NBSTSA Preoperative & Postoperative Patient Care 4 — Questions and Answers
Question 1: A patient states they took aspirin two days before their scheduled surgery. What is the primary concern for the surgical team?
- Increased risk of postoperative nausea
- Impaired platelet aggregation leading to increased bleeding risk (Correct answer)
- Elevated blood pressure during anesthesia
- Delayed wound healing due to anti-inflammatory effects
Correct answer: Impaired platelet aggregation leading to increased bleeding risk
Aspirin irreversibly inhibits platelet aggregation for the platelet's lifespan (~7–10 days), significantly increasing intraoperative and postoperative bleeding risk.
Question 2: During the postoperative period, a patient develops sudden onset shortness of breath, chest pain, and tachycardia. The surgical technologist should recognize these as potential signs of:
- Atelectasis
- Pulmonary embolism (Correct answer)
- Pneumonia
- Pleural effusion
Correct answer: Pulmonary embolism
Sudden dyspnea, chest pain, and tachycardia in the postoperative period are classic warning signs of pulmonary embolism requiring immediate intervention.
Question 3: Which lab value is most critical to review before a patient undergoes a procedure requiring general anesthesia?
- Serum albumin
- Hemoglobin and hematocrit (Correct answer)
- Urine specific gravity
- Serum calcium
Correct answer: Hemoglobin and hematocrit
Hemoglobin and hematocrit assess the patient's oxygen-carrying capacity, which directly impacts anesthetic safety and tolerance of blood loss during surgery.
Question 4: A preoperative patient reports a shellfish allergy. Which intraoperative agent should be flagged for potential cross-reactivity?
- Heparin sodium
- Povidone-iodine (Correct answer)
- Protamine sulfate
- Vancomycin
Correct answer: Povidone-iodine
Povidone-iodine contains iodine, and while the exact cross-reactivity with shellfish allergy is debated, it is standard practice to flag and assess risk in patients with shellfish or iodine sensitivities.
Question 5: Postoperative wound dehiscence is most likely associated with which patient condition?
- Hypertension
- Malnutrition and poor protein intake (Correct answer)
- Hypothyroidism
- Osteoporosis
Correct answer: Malnutrition and poor protein intake
Malnutrition and inadequate protein intake impair collagen synthesis and tissue repair, significantly increasing the risk of wound dehiscence.
Question 6: Which preoperative teaching intervention best reduces a patient's risk of postoperative pulmonary complications?
- Instructing the patient to limit oral fluid intake
- Teaching incentive spirometry and deep breathing exercises (Correct answer)
- Advising the patient to avoid all ambulation for 48 hours
- Recommending supplemental oxygen use at home before surgery
Correct answer: Teaching incentive spirometry and deep breathing exercises
Incentive spirometry and deep breathing exercises expand lung volumes and clear secretions, directly reducing the incidence of atelectasis and pneumonia after surgery.
Question 7: A patient is scheduled for elective abdominal surgery and is currently taking warfarin. What preoperative management is typically expected?
- Continue warfarin at the same dose through surgery
- Discontinue warfarin and bridge with low-molecular-weight heparin if indicated (Correct answer)
- Switch warfarin to aspirin 24 hours before surgery
- Administer vitamin K on the morning of surgery without stopping warfarin
Correct answer: Discontinue warfarin and bridge with low-molecular-weight heparin if indicated
Warfarin is typically held preoperatively and patients at high thromboembolic risk are bridged with low-molecular-weight heparin per the surgeon and anticoagulation team's protocol.
NBSTSA Preoperative & Postoperative Patient Care 4
A patient states they took aspirin two days before their scheduled surgery.
What is the primary concern for the surgical team?