Chapter 36: Surgical Office Procedures Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient has actinic keratosis and the provider elects to use cryosurgery to remove the lesions. How will the provider administer this procedure?

a. Applying one or two freeze-thaw cycles to each lesion b. Applying two or more freeze-thaw cycles to each lesion c. Applying until the freeze spreads laterally 1 mm from the lesion edges d. Applying until the freeze spreads laterally 4 mm from the lesion edges

ANS: A a. Administer the electrocautery per the usual protocol. b. Apply electrocautery in short burst at low voltage. c. Refer the patient to a dermatologist for removal. d. Suggest another method for removal of the lesions.

For actinic keratosis, one to two freeze-thaw cycles are usually enough. Two or more freeze-thaw cycles are generally required for thicker, seborrheic keratosis lesions. The freeze should spread laterally 3 to 4 mm from the edge of the lesions.

2. A provider is preparing to administer electrocautery to a patient who has several seborrheic keratoses. The patient tells the provider that he has a pacemaker. Which action is correct?

ANS: B

Patients with pacemakers or implantable cardioverter-defibrillators may receive electrocautery if appropriate precautions, such as lower voltage and shorter bursts are taken. It is not necessary to suggest another method or to refer to a dermatologist.

NURSINGTB.COM a. Curettage b. Punch biopsy c. Scissor excision d. Shave biopsy

3. Which type of office surgical procedure warrants sterile technique?

ANS: B

Punch biopsy requires sterile technique. The other procedures require cleaning with alcohol and clean technique with universal precautions.