Giáo trình surgical technology examination QA 7e by sherman

2


Copyright © 2017 by McGraw-Hill Education. All rights reserved. Except as permitted under the United
States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by
any means, or stored in a database or retrieval system, without the prior written permission of the publisher.
ISBN: 978-1-25-958611-8
MHID: 1-25-958611-1.
The material in this eBook also appears in the print version of this title: ISBN: 978-1-25-958811-2, MHID:
1-25-958811-4.
eBook conversion by codeMantra
Version 1.0
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every
occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the
trademark owner, with no intention of infringement of the trademark. Where such designations appear in this
book, they have been printed with initial caps.
McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales
promotions or for use in corporate training programs. To contact a representative, please visit the Contact Us
page at www.mhprofessional.com.
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge,
changes in treatment and drug therapy are required. The authors and the publisher of this work have checked
with sources believed to be reliable in their efforts to provide information that is complete and generally in
accord with the standards accepted at the time of publication. However, in view of the possibility of human
error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been
involved in the preparation or publication of this work warrants that the information contained herein is in
every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the
results obtained from use of the information contained in this work. Readers are encouraged to confirm the
information contained herein with other sources. For example and in particular, readers are advised to check
the product information sheet included in the package of each drug they plan to administer to be certain that

the information contained in this work is accurate and that changes have not been made in the recommended
dose or in the contraindications for administration. This recommendation is of particular importance in
connection with new or infrequently used drugs.
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work.
Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right
to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce,
3


modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the
work or any part of it without McGraw-Hill Education’s prior consent. You may use the work for your own
noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work
may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS
MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR
COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK,
INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA
HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS
OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill Education
and its licensors do not warrant or guarantee that the functions contained in the work will meet your
requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill Education nor its
licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the
work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for the content of
any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its
licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result
from the use of or inability to use the work, even if any of them has been advised of the possibility of such
damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause
arises in contract, tort or otherwise.

4


Contents

Preface
Acknowledgments
Introduction
1. Medical Terminology
Answers and Explanations
2. Microbiology
Questions
Answers and Explanations
3. Pharmacology and Anesthesia
Questions
Answers and Explanations
4. Blood Values
Questions
Answers and Explanations
5. Aseptic Technique
Questions
Answers and Explanations
6. Sterilization and Disinfection
Questions
Answers and Explanations
7. Operating Room Environment
Questions
Answers and Explanations
8. Transportation and Positioning

Questions

5


Answers and Explanations
9. Counts
Questions
Answers and Explanations
10. Specimens
Questions
Answers and Explanations
11. Medical, Ethical, and Legal Responsibilities
Questions
Answers and Explanations
12. Diagnostic Procedures
Questions
Answers and Explanations
13. Consents
Questions
Answers and Explanations
14. Skin Preparation and Draping
Questions
Answers and Explanations
15. Instruments
Questions
Answers and Explanations
16. Sutures, Stapling Devices, and Drains
Questions
Answers and Explanations

17. Wound Healing and Dressings
Questions
Answers and Explanations
18. General Surgery
Questions
Answers and Explanations
19. Obstetrics and Gynecology

6


Questions
Answers and Explanations
20. Ophthalmology
Questions
Answers and Explanations
21. Otorhinolaryngology
Questions
Answers and Explanations
22. Plastic and Reconstructive Surgery
Questions
Answers and Explanations
23. Genitourinary
Questions
Answers and Explanations
24. Thoracic
Questions
Answers and Explanations
25. Cardiac
Questions

Answers and Explanations
26. Vascular
Questions
Answers and Explanations
27. Neurosurgery
Questions
Answers and Explanations
28. Orthopedics
Questions
Answers and Explanations
29. Pediatrics
Questions
Answers and Explanations

7


30. Biomedical Science (Electricity, Hemostasis, Lasers, and Computers)
Questions
Answers and Explanations
31. Occupational Hazards/Fire Safety
Questions
Answers and Explanations
32. Endoscopy, Minimally Invasive Surgery, and Robotics
Questions
Answers and Explanations
Bibliography
Index

8

Preface

Lange Q&A: Surgical Technology Examination, Seventh Edition, has been designed to assist surgical technicians
planning to take the National Certification Examination for Surgical Technologists. Although unable to
guarantee a perfect score, a study guide can provide a good deal of assistance in test preparation by enabling
the student to review relevant material while becoming familiar with the type of questions that will be
encountered on the examination.
The ever-growing body of knowledge necessary to prepare the surgical technologist for a professional role
in the operating room requires that competency be measured by an examination that tests both constant and
technologically up-to-date information. With this in mind, the authors have prepared a seventh edition of the
review book that has been extensively revised and updated to include those advances in technology that have
emerged since the previous edition.
The book contains over 1,900 questions that closely correlate in percentage the amount prescribed in the
Study Guide for Certification provided by the Liaison Council of the Association of Surgical Technologists.
The text is divided into 32 chapters. Following each chapter are questions. Each question has one answer and
a full-length explanation, a difficulty in a single area indicates a need for individual study emphasis.

9


Acknowledgments

We would like to give special thanks to Mark Sherman and John Chmielewski for giving us their
overwhelming support throughout the process of writing this review book. We also would like to thank all
students past, present, and future for giving us the inspiration to write this review book.

10

Introduction

ORGANIZATION OF THE BOOK
The book is organized into 32 chapters covering the major topic areas found on the Certifying Examination
for Surgical Technologists. Each chapter is designed to facilitate your review of the major content areas of
surgical technology. Each chapter ends with detailed explanations of each question for reinforcement of
knowledge.

HOW TO ANSWER A QUESTION INTELLIGENTLY
Unlike many examinations, which are a composite of several multiple-choice questions, the National
Certification Examination for Surgical Technologists uses only one major type of question. Each question will
have one correct answer and the other options are incorrect. However, the remaining three choices may be
partially correct, but there can only be one best answer.
When the question reads “EXCEPT’’ it is to remind you that the correct answer will be the exception to
the statement in the question.
Sample Question 1
A left subcostal incision indicates surgery of the:
(A) gallbladder
(B) pancreas
(C) spleen
(D) common bile duct
This question could be answered from rote memory, placing the term “subcostal” with the anatomic structure
“spleen.” It is more likely that the student will conjure up a picture of the human abdomen and discount
gallbladder (choice A) and common bile duct (choice D) immediately because they are located on the right
side of the abdominal cavity. Thus, two choices are ruled out as possible answers, improving the odds of
selecting the correct answer from 25% to 50%. Although the tail of the pancreas reaches over to the left side of
the body and is adjacent to the spleen, spleen is clearly the best choice and the only correct answer.
Sample Question 2
An elderly female, sleeping soundly, arrives in the OR via stretcher with siderails in place and safety strap

intact. She is placed alone outside her assigned OR. The woman awakes, climbs off the stretcher, and, falling,

11


receives a deep scalp laceration. The circulating nurse:
(A) can be charged with abandonment
(B) can be charged with simple assault
(C) can be charged with battery
(D) cannot be charged because safety devices were in place
This question is more difficult. Although we clearly see choices B and C as incorrect because the nurse had no
physical part in the injury to the patient, the difficulty is now in choosing between the remaining answers.
Choice D may seem correct because the stem of the questions tells us that all safety devices were intact. It is
only with knowledge of the legal aspect of OR procedure that we know that the key word alone signifies
culpability on the part of the nurse. Standard OR procedures claim that one is guilty of abandonment if a
patient is left alone at any time when in the care of OR personnel and may be charged as such in a court of
law.
Table 1. Strategies for Answering Questionsa
1. Remember that only one choice can be the correct answer.
2. Read the question carefully to be sure that you understand what is being asked.
3. Quickly read each choice for familiarity. (This important step is often not done by test takers.)
4. Go back and consider each choice individually.
5. If a choice is partially correct, tentatively consider it to be incorrect. (This step will help you lessen your
choices and increase your odds of choosing the correct choice/answer.)
6. Consider the remaining choices, and select the one you think is the answer. At this point, you may want to
quickly scan the stem to be sure you understand the question and your answer.
7. Select the appropriate answer. Even if you do not know the answer, you should at least guess—you are
scored on the number of correct answers, so do not leave any blanks.
aNote

that steps 2 through 7 should take an average of 45–55 seconds total. The actual examination is timed

for an average of 45–55 seconds per question.

HOW TO USE THE BOOK
Read the chapter review followed by answering the questions at the end of the chapter. Continual notation in
this book will provide you with a quick review at the end of the chapter. This will help you determine those
areas that require the most emphasis for study and those areas that require additional review. Most of the
references are texts that are readily available at your nearest library, or that you may already own.
The official source of applications for and information about the surgical technology examination can be
obtained from The National Board of Surgical Technology and Surgical Assisting ().

12


13


___________________ CHAPTER 1 ___________________

Medical Terminology

• This is the language spoken by health professionals in hospitals, surgicenters, clinics, and physicians’
offices.
• You must be able to identify the four basic word parts, construct medical terms by using the word parts
and use the correct pronunciation.
• The four word parts include: root words, prefixes, suffixes, and combining words.

Root Rword—primary meaning

Prefix—placed before the root word

Suffix—placed after the root word

Combining forms—usually an O but can be an I or E
• Example #1: Endocarditis

endo—prefix—meaning within

card—root word—pertaining to the heart

itis—suffix—meaning inflammation of
• Example #2: Osteoarthritis

oste—root—pertaining to bone

o—combining vowel

arthr—root—pertaining to a joint

itis—suffix—meaning inflammation of

14


15


16

17


18


Answers and Explanations

19


20


21


22


___________________ CHAPTER 2 ___________________

Microbiology

• ASEPSIS—absence of disease causing micro-organisms
• STERILE—free of all living microorganisms including spores
• SURGICALLY CLEAN—mechanically disinfected but not sterile
• AERATION—this is the method by which ethylene oxide (a type of sterilization process) is removed
from the ETO-sterilized items

• AEROBES—microbes that cannot live and reproduce without oxygen
• FACULTATIVE ANAEROBES—can live in both environments
• ANAEROBES—microbes living in the presence of oxygen
• FOMITE—inanimate object that contains microorganisms
• CELLS—smallest unit of living things

MITOCHONDRIA—they are the power house of the cell and provide energy

FLAGELLA—provides locomotion to the cell

CELL WALL—protects the cell

CYTOPLASMIC MEMBRANE—semipermeable membrane within the cell
• BACTERIA—all living cells are classified into two groups:

PROKARYOTES—less complex organisms. Single circular chromosome, without a nuclear membrane
or membrane-bound organelles

EUKARYOTES—complex cellular structure, they include fungi, algae, plant and animal cells. HAS A
NUCLEUS
• Bacteria divide by BINARY FISSION—this is the asexual reproduction of a cell by division into two
identical daughter cells
• Bacteria are shaped: rod shaped/spherical shaped/spiral shaped
• GRAM-POSITIVE—purple
• GRAM-NEGATIVE—red
• BACTERICIDE—kills gram-positive and gram-negative bacteria
• BACTERIOSTATIC—inhibits (to prevent something from developing) the growth of bacteria
• BIOBURDEN—the amount of microorganisms on an item before sterilization
• BIOLOGICAL INDICATOR—a sterilization monitoring system used to test the effectiveness of the
sterilization process used

GEOBACILLUS STEAROTHERMOPHILUS—is the microbes used in steam sterilization

23


BACILLUS ATROPHIES/GEOBACILLUS SUBTILIS—are the microbes used for ETO
sterilization
• CONTAMINATION—presence of pathogenic microorganisms (disease-causing microorganisms) on
animate (living being) and inanimate (nonliving) objects
• DECONTAMINATION—process by which chemical or physical agents are used to clean inanimate
objects, NONCRITICAL surfaces
• SSI—SURGICAL SITE INFECTION
• DEEP INCISIONAL SSI—an infection involving deep soft tissue, fascia DISINFECTION—not used
on living tissue
• ANTISEPTIC—used on living tissue
• FUNGICIDE—kills fungi
• IMMUNITY—resistant to infection

NATURALLY ACQUIRED ACTIVE IMMUNITY—acquired when you get a disease and acquire
antibodies

ARTIFICIALLY ACQUIRED ACTIVE IMMUNITY—vaccination

NATURALLY ACQUIRED PASSIVE IMMUNITY—antibodies from mother to child through the
placenta

ARTIFICIALLY ACQUIRED PASSIVE IMMUNITY—a short-term immunization by the
injection of antibodies, such as gamma globulin, that are not produced by the recipient’s cells
• INFECTION—invasion and multiplication of microorganisms in body tissues, causing cellular damage.

• SKIN—it is the first line of defense against bacteria
• NOSOCOMIAL INFECTION—an infection that was acquired in the hospital
• PASTEURIZATION—this is not a method of sterilization but a heating process of destroying
pathogenic microorganisms such as in milk or wine
• PARASITES—microorganisms that reside on or within living organisms. Some are OBLIGATORY
(means they depend on living tissue) and others are FACULTATIVE (meaning they can live on dead
tissue)
• PATHOGEN—any disease-producing micro-organism
• RESIDENT MICROORGANISMS—these are microorganisms that live deep in the epidermis (outer
most layer of skin), they live in the folds and crevices of the skin
• TRANSIENT MICROORGANISMS—these are microorganisms that live on the surface of the
epidermis, they have a very short life span and can be removed with a good hand scrub
• VIRUCIDE—kills viruses
• MICROORGANISMS:

STAPHYLOCOCCUS AUREUS—commonly found in RESPIRATORY PASSAGES

ENTEROCOCCI—found in the normal flora of the GI tract. These organisms are associated with
surgical site infections (SSIs)

STREPTOCOCCI—found in the GI tracts, upper respiratory tracts, and genitourinary tracts.

24


HELMINTHS—parasitic worms (round worms, tape worms). This is acquired by ingestion of
contaminated soil with fecal matter

RICKETTSIAE—they are parasites transmitted by insects

CLOSTRIDIA—produces virulent toxins

CLOSTRIDIUM PERFRINGENS—GAS GANGRENE (serious infection in body tissue, the
severe infection causes a buildup of gas)

C. TETANI—TETANUS (muscle twitching, cramps that are caused by a problem with the
parathyroid glands involving calcium)

C. DIFFICILE—the normal flora in the intestines is altered usually caused by the overuse of
antibiotics causing severe diarrhea and dehydration

MYCOBACTERIUM TUBERCULOSIS—it is transmitted directly from the respiratory tract,
causing TB.

VIRUSES—some examples of a virus include: HIV, herpes simplex, hepatitis B, C, and D

METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)—this is a particular
strain of a virus that is resistant to most all antibiotics; the only antibiotic that works on this virus is
VANCOMYCIN

CREUTZFELDT–JAKOB DISEASE—this is a fatal neurodegenerative disease of the central
nervous system caused by a HUMAN PRION
• PRION/PROTEINACEOUS INFECTIOUS PARTICLE—is the smallest infectious particle; it is
neither viral, bacterial, nor fungal. Prions are also responsible for the disease known as mad cow disease.
This disease is important for the STSR because there is no sterilization process that kills these prions,
when surgery is performed on these patients, disposable instruments are used so they can be disposed of
• BIOTERRORIST AGENTS—

Anthrax

Smallpox

Plague (pneumonic, bubonic)

Tularemia (various types of insect bites)

Botulism
• MUTUALISM—when different organisms exist and benefits from the other
• COMMENSALISM—when one organism benefits and the other does not benefit and is not harmed
• PARASITISM—when one organism benefits from the other and is harmed
• OSMOSIS—a fluid, usually water passes through a membrane solution of higher concentration which
equalizes the concentrations of materials on either side of the membrane
• MITOSIS—division of a single cell into two identical cells. Each cell has an identical number of
chromosomes as the parent cell. They have the same genes
• MEIOSIS—cell division involving sexually reproducing organisms
• CHRONIC INFECTION—there is a continued presence of infection
• ACUTE INFECTION—a rapid onset of the disease but for a short time

25