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

A serum potassium below 3.0 mEq/L increases risk of intraoperative arrhythmias and should be corrected before elective surgery proceeds.

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

The clinical picture represents opioid-induced respiratory depression; titrated naloxone reverses mu-opioid receptor effects while minimizing acute pain and hemodynamic rebound.

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

St. John's Wort is a potent CYP3A4 inducer that can accelerate metabolism of many drugs used in anesthesia, including opioids and benzodiazepines, reducing their effectiveness.

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

A train-of-four ratio less than 0.9 on quantitative neuromuscular monitoring objectively confirms residual blockade before the patient can maintain adequate ventilation reliably.

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

In obese patients in Trendelenburg, abdominal contents shift cephalad compressing the diaphragm, decreasing lung compliance and necessitating higher airway pressures to maintain adequate tidal volumes.

(CAA) Certified Anesthesia Assistant Practice Test

(CAA) Certified Anesthesia Assistant Practice Test

CAA CAA Perioperative Patient Care & Assessment 3