Hemostasis, Wound Healing, and Wound Closure test

Which of the following interweaves its fibers during the maturation phase of wound healing and increases its tensile strength?

a. collagen

b. enzymes

c. fibrin

d. protein

collagen

A wound that is not sutured and gradually fills in by granulation heals by which intention?

a. first

b. second

c. placement of wound drain

d. fourth

second

Nosocomial wound incision infections are considered?

surgical site infection SSI

Which postoperative wound complication would require immediate surgical treatment?

a. fistula

b. adhesions

c. infection

d. evisceration

evisceration

Which phase of healing for wounds closed by first intention begins within minutes of the incision or injury?

a. inflammatory

b. proliferation

c. maturation

d. granulation

inflammatory

What is the name of a raised, hypertrophic scar due to excessive collagen formation in some darker-skinned individuals?

a. cicatrix

b. granuloma

c. keloid

d. seroma

keloid

Which tissue layer of the abdominal wall provides the greatest strength and support of the wound?

a. skin

b. fascia

c. peritoneum

d. subcutaneous

fascia

Which type of suture needle is used on friable tissue such as liver or kidney?

a. blunt

b. cutting

c. taper

d. trocar

blunt

When closing a class 1 abdominal wound/wall which of the following choices is the correct order of the suture use?

3-0 Vicryl for underlying tissues

2 Prolene additional long-term support

3-0 Monocryl for skin closure

Tissue trauma is minimized by using which type of suture-needle combination?

a. Threaded suture on a closed-eye taper needle

b. Threaded suture on a closed-eye Keith needle

c. Suture loaded on a French-eyes taper needle

d. Suture permanently swaged on an eyeless needle

suture permanently swaged on an eyeless needle

Another name for a suture ligature is a:

a. free tie

b. stick tie

c. tie-on-a-passer

d. ligature reel

stick tie

Which type of needle is preferred for suturing of skin?

a. blunt

b. cutting

c. taper

d. spatula

cutting

What is the term for removal of foreign material or contaminated debris from a wound?

a. debridement

b. dehiscence

c. denuding

d. desiccaion

debridement

Evisceration of an abdominal wound is:

a. filling in of a wound from bottom up

b. excessive scar formation after surgery

c. protrusion of viscera through all tissue layers

d. single- or multi-layer separation of wound edges

protrusion of viscera through all tissue layers

Which type of healing occurs in an aseptic wound with good approximation and ideal surgical conditions?

a. first intention

b. second intention

c. third intention

d. fourth intention

first intention

If tissue is approximated too tightly, it can result in:

(occlusion)

a. adhesions

b. granulation

c. ischemia

d. keloids

ischemia

Primary union wound healing occurs

:a. bottom to top

b. top to bottom

c. end to end

d. side to side

side to side

Inflammation can BEST be described as:

a. disease process accompanied by fever

b. an exaggerated immune system response

c. a normal protective response to tissue injury

d. an abnormal physiologic response to tissue injury

normal protective response to tissue injury

Which of the following wouds would be assigned to Class I?

a. compound femoral fracture

b. gunshot wound to the abdomen

c. appendectomy with no major intestinal spillage

d. inguinal hernia repair with no breaks in technique

inguinal hernia repair with no breaks in technique

What kind of wound is a sacral decubitus ulcer?

a. chronic

b. clean

c. closed

d. contusion

chronic

Which wound classification would be assigned to a vaginal hysterectomy with anterior and posterior colporrhaphy?

a. Class I

b. Class II

c. Class III

d. Class IV

Class II

A patient undergoing chemotherapy and radiation therapy for cancer might experience prolonged wound healing due to:

a. Class I, primary union wound

b. hyperactive immune response

c. immunosuppressed status

d. vascular proliferation

immunosuppressed status

What is the term for a type of suture that has the strand of suture material inserted into the hollowed-out needle end?

a. closed eye

b. crimped

c. French-eye

d. swaged

swaged

Which of the following is a natural, multifilament suture classified as non-absorbable but loses much of its tensile strength in a year and is undetectable in tissues after 2 years?

a. polyester

b. polypropylene

c. surgical silk

d. stainless steel

surgical silk

Some multifilament sutures are coated to:

a. provide smooth passage through tissue

b. decrease the absorption rate

c. increase the capillarity

d. prevent knot slippage

provide smooth passage through tissue

Which of the following sutures has comparatively inconsistent tensile strength and rapid absorption rate in vivo with moderate tissue reaction?

a. plain surgical gut

b. poliglecaprone

c. polyflyconate

d. polydioxanone

plain surgical gut

Ethicon sutures may be available with a designation of "plus" for some sutures, which means they:

a. are longer strands than the original versions

b. have more than one needle in the package

c. have a heavier gauge needle for thicker tissues

d. are impregnated with an antibacterial coating

are impregnated with an antibacterial coating

Which organization specifies diameter ranges for sutures?

a. American National Standards Institute

b. Brown and Sharpe

c. US Pharmacopeia

d. US Food and Drug Administration

US Pharmacopeia

What is the chemical name of Gore-Tex suture?

a. polybutester

b. polpropylene

c. polyglactin

d. polytetrafluoroethylene

polytetrafluoroethylene

Which suture is MOST inert in tissue?

a. chromic gut

b. plain gut

c. stainless steel

d. surgical silk

stainless steel

What is the primary reason bolsters are used with retention sutures?

a. to facilitate easy post-op suture removal

b. to prevent sutures from cutting into the skin

c. to stabilize heavy dressings without use of tape

d. to prevent dressings from touching the suture line

to prevent sutures from cutting into the skin

Ligatures are used to:

a. prevent evisceration

b. eliminate dead space

c. approximate tissue layers

d. occlude the lumen of a blood vessel

occlude the lumen of a blood vessel

What is the term that describes the measure of how much a suture strand can be stretched before breaking?

a. gauge

b. capillarity

c. tensile strength

d. drag coefficient

tensile strength

Which of the following needles causes the least amount of tissue damage?

swaged

How will the surgeon manipulate skin edges of a wound before the surgical technologist places an approximating skin staple?

a. evert the edges outward

b. invert the edges inward

c. overlap the edges slightly

d. rotate the edges slightly

evert the edges outward

Which of the following types of tissue is usually separated rather than cut and therefore does not need to be closed?

fascia

subcutaneous

muscle

peritoneum

muscle

Which non-suture needle is used for insufflation of carbon dioxide into the abdomen for laparoscopy?

a. arterial

b. hypodermic

c. spinal

d. Veress

Veress

Which needle has the cutting edge on the outside curvature of the needle body?

a. conventional

b. Keith straight

c. reverse

d. spatula

reverse

Which suture gauge would be MOST appropriate for ophthalmic surgery?

a. #5

b. 0

c. 3-0

d. 8-0

8-0

A continuous suturing technique that places sutures in the endothelial layer of the skin in short, lateral throws is called:

a. mattress suture

b. purse-string suture

c. traction suture

d. subcuticular suture

subcuticular suture

Which of the following surgical needles is a solid bore (not hollow) type of needle? Straight body

a. Dorsey

b. heparin

c. Keith

d. Tru-cut

Keith

Which type of suture ties has an attached needle?

a. free tie

b. ligature reel

c. suture ligatures

d. tie-on-a-passer

suture ligatures

The suturing technique MOST appropriate for wounds likely to become infected or suffer potential stress is:

a. blanket

b. interrupted

c. purse-string

d. simple continuous

interrupted

Which of the following statements is TRUE regarding natural absorbable sutures? Packed wet which one?

a. they are packaged dry

b. they are packaged wet

c. they are braided multifilament strands

d. they have less tissue reaction than synthetics

they are packaged wet, Chromic

A way in which the surgical technologist can assist the surgeon by keeping the suture strand out of the way during a continuous running closure is by:

tagging

tracking

pulling

controlling

controlling (following)

Which of the following sutures is classified as a monofilament suture?

Dacron

Ethilon

Fiberwire

Vicryl

ethicon

Which absorbable suture provides for the MOST extended wound support?

a. Vicryl

b. Monocryl

c. PDS Plus

d. polysorb

PDS Plus

Which suturing technique would be used to close the stump of the appendix in an open appendectomy?

a. horizontal mattress

b. vertical mattress

c. purse-string suture

d. retention

purse-string suture

Which of the following is synthetic monofilament, non-absorbable, and the most inert synthetic suture used frequently in cardiovascular and ophthalmology procedures?

a. polybutester

b. polypropylene

c. polyterephthalate

d. polytetrafluoroethylene

polypropylene

Which type of suture is often used to create a vascular anastomosis?

a. synthetic, absorbable, multifilament on a 3/8 circle cutting needle

b. synthetic, non-absorbable, multifilament on a 1/2 circle taper needle

c. synthetic, absorbable, monofilament on a Keith straight needle

d. synthetic, non-absorbable, monofilament with double-armed taper needles

synthetic, non-absorbable, monofilament with double-armed taper needles

Which type of synthetic mesh is absorbable?

a. polyglactin 910

b. polypropylene

c. polyester fiber

d. PTFE

polyglactin 910

Which internal stapling device fires a circular double row of staples to re-anastomose the colon?

a. intraluminal stapler

b. linear cutter

c. linear stapler

d. ligating clip applier

intraluminal staple

What is used to close the epidural layer when a subcuticular wound closure has been done for good cosmesis?

a. suture bridge

b. skin closure tapes

c. split lead shots

d. suture anchors

skin closure tapes

Which of the following types of vessel loops are available for use on veins?

a. blue colored for veins

b. red colored for arteries

c. yellow colored for nerves

d. green colored for bile ducts

blue

What is the chemical name for Durabond or Indermil?

a. cryoprecipitate

b. cyanoacrylate

c. fibrin glue

d. polymethyl methacrylate

cyanoacrylate

What would be the type of suture placed temporarily in the tongue to hold it out of the way in a maxillofacial procedure?

retention

purse-string

traction

suture ligature

traction

Which the following procedures would require the use of a CT scan or fluoroscopy?

chiba needle biopsy

Which layer of the abdominal wall must be approximated securely, even if the other layers are not?

a. skin

b. fascia

c. peritoneum

d. subcutaneous fat

fascia

In general, a monofilament suture would require ___ knot throws for security than a multifilament suture.

a. more

b. fewer

c. the same number of

d. none

more

To achieve the goal of leaving as little foreign material in a wound, the ideal suture selected should have:

a. large diameter gauge

b. an antibacterial coating over it

c. tightly braided fibers with capillarity

d. high-tensile strength and small diameter

high-tensile strength and small diameter

What is the term for tissue that is easily torn or shredded?

a. adhesive

b. dehisced

c. eviscerated

d. friable

friable

By which intention would a purulent wound treated by debridement and placement of medicated packing, then sutured after resolution of the infection heal?

a. first intention

b. second intention

c. third intention

d. primary union

third intention

Natural absorbable sutures are broken down in the body by:

a. capillarity

b. enzymatic digestion

c. third intention

d. metabolic factors

enzymatic digestion

The term that describes blood products donated by another person is:

a. hemolytic.

b. hemostatic.

c. homologous.

d. homeostasi

homologous.

An example of acceptable and safe intraoperative autotransfusion blood collection is:

a. bloody ascites fluid drained from the peritoneal cavity during surgery for ovarian cancer.

b. bloody fluid suctioned during liver resection with use of reconstituted topical thrombin spray on oozing bleeders.

c. blood collected during a major abdominal trauma procedure with small bowel perforation.

d. blood collected from sponges into a basin of sterile saline during repair of ruptured abdominal aortic aneurysm.

blood collected from sponges into a basin of sterile saline during repair of ruptured abdominal aortic aneurysm.

Elective surgery patients may be asked to discontinue use of which of the following medications to prevent drug-therapy-induced platelet dysfunctions?

a. antacids

b. aspirin

c. anticonvulsants

d. antibiotics

aspirin