CVA Surgical and Exam Procedures 2 — Questions and Answers
Question 1: What is the correct way to open a sterile instrument pack for a gowned surgeon?
- Open toward yourself first, then sides, then far flap last
- Toss the entire pack onto the sterile field
- Open the far flap first, then sides, then nearest flap last (Correct answer)
- Remove instruments individually with bare hands
Correct answer: Open the far flap first, then sides, then nearest flap last
Opening the far flap first prevents reaching over sterile contents. Sides are opened next, and the nearest flap last.
The sequence prevents contamination: far flap first (away from you), side flaps, then near flap (toward you). Each flap is handled by its outside corner only.
Question 2: During a canine spay, what vital sign change should be immediately reported?
- Heart rate of 100 bpm in a medium dog under isoflurane
- Sudden drop in blood pressure below 60 mmHg systolic with pale gums (Correct answer)
- Respiratory rate of 12 breaths per minute under anesthesia
- Body temperature of 99.5 degrees F
Correct answer: Sudden drop in blood pressure below 60 mmHg systolic with pale gums
Systolic BP below 60 mmHg with pale membranes indicates severe hypotension that can lead to organ failure and requires immediate intervention.
Severe hypotension with pale mucous membranes can indicate hemorrhage from a slipped pedicle ligature, excessive anesthetic depth, or cardiovascular collapse. The other findings are within acceptable ranges for anesthetized dogs.
Question 3: What is the primary purpose of pulse oximetry during anesthesia?
- To measure blood pressure
- To monitor oxygen saturation of hemoglobin and pulse rate (Correct answer)
- To measure body temperature
- To count respiratory rate and tidal volume
Correct answer: To monitor oxygen saturation of hemoglobin and pulse rate
Pulse oximetry measures the percentage of hemoglobin saturated with oxygen (SpO2) and displays pulse rate using light absorption technology.
Normal SpO2 is above 95%. Values of 90-94% indicate mild hypoxemia, below 90% is critical. The device detects the pulsatile signal to display heart rate. Limitations include inaccuracy with poor perfusion.
Question 4: What is the correct pattern for applying surgical scrub to a surgical site?
- Random circles covering the area equally
- Start at the incision site and scrub outward in expanding circles, never returning to center (Correct answer)
- Start at edges and work inward
- Straight lines back and forth
Correct answer: Start at the incision site and scrub outward in expanding circles, never returning to center
Starting at the incision site and spiraling outward pushes bacteria away from the surgical site rather than toward it.
The scrub alternates between antiseptic scrub and alcohol, typically 3 cycles. Each stroke moves outward and the sponge never returns to an already-cleaned area.
Question 5: Which suture material is most commonly used for skin closure requiring removal in 10-14 days?
- Chromic gut (absorbable)
- Polydioxanone (absorbable)
- Nylon (non-absorbable monofilament) (Correct answer)
- Polyglycolic acid (absorbable)
Correct answer: Nylon (non-absorbable monofilament)
Nylon monofilament is non-absorbable with low tissue reactivity, good tensile strength, and is easily removed.
Nylon monofilament has minimal tissue reactivity and resists infection due to its smooth surface. Absorbable sutures are used for internal closures where removal is not possible.
Question 6: What should you do when a patient shows hypothermia below 97 degrees F during surgery?
- It is normal, no action needed
- Apply active warming measures and inform the veterinarian (Correct answer)
- Increase anesthetic gas concentration
- Reduce IV fluid rate to zero
Correct answer: Apply active warming measures and inform the veterinarian
Hypothermia requires active warming including forced-air blankets, warm fluids, and communication with the veterinarian about temperature trends.
Below 97 degrees F, negative effects include prolonged recovery, coagulopathy, cardiac arrhythmias, and increased infection risk. Active warming measures include forced-air warming blankets and warm IV fluids. Never use electric heating pads.
CVA Surgical and Exam Procedures 2
What is the correct way to open a sterile instrument pack for a gowned surgeon?