Cardiac Surgery Certification Exam Perioperative Care in Cardiac Surgery 1 — Questions and Answers
Question 1: Which preoperative medication is typically continued until the day of cardiac surgery to prevent rebound angina?
- Beta-blockers (Correct answer)
- Warfarin
- Metformin
- ACE inhibitors
Correct answer: Beta-blockers
Beta-blockers should be continued perioperatively to prevent rebound tachycardia and ischemia in patients undergoing cardiac surgery.
Question 2: The most common early arrhythmia occurring after cardiac surgery is:
- Atrial fibrillation (Correct answer)
- Ventricular fibrillation
- Complete heart block
- Ventricular tachycardia
Correct answer: Atrial fibrillation
Atrial fibrillation occurs in up to 30–40% of patients after cardiac surgery and is the most common postoperative arrhythmia.
Question 3: Low cardiac output syndrome after cardiac surgery is best initially managed with:
- Inotropic support and optimization of preload and afterload (Correct answer)
- Immediate reoperation
- High-dose diuresis
- Anticoagulation
Correct answer: Inotropic support and optimization of preload and afterload
Low cardiac output syndrome is managed by optimizing preload, reducing afterload, and adding inotropes to improve myocardial contractility.
Question 4: Cardiac tamponade after cardiac surgery classically presents with:
- Hypotension, elevated CVP, and equalization of filling pressures (Correct answer)
- Hypertension, low CVP, and wide pulse pressure
- Bradycardia and high cardiac output
- Normal hemodynamics with chest pain only
Correct answer: Hypotension, elevated CVP, and equalization of filling pressures
Cardiac tamponade produces the classic triad of hypotension, elevated central venous pressure, and equalization of diastolic pressures across cardiac chambers.
Question 5: Which electrolyte abnormality most commonly predisposes patients to arrhythmias in the early postoperative period after cardiac surgery?
- Hypokalemia (Correct answer)
- Hypernatremia
- Hypercalcemia
- Hyperphosphatemia
Correct answer: Hypokalemia
Hypokalemia is common after cardiac surgery due to diuresis and hemodilution, and it significantly increases the risk of postoperative arrhythmias.
Question 6: The most reliable indicator of adequate renal perfusion in the immediate postoperative cardiac surgery patient is:
- Urine output greater than 0.5 mL/kg/hour (Correct answer)
- Normal serum creatinine immediately postoperatively
- Central venous pressure above 15 mmHg
- Mean arterial pressure above 90 mmHg
Correct answer: Urine output greater than 0.5 mL/kg/hour
A urine output greater than 0.5 mL/kg/hour is the most practical real-time indicator of adequate renal perfusion in cardiac surgery patients.
Cardiac Surgery Certification Exam Perioperative Care in Cardiac Surgery 1
Which preoperative medication is typically continued until the day of cardiac surgery to prevent rebound angina?