CFA Perioperative Assessment 3

Question 1

During intraoperative assessment, the first assistant notices the patient's urine output has fallen to 15 mL/hr for the past two hours. What does this most likely indicate?

Accepted Answer

Inadequate renal perfusion or fluid deficit

Answer

Oliguria (less than 0.5 mL/kg/hr) during surgery typically indicates decreased renal perfusion due to hypovolemia, hypotension, or inadequate cardiac output.

Question 2

The surgeon asks the first assistant to assess abdominal wall tension during a laparotomy. Increased tension is MOST likely caused by:

Accepted Answer

Inadequate muscle relaxation or increased intra-abdominal pressure

Answer

Increased abdominal wall tension during surgery is most commonly caused by insufficient neuromuscular blockade or elevated intra-abdominal pressure from bowel distension or bleeding.

Question 3

Intraoperatively, the patient develops sudden hypotension, tachycardia, and bronchospasm 20 minutes after receiving cefazolin. The first assistant should immediately recognize this as:

Accepted Answer

Anaphylaxis

Answer

The triad of hypotension, tachycardia, and bronchospasm following antibiotic administration is classic for anaphylaxis and requires immediate treatment with epinephrine.

Question 4

During a lengthy orthopedic procedure, the first assistant should monitor for signs of compartment syndrome. Which finding is the EARLIEST indicator?

Accepted Answer

Pain out of proportion to injury and pain with passive stretch

Answer

Pain out of proportion and pain with passive muscle stretch are the earliest clinical signs of compartment syndrome, before vascular compromise develops.

Question 5

The patient's core temperature drops to 35.2°C (95.4°F) during a prolonged abdominal case. Which intraoperative complication is most directly associated with this finding?

Accepted Answer

Coagulopathy and increased bleeding

Answer

Hypothermia impairs platelet function and coagulation factor activity, leading to coagulopathy and increased intraoperative blood loss.

CFA Practice Test

CFA Practice Test

CFA Perioperative Assessment 3