NCCT Q
A general surgeon is preparing to close a patient’s abdomen. The patient has increased
swelling and the surgeon has informed the surgical team that he will need to reinforce the
closure. Which of the following materials should the technologist retrieve to prepare for the
closure?
A. silk suture on a straight needle
B. PDS suture on a reverse cutting needle
C. Monocryl suture
D. nylon suture and bolsters
D. Nylon suture and bolsters
Rationale
Bolsters are placed around sutures to help alleviate pressure that the suture strand places
on the skin, and will be needed in any incision where excess swelling or pressure is present.
The other sutures will not help with reinforcing the incision for closure.
A surgeon has placed a venous access port in a patient receiving chemotherapy. What
dressing would be used to cover the port site?
A. Opsite
B. Peri-pad
C. Xeroform gauze
D. Kerlix
A. Opsite
Rationale
Port sites are often covered with a one-layer adhesive dressing such as an Op-site or
Bioclusive. Peri-pads are used most often in the perineal region for dressing. Xeroform
gauze is used as an occlusive dressing but is impregnated with an emulsion. Kerlix is a type
of cast padding material.
,What is the proper order to set up dressings on a Mayo at the end of a basic case?
A. Dressing sponges, xeroform, suture, tegaderm
B. Suture, wet sponge, dry sponge, dressing sponges, xeroform, tegaderm
C. Suture, wet sponge, dry sponge, xeroform, dressing sponges, tegaderm
D. Suture, dressing sponges, tegaderm, wet sponge, dry sponge
C. Suture, wet sponge, dry sponge, xeroform, dressing sponges, tegaderm
Rationale
The mayo stand is used for immediate use instruments and supplies. When closing a case,
the mayo stand should be set up with all the items needs to complete the case. The correct
order is suture, wet sponge, dry sponge, xeroform, dressing sponges, tegaderm.
At what point does the surgical technologist activate a Hemo-Vac drain?
A. when received on the back table
B. when handed to the surgeon
C. when inserted into the incision
D. when the incision is closed
D. when the incision is closed
Rationale
The drain should not be opened until is toward the end of the case. After the surgeon closes
the incision, you can activate the drain by compressing the reservoir and attaching the
drainage tube to it. It cannot be activated until the drain is placed in the wound.
Which of the following surgeries would involve the use of a bulky jones dressing?
A. Splenectomy
B. Humeral fracture
,C. Rotator cuff repair
D. Ankle fracture
D. Ankle fracture
Rationale
An ankle fracture would involve the use of a bulky jones dressing. A splenectomy is the
removal of the spleen, which is done open or laparoscopic, there would not be a need for a
bulky dressing. A humeral fracture is a broken bone in the upper arm and would be placed in
a cast or a splint. It would not require bulky dressing. A rotator cuff repair will require an arm
sling.
An orthopedic surgeon requested a Hemovac drain during a total knee replacement
procedure due to excessive fluid drainage. At the end of the procedure, the surgeon asked
the surgical technologist to activate the drain. The technologist should connect the distal end
of the drain to
A. the “Y” connector.
B. the reservoir.
C. insufflation tubing.
D. suction tubing.
B. the reservoir.
Rationale
The reservoir must be activated by first compressing it and creating negative pressure within
it. This allows room for fluid to drain into the reservoir. Insufflation tubing is used to create
pneumoperitoneum in laparoscopic cases. Suction tubing is used during the case to suction
fluid from the field into the suction canister. A second drain tube could be connected to a “Y”
adapter if necessary.
The surgical technologist is given 0.25% of Marcaine plain, 30ml/cc and 1% of lidocaine with
epinephrine, 20ml/cc. The surgeon asks for a 50/50 mix of the medication in a 20ml/cc
syringe. She hands back the syringe with 10ml/cc remaining. How much of each medication
was injected?
A. 10ml/cc of Marcaine and 10ml/cc of lidocaine
, B. 5ml/cc of Marcaine and 5ml/cc of lidocaine
C. 5ml/cc of Marcaine and 10ml/cc of lidocaine
D. 10ml/cc of Marcaine and 5ml/cc of lidocaine
B. 5ml/cc of Marcaine and 5ml/cc of lidocaine
Rationale
10 mL’s of each drawn up into a 20 cc syringe makes a 50/50 mix. If 10 mL’s remain, that
means only 5 mL’s of each medication remains in the syringe.
A surg tech just finished assisting a long carotid endarterectomy where the patient was
experiencing bleeding issues. The anesthesiologist has begun the extubation process.
Shortly after, the patient starts coughing violently and the incision site becomes engorged
with blood. What should the tech do?
A. Notify the charge nurse that the patient is bleeding.
B. Notify the general surgeon on call to scrub in.
C. Notify the circulating nurse and maintain a sterile back table.
D. Notify the surgeon after the patient has been moved to the ICU.
C. Notify the circulating nurse and maintain a sterile back table.
Rationale
In this case, the surg tech would notify the circulating nurse and maintain sterility on the back
table because sterile instruments would be available and the sterile field in tact if there is a
need to reopen the surgical incision. The charge nurse is not a part of the surgical procedure
and would not need to be notified. The operative surgeon would be the person to notify the
on call surgeon if they are needed. Notifying the surgeon after the patient has been
transported to ICU is not only unacceptable practice, but could be fatal for the patient.
At the closing of an exploratory laparotomy, the surgical technologist notices a tear on the
back table drape. The surgical technologist will need to change the wound classification to
which of the following?
A. Class III
A general surgeon is preparing to close a patient’s abdomen. The patient has increased
swelling and the surgeon has informed the surgical team that he will need to reinforce the
closure. Which of the following materials should the technologist retrieve to prepare for the
closure?
A. silk suture on a straight needle
B. PDS suture on a reverse cutting needle
C. Monocryl suture
D. nylon suture and bolsters
D. Nylon suture and bolsters
Rationale
Bolsters are placed around sutures to help alleviate pressure that the suture strand places
on the skin, and will be needed in any incision where excess swelling or pressure is present.
The other sutures will not help with reinforcing the incision for closure.
A surgeon has placed a venous access port in a patient receiving chemotherapy. What
dressing would be used to cover the port site?
A. Opsite
B. Peri-pad
C. Xeroform gauze
D. Kerlix
A. Opsite
Rationale
Port sites are often covered with a one-layer adhesive dressing such as an Op-site or
Bioclusive. Peri-pads are used most often in the perineal region for dressing. Xeroform
gauze is used as an occlusive dressing but is impregnated with an emulsion. Kerlix is a type
of cast padding material.
,What is the proper order to set up dressings on a Mayo at the end of a basic case?
A. Dressing sponges, xeroform, suture, tegaderm
B. Suture, wet sponge, dry sponge, dressing sponges, xeroform, tegaderm
C. Suture, wet sponge, dry sponge, xeroform, dressing sponges, tegaderm
D. Suture, dressing sponges, tegaderm, wet sponge, dry sponge
C. Suture, wet sponge, dry sponge, xeroform, dressing sponges, tegaderm
Rationale
The mayo stand is used for immediate use instruments and supplies. When closing a case,
the mayo stand should be set up with all the items needs to complete the case. The correct
order is suture, wet sponge, dry sponge, xeroform, dressing sponges, tegaderm.
At what point does the surgical technologist activate a Hemo-Vac drain?
A. when received on the back table
B. when handed to the surgeon
C. when inserted into the incision
D. when the incision is closed
D. when the incision is closed
Rationale
The drain should not be opened until is toward the end of the case. After the surgeon closes
the incision, you can activate the drain by compressing the reservoir and attaching the
drainage tube to it. It cannot be activated until the drain is placed in the wound.
Which of the following surgeries would involve the use of a bulky jones dressing?
A. Splenectomy
B. Humeral fracture
,C. Rotator cuff repair
D. Ankle fracture
D. Ankle fracture
Rationale
An ankle fracture would involve the use of a bulky jones dressing. A splenectomy is the
removal of the spleen, which is done open or laparoscopic, there would not be a need for a
bulky dressing. A humeral fracture is a broken bone in the upper arm and would be placed in
a cast or a splint. It would not require bulky dressing. A rotator cuff repair will require an arm
sling.
An orthopedic surgeon requested a Hemovac drain during a total knee replacement
procedure due to excessive fluid drainage. At the end of the procedure, the surgeon asked
the surgical technologist to activate the drain. The technologist should connect the distal end
of the drain to
A. the “Y” connector.
B. the reservoir.
C. insufflation tubing.
D. suction tubing.
B. the reservoir.
Rationale
The reservoir must be activated by first compressing it and creating negative pressure within
it. This allows room for fluid to drain into the reservoir. Insufflation tubing is used to create
pneumoperitoneum in laparoscopic cases. Suction tubing is used during the case to suction
fluid from the field into the suction canister. A second drain tube could be connected to a “Y”
adapter if necessary.
The surgical technologist is given 0.25% of Marcaine plain, 30ml/cc and 1% of lidocaine with
epinephrine, 20ml/cc. The surgeon asks for a 50/50 mix of the medication in a 20ml/cc
syringe. She hands back the syringe with 10ml/cc remaining. How much of each medication
was injected?
A. 10ml/cc of Marcaine and 10ml/cc of lidocaine
, B. 5ml/cc of Marcaine and 5ml/cc of lidocaine
C. 5ml/cc of Marcaine and 10ml/cc of lidocaine
D. 10ml/cc of Marcaine and 5ml/cc of lidocaine
B. 5ml/cc of Marcaine and 5ml/cc of lidocaine
Rationale
10 mL’s of each drawn up into a 20 cc syringe makes a 50/50 mix. If 10 mL’s remain, that
means only 5 mL’s of each medication remains in the syringe.
A surg tech just finished assisting a long carotid endarterectomy where the patient was
experiencing bleeding issues. The anesthesiologist has begun the extubation process.
Shortly after, the patient starts coughing violently and the incision site becomes engorged
with blood. What should the tech do?
A. Notify the charge nurse that the patient is bleeding.
B. Notify the general surgeon on call to scrub in.
C. Notify the circulating nurse and maintain a sterile back table.
D. Notify the surgeon after the patient has been moved to the ICU.
C. Notify the circulating nurse and maintain a sterile back table.
Rationale
In this case, the surg tech would notify the circulating nurse and maintain sterility on the back
table because sterile instruments would be available and the sterile field in tact if there is a
need to reopen the surgical incision. The charge nurse is not a part of the surgical procedure
and would not need to be notified. The operative surgeon would be the person to notify the
on call surgeon if they are needed. Notifying the surgeon after the patient has been
transported to ICU is not only unacceptable practice, but could be fatal for the patient.
At the closing of an exploratory laparotomy, the surgical technologist notices a tear on the
back table drape. The surgical technologist will need to change the wound classification to
which of the following?
A. Class III
