CSFA Preoperative Patient Preparation 3 — Questions and Answers
Question 1: During the preoperative Time Out, which element is NOT required per the Universal Protocol?
- Patient identity
- Correct surgical site
- Surgeon's board certification (Correct answer)
- Correct procedure
Correct answer: Surgeon's board certification
The Universal Protocol Time Out verifies patient identity, procedure, and site — not the surgeon's credentials.
Question 2: A patient with a history of malignant hyperthermia susceptibility (MHS) requires which preoperative measure?
- Administration of succinylcholine prophylactically
- Avoidance of triggering agents and preparation of dantrolene (Correct answer)
- Preoperative cooling blanket application
- Routine administration of volatile anesthetics
Correct answer: Avoidance of triggering agents and preparation of dantrolene
MHS patients require avoidance of volatile anesthetics and succinylcholine, with dantrolene immediately available for treatment.
Question 3: Which preoperative intervention is most important to prevent surgical site infections (SSI)?
- Routine preoperative blood transfusion
- Appropriate timing of prophylactic antibiotics within 60 minutes before incision (Correct answer)
- Postoperative wound irrigation with betadine
- Shaving the surgical site the night before surgery
Correct answer: Appropriate timing of prophylactic antibiotics within 60 minutes before incision
Prophylactic antibiotics administered within 60 minutes before incision significantly reduce SSI risk, per evidence-based guidelines.
Question 4: An ASA Class IV patient is best described as having:
- No systemic disease
- Mild systemic disease with no functional limitation
- Severe systemic disease that is a constant threat to life (Correct answer)
- A moribund patient not expected to survive without surgery
Correct answer: Severe systemic disease that is a constant threat to life
ASA Class IV patients have severe systemic disease that poses a constant threat to life, such as end-stage organ failure.
Question 5: Which preoperative assessment finding requires immediate notification to the anesthesia team and surgeon before proceeding?
- Blood pressure of 128/82 mmHg
- Heart rate of 78 bpm
- Blood glucose of 380 mg/dL in a diabetic patient (Correct answer)
- Temperature of 37.1°C (98.8°F)
Correct answer: Blood glucose of 380 mg/dL in a diabetic patient
Severely elevated blood glucose (380 mg/dL) indicates poor diabetic control and increases infection and healing risks, warranting provider notification.
Question 6: The purpose of a preoperative bowel prep before colorectal surgery is primarily to:
- Reduce intraoperative bleeding
- Decrease bacterial load and fecal contamination risk (Correct answer)
- Improve anesthesia induction
- Prevent anastomotic leak
Correct answer: Decrease bacterial load and fecal contamination risk
Mechanical bowel prep reduces fecal bacteria and decreases the risk of peritoneal contamination if bowel is entered during surgery.
Question 7: Which document must be reviewed to confirm a patient has designated a healthcare proxy before an elective procedure?
- Insurance authorization form
- Advance directive or healthcare proxy document (Correct answer)
- Anesthesia pre-assessment form
- Consent for blood transfusion
Correct answer: Advance directive or healthcare proxy document
The advance directive or healthcare proxy document legally designates who can make medical decisions if the patient becomes incapacitated.
CSFA Preoperative Patient Preparation 3
During the preoperative Time Out, which element is NOT required per the Universal Protocol?