Surgical Technology Principles And Practice 5th Edition By Joanna Kotcher – Test Bank

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Fuller: Surgical Technology, 5^th Edition

Chapter 5: Introduction to the Health Care Facility

Test Bank

TRUE/FALSE

1.The chain of command is a hierarchy of personnel positions that establishes the pay scale.

ANS: F

The chain of command is a relationship between management and staff. An employee reports (is responsible to) the person directly upward on the organizational chart. Management systems rely on the flow of information from specific people in particular positions to other specific positions. Chain of command defines the domains and specific areas of focus for each manager. It allows managers to focus their attention where it is intended. This creates a smoother running department and better patient outcomes. Chain of command is important to resolution of policy and protocol questions.

DIF: 2 REF: p. 64

2.A policy is a written declaration that defines the central goal of the health care institution and reflects the organization’s ethical and moral beliefs.

ANS: F

The responsibilities and functions of all employees in the surgical department are clearly defined in writing in the personnel policy manual. These policies are written to clarify job descriptions and to establish the accountability of each employee. They include topics such as employee safety, how to respond in emergency situations, insurance issues, and ethical conduct. They comply with state and federal laws and ensure that the hospital meets the minimum standards set by The Joint Commission. Policies must be strictly followed because they define the scope of practice necessary to the safe and efficient operation of the department. Employees are required to read these policies and must often sign a form stating that they understand the policies in order for the hospital to enforce compliance.

DIF: 2 REF: p. 64

3.Hospitals must be accredited in order to have a satellite facility.

ANS: F

Larger hospitals or medical centers also operate satellite facilities in rural or urban areas away from the central facility. Satellite facilities deliver various types of care or treatments to patients. Services may include, but are not limited to, ambulatory surgery centers, clinics, urgent-care centers, laboratory and radiology centers, physician offices, extended-care centers, and rehabilitation facilities.

DIF: 2 REF: p. 62

4.Only personnel in scrub attire, including complete head, nose, and mouth covering, are permitted in restricted areas of the operating room.

ANS: T

Entry into a restricted area requires the highest level of precautions against contamination. Only personnel in scrub attire, including complete head, nose, and mouth covering, are permitted in these areas. Restricted locations include the surgical suites, procedure rooms, sterile corridor or sub-sterile rooms where flash sterilizers are located and sterile supply rooms.

DIF: 1 REF: p. 55

5.Accreditation is the process in which a team of professionals evaluate the practices, policies, and outcomes of patient care.

ANS: T

Accreditation is the process in which a team of professionals evaluate the practices, policies, and outcomes of patient care. The institution is awarded accreditation when these standards are met. Accreditation is a voluntary process, but government agencies and insurers use accreditation to determine whether an institution qualifies for patient care reimbursement. Accreditation implies a high standard of care and commitment to public safety and welfare.

DIF: 1 REF: p. 62

6.An ambulatory surgery center performs all of the same surgical procedures that a hospital facility would perform.

ANS: F

Ambulatory surgical centers perform minor surgery that does not require postoperative hospital recovery. Ambulatory-surgery or outpatient-surgery departments within hospitals are also increasingly popular.

DIF: 2 REF: p. 62

7.Hospital management and operational staff are usually organized by an organizational chart.

ANS: T

The significance of the organizational chart is that it depicts each manager’s areas of responsibility and accountability. It prevents ambiguity about who is in charge of what and the level of responsibility.

DIF: 2 REF: p. 63-64

8.A frozen-section analysis of a specimen is performed by a pathologist.

ANS: T

A pathologist is a medical doctor who examines each specimen to determine the type of tissue, to identify disease within the tissue, and to create a permanent legal record. If the surgeon requires an immediate tissue evaluation, as in the case of a suspected malignancy, the pathologist is available to perform a frozen section analysis.

DIF: 2 REF: p. 59-60

9.The potential for acquiring an infection in a hospital setting is generally low.

ANS: F

The health care environment is a potential source for the spread of many types of infection. Whenever people are in physical proximity, especially people who are already ill or are debilitated by surgery, nutritional problems, stress, or trauma, the potential for infection is high.

DIF: 2 REF: p. 60-61

10.Patience, respect, and professionalism build good interdepartmental relationships and help prevent increased stress and interdepartmental conflict.

ANS: T

In many instances, departments face multiple demands that may exceed their limits of available personnel and time. Patience, respect, and professionalism build good interdepartmental relationships and help reduce stress and improve patient care.

DIF: 1 REF: p. 59

MULTIPLE CHOICE

1.The process whereby a hospital is evaluated by a team of surveyors, based on national guidelines and standards set by health care professionals, is called ________.

a.	chain of command
b.	The Joint Commission accreditation
c.	mission statement
d.	policy

ANS: B

Accreditation is the process in which a team of professionals evaluate the practices, policies, and outcomes of patient care. Health care facilities and institutions in the United States are accredited by The Joint Commission (TJC). To become accredited by TJC, an institution must meet or exceed the high standards set by this commission. TJC bases its own standards on those of professional and governmental agencies.

DIF: 2 REF: p. 62

2.________ make up the hospital management and operational staff.

a.	Radiology, blood bank, and medical records
b.	Surgeons, patients, and employees
c.	The board of directors, medical staff, and administration
d.	The surgical technologist, circulator, and anesthesia provider

ANS: C

The board of directors or trustees is usually responsible for hiring the chief executive officer. It determines the hospital’s administrative and development policies and mission, and reviews the delivery of safe and ethical patient care. The administrative sector designs and implements personnel procedures and policies as well as financial systems. The medical and other licensed professional staff deliver services according to the privileges granted them by license and state codes.

DIF: 2 REF: p. 63

3.The responsibilities and functions of every member of the surgical department are clearly defined in the ________.

a.	organizational chart
b.	operative record
c.	patient’s chart
d.	personnel policy

ANS: D

The responsibilities and functions of all employees in the surgical department are clearly defined in writing in the personnel policy manual.

DIF: 1 REF: p. 64

4.The ________ is a specialist in perioperative medicine, responsible for the meticulous assessment, monitoring, and adjustment of the patient’s physiological status during surgery.

a.	surgeon
b.	anesthesiologist
c.	nurse manager
d.	physician’s assistant

ANS: B

The anesthesiologist is either an MD or a DO and is a specialist in anesthesia and pain management. The anesthesiologist is responsible for the meticulous assessment, monitoring, and adjustment of the patient’s physiological status during surgery.

DIF: 1 REF: p. 65

5.The ________________ is the agency that sets the standards for hospitals and health care facilities in the United States.

a.	Joint Commission on Accreditation of Healthcare Organizations
b.	Centers for Disease Control and Prevention
c.	American Hospital Association
d.	Occupational Safety and Health Administration

ANS: A

Health care facilities and institutions in the United States are accredited by The Joint Commission on Accreditation of Healthcare Organizations.

DIF: 1 REF: p. 62

6.The _______________ is usually hired by a specialist surgeon or health care facility to perform in a role specific to that specialty such as ophthalmic, ENT, or orthopedic surgery.

a.	CST
b.	LPN
c.	CST/CFA
d.	RN

ANS: C

The CST-CFA assists the surgeon with selected procedures but is not licensed to perform surgery. The CST-CFA is usually hired by a specialist surgeon or health care facility to perform in a role specific to that specialty such as ophthalmic, ENT, or orthopedic surgery.

DIF: 1 REF: p. 65

7.The restricted area of the operating room in which sterile supplies and flash sterilizers are located is called the _________________.

a.	central core
b.	central service
c.	decontamination area
d.	transitional area

ANS: A

The central core contains clean and sterile equipment and supplies. Contaminated instruments and equipment are processed outside the central core in another area. The primary design goal of the floor plan is to create a clear separation between soiled and clean equipment.

DIF: 1 REF: p. 55

8.The temperature of the operating room is maintained at ____° to ____° F.

a.	62; 67
b.	56; 61
c.	68; 73
d.	74; 79

ANS: C

The operating room is maintained at 20° to 23° C (68° to 73° F). This temperature range is less hospitable to the growth of microorganisms and maintains the temperature within the comfort range of patients and personnel.

DIF: 1 REF: p. 57

9.A ________ is a medical professional who practices medicine under the supervision of a physician.

a.	assistant surgeon
b.	licensed practical nurse
c.	operating room educator
d.	physician assistant

ANS: D

A physician assistant (PA) is a medical professional who practices medicine under the supervision of a physician. A PA is required to pass a national certification examination and earn the title of a physician assistant–certifi ed (PA-C).

DIF: 2 REF: p. 66

10.The Occupational Safety and Health Administration ________.

a.	creates a mission statement
b.	establishes rules and standards to protect employees in the workplace
c.	produces changes in policies and enforces them
d.	offers primary and preventive health care services

ANS: B

OSHA is the Section of the U.S. Department of Labor that establishes rules and standards to protect the safety of employees in the workplace.

DIF: 1 REF: p. 53

11.A public announcement that communicates the moral or ethical basis on which the hospital was created and its beliefs about how health care should be delivered is called a/an ________.

a.	policy and procedure manual
b.	organizational chart
c.	patient’s chart
d.	mission statement

ANS: D

A mission statement is defined as a written declaration that defines the central goal of the health care institution and reflects the organization’s ethical and moral beliefs in broad terms.

DIF: 2 REF: p. 53

12.The process of tracking, evaluating, and studying accidents and incidents to protect patients and employees is called ________.

a.	bioengineering
b.	sterile processing department
c.	risk management
d.	maintenance department

ANS: C

Because of the many environmental risks and the possibility for errors and omissions by personnel, surveillance is required to track the number and exact nature of adverse events in a given period. The cause of each event is studied, and policies are enacted to prevent future incidents of the same type. This process is known as risk management.

DIF: 2 REF: p. 61

13.___________ technologists are required to maintain the safety and operating condition of many of the hospital’s medical devices, including those used in surgery.

a.	Radiology
b.	Biomedical
c.	Engineering
d.	Surgical

ANS: B

Biomedical technologists are required to maintain the safety and operating condition of many of the hospital’s medical devices, including those used in surgery. The complexity of sophisticated devices requires technologists that are specially trained in biomedical engineering.

DIF: 1 REF: p. 61

14.The ________ is responsible for orientation and assignments for new employees in the operating room and may also work directly with surgical technology programs assisting with student surgical technologists assigned to her or his facility as a clinical site.

a.	surgeon
b.	operating room director
c.	operating room educator
d.	certified registered nurse anesthetist

ANS: C

The operating room nurse educator is usually an RN with extensive operating room experience. He or she is develops and implements educational programs, seminars, and in-services (informational training on new products or techniques) within the department. Not all surgical departments have a designated educator but provide training on a more informal basis. The surgical technologist instructor is designated by the health facility to orient and teach newly recruited surgical technologists or those in a specialty.

DIF: 2 REF: p. 66

15.Blood may be transfused only after ________.

a.	the surgeon signs a verification form
b.	risk management checks the temperature and date of the blood
c.	two licensed personnel have together verified the identification number of the patient and confirmed information on the blood bag unit
d.	the surgeon and anesthesia provider write an order in the patient’s chart for blood products

ANS: C

The technologist may interact with blood bank personnel and should be familiar with their institution’s policy regarding ordering and receiving blood products. Under most circumstances blood may be transfused only after two licensed personnel have together verified all patient and blood identification information.

DIF: 1 REF: p. 61

16.Nuclear medicine procedures use ________ to diagnose and treat diseases.

a.	radioactive materials or radiopharmaceuticals
b.	anesthetic agents
c.	microscopic and bacteriological examinations
d.	operative reports

ANS: A

Nuclear medicine involves the use of radioactive materials or radiopharmaceuticals to diagnose and treat disease. These special procedures are performed in a designated nuclear medicine department which has the technical capability to perform a variety of different procedures following the strict regulations needed to ensure patient and staff safety.

DIF: 1 REF: p. 60

17.The ________ is responsible for overseeing all clinical and professional activities in the operating room. He or she helps set policies concerning major clinical and professional practices in the operating room.

a.	operating room supervisor
b.	nurse manager
c.	operating room educator
d.	surgeon

ANS: A

The director of surgical services (also known in some areas as the operating room supervisor) is responsible for overseeing all clinical and professional activities in the department. He or she creates and implements policies about clinical and professional practices in the operating room using evidenced-based standards.

DIF: 1 REF: p. 66

18.The ____________Officer of the health facility is responsible for the overall operational planning and implementation of the facility’s strategic plan.

a.	Chief Financial
b.	Chief Executive
c.	Public Relations
d.	Chief Operations

ANS: B

The Chief Executive Officer (CEO) of the health facility is responsible for the overall operational planning and implementation of the facility’s strategic plan. This role may be shared with the Chief Operations Officer who is expected to assume the role of the CEO in her or his absence.

DIF: 1 REF: p. 66

19.At the end of a surgical procedure, the circulator needs help transferring the patient from the operating table to the patient’s stretcher, the room needs to be cleaned, and supplies need to be restocked for the next case. The ________ is commonly assigned to help perform all of these duties.

a.	unit secretary
b.	physician’s assistant
c.	surgical orderly or aide
d.	licensed practical nurse

ANS: C

The surgical orderly participates in many types of patient-care services, including the transportation of the patient to and from the surgical department. He or she also may participate in the safe clean-up of the surgical suite after procedures and the restocking of supplies. Aids often assist in the preparation of supplies and instruments for decontamination and sterilization. The work is demanding because many members of the surgery department make many requests for their attention.

DIF: 1 REF: p. 66

20.Building good interdepartmental relationships helps prevent increased stress and interdepartmental conflict. Showing ________ while working with other departments ensures that the operating room will maintain good interdepartmental relationships with the various departments that are depended on for the successful care of the patient.

a.	patience, respect, and professionalism
b.	the needs of the operating room are more important than other departments
c.	proof of accreditation
d.	the policy and procedure manual

ANS: A

In many instances, departments face multiple demands that may exceed their limits of available personnel and time. Patience, respect, and professionalism build good interdepartmental relationships and help reduce stress and improve patient care.

DIF: 2 REF: p. 59

21.A ________ is a hierarchy of personnel positions that establishes both vertical and horizontal relationships between positions.

a.	mission statement
b.	chain of command

ANS: B

Chain of command is defined as a hierarchy of personnel positions that establishes both vertical and horizontal relationships between positions.

DIF: 1 REF: p. 64

22.________ is a section of the U.S. Department of Labor that establishes rules and standards to protect the safety of employees in the workplace.

a.	OSHA
b.	TJC

ANS: A

Occupational Safety and Health Administration (OSHA) is the section of the U.S. Department of Labor that establishes rules and standards to protect the safety of employees in the workplace.

DIF: 1 REF: p. 53

23.An organizational chart is a graphic representation of the ________________.

a.	hospital departments
b.	management chain of command

ANS: B

An organizational chart is a graphic representation of the management chain of command. The significance of the organizational chart is that it depicts each manager’s areas of responsibility and accountability. It prevents ambiguity about who is in charge of what and the level of responsibility.

DIF: 1 REF: p. 63

24.Minor surgeries that do not require postoperative hospital recovery would most likely be performed in an ________.

a.	ambulatory surgical center
b.	acute-care facility

ANS: A

Ambulatory surgical centers perform minor surgery that does not require postoperative hospital recovery.

DIF: 1 REF: p. 62

25.A public announcement that communicates the moral or ethical basis on which the hospital was created and its belief about how care should be delivered is known as the facility’s ________.

a.	mission statement
b.	organizational chart

ANS: A

A mission statement is defined as a written declaration that defines the central goal of the health-care institution and reflects the organization’s ethical and moral beliefs in broad terms.

DIF: 1 REF: p. 53

26.Accreditation by ________________________ implies a high standard of care and commitment public safety and welfare.

a.	The Joint Commission
b.	National Institute for Occupational Safety and Health

ANS: A

Health care facilities and institutions in the United States are accredited by The Joint Commission or TJC. Accreditation implies a high standard of care and commitment public safety and welfare.

DIF: 1 REF: p. 62

27.The pathologist in the pathology department can provide an immediate evaluation of tissue for the surgeon by performing a ________.

a.	frozen-section analysis
b.	blood type and cross-match

ANS: A

If the surgeon requires an immediate tissue evaluation, as in the case of a suspected malignancy, the pathologist is available to perform a frozen section analysis.

DIF: 2 REF: p. 59

28.Proper working conditions of the environmental system in a hospital are the responsibility of the ________ department.

a.	environmental services
b.	maintenance

ANS: B

The maintenance department is responsible for environmental systems in the hospital. These include the hospital’s power source (regular and emergency), ventilation, in-line gases, suction, electricity, water, light, heat, cooling, and humidity control. Standards for environmental control and safety are established by TJC and government agencies.

DIF: 1 REF: p. 62

29.The patient’s primary care physician in the operating room is the ________.

a.	surgeon
b.	anesthesiologist

ANS: A

The surgeon is the patient’s primary physician in the operating room and is responsible for guiding the surgical team during the procedure.

DIF: 1 REF: p. 64

30.A certified surgical technologist who has completed a formal educational program for first assisting and successfully passes the certification exam may use the title ________.

a.	CST-CFA
b.	CRNA

ANS: A

The certified surgical technologist-certified first assistant (CST-CFA) is a certified surgical technologist who has completed an educational program for assisting the surgeon during a procedure.

DIF: 1 REF: p. 65

MATCHING

Choose from the terms listed and match them with their most correct description. You will use the same answer more than once.

a.	biomedical engineering
b.	pathology department
c.	central supply department

1.Maintain the safety and operating condition medical devices

2.Receives all tissue samples and other specimens from surgery

3.Called in the event of equipment failure

4.Distributes disposable items, linens, and equipment are

5.Performs frozen sections

6.Ensures that all of the malignancy has been removed

7.Does wrapping and sterilization

8.Tracks distribution of supplies to control costs

9.Receives soiled equipment

10.Examines specimens under a microscope

1.ANS:ADIF:3REF:p. 52-53

2.ANS:BDIF:3REF:p. 52-53

3.ANS:ADIF:3REF:p. 52-53

4.ANS:CDIF:3REF:p. 52-53

5.ANS:BDIF:3REF:p. 52-53

6.ANS:BDIF:3REF:p. 52-53

7.ANS:CDIF:3REF:p. 52-53

8.ANS:CDIF:3REF:p. 52-53

9.ANS:CDIF:3REF:p. 52-53

10.ANS:BDIF:3REF:p. 52-53

Choose from the terms listed and match them with their most correct description. You will use the same answer more than once.

a.	unrestricted area
b.	semi restricted area
c.	restricted area

11.Family waiting room

12.Surgical suite

13.Sterile instrument room

14.Anesthesia workroom

15.Sub sterile room

16.Closed areas for the scrub sinks

17.Personnel must wear surgical attire (mask not necessary)

18.Personnel must wear scrub attire including complete head, nose, and mouth covering

19.Personnel dressed in street clothes

20.Corridors between surgical rooms

11.ANS:ADIF:3REF:p. 52-53

12.ANS:CDIF:3REF:p. 52-53

13.ANS:CDIF:3REF:p. 52-53

14.ANS:BDIF:3REF:p. 52-53

15.ANS:CDIF:3REF:p. 52-53

16.ANS:CDIF:3REF:p. 52-53

17.ANS:BDIF:3REF:p. 52-53

18.ANS:CDIF:3REF:p. 52-53

19.ANS:ADIF:3REF:p. 52-53

20.ANS:BDIF:3REF:p. 52-53