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Postoperative Patient Management Flashcards

7 cards from real CSFA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. When assessing a postoperative patient's pain using the numeric rating scale (NRS), the surgeon has ordered analgesics for pain rated 7 or above. A patient rates pain at 8 but appears calm and is watching TV. The surgical first assistant should:

    Answer: Administer the analgesic as ordered based on the patient's self-report

    Self-report is the gold standard for pain assessment; behavioral cues do not override the patient's rating, and the analgesic should be given per the order.

  2. A patient who underwent total knee replacement is on a multimodal pain regimen including scheduled acetaminophen, celecoxib, and PRN oxycodone. This approach is designed primarily to:

    Answer: Minimize opioid consumption by targeting multiple pain pathways

    Multimodal analgesia combines agents with different mechanisms to achieve superior pain control while reducing opioid-related side effects.

  3. Which postoperative complication presents with sudden pleuritic chest pain, dyspnea, tachycardia, and decreased breath sounds on one side following a subclavian central line insertion?

    Answer: Pneumothorax

    Pneumothorax from central line insertion presents with unilateral decreased breath sounds, pleuritic pain, and respiratory distress.

  4. A postoperative patient develops confusion, agitation, and visual hallucinations on postoperative day 2 after a prolonged orthopedic surgery. The MOST likely diagnosis in an elderly patient is:

    Answer: Postoperative delirium

    Postoperative delirium is the most common neurologic complication in elderly surgical patients, typically peaking on POD 1-3.

  5. Which intervention is MOST effective in preventing postoperative deep vein thrombosis (DVT) in patients undergoing total hip arthroplasty?

    Answer: Combination of pharmacologic anticoagulation and mechanical compression devices

    Combined pharmacologic and mechanical prophylaxis provides superior DVT prevention compared to either modality used alone in high-risk orthopedic procedures.

  6. A patient reports feeling a 'pop' and notices a pink watery discharge from their abdominal wound on postoperative day 5. The MOST likely complication is:

    Answer: Wound dehiscence with evisceration risk

    A 'popping' sensation followed by salmon-colored (serosanguineous) discharge is a classic presentation of fascial dehiscence requiring immediate wound assessment.

  7. Postoperative nausea and vomiting (PONV) is MOST strongly associated with which combination of patient and surgical factors?

    Answer: Female sex, non-smoker, history of PONV, and use of postoperative opioids

    The Apfel score identifies female sex, non-smoking status, history of PONV/motion sickness, and postoperative opioid use as the four major PONV risk factors.