NIFA Perioperative Exam Questions With 100%
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CHAPTER 7 NEEDLES, SUTURES, INSTRUMENTS
Describe when surgical counts (e.g., sponge, sharp, instrument) are performed.
Counts are performed initially, before the patient enters the operating room (OR), before
closure of a body cavity or deep, large incision; after closure of a body cavity; and at
skin closure
Define the term subcuticular suture.
Subcuticular sutures are placed completely under the epidermal layer of the skin. This
technique is often used for cosmetic closure. - ANSWER
Define tensile strength.
Tensile strength is the amount of weight (breaking load) necessary to break a suture
(breaking strength); it varies according to the type of suture material.
Describe the techniques used to ligate in deep tissues.
The following techniques can be used to ligate in deep tissue: (1) A hemostat is placed
on the end of the structure; the ligature is then placed around the vessel. The knot is
tied and tightened with the surgeon's fingers or with the aid of forceps. (2) A slipknot is
made, and its loop is placed over the involved structure by means of a forceps or clamp.
(3) In deeper cavities, ties are often placed on clamps with the long end extending from
the tip. These are sometimes called ties on a pass or bow ties. The extending long end
is held tightly against the rings by the surgeon (creating the bow), who then passes the
tip of the clamp under the vessel or duct to be ligated. The first assistant grasps the
extending tie with a forceps, the surgeon releases it, and the tie is pulled under and up
to the wound surface and tied. (4) A forceps or a clamp is applied to the structure, and
transfixion sutures are applied and tied. A suture ligature, stick tie, or transfixion ligature
is a strand of suture material threaded or swaged on a needle. This is usually placed
through the vessel and around it to prevent the ligature from slipping off the end. -
,ANSWER
List examples of absorbable sutures.
Plain or chromic surgical gut, collagen, and glycolic acid polymers are all examples of
absorbable suture
List examples of accessory and ancillary instruments.
Suction tips and tubing; irrigators-aspirators; electrosurgical devices; and special-use
devices, such as probes, dilators, mallets, and screwdrivers. - ANSWER
Describe the purpose of surgical retractors.
Retractors are used for holding back the wound edges, structures, or tissues to provide
exposure of the operative site.
Define the term continuous suture.
A continuous suture consists of a series of stitches, of which only the first and last are
tied. - ANSWER
Define the term interrupted suture.
An interrupted suture is inserted into tissues or vessels in such a way that each stitch is
placed and tied individually.
Define the term purse-string suture.
A purse-string is a continuous circular suture placed to surround an opening in a
structure and cause it to close. This type of suture is often used around the appendix or
in an organ such as the cecum, gallbladder, or urinary bladder before it is opened so
that a drainage tube can be inserted. - ANSWER
List examples of types of surgical clamps.
Clamps include hemostats, occluding clamps, graspers and holders, forceps, pickups,
and needle holders
,Describe the parts of a surgical needle.
The eye, the body, and the point or tip comprise the parts of the surgical needle. -
ANSWER
Define the primary suture line.
A primary suture line is composed of those sutures that obliterate dead space, prevent
serum from accumulating in the wound, and hold the wound edges in approximation
until healing takes place.
Describe key features used to evaluate suture material.
Key features to evaluate when choosing suture material include: (1) physical
characteristics, (2) handling characteristics, and (3) tissue-reaction characteristics. -
ANSWER
List examples of cutting instruments.
Cutting instruments include scalpels, scissors, drills, saws, osteotomes, rongeurs,
adenotomes, dermatomes, and curettes
Define the term root cause analysis.
A root cause analysis is a systematized process used to identify variations in
performance that cause or could cause untoward patient events - ANSWER
Define the term extracellular fluid.
Extracellular fluids (ECFs) are those fluids in compartments outside the cells of the
body, including plasma, intravascular fluids, fluids in the gastrointestinal (GI) tract, and
cerebrospinal fluid (CSF). ECFs comprise 30% of the body's fluid.
Define the term sentinel event.
Sentinel events are unexpected occurrences involving death or risk of serious physical
or psychologic injury to a patient. - ANSWER
Define the term "never events."
, Never events are events resulting in unsafe patient outcomes that are no longer
considered reimbursable under the Centers for Medicare & Medicaid Services (e.g.,
wrong-site surgery
Define the term osmosis.
Osmosis is the movement of a fluid through a semipermeable membrane from a
solution that has a lower solute concentration to one that has a higher solute
concentration. - ANSWER
How are first, second, and third spacing defined?
First spacing is the normal distribution of fluid in extracellular and intracellular
compartments. Second spacing refers to excess accumulation of interstitial fluid
(edema), while third spacing occurs when fluid accumulates in areas that normally have
no fluid or only a minimal amount of fluid
List the minimum information needed for a surgical specimen identification.
Information needed for a surgical specimen includes: correct patient name and
identification number, specific origin of the specimen, and laterality (e.g., Jane Doe,
100001, right breast biopsy) - ANSWER
What are the key elements of informed consent?
During informed consent, the patient must be informed about the proposed operation or
other invasive procedure and its inherent risks, benefits, alternatives, and complications
in terms that he or she can understand.
Define the acronym SBAR.
SBAR stands for: S=Situation, B=Background, A=Assessment, R=Recommendation. -
ANSWER
Define the term active transport.
Active transport is the process by which molecules are moved across a cell membrane
against a concentration gradient, with the use of external energy
How is a count recorded in the record when an item is missing but not located on an X-
ray?
Verified solution
CHAPTER 7 NEEDLES, SUTURES, INSTRUMENTS
Describe when surgical counts (e.g., sponge, sharp, instrument) are performed.
Counts are performed initially, before the patient enters the operating room (OR), before
closure of a body cavity or deep, large incision; after closure of a body cavity; and at
skin closure
Define the term subcuticular suture.
Subcuticular sutures are placed completely under the epidermal layer of the skin. This
technique is often used for cosmetic closure. - ANSWER
Define tensile strength.
Tensile strength is the amount of weight (breaking load) necessary to break a suture
(breaking strength); it varies according to the type of suture material.
Describe the techniques used to ligate in deep tissues.
The following techniques can be used to ligate in deep tissue: (1) A hemostat is placed
on the end of the structure; the ligature is then placed around the vessel. The knot is
tied and tightened with the surgeon's fingers or with the aid of forceps. (2) A slipknot is
made, and its loop is placed over the involved structure by means of a forceps or clamp.
(3) In deeper cavities, ties are often placed on clamps with the long end extending from
the tip. These are sometimes called ties on a pass or bow ties. The extending long end
is held tightly against the rings by the surgeon (creating the bow), who then passes the
tip of the clamp under the vessel or duct to be ligated. The first assistant grasps the
extending tie with a forceps, the surgeon releases it, and the tie is pulled under and up
to the wound surface and tied. (4) A forceps or a clamp is applied to the structure, and
transfixion sutures are applied and tied. A suture ligature, stick tie, or transfixion ligature
is a strand of suture material threaded or swaged on a needle. This is usually placed
through the vessel and around it to prevent the ligature from slipping off the end. -
,ANSWER
List examples of absorbable sutures.
Plain or chromic surgical gut, collagen, and glycolic acid polymers are all examples of
absorbable suture
List examples of accessory and ancillary instruments.
Suction tips and tubing; irrigators-aspirators; electrosurgical devices; and special-use
devices, such as probes, dilators, mallets, and screwdrivers. - ANSWER
Describe the purpose of surgical retractors.
Retractors are used for holding back the wound edges, structures, or tissues to provide
exposure of the operative site.
Define the term continuous suture.
A continuous suture consists of a series of stitches, of which only the first and last are
tied. - ANSWER
Define the term interrupted suture.
An interrupted suture is inserted into tissues or vessels in such a way that each stitch is
placed and tied individually.
Define the term purse-string suture.
A purse-string is a continuous circular suture placed to surround an opening in a
structure and cause it to close. This type of suture is often used around the appendix or
in an organ such as the cecum, gallbladder, or urinary bladder before it is opened so
that a drainage tube can be inserted. - ANSWER
List examples of types of surgical clamps.
Clamps include hemostats, occluding clamps, graspers and holders, forceps, pickups,
and needle holders
,Describe the parts of a surgical needle.
The eye, the body, and the point or tip comprise the parts of the surgical needle. -
ANSWER
Define the primary suture line.
A primary suture line is composed of those sutures that obliterate dead space, prevent
serum from accumulating in the wound, and hold the wound edges in approximation
until healing takes place.
Describe key features used to evaluate suture material.
Key features to evaluate when choosing suture material include: (1) physical
characteristics, (2) handling characteristics, and (3) tissue-reaction characteristics. -
ANSWER
List examples of cutting instruments.
Cutting instruments include scalpels, scissors, drills, saws, osteotomes, rongeurs,
adenotomes, dermatomes, and curettes
Define the term root cause analysis.
A root cause analysis is a systematized process used to identify variations in
performance that cause or could cause untoward patient events - ANSWER
Define the term extracellular fluid.
Extracellular fluids (ECFs) are those fluids in compartments outside the cells of the
body, including plasma, intravascular fluids, fluids in the gastrointestinal (GI) tract, and
cerebrospinal fluid (CSF). ECFs comprise 30% of the body's fluid.
Define the term sentinel event.
Sentinel events are unexpected occurrences involving death or risk of serious physical
or psychologic injury to a patient. - ANSWER
Define the term "never events."
, Never events are events resulting in unsafe patient outcomes that are no longer
considered reimbursable under the Centers for Medicare & Medicaid Services (e.g.,
wrong-site surgery
Define the term osmosis.
Osmosis is the movement of a fluid through a semipermeable membrane from a
solution that has a lower solute concentration to one that has a higher solute
concentration. - ANSWER
How are first, second, and third spacing defined?
First spacing is the normal distribution of fluid in extracellular and intracellular
compartments. Second spacing refers to excess accumulation of interstitial fluid
(edema), while third spacing occurs when fluid accumulates in areas that normally have
no fluid or only a minimal amount of fluid
List the minimum information needed for a surgical specimen identification.
Information needed for a surgical specimen includes: correct patient name and
identification number, specific origin of the specimen, and laterality (e.g., Jane Doe,
100001, right breast biopsy) - ANSWER
What are the key elements of informed consent?
During informed consent, the patient must be informed about the proposed operation or
other invasive procedure and its inherent risks, benefits, alternatives, and complications
in terms that he or she can understand.
Define the acronym SBAR.
SBAR stands for: S=Situation, B=Background, A=Assessment, R=Recommendation. -
ANSWER
Define the term active transport.
Active transport is the process by which molecules are moved across a cell membrane
against a concentration gradient, with the use of external energy
How is a count recorded in the record when an item is missing but not located on an X-
ray?
