CSFA Postoperative and Emergency Care 4

Question 1

Which of the following interventions is the primary treatment for postoperative urinary retention (POUR) after spinal anesthesia?

Accepted Answer

Urinary catheterization

Answer

Urinary catheterization is the primary treatment for POUR when the bladder is significantly distended and the patient cannot void spontaneously.

Question 2

A surgical patient returning from the OR has a temperature of 38.9°C on day 2 postoperatively. What is the most common cause of fever at this time point?

Accepted Answer

Pulmonary atelectasis

Answer

Fever within the first 48 hours postoperatively is most commonly caused by atelectasis due to shallow breathing and mucus plugging.

Question 3

During a postoperative assessment, the surgical first assistant notes that a patient's wound has separated with visible bowel loops protruding through the incision. This complication is called:

Accepted Answer

Evisceration

Answer

Evisceration is the protrusion of abdominal viscera through an open wound, which is a surgical emergency requiring immediate sterile saline-moistened dressing and urgent return to the OR.

Question 4

What is the correct initial management of evisceration discovered postoperatively at the bedside?

Accepted Answer

Cover the exposed viscera with a sterile saline-moistened dressing and call the surgeon immediately

Answer

Covering the bowel with moist sterile dressings prevents desiccation and further contamination while the surgeon is urgently notified for operative repair.

Question 5

A patient on the surgical floor three days postoperatively develops a fever of 39.2°C, dysuria, and a urinalysis positive for nitrites and leukocyte esterase. What is the most likely source of infection?

Accepted Answer

Catheter-associated urinary tract infection (CAUTI)

Answer

Fever with urinary symptoms and a positive UA on postoperative day 3 in a patient who likely had an indwelling catheter is consistent with CAUTI.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Postoperative and Emergency Care 4