CSFA Postoperative Patient Management 5

Question 1

Which postoperative complication is MOST associated with unilateral leg swelling, warmth, and a positive Homans' sign in a patient who had a 6-hour pelvic surgery?

Accepted Answer

Deep vein thrombosis (DVT)

Answer

Prolonged pelvic surgery causes venous stasis, and DVT presents with unilateral limb swelling, warmth, erythema, and calf pain with dorsiflexion (Homans' sign).

Question 2

A patient 6 hours after a laparoscopic cholecystectomy complains of right shoulder pain. The surgical first assistant should recognize this as:

Accepted Answer

Referred pain from residual CO2 irritating the diaphragm

Answer

Residual carbon dioxide gas after laparoscopy irritates the diaphragm, which refers pain to the right shoulder via the phrenic nerve (C3-C5).

Question 3

When performing a postoperative surgical wound assessment, which finding requires IMMEDIATE notification of the surgeon?

Accepted Answer

Wound edges separating with visible bowel loops (evisceration)

Answer

Evisceration (protrusion of abdominal organs through the wound) is a surgical emergency requiring immediate coverage with a sterile moist dressing and surgeon notification.

Question 4

A postoperative patient on a beta-blocker develops a heart rate of 48 bpm, blood pressure of 88/54 mmHg, and is symptomatic with dizziness. The MOST appropriate pharmacologic intervention is:

Accepted Answer

Atropine IV for symptomatic bradycardia

Answer

Atropine is the first-line treatment for symptomatic bradycardia by blocking vagal tone to increase heart rate.

Question 5

Following a thyroidectomy, a patient develops perioral numbness, tingling of the fingertips, and a positive Chvostek's sign. These findings are MOST consistent with:

Accepted Answer

Hypocalcemia due to parathyroid gland injury

Answer

Inadvertent parathyroid removal or devascularization during thyroidectomy causes hypocalcemia, which presents with perioral numbness, tetany, and a positive Chvostek's sign.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Postoperative Patient Management 5