202 Test

Question 2

Which of the following procedures for obtaining an informed consent form is appropriate?

Answer 2

The patient is asked to sign the consent form after the surgeon has explained the procedure

Question 3

A female patient with end-stage pancreatic cancer was admitted from hospice for a celiac plexus block to treat intractable pain. She wanted to be able to complete “getting her things in order” and saying good-bye to her friends and family while enjoying her last days pain-free. The patient insisted that her Do Not Resuscitate (DNR) status NOT be rescinded. She was conscious and competent and knew what was best for herself. The patient was taking full advantage of what provision for her care?

Answer 3

PSDA and advance directives
(Patient Self-Determination Act)

Question 4

Which nonprofit organization improves patient care through applied research into effectiveness and safety of devices, drugs, procedures, and processes?

Answer 4

Emergency Care Research Institute (ECRI)

Question 5

A specimen obtained for frozen section is generally removed from the sterile field intraoperatively because it:

Answer 5

Is sent to pathology immediately

Question 6

Which of the following are reasons for keeping the OR at a relative humidity level of between 50-55%?
1. Reduced risk of infection
2. Lower levels of patient discomfort
3. Minimization of static electricity
4. Depressed waste anesthesia ga

Answer 6

1 & 3

Question 7

What type of biopsy is performed during a flexible endoscopic procedure?

Answer 7

Brush Biopsy

Question 8

Which action by the SFA demonstrates proactive involvement in the universal protocol?

Answer 8

Participating in the surgical timeout and confirming site marking with the surgeon

Question 9

A robotic gynecologic procedure is underway, and the surgical team needs to adjust patient positioning. What major safety concern does traditional robotic equipment pose?

Answer 9

Robotic arms must be removed from the abdomen prior to repositioning

Question 10

A robotic instrument tip fractures during dissection, and a fragment falls into the patient. What SFA action is most appropriate?

Answer 10

Assist in visualization and precise retrieval to prevent RSI

Question 11

Proper handling of specimens is crucial for patient safety. What is the most serious negative outcome that could occur as a result of the loss, mislabeling or mishandling of a surgical specimen?

Answer 11

The patient’s condition could be misdiagnosed

Question 12

Direct contact with an uninsulated ESU active electrode during activation would most likely cause:

Answer 12

Concentrated electrical burn or shock

Question 13

Which RSI type is most frequently retained following surgical procedures?

Answer 13

Soft goods such as sponges

Question 14

During a laparoscopic procedure, the surgeon accidentally creates a small bowel perforation. As a SFA, your immediate response should be to:

Answer 14

Promptly assist in locating and assessing the perforation while maintaining suction and visualization.

Question 15

The OR is a danger-prone area for both patients and staff. Providing a safe environment of care for the patient involves identifying, mitigating, and managing the hazards inherent in surgical care. Choose the answer below that completes the blanks in this sentence: the risk of the surgical hazard of _________________ can be mitigated through _______________________.

Answer 15

Wrong patient, wrong site, and wrong side surgery; site marking and presurgical checklists

Question 16

15. An inexperienced team member places a frozen section specimen into formalin. What is the most significant consequence?

Answer 16

Permanent alteration of cells and loss of diagnostic value

Question 17

When unexpected events occur that have, or could have, compromised patient safety, a systematic investigatory process takes place. Significant information is gained through this meticulous exploration. The primary motive for carrying out a root cause analysis is to:

Answer 17

Find out what needs to take place to prevent a recurrence of the event

Question 18

Governmental and professional agencies and organizations, whether voluntary or involuntary, have a significant influence on patient safety policies in the healthcare setting. Select the agency or organization statement that presents a true reflection of its focus or purpose.

Answer 18

World Health Organization (WHO): United Nations (UN)–based and supported authority on health throughout most of the world

Question 19

RFID sponge-tracking technology is being used during a complex abdominal procedure. What is the SFA’s primary responsibility in relation to this system?

Answer 19

Maintain visibility and control of soft goods and instruments in the wound

Question 20

Fires and explosions in the perioperative setting require three components, described as the “fire triangle.” The element of the triangle the perioperative nurse has the most control over is:

Answer 20

The Fuel

Fuel (Combustible Material)
Heat (to reach ignition temperature)
Oxygen (an oxidizing agent)

Question 21

Laparoscopic procedures that emergently convert to open procedures place the patient at risk for unintentional retained surgical items (RSIs). What new and evolving risk reduction strategy could prevent RSIs and frustrating, time-consuming miscount adventures at the end of these procedures?

Answer 21

Replacing or tagging sponges and laparotomy instruments with radiofrequency identification (RFID) chips

Question 22

If a routine surgical procedure was performed without consent, what action would be committed?

Answer 22

Battery

Question 23

A tissue specimen cannot be sent immediately to pathology. It is placed into formalin. What risk must the SFA be most aware of?

Answer 23

Formalin fumes may cause respiratory irritation and tissue injury

Question 24

An obese, malnourished patient who presents for surgery is at higher risk for

Answer 24

Wound Infection

Question 25

A lymph node is removed from the groin during melanoma excision. What is the most important labeling requirement for pathology interpretation?

Answer 25

Identification of the nodal basin and laterality

Question 26

Which of the following situations requires informed consent from the patient/family?

Answer 26

Organ procurement

Question 27

A patient was presented with the prepared informed consent form during the discussion with her surgeon concerning her scheduled vaginal-assisted laparoscopic hysterectomy. She demonstrated and verbalized that she understood the procedure, risks, expected outcome, complications, and procedural process. Before she signed the consent form, she informed the surgeon that she did not want any medical students or surgical residents performing any parts of the procedure other than assisting and did not want any photographs of her body taken. The surgeon agreed, and she crossed out those portions of the form and initialed them before she signed. The patient was exercising her:

Answer 27

Right to informed consent

Question 28

A high-BMI patient is scheduled for lengthy robotic pelvic surgery. Why does this body habitus increase pressure injury risk?

Answer 28

Increased body mass elevates force, raising pressure over dependent areas.

Question 29

During a lumpectomy, the surgeon requests a frozen section to assess margin status. What is the correct method for SFA specimen handling?

Answer 29

Place the tissue on moistened telfa and avoid fixatives

Question 30

During total hip arthroplasty in lateral decubitus, a sudden postoperative foot drop is noted. Which nerve was most likely compressed?

Answer 30

Common Peroneal Nerve

Question 31

During a lumpectomy with sentinel lymph node biopsy, the surgeon removes the sentinel node containing blue dye and radioactive tracer. What is the SFA’s primary responsibility at this stage?

Answer 31

Ensure the node is clearly identified, oriented, and labeled separately from the breast specimen

Question 32

A facility prepares for a combined surgical procedure requiring two consents. Which safety action must occur?

Answer 32

A second time-out must be performed before the additional procedure

Question 33

In prolonged supine positioning, the SFA reinforces padding under the elbows to protect which nerve?

Answer 33

Ulnar Nerve

Question 34

33. A patient was positioned, prepped, and draped following general endotracheal anesthesia induction. The team assembled to perform the time-out as described in the WHO surgical checklist. Successful employment of the time-out can only be ensured when:

Answer 34

Each member of the team has an equal role and voice.

Question 35

The SFA is passing instruments back to the scrub technologist during closure. What counting behavior supports RSI prevention?

Answer 35

Audibly and Visually confirming items as they are removed from the field

Question 36

Which type of specimen-handling error poses the greatest risk of misdiagnosis?

Answer 36

Incorrect laterality or site Identification

Question 37

During colectomy for colon cancer, the surgeon requests specimen marking to identify the proximal margin. Why must the SFA ensure clarity and accuracy?

Answer 37

Margin designation guides pathologic evaluation, informing staging and surgical success

Question 38

Which of the following organisms normally found on skin can cause wound infections?

Answer 38

Staphylococcus aureus

Question 39

Which of the following are the MOST important consideration when preventing wound infection in the surgical patient? 1. Pathogen transmittal 2. Portal of entry into the susceptible host 3. Anesthetic options for the patient's operative process 4. Invasion of the susceptible host

Answer 39

1, 2, & 4

Question 40

Proper care and handling of surgical specimens is imperative for correct diagnosis, treatment, and prognosis planning of the patient. Select the response that best reflects correct specimen care and handling.

Answer 40

Avoid placing specimens for frozen section in formalin

Question 41

If a Kelly clamp is left in a patient who underwent a cholecystectomy, which of the following legal charges can be filed?

Answer 41

Res ipsa loquitur

Question 42

Staphylococcus aureus would most likely be transmitted by:

Answer 42

Nose and mouth

Question 43

Which factor most explains why endogenous skin flora remain a major cause of SSIs despite modern antisepsis?

Answer 43

Up to 20% of organisms reside in deep follicles beyond antiseptic penetration

Question 44

Which of the following techniques demonstrate a proven benefit in the prevention of postoperative wound infections? 1. Administering appropriate antibiotics within 1 hour of incision time 2. Maintaining suitable antibiotic coverage fro 48-72 hours postoperatively 3. Irrigating the wound with normal saline 4. Irrigating the wound with sterile water

Answer 44

1 & 3

Question 45

Clostridium perfringens is associated with which clinical condition?

Answer 45

Gas Gangrene

Question 46

The evening before the procedure was scheduled, the central sterile processing department received two complete sets of an orthopedic spine fusion system that contained titanium-implantable instrumentation, four flexible coated retractor blades, and an unsterilized internal paper inventory form. The sterilization instructions provided by the vendor representative recommended steam sterilization for the implants, but stated that the flexible coated blade retractors could not be exposed to temperatures higher than 220° F. The appropriate sterilization option for these instruments and devices would be:

Answer 46

steam sterilization for the implant sets and paper inventory form, hydrogen peroxide gas plasma for the retractors, wrapped separately.

Question 47

Why are prions responsible for Creutzfeldt–Jakob disease exceptionally difficult to eliminate using standard reprocessing?

Answer 47

They lack DNA/RNA and resist conventional sterilization/disinfection methods

Question 48

A 55-year-old woman undergoes laparotomy for small bowel obstruction. During lysis of adhesions, an enterotomy is made in the obstructed, but viable, bowel, and a large amount of fecal-looking bowel contents are spilled into the abdomen. The incision would now be considered what kind of wound?

Answer 48

Contaminated

Question 48

Which bloodborne pathogen poses the highest transmission risk from a single needlestick injury in an unvaccinated healthcare worker?

Answer 48

Hepatitis B virus

Question 49

The Centers for Disease Control and Prevention (CDC) have identified pathogens that could pose a threat to national and world security and safety through bioterrorism. Select the four most probable agents that could be used to cause mass transmission, mortality, panic, and social disruption.

Answer 49

Smallpox, plague, botulism, tularemia

Question 50

A patient undergoing biopsy is being evaluated for suspected prion disease. What instrument management strategy best reduces transmission risk?

Answer 50

Use of disposable surgical instruments

Question 51

Herpes simplex is commonly called:

Answer 51

Cold sore

Question 52

12. What is the recommended timeframe to initiate HIV postexposure prophylaxis (PEP)?

Answer 52

Within 72 hrs