Nbstsa Cfsa – Best Study Guide

Which of the following is an affirmative defense that alleges that the plaintiff is mutually responsible for an injury through a lack of care in combination with negligence of the healthcare provider? o Malevolence o Comparative negligence o Malfeasance o Contributary negligence - Answers- o Contributary negligence Which of the following intraoperative procedures is used to visualize the cystic, hepatic, and common ducts? o Barium enema o Intravenous pyelography o Cholangiography o Upper gastrointestinal series - Answers- Cholangiography Which of the following are safety factors to consider when using electrosurgery unites (ESU)? o All active electrodes should be stored in an insulated holster o All jewelry should be removed to prevent risk of potential burns to the patient o Any malfunctioning ESU should be serviced before and after each case o Dispersive electrodes should not be located in proximity to internal implants - Answers- o All active electrodes should be stored in an insulated holster o All jewelry should be removed to prevent risk of potential burns to the patient o Dispersive electrodes should not be located in proximity to internal implants To reduce radiation exposure to a patient's reproductive organs, shields should be placed over which of the following regions? o Hips o Abdomen o Upper leg o Thoracic cavity - Answers- o Hips o Abdomen o Upper leg Which of the following radiopaque contrast media are appropriate for cholangiogram? o Optiray o Omnipaque o Barium sulfate o Hypaque - Answers- o Optiray o Omnipaque o Hypaque Which of the following denotes a civil wrong committed against a person or property, excluding a breach of contract? o Tort o Fraud o Assault o Nonfeasance - Answers- o Tort Which of the following doctrines state that a surgeon may, in certain cases, rely on the professionalism of the surgical first assistant and delegate responsibility for a certain injury? o Res ipsa loquitur o Detrimental reliance o Foreseeability o Respondeat superior liability - Answers- o Detrimental reliance The legal argument that allows a defendant to show that the patient's condition was caused by factors other than negligence is: o Denial o Affirmative defense o Consequential damages o Technical defense - Answers- o Affirmative defense A patient in the preoperative holding area has questions about a surgical procedure. The surgical first assistant should: o Answer the questions o Ask the anesthesia provider to answer the questions o Ask the surgeon to speak with the patient o Proceed with the procedure - Answers- o Ask the surgeon to speak with the patient According to Maslow's Hierarchy of Needs which of the following patient needs should be met first? o Esteem o Safety o Physiological o Belonging - Answers- o Physiological A patient who is opposed to the acceptance of blood transfusion on religious principle is undergoing a hysterectomy. During surgery, there was significant blood loss causing hematocrit to drop to 30% with a resulting drop in oxygen saturation. Under these conditions, which of the following is the appropriate response? o Change IV fluid to dextrose 5% with water o Transfuse whole blood o Increase fluid drop to allow hemodilution o Transfuse platelets. - Answers- o Increase fluid drop to allow hemodilution Which of the following should take place when an incorrect and unresolved count occurs? o Filing an incident report o Documenting the incident on the MedWatch reporting form o Reporting the incident to The Joint Commission o Noting the occurrence in the patient's permanent record - Answers- o Filing an incident report Which of the following radiological techniques is described as an x-ray beam that moves back and forth across the body to project cross-sectional images? o Computerized axial tomography (CAT) o Angiography o Ultrasonography o Magnetic resonance imaging (MRI) - Answers- o Computerized axial tomography (CAT) Disaster plans developed by the hospital disaster committee should be tested in drills how many times per year? o 1 o 2 o 3 o 4 - Answers- o 2 If a Kelly clamp is left in a patient who underwent a cholecystectomy, which of the following legal charges can be filed? o Res ipsa loquitur o Intentional tort o Foreseeability o Primum non nocere - Answers- o Res ipsa loquitur Which of the following organisms normally found on the skin can cause wound infections? o Diplococcus pneumonia o Bacillus botulinum o Staphylococcus aureus o Candida albicans - Answers- o Staphylococcus aureus An adult male is injured in an automobile accident at 2 AM. An exploratory laparotomy for possible perforated bowel is initiated at 5 AM. Which of the following is the best wound classification in this scenario? o Clean o Clean-contaminated o Contaminated o Dirty or infected - Answers- o Contaminated Rough and excessive handling of tissue (intestines or blood vessels) by the surgical first assistant can result in which of the following results? o Paralytic ileus o Portal insufficiency o Hypovolemia o Increased inflammatory response - Answers- o Paralytic ileus o Increased inflammatory response An obese malnourished patient who presents of surgery is a higher risk for: o Malignant hyperthermia o Postoperative hypothermia o Postoperative hyperkalemia o Wound infection - Answers- o Wound infection To reduce the incidence of surgical site infection in a patient with an anticipated Class 2 wound, which of the following actions should be taken? o Remove hair at the surgical site o Maintain a blood glucose level of 70-110 mg/dL o Regulate normothermia o Administer 72 hours of prophylactic antibiotics - Answers- o Remove hair at the surgical site o Maintain a blood glucose level of 70-110 mg/dL o Regulate normothermia A wound that is known to be infected at the time of surgery and is left open to be closed at a later date is categorized as: o First intention o Delayed primary closure o Granulation o Second intention - Answers- o Delayed primary closure Which of the following techniques demonstrates a proven benefit in the prevention of postoperative wound infections? o Administering appropriate antibiotics within 1 hour of incision time o Maintaining suitable antibiotic coverage for 48-72 hours postoperatively o Irrigating the wound with normal saline o Irrigating the wound with sterile water - Answers- o Administering appropriate antibiotics within 1 hour of incision time A type of wound in which the alimentary, oropharyngeal, respiratory, or genitourinary regions are entered is classified as: o Clean o Clean-contaminated o Infected o Contaminated - Answers- o Clean-contaminated The initial reaction to invasion of a foreign body or a local injury is called: o Neovascularization o Infection o Inflammation o Immunity - Answers- o Inflammation Which of the following are the most important considerations when preventing wound infection in the surgical patient? o Pathogen transmittal o Portal of entry into the susceptible host o Anesthetic options for the patient's operative process o Invasion of the susceptible host - Answers- o Pathogen transmittal o Portal of entry into the susceptible host o Invasion of the susceptible host Sutures are usually removed within the fifth to sixth day postoperatively. Sutures should be left in longer in which of the following situations? o Incision is closed under tension o Incision is in the hand o Patient is diabetic o Suture tracts show signs of infection - Answers- o Incision is closed under tension o Incision is in the hand o Patient is diabetic A 70-year-old patient who underwent an 8-hour colon resection is at the greatest risk for which of the following? o Postoperative infection o Hyperthermia o Diverting colostomy o Myocardial infarction - Answers- o Postoperative infection A patient returns to the OR 1 week postoperatively with wound dehiscence. Which of the following phases of the wound healing process has been interrupted? o Granulation o Inflammatory o Remodeling o Proliferative - Answers- o Proliferative In patients who who develop fever, abdominal pain, and profuse diarrhea, the most frequently seen antibiotic-associated enterocolitis is due to which of the following organisms? o Clostridium difficile o Enterobacter cloacae o Enterococcus faecalis o Pseudomonas aeruginosa - Answers- o Clostridium difficile When considering the plain of care for an 80-year-old obese male with diabetes undergoing thoracotomy for lobectomy, which of the following immediate factors can be altered to influence wound healing? o The patient's BMI o The time of day the procedure is performed o The suture material selected o A postoperative exercise program - Answers- o The suture material selected A long-term complication of a cemented total hip arthroplasty is: o Posterior dislocation o Loosening of the prosthesis o Anterior dislocation o Impingement of the sciatic nerve - Answers- o Loosening of the prosthesis Which of the following bones is the most superior tarsal and articulates with the distal end of the tibia? o Talus o Cuboid o Calcaneus o Navicular - Answers- o Talus During chest tube placement, it is most important to place the tube in the inferior aspect of the intercostal space to avoid: o Lung injury o Pneumothorax o Neurovascular injury o Rib fracture - Answers- o Neurovascular injury During a hepatic resection, which of the following ligaments separates the left lateral and the left medial segments of the liver? o Falciform o Coronary o Gastrohepatic o Triangular - Answers- o Falciform Which of the following nerves innervates the latissimus dorsi muscle? o Long thoracic o Lateral pectoral o Medial pectoral o Thoracodorsal - Answers- o Thoracodorsal Which of the following hernias occurs most often? o Femoral o Sliding o Ventral o Inguinal - Answers- o Inguinal When a patient is diagnosed with varicose veins, which of the following is the most likely cause? o Gravity o Incompetent valves o Blood clot o Venous stasis - Answers- o Incompetent valves The third ventricle empties into the fourth ventricle through which of the following small ducts, which is the only exit for the third and lateral ventricles? o Foramina of Magendie o Foramen of Monro o Aqueduct of Sylvius o Foramina of Luschka - Answers- o Aqueduct of Sylvius