Surgical Nursing practice questions

Answer: A) Cavitation

• ACorrect. Tiny bubbles scrub surfaces.
• BIncorrect. That's for sterilizing.
• CIncorrect. That's for sterilizing.
• DIncorrect. That isn't how it works.

Answer: B) Above the elbows

• AIncorrect. Keep them elevated.
• BCorrect. Water drains away from the hands.
• CIncorrect. Keep them elevated.
• DIncorrect. Keep them in view and elevated.

Answer: B) Clearing the airway and rubbing them dry briskly

• AIncorrect. That's harmful.
• BCorrect. Keep them warm.
• CIncorrect. Remove the membranes.
• DIncorrect. That's no longer recommended.

Answer: A) Heavy tissue

• ACorrect. Such as fascia.
• BIncorrect. Use Metzenbaums.
• CIncorrect. Use bandage scissors.
• DIncorrect. Use wire cutters.

Answer: D) To relieve tension on wound edges

• AIncorrect. That's intradermal.
• BIncorrect. It's used in many tissues.
• CIncorrect. Tension relief is the purpose.
• DCorrect. It spreads tension along the wound.

Answer: C) Opened or unlocked so the box lock and jaws are exposed

Hinged instruments are sterilized opened or unlocked so steam can reach the box lock and jaw surfaces. They are packaged in approved materials such as sterilization wraps or peel pouches.

• AIncorrect. Closed, tightly stacked instruments keep steam from reaching the joints and touching surfaces. CDC says hinged instruments should be opened.
• BIncorrect. With the ratchets locked, the jaws and box lock stay pressed together, so steam cannot reach those surfaces.
• CCorrect. CDC states that hinged instruments should be opened so the sterilant can reach every surface, including the box lock.
• DIncorrect. Kitchen-type plastic wrap is not an acceptable sterilization packaging material. Approved wraps and paper/plastic peel pouches are used instead, because they let the sterilant in and keep the item sterile afterward.

Answer: B) Lifting the uterine horn through a small incision

• AIncorrect. That's suture scissors.
• BCorrect. It helps locate the uterus.
• CIncorrect. That's a towel clamp.
• DIncorrect. That's a bone cutter.

Answer: B) An incision into the urinary bladder

• AIncorrect. That's an OHE.
• BCorrect. It's often done to remove stones.
• CIncorrect. That's a gastrotomy.
• DIncorrect. That's a splenectomy.

Answer: A) It is gradually broken down in the tissue, so the buried layer never has to be removed

Absorbable sutures such as polyglactin 910 are broken down in the body (synthetics by hydrolysis), so they suit buried layers such as subcutaneous tissue, where removal isn't possible.

• ACorrect. Polyglactin 910 is a synthetic absorbable suture. It is broken down mainly by hydrolysis, as water breaks the polymer's ester bonds, and it loses strength and is absorbed over weeks to months. That makes it practical for buried layers that can't be reached for removal.
• BIncorrect. This describes nonabsorbable suture, which stays in the tissue and is walled off by the body instead of broken down.
• CIncorrect. Scheduled removal applies to external skin sutures or staples, which are usually nonabsorbable. A buried subcutaneous layer is never removed.
• DIncorrect. This describes catgut, which comes from sheep or cattle intestine and is broken down by proteolytic enzymes and macrophages, causing more tissue reaction. Polyglactin 910 is a synthetic polymer that is broken down by hydrolysis.

Answer: A) Dip them in a water-soluble instrument lubricant (instrument milk)

After cleaning and before packing, hinged instruments are dipped in a water-soluble lubricant that steam can penetrate. Oil-based products block the sterilant, bleach corrodes steel, and instruments should be sterilized with their ratchets open.

• ACorrect. A water-soluble lubricant protects box locks and hinges and still lets steam reach the instrument surfaces during sterilization.
• BIncorrect. Oil-based lubricants leave a film that keeps steam from reaching the metal. CDC lists lubricant material as residue that interferes with disinfection and sterilization.
• CIncorrect. CDC notes that hypochlorites corrode metals at high concentrations (>500 ppm). Bleach pits stainless steel and does nothing to lubricate the joints.
• DIncorrect. CDC guidance says hinged instruments should be opened for processing so the sterilant reaches the joints and serrations. Locked ratchets also strain the box lock.