Patient Assessment and Evaluation Flashcards
7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Assessment and Evaluation flashcards as text
A patient with end-stage renal disease on hemodialysis presents for arteriovenous fistula revision. Which preoperative concern is most specific to this patient population?
Answer: Hyperkalemia-induced cardiac dysrhythmias
Patients on hemodialysis are prone to hyperkalemia, which can cause life-threatening dysrhythmias; a preoperative potassium level and recent dialysis timing must be confirmed.
Which of the following best describes the significance of a STOP-BANG score of 5 or greater in a preoperative patient?
Answer: High risk for obstructive sleep apnea requiring perioperative precautions
A STOP-BANG score ≥ 5 indicates high risk for moderate-to-severe OSA, warranting perioperative precautions such as continuous pulse oximetry and possible CPAP use.
A 55-year-old patient reports a prior episode of 'awareness during surgery' years ago. Which preoperative action is most important when planning the current anesthetic?
Answer: Document the history, assess for contributing factors, and discuss the anesthetic plan and monitoring with the patient
Thorough documentation and counseling are essential; identifying prior risk factors (light anesthesia, paralysis without adequate hypnosis) guides the individualized anesthetic plan.
Which preoperative cardiac evaluation is indicated in a patient with poor functional capacity (< 4 METs) scheduled for high-risk vascular surgery who has two clinical risk factors per the Revised Cardiac Risk Index?
Answer: Pharmacologic stress testing
Per ACC/AHA guidelines, patients with poor functional capacity, elevated surgical risk, and clinical risk factors may benefit from pharmacologic stress testing to guide further management.
During preoperative evaluation, a patient with rheumatoid arthritis taking methotrexate presents for elective shoulder surgery. Which airway concern is most critical for this population?
Answer: Atlantoaxial instability causing risk of cervical cord injury during intubation
Rheumatoid arthritis can cause atlantoaxial subluxation, which poses a risk of cervical spinal cord injury during neck manipulation for intubation.
A patient scheduled for elective spine surgery has a preoperative hemoglobin of 8.2 g/dL. Which is the most appropriate next step?
Answer: Postpone surgery and investigate the cause of anemia before proceeding
Preoperative anemia increases perioperative risk; identifying and treating the underlying cause (iron deficiency, bleeding) optimizes outcomes before elective high-blood-loss procedures.
In the preoperative assessment of a patient with myasthenia gravis, which factor most influences the choice of neuromuscular blocking agent?
Answer: Profound sensitivity to nondepolarizing agents requiring significantly reduced doses
Myasthenia gravis patients have reduced acetylcholine receptors at the neuromuscular junction, making them exquisitely sensitive to nondepolarizing neuromuscular blocking agents.