CRNFA Perioperative Patient Assessment 1 — Questions and Answers
Question 1: A patient with a known latex allergy should be scheduled as which type of surgical case?
- Last case of the day to allow room decontamination
- First case of the morning before latex particulates accumulate in the air (Correct answer)
- Requires a separate operating room only
- No special scheduling is needed if latex-free gloves are used
Correct answer: First case of the morning before latex particulates accumulate in the air
Latex-allergic patients should be scheduled as the first case of the day when airborne latex particle levels are lowest.
Question 2: When reviewing a patient's medication list preoperatively, which class of medications requires the MOST immediate concern regarding intraoperative bleeding risk?
- Antihypertensives
- Antiplatelet agents such as clopidogrel (Correct answer)
- Proton pump inhibitors
- Thyroid hormone replacements
Correct answer: Antiplatelet agents such as clopidogrel
Antiplatelet agents like clopidogrel inhibit platelet aggregation and significantly increase intraoperative bleeding risk; cessation timing must be confirmed with the surgeon.
Question 3: An ASA Class III patient is best described as having which condition?
- A healthy patient with no systemic disease
- A patient with mild systemic disease causing no functional limitations
- A patient with severe systemic disease causing substantive functional limitations (Correct answer)
- A patient not expected to survive without the operation
Correct answer: A patient with severe systemic disease causing substantive functional limitations
ASA Class III describes a patient with severe systemic disease that causes substantive functional limitations but is not incapacitating.
Question 4: Which preoperative finding most strongly warrants postponement of elective surgery?
- Blood pressure of 148/88 mmHg
- Random blood glucose of 180 mg/dL in a known diabetic
- Serum potassium of 2.8 mEq/L (Correct answer)
- Hemoglobin of 11.5 g/dL in a stable patient
Correct answer: Serum potassium of 2.8 mEq/L
A serum potassium below 3.0 mEq/L (hypokalemia) increases risk of life-threatening cardiac arrhythmias during anesthesia and warrants correction before elective surgery.
Question 5: When performing a preoperative skin assessment, which finding is most important to document and report?
- A well-healed scar from a prior surgery
- Active skin breakdown or wound over the surgical site (Correct answer)
- A tattoo near the incision site
- Dry skin on the lower extremities
Correct answer: Active skin breakdown or wound over the surgical site
Active skin breakdown or open wound over the planned surgical site is a contraindication to elective surgery and must be reported to prevent infection.
Question 6: A patient reports a prior reaction to a 'caine' medication at the dentist. The CRNFA should prioritize communicating which concern to the anesthesia team?
- Risk of malignant hyperthermia
- Possible allergy to amide or ester local anesthetics (Correct answer)
- Contraindication to general anesthesia
- Need for antihistamine premedication only
Correct answer: Possible allergy to amide or ester local anesthetics
A prior reaction to local anesthetics used in dentistry may indicate allergy to amide or ester class agents, which must be clarified before administering local or regional anesthesia.
CRNFA Perioperative Patient Assessment 1
A patient with a known latex allergy should be scheduled as which type of surgical case?