CAA CAA Perioperative Patient Care & Assessment 3

Question 1

Which preoperative lab value would most prompt postponement of elective surgery in a patient with no clinical symptoms?

Accepted Answer

Serum potassium of 2.9 mEq/L

Answer

Hemoglobin of 11.5 g/dL

Answer

Platelet count of 140,000/µL

Answer

Creatinine of 1.2 mg/dL

Question 2

A patient in the PACU has respiratory rate of 6 breaths/min, shallow respirations, miosis, and somnolence following spinal surgery with intraoperative morphine. What is the first-line treatment?

Accepted Answer

Naloxone 0.04–0.4 mg IV titrated

Answer

Flumazenil 0.2 mg IV

Answer

Neostigmine 2 mg IV

Answer

Succinylcholine 1 mg/kg IV

Question 3

During a preoperative assessment, a patient states she takes St. John's Wort daily. Which anesthesia-related concern does this herbal supplement raise?

Accepted Answer

Induction of cytochrome P450 enzymes, reducing efficacy of some anesthetic drugs

Answer

Increased MAC of volatile anesthetics

Answer

Prolonged neuromuscular blockade from succinylcholine

Answer

Hypertensive crisis when combined with epinephrine

Question 4

Which is the most reliable sign of inadequate reversal of neuromuscular blockade in the PACU?

Accepted Answer

Train-of-four ratio less than 0.9 on quantitative monitoring

Answer

SpO2 of 96% on room air

Answer

Patient complaint of mild incision pain

Answer

Heart rate of 88 bpm

Question 5

An obese patient (BMI 45) undergoing laparoscopic bariatric surgery is placed in steep Trendelenburg. Which intraoperative respiratory change should the anesthesia assistant anticipate?

Accepted Answer

Decreased lung compliance and higher airway pressures

Answer

Increased functional residual capacity

Answer

Improved ventilation-perfusion matching

Answer

Reduced end-tidal CO2 concentration

Question 6

Which postoperative temperature threshold defines hypothermia requiring active warming in the PACU?

Accepted Answer

Less than 36°C (96.8°F)

Answer

Less than 37.5°C (99.5°F)

Answer

Less than 35°C (95°F)

Answer

Less than 34°C (93.2°F)

Question 7

A patient with a known latex allergy is scheduled for surgery. What is the most important perioperative precaution the anesthesia assistant must coordinate?

Accepted Answer

Ensure a latex-free environment in the OR and prepare epinephrine for potential anaphylaxis

Answer

Administer prophylactic diphenhydramine only

Answer

Schedule the case last on the list to allow room cleaning

Answer

Avoid all inhalational anesthetics