NBSTSA Preoperative & Postoperative Patient Care 2 — Questions and Answers
Question 1: Which laboratory value is most important to review preoperatively to assess a patient's oxygenation capacity and anemia risk?
- Serum creatinine
- Hemoglobin and hematocrit (Correct answer)
- Prothrombin time
- Serum potassium
Correct answer: Hemoglobin and hematocrit
Hemoglobin and hematocrit values reflect the patient's red blood cell mass and oxygen-carrying capacity, which is critical for safe anesthesia and surgical blood loss tolerance.
Question 2: The Universal Protocol for preventing wrong-site surgery requires a time-out to be performed at what point?
- When the patient arrives in preop
- Immediately before the skin incision (Correct answer)
- After the patient is positioned
- When the consent form is signed
Correct answer: Immediately before the skin incision
The Universal Protocol requires a time-out immediately before the skin incision, when all team members verbally confirm patient identity, procedure, site, and any special equipment needs.
Question 3: Which patient position is used for procedures involving the lower abdomen and pelvis, placing the patient flat with legs elevated and abducted?
- Prone position
- Lithotomy position (Correct answer)
- Trendelenburg position
- Lateral decubitus position
Correct answer: Lithotomy position
The lithotomy position places the patient supine with legs elevated, abducted, and supported in stirrups, providing optimal access to the perineum, vagina, rectum, and lower pelvis.
Question 4: A patient in the PACU is experiencing postoperative nausea and vomiting (PONV). Which factor in the patient's history most increases PONV risk?
- Male sex
- History of smoking
- History of motion sickness (Correct answer)
- Age over 65
Correct answer: History of motion sickness
A personal history of motion sickness or previous PONV is one of the strongest independent risk factors for postoperative nausea and vomiting.
Question 5: When positioning a patient in the Trendelenburg position, what is the primary physiological concern the surgical team must monitor?
- Increased cardiac afterload
- Increased intracranial pressure (Correct answer)
- Decreased venous return
- Peripheral nerve compression only
Correct answer: Increased intracranial pressure
Trendelenburg position (head-down tilt) causes blood to shift toward the head, increasing intracranial and intraocular pressure, which is especially dangerous for patients with head injury or glaucoma.
Question 6: Which postoperative complication is characterized by a sudden onset of tachycardia, hypotension, and decreased oxygen saturation, and is associated with immobility after surgery?
- Atelectasis
- Wound dehiscence
- Pulmonary embolism (Correct answer)
- Urinary retention
Correct answer: Pulmonary embolism
Pulmonary embolism results from a deep vein thrombus traveling to the pulmonary vasculature and classically presents with sudden cardiorespiratory compromise including tachycardia, hypotension, and hypoxia.
Question 7: During preoperative checklist completion, the surgical technologist verifies that the operative site has been marked. Who is responsible for marking the surgical site?
- The circulating nurse
- The surgical technologist
- The licensed practitioner performing the procedure (Correct answer)
- The anesthesiologist
Correct answer: The licensed practitioner performing the procedure
Per The Joint Commission's Universal Protocol, the licensed practitioner who will perform the procedure is responsible for marking the operative site.
NBSTSA Preoperative & Postoperative Patient Care 2
Which laboratory value is most important to review preoperatively to assess a patient's oxygenation capacity and anemia risk?