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WorksheetsMTR Chapter 11 Read It: Hemostasis, Wound Healing and Closure
Total questions: 93
Worksheet time: 47mins
Name
Class
Date
1.
Which of the following choices interweaves its fibers during the maturation phase of wound healing and increases its tensile strength?
a)
collagen
b)
enzymes
c)
fibrin
d)
protein
2.
A wound that is not sutured and that gradually fills in by granulation heals by _____ intention.
a)
first
b)
second
c)
third
d)
fourth
3.
Incisional, nosocomial, and deep are all types of:
a)
wound approximation techniques
b)
surgical site infections
c)
radiation treatments
d)
microbial preventions
4.
Which of the following postoperative wound complications would require immediate surgical intervention?
a)
fistula
b)
adhesions
c)
infection
d)
evisceration
5.
Which of the following phases of healing for wounds closed by first intention begins within minutes of the incision or injury?
a)
inflammatory
b)
proliferation
c)
maturation
d)
granulation
6.
The name of a raised, hypertrophic scar due to excessive collagen formation is:
a)
cicatrix
b)
granuloma
c)
keloid
d)
seroma
7.
Which of the following types of suture needles is used on friable tissue such as liver or kidney?
a)
blunt
b)
cutting
c)
taper
d)
trocar
8.
Which of the following tissue layers of the abdominal wall is the primary supportive tissue and must be closed securely?
a)
skin
b)
fascia
c)
peritoneum
d)
subcutaneous fat
9.
When closing a class I abdominal wound, which of the following choices is the correct order of suture use?
a)
2 Prolene, 3-0 Monocryl, 3-0 Vicryl
b)
2 Prolene, 3-0 Vicryl, 3-0 Monocryl
c)
3-0 Vicryl, 2 Prolene, 3-0 Monocryl
d)
3-0 Vicryl, 3-0 Monocryl, 2 Prolene
10.
Tissue trauma is minimized by using which of the following types of suture-needle combinations?
a)
threaded suture on a closed-eye taper needle
b)
threaded suture on a closed-eye Keith needle
c)
suture loaded on a French-eyed taper needle
d)
suture permanently swaged on an eyeless needle
11.
Another name for a suture ligature is a:
a)
free tie
b)
stick tie
c)
tie-on-a-passer
d)
ligature reel
12.
Which of the following types of needles is preferred for suturing of skin?
a)
blunt
b)
cutting
c)
taper
d)
spatula
13.
The term for removal of foreign material or contaminated debris from a wound is:
a)
debridement
b)
dehiscence
c)
denuding
d)
desiccation
14.
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
15.
Which of the following types 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
16.
Occlusion banding causes:
a)
adhesions
b)
granulation
c)
ischemia
d)
keloids
17.
Primary union wound healing occurs:
a)
bottom to top
b)
top to bottom
c)
end to end
d)
side to side
18.
Inflammation can BEST be described as:
a)
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
19.
Which of the following wounds would be assigned a 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
20.
Which of the following kinds of wounds is a sacral decubitus ulcer?
a)
chronic
b)
clean
c)
closed
d)
contusion
21.
Which of the following wound classifications would be assigned to a vaginal hysterectomy with anterior and posterior colporrhaphy?
a)
Class I
b)
Class II
c)
Class III
d)
Class IV
22.
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
23.
The term for a type of suture that has the strand of suture material inserted into the hollowed-out needle end is:
a)
closed eye
b)
crimped
c)
French-eye
d)
swaged
24.
Which of the following sutures is a natural, multifilament suture classified as nonabsorbable but is undetectable in tissues after two years?
a)
polyester
b)
polypropylene
c)
surgical silk
d)
stainless steel
25.
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
26.
Which of the following sutures has a rapid absorption rate?
a)
plain surgical gut
b)
poliglecaprone
c)
polyglyconate
d)
polydioxanone
27.
Some sutures may be available with a designation of “plus”, 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
28.
Which of the following organizations specifies diameter ranges for sutures?
a)
American National Standards Institute (ANSI)
b)
Brown and Sharpe (B&S)
c)
U.S. Pharmacopeia (USP)
d)
U.S. Food and Drug Administration (FDA)
29.
What is the chemical name of Gore-Tex suture?
a)
polybutester
b)
polypropylene
c)
polyglactin 910
d)
polytetrafluoroethylene
30.
Which of the following types of mesh is MOST inert in tissue?
a)
polyester fiber
b)
polypropylene
c)
stainless steel
d)
polytetrafluoroethylene
31.
The primary reason bolsters are used with retention sutures is to:
a)
facilitate easy postop suture removal
b)
prevent sutures from cutting into the skin
c)
stabilize heavy dressings without use of tape
d)
prevent dressings from touching the suture line
32.
Ligatures are used to:
a)
prevent evisceration
b)
eliminate dead space
c)
approximate tissue layers
d)
tie off blood vessels
33.
The term that describes the measure of how much a suture strand can be stretched before breaking is:
a)
gauge
b)
capillarity
c)
tensile strength
d)
drag coefficient
34.
Which of the following needles causes the least amount of tissue damage?
a)
closed
b)
French-eye
c)
free
d)
swaged
35.
The surgeon manipulates skin edges of a wound before the surgical technologist places an approximating skin staple by:
a)
everting the edges outward
b)
inverting the edges inward
c)
overlapping the edges tightly
d)
rotating the edges slightly
36.
Which of the following types of tissue is usually separated rather than cut and therefore does not need to be closed?
a)
fascia
b)
muscle
c)
peritoneum
d)
subcutaneous
37.
Which specialty needle is used for insufflation of carbon dioxide into the abdomen for laparoscopy?
a)
arterial
b)
hypodermic
c)
spinal
d)
Veress
38.
Which of the following needles has the cutting edge on the outside curvature of the needle body?
a)
conventional
b)
Keith straight
c)
reverse
d)
spatula
39.
Which of the following suture gauges would be MOST appropriate for ophthalmic surgery?
a)
2.0
b)
1-0
c)
3-0
d)
8-0
40.
A continuous suturing technique that places sutures in the endothelial layer of the skin in short bites is called a:
a)
mattress suture
b)
purse-string suture
c)
traction suture
d)
subcuticular suture
41.
Which of the following surgical needles has a straight body?
a)
Dorsey
b)
heparin
c)
Keith
d)
Tru-cut
42.
Which of the following types of suture ties has an attached needle?
a)
free tie
b)
ligature reel
c)
suture ligature
d)
tie-on-a-passer
43.
The suturing technique used to close infected tissue is:
a)
blanket
b)
interrupted
c)
purse-string
d)
simple continuous
44.
Which of the following sutures is packaged wet?
a)
PDS
b)
chromic
c)
sile
d)
biosyn
45.
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:
a)
controlling
b)
pulling
c)
tagging
d)
tracking
46.
Which of the following sutures is classified as a monofilament suture?
a)
Fiberwire
b)
Dacron
c)
Vicryl
d)
Ethilon
47.
Which of the following absorbable sutures provides for the MOST extended wound support?
a)
Vicryl
b)
Monocryl
c)
PDS Plus
d)
Polysorb
48.
Which of the following suturing techniques would be used to close the stump of the appendix in an open appendectomy?
a)
horizontal mattress
b)
vertical mattress
c)
purse-string
d)
retention
49.
Which of the following sutures is synthetic, monofilament, nonabsorbable, and the most inert synthetic suture used frequently in cardiovascular and ophthalmology procedures?
a)
polybutester
b)
polypropylene
c)
polyterephthalate
d)
polytetrafluoroethylene
50.
Which of the following types of sutures is often used to create a vascular anastomosis?
a)
synthetic, absorbable, multifilament on a 3/8 circle cutting needle
b)
synthetic, nonabsorbable, multifilament on a 1/2 circle taper needle
c)
synthetic, absorbable, monofilament on a Keith straight needle
d)
synthetic, nonabsorbable, monofilament with double-armed taper needles
51.
Which of the following types of synthetic mesh is absorbable?
a)
polyglactin 910
b)
polypropylene
c)
polyester fiber
d)
PTFE
52.
Which of the following internal stapling devices fires a circular double row of staples to reanastomose the colon?
a)
intraluminal stapler
b)
linear cutter
c)
linear stapler
d)
ligating clip applier
53.
Which of the following devices is used to close the epidermal 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
54.
Which of the following types of vessel loops would you expect to use on veins?
a)
blue
b)
red
c)
yellow
d)
green
55.
What is the chemical name for Dermabond™ or Indermil™?
a)
cryoprecipitate
b)
cyanoacrylate
c)
fibrin glue
d)
polymethyl methacrylate
56.
Which of the following types of sutures is placed temporarily in the tongue to hold it out of the way in a maxillofacial procedure?
a)
purse-string
b)
retention
c)
suture ligature
d)
traction
57.
Which of the following procedures would require the use of a CT scan or fluoroscopy?
a)
Chiba needle lung biopsy
b)
placement of a Veress needle
c)
placement of a spinal needle
d)
insertion of antecubital hypodermic needle
58.
Which of the following layers of the abdominal wall must be approximated securely, even if the other layers are not?
a)
skin
b)
fascia
c)
peritoneum
d)
subcutaneous fat
59.
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)
more, but only if coated
60.
To achieve the goal of leaving as little foreign material in a wound, the ideal suture selected should have:
a)
a large diameter gauge
b)
an antibacterial coating over it
c)
tightly braided fibers with capillarity
d)
high-tensile strength and small diameter
61.
The term for tissue that is easily torn or shredded is:
a)
adhesive
b)
dehisced
c)
eviscerated
d)
friable
62.
By which of the following intentions 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
63.
Natural absorbable sutures are broken down in the body by:
a)
capillarity
b)
enzymatic digestion
c)
granulation
d)
metabolic factors
64.
An example of acceptable and safe intraoperative autotransfusion blood collection is:
a)
blood collected during a major abdominal trauma procedure with small bowel perforation
b)
bloody ascites fluid drained from the peritoneal cavity during surgery for ovarian cancer
c)
blood collected from sponges into a basin of sterile saline during repair of ruptured abdominal aortic aneurysm
d)
bloody fluid suctioned during liver resection with use of reconstituted topical thrombin spray on oozing bleeders
65.
The term that describes blood products donated by another person is:
a)
hemolytic
b)
hemostatic
c)
homeostasis
d)
homologous
66.
Which of the following choices is NOT a method of achieving hemostasis?
a)
apportional
b)
chemical
c)
mechanical
d)
thermal
67.
Which of the following terms refers to a genetic clotting deficiency?
a)
anaphylaxis
b)
aplastic anemia
c)
hemophilia
d)
hyperthermia
68.
Which of the following blood types is considered the universal recipient?
a)
A
b)
B
c)
AB+
d)
O
69.
Elective surgery patients may be asked to discontinue use of which of the following medications to prevent drug-therapy-induced platelet dysfunctions?
a)
antibiotics
b)
anticonvulsants
c)
antacids
d)
aspirin
70.
Kittners, cottonoids, and laps are surgical:
a)
clamps
b)
ligatures
c)
sponges
d)
tourniquets
71.
Approximation is bringing two sides of a wound together closely with sutures, wound zippers, or special adhesives so that the wound can heal from side to side.
a)
"True"
b)
"False"
72.
Suture gauge can range from #5 (being the smallest) to 11-0 (being the heaviest) diameter.
a)
"True"
b)
"False"
73.
The tensile strength of suture material should equal the tensile strength of the tissue into which the suture is placed.
a)
"True"
b)
"False"
74.
A surgeon’s choice of suture is based on the surgeon’s training, the condition of the patient, the type of wound, and the conditions surrounding the surgical intervention.
a)
"True"
b)
"False"
75.
Monofilament sutures with memory, such as chromic gut and nylon, should be stretched tightly to remove all kinks in the strand before being handed to the surgeon.
a)
"True"
b)
"False"
76.
Tourniquets provide permanent mechanical hemostasis and enhance visualization by creating a bloodless field.
a)
"True"
b)
"False"
77.
Avitene®, Gelfoam®, and Surgicel® are examples of mechanical methods of hemostasis.
a)
"True"
b)
"False"
78.
Two members of the surgical team must perform the checks of identification information including patient armband, blood and Rh type, unit number, and expiration date prior to administration of any blood products to a patient.
a)
"True"
b)
"False"
79.
A surgical procedure that is booked as I&D of a leg abscess would have a wound classification of:
a)
Class 2.
b)
Class 4.
c)
Class 1.
d)
Class 3.
80.
While performing the excision of a sacral decubitus, the surgeon tells John, the CST, "I want this wound to heal by granulation." John knows this would be healing by:
a)
first intention.
b)
second intention.
c)
fourth intention.
d)
third intention.
81.
One day after surgery, a postoperative patient's wound has several separated layers. This would be a:
a)
separation wound.
b)
evisceration wound.
c)
dehiscence wound.
d)
adhesions wound.
82.
On closure of an infected wound, the surgeon requests a monofilament, non-absorbable suture. The best choice for the CST would be:
a)
silk.
b)
chromic gut.
c)
Prolene.
d)
Vicryl.
83.
Phase 1 of wound healing by first intention is the lag phase.
a)
"True"
b)
"False"
84.
A keloid is a raised, thickened scar caused by excessive collagen formation.
a)
"True"
b)
"False"
85.
Vicryl is a brand name.
a)
"True"
b)
"False"
86.
During an abdominal perineal resection procedure, the ends of the intestines need to be anastomosed together. The stapler that would best facilitate this would be the:
a)
EEA.
b)
linear cutter.
c)
GIA.
d)
TA.
87.
The surgeon asks for bolsters for the secondary suture line for closure of the laparotomy. The CST knows this procedure will require closure with:
a)
interrupted sutures.
b)
continuous sutures.
c)
traction sutures.
d)
retention sutures.
88.
A fistula is a tract between two epithelium-lined surfaces that is open at both ends.
a)
"True"
b)
"False"
89.
Nylon is nonabsorbable.
a)
"True"
b)
"False"
90.
Smoking can affect wound healing.
a)
"True"
b)
"False"
91.
In terms of tissue handling, friable means:
a)
frequent.
b)
cooks easily with an electrosurgery unit (ESU).
c)
easily torn.
d)
infection.
92.
Ligatures are also called:
a)
ties.
b)
ligament covers.
c)
hemostats.
d)
vessel covers.
93.
The end of the needle where the suture attaches is called the:
a)
body.
b)
shaft.
c)
point.
d)
eye.
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