,
,Sentinel U APS Women's Health GYN, Tanisha Smith | 100%
Score, Activity Report | Latest Update .
Section 1: Preoperative Assessment & History (Questions 1–15)
Question 1: Tanisha Smith, a 42-year-old female, is admitted for a total abdominal
hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) due to symptomatic uterine
fibroids and menorrhagia. Which finding in her history is MOST concerning for increased
surgical risk?
A. History of seasonal allergies
B. Body mass index (BMI) of 34 (obesity)
C. History of occasional heartburn
D. Previous uncomplicated appendectomy
CorreCt Answer: B. Body mass index (BMI) of 34 (obesity).
rAtionAle: Obesity (BMI ≥30) increases risks of venous thromboembolism (VTE), wound
infection, anesthesia complications, and longer operative times. All other options are minor or
irrelevant to surgical risk.
Question 2: Tanisha reports heavy menstrual bleeding requiring pad changes every 1–2 hours
with large clots. Her hemoglobin is 9.2 g/dL. This indicates:
A. Normal hemoglobin
B. Mild anemia
C. Moderate anemia
D. Severe anemia
CorreCt Answer: C. Moderate anemia.
rAtionAle: Normal hemoglobin for adult women is 12–16 g/dL. Mild anemia = 10–12 g/dL;
moderate = 8–10 g/dL; severe <8 g/dL. Tanisha has moderate anemia from chronic
menorrhagia.
Question 3: Preoperative orders include a type and screen. This test is performed to:
A. Check for pregnancy
B. Determine blood type in case a transfusion is needed during surgery
C. Assess kidney function
D. Measure clotting factors
CorreCt Answer: B. Determine blood type in case a transfusion is needed during surgery.
, rAtionAle: A type and screen determines the patient's ABO/Rh blood type and screens for
unexpected antibodies, ensuring compatible blood is available if transfusion is needed during
surgery.
Question 4: Tanisha has a history of one prior cesarean section. This is relevant because:
A. It guarantees a normal delivery
B. Prior abdominal surgery increases risk of intra-abdominal adhesions, which may complicate
hysterectomy
C. It is not relevant
D. It increases the risk of ovarian cancer
CorreCt Answer: B. Prior abdominal surgery increases risk of intra-abdominal adhesions,
which may complicate hysterectomy.
rAtionAle: Prior abdominal/pelvic surgery creates adhesions, increasing operative difficulty,
risk of bowel/bladder injury, and operative time.
Question 5: Tanisha's preoperative vital signs are: BP 138/88, HR 92, RR 18, O2 98% on room
air. Which finding requires notification of the provider?
A. Heart rate 92
B. Respiratory rate 18
C. Blood pressure 138/88
D. None; all are within acceptable preoperative ranges
CorreCt Answer: D. None; all are within acceptable preoperative ranges.
rAtionAle: Mild hypertension (138/88), mild tachycardia (92), and normal RR and O2 are not
critical. However, the anesthesia provider should be aware of baseline hypertension.
Question 6: Tanisha is prescribed preoperative prophylactic antibiotics (cefazolin). The purpose
is:
A. To treat her menorrhagia
B. To reduce the risk of surgical site infection
C. To sedate her before anesthesia
D. To prevent nausea
CorreCt Answer: B. To reduce the risk of surgical site infection.
rAtionAle: Prophylactic antibiotics given within 60 minutes before incision reduce surgical
site infection (SSI) risk, especially for abdominal hysterectomy.
Question 7: Tanisha reports taking ibuprofen daily for cramping. The nurse should:
,Sentinel U APS Women's Health GYN, Tanisha Smith | 100%
Score, Activity Report | Latest Update .
Section 1: Preoperative Assessment & History (Questions 1–15)
Question 1: Tanisha Smith, a 42-year-old female, is admitted for a total abdominal
hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) due to symptomatic uterine
fibroids and menorrhagia. Which finding in her history is MOST concerning for increased
surgical risk?
A. History of seasonal allergies
B. Body mass index (BMI) of 34 (obesity)
C. History of occasional heartburn
D. Previous uncomplicated appendectomy
CorreCt Answer: B. Body mass index (BMI) of 34 (obesity).
rAtionAle: Obesity (BMI ≥30) increases risks of venous thromboembolism (VTE), wound
infection, anesthesia complications, and longer operative times. All other options are minor or
irrelevant to surgical risk.
Question 2: Tanisha reports heavy menstrual bleeding requiring pad changes every 1–2 hours
with large clots. Her hemoglobin is 9.2 g/dL. This indicates:
A. Normal hemoglobin
B. Mild anemia
C. Moderate anemia
D. Severe anemia
CorreCt Answer: C. Moderate anemia.
rAtionAle: Normal hemoglobin for adult women is 12–16 g/dL. Mild anemia = 10–12 g/dL;
moderate = 8–10 g/dL; severe <8 g/dL. Tanisha has moderate anemia from chronic
menorrhagia.
Question 3: Preoperative orders include a type and screen. This test is performed to:
A. Check for pregnancy
B. Determine blood type in case a transfusion is needed during surgery
C. Assess kidney function
D. Measure clotting factors
CorreCt Answer: B. Determine blood type in case a transfusion is needed during surgery.
, rAtionAle: A type and screen determines the patient's ABO/Rh blood type and screens for
unexpected antibodies, ensuring compatible blood is available if transfusion is needed during
surgery.
Question 4: Tanisha has a history of one prior cesarean section. This is relevant because:
A. It guarantees a normal delivery
B. Prior abdominal surgery increases risk of intra-abdominal adhesions, which may complicate
hysterectomy
C. It is not relevant
D. It increases the risk of ovarian cancer
CorreCt Answer: B. Prior abdominal surgery increases risk of intra-abdominal adhesions,
which may complicate hysterectomy.
rAtionAle: Prior abdominal/pelvic surgery creates adhesions, increasing operative difficulty,
risk of bowel/bladder injury, and operative time.
Question 5: Tanisha's preoperative vital signs are: BP 138/88, HR 92, RR 18, O2 98% on room
air. Which finding requires notification of the provider?
A. Heart rate 92
B. Respiratory rate 18
C. Blood pressure 138/88
D. None; all are within acceptable preoperative ranges
CorreCt Answer: D. None; all are within acceptable preoperative ranges.
rAtionAle: Mild hypertension (138/88), mild tachycardia (92), and normal RR and O2 are not
critical. However, the anesthesia provider should be aware of baseline hypertension.
Question 6: Tanisha is prescribed preoperative prophylactic antibiotics (cefazolin). The purpose
is:
A. To treat her menorrhagia
B. To reduce the risk of surgical site infection
C. To sedate her before anesthesia
D. To prevent nausea
CorreCt Answer: B. To reduce the risk of surgical site infection.
rAtionAle: Prophylactic antibiotics given within 60 minutes before incision reduce surgical
site infection (SSI) risk, especially for abdominal hysterectomy.
Question 7: Tanisha reports taking ibuprofen daily for cramping. The nurse should:
