Certified Surgical Technologist Preoperative Care and Preparation 5 — Questions and Answers
Question 1: A patient undergoing cardiac surgery requires placement of a Foley catheter. When should this catheter ideally be inserted?
- In the preoperative holding area before the patient is transported to the OR
- After the patient is intubated and positioned on the OR table (Correct answer)
- After the first incision is made and the surgical field is established
- Only if the patient cannot void spontaneously postoperatively
Correct answer: After the patient is intubated and positioned on the OR table
Foley catheters for major surgery are typically inserted after anesthesia induction to maximize patient comfort and reduce anxiety during the procedure.
Question 2: Which preoperative action helps reduce the risk of hypothermia during surgery?
- Lowering the OR temperature to 62°F before patient arrival
- Applying a forced-air warming blanket in the preoperative area (Correct answer)
- Administering IV fluids at room temperature throughout the case
- Removing all blankets to allow skin assessment before transfer
Correct answer: Applying a forced-air warming blanket in the preoperative area
Pre-warming patients with forced-air warming blankets before surgery reduces the temperature gradient that causes core-to-peripheral heat redistribution after induction.
Question 3: The surgeon marks the correct operative site on the patient before surgery. Who is responsible for verifying this mark during the time-out?
- Only the circulating nurse, as they are the patient advocate
- The entire surgical team, including surgeon, anesthesia provider, and scrub tech (Correct answer)
- The anesthesia provider alone, as they control the patient's safety
- The hospital administrator who approved the surgical schedule
Correct answer: The entire surgical team, including surgeon, anesthesia provider, and scrub tech
The Universal Protocol requires all members of the surgical team to actively participate in the time-out and confirm the correct site marking before incision.
Question 4: A patient with Type 1 diabetes has a preoperative blood glucose of 320 mg/dL. What is the priority action?
- Proceed with surgery since glucose normalizes under anesthesia
- Notify the surgeon and anesthesia provider for glucose management before surgery (Correct answer)
- Administer the patient's home insulin dose without a physician order
- Reschedule the case for 6 months until glucose is better controlled
Correct answer: Notify the surgeon and anesthesia provider for glucose management before surgery
Hyperglycemia above 180-200 mg/dL significantly increases infection risk and impairs wound healing; the team must manage glucose levels before proceeding with elective surgery.
Question 5: What is the correct chlorhexidine gluconate (CHG) skin prep technique for a patient with iodine sensitivity?
- Use povidone-iodine but apply it in smaller amounts
- CHG is an appropriate iodine-free alternative for surgical skin preparation (Correct answer)
- Use only sterile saline for patients with iodine allergies
- No skin preparation is needed if the patient is allergic to iodine
Correct answer: CHG is an appropriate iodine-free alternative for surgical skin preparation
Chlorhexidine gluconate does not contain iodine and provides excellent broad-spectrum antimicrobial coverage as an alternative prep agent for iodine-sensitive patients.
Question 6: Which assessment finding in the preoperative period requires the surgical technologist to immediately alert the circulating nurse?
- The patient states they are nervous about the procedure
- The patient's armband is missing and identity cannot be confirmed (Correct answer)
- The patient requests a warm blanket before surgery
- The patient reports mild nausea from preoperative medications
Correct answer: The patient's armband is missing and identity cannot be confirmed
A missing armband prevents proper two-identifier verification; surgery cannot safely proceed until patient identity is confirmed by the circulating nurse and charge nurse.
Question 7: When preparing the OR for a morbidly obese patient (BMI > 40), which preoperative consideration is most important for positioning?
- Standard OR tables and positioning aids are sufficient for all patients
- A bariatric-rated OR table and appropriately sized positioning aids must be confirmed available (Correct answer)
- The patient should be positioned in the prone position to distribute weight evenly
- Obese patients are always placed in the Trendelenburg position for all procedures
Correct answer: A bariatric-rated OR table and appropriately sized positioning aids must be confirmed available
Bariatric patients require specially rated tables (typically ≥500 lb capacity) and wider positioning aids to prevent equipment failure and pressure injuries.
Certified Surgical Technologist Preoperative Care and Preparation 5
A patient undergoing cardiac surgery requires placement of a Foley catheter.
When should this catheter ideally be inserted?