CBC Pre-Surgical Patient Assessment 3 — Questions and Answers
Question 1: During assessment, a patient states they expect to lose 100% of their excess weight and never regain any. How should the counselor respond?
- Address unrealistic expectations, since typical excess weight loss is roughly 50-70% depending on procedure (Correct answer)
- Affirm the goal to keep the patient motivated
- Recommend cancelling the surgery immediately
- Refer the patient directly to the anesthesiologist
Correct answer: Address unrealistic expectations, since typical excess weight loss is roughly 50-70% depending on procedure
Counselors must correct unrealistic expectations because typical excess weight loss ranges from about 50-70% and some regain is common.
Question 2: Which laboratory finding during pre-surgical workup most directly suggests the need for nutritional correction before surgery?
- Low vitamin D and iron deficiency anemia (Correct answer)
- Slightly elevated HDL cholesterol
- Normal fasting glucose
- Normal thyroid-stimulating hormone
Correct answer: Low vitamin D and iron deficiency anemia
Preexisting deficiencies like low vitamin D or iron should be corrected preoperatively because malabsorptive procedures worsen them.
Question 3: A patient scheduled for gastric bypass has poorly controlled type 2 diabetes with an HbA1c of 10.5%. What is the most appropriate pre-surgical step?
- Work with the medical team to improve glycemic control before surgery (Correct answer)
- Proceed immediately since surgery cures diabetes
- Stop all diabetes medications to get a true baseline
- Switch the patient to a liquid diet indefinitely
Correct answer: Work with the medical team to improve glycemic control before surgery
Poor glycemic control increases surgical complications, so optimizing HbA1c preoperatively is standard practice.
Question 4: Which sleep-related condition should routinely be screened for during bariatric pre-surgical assessment?
- Obstructive sleep apnea (Correct answer)
- Narcolepsy
- Restless leg syndrome
- Sleepwalking
Correct answer: Obstructive sleep apnea
Obstructive sleep apnea is highly prevalent in bariatric candidates and increases anesthesia risk, so screening tools like STOP-BANG are routine.
Question 5: A patient discloses they take daily NSAIDs for chronic joint pain. Why does this matter before gastric bypass?
- NSAIDs significantly raise the risk of marginal ulcers after bypass and alternatives should be planned (Correct answer)
- NSAIDs cause immediate weight gain
- NSAIDs are required after all bariatric procedures
- NSAIDs interfere with psychological testing results
Correct answer: NSAIDs significantly raise the risk of marginal ulcers after bypass and alternatives should be planned
Chronic NSAID use is a major risk factor for marginal ulceration at the gastrojejunal anastomosis, so pain management alternatives must be arranged.
Question 6: What is the primary reason for assessing a patient's social support system before bariatric surgery?
- Strong support improves adherence to postoperative diet, follow-up, and lifestyle changes (Correct answer)
- Family members must legally co-sign the surgical consent
- Support systems determine insurance eligibility
- Patients without support are always denied surgery
Correct answer: Strong support improves adherence to postoperative diet, follow-up, and lifestyle changes
Social support is a consistent predictor of postoperative adherence and long-term weight-loss success.
Question 7: A female patient of childbearing age is being assessed for surgery. What counseling point is standard regarding pregnancy?
- Pregnancy should be avoided for approximately 12-18 months after surgery during rapid weight loss (Correct answer)
- Pregnancy is encouraged within the first six months to maximize benefits
- Bariatric surgery makes pregnancy impossible
- Contraception is unnecessary after bariatric surgery
Correct answer: Pregnancy should be avoided for approximately 12-18 months after surgery during rapid weight loss
Rapid weight loss and nutritional instability in the first 12-18 months post-surgery pose fetal risks, so pregnancy should be deferred.
CBC Pre-Surgical Patient Assessment 3
During assessment, a patient states they expect to lose 100% of their excess weight and never regain any.
How should the counselor respond?