NCCT CST Practice Exam With Complete Solutions Latest Update, Exams of Surgical Pathology

Download NCCT CST Practice Exam With Complete Solutions Latest Update and more Exams Surgical Pathology in PDF only on Docsity! NCCT CST Practice Exam With Complete Solutions Latest Update The circulating nurse notices that the patient is actively bleeding from one of the operative sites and the surgeon has left the room. Which of the following actions should the surgical technologist take? A. Break scrub and inform the surgeon. B. Remain in gown and gloves and apply pressure. C. Break scrub and monitor the sterile field. D. Open a new sterile field for the patient. - correct answers B. Remain in gown and gloves and apply pressure. Rationale: The surgical technologist should remain sterile until the patient is out of the operating room and in PACU. If the surgical technologist has not broken scrub she can apply pressure until the surgeon is called back into the room. Since the field remains sterile it is not necessary to open a new sterile field. The surgical technologist is helping the surgeon complete a laparoscopic cholecystectomy and the surgeon has placed the dressing on the patient. Which of the following should the surgical technologist do next? A. Remove the top glove, hold the dressing in place, roll away the drape and discard. B. Remove Mayo stand, back table and top glove, hold the dressing in place, tear the drape off the patient and discard. C. Remove top glove, hold dressing in place, tear the drape off patient and discard. D. Remove the Mayo stand, back table and top glove, hold the dressing in place, roll away the drape and discard. - correct answers D. Remove the Mayo stand, back table and top glove, hold the dressing in place, roll away the drape and discard. Rationale: The Mayo stand and back table need to remain sterile until the patient is out of the room. The top gloves need replaced to prohibit any debris from getting the dressing dirty. By holding the dressing on with the clean gloves the drape can be removed so any biohazardous materials are contained within the drapes and discarded. A tornado warning is in effect and power has been switched to the generator due to downed electrical lines. The hospital's disaster triage protocol has been activated. A surgical procedure is in progress. Which of the following is the best course of action to ensure patient safety? A. Immediately evacuate the patient to the preoperative holding area. B. Finish the procedure and evacuate the patient. doctor should be in control of the foot control pedal to the laser. During a vaginal hysterectomy the surgical team noticed that the safety belt was left off the patient before the drape was applied and discovered after draping. How can the patient be secured to the OR bed without interrupting the sterile field or procedure? A. The surgical technologist can watch for movement of the patient and inform the circulator. B. The anesthesiologist can secure the head to prevent shifting. C. The circulator can reach under the sterile drape and apply the safety strap. D. The surgeon can request sterile coban to secure the patient. - correct answers C. The circulator can reach under the sterile drape and apply the safety strap. Rationale: The underside of the drape is not sterile, therefore, can be touched by the unsterile circulating nurse, while she secures the patient with the safety strap. The surgical team is at the surgical field and has just completed the time-out. The surgeon turns to the surgical technologist and asks for local. Which of the following actions should the surgical technologist take next before passing the local? A. Read aloud the medication label on the syringe. B. Pass the correctly labeled medication syringe. C. Confirm with the circulator the medication label on the syringe. D. Confirm with the anesthesiologist the medication on the syringe. - correct answers A. Read aloud the medication label on the syringe. Rationale: The medication has already been verified by the circulator and the surgical technologist upon placement on the sterile field. The surgical technologist needs to read aloud the syringe contents when handing the syringe to the surgeon. The anesthesiologist is not part of the sterile team environment. The surgeon is doing a laparoscopic procedure using an endo GIA stapler. He passes the stapler to the surgical technologist and asks him to reload. Which of the following should the technologist do to the stapler before passing back to the surgeon? A. Open the jaws. B. Pre-fire the jaws. C. Lubricate the jaws. D. Close the jaws. - correct answers D. Close the jaws. Rationale: The jaws must be closed to fit through the laparoscopic port. Each refill is single-use, therefore pre- firing the stapler will activate the staples, rendering the reload useless. There is no need to lubricate the jaws. Which member of the surgical team is in charge of the transfer of an immobile or unconscious patient from the OR table to the stretcher? A. surgeon B. circulator C. anesthesia provider D. surgical technologist - correct answers C. anesthesia provider Rationale: The anesthesia provider is in control of the patient transfer and coordinates the move. They have control of the head and the patient's airway. The surgeon most likely has already left the room and cannot help with the transfer. The circulator is on the other side of the bed waiting on the transfer device when anesthesia gives the permission. The surgical technologist is on the other side waiting to help transfer the patient. There should always be 4 people to transfer a patient. Anesthesia is at the head of the bed and one person is on each side with one at the end of the bed to help transfer the feet. The surgical technologist observed a patient fall during the transfer from the gurney to the operating bed. Which of the following items are required in the incident report? (Select the three (3) correct answers.) During a laparoscopic procedure, the screen on the monitor becomes darker and visualization is impaired. The surgeon discovers that carbon dioxide is escaping. Which of the following should the surgical technologist check first? A. light cord B. camera C. insufflation tubing D. ESU - correct answers C. insufflation tubing Rationale: Insufflation tubing is connected to the CO2 tank or gas line, and also is connected to the scope. The insufflator is set to a certain pressure to maintain visibility in the abdomen during laparoscopic surgery. Connection of the insufflation tubing can be checked by the ST at scope. Connection of the insufflation tubing at the insufflator itself, must be checked by a non-sterile team member. Which of the following actions by the surgical technologist reduces the risk of bioburden accumulation on serrated hemostatic forceps postoperatively? A. Soak in sterile saline within 24 hours. B. Soak in enzymatic solution within 20 minutes. C. Allow to dry completely prior to placing in autoclave. D. Sterilize with rings together. - correct answers B. Soak in enzymatic solution within 20 minutes. Rationale: Instruments are not soaked in saline because it will pit them. Instruments should not be sterilized with rings together, because they cannot be properly sterilized. The instruments dry in sterile processing prior to being placed in the autoclave. A patient is undergoing a right partial pneumonectomy. Which of the following drains should the surgical technologist prepare for placement at the end of the case? A. Jackson Pratt B. chest tube C. Penrose D. Hemovac - correct answers B. chest tube Rationale: Any time the chest cavity is entered and the normally present negative intrapleural pressure is compromised, a chest tube must be placed to reestablish the negative pressure. A penrose is a passive drain that is partially placed within the wound allowing fluid to move out of the tube onto a dressing. The Jackson Pratt drain is commonly used for general and abdominal procedures for moderate drainage. The Hemovac drainage is commonly used for orthopedics for moderate drainage. Which of the following must the surgical technologist verify before implants are opened during a total knee replacement? (Select the three (3) correct answers.) A. expiration date B. name of component C. lot number D. size E. manufacturer name - correct answers A. expiration date B. name of component D. size Rationale: Manufacturer name and lot number do not have to be verified by the surgical technologist, but are charted by the circulator for documentation. Always verify implant type, size, and expiration date, prior to opening. In a sterilized package, a chemical indicator is used to A. verify elimination of living flora on the package. B. confirm that the package was exposed to sterilization. C. show that no moisture entered the package. D. ensure that the package is sterile. - correct answers B. confirm that the package was exposed to sterilization. following parameters must be met for sterilization with gravity displacement steam? (Select the two (2) correct answers.) A. 3-4 minute exposure time B. 270 F C. 10 minute exposure time D. 132o F E. 4 minute drying time - correct answers A. 3-4 minute exposure time B. 270 F Rationale: Per CDC guidelines, proper parameters for an unwrapped, non-porous item with no lumen in a gravity displacement sterilizer are 132 degrees Celsius, or 270F for 3 minutes. When reviewing the autoclave log, the surgical technologist should confirm that which of the following items have been documented before using the instrumentation? A. expiration date B. Sterrad indicator C. exposure temperature D. gas volume - correct answers C. exposure temperature Rationale: Exposure temperature is one of the items of documentation that should be on the monitoring log. This will allow the ST to see if the sterilizer has reached the required temperature to deem the item or tray sterile. The patient is scheduled to have a Meniscal repair done on his right knee. Which of the following best represents how the site should be marked in the preoperative holding area to verify correct surgical site? A. A "yes" written on the right knee, with a small line showing where the incision will be. B. An "X" marked on the right knee, with a small line showing where the incision will be. C. An "X" marked on the left knee, showing that this is not the correct surgical site. D. A "no" written on the left knee, showing that this is not the correct surgical site. - correct answers A. A "yes" written on the right knee, with a small line showing where the incision will be. Rationale: The operative site will be marked by the surgeon. Indelible marker should be used, so that prep solutions, drapes and tape do not inhibit the ability to read it clearly. The word "yes" or the surgeon's initials are commonly acceptable ways to mark the correct surgical site. "X" or "no" are not acceptable, as to it could lead to confusion or misunderstanding of whether site is correct or not. Which of the following resources should the surgical technologist use if a question arises concerning the correct use of a cleaning solution? A. OSHA regulations B. CDC guidelines C. MSDS D. Bowie-Dick test sheet - correct answers C. MSDS Rationale: OSHA is the Occupational Safety and Health Administration. CDC stands for the Centers for Disease Control and Prevention. Material Safety Data Sheets (MSDS) contains information on all hazardous chemicals: precautions for handling the chemicals, the hazards associated with chemicals, and the firefighting techniques--along with first aid for exposure. The Bowie- Dick test is used to test and monitor high vacuum steam sterilizer. Prior to a case the surgical technologist determines the power saw is not functioning. Which of the following is the most likely cause? A. It is not plugged into the electrical outlet. B. The battery has not been adequately charged. C. It has not been attached to the foot pedal. D. The arthroscopy shaver is not connected. - correct answers B. The battery has not been adequately charged. spinal column not visible by CT scan or MRI alone. A periosteal elevator is used in open orthopedic procedures to scrape periosteum off bone. Prolene mesh is commonly used to repair hernias. A Williams retractor is a self- retaining retractor used in lumbar discectomy procedures. When being relieved for lunch during surgery, which of the following tasks is performed by the outgoing surgical technologist? A. removing supplies and equipment from the Mayo stand B. counting sharps and sponges C. adding gown and gloves to the back table for return to surgery D. placing all softs and sharps onto the back table - correct answers B. counting sharps and sponges Rationale: The surgical technologist should ensure that all sharps and sponges are accounted for prior to being relieved for lunch or break. The surgical technologist prepared a breast lump to send as a frozen section to pathology. The surgical technologist should pass off the specimen placed A. in normal saline. B. on a raytec sponge. C. on a telfa pad. D. in formalin. - correct answers C. on a telfa pad Rationale: A fresh frozen specimen means that the specimen is not in formalin, or any fixative agent. The STs responsibility is to place the specimen on a moist Telfa, which will allow it to be easily removed in the lab and not stick to an untreated surface. The ST should pass the specimen off on the Telfa to her circulator who will then place it in a clean specimen container and arrange for immediate transport to pathology. The surgeon will be taking bilateral skin grafts from the patient's thighs for placement on a left lower leg fasciotomy. For both surgical sites, which of the following dressings should the surgical technologist anticipate the surgeon needing? A. Duoderm B. iodoform gauze C. Xeroform D. adhesive skin closure strips - correct answers C. Xeroform Rationale: Xeroform is an occlusive dressing and it would not stick to the sites. This allows for a painless removal of the dressing because it is non-adherent. Iodoform gauze would not be used because it would stick to the surgical site. Adhesive skin closure tapes are used to approximate the wound edges together. Duoderm is used to treat bed sores or pressure ulcers. A cardiac arrest occurs during a thoracotomy procedure, and the surgeon calls a CODE BLUE. The surgeon is attempting to resuscitate the patient using CPR. Which of the following is the responsibility of the surgical technologist in this situation? A. Hand the surgeon a loaded needle holder and forceps for closing. B. Break scrub and retrieve the code cart. C. Prepare internal defibrillator paddles. D. Prepare external defibrillator paddles. - correct answers C. prepare internal defibrillator paddles Rationale: The surgery is already in progress when the Code Blue is called the surgical technologist may be required to prepare the internal defibrillator paddles. The surgical technologist does not break scrub to get the crash cart the circulator will get any necessary equipment needed. Which of the following are duties the surgeon may delegate to the surgical technologist? (Select the three (3) correct answers.) A. dissect tissue B. silver nitrate C. acetic acid D. sorbitol solution - correct answers A. isopropyl alcohol Rationale: Silver nitrate is a hemostatic agent. Acetic acid is also known as vinegar and is not flammable. Sorbitol solution is a sugar alcohol and is not flammable. Isopropyl alcohol is highly flammable and can start a fire. During a laparoscopic procedure the surgeon decides to convert to open. Which of the following additional supplies and equipment need to be opened? A. insufflation tubing B. endo-pouch C. lap sponges D. Veress needle - correct answers C. lap sponges Rationale: When converting to an open case the incision will be extended. Laparotomy sponges will be needed because they are the largest and most absorbent in open cases. The insufflation tubing, endo-pouch, and Veress needle are part of a set-up for a laparoscopic procedure and are not used on open laparotomy surgeries. Which of the following areas of the surgical gown is considered sterile? A. the front of the gown from the neckline to the waist B. the cuffs and sleeves of both arms up to the shoulders C. the front of gown from the chest to the waist D. the back of the gown - correct answers C. the front of gown from the chest to the waist Rationale: The front of the gown from the mid-chest level to the waist and the sleeves circumferentially to 2 in proximal to the elbows is considered sterile. An emaciated patient is scheduled for an abdominal hysterectomy with removal of excessive skin on bilateral thighs. The circulator has opted to place the ESU grounding pad on the patient's forearm. The surgical technologist should suggest that the ESU pad be removed and placed on A. either thigh. B. either ankle. C. the clavicle. D. the buttocks. - correct answers D. the buttocks. Rationale: It is essential that the grounding pad be completely in contact with the patient's skin. In this case, the patient is emaciated, so the forearm would likely be too small to facilitate the full size of the grounding pad. Placement on the buttock allows for the complete pad to be in contact with the patient's skin. When steam sterilizing biological indicators, how long are they incubated before the reading is recorded? A. 12 hours B. 24 hours C. 48 hours D. 72 hours - correct answers B. 24 hours Rationale: Per CDC guidelines, steam sterilizer biological indicators must be incubated for 24 hours before the reading is recorded. The surgical technologist notices smoke and flames coming from the drape surrounding the surgical site. Which of the following actions should the surgical technologist take? A. Move away and protect the sterility of the back table. B. Smother the drape with a wet sterile towel. C. Place the flame retardant blanket over the patient. D. Disconnect the electrical surgical unit. - correct answers B. Smother the drape with a wet sterile towel. Rationale: The first thing the surgical technologist should do is to smother the drape with a wet sterile towel to contain the fire. The surgical technologist should not abandon the patient. The fire should be taken care of B. Inform the circulator that the drain is full and there is the potential for active bleeding in the surgical site. Rationale: The circulator needs to be informed since there may be a potential active bleed and the surgeon has left the room. The surgical technologist should then remove the bulb and empty the contents in the appropriate container. The circulator should document the amount in the bulb. If the drain keeps filling up the surgeon would need to return to the room. The Jackson Pratt drain can be emptied since it has a removable bulb. A new one is not needed since it can be emptied and replaced. Since there is potential bleeding the surgical technologist should not cover it up. Postoperatively a hernia repair patient complains of ulnar pain, numbness and tingling bilaterally. The most likely cause of the patient's discomfort is that the surgical technologist forgot to A. adduct the arm. B. place the axillary roll. C. place arm pads. D. abduct the arm. - correct answers C. place arm pads. Rationale: Adduction/abduction are motions performed during surgery. Axillary rolls are used during the lateral position. Arm pads are used throughout surgery to prevent damage to the ulnar nerve. The arms are placed on arm boards with the palm facing upwards. During an abdominal hysterectomy, the surgeon found a lesion on the ovary. The surgeon excised the lesion and asked that the specimen be sent to the lab for immediate analysis. Which of the following types of specimen is this? A. permanent B. frozen C. partial D. fresh - correct answers B. frozen Rationale: A frozen specimen is sent to the lab dry for immediate analysis. It is useful for checking margins on the specimen. Permanent sections are placed in a fixative solution for further analysis later. A fresh specimen is one that has to be sent to the lab dry and then will be fixed with a fixative solution upon arrival in the lab. Which of the following items should the surgical technologist have in the room for an ORIF of an ankle case? (Select the two (2) correct answers.) A. reciprocating saw B. laminectomy tray C. extremity pack D. vascular tray E. small fragment tray - correct answers C. extremity pack E. small fragment tray Rationale: The ORIF Open Reduction Internal Fixation involves the ankle fracture which is an extremity so an extremity pack will be needed. The Small fragment will also be need because it contains screws, plates and drill bits that will be needed for the fixation. The procedure does not need a laminectomy pack since we are not working on the spine. A vascular tray would not be needs because veins and arteries are not involved. Ten minutes into an automatic chemical washer cycle for an instrument string, the surgical technologist notices she has missed a few critical instruments. Which of the following should the technologist do? A. Immediately power down the washer and add the instruments. B. Wait until the washer stops and run a new cycle with the instruments. C. Open the washer door on the dirty side and add manually decontaminated instruments. D. Open the washer door on the clean side and add manually decontaminated instruments. - correct answers B. Wait until the washer stops and run a new cycle with the instruments. under the strap with ease. Placing the strap across the torso would not secure the legs to the bed. Placing the strap below the knees does not provide adequate safety support to the rest of the body. An OB-GYN surgeon has posted a laparoscopic partial hysterectomy and has informed the surgical team that the ovaries are remaining. However, the fallopian tubes will require ligation involving the tubes being clipped and cauterized. Which of the following instruments should the surgical technologist open? A. a Filshie and a Kleppinger B. a harmonic scalpel and hemoclip applier C. a Filshie and hemoclip applier D. a Kleppinger and harmonic scalpel - correct answers A. a Filshie and a Kleppinger Rationale: A Filshie is a small titanium clip with a soft lining used specifically for female sterilization. The Kleppinger would be used next as a secondary measure to cauterize the exposed ends of the Fallopian tubes. A harmonic scalpel is used to cut and coagulate tissue, but the Kleppinger offers a smaller, more precise coagulation area. Hemoclip appliers are not used as a sterilization method. When transferring a patient to the operation room table, the surgical technologist should A. power off any medical equipment during the transfer. B. ensure that the O.R table remains unlocked in order to position the table to the surgeon's preference. C. allow 5-6 fingerbreadths between the safety strap and the patient. D. transfer medical equipment first and then move the patient. - correct answers D. transfer medical equipment first and then move the patient. Rationale: Powering off medical equipment could harm the patient. Unlocked operating room tables increase the patients risk for injury. The safety strap should be snug for the safety of the patient without causing injury. Transferring medical equipment first ensures the equipment remains functional throughout the transfer. Instruments and supplies have been opened by the surgical technologist for a case in Room 5. Soon after the surgical technologist was informed that the case has been moved to Room 1, but there is a similar case scheduled for Room 5 later that morning. Which of the following is the best course of action? A. Cover the back table with a sterile drape and leave it in Room 5. B. Leave the set-up in Room 5 to be used on the later case for no longer than one hour. C. Leave the case in Room 5 in order to save costs and alert the charge nurse about the move to Room 1. D. Take unopened supplies to Room 1, build a new set-up, and break down Room 5. - correct answers D. Take unopened supplies to Room 1, build a new set-up, and break down Room 5. Rationale: If a room is delayed or cancelled, there is no way to ensure the set up remains sterile, unless a staff member stays in the room and monitors. Facility policy may also dictate a time frame for use of opened sterile items. When cutting 7-0 nylon suture, which of the following is the best instrument to use? A. straight Iris scissors B. straight Mayo scissors C. curved Metzenbaum scissors D. curved Stevens tenotomy scissors - correct answers A. straight Iris scissors Rationale: Suture should always be cut with a straight scissor, and one that is compatible with the heaviness of the suture material being cut. The best choice is the straight Iris scissor, since it is a smaller, finer scissor than a Mayo. A charge nurse has just notified the surgical technologist to be prepared for a post-operative emergency for a post Rationale: A long Bovie tip would need to be opened because the patient is 300 pounds. Also extra lap tapes would be needed because of the patient weight and the potential for bleeding. Suture should be held because it may not be the correct suture needed because of the patient's size. An 11 blade is used on laparoscopic cases and would not be necessary for an open procedure. Raytecs should not be opened or free on opened procedures 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? A. Open the inner layer onto the sterile field. B. Discard the item and retrieve a new one. C. Check the indicator to ensure the item has been sterilized. D. Place the package on a prep stand and open away from the sterile field. - correct answers B. 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. The surgical technologist is scrubbed in on a scheduled breast biopsy with a frozen section. After removing the specimen the surgeon tags the specimen with suture at 6 o'clock and passes it to the technologist. Which of the following should the technologist do first? A. Label the specimen. B. Pass off the specimen to the nurse immediately. C. Ask the surgeon to identify the specimen. D. Place the specimen on a Raytec sponge. - correct answers C. Ask the surgeon to identify the specimen. Rationale: The specimen must always be verified by the surgeon before being passed off. Patient labels will be placed in the sterile, dry, container after verification and the specimen will be passed off to the circulator to be transported to the lab immediately. Specimens should never be placed on sponges. Which of the following retractors has sharp disposable inserts that must be disposed of in an appropriate sharps container following the end of the surgical case? A. Mayfield B. Cloward C. Bookwalter D. Greenfield - correct answers A. Mayfield Rationale: The Mayfield is a headrest that pins the head for stabilization. The pins used are very sharp and must be placed in the sharps container after the procedure. A Cloward is a hand held retractor used in an anterior cervical procedure. The Bookwalter is a self-retaining retractor used for open abdominal procedure. The Greenfield is a self-retaining retractor used on the brain. An alert, oriented, and mobile 300 lb. patient is brought into the OR on a transport cart. Which of the following is the best method of slowly transferring this patient to the OR bed? A. Align the beds together, lock the wheels, and use a roller board. B. Align the beds together, lock the wheels, and ask the patient to move himself. C. Use a mechanical lift to assist in moving the patient. D. Call for more lifting help to assist in moving the patient. - correct answers B. Align the beds together, lock the wheels, and ask the patient to move himself. Rationale: The mobile patient should be asked to move herself to the OR table independently. A minimum of two team members should be available to assist in any way possible. It is important to make sure all wheels are locked on both the gurney and the OR bed. spermatic cord. Which of the following should the surgical technologist provide? A. Army-Navy retractor B. vessel loop C. moist Penrose D. Weitlaner - correct answers C. moist Penrose Rationale: A moist Penrose drape is used with a Kelly clamp to retract and preserve the spermatic cord during an inguinal hernia. The Army Navy is a hand retractor which provides exposure to the operative site. A Weitlaner is a self-retaining retractor used to provide exposure to the operative site. Vessel loops are used to retract nerves, arteries, or veins. While cleaning the back table after a cystoscopy case, the tray of instruments accidentally falls on the floor. After retrieving all instruments, which of the following should the surgical technologist do before returning instruments to decontamination? A. Send the contents of the tray to Biomedical Engineering. B. Visually inspect the instruments. C. Inform Central Sterile that the instruments need inspection. D. Assemble the instruments that have not been used. - correct answers B. Visually inspect the instruments. Rationale: The first thing that needs to be done is to visually inspect the instruments for cracks or breakage. The case is over, so the instruments do not need assembled. Central Sterile can be notified also, but that occurs after the surgical technologist inspects them. The contents would not be sent to Bio Med. At the beginning of a carpal tunnel procedure the surgeon announces that he will use a Steven's scissor for every hand case he does from this day forward. After the case, which of the following is the most efficient way to make sure he has his Steven's scissor moving forward? A. Speak to the Sterile Processing manager, and ask that a Steven's scissor be added to every hand tray in the department. B. Add the Steven's scissor to every hand procedure preference card for the surgeon. C. Post a note in the supply room announcing the surgeon's request. D. Speak to the Materials Management department and ask they order additional Steven's scissors since the surgeon is going to use them more frequently. - correct answers B. Add the Steven's scissor to every hand procedure preference card for the surgeon. Rationale: Preference cards hold information for surgeon and case specific requirements. Putting the information on this card, will ensure that the scissor will be pulled, each time this surgeon does a hand case. Including the scissor in every hand tray is redundant, as all surgeons may not require its use. Notifying the Materials Management department of this request may be helpful, but will not be the best choice to ensure the surgeon has what he needs for future hand cases. The OR needs to be set up for a spinal laminectomy, where the surgeon has asked for a spinal positioner to arch the back in a prone position. Which of the following positioners should be chosen? A. Mayfield headrest B. MorphBoard positioning system C. Wilson frame D. Stulberg sliding bolster - correct answers C. Wilson frame Rationale: The Mayfield headrest is used to pin the head in neuro surgeries. A MorphBoard positioning device is a peg board used to position the hip in the lateral position. The Wilson frame is used to put the patient in the prone position to expose the back for an laminectomy. The Stulberg sliding bolster is used for knee surgery as a positioner. During an I&D of a back wound with the patient in the prone position the anesthesiologist announces that the patient is turning blue and calls a code. Which of the following actions should the surgical technologist take to assist? A. Assist the surgeon in closing the wound, remove the drapes, and flip the patient. B. Cover the wound and remove the Mayo and back table. C. Flip the patient immediately. D. Assist anesthesia with the patient while the surgeon continues surgery. - correct answers B. Cover the wound and remove the Mayo and back table. Rationale: The first thing that needs to be done is to maintain the patient's airway. The wound should be covered and the mayo should be removed so the patient can be flipped in order for anesthesia to take care of the airway, then assist anesthesia with the patient. Which of the following is the minimum number of counts for a Cesarean section case? A. two B. seven C. four D. three - correct answers C. Four Rationale: There is always a minimum of four (4) counts on a C-section: one prior to the incision, one prior to closure of the uterus, one prior to closing the abdominal cavity, and one prior to closing the skin. Seven would be too excessive and unnecessary. Which of the following is the minimum amount of time an unwrapped Kelly clamp needs to be flash sterilized for? A. 6 minutes B. 3 minutes C. 7 minutes D. 12 minutes - correct answers B. 3 minutes Rationale: The minimum amount of time is 3 minutes. While assisting the surgeon in draping a patient the surgical technologist is told that she has contaminated her gloves. Which of the following actions should the technologist take? A. Remove the contaminated drape, place a new drape, and re-glove. B. Step away from the field and re-glove. C. Place a new drape over the contaminated drape, and re-glove. D. Break from field, scrub and re-glove. - correct answers B. Step away from the field and re-glove. Rationale: The drape is not contaminated, making removal of the drape unnecessary. There is also no need to cover the drape with a new one. Breaking scrub completely is not necessary because re-gloving is adequate if the scrub is able to do this without contaminating the gown. The surgeon begins to close the uterus during a myomectomy. Which of the following actions should the surgical technologist take before continuing with the closure of the wound? A. Initiate the closing count. B. Initiate the cavity count. C. Obtain sterile wound dressing material. D. Weigh the myoma. - correct answers B. Initiate the cavity count. Rationale: Always count upon closing a cavity within a cavity, like the uterus within the abdomen. The final closing count is initiated at skin closure. Any dressing material should be opened after skin closure is completed. There is no need to weigh the myoma in the operating room. Which of the following is the best method of terminal sterilization? During a total abdominal hysterectomy, the surgeon has begun placing the Balfour retractor. In anticipation of bowel packing, the surgical technologist should moisten A. laparotomy sponges. B. Ray-Tec sponges. C. Kittner sponges. D. sterile blue towels. - correct answers A. laparotomy sponges. Rationale: Laparotomy sponges are the best choice for packing the bowel during an abdominal case because they are a large sponge used for larger incisions. Ray-tec sponges should never be used in the abdomen without a sponge stick because they can get lost very easily. Kittner sponges are only used for very small dissection or dabbing of blood. Blue towels should never be placed within an open incision because they do not have an x- ray detectable strip and they have not been counted like other sponges. After a resident connects the Yankauer suction tip, it falls slightly below the edge of the sterile field. Which of the following should be considered contaminated? A. Yankauer suction tip and the resident's gown B. Yankauer suction tip and the drape C. Yankauer suction tip D. Yankauer suction tip, the drape, and the resident's gown - correct answers C. Yankauer suction tip Rationale: Anything below the level of the sterile field is considered unsterile. When the tip of the Yankauer falls below the edge of the sterile field, it is considered contaminated. Unless it comes in contact with the drapes, or the residents gown as it's being passed off - it would be all that is considered contaminated. Which of the following hemostatic agents must be handled dry? A. prothrombin/Thrombin B. microfibrillar collagen/Avitene C. gelatin sponge/Gelfoam D. bone wax - correct answers B. microfibrillar collagen/Avitene Rationale: Avitene must be handled dry because it will stick to wet surfaces. Prothrombin/ thrombin are enzymes that assist the blood in the clotting cascade. Bone wax is a waxy substance made from beeswax and can be handled with wet or dry hands. If the surgical technologist's request for an initial count is refused by the circulator due to emergent nature of a procedure, which of the following is the proper course of action? A. Continue with subsequent counts and follow procedure from that point on in the case. B. Do not proceed with the case until the initial count is completed. C. Perform the initial count independently, using the count sheet inside the tray. D. Ask a different member of the surgical team to assist in the initial count. - correct answers A. Continue with subsequent counts and follow procedure from that point on in the case. Rationale: Per AST guidelines, if an emergency procedure will not allow time for a pre-operative count, subsequent counts should be completed at the appropriate time. If there are any discrepancies in the number of items used during the case, an x-ray should be done at time of closing to ensure no items were left in the patient. The surgeon requests a non-absorbable suture for skin closure. Which of the following sutures is non-absorbable? A. Vicryl B. Chromic C. Plain Gut D. Nylon - correct answers D. Nylon C. The circulator removes the contaminated glove and then the technologist re-gloves herself. D. The circulator removes the contaminated glove and re- gloves the surgical technologist away from field. - correct answers C. The circulator removes the contaminated glove and then the technologist re-gloves herself. Rationale: Because the surgery is already in progress, it is not necessary for the surgical technologist to re-scrub and re-gown. The circulator can remove the contaminated glove, and the surgical technologist can re-glove. The surgical technologist cannot remove their own glove, because the surgery is in progress. And the surgical technologist cannot leave the sterile field since the surgery is in progress. When opening a wrapped item using aseptic technique, the proper sequence is to open the top flap A. away from operator, proximal flap opened, side flap opened last. B. toward operator, side flaps opened, distal flap opened last. C. toward operator, side flaps opened, proximal flap opened last. D. away from operator, side flaps opened, proximal flap opened last. - correct answers D. away from operator, side flaps opened, proximal flap opened last. Rationale: It is best to open the first flap away from while the remaining flaps are unfolded so the wrap is still covering the area closest to you. The side flaps will be opened next with the last flap opened away from you while not reaching over the sterile area. Which of the following is used to help maintain hemostasis intraoperatively in neurosurgery? A. skin stapler B. Indermil glue C. Dermabond glue D. Raney clips - correct answers D. Raney clips Rationale: Raney clips are used to control bleeding along scalp edges. A skin stapler is used only to close skin incisions. Indermil glue is a type of tissue adhesive for skin closure at the end of the surgery. Dermabond is a skin adhesive barrier used in addition to sutures to close incisions. When preparing peel pack instruments for steam sterilization the surgical technologist should inspect the instrument, place an indicator in the package, and A. adjust the sterilizer temperature. B. use a Sterrad indicator. C. label the package. D. use a biological indicator. - correct answers C. label the package. Rationale: The last thing that needs to be done to the package is to label the contents. It is being steam sterilized so it does not need a Sterrad indicator. Since it is in a peel pack it does not need a biological indicator. The steam sterilizer temperature is already set. The surgical technologist has just handed the surgeon a 2-0 Silk suture. Which of the following scissors should the surgical technologist have ready? A. curved Mayo scissors B. Metzenbaum scissors C. tenotomy scissors D. straight Mayo scissors - correct answers D. straight Mayo scissors Rationale: Selecting a straight scissor to cut suture with is imperative. The heaviness of the suture material should also gauge the size of the scissor the ST should select. The Metzenbaum is a slightly curved tissue scissor, and the tenotomy scissor is meant for finer, lighter cutting. Here the best choice is the straight Mayo scissor. The surgical technologist reviews the schedule for the following day and notices that an orthopedic surgeon has C. package integrity and on the case cart D. on the case cart and on the preference card - correct answers B. on the preference card and expiration date Rationale: The package should be checked for holes and the integrity should be good. The expiration date should be checked to make sure it has not expired. The expiration date is not on the case cart or preference card for the sterile supplies. The patient is undergoing cardiothoracic surgery, and placed in the Sims position. Which of the following actions prevents the likelihood of an intraoperative positioning injury to the brachial plexus? A. Apply flank padding and a head stabilizer. B. Place rolled towel padding beneath abducted down- side arm. C. Place lower leg stirrup sling directly over Achilles tendon. D. Apply pillows directly under the knee joint. - correct answers B. Place rolled towel padding beneath abducted down-side arm. Rationale: Placing a rolled towel, or gelpads under the down-side arm, will protect the brachial plexus during long surgical procedures. Extended time in the Sims position, can irritate this network of nerves, if not properly protected and padded while the patient is on the OR table. The patient has undergone cardiac bypass surgery. Protamine has been administered and the surgeon is preparing to close the sternotomy. Bleeding is a postoperative concern. Which of the following systems should the surgical technologist anticipate the surgeon will use? A. Jackson Pratt B. Hemovac C. Pleur-Evac D. Penrose - correct answers C. Pleur-Evac Rationale: The Pleur-Evac drain is used following thoracic or cardiothoracic procedures to reestablish negative pressure, assist in post-op drainage, and seal any air leaks in the pleura if present. The Jackson Pratt and Hemovac drains are used for moderate drainage in orthopedics or general procedures. A Penrose drain is a passive drain not intended for moderate or heavy drainage. Patient skin preparation for LAVH and abdominal to perineal procedures should be performed using which of the following solutions? A. chlorhexidine B. isopropyl alcohol C. iodophor paint D. ethyl alcohol - correct answers C. iodophor paint Rationale: Iodophor paint is less likely to cause irritation vaginal mucosa. Use of it is contraindicated if the patient has a sensitivity to povidone-iodine. Alcohol and chlorhexadine are not safe to use for skin prep in perineal procedures. In preparation for a carotid endarterectomy the surgical technologist should anticipate using which of the following sutures? A. 7-0 prolene B. 7-0 chromic C. 7-0 ethibond D. 7-0 silk - correct answers A. 7-0 prolene Rationale: The arteriotomy of a carotid endarterectomy is closed with Prolene. All vascular surgery utilizes non- absorbable suture such as Prolene. While preparing to do an abdominal hysterectomy on a 500 pound female the surgical technologist begins to retrieve supplies and instrumentation. Which of the Which of the following are done during the initial count for a tubal ligation case? (Select the three (3) correct answers.) A. state the name of each item as you begin to count it B. count syringes C. circulator records the items counted D. count laps, Raytecs, needles, and blades E. count dressings - correct answers A. state the name of each item as you begin to count it C. circulator records the items counted D. count laps, Raytecs, needles, and blades Rationale: Dressings should not be opened until the end of the case. Counted items do include lap tapes, Raytecs, needles and blades, but not syringes. Always state each item being counted as you begin to count out loud with the circulator. Which of the following sites require the surgical technologist to prep the surrounding area first and then the dirty area? (Select the three (3) correct answers.) A. armpit B. sinus tract C. mucous membrane D. foot E. stomas - correct answers B. sinus tract C. mucous membrane E. stomas Rationale: Any areas that have a high microbial count must be prepped last, after the surrounding area has been prepped. This prevents any microbes from being spread to the cleaner areas. Any sinus tract, mucous membrane or stoma is considered dirty. The foot and armpit are not considered dirty areas. A patient has a latex allergy and is scheduled for an abdominal hysterectomy. A catheter will be inserted in the patient's bladder pre-operatively. Which of the following is the proper catheter to use for this patient? A. rubber Foley catheter B. Teflon ureteral catheter C. polyethylene Malecot catheter D. silicone retention catheter - correct answers D. silicone retention catheter Rationale: While Teflon, polyethylene, and silicone are all substitute material options for latex products, the difference is in the types of catheters listed. A Malecot is a wing-tipped catheter often used for suprapubic catheter placement. A ureteral catheter is placed in the ureters, not the bladder. A rubber Foley is the traditional Foley that contains latex. Following an eyelid laceration repair, the surgeon begins to close the skin. Anticipating the surgeon's needs the surgical technologist should hand the surgeon A. iodophor gauze. B. staples. C. Dermabond. D. steri strips. - correct answers D. steri strips. Rationale: Steri-trips are used to approximate would edges and hold them together. Staples would not be used on an eyelid laceration because they are metal. Dermabond would not be used because it is a liquid skin adhesive. Iodophor gauze is a packing that is used to pack wounds. 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? A. Ensure all bony prominences are sufficiently padded. B. Make sure that the implant is appropriately sized for the patient. C. Be attentive to intraoperative signs of discomfort or distress. in a total of 10, so subtracting one from the count would complicate the surgery if relief would come in. The surgical technologist must discard a malfunctioning sterilant and replace with a new one. Where should the technologist look to find the proper disposal protocol for this product? A. hospital hazard log B. hospital MSDS log C. manufacturer's packaging D. materials management shipping log - correct answers B. hospital MSDS log Rationale: MSDS sheets (Material Safety Data Sheets) contain information on all hazardous chemicals. They contain the precautions for handling the chemicals, the hazards associated with chemicals and the firefighting techniques—along with first aid for exposure. The hospital hazard log, manufacturer's packing, and materials management shipping log, would not contain the information needed. While preparing the room for a carotid endarectomy, the surgeon walks in and tells the surgical technologist there is an emergent case scheduled next and the technologist needs to speed up the process of getting the patient prepped and draped. In order to have a safe outcome for the patient the technologist should prep the patient with A. Duraprep stick and place towels around the expected incision site. B. Duraprep stick and use a sterile towel to pat the prepped area dry. C. a chlorahexadine prep kit and place towels around the expected incision site. D. a chlorahexadine prep kit and use a sterile towel to pat the prepped area dry. - correct answers A. Duraprep stick and place towels around the expected incision site. Rationale: A Duraprep stick typically requires the use of only one hand and is a faster method of prepping. The incision site does not need to be patted dry with Duraprep because it needs to be allowed to dry on the skin so the solution can properly reduce microorganisms during and after the procedure. Chlorahexadine is the same thing as Hibiclens and would not be used because it takes longer to prep with as opposed to the Duraprep stick. The surgical team is setting up for an exploratory laparotomy. The circulator opens the casket housing the laparotomy instruments and verifies its sterility. The surgical technologist lifts the tray out of the casket and is holding it. At this time it is discovered that the bottom filter is missing. The surgical technologist should give the tray back and A. tear down the entire set up. B. change gloves. C. change mask, gown and gloves. D. tear down the back table. - correct answers B. change gloves. Rationale: The surgical technologist has only contaminated her gloves at this point, by lifting the tray out of the casket. The tray has not come in contact with any other part of the sterile field, so the only need is for her to change her gloves. A surgical technologist working the night shift is preparing implants for the next morning. After running the autoclave, the cycle fails. Which of the following should the surgical technologist do? A. Rerun the wrapped implants with an external chemical monitor taped to the outside of the sets to ensure proper sterility has been achieved. B. Ask the night operating room supervisor to postpone the orthopedic surgical procedure until the oncoming day shift surgical technologists can run a BI test pack on the first load of the day. C. Unwrap, decontaminate and re-sterilize implants with a biological test pack and place a hold on the use of the sets until the BI test results are available. D. Have the sterilizer scheduled for repair and halt the sterilization of all implants. - correct answers C. Unwrap, decontaminate and re-sterilize implants with a biological pit and corrode instruments and can cause damage. Lactated ringers would not be on the sterile field because it is used by anesthesia for the IV. The surgical technologist is preparing the back table for an open inguinal hernia repair. Which of the following retractors is essential to this patient's surgery? A. Weitlaner B. Bookwalter C. Balfour D. Gelpi - correct answers A. Weitlaner Rationale: Weitlaner is the appropriate retractor to use due to its overall size, the ability to self-retain, and the prongs on the arms. The Bookwalter and Balfour retractors would be too larger for an inguinal hernia incision. The Gelpi retractor may not provide enough retraction depth. Which of the following is a passive drain? A. Penrose B. Hemovac C. Jackson-Pratt D. Pluerovac - correct answers A. Penrose Rationale: A Penrose is a passive drain that allows fluid to move out of the tube because the fluid is moving from an area of higher concentration (within the wound) to an area of lower concentration (the drainage sponge). The Hemovac, Jackson-Pratt, and Pleur-Evac drains are all active drains that use negative pressure to draw fluid out into a reservoir. During the liquid chemical sterilization, which of the following is the primary chemical sterilization compound used to sterilize endoscopic instrumentation and scopes? A. peracetic acid B. quaternary ammonium C. sodium hypochlorite D. phenolic compound - correct answers A. peracetic acid Rationale: Peracetic acid is a used for sterilization. The three others answers are all used for environmental cleaning only. Which of the following information must every drug container be labeled with as soon as it is received by the surgical technologist? A. abbreviated medication name and quantity B. abbreviated medication name, quantity and strength C. strength and expiration date D. quantity and expiration date - correct answers B. abbreviated medication name, quantity and strength Rationale: The medication name, strength, and quantity all must be on the label when medication is received on the sterile field. The expiration date is not necessary unless the expiration date is within 24 hours of distribution. A patient presents to the operating room for a hydrocelectomy. Which of the following dressings should the surgical technologist anticipate needing? A. Ace bandage B. gauze packing C. scrotal support D. Elastoplast - correct answers C. scrotal support Rationale: A hydrocelectomy is the accumulation of fluid in the membrane tunica vaginalis which covers the male testes. The scrotal support would help support the male testes. Elastoplast is tape and would not be used. Gauze packing is used to pack an incision and not used as a dressing. An ace bandage is used on an extremity to cover dressings. After scrubbing in and draping the patient, which of following does the surgical technologist need to check Rationale: BKA stands for Below the Knee Amputation the following equipment will be needed to remove the extremity. A Power saw to cut the bone, a cautery unit is needed to stop any bleeding along the way to remove the bone. A pneumatic tourniquet will help stop blood flow the leg and knee. A pneumatic Kerrison is used to remove bone from the spine. A vascular set is not needed since we are not preserving the extremity. When assembling instruments for sterilization, the surgical technologist should place instruments on the stringer with A. smaller instruments grouped together. B. babcocks in the locked position. C. larger instruments grouped together. D. clamps in the open position. - correct answers D. clamps in the open position. Rationale: Maintain instruments in open position during sterilization process. This allows the steam heat or chemicals to reach the interior of the locking mechanism and jaws of the instrument, that might not be accessible if the clamps are closed. When opening sterile supplies aseptically for surgery the surgical technologist should A. open extra suture, special equipment, and implants ahead of time to prevent unnecessary wait time for the surgeon. B. open gown and gloves onto a small table away from where sterile items have been distributed. C. break the seal and lift the top from sterilized trays to allow placement of more sterile items into the trays. D. open suture and blades first and proceed to cover sharps under other sterile items to prevent injuries. - correct answers B. open gown and gloves onto a small table away from where sterile items have been distributed. Rationale: The surgical technologist should open the gown and gloves onto the Mayo stand away from the sterile field. Extra supplies and implants should not be opened because it would increase the cost of the surgery. Suture and blades should always be visible to prevent injury and contamination. Sterility of the tray has not been confirmed so you would not open sterile supplies in the tray. The anesthesia provider would typically ask the surgical technologist how much fluid has been used in order to A. assess for anaphylaxis. B. estimate blood loss. C. evaluate for drug toxicity. D. prevent malignant hyperthermia. - correct answers B. estimate blood loss. Rationale: Any irrigation used during the case will be suctioned into the same canister as blood so it will be impossible to distinguish between the two. It is impossible to measure blood loss without being able to deduct the amount of irrigation used. Drug toxicity and anaphylaxis are monitored by anesthesia. Preventing malignant hyperthermia starts with a preoperative evaluation of medical history by the anesthesia care provider. Which of the following retractors will the surgical technologist need for an emergent bring back case on a 450 lb abdominal hysterectomy patient? A. Greenberg B. O'Connor O'Sullivan C. Bookwalter D. Nathanson - correct answers C. Bookwalter Rationale: The Bookwalter is used for large abdominal wounds to provide adequate exposure and retraction. The bookwalter is the optimal choice due to the size of the patient; the patient's size determines what retractors can be used. The O'Connor-O'Sullivan is used during open abdominal and pelvic procedures for exposure and retracting in smaller patients. A Nathanson is a liver retractor used to support and retract the liver during Rationale: Poole suction can suction much more quickly than an Andrews tip, due to its size. Lap sponges have the ability to absorb greater quantities of fluid than a raytec does. The surgical technologist has just completed scrubbing for a repair of an abdominal aneurysm. The aneurysm repair ruptures during transport from the operating room bed to the stretcher. Which of the following actions should the surgical technologist take next? A. Begin chest compressions. B. Prepare the crash cart. C. Don new gown and gloves. D. Retrieve a chest retractor from the back table. - correct answers C. Don new gown and gloves. Rationale: The surgeon will need to make an incision fast so the surgical technologist will need to be able to help apply the drapes and pass the instruments needed for the surgery. The surgical technologist cannot pass the chest retractor until he has a gown and gloves on. The surgical technologist is to remain sterile and protect the sterile field, so he would not prepare the crash cart or begin chest compressions. During an otorhinolaryngologic procedure, which of the following precautions should the surgical technologist take if the anesthesia provider is using an uncuffed endotracheal tube? A. Fill the endotracheal tube with sterile water and saline to reduce leakage of oxygen. B. Fill the endotracheal tube with sterile saline and methylene blue to check for leakage of oxygen. C. Moisten the head drape around the field prior to start of procedure to minimize leakage and reduce heat buildup. D. Moisten sponges and place around the field prior to start of procedure to minimize leakage and reduce heat buildup. - correct answers D. Moisten sponges and place around the field prior to start of procedure to minimize leakage and reduce heat buildup. Rationale: The uncuffed endotracheal tube should be filled with water, and wet sponges should be placed around it to minimize leakage. Saline should not be used, because it crystalizes. Methylene blue is dye and used to check the patency of the tubes. The surgical technologist is preparing the incision site for placement of a dressing following a mastectomy. The surgical technologist noticed that the patient has developed a hematoma at the incision site. The surgeon has left the operating room. Which of the following actions should the surgical technologist take? A. Apply an ABD dressing. B. Apply a pressure dressing. C. Call a code. D. Ask the surgeon to return. - correct answers D. Ask the surgeon to return. Rationale: If a hematoma is seen at the incision site the surgeon should be called back to the room to look at the incision before the dressing is applied: the surgical technologist should not ignore it and apply dressings. The patient is not is distress, so there is no need to call a code. The surgeon is closing skin with the final stitch and all counts are complete. Which of the following should the surgical technologist have ready for next step? (Select the three (3) correct answers.) A. wet sponge B. dry sponge C. ABD pad D. Duraprep E. cottonoids - correct answers A. wet sponge B. dry sponge C. ABD pad In which of the following circumstances is it appropriate for the surgical technologist to perform immediate-use steam sterilization for "just in time" processing? A. The surgical instrument inventory budget is low. B. The procedure is emergent. C. The surgical site infection risk is low. D. The scheduled procedure is minimally invasive. - correct answers B. The procedure is emergent. Rationale: Immediate use sterilization should be used as a last resort. It is safe and effective if performed correctly, but should not be routinely used as a method of sterilization. This method is also referred to as "flash" sterilization. The surgeon requests suture to close the skin incision. Which of the following types of needles should be used? A. tapered B. blunt C. Veress D. cutting - correct answers D. Cutting Rationale: Cutting needles are used for passage of suture material through tough tissue difficult to penetrate, such as skin. Blunt and tapered needles do not pass through skin tissue as well as a cutting needle. A Veress needle is used to insufflate the abdomen for a laparoscopy. Which of the following chemicals used in the Peri- Operative Department is non-carcinogenic? A. polymethlymethacrylate B. formalin C. ethylene oxide D. Monsel's - correct answers D. Monsel's Rationale: Polymethlymethacrylate, formalin and ethylene oxide are all chemical hazards and are considered carcinogenic. Monsel's is a hemostatic agent and is non- carcinogenic. For which of the following drains is a sterile safety pin used? A. Penrose B. Pleur-evac C. closed vacuum D. red Robinson - correct answers A. Penrose Rationale: A Penrose comes with a safety pin that can be attached at the end of the drain to the dressing sponge that keeps both the drain and sponge in place. Which of the following instruments should be passed to the surgeon to achieve hemostasis at the beginning of an operative procedure? (Select the three (3) correct answers.) A. electrosurgical pen B. sponge C. scalpel D. suction device E. sponge forceps - correct answers A. electrosurgical pen B. sponge D. suction device Rationale: To achieve hemostasis, a sponge can be used to clear the area to see where the bleeding is coming from. An electrosurgical pen can be used to stop bleeding because the thermal heat will disperse to stop bleeding. The suction device is used to provide visualization so that the bleeding can be stopped. A scalpel is used to make an incision. Sponge forceps would not be used to control superficial bleeding at the beginning of the case. When disinfecting a flexible endoscope used on a patient with TB, which of the following sterilization methods should be employed? A. steris