Certified Surgical Technologist Preoperative Care and Preparation 4 — Questions and Answers
Question 1: A patient's preoperative blood pressure reads 188/110 mmHg. What is the most appropriate action?
- Transport the patient to the OR immediately to avoid further delay
- Notify the anesthesia provider and surgeon before proceeding (Correct answer)
- Administer an antihypertensive from the crash cart
- Document the reading and assume it is white-coat hypertension
Correct answer: Notify the anesthesia provider and surgeon before proceeding
Severely elevated blood pressure must be reported to the surgical team because it increases anesthetic and intraoperative bleeding risk and may require intervention before surgery.
Question 2: Which of the following is the correct technique for verifying patient identity in the preoperative area?
- Ask the patient their room number and confirm it matches the chart
- Use two patient identifiers such as name and date of birth, confirmed verbally and with the wristband (Correct answer)
- Accept verbal confirmation from the transporter who brought the patient
- Check the patient's face against the photo in the electronic record only
Correct answer: Use two patient identifiers such as name and date of birth, confirmed verbally and with the wristband
Two independent patient identifiers (e.g., full name and date of birth) confirmed verbally and matched to the wristband are required per Joint Commission National Patient Safety Goals.
Question 3: What is the purpose of applying sequential compression devices (SCDs) preoperatively?
- To monitor arterial blood pressure continuously during surgery
- To prevent deep vein thrombosis by promoting venous return (Correct answer)
- To stabilize the lower extremities during positioning
- To measure leg compartment pressures intraoperatively
Correct answer: To prevent deep vein thrombosis by promoting venous return
SCDs apply intermittent pneumatic compression to the legs, promoting venous return and reducing the risk of deep vein thrombosis during prolonged surgery.
Question 4: Which preoperative finding would most likely require postponement of an elective surgical procedure?
- A patient with controlled hypertension on medication
- A patient with a potassium level of 2.8 mEq/L (Correct answer)
- A patient with a history of seasonal allergies
- A patient with a BMI of 28
Correct answer: A patient with a potassium level of 2.8 mEq/L
Hypokalemia (K+ < 3.0 mEq/L) increases the risk of cardiac dysrhythmias during anesthesia and is a common reason to postpone elective surgery.
Question 5: When setting up the OR for a case involving a patient with a known MRSA infection, what precaution is most important preoperatively?
- Scheduling the patient as the first case of the day to reduce exposure
- Placing the patient in isolation in the preoperative holding area and using contact precautions (Correct answer)
- Requiring all staff to wear N95 respirators throughout the entire case
- Flooding the OR with UV light one hour before the patient arrives
Correct answer: Placing the patient in isolation in the preoperative holding area and using contact precautions
Contact precautions—including gown, gloves, and dedicated equipment—are required for MRSA-positive patients to prevent transmission in the perioperative environment.
Question 6: A patient undergoing thyroid surgery is placed in which specialized position to improve surgical access?
- Prone jackknife
- Supine with neck hyperextended using a shoulder roll (Correct answer)
- Lateral decubitus with bean bag
- Trendelenburg with arms tucked
Correct answer: Supine with neck hyperextended using a shoulder roll
Placing a shoulder roll under the patient's shoulders extends the neck, elevating and exposing the thyroid gland for optimal surgical access.
Question 7: Which of the following best describes the surgical technologist's responsibility regarding the preoperative count?
- Counts are performed only by the circulating nurse
- The scrub tech and circulator count together audibly before the procedure begins (Correct answer)
- Counts are optional for procedures lasting less than 30 minutes
- Only sponges are counted preoperatively; instruments are counted intraoperatively
Correct answer: The scrub tech and circulator count together audibly before the procedure begins
The scrub technologist and circulating nurse perform an audible concurrent count of all sponges, sharps, and instruments before the procedure to establish a baseline.
Certified Surgical Technologist Preoperative Care and Preparation 4
A patient's preoperative blood pressure reads 188/110 mmHg.
What is the most appropriate action?