CSFA Practice Test correct answers latest

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which of the following congenital anomalies does the urethra open on the
underside of the penis

A. chordee

B. epispadias

C. phimosis

D. hypospadias ANS✔✔ D.

Which of the following are used for skin preparation prior to surgery?

1. Triclosan 1%

2. alcohol 70%

3. povidone-iodine

4. glutaraldehyde

A. 1, 2, and 3 only

B. 1, 2, and 4 only

C. 1, 3, and 4 only

D. 2, 3, and 4 only ANS✔✔ A. 1,2,and 3 only

When should the patient's chest tubes be attached to the drainage system
during a thoracotomy?

A. after the thoracic cavity is closed

B. immediately upon insertion

C. within an hour of the procedure

D. upon arrival in the PACU ANS✔✔ A

In patients who develop fever, abdominal pain, and profuse diarrhea, the
MOST frequently seen antibiotic-associated enterocolitis is due to which of
the following organisms?

A. Enterobacter cloacae

B. Enterococcus faecalis

C. Pseudomonas aeruginosa

D Clostridium difficile ANS✔✔ D

During a carotid endarterectomy, the final occlusion clamp to be removed

after anastomosis is on the

A. common carotid.

B. internal carotid.

C. external carotid.

D. thyroid branch. ANS✔✔ B. The clamp on the internal carotid artery should
be removed last so that all debris left in the area is flushed out through the
external carotid artery.

During a routine abdominal hysterectomy, the anesthesiologist notes that

the patient is becoming progressively tachycardic. He notes that there has
been virtually no blood loss. The surgeon requests additional muscle
relaxation because the patient's abdominal musculature is "tightening up."
The esophageal temperature probe indicates a core body temperature of
103°F (39°C). The anesthesiologist notices that the CO2 monitors are
alarming with high levels. The anesthesiologist turns off his anesthetic agent,
hyperventilates the patient with 100% oxygen, and administers which of the
following drugs?

A. succinylcholine
B. dantrolene

C. atropine

D. epinephrine ANS✔✔ B.The scenario is describing the anesthesia

emergency malignant hyperthermia (MH). Dantrolene is the medication
given to combat MH (2-3 mg/kg until signs are controlled). Some signs of MH
are tachycardia, tachypnea, hypercarbia, muscle stiffness and rigidity,
hypoxia, elevated BP, cardiac dysrhythmias, changes in CO2 absorption, and
elevated temperature.

A pledgeted suture is used for hemostasis in liver injury to

A. align the suture placement.

B. add bulk to the injury site.

C. reduce the likelihood of suture cut- through.

D. provide traction for increased exposure. ANS✔✔ C. Pledgeted sutures

(buttresses) are sutures passed through a small patch of reinforcing material
(usually Teflon). This type of suture is used in areas where the surgeon
considers buffering to be beneficial, particularly in delicate or friable tissue.

During cardiac arterial bypass grafting, a surgeon needs to vasodilate and

stop arterial spasm. Which of the following drugs should be used?

A. papaverine

B. heparin

C. protamine

D. norepinephrine ANS✔✔ A. Papaverine stops spasming and relaxes smooth

muscles, especially those of large arteries.

When ligating the short gastric arteries, placing them under too much
tension may result in a tear of the

A. splenic capsule.
B. lesser omentum.

C. celiac trunk.

D. common bile duct. ANS✔✔ A. The splenic capsule is attached to the short
gastric arteries and tension would result in tearing.

Which of the following is needed to complete the circuit on an ESU when

using a monopolar electrode tip?

A. a bipolar forceps

B. an insulated holster

C. an active electrode

D. a dispersive pad ANS✔✔ D. The dispersive pad disperses high-frequency

current released through the active electrode and provides low current
density return from tissues back to the generator to complete the circuit.

A complication of steep reverse Trendelenburg position is

A. deep vein thrombosis.

B. arterial compression.

C. cardiac overload.

D. respiratory alkalosis. ANS✔✔ A. Steep reverse Trendelenburg position

decreases venous return. Sequential compression stockings are applied to
prevent deep venous thrombosis.

The topical hemostatic agent thrombin should never be directly injected or

allowed to enter into a vessel because

A. it causes uncontrollable vasospasms.

B. the effects are reversed when directly injected and cause more severe
bleeding.
C. it can cause clotting and may ultimately lead to death.

D. the risk of infection increases with direct injection. ANS✔✔ C. Thrombin

will cause blood in the vessel to clot and will cause thrombosis, which can
lead to death if not realized and corrected immediately.

According to Maslow's Hierarchy of Needs, which of the following patient

needs should be met first?

A. esteem

B. belonging

C. physiological

D. safety ANS✔✔ C. Physiological needs must be met first before any of the
other needs can be considered. Physiological needs include breathing,
circulation, and the patient's physical condition.

An epidural catheter is introduced into a patient in the preoperative holding

room. When the patient is given a bolus of local anesthetic in the OR, the
surgical first assistant observes hypotension and signs of complete
respiratory failure. Which of the following is the MOST likely cause?

A. migration of the epidural catheter through the dura

B. poor cardiac output

C. administration of ropivacaine instead of bupivacaine

D. use of a Bier block ANS✔✔ A. With patient movement, the epidural

catheter may migrate through the dura. A bolus injection into the subdural
space can cause total spinal anesthesia resulting in hypotension and
respiratory failure.

Taper point needles are generally used in which of the following tissue
types?

1. gastrointestinal
2. tendons

3. adipose

4. vascular ANS✔✔ 1. It is used on GI tissues to reduce the amount of tissue

trauma.

3. Adipose is a less dense tissue and a taper needle works well.

4. Vascular tissue needs a taper to prevent further tissue damage as well.

A threaded cortical screw cannot provide compression of bone fragments

unless the

A. hole is tapped.

B. screw is self-tapping.

C. near cortex is overdrilled.

D. screw is cannulated. ANS✔✔ C. Cortical screws can function in

interfragmentary compression if the hole in the near cortex is overdrilled.

Which of the following is a normal adult hematocrit range?

A. 21 to 36%

B. 37 to 52%

C. 54 to 69%

D. 72 to 87% ANS✔✔ B. A hematocrit range of 37 to 48% is normal for a

female. A hematocrit range of 45 to 52% is normal for a male.

Excessive limb lengthening during total hip arthroplasty can increase the risk
of injury to the

A. median nerve.

B. sciatic nerve.

C. brachial plexus.
D. celiac artery ANS✔✔ B. Sciatic nerve injury is a complication of total hip
arthroplasty. The risk increases with limb lengthening of the operative side.

Which of the following disease processes can affect cranial nerve VII?

1. acoustic neuroma

2. mastoid infections

3. hydrocephalus

4. Bell's Palsy

A. 1, 2, and 3 only

B. 1, 2, and 4 only

C. 1, 3, and 4 only

D. 2, 3, and 4 only ANS✔✔ 1. True. Cranial nerve VII controls motor and
sensory impulses to the face for facial expression, tearing, and salivation.
Acoustic neuroma may damage cranial nerve VII.

2. True. Mastoid infections may spread to cranial nerve VII and cause
paralysis if not treated.

4. True. Bell's Palsy is a viral infection that affects cranial nerve VII.

A patient involved in a motor vehicle crash arrives in the OR. The patient
presents with the following:

The surgical first assistant should prepare the OR for

A. a ORIF left femoral fracture.

B. a left temporal craniotomy.

C. a repair of the left temporal laceration.

D. an exploratory laparotomy. ANS✔✔ D. Clinical hypotension and blood in

the urine indicate intra-abdominal injury. Exploratory laparotomy is
necessary and should be the initial step in the surgical treatment of the
patient.
During digital reanastomosis, which of the following items is commonly
used?

A. operative microscope

B. nerve stimulator

C. epiphyseal staple

D. micro-oscillating saw ANS✔✔ A. Vascular repair during a digital

reanastomosis will typically require the utilization of an operative
microscope, micro-instruments, and micro-suture.

When a flank approach is used for a nephrectomy, which of the following

muscles are involved?

A. serratus anterior and trapezius

B. gluteus maximus and pectoralis major

C. latissimus dorsi and internal oblique

D. transverse abdominis and rectus abdominis ANS✔✔ C. The latissimus

dorsi curves upward from the lower back around the arm to the armpit. The
internal oblique muscle would be involved.

Immediately following an arthroscopic assisted anterior cruciate ligament

(ACL) reconstruction, a patient's knee is typically placed in

A. a hinged knee brace.

B. a posterior splint.

C. a long-leg cast.

D. an anterior splint. ANS✔✔ A. A hinged knee brace is most commonly used

following ACL reconstruction.
Joseph button-end knife, Ballenger swivel knife, and Cottle elevator are all
considered which of the following kinds of instrument?

A. neuro

B. CV

C. ENT

D. ortho ANS✔✔ C. These instruments are used in ENT surgery for

septoplasty or rhinoplasty.

Which of the following has been shown to have proven benefit in the
prevention of postoperative wound infections?

1. administrating appropriate antibiotics within 1 hour of incision time

2. maintaining suitable antibiotic coverage for 48-72 hours postoperatively

3. irrigating the wound with normal saline

4. irrigating the wound with antibiotic-based solution

A. 1 and 3 only

B. 1 and 4 only

C. 2 and 3 only

D. 2 and 4 only ANS✔✔ 1. True. There is a general trend toward providing a

single preoperative dose, as antibiotics prophylaxis may not impart any
benefit at all beyond the initial dosing.

3. True. Serial irrigation of the operative field and the surgical wound with
saline solution has shown benefit in controlling wound inoculum.

During a carotid endarterectomy, the arteries are unclamped and reclamped

before arteriotomy closure is performed to

A. flush free debris from the carotid bulb.

B. restore complete blood flow to the brain.

C. increase collateral flow.

D. ensure patency of the carotid body. ANS✔✔ A. Before complete closure,

blood flow is temporarily restored through the arteries to wash away debris,
such as free plaque, air, or thrombi.

When performing compression hip screw fixation, the lag screw is inserted

A. into the femoral neck with the threads 2 cm lateral to the fracture site.

B. within 1 cm of the femoral articular surface.

C. into the articular cartilage of the femoral head.

D. in the superior aspect of the femoral head. ANS✔✔ B. Lag screw

placement within 1 cm (10 mm) of the femoral articular surface is considered
optimal for fracture fixation.

Which of the following are the most common lasers used in gynecological
surgery?

A. ruby and CO2

B. Nd:YAG and argon

C. argon and ruby

D. CO2 and Nd:YAG ANS✔✔ D. Both CO2 and Nd:YAG lasers are used for
gynecological surgery.

Which of the following capsules must be entered to gain access to the kidney
or suprarenal gland for repair?

A. Camper's fascia

B. renal corpuscle
C. Gerota's fascia

D. suprarenal cortex ANS✔✔ C. Gerota's fascia is a dense capsule made of

connective tissue and perinephric fat that encapsulates both the kidney and
suprarenal gland.

While a patient is in the lithotomy position, which of the following nerves are
at risk for injury?

1. sciatic

2. phrenic

3. obturator

4. femoral cutaneous

A. 1, 2, and 3 only

B. 1, 2, and 4 only

C. 1, 3, and 4 only

D. 2, 3, and 4 only ANS✔✔ 1. True. The sciatic nerve is in the lower

extremities and arises from L4-S3.

3. True. The obturator nerve is in the lower extremities and arises from L2-
L4.

4. True. The femoral cutaneous nerve is in the lower extremities and arises
from L2-L3.

Blood spatterings on the lens of an operative microscope should be removed

with

A. alcohol.

B. water.

C. fred.
D. saline. ANS✔✔ B. Distilled water is used with a cotton ball or cotton-tipped
applicator when removing blood, water, and irrigating solutions from the lens
surface.

A 3-way Foley catheter with a 30 cc balloon should be inserted following a

transurethral prostate resection (TURP) to

A. irrigate and facilitate hemostasis.

B. prevent the patient from getting out of bed.

C. keep accurate input and output records.

D. minimize postoperative hypertrophy. ANS✔✔ A. The pressure of the 30 cc

balloon against the walls of the urethra, where the prostate was removed by
electrocautery, allows hemostasis, while the lumen of the catheter can be
used to irrigate clots from the bladder.

In axillary node dissection, the sentinel node is

A. closest to the primary tumor.

B. located along the thoracic nerve.

C. part of the thoracic duct.

D. located along the superior vena cava. ANS✔✔ A. A sentinel node is a

lymph node that receives drainage from a tumor and is likely to harbor
metastatic disease.

Which of the following catheters is used primarily for suprapubic drainage for
poor-risk patients?

A. Foley

B. Malecot

C. urethral
D. Pezzer ANS✔✔ D. The Pezzer catheter is used for poor-risk patients who
have uremia, neurogenic bladder syndrome, or long-standing urinary
retention.

Which of the following incisions is usually used for an open cholecystectomy?

A. McBurney's

B. Pfannenstiel

C. lower midline

D. right subcostal ANS✔✔ D. The right subcostal (Kocher) incision is

appropriate for operations on the liver, gallbladder, and biliary tract.

Which of the following must be adhered to when positioning a patient

laterally for thoracotomy?

1. padding pressure points

2. protecting nerves and vessels

3. preventing hyperextension of limbs

4. flexing upper legs

A. 1, 2, and 3 only

B. 1, 2, and 4 only

C. 1, 3, and 4 only

D. 2, 3, and 4 only ANS✔✔ 1. True. All pressure points should be padded for
all positions to prevent pressure injuries.

2. True. Protecting nerves and vessels must be done during positioning and
would be applicable.

3. True. Hyperextension of the arms relates to preventing nerve and vessel

damage.
During induction of anesthesia, the administration of propofol (Diprivan®)
would cause

A. a hypnotic state and sedation to unconsciousness.

B. thinning of the blood and prevention of clotting.

C. relaxation of muscles and dilation of arteries.

D. relaxation of the bladder and production of urine. ANS✔✔ A. Diprivan® is

used for induction and maintenance of anesthesia for sedation and hypnosis.

Heparin is used as an anticoagulant to prevent clotting.

Papaverine stops vasospasms and relaxes smooth muscles, especially those

of large arteries.

Furosemide (Lasix®) is used on adults and children for the treatment of

edema by producing urine. ANS✔✔ INFO

A patient scheduled for elective surgery has a positive pregnancy test. Which
of the following is MOST appropriate?

A. Proceed with surgery regardless of the trimester.

B. Only proceed with surgery during the first trimester.

C. Use a general anesthetic with a halogenated agent only.

D. Defer the surgery until after the delivery. ANS✔✔ D. Elective surgical
procedures should be deferred until after delivery of the neonate, once the
anatomic and physiologic changes of pregnancy have returned to normal.
Which of the following methods of suturing should be used to close a deep
layer located on the medial edge of a myocutaneous flap closure of a sacral
decubitus ulcer?

A. simple running with 0 Vicryl SH

B. Cushing suture with 1 Prolene FS

C. Halstead suture with 0 Vicryl CTX

D. half-buried mattress suture with 0 PDS FS ANS✔✔ D. The half-buried

mattress (Grey-Turner) method of suture is a series of inverted interrupted
horizontal or vertical mattress stitches. In this method, the knot is tied deep
to avoid the incision line and prevent irritation. The interrupted status helps
to avoid wound dehiscence should a suture fail. PDS has the same qualities
of Vicryl, but is monofilament so it does not lend itself to wicking of possible
SSI. The 0 gauge is an appropriate gauge suture. The FS needle is an
appropriate needle selection for closing this layer.

Which of the following tests measures the velocity of the flow of red blood
cells?

A. Doppler

B. B. mode ultrasound

C. duplex ultrasound

D. angiography ANS✔✔ A. Doppler measures the velocity of the flow of red

blood cells.

1. mode ultrasound projects a two-dimensional image on an oscilloscope

screen. The image appears as dots from the echoes of the signal.

2. Duplex ultrasound is a combination of the pulse Doppler and the real time
B. mode image ultrasonogram.

3. Angiography is a study used to evaluate the vascular system using

fluoroscopy and contrast medium. ANS✔✔ INFO
A 70-year-old patient who underwent an 8-hour colon resection is at the
greatest risk for which of the following?

A. diverting colostomy

B. postoperative infection

C. myocardial infarction

D. hyperthermia ANS✔✔ B. All 3 components to this question are

contributing factors to higher risk of wound infection: 1) the age of the
patient, 2) the extended time of the procedure, and 3) the wound
classification.

When a surgeon places a 2-stage venous cannula for cardiopulmonary

bypass, where should the cannula be placed?

A. ascending aorta

B. right atrium

C. right ventricle

D. right superior pulmonary vein ANS✔✔ B. The right atrium sends

deoxygenated blood to the bypass unit through the venous cannula.

A. The ascending aorta carries oxygenated blood to the patient via the aortic
cannula.

C. The right ventricle is not used in the bypass circuit at all.

D. The right superior pulmonary vein is used for left ventricular venting
through a vent cannula ANS✔✔ INFO

Using Standard Precautions, which of the following is proper procedure when

handling contaminated items?

A. removing scalpel blades by hand

B. disposing suctioned body fluids into a drain connected to a sanitary sewer

C. placing sharps in an emesis basin for disposal into the biohazard trashbag

D. discarding used needles by hand ANS✔✔ B. Suctioned body fluids may

safely be poured down a drain connected to a sanitary sewer.

A 60-year-old obese patient with a history of diabetes and renal insufficiency

has undergone drainage of an abdominal abscess through a midline incision.
Which of the following should the surgical first assistant consider during
wound closure?

A. Multifilament, absorbable suture material provides for optimal wound

healing.

B. A continuous suture line should be utilized.

C. An interrupted retention suture should be utilized.

D. Use of blunt surgical needles is a consideration in the presence of

infection. ANS✔✔ C. Interrupted retention suturing effectively provides a
secondary suture line relieving strain on the wound and providing a better
opportunity for healing by first intention.

Vertical-banded gastroplasty (VAB) and gastric bypass Roux-en-Y are

common procedures performed in which of the following types of surgery?

A. colorectal

B. general

C. bariatric

D. thoracic ANS✔✔ C. This is common description of two bariatric procedures

done today

Which of the following are reasons for keeping the OR at a relative humidity
level of between 50 - 55%?

1. reduced risk of infection

2. lower levels of patient discomfort

3. minimization of static electricity

4. depressed waste anesthesia gas

A. 1 and 3 only

B. 1 and 4 only

C. 2 and 3 only

D. 2 and 4 only ANS✔✔ EXPLANATIONS:

1. True. Humidity levels above 60% are conducive to bacterial growth, so

OSHA recommends having humidity remain between 50 - 55%.

3. True. High humidity increases the risk of electrical conductivity, which

could lead to fires in the OR. Lower humidity levels will minimize the static
electricity in the room.

During a Nissen fundoplication, care should be taken when placing medial

traction on the stomach to prevent avulsion of the

A. splenic artery.

B. gastric arteries.

C. common duct.

D. pancreatic duct. ANS✔✔ B. The gastric arteries run between the greater
curvature of the stomach and the spleen.

A. The splenic artery runs retroperitoneal below the stomach

C. The common duct is medial to the stomach.

D. The pancreatic duct is retroperitoneal and underneath the stomach.

ANS✔✔ INFO