CSFA Preoperative Patient Preparation Questions and Answers

Question 1

A 68-year-old male is scheduled for an elective total knee arthroplasty.
He has a history of atrial fibrillation and has been on a direct oral anticoagulant (DOAC).
According to current guidelines for a high-bleed-risk surgery, what is the most appropriate instruction regarding his anticoagulation medication?

Accepted Answer

Stop the DOAC 2 days before the procedure and skip it on the day of and the day after surgery.

Answer

Continue the DOAC until the morning of surgery.

Answer

Stop the DOAC 7 days prior to surgery.

Answer

Bridge with low-molecular-weight heparin starting 5 days before surgery.

Question 2

Which of the following is the primary goal of the preoperative "Time Out" as mandated by The Joint Commission's Universal Protocol?

Accepted Answer

To conduct a final verification of the correct patient, procedure, and site involving the entire surgical team.

Answer

To allow the surgeon a final moment to review the patient's imaging.

Answer

To ensure all necessary surgical instruments and implants are available.

Answer

To confirm the patient's NPO status and allergy information with the anesthesia provider.

Question 3

Regarding preoperative hair removal at the surgical site, which method and timing are most consistent with evidence-based guidelines to reduce the risk of surgical site infections (SSIs)?

Accepted Answer

Using clippers immediately before the procedure, outside the operating room.

Answer

Shaving with a razor the night before surgery.

Answer

Using a depilatory cream 2 hours before surgery.

Answer

Hair should always be removed to ensure a clean field.

Question 4

A patient is scheduled for an elective cholecystectomy at 2:00 PM. According to the American Society of Anesthesiologists (ASA) NPO guidelines, which of the following is permissible?

Accepted Answer

Water and other clear liquids up until 12:00 PM.

Answer

A light breakfast (toast and tea with milk) at 6:00 AM.

Answer

Chewing gum until being called to the preoperative holding area.

Answer

Nothing by mouth after midnight the night before surgery.

Question 5

During the preoperative verification process, the CSFA notes that the patient's signed surgical consent form lists "Right knee arthroscopy," but the surgeon's H&P and the OR schedule both state "Left knee arthroscopy." What is the most appropriate immediate action?

Accepted Answer

Bring the discrepancy to the immediate attention of the surgeon and the circulating nurse to be resolved before the patient enters the OR.

Answer

Assume the consent form has a clerical error and proceed with preparing for a left knee procedure.

Answer

Ask the patient in the holding area which knee is being operated on and proceed based on their answer.

Answer

Correct the consent form by crossing out "Right" and writing "Left" and initialing the change.

Question 6

Which of the following is NOT a required element for a valid informed surgical consent?

Accepted Answer

A detailed explanation of the surgeon's experience with the procedure.

Answer

The diagnosis and the nature and purpose of the proposed procedure.

Answer

A discussion of potential risks, benefits, and complications.

Answer

Information about potential alternative treatments and the consequences of no treatment.