CTS Practice Exam B Question and Detailed
Answers
1 A surgical technologist is preparing the incision site for the dressing
following a TAH. The patient has developed a hematoma at the incision site.
The surgeon has left the room. Which of the following actions should the
surgical technologist take?
A. Place a pressure dressing.
B. Cover with Dermabond.
C. Steri-Strip the incision.
D. Have the surgeon return.
EXPLANATIONS:(u) A. Although placing a pressure dressing may help the
hematoma from getting bigger, this will not correct the problem.(u) B.
Dermabond is a fibrin glue used to join skin edges without using sutures.(u)
C. Steri-Strips are used to reinforce skin closure and would not help in
eliminating a hematoma.(c) D. The surgeon would need to see the incision
site and evaluate the extent of the hematoma. Some hematomas require
evacuation to prevent infection; others reabsorb and require no further
action. REFERENCE:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 374
2 Which of the following is a sign of cardiac arrest?
A. edema
B. convulsion
C. cyanosis
D. hypertension
EXPLANATIONS:(u) A. Edema is not a sign of cardiac arrest. (u) B.
Convulsions are not a sign of cardiac arrest.(c) C. With lack of circulation
(which provides oxygen to tissues) in cardiac arrest, the patient will look blue
(cyanotic).(u) D. Lack of circulation related to cardiac arrest causes a
decrease in blood pressure.REFERENCE:
American Heart Association - CPR Guidelines: www.heart.org
3 The number of Staphylococcus aureus micro-organisms carried by the
surgical technologist can be drastically reduced by
A. wearing a surgical cap.
B. wearing hospital scrubs.
C. keeping the OR doors closed.
D. a thorough surgical hand scrub.
EXPLANATIONS:(u) A. The surgical cap will keep hair from the surgical area;
staph is found predominantly on the skin.(u) B. The hospital scrubs are there
to keep the employees from bringing micro-organisms from outside the OR
into the surgical environment.(u) C. Keeping OR doors closed helps to keep
micro-organisms outside the room from entering; however, staph is found
predominantly on the skin.(c) D. A thorough surgical hand scrub (followed by
sterile gloves) removes many staph micro-organisms from these skin
, surfaces, where they are commonly carried.REFERENCES:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 156Surgical Technology for the Surgical Technologist: A Positive
Care Approach, 2008, 3rd Ed., Kevin Frey, pg. 317
4 List in order the sequence of induction for general anesthesia:
1. leads placed on the patient
2. induction agent is given through an IV
3. patient is prompted to breathe 100% oxygen
4. patient is intubated
5. anesthetic gas agent is selected and applied
A. 1, 3, 5, 4, and 2
B. 5, 2, 3, 1, and 4
C. 1, 3, 2, 4, and 5
D. 4, 2, 3, 1, and 5
EXPLANATIONS:(u) A. Anesthetic gas is not selected or applied until the
airway is secured and the induction agent is given.(u) B. The airway must be
maintained in order to deliver anesthetic gas. (c) C. 1. Leads are placed in
order to monitor all cardiac activity during the induction of anesthesia. 3. The
patient's blood oxygen saturation is raised as high as possible to sustain
them during intubation. 2. The induction agent causes a loss of
consciousness and is associated with depressed reflexes, respiratory
depression, and an inadequate airway. 4. The patient is secured and
maintained after being depressed. 5. Anesthetic gas is selected and applied.
(u) D. The patient cannot be intubated until the other steps are
completed.REFERENCE:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 239-241
5 Place the following phases of wound healing by first intention in correct
order from first to last
I. proliferation
II. remodeling
III. inflammatory
A. I, II, III
B. II, I, III
C. III, I, II
D. III, II, I
EXPLANATIONS:(u) A. The proliferation phase of wound healing does not
occur until the third day following tissue trauma.(u) B. Remodeling of the
wound is the final phase of wound healing. Scar (cicatrix) formation occurs
during this phase.(c) C. The inflammatory phase begins within minutes of a
tissue trauma. The proliferation phase begins on the third day following
tissue trauma. The remodeling phase begins 14 days following tissue trauma.
(u) D. Remodeling is the final phase of healing and begins after the
, proliferation phase.REFERENCE:
Surgical Technology for the Surgical Technologist: A Positive Care
Approach, 2008, 3rd Ed., Kevin Frey, pg. 281-282
6 A surgical technologist has selected the sutures for a procedure based on
the surgeon’s preference card. The surgeon states he would like additional
sutures and his preference card is outdated. Which of the following is the
surgical technologist’s BEST course of action?
A. Open all of the sutures that were collected and place them on the
back table just in case the surgeon needs them.
B. Return the sutures that are not needed to sterile supply and proceed
with the case.
C. Ask the surgeon if he would like to have his preference card updated
and proceed accordingly.
D. Update the surgeon's preference card to reflect the sutures that have
been requested for this case.
EXPLANATIONS:(u) A. The surgical technologist should only open as many
suture packets as are necessary because leftover sutures cannot be
resterilized.(u) B. The surgical technologist should return the sutures that are
not needed. Since the surgeon has mentioned that his preference card is
outdated, the surgical technologist should inquire as to whether or not the
surgeon would like to update it so that it will be accurate for future cases.(c)
C. Since the surgeon has mentioned that his preference card is outdated, the
surgical technologist should inquire as to whether or not the surgeon would
like to update it so that it will be accurate for future cases. If the surgeon
indicates that he would like to have his preference card updated, the surgical
technologist should proceed accordingly.(u) D. The surgical technologist can
update the surgeon's preference card, but would need to obtain the
surgeon's new preferences and approval prior to updating the preference
card. REFERENCE:
Surgical Technology for the Surgical Technologist: A Positive Care
Approach, 2008, 3rd Ed., Kevin Frey, pg. 110 and 291
7 While being transferred from the stretcher to the operating room bed, the
patient expresses fear of not awakening from anesthesia. The surgical
technologist should
A. proceed with the transfer and disregard patient comments.
B. explain the action of the anesthetic agent.
C. reassure the patient that the anesthetic is safe.
D. have the anesthesia care provider address the patient's concerns.
EXPLANATIONS:(u) A. The surgical technologist is sterile and will not be able
to assist with patient transfer, and ignoring the patient's comments is
inappropriate.(u) B. The surgical technologist is not trained in anesthetic
techniques and should refer questions to the anesthesia care provider.(u) C.
The surgical technologist should not make reassurances regarding
, anesthesia and should refer questions to the anesthesia provider.(c) D. The
anesthesia care provider is best suited to calm a patient's fears and educate
the patient regarding anesthetic safety.REFERENCES:
Surgical Technology for the Surgical Technologist: A Positive Care
Approach, 2008, 3rd Ed., Kevin Frey, pg. 60Surgical Technology: Principles
and Practice, 2009, 5thEd., Joanna Kotcher Fuller, pg. 24-25
8 When preparing endoscopic cameras for ethylene oxide sterilization, which
of the following monitoring processes would be utilized to ensure all
parameters of sterilization were met?
A. external tape
B. biological indicator
C. dynamic air removal
D. internal strip
EXPLANATIONS:(u) A. External tape does not ensure that all parameters of
sterilization have been met. (c) B. Biological monitors are used for routine
load release, efficacy monitoring, qualification testing, and quality
assurance. (u) C. Dynamic air removal is mechanically assisted air removal
from a sterilizer's chamber. This includes prevacuum and steam flash, and
pressure pulsed steam sterilizers. This is a test and not a biological
monitoring device.(u) D. Internal strip indicators do not ensure that all
parameters of sterilization are met. REFERENCE:
Alexander’s Care of the Patient in Surgery, 2010, 14th Ed., Jane C. Rothrock,
pg. 75
9 Which of the following rongeurs is used to expand the antrostomy in a
Caldwell-Luc procedure?
A. Cushing
B. Bethune
C. Kerrison
D. Stille-Luer
EXPLANATIONS:(u) A. A Cushing is an intervertebral rongeur. (u) B. A
Bethune is rib shears.(c) C. Kerrison is the rongeur used for this procedure.
(u) D. A Stille-Luer is a large orthopedic rongeur.REFERENCES:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 705Surgical Technology for the Surgical Technologist: A Positive
Care Approach, 2008, 3rd Ed., Kevin Frey, pg. 646
10 The surgical technologist in the scrub role should remain sterile following
which of the following surgical procedures?
A. laparoscopic cholecystectomy
B. carotid endarterectomy
C. total hip arthroplasty
D. tympanoplasty
Answers
1 A surgical technologist is preparing the incision site for the dressing
following a TAH. The patient has developed a hematoma at the incision site.
The surgeon has left the room. Which of the following actions should the
surgical technologist take?
A. Place a pressure dressing.
B. Cover with Dermabond.
C. Steri-Strip the incision.
D. Have the surgeon return.
EXPLANATIONS:(u) A. Although placing a pressure dressing may help the
hematoma from getting bigger, this will not correct the problem.(u) B.
Dermabond is a fibrin glue used to join skin edges without using sutures.(u)
C. Steri-Strips are used to reinforce skin closure and would not help in
eliminating a hematoma.(c) D. The surgeon would need to see the incision
site and evaluate the extent of the hematoma. Some hematomas require
evacuation to prevent infection; others reabsorb and require no further
action. REFERENCE:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 374
2 Which of the following is a sign of cardiac arrest?
A. edema
B. convulsion
C. cyanosis
D. hypertension
EXPLANATIONS:(u) A. Edema is not a sign of cardiac arrest. (u) B.
Convulsions are not a sign of cardiac arrest.(c) C. With lack of circulation
(which provides oxygen to tissues) in cardiac arrest, the patient will look blue
(cyanotic).(u) D. Lack of circulation related to cardiac arrest causes a
decrease in blood pressure.REFERENCE:
American Heart Association - CPR Guidelines: www.heart.org
3 The number of Staphylococcus aureus micro-organisms carried by the
surgical technologist can be drastically reduced by
A. wearing a surgical cap.
B. wearing hospital scrubs.
C. keeping the OR doors closed.
D. a thorough surgical hand scrub.
EXPLANATIONS:(u) A. The surgical cap will keep hair from the surgical area;
staph is found predominantly on the skin.(u) B. The hospital scrubs are there
to keep the employees from bringing micro-organisms from outside the OR
into the surgical environment.(u) C. Keeping OR doors closed helps to keep
micro-organisms outside the room from entering; however, staph is found
predominantly on the skin.(c) D. A thorough surgical hand scrub (followed by
sterile gloves) removes many staph micro-organisms from these skin
, surfaces, where they are commonly carried.REFERENCES:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 156Surgical Technology for the Surgical Technologist: A Positive
Care Approach, 2008, 3rd Ed., Kevin Frey, pg. 317
4 List in order the sequence of induction for general anesthesia:
1. leads placed on the patient
2. induction agent is given through an IV
3. patient is prompted to breathe 100% oxygen
4. patient is intubated
5. anesthetic gas agent is selected and applied
A. 1, 3, 5, 4, and 2
B. 5, 2, 3, 1, and 4
C. 1, 3, 2, 4, and 5
D. 4, 2, 3, 1, and 5
EXPLANATIONS:(u) A. Anesthetic gas is not selected or applied until the
airway is secured and the induction agent is given.(u) B. The airway must be
maintained in order to deliver anesthetic gas. (c) C. 1. Leads are placed in
order to monitor all cardiac activity during the induction of anesthesia. 3. The
patient's blood oxygen saturation is raised as high as possible to sustain
them during intubation. 2. The induction agent causes a loss of
consciousness and is associated with depressed reflexes, respiratory
depression, and an inadequate airway. 4. The patient is secured and
maintained after being depressed. 5. Anesthetic gas is selected and applied.
(u) D. The patient cannot be intubated until the other steps are
completed.REFERENCE:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 239-241
5 Place the following phases of wound healing by first intention in correct
order from first to last
I. proliferation
II. remodeling
III. inflammatory
A. I, II, III
B. II, I, III
C. III, I, II
D. III, II, I
EXPLANATIONS:(u) A. The proliferation phase of wound healing does not
occur until the third day following tissue trauma.(u) B. Remodeling of the
wound is the final phase of wound healing. Scar (cicatrix) formation occurs
during this phase.(c) C. The inflammatory phase begins within minutes of a
tissue trauma. The proliferation phase begins on the third day following
tissue trauma. The remodeling phase begins 14 days following tissue trauma.
(u) D. Remodeling is the final phase of healing and begins after the
, proliferation phase.REFERENCE:
Surgical Technology for the Surgical Technologist: A Positive Care
Approach, 2008, 3rd Ed., Kevin Frey, pg. 281-282
6 A surgical technologist has selected the sutures for a procedure based on
the surgeon’s preference card. The surgeon states he would like additional
sutures and his preference card is outdated. Which of the following is the
surgical technologist’s BEST course of action?
A. Open all of the sutures that were collected and place them on the
back table just in case the surgeon needs them.
B. Return the sutures that are not needed to sterile supply and proceed
with the case.
C. Ask the surgeon if he would like to have his preference card updated
and proceed accordingly.
D. Update the surgeon's preference card to reflect the sutures that have
been requested for this case.
EXPLANATIONS:(u) A. The surgical technologist should only open as many
suture packets as are necessary because leftover sutures cannot be
resterilized.(u) B. The surgical technologist should return the sutures that are
not needed. Since the surgeon has mentioned that his preference card is
outdated, the surgical technologist should inquire as to whether or not the
surgeon would like to update it so that it will be accurate for future cases.(c)
C. Since the surgeon has mentioned that his preference card is outdated, the
surgical technologist should inquire as to whether or not the surgeon would
like to update it so that it will be accurate for future cases. If the surgeon
indicates that he would like to have his preference card updated, the surgical
technologist should proceed accordingly.(u) D. The surgical technologist can
update the surgeon's preference card, but would need to obtain the
surgeon's new preferences and approval prior to updating the preference
card. REFERENCE:
Surgical Technology for the Surgical Technologist: A Positive Care
Approach, 2008, 3rd Ed., Kevin Frey, pg. 110 and 291
7 While being transferred from the stretcher to the operating room bed, the
patient expresses fear of not awakening from anesthesia. The surgical
technologist should
A. proceed with the transfer and disregard patient comments.
B. explain the action of the anesthetic agent.
C. reassure the patient that the anesthetic is safe.
D. have the anesthesia care provider address the patient's concerns.
EXPLANATIONS:(u) A. The surgical technologist is sterile and will not be able
to assist with patient transfer, and ignoring the patient's comments is
inappropriate.(u) B. The surgical technologist is not trained in anesthetic
techniques and should refer questions to the anesthesia care provider.(u) C.
The surgical technologist should not make reassurances regarding
, anesthesia and should refer questions to the anesthesia provider.(c) D. The
anesthesia care provider is best suited to calm a patient's fears and educate
the patient regarding anesthetic safety.REFERENCES:
Surgical Technology for the Surgical Technologist: A Positive Care
Approach, 2008, 3rd Ed., Kevin Frey, pg. 60Surgical Technology: Principles
and Practice, 2009, 5thEd., Joanna Kotcher Fuller, pg. 24-25
8 When preparing endoscopic cameras for ethylene oxide sterilization, which
of the following monitoring processes would be utilized to ensure all
parameters of sterilization were met?
A. external tape
B. biological indicator
C. dynamic air removal
D. internal strip
EXPLANATIONS:(u) A. External tape does not ensure that all parameters of
sterilization have been met. (c) B. Biological monitors are used for routine
load release, efficacy monitoring, qualification testing, and quality
assurance. (u) C. Dynamic air removal is mechanically assisted air removal
from a sterilizer's chamber. This includes prevacuum and steam flash, and
pressure pulsed steam sterilizers. This is a test and not a biological
monitoring device.(u) D. Internal strip indicators do not ensure that all
parameters of sterilization are met. REFERENCE:
Alexander’s Care of the Patient in Surgery, 2010, 14th Ed., Jane C. Rothrock,
pg. 75
9 Which of the following rongeurs is used to expand the antrostomy in a
Caldwell-Luc procedure?
A. Cushing
B. Bethune
C. Kerrison
D. Stille-Luer
EXPLANATIONS:(u) A. A Cushing is an intervertebral rongeur. (u) B. A
Bethune is rib shears.(c) C. Kerrison is the rongeur used for this procedure.
(u) D. A Stille-Luer is a large orthopedic rongeur.REFERENCES:
Surgical Technology: Principles and Practice, 2009, 5th Ed., Joanna Kotcher
Fuller, pg. 705Surgical Technology for the Surgical Technologist: A Positive
Care Approach, 2008, 3rd Ed., Kevin Frey, pg. 646
10 The surgical technologist in the scrub role should remain sterile following
which of the following surgical procedures?
A. laparoscopic cholecystectomy
B. carotid endarterectomy
C. total hip arthroplasty
D. tympanoplasty
