CSFA Postoperative and Emergency Care 3

Question 1

Following a laparoscopic cholecystectomy, a patient complains of severe right shoulder pain. What is the most likely cause?

Accepted Answer

Referred pain from residual CO2 irritating the diaphragm

Answer

Residual carbon dioxide trapped under the diaphragm causes phrenic nerve irritation, which refers pain to the shoulder tip postoperatively.

Question 2

The surgical first assistant notes that a patient's blood pressure is 80/50 mmHg and heart rate is 128 bpm one hour post-abdominal surgery. The abdomen is distended. What emergency condition should be suspected?

Accepted Answer

Intra-abdominal hemorrhage

Answer

Hypotension with tachycardia and abdominal distension in the early postoperative period strongly suggests intra-abdominal hemorrhage requiring urgent evaluation.

Question 3

Which scoring system is used in the PACU to assess a patient's readiness for discharge?

Accepted Answer

Aldrete Score

Answer

The Aldrete (or Modified Aldrete) Score evaluates activity, respiration, circulation, consciousness, and oxygen saturation to determine PACU discharge readiness.

Question 4

A patient develops sudden dyspnea, hypotension, and jugular venous distension after a central line placement. What is the most likely emergency?

Accepted Answer

Tension pneumothorax

Answer

Tension pneumothorax after central line insertion presents with dyspnea, hypotension, JVD, and absent breath sounds on the affected side, requiring immediate needle decompression.

Question 5

Which of the following best describes the purpose of incentive spirometry in the postoperative period?

Accepted Answer

Prevent atelectasis by promoting deep breathing and alveolar expansion

Answer

Incentive spirometry encourages sustained maximal inspiration to open collapsed alveoli and prevent postoperative atelectasis and pneumonia.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Postoperative and Emergency Care 3