NCCT SURGICAL TECH EXAM
REVIEW
An-85-year-old-patient-is-currently-in-the-operating-room-under-general-anesthesia-for-a-
right-hip-arthroplasty.-Which-of-the-following-will-best-help-to-prevent-perioperative-
positioning-injuries?
Ensure-all-bony-prominences-are-sufficiently-padded.
Make-sure-that-the-implant-is-appropriately-sized-for-the-patient.
Be-attentive-to-intraoperative-signs-of-discomfort-or-distress.
Use-a-body-warming-blanket-during-the-pre-operative-phase.---ans-✔✔Ensure-all-bony-
prominences-are-sufficiently-padded.
Rationale:-Elderly-patients-are-likely-to-have-pressure-ulcers-develop-if-bony-
prominences-are-not-cushioned-and-protected-from-the-hard-surface-of-the-operating-
room-table.-Their-skin-is-delicate-and-fragile-due-to-their-age,-and-other-conditions-such-
as-diabetes,-or-poor-circulation.
The-surgical-technologist-is-opening-for-a-procedure-and-notices-the-wrapped-item-she-
just-opened-has-a-hole-in-the-outer-layer.-Which-of-the-following-is-the-proper-course-of-
action?
Open-the-inner-layer-onto-the-sterile-field.
Discard-the-item-and-retrieve-a-new-one.
Check-the-indicator-to-ensure-the-item-has-been-sterilized.
Place-the-package-on-a-prep-stand-and-open-away-from-the-sterile-field.---ans-
✔✔Discard-the-item-and-retrieve-a-new-one.
Rationale:-If-the-integrity-of-the-package-has-been-compromised,-it-should-not-be-taken-
on-the-sterile-field.-When-in-doubt-throw-it-out-and-get-a-new-one.-If-the-package-has-a-
hole-it-should-never-be-used.-If-it-was-taken-onto-the-sterile-field-it-would-contaminate-the-
whole-field.
Before-medications-or-solutions-are-poured-onto-the-sterile-field,-the-surgical-technologist-
should-verify-which-of-the-following?-(Select-the-three-(3)-correct-answers.)
Patient
Date
Medication
Dosage
,Procedure---ans-✔✔Date,-Medication,-Dosage
Rationale:-Correct-patient-and-procedure-are-the-responsibility-of-the-circulator-prior-to-
obtaining-medication.-Expiration-date,-name-of-medication-and-dosage-must-be-
communicated-during-transfer-of-medication-by-the-circulator-and-surgical-technician-to-
reduce-medication-errors.
The-surgical-technologist-has-just-completed-scrubbing-for-a-right-knee-arthroscopy.-As-
the-surgeon-takes-down-the-tourniquet,-and-the-surgical-technologist-begins-to-
breakdown-the-back-table,-a-plume-of-smoke-is-seen-coming-from-the-sterile-field.-Which-
of-the-following-is-the-most-likely-source-of-this-smoke?
The-light-source-was-left-on-and-the-drape-is-igniting.
The-iodine-is-still-damp-and-is-igniting-from-use-of-the-cautery-pencil.
Lactated-ringers-was-used-for-irrigation-instead-of-glycine.
A-faulty-grounding-pad-is-in-place.---ans-✔✔The-light-source-was-left-on-and-the-drape-is-
igniting.
Rationale:-The-light-source-with-the-fiber-optic-beam,-along-with-a-paper-drape,-would-be-
where-the-smoke-plume-was-coming-from-because-of-the-heat.-Iodine-and-lactated-
ringers-are-not-a-flammable-liquids-and-would-not-be-the-source-of-the-heat.-A-faulty-
ground-pad-would-not-be-the-source-of-the-heat-since-it's-not-working-properly.
Before-medications-or-solutions-are-poured-onto-the-sterile-field,-the-surgical-technologist-
should-verify-which-of-the-following?-(Select-the-three-(3)-correct-answers.)
Patient
Date
Medication
Dosage
Procedure---ans-✔✔Date,-Medication,-Dosage
Rationale:-Correct-patient-and-procedure-are-the-responsibility-of-the-circulator-prior-to-
obtaining-medication.-Expiration-date,-name-of-medication-and-dosage-must-be-
communicated-during-transfer-of-medication-by-the-circulator-and-surgical-technician-to-
reduce-medication-errors.
The-surgical-technologist-has-just-completed-scrubbing-for-a-right-knee-arthroscopy.-As-
the-surgeon-takes-down-the-tourniquet,-and-the-surgical-technologist-begins-to-
breakdown-the-back-table,-a-plume-of-smoke-is-seen-coming-from-the-sterile-field.-Which-
of-the-following-is-the-most-likely-source-of-this-smoke?
The-light-source-was-left-on-and-the-drape-is-igniting.
The-iodine-is-still-damp-and-is-igniting-from-use-of-the-cautery-pencil.
Lactated-ringers-was-used-for-irrigation-instead-of-glycine.
A-faulty-grounding-pad-is-in-place.---ans-✔✔The-light-source-was-left-on-and-the-drape-is-
igniting.
Rationale:-The-light-source-with-the-fiber-optic-beam,-along-with-a-paper-drape,-would-be-
where-the-smoke-plume-was-coming-from-because-of-the-heat.-Iodine-and-lactated-
ringers-are-not-a-flammable-liquids-and-would-not-be-the-source-of-the-heat.-A-faulty-
ground-pad-would-not-be-the-source-of-the-heat-since-it's-not-working-properly.
, When-sterilizing-an-unwrapped,-non-porous-item-with-no-lumen-in-an-immediate-use-
sterilization-unit,-which-of-the-following-parameters-must-be-met-for-sterilization-with-
gravity-displacement-steam?-(Select-the-two-(2)-correct-answers.)
3-4-minute-exposure-time
270o-F
10-minute-exposure-time
132o-F
4-minute-drying-time---ans-✔✔3-4-minute-exposure-time,-270F
The-anesthesia-care-provider-(ACP)-is-performing-an-induction-on-a-known-asthmatic-
patient.-The-patient-experiences-a-laryngospasm-during-intubation.-The-patient's-oxygen-
saturation-is-65%.-The-scrubbed-surgical-technologist-should
prepare-for-a-tracheostomy.
prepare-the-machine-for-positive-pressure-ventilation-of-the-airway.
prepare-for-a-laryngoscopy.
hold-cricoid-pressure.---ans-✔✔prepare-for-a-tracheostomy.
Rationale:-The-asthmatic-patient-had-difficulty-breathing-when-intubated-and-the-oxygen-
saturation-dropped.-To-support-airway-management,-it-would-be-necessary-to-set-up-for-a-
tracheostomy.-The-surgical-technologist-would-not-prepare-the-machine-or-hold-cricoid-
pressure-due-to-it-is-not-in-their-scope-of-practice.-A-laryngoscopy-would-not-aid-in-air-way-
management.
Where-should-the-ST-place-the-back-table-when-setting-up-a-case?
On-the-side-of-the-OR-table-where-the-surgeon-will-stand.
As-far-from-the-OR-doors-as-possible.
Angled-to-the-foot-of-the-OR-table-for-tower-placement.
Placed-where-the-floor-plan-for-that-suite-has-designated-it.---ans-✔✔As-far-from-the-OR-
doors-as-possible.
Rationale:-When-the-OR-doors-open-and-close,-air-movement-is-at-its-highest.-Therefore,-
it-is-advantageous-to-establish-the-sterile-field-as-far-as-possible-from-the-doors-and-from-
human-traffic-into-and-out-of-the-room.
The-surgical-technologist-is-preparing-for-a-case-that-requires-an-extreme-reverse-
Trendelenburg.-Special-padding-is-ordered-to-prevent-the-patient-from-slipping.-What-is-
the-other-purpose-of-this-padding?
Assist-in-thermoregulation.
Prevent-shearing.
Provide-moisture-wicking.
Prevent-mobility-impairment.---ans-✔✔Prevent-shearing.
Rationale:-The-Trendelenburg-position-can-cause-a-patient-to-slip-down-the-operating-
table.-That-slippage-can-leave-a-patient-with-painful-skin-shear-injuries.-Place-a-foam-or-
gel-pad-under-the-patient-between-their-skin-and-the-table-to-prevent-skin-shearing.-The-
friction-created-by-the-pads,-which-are-taped-to-the-table-or-held-down-with-straps,-helps-
hold-the-patient-in-place.-Foam-padding-and-sponges-can-also-serve-to-protect-parts-of-
the-patient's-body-that-might-be-injured-under-pressure-or-accidental-poking.
REVIEW
An-85-year-old-patient-is-currently-in-the-operating-room-under-general-anesthesia-for-a-
right-hip-arthroplasty.-Which-of-the-following-will-best-help-to-prevent-perioperative-
positioning-injuries?
Ensure-all-bony-prominences-are-sufficiently-padded.
Make-sure-that-the-implant-is-appropriately-sized-for-the-patient.
Be-attentive-to-intraoperative-signs-of-discomfort-or-distress.
Use-a-body-warming-blanket-during-the-pre-operative-phase.---ans-✔✔Ensure-all-bony-
prominences-are-sufficiently-padded.
Rationale:-Elderly-patients-are-likely-to-have-pressure-ulcers-develop-if-bony-
prominences-are-not-cushioned-and-protected-from-the-hard-surface-of-the-operating-
room-table.-Their-skin-is-delicate-and-fragile-due-to-their-age,-and-other-conditions-such-
as-diabetes,-or-poor-circulation.
The-surgical-technologist-is-opening-for-a-procedure-and-notices-the-wrapped-item-she-
just-opened-has-a-hole-in-the-outer-layer.-Which-of-the-following-is-the-proper-course-of-
action?
Open-the-inner-layer-onto-the-sterile-field.
Discard-the-item-and-retrieve-a-new-one.
Check-the-indicator-to-ensure-the-item-has-been-sterilized.
Place-the-package-on-a-prep-stand-and-open-away-from-the-sterile-field.---ans-
✔✔Discard-the-item-and-retrieve-a-new-one.
Rationale:-If-the-integrity-of-the-package-has-been-compromised,-it-should-not-be-taken-
on-the-sterile-field.-When-in-doubt-throw-it-out-and-get-a-new-one.-If-the-package-has-a-
hole-it-should-never-be-used.-If-it-was-taken-onto-the-sterile-field-it-would-contaminate-the-
whole-field.
Before-medications-or-solutions-are-poured-onto-the-sterile-field,-the-surgical-technologist-
should-verify-which-of-the-following?-(Select-the-three-(3)-correct-answers.)
Patient
Date
Medication
Dosage
,Procedure---ans-✔✔Date,-Medication,-Dosage
Rationale:-Correct-patient-and-procedure-are-the-responsibility-of-the-circulator-prior-to-
obtaining-medication.-Expiration-date,-name-of-medication-and-dosage-must-be-
communicated-during-transfer-of-medication-by-the-circulator-and-surgical-technician-to-
reduce-medication-errors.
The-surgical-technologist-has-just-completed-scrubbing-for-a-right-knee-arthroscopy.-As-
the-surgeon-takes-down-the-tourniquet,-and-the-surgical-technologist-begins-to-
breakdown-the-back-table,-a-plume-of-smoke-is-seen-coming-from-the-sterile-field.-Which-
of-the-following-is-the-most-likely-source-of-this-smoke?
The-light-source-was-left-on-and-the-drape-is-igniting.
The-iodine-is-still-damp-and-is-igniting-from-use-of-the-cautery-pencil.
Lactated-ringers-was-used-for-irrigation-instead-of-glycine.
A-faulty-grounding-pad-is-in-place.---ans-✔✔The-light-source-was-left-on-and-the-drape-is-
igniting.
Rationale:-The-light-source-with-the-fiber-optic-beam,-along-with-a-paper-drape,-would-be-
where-the-smoke-plume-was-coming-from-because-of-the-heat.-Iodine-and-lactated-
ringers-are-not-a-flammable-liquids-and-would-not-be-the-source-of-the-heat.-A-faulty-
ground-pad-would-not-be-the-source-of-the-heat-since-it's-not-working-properly.
Before-medications-or-solutions-are-poured-onto-the-sterile-field,-the-surgical-technologist-
should-verify-which-of-the-following?-(Select-the-three-(3)-correct-answers.)
Patient
Date
Medication
Dosage
Procedure---ans-✔✔Date,-Medication,-Dosage
Rationale:-Correct-patient-and-procedure-are-the-responsibility-of-the-circulator-prior-to-
obtaining-medication.-Expiration-date,-name-of-medication-and-dosage-must-be-
communicated-during-transfer-of-medication-by-the-circulator-and-surgical-technician-to-
reduce-medication-errors.
The-surgical-technologist-has-just-completed-scrubbing-for-a-right-knee-arthroscopy.-As-
the-surgeon-takes-down-the-tourniquet,-and-the-surgical-technologist-begins-to-
breakdown-the-back-table,-a-plume-of-smoke-is-seen-coming-from-the-sterile-field.-Which-
of-the-following-is-the-most-likely-source-of-this-smoke?
The-light-source-was-left-on-and-the-drape-is-igniting.
The-iodine-is-still-damp-and-is-igniting-from-use-of-the-cautery-pencil.
Lactated-ringers-was-used-for-irrigation-instead-of-glycine.
A-faulty-grounding-pad-is-in-place.---ans-✔✔The-light-source-was-left-on-and-the-drape-is-
igniting.
Rationale:-The-light-source-with-the-fiber-optic-beam,-along-with-a-paper-drape,-would-be-
where-the-smoke-plume-was-coming-from-because-of-the-heat.-Iodine-and-lactated-
ringers-are-not-a-flammable-liquids-and-would-not-be-the-source-of-the-heat.-A-faulty-
ground-pad-would-not-be-the-source-of-the-heat-since-it's-not-working-properly.
, When-sterilizing-an-unwrapped,-non-porous-item-with-no-lumen-in-an-immediate-use-
sterilization-unit,-which-of-the-following-parameters-must-be-met-for-sterilization-with-
gravity-displacement-steam?-(Select-the-two-(2)-correct-answers.)
3-4-minute-exposure-time
270o-F
10-minute-exposure-time
132o-F
4-minute-drying-time---ans-✔✔3-4-minute-exposure-time,-270F
The-anesthesia-care-provider-(ACP)-is-performing-an-induction-on-a-known-asthmatic-
patient.-The-patient-experiences-a-laryngospasm-during-intubation.-The-patient's-oxygen-
saturation-is-65%.-The-scrubbed-surgical-technologist-should
prepare-for-a-tracheostomy.
prepare-the-machine-for-positive-pressure-ventilation-of-the-airway.
prepare-for-a-laryngoscopy.
hold-cricoid-pressure.---ans-✔✔prepare-for-a-tracheostomy.
Rationale:-The-asthmatic-patient-had-difficulty-breathing-when-intubated-and-the-oxygen-
saturation-dropped.-To-support-airway-management,-it-would-be-necessary-to-set-up-for-a-
tracheostomy.-The-surgical-technologist-would-not-prepare-the-machine-or-hold-cricoid-
pressure-due-to-it-is-not-in-their-scope-of-practice.-A-laryngoscopy-would-not-aid-in-air-way-
management.
Where-should-the-ST-place-the-back-table-when-setting-up-a-case?
On-the-side-of-the-OR-table-where-the-surgeon-will-stand.
As-far-from-the-OR-doors-as-possible.
Angled-to-the-foot-of-the-OR-table-for-tower-placement.
Placed-where-the-floor-plan-for-that-suite-has-designated-it.---ans-✔✔As-far-from-the-OR-
doors-as-possible.
Rationale:-When-the-OR-doors-open-and-close,-air-movement-is-at-its-highest.-Therefore,-
it-is-advantageous-to-establish-the-sterile-field-as-far-as-possible-from-the-doors-and-from-
human-traffic-into-and-out-of-the-room.
The-surgical-technologist-is-preparing-for-a-case-that-requires-an-extreme-reverse-
Trendelenburg.-Special-padding-is-ordered-to-prevent-the-patient-from-slipping.-What-is-
the-other-purpose-of-this-padding?
Assist-in-thermoregulation.
Prevent-shearing.
Provide-moisture-wicking.
Prevent-mobility-impairment.---ans-✔✔Prevent-shearing.
Rationale:-The-Trendelenburg-position-can-cause-a-patient-to-slip-down-the-operating-
table.-That-slippage-can-leave-a-patient-with-painful-skin-shear-injuries.-Place-a-foam-or-
gel-pad-under-the-patient-between-their-skin-and-the-table-to-prevent-skin-shearing.-The-
friction-created-by-the-pads,-which-are-taped-to-the-table-or-held-down-with-straps,-helps-
hold-the-patient-in-place.-Foam-padding-and-sponges-can-also-serve-to-protect-parts-of-
the-patient's-body-that-might-be-injured-under-pressure-or-accidental-poking.
