Practice Test 2
Which of the following needs an urgent thoracotomy?
- Hemothrorax draining 1.5 liters as tube is inserted or draining more than 200mL every hour
- Fail chest
- Tension pneumothorax
- Hemothrorax draining 1.5 liters in 24 hours
- Hemothrorax draining 1.5 liters in 48 hours
Correct Answer : A. Hemothrorax draining 1.5 liters as tube is inserted or draining more than 200mL every hour
Hemothorax draining 1.5L as tube is inserted or draining more than 200mL every hour needs an emergency resuscitative thoracotomy. This condition needs immediate nursing assessment and preparation for surgery. All other above mentioned options are not absolute indications for thoracotomy.
What is considered as the turnover time in an operation room?
- Delay between cases
- Delayed interval between cases
- Time for patient to relax
- Time for nurses to relax
- Time between a patient’s exit until the next patient’s entry in the same OR.
Correct Answer : E. Time between a patient’s exit until the next patient’s entry in the same OR.
Turnover time is the time that elapses when a patient exits an operation room until the next patient enters the same operation room. During this time the operation room nurse cleans and sets articles for the next case. Turnover time does not include delays between cases. Times between patients which are longer than a defined interval must be considered delays, not turnovers.
When cleaning surgical instruments, which of the following detergents must be used?
- High pH detergent
- Low pH detergent
- Neutral pH detergent
- Both high and low pH detergent
- Highest PH detergent
Correct Answer : C. Neutral PH detergent
Neutral pH detergent must be used for proper management of surgical instruments. If a high pH detergent is used, it will cause deposits on the surface of instruments. The instruments will have brown deposits if high pH detergents are used. Low pH detergents will cause breakdown of instruments’ protective surface with black staining.
Which of the following is known as autoclaving?
- Ethylene oxide sterilization
- Chemical sterilization
- Dry heat sterilization
- Glass bead sterilization
- Steam sterilization
Correct Answer : E. Steam sterilization
Surgical instruments will contact the surgical site, so they must be sterilized before every use. A method of instrument sterilization is steam sterilization which is known as autoclaving. Ethylene oxide is a gas sterilizer. Chemical sterilization and dry heat sterilization are done with glass bead sterilizers.
Which of the following is used for opening skin and ribs?
- Mechanical cutters
Correct Answer : A. Retractors
Retractors are used for opening skin and ribs. Distracters are used for positioning. Dilators are used to pass through narrow passages. Mechanical cutters are used for cutting the parts. Drills are powered devices used for drilling the parts. All other above mentioned articles other than retractors cannot open skin and ribs.
Which of the following instruments is used for occluding the blood vessels?
- Anaesthesia forceps
- Biopsy forceps
- Bone-cutting forceps
- Magill forceps
- Kelly’s forceps
Correct Answer : E. Kelly’s forceps
Anaesthesia forceps are used while providing anesthesia. Biopsy forceps are used for biopsy specimen collection. Bone- cutting forceps are used in cutting bone during orthopedic procedures. Magill forceps are used for removing foreign bodies. Kelly’s forceps are used for occluding blood vessels.
When is Deaver’s retractor used in a surgery?
- To hold the edges of an abdominal opening
- To widen an incision
- To keep the wound dry
- To hold the tissues in neuro-surgery
- To expose bones
Correct Answer : A. To hold the edges of an abdominal opening
Deaver’s retractor is used to the hold edges of an abdominal opening. To widen an incision, Langenbeck Retractor is used. To keep a wound dry, retractors with fibre optic light are used. To hold the tissues in neuro-surgery, love nerve retractor is used. To expose bones, Hohmann retractor is used.
Which of the following instruments will hold the tissue without slipping?
- Rat tooth forceps
- Adson tissue forceps
- Allis intestinal tissue forceps
- Babcock intestinal tissue forceps
- Sponge forceps
Correct Answer : A. Rat tooth forceps
In Rat tooth forceps, there are tooth like inter-digitating design, which helps to prevent the tissue from slipping. Adson tissue forceps are used for careful handling of tissues as they have light in them. Allis intestinal tissue forceps are used for holding the intestinal skin. Babcock intestinal tissue forceps hold viscera. Sponge forceps are used for holding sponges.
When dropping instruments from sterile packs into a sterile tray, how much distance must the packs be held at by the nurse?
- 1 inch
- 2 inches
- 3 inches
- 4 inches
- 5 inches
Correct Answer : C. 3 inches
While dropping the sterile packed surgical instruments into the sterile tray, the nurse has to hold the packs 3 inches above the sterile tray. The outer covering of the sterile packs, can have slight contact with the outside environment and the pack is always held at 3 inches above the tray. All other above-mentioned distances are not appropriate.
What is antisepsis in a surgical unit?
- Use of sterile instruments
- Use of gloves
- Use of no touch technique
- Absence of infectious organism
- Removal of transient micro-organisms from skin
Correct Answer : E. Removal of transient micro-organisms from skin
In antisepsis, disinfection is done with the help of chemicals. It involves the removal of transient microorganisms from the skin surface and helps to minimize the resident flora. Asepsis is the absence of infectious organisms. In asepsis, usually sterile instruments are used. Gloved no touch technique is also used.
Which one of the following surgical skin-preparation agents acts by oxidation?
- Isopropyl alcohol
Correct Answer : E. Povidone-iodine
Povidone-iodine acts by oxidation. Isopropylene is not used as a skin-preparation agent. Isopropyl alcohol is used for skin-preparation, which acts by denaturing the protein. Chlorhexidine is used for disrupting the bacterial cell wall. Hexidine is not used for skin-preparation.
When pouring fluids in the sterile operation tray, which area or method is considered as sterile?
- Outer cap of pouring container
- Inner cap and lip of the container
- Whole container
- Splashing the fluid in the tray
- Spraying the fluid
Correct Answer : B. Inner cap and lip of the container
When pouring fluids into the sterile operation tray, the lip and inner cap of the pouring container is the only area considered as sterile. The pouring container should not touch the sterile operation tray. While pouring 3 inches of gap must be maintained between the tray and the container. Splashing and spraying of the fluids should be avoided.
Which one of the following statements is not correct about surgical asepsis?
- All articles in the sterile tray must be sterile
- Moist areas are always sterile
- Gowns are sterile in the front, from chest to waist
- Tables are sterile when seen at or above the level of the table
- Non sterile items should not cross above a sterile field
Correct Answer : B. Moist areas are always sterile
Moist area is not sterile. There are more chances of growth of micro-organisms when the area is not kept dry. Moist places favor the growth rate of pathogens. The operation room nurse must keep sterile area dry. All other above-mentioned statements are rules followed in an operation room.
Which of the following rejections is caused by preformed anti-donor antibodies?
- Acute rejection
- Hyperacute rejection
- Chronic rejection
- Non-adherence rejection
Correct Answer : B. Hyperacute rejection
Hyperacute rejection is due to preformed anti-donor antibodies. Hyperacute rejection occurs in a few minutes to a few hours after liver transplant. Acute rejection is due to the mediation of T cells. Any sign and symptom of rejection after 1 year is called chronic rejection. Its cause is unknown. Liver rejection can occur anytime after the transplant.
Which of the following is not a complication of post kidney transplantation?
Correct Answer : E. Tuberculosis
After kidney transplantation there will be transplant rejection. It may be hyperacute, acute or chronic rejection. Infection and sepsis also occur as complications. Because of the side effects of immune-suppressant medications, obesity and osteoporosis occur. Tuberculosis is not related to post kidney transplantation complications.