids
- Light anesthetic plane
Correct answer: Oculocardiac reflex triggered by traction on the globe or extraocular muscles
The oculocardiac reflex (trigeminal-vagal arc) causes bradycardia when pressure or traction is applied to the globe or periorbital structures.
Question 5: Absorbable suture material is MOST appropriate for which of the following applications?
- Skin closure in a contaminated wound
- Ligation of internal vessels and closure of deeper tissue layers (Correct answer)
- Securing indwelling catheters externally
- Repair of tendons requiring prolonged tensile strength
Correct answer: Ligation of internal vessels and closure of deeper tissue layers
Absorbable sutures are used for internal tissues (fascia, vessels, subcutaneous layers) where eventual degradation eliminates the need for removal.
Question 6: A patient draped for surgery moves and breaks the sterile field. The appropriate response is:
- Continue surgery if only one drape shifted
- Re-drape the patient with new sterile drapes before continuing (Correct answer)
- Apply extra antiseptic to the exposed area and continue
- Document the event and proceed
Correct answer: Re-drape the patient with new sterile drapes before continuing
Any break in the sterile field requires re-establishing sterility with new sterile drapes before the procedure continues.
Question 7: When calculating fluid therapy for a surgical patient, what is the standard intraoperative maintenance rate for a healthy dog?
- 1–2 mL/kg/hr
- 5–10 mL/kg/hr (Correct answer)
- 15–20 mL/kg/hr
- 25 mL/kg/hr
Correct answer: 5–10 mL/kg/hr
The standard intraoperative fluid rate for healthy dogs is 5–10 mL/kg/hr, adjusted for blood loss, hypotension, and individual patient factors.
VTNE Surgical Nursing 4
What does the term 'first-intention healing' refer to in wound management?