CSFA Postoperative and Emergency Care 5 — Questions and Answers
Question 1: Which of the following is the correct rate for adult chest compressions during CPR according to the AHA guidelines?
- 60-80 compressions per minute
- 80-100 compressions per minute
- 100-120 compressions per minute (Correct answer)
- 120-140 compressions per minute
Correct answer: 100-120 compressions per minute
AHA guidelines recommend high-quality CPR at a rate of 100-120 chest compressions per minute for adults to maintain adequate cardiac output.
Question 2: A postoperative patient develops sudden-onset confusion, contralateral facial droop, and arm weakness. The surgical first assistant suspects a stroke. What is the priority action?
- Obtain a head CT and administer aspirin immediately
- Activate the stroke protocol and note the exact time of symptom onset (Correct answer)
- Administer IV tPA without delay
- Lower the blood pressure to below 120/80 mmHg urgently
Correct answer: Activate the stroke protocol and note the exact time of symptom onset
Activating the stroke team and recording exact symptom onset time are critical because eligibility for reperfusion therapy depends on the time window.
Question 3: Which type of shock is characterized by warm, flushed skin, bounding pulses, and low systemic vascular resistance in the early phase?
- Hypovolemic shock
- Cardiogenic shock
- Distributive (septic) shock (Correct answer)
- Obstructive shock
Correct answer: Distributive (septic) shock
Early distributive shock (septic) presents with vasodilation, causing warm flushed skin and bounding pulses due to decreased systemic vascular resistance.
Question 4: When assessing a postoperative surgical wound, which finding is most indicative of developing infection?
- Slight pinkness along the incision edges on day 1
- Increasing erythema, warmth, and purulent drainage on day 4 (Correct answer)
- A small amount of serous drainage on day 2
- Mild bruising adjacent to the wound on day 3
Correct answer: Increasing erythema, warmth, and purulent drainage on day 4
Progressive erythema, warmth, and purulent discharge after postoperative day 3-4 are classic signs of surgical site infection (SSI).
Question 5: In the immediate postoperative period, which assessment finding would MOST concern the surgical first assistant monitoring a patient after thyroidectomy?
- Mild sore throat from intubation
- Hoarseness and stridor with perioral tingling (Correct answer)
- Serosanguineous drainage at the wound site
- Heart rate of 88 bpm
Correct answer: Hoarseness and stridor with perioral tingling
Stridor with hoarseness and perioral tingling after thyroidectomy suggests hypocalcemia from parathyroid injury plus potential airway compromise from hematoma or nerve damage.
Question 6: A patient begins seizing in the PACU after intracranial surgery. What is the FIRST action the surgical first assistant should take?
- Restrain the patient to prevent injury
- Protect the airway, turn the patient to the lateral position, and call for help (Correct answer)
- Administer IV diazepam immediately without waiting
- Place a padded tongue blade between the teeth
Correct answer: Protect the airway, turn the patient to the lateral position, and call for help
Airway protection in the lateral recovery position and immediately calling for assistance are the first priorities during a postoperative seizure.
Question 7: Which of the following accurately describes the purpose of a Jackson-Pratt (JP) drain in postoperative care?
- To provide continuous wound irrigation with antibiotic solution
- To evacuate fluid and blood from a surgical site using closed suction (Correct answer)
- To maintain a sterile field over the incision postoperatively
- To deliver topical analgesics directly to the wound bed
Correct answer: To evacuate fluid and blood from a surgical site using closed suction
A Jackson-Pratt drain uses a compressible bulb to create negative pressure, removing accumulated blood and serosanguineous fluid to prevent hematoma and seroma formation.
CSFA Postoperative and Emergency Care 5
Which of the following is the correct rate for adult chest compressions during CPR according to the AHA guidelines?