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Question 1
A patient scheduled for an elective inguinal hernia repair reports
that they took their daily 81 mg aspirin this morning. The surgical
assistant should anticipate which action?
A) Proceed with surgery as planned
B) Notify the surgeon, as aspirin is often withheld 5 to 7 days
before surgery due to bleeding risk
C) Administer vitamin K to reverse the aspirin effect
D) Give a platelet transfusion before incision
Correct Answer: B
Rationale: Aspirin irreversibly inhibits cyclooxygenase and platelet
aggregation for the life of the platelet (7 to 10 days). Elective
surgery is typically postponed or aspirin stopped per protocol to
reduce bleeding risk. Vitamin K does not reverse aspirin, and
platelet transfusion is not routine.
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,Question 2
The surgical assistant is performing a preoperative verification.
Which three elements must be confirmed according to the
Universal Protocol?
A) Patient age, diagnosis, and insurance status
B) Correct patient identity, correct procedure, and correct
surgical site
C) Surgeon name, anesthesia type, and operative duration
D) Blood type, allergies, and fasting status
Correct Answer: B
Rationale: The Universal Protocol mandates a preoperative
"timeout" verifying correct patient identity, correct procedure, and
correct surgical site (including laterality) to prevent wrong site,
wrong procedure, and wrong person surgery.
Question 3
A patient has a documented allergy to latex. Which action
should the surgical assistant take when setting up the operating
room?
A) Wear standard gloves but avoid latex drapes
B) Remove all latex containing products from the room and use
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,latex free gloves, drapes, and supplies
C) Apply a barrier cream to the patient's skin
D) Proceed with latex products but keep injectable epinephrine
available
Correct Answer: B
Rationale: Latex allergy can cause mild to life threatening
reactions. A latex free cart must be used, and all team members
must wear non latex gloves. All latex containing items must be
removed from the room.
Question 4
The surgical assistant reviews a patient's medication list and notes
warfarin (Coumadin) for atrial fibrillation. The patient has an
international normalized ratio (INR) of 3.2. What is the most
appropriate next step?
A) Proceed with surgery because the INR is therapeutic for atrial
fibrillation
B) Administer protamine sulfate immediately
C) Notify the surgeon and anesthesia provider; surgery may be
postponed or bridging therapy planned
D) Give fresh frozen plasma without delaying surgery
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, Correct Answer: C
Rationale: An INR above 1.5 to 2.0 for most procedures (or above
1.2 for neurosurgery) indicates increased bleeding risk. Elective
surgery is often delayed or warfarin is reversed with vitamin K or
bridging therapy. Protamine reverses heparin, not warfarin.
Question 5
Before induction of anesthesia, the surgical assistant confirms that
the surgical site has been marked. Who should perform the site
marking?
A) The circulating nurse
B) The anesthesia provider
C) The operating surgeon, ideally with the patient involved and
awake
D) The surgical assistant
Correct Answer: C
Rationale: The Joint Commission requires the surgeon to mark the
operative site, using a permanent marker, and the patient should
participate when possible. The mark should be unambiguous and
placed at or near the incision site.
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