Deck 15: Obstetric and Gynecologic Surgery

Question 1

What is the procedure name for the removal of fibroid tumors of the uterus with the preservation of fertility?

A) endometrial ablation
B) myomectomy
C) oophorectomy
D) pelvic exenteration

Answer 1

B

Question 2

What is the name of the fingerlike projections at the terminal end of the fallopian tube that guides oocytes into the lumen?

A) ampulla
B) external os
C) fimbria
D) isthmus

Answer 2

C

Question 3

What is the name of the routine surgical treatment of infected Bartholin's gland cysts?

A) cerclage
B) episiotomy
C) labioplasty
D) marsupialization

Answer 3

D

Question 4

What color is the abnormal tissue after staining with acetic acid in a cervical biopsy?

A) blue
B) white
C) brown
D) no color change

Question 5

What is the main purpose of putting a bolster sheet or roll under the right hip of a patient just prior to C-section?

A) It keeps the epidural catheter from being kinked.
B) It prevents sacral decubitus ulcer formation.
C) It reduces low back strain while in the supine position.
D) It reduces the pressure of the gravid uterus on the vena cava.

Question 6

Which radiological study might be ordered preoperatively for a patient scheduled for tuboplasty?

A) angiography
B) cholangiogram
C) hysterosalpingogram
D) retrograde urography

Question 7

Which of the following structures is NOT part of the anatomy of the vulva?

A) cervix
B) clitoris
C) labia
D) mons pubis

Question 8

What color is the abnormal tissue after staining with Lugol's solution in a cervical biopsy?

A) blue
B) white
C) brown
D) no color change

Question 9

All of the following are paired ligaments that support the uterus in the lower abdomen and attach it to the pelvis, EXCEPT:

A) broad
B) round
C) cardinal
D) Cooper's

Question 10

Which piece of operating room furniture would likely be unnecessary for many vaginal surgical procedures?

A) back table
B) ESU
C) kick bucket
D) Mayo stand

Question 11

How many stages of labor and delivery does the patient go through?

A) two
B) three
C) four
D) five

Question 12

Which incision is MOST frequently used for cesarean sections?

A) epigastric
B) paramedian
C) Pfannenstiel
D) vertical midline

Question 13

For a dilation and curettage (D&C), which of the following orders of instrument use is CORRECT for endometrial biopsy?

A) cervical dilators, uterine sound, weighted vaginal speculum, tenaculum, endometrial curettes
B) tenaculum, uterine sound, weighted vaginal speculum, cervical dilators, endometrial curettes
C) weighted vaginal speculum, tenaculum, uterine sound, cervical dilators, endometrial curettes
D) uterine sound, weighted vaginal speculum, tenaculum, cervical dilators, endometrial curettes

Question 14

Which method of tubal ligation is less frequently performed and requires use of long instruments, but may pose a higher risk of postoperative surgical site infection due to the approach?

A) colpotomy
B) laparoscopic
C) minilaparotomy
D) open, combined with cesarean section

Question 15

Cephalopelvic disproportion is a component of which of the following indications for a cesarean section delivery?

A) dystocia
B) placenta previa
C) preeclampsia
D) uterine rupture

Question 16

In which procedure would the surgeon likely request 8-0 or 9-0 suture?

A) cervical cerclage
B) cesarean section
C) tubal ligation
D) tuboplasty

Question 17

Cervical cerclage is performed to:

A) biopsy the areas of dysplasia
B) repair a cystocele
C) prevent spontaneous abortion
D) vaporize vaginal condylomata

Question 18

Which maneuver might be performed by the surgical technologist during a cesarean section to aid in the delivery as the surgeon gently manipulates the head of the fetus out of the uterus?

A) application of external pressure over the bladder
B) application of external pressure over the fundus of the uterus
C) insertion of the surgical technologist's hand into the uterus to pull the legs of the fetus out
D) use of two Balfour bladder blades to widen the uterine opening

Question 19

Which medication may be injected into the uterus for hemostasis, before closure of the uterus in a cesarean section?

A) dextran
B) Hyskon
C) Lugol's
D) oxytocin

Question 20

What is the MOST common surgical intervention for a vaginal delivery?

A) cerclage
B) episiotomy
C) labioplasty
D) marsupialization

Question 21

Which anatomical area is located between the posterior vaginal opening and the anus?

A) labia majora
B) mons pubis
C) perineum
D) urethral orifice

Question 22

Which anatomical structure is located anterior to the symphysis pubis and superior to the vaginal opening?

A) labia majora
B) mons pubis
C) perineum
D) urethral orifice

Question 23

What is the name of the heavy, right-angle scissors frequently used to dissect around the cervix during hysterectomy?

A) Braun
B) Jorgenson
C) Metzenbaum
D) tenotomy

Question 24

Which term means the number of times a woman has been pregnant?

A) gravida
B) menarche
C) parity
D) rotation

Question 25

Which of the following is a weighted vaginal speculum?

A) Auvard
B) Graves
C) Heaney
D) Sims

Question 26

Cherney, Maylard, and Pfannenstiel are examples of gynecologic:

A) fenestrated drape sheets
B) self-retaining retractors
C) transverse abdominal incisions
D) urinary drainage catheters

Question 27

Delivery of the placenta is the conclusion of which stage of labor?

A) first
B) second
C) third
D) fourth

Question 28

Which of the following procedures would likely be assigned a Class III or Class IV wound and may require aerobic and anaerobic culture tubes?

A) dilation and curettage
B) radical hysterectomy
C) cesarean section delivery
D) marsupialization of Bartholin's cyst

Question 29

Which gynecologic procedure is used for visualization of the endometrium and may be used to treat polyps or myomas?

A) laparoscopy
B) hysteroscopy
C) cervical cerclage
D) dilation and curettage

Question 30

In which of the following procedures would the patient be left without a vagina or any of the female reproductive organs and have a permanent colostomy and ileostomy?

A) cerclage
B) colporrhaphy
C) exenteration
D) marsupialization

Question 31

What is the name of a bivalve speculum frequently found in a vaginal procedure tray?

A) Goelet
B) Graves
C) Heaney
D) Hegar

Question 32

Bulb syringes are used in obstetrical delivery procedures to:

A) collect cord blood gas specimens
B) collect pelvic washings for cytology
C) suction amniotic fluid from the field
D) suction the mouth and nares of the neonate

Question 33

What is the preferred method of anesthesia for a cesarean section delivery?

A) Bier block
B) epidural
C) general
D) spinal

Question 34

Which gynecologic procedure is performed for treatment of urinary incontinence or cystocele?

A) anterior colporrhaphy
B) posterior colporrhaphy
C) Shirodkar procedure
D) Wertheim's procedure

Question 35

Which self-retaining retractor has the shape of a figure-of-eight (8) when in the closed position?

A) Balfour
B) Franz
C) Gelpi
D) O'Sullivan-O'Connor

Question 36

What is the name of the anatomical area where the fallopian tubes are attached and enter the uterus?

A) cervix
B) cornu
C) infundibulum
D) isthmus

Question 37

For which procedure would the surgical technologist want to be sure to have adequate numbers of Allis or Allis-Adair tissue forceps?

A) A&P repair
B) D&C
C) LAVH
D) TAH-BSO

Question 38

When is the first closing count performed in a cesarean section?

A) when the umbilical cord is clamped and cord blood is collected
B) immediately prior to delivery of the placenta
C) when the first suture is given for closure of the uterus
D) as the fascial or muscle layer is being sutured

Question 39

Tubal ligation is performed for:

A) blood gas collection
B) elective sterilization
C) unruptured tubal pregnancy
D) urinary incontinence treatment

Question 40

Which of the following is routinely done first in a basic gynecologic laparoscopy that may require a small separate setup and glove change before proceeding?

A) cervical conization
B) pelvic ultrasonography
C) insertion of uterine manipulator
D) injection of methylene blue into IV

Question 41

The term adnexa refers to which gynecologic anatomical structures?

A) labia minora, labia majora, urinary orifice, and clitoris
B) isthmus, internal os, cervix, and external os
C) fallopian tubes, ovaries, and infundibulum
D) endometrium, myometrium, and peritoneum

Question 42

What is the general term for the treatment method that destroys genital condylomata with a carbon dioxide laser?

A) ablation
B) curettage
C) exenteration
D) suspension

Question 43

Which instrument should the surgical technologist have ready to provide exposure during cesarean section procedures when the uterine incision is made?

A) Auvard
B) bladder blade
C) Gelpi
D) Graves

Question 44

Which of the following statements is CORRECT regarding anatomical changes following pelvic exenteration?

A) Colostomy and ileostomy will both exit on the right side of the abdomen.
B) Colostomy and ileostomy will both exit on the left side of the abdomen.
C) Colostomy will exit on the right and ileostomy on the left side of the abdomen.
D) Colostomy will exit on the left and ileostomy on the right side of the abdomen.

Question 45

Which pistol-grip type of instrument might be found in a D&C tray for cervical biopsy?

A) Kerrison
B) pituitary
C) Takahashi
D) Tischler

Question 46

Which of the following types of stirrups would likely be used for a laparoscopically assisted vaginal hysterectomy (LAVH)?

A) Allen low lithotomy
B) candy cane hanging
C) fiberglass hanging
D) posterior knee support

Question 47

Which procedure involves an en bloc removal of the uterus, bilateral ovaries and fallopian tubes, supporting ligaments, upper third of the vagina, and pelvic lymph nodes?

A) anterior and posterior colporrhaphy
B) bilateral laparoscopic tubal ligation
C) radical hysterectomy
D) suprapubic hysterectomy

Question 48

Radionuclide seeds are used to treat:

A) dysmenorrhea/menorrhalgia
B) endometriosis
C) uterine/cervical carcinoma
D) vulvar condylomata

Question 49

Which of the following procedures does NOT require an incision, use of trocars, or distention with gas or fluid?

A) colposcopy
B) hysteroscopy
C) laparoscopy
D) pelviscopy

Question 50

Total abdominal hysterectomy is assigned which wound classification?

A) Class I
B) Class II
C) Class III
D) Class IV

Question 51

Which instrument is used to manipulate the fallopian tubes without compression or damage?

A) Babcock tissue forceps
B) Ferris-Smith tissue forceps
C) Heaney clamp
D) Kocher clamp

Question 52

Which instrument is used to test the patency of the fallopian tube during tuboplasty?

A) Hegar dilator
B) lacrimal probe
C) uterine sound
D) Veress needle

Question 53

The fallopian tubes are located bilaterally in the mesosalpinx of which uterine-pelvic ligaments?

A) broad
B) cardinal
C) round
D) uterosacral

Question 54

Which paired ligaments are encountered and ligated last in an abdominal hysterectomy and first in a vaginal hysterectomy?

A) cardinal
B) infundibulopelvic
C) round
D) uterosacral

Question 55

Which of the following is used for creating pneumoperitoneum in laparoscopy?

A) carbon dioxide
B) helium
C) nitrogen
D) oxygen

Question 56

Which of the following is the largest supporting ligament in the female pelvis that has anterior and posterior leaves?

A) broad
B) cardinal
C) round
D) suspensory

Question 57

What is a Veress needle used for?

A) amniocentesis
B) epidural anesthesia
C) laparoscopic insufflation
D) suprapubic catheter placement

Question 58

What is another name for the ovarian suspensory ligament?

A) cardinal
B) infundibulopelvic
C) round
D) uterosacral

Question 59

Instruments used for closure of the vaginal cuff in total abdominal hysterectomy are:

A) discarded in the trash
B) isolated as contaminated
C) flash sterilized by the circulator
D) used to elevate the fascia during closure

Question 60

Which type of needle holder is curved and frequently used for hysterectomy procedures?

A) Castroviejo
B) Heaney
C) Mayo-Hegar
D) Webster

Question 62

Which instrument is used to grasp the cervix and provide traction during cervical dilation?

A) Allis-Adair tissue forceps
B) Babcock tissue forceps
C) perforating Backhaus clip
D) single-tooth tenaculum

Question 63

Laparoscopic linear stapling devices are often used to ligate and cut the uterine ligaments and vessels during LAVH.

Question 64

Which of the following is a serum analysis done to detect ovarian carcinoma?

A) CA-125
B) CBC
C) FSH
D) KUB

Question 65

For which procedure would the gynecologist likely wear surgical loupes?

A) cesarean section
B) endometrial ablation
C) robotically assisted hysterectomy
D) tubal reanastomosis

Question 66

Adhesion formation is a normal physiologic inflammatory response to abdominal surgery that cannot be prevented or minimized.

Question 67

Which muscle is incised in transverse abdominal approaches for gynecologic procedures?

A) anterior rectus
B) external oblique
C) internal oblique
D) serratus anterior

Question 68

What is used to achieve tissue destruction in an endometrial balloon ablation?

A) electrical energy
B) hot dextrose water
C) laser light energy
D) ultrasonic friction

Question 69

Clamp, clamp, cut, tie (CCCT) is a way to anticipate routine dissection steps during hysterectomy procedures.

Question 70

In a robotically assisted hysterectomy, the surgical technologist may be responsible for removing the specimen from the vagina after the vaginal cuff closure has been completed.

Question 71

Radionuclide seeds are placed in infected Bartholin's gland cysts to treat the infected contents.