ABA Safety Protocols & Risk Management 2 — Questions and Answers
Question 1: According to ASA guidelines, which preoperative fasting interval applies to clear liquids in elective non-pregnant adults?
- 2 hours (Correct answer)
- 4 hours
- 6 hours
- 8 hours
Correct answer: 2 hours
ASA NPO guidelines permit clear liquids up to 2 hours before elective procedures in healthy adults.
Question 2: The WHO Surgical Safety Checklist 'Sign Out' phase is performed at which point?
- Before induction of anesthesia
- Before skin incision
- Before the patient leaves the operating room (Correct answer)
- On arrival to the PACU
Correct answer: Before the patient leaves the operating room
The Sign Out occurs before the patient leaves the OR to confirm specimen labeling, instrument counts, and post-op concerns.
Question 3: Which gas-delivery system feature prevents inadvertent administration of a hypoxic mixture by linking O2 and N2O flow controls?
- Pressure-reducing valve
- Oxygen flush valve
- Proportioning system (Correct answer)
- Fail-safe valve
Correct answer: Proportioning system
The proportioning system (e.g., Link-25 or ORMC) mechanically couples N2O and O2 flowmeters to maintain a minimum O2 concentration.
Question 4: A patient undergoing carotid endarterectomy suddenly becomes unresponsive and apneic under regional anesthesia. The FIRST priority is:
- Administer epinephrine IV
- Secure the airway and ventilate (Correct answer)
- Convert to general anesthesia immediately
- Check for local anesthetic systemic toxicity with lipid emulsion
Correct answer: Secure the airway and ventilate
Airway management and oxygenation are always the first priority regardless of the suspected cause.
Question 5: Which ASA physical status classification is assigned to a patient with end-stage renal disease on hemodialysis?
- ASA II
- ASA III
- ASA IV (Correct answer)
- ASA V
Correct answer: ASA IV
End-stage renal disease on dialysis represents a severe systemic disease with a constant threat to life, consistent with ASA IV.
Question 6: In the context of malignant hyperthermia (MH) crisis management, the recommended initial dantrolene dose is:
- 0.5 mg/kg IV
- 1 mg/kg IV
- 2.5 mg/kg IV (Correct answer)
- 5 mg/kg IV
Correct answer: 2.5 mg/kg IV
The MHAUS protocol recommends an initial dantrolene dose of 2.5 mg/kg IV, repeated every 5 minutes as needed.
Question 7: Which practice is the most effective single intervention to reduce wrong-site surgery?
- Pre-op verbal confirmation with the patient
- Radiologic review in the OR
- Surgical site marking before the procedure (Correct answer)
- Nursing timeout at patient check-in
Correct answer: Surgical site marking before the procedure
Pre-procedure surgical site marking by the operating surgeon is the cornerstone of wrong-site surgery prevention per JCAHO Universal Protocol.
ABA Safety Protocols & Risk Management 2
According to ASA guidelines, which preoperative fasting interval applies to clear liquids in elective non-pregnant adults?