NBSTSA Preoperative & Postoperative Patient Care 5 — Questions and Answers
Question 1: Which of the following best describes the purpose of a preoperative Time Out?
- To allow the anesthesiologist to complete medication preparation
- To verify patient identity, surgical site, procedure, and team readiness before incision (Correct answer)
- To confirm the sterile field is established and all drapes are secured
- To document the count of instruments before the case begins
Correct answer: To verify patient identity, surgical site, procedure, and team readiness before incision
The Time Out is a Joint Commission-required pause performed immediately before incision to confirm correct patient, site, side, and procedure, preventing wrong-site surgery.
Question 2: Postoperative urinary retention is most commonly caused by which factor?
- Excessive IV fluid administration
- Effects of anesthesia and opioid analgesics on bladder function (Correct answer)
- Wound infection near the urinary tract
- Hyperthermia during recovery
Correct answer: Effects of anesthesia and opioid analgesics on bladder function
Anesthetic agents and opioids reduce detrusor muscle tone and suppress the urge to void, making urinary retention one of the most common postoperative complications.
Question 3: When preparing a diabetic patient for surgery, which preoperative concern takes highest priority?
- Ensuring the patient has received their full insulin dose that morning
- Monitoring and managing blood glucose levels to prevent hypo- or hyperglycemia (Correct answer)
- Restricting all carbohydrate intake for 72 hours preoperatively
- Administering oral hypoglycemics with a sip of water on the morning of surgery
Correct answer: Monitoring and managing blood glucose levels to prevent hypo- or hyperglycemia
Tight perioperative blood glucose management reduces infection risk, promotes wound healing, and decreases morbidity in diabetic surgical patients.
Question 4: A patient who is 4 hours postoperative following abdominal surgery develops a rigid, board-like abdomen with rebound tenderness and fever. This presentation is most consistent with:
- Paralytic ileus
- Surgical site infection
- Anastomotic leak with peritonitis (Correct answer)
- Abdominal wound dehiscence
Correct answer: Anastomotic leak with peritonitis
Board-like rigidity, rebound tenderness, and fever after abdominal surgery are classic signs of peritonitis, often caused by an anastomotic leak requiring urgent surgical intervention.
Question 5: Which preoperative patient statement indicates a need for further education about NPO (nothing by mouth) guidelines?
- 'I stopped eating solid food at midnight last night.'
- 'I can take my blood pressure pill with a tiny sip of water this morning.'
- 'I drank a full glass of orange juice two hours before my procedure.' (Correct answer)
- 'I brushed my teeth but did not swallow the water.'
Correct answer: 'I drank a full glass of orange juice two hours before my procedure.'
Current ASA NPO guidelines require clear liquids to be stopped at least 2 hours before surgery, and orange juice (a clear liquid with pulp) consumed 2 hours prior is a borderline violation that warrants clarification and possible case delay.
Question 6: What is the primary purpose of applying sequential compression devices (SCDs) in the perioperative period?
- Maintaining intraoperative blood pressure stability
- Preventing deep vein thrombosis by promoting venous return (Correct answer)
- Reducing lower extremity edema from IV fluid administration
- Providing thermal regulation during prolonged procedures
Correct answer: Preventing deep vein thrombosis by promoting venous return
SCDs mechanically compress the lower extremities in a sequential pattern to promote venous return and prevent venous stasis, thereby reducing DVT formation.
Question 7: A surgical technologist is reviewing a patient's chart preoperatively and notes the patient has a latex allergy. Which action is the FIRST priority?
- Switching all gloves in the room to non-latex alternatives only
- Notifying the entire surgical team and ensuring a latex-safe environment is established (Correct answer)
- Placing an allergy wristband on the patient and proceeding with the normal setup
- Cancelling the case until the allergy is further evaluated by an allergist
Correct answer: Notifying the entire surgical team and ensuring a latex-safe environment is established
The first priority is to notify all team members and systematically create a latex-safe environment, as latex anaphylaxis can be life-threatening and requires team-wide awareness and preparation.
NBSTSA Preoperative & Postoperative Patient Care 5
Which of the following best describes the purpose of a preoperative Time Out?