CSFA Postoperative Patient Management 3

Question 1

When assessing a postoperative patient's pain using the numeric rating scale (NRS), the surgeon has ordered analgesics for pain rated 7 or above. A patient rates pain at 8 but appears calm and is watching TV. The surgical first assistant should:

Accepted Answer

Administer the analgesic as ordered based on the patient's self-report

Answer

Self-report is the gold standard for pain assessment; behavioral cues do not override the patient's rating, and the analgesic should be given per the order.

Question 2

A patient who underwent total knee replacement is on a multimodal pain regimen including scheduled acetaminophen, celecoxib, and PRN oxycodone. This approach is designed primarily to:

Accepted Answer

Minimize opioid consumption by targeting multiple pain pathways

Answer

Multimodal analgesia combines agents with different mechanisms to achieve superior pain control while reducing opioid-related side effects.

Question 3

Which postoperative complication presents with sudden pleuritic chest pain, dyspnea, tachycardia, and decreased breath sounds on one side following a subclavian central line insertion?

Accepted Answer

Pneumothorax

Answer

Pneumothorax from central line insertion presents with unilateral decreased breath sounds, pleuritic pain, and respiratory distress.

Question 4

A postoperative patient develops confusion, agitation, and visual hallucinations on postoperative day 2 after a prolonged orthopedic surgery. The MOST likely diagnosis in an elderly patient is:

Accepted Answer

Postoperative delirium

Answer

Postoperative delirium is the most common neurologic complication in elderly surgical patients, typically peaking on POD 1-3.

Question 5

Which intervention is MOST effective in preventing postoperative deep vein thrombosis (DVT) in patients undergoing total hip arthroplasty?

Accepted Answer

Combination of pharmacologic anticoagulation and mechanical compression devices

Answer

Combined pharmacologic and mechanical prophylaxis provides superior DVT prevention compared to either modality used alone in high-risk orthopedic procedures.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Postoperative Patient Management 3