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CST practice questions

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Question 1Preoperative Preparation

When verifying a patient's identity in the preoperative holding area, which two identifiers should the surgical technologist use?

  1. Surgical procedure and surgeon name
  2. Full name and date of birth Correct answer.
  3. Hospital identification number alone
  4. Room number and bed assignment

Explanation

Two independent identifiers are required before any procedure or medication. Acceptable identifiers include the patient's full name, date of birth, or medical record number, and they are confirmed against the identification band. Room or bed location is not a unique identifier and must never be used.

Question 2Preoperative Preparation

A 10-year-old is scheduled for an elective procedure, and the parents are present. Who may sign the surgical informed consent?

  1. The patient's adult sibling
  2. The circulating nurse
  3. Any adult accompanying the patient
  4. A parent or legal guardian Correct answer.

Explanation

Minors cannot legally consent to surgery, so consent must come from a parent or court-appointed legal guardian. The signature confirms the risks, benefits, and alternatives were explained by the surgeon. An unrelated adult cannot consent for a minor.

Question 3Preoperative Preparation

According to standard fasting guidelines, how long before induction should a patient stop drinking clear liquids?

  1. Two hours Correct answer.
  2. Six hours
  3. Eight hours
  4. Four hours

Explanation

Clear liquids empty rapidly from the stomach, so the recommended fasting interval is at least 2 hours. Breast milk requires 4 hours, and infant formula or a light meal requires 6 hours. Longer fasting does not improve safety and can cause dehydration and discomfort.

Question 4Preoperative Preparation

A patient arrives wearing rings, a necklace, and dentures. What is the most appropriate preoperative action?

  1. Leave rings in place to preserve dignity
  2. Secure removed items with the patient's valuables Correct answer.
  3. Tape rings to the finger for the procedure
  4. Place dentures in the bedside drawer

Explanation

Jewelry and removable dental prostheses are removed before surgery to reduce the risk of pressure injury, burns from electrosurgery, and airway obstruction. Items should be documented and secured according to facility policy, usually with family or in the valuables safe.

Question 5Preoperative Preparation

Who is responsible for marking the operative site before surgery?

  1. The operating surgeon Correct answer.
  2. The preoperative holding nurse
  3. The circulating nurse
  4. The anesthesia provider

Explanation

The operating surgeon performs site marking because the surgeon is responsible for the planned procedure and knows the intended site. Marking is done with the patient involved when possible and before sedation. Other team members verify the mark but do not create it.

Question 6Preoperative Preparation

Which method of preoperative hair removal is preferred when hair must be removed from the surgical site?

  1. Apply a depilatory cream in holding
  2. Clip hair immediately before surgery Correct answer.
  3. Shave with a razor the night before
  4. Remove hair with wax strips in the room

Explanation

Electric clippers performed immediately before surgery cause fewer skin microabrasions than shaving and reduce surgical site infection risk. Shaving the night before allows small cuts to become colonized. Depilatory creams can cause irritation and allergic reactions.

Question 7Preoperative Preparation

For most procedures, prophylactic antibiotics should be administered within what time frame before the incision?

  1. Within 60 minutes before incision Correct answer.
  2. Within 4 hours before incision
  3. At the end of the procedure
  4. After the incision is made

Explanation

Prophylactic antibiotics must achieve adequate tissue levels at the time of incision, so most agents are given within 60 minutes before the cut. Vancomycin and fluoroquinolones require a longer infusion and are started within 120 minutes. Giving the drug after incision misses the period of highest contamination risk.

Question 8Preoperative Preparation

A patient scheduled for abdominal surgery does not have a urinary catheter. Before transfer to the OR, the technologist should confirm that the patient has:

  1. Been given a diuretic
  2. Had a bladder scan
  3. Drunk 500 mL of water
  4. Voided recently Correct answer.

Explanation

An empty bladder reduces the risk of injury during abdominal access and improves comfort during transfer. Patients without an indwelling catheter are asked to void shortly before going to the OR. Forced fluids or diuretics are not routine preoperative measures.

Question 9Preoperative Preparation

An alcohol-based chlorhexidine skin prep has been applied. What should the technologist do next?

  1. Blot the prep dry with a sterile towel
  2. Fan the area with a sterile drape
  3. Allow the prep to dry completely before draping Correct answer.
  4. Drape immediately to prevent contamination

Explanation

Alcohol-based preps must dry fully to achieve maximal antimicrobial effect and to eliminate flammable vapors before draping or electrosurgery. Pooled solution should be removed from skin folds and the patient's sides. Blotting or fanning interferes with the drying process.

Question 10Preoperative Preparation

A patient reports a personal history of malignant hyperthermia. Which anesthetic plan is most appropriate?

  1. Proceed with sevoflurane and monitor temperature
  2. Cancel surgery permanently
  3. Give succinylcholine for rapid sequence induction
  4. Use a total intravenous anesthetic and avoid triggers Correct answer.

Explanation

Malignant hyperthermia is triggered by volatile anesthetics and succinylcholine, so a trigger-free total intravenous anesthetic is used. A vapor-free anesthesia machine or charcoal filters are prepared, and dantrolene is available. Surgery is not permanently contraindicated.

Question 11Preoperative Preparation

For a patient with an implanted pacemaker, which action best reduces the risk of device interference during surgery?

  1. Place the dispersive pad on the ipsilateral shoulder
  2. Keep the pacemaker programmed in demand mode
  3. Set the electrosurgical unit to the highest power
  4. Use bipolar electrosurgery when feasible Correct answer.

Explanation

Bipolar electrosurgery confines current to the small area between the tips, minimizing current through the heart and device. If monopolar current is unavoidable, the dispersive pad is placed so the current path does not cross the generator or leads. Higher power settings increase interference risk.

Question 12Preoperative Preparation

A patient with a documented latex allergy is scheduled for surgery. Which scheduling approach is preferred?

  1. Schedule the patient as the first case of the day Correct answer.
  2. Place the patient in the general holding area
  3. Use powdered gloves in the room
  4. Schedule the patient as the last case

Explanation

Scheduling a latex-allergic patient first reduces exposure to airborne latex particles that accumulate in the OR during the day. The room should be cleared of latex-containing items, and powdered gloves are avoided entirely. Holding areas may also need latex-safe precautions.

Question 13Preoperative Preparation

Which measure helps prevent venous thromboembolism in a high-risk patient during the preoperative period?

  1. Elevate the legs on a pillow only
  2. Wait until the patient is in the recovery room
  3. Apply sequential compression devices before induction Correct answer.
  4. Massage the calves during the case

Explanation

Sequential compression devices should be applied and functioning before anesthesia induction because venous stasis begins with immobility and muscle relaxation. They are combined with pharmacologic prophylaxis when indicated. Calf massage is not a substitute and may dislodge thrombus.

Question 14Preoperative Preparation

During preoperative verification, the technologist finds that the consent form lists a different procedure than the OR schedule. What is the best action?

  1. Proceed and clarify after induction
  2. Notify the surgeon and hold until resolved Correct answer.
  3. Ask the patient to sign a blank consent
  4. Change the schedule to match the consent

Explanation

A discrepancy between the consent, schedule, and patient understanding must be resolved by the surgeon before anesthesia. Proceeding could result in wrong-site or unauthorized surgery. The consent must reflect the actual planned procedure and be signed voluntarily.

Question 15Preoperative Preparation

An adult scheduled for elective surgery has an INR of 3.5. What should the technologist do?

  1. Repeat the test after premedication
  2. Document the result and continue preparation
  3. Give vitamin K from floor stock
  4. Notify the surgeon before the patient enters the OR Correct answer.

Explanation

An INR of 3.5 reflects impaired coagulation and a high bleeding risk, so the surgeon and anesthesia team must be informed before the case proceeds. Elective surgery is often postponed until the abnormality is corrected. The technologist does not administer reversal agents independently.

Question 16Preoperative Preparation

Which finding suggests that a mechanical bowel preparation has been effective?

  1. Clear yellow effluent Correct answer.
  2. Solid stool in the rectum
  3. No output at all
  4. Dark green liquid output

Explanation

A well-prepared colon produces clear or pale yellow effluent without solid matter. Retained stool increases contamination risk during colorectal surgery. Absence of output does not confirm adequate cleansing.

Question 17Preoperative Preparation

When moving a patient from the stretcher to the OR bed, the technologist should:

  1. Move the patient alone to save time
  2. Ask the patient to help move
  3. Use a transfer device and adequate staff Correct answer.
  4. Pull the patient by the shoulders

Explanation

Lateral transfer devices and enough personnel protect both the patient and staff from injury and maintain spinal alignment. Pulling by the shoulders can cause skin shear and musculoskeletal injury. An anesthetized or sedated patient cannot safely assist.

Question 18Preoperative Preparation

When positioning a patient supine with arms at the sides, which arm position is safest?

  1. Let arms hang off the table edges
  2. Tuck arms at the sides with palms toward the body Correct answer.
  3. Place arms above the head for access
  4. Abduct both arms to 120 degrees

Explanation

Arms tucked with palms facing the body reduce stretch on the brachial plexus. Abduction beyond 90 degrees, extreme extension, or letting arms hang off the table can cause nerve injury. Padding at the elbows and wrists protects pressure points.

Question 19Preoperative Preparation

To help prevent inadvertent perioperative hypothermia, the technologist should:

  1. Keep the room at 12°C
  2. Withhold warmed blankets until recovery
  3. Use only cotton drapes for insulation
  4. Apply an active warming device before induction Correct answer.

Explanation

Active warming before induction reduces the initial drop in core temperature caused by redistribution. Forced-air warming and warmed intravenous fluids are common measures. Cold rooms and passive cotton drapes alone promote heat loss.

Question 20Preoperative Preparation

Before transfusing packed red blood cells, the technologist should confirm that:

  1. The unit has been warmed to 40°C
  2. Two qualified staff verified the unit at the bedside Correct answer.
  3. The unit is compatible with lactated Ringer's
  4. The patient has signed a separate blood consent

Explanation

Bedside verification by two qualified staff confirms the patient identifiers, blood type, unit number, and expiration match. Blood is warmed only with a validated blood warmer when indicated. Lactated Ringer's is not given with blood because it contains calcium.

Question 21Preoperative Preparation

For a patient with known malignant hyperthermia susceptibility, which preparation is most important?

  1. Chill several bags of intravenous saline
  2. Place a tourniquet at the bedside
  3. Have a cooling blanket set to 4°C
  4. Confirm dantrolene is immediately available Correct answer.

Explanation

Dantrolene is the specific antidote for malignant hyperthermia and must be accessible before induction. A trigger-free anesthesia machine and monitoring for hypercarbia and temperature elevation are also prepared. Cooling measures support treatment but do not replace dantrolene.

Question 22Preoperative Preparation

An alcohol-based prep is used near the head and neck. Which action best reduces fire risk?

  1. Blot with a dry sponge and proceed
  2. Use electrosurgery only after 10 seconds
  3. Remove pooled solution and let the area dry fully Correct answer.
  4. Drape immediately to trap the vapors

Explanation

Alcohol vapors are flammable and can ignite with electrosurgery or cautery. Pooled solution must be removed from skin folds and the surrounding area, and the prep must dry completely. Ten seconds is not a validated drying time.

Question 23Preoperative Preparation

A patient with diabetes is scheduled as the first case of the day. The technologist should expect that the patient:

  1. Needs a glucose check only if symptoms appear
  2. Received the usual full insulin dose with breakfast
  3. Should skip all insulin until after surgery
  4. Will have glucose checked and a modified insulin dose Correct answer.

Explanation

Diabetic patients having surgery require perioperative glucose monitoring and an adjusted insulin regimen to avoid both hyperglycemia and hypoglycemia. The dose is individualized based on the type of diabetes and insulin. Omitting all insulin can cause hyperglycemia and ketoacidosis.

Question 24Preoperative Preparation

When should the surgical team perform the formal time-out?

  1. Before the incision with the full team present Correct answer.
  2. When the surgeon requests it
  3. Only for procedures involving implants
  4. After the patient is draped and positioned

Explanation

The time-out occurs before incision with all team members present and participating. The team confirms patient identity, procedure, site, consent, positioning, and imaging. It is required for all procedures, not only those with implants.

Question 25Preoperative Preparation

During a long procedure with major blood loss, the technologist should remind the team that prophylactic antibiotics may need to be:

  1. Held until the patient reaches recovery
  2. Stopped once the incision is closed
  3. Redosed according to half-life and blood loss Correct answer.
  4. Changed to a different class

Explanation

Intraoperative redosing is based on the antibiotic's half-life and the amount of blood lost or replaced. Adequate tissue levels must be maintained throughout the procedure. Stopping or switching agents without indication compromises prophylaxis.

Question 26Preoperative Preparation

According to standard preoperative fasting guidelines for healthy adults, clear liquids may be taken up until how long before induction of anesthesia?

  1. 4 hours
  2. 8 hours
  3. 2 hours Correct answer.
  4. 6 hours

Explanation

Clear liquids empty from the stomach rapidly, so standard guidelines allow them until 2 hours before anesthesia. Breast milk and light meals require longer intervals. The 2-hour rule applies to clear liquids only, not to solid food.

Question 27Preoperative Preparation

A patient arrives in the preoperative holding area wearing a metal necklace and earrings. What should the technologist do?

  1. Tape the necklace in place and leave the earrings in
  2. Remove only the earrings and document the necklace
  3. Remove them and secure them with family Correct answer.
  4. Allow the jewelry if it is covered by the surgical gown

Explanation

Metal jewelry can conduct electrical current from electrocautery and can cause pressure injury or loss. It should be removed and secured with family or placed in a valuables container according to facility policy. Covering jewelry does not eliminate the risks.

Question 28Preoperative Preparation

Who is responsible for obtaining informed consent for a surgical procedure?

  1. The anesthesia professional during the preop visit
  2. The circulating nurse after the patient arrives
  3. The surgical technologist during skin preparation
  4. The surgeon performing the procedure Correct answer.

Explanation

Informed consent requires a discussion of risks, benefits, and alternatives by the provider performing the procedure. The surgeon is responsible for that discussion and for obtaining consent. Other team members may witness or verify documentation but do not obtain surgical consent.

Question 29Preoperative Preparation

A patient scheduled for general anesthesia arrives with dentures. What is the appropriate preoperative action?

  1. Tape them in place during induction of anesthesia
  2. Remove only the lower denture before transport
  3. Leave them in place to maintain the patient's appearance
  4. Remove them and place them in a labeled container Correct answer.

Explanation

Dentures can obstruct the airway or be damaged during induction and airway management. They should be removed before anesthesia and stored in a labeled container. Leaving them in place or taping them is unsafe.

Question 30Preoperative Preparation

Which two identifiers are acceptable for preoperative patient verification?

  1. Room number and bed assignment
  2. Full name and date of birth Correct answer.
  3. Surgical procedure and surgeon name
  4. Age and admitting diagnosis

Explanation

Patient identity must be verified with two independent identifiers, commonly full name and date of birth. The identifiers must be directly confirmed with the patient or an identification band. Procedure names and room assignments are not patient identifiers.

Question 31Preoperative Preparation

A patient is instructed to shower with chlorhexidine gluconate the night before and the morning of surgery. What is the main purpose?

  1. Remove surgical site markings before surgery
  2. Reduce skin bacteria and infection risk Correct answer.
  3. Sterilize the skin so no prep is needed in the OR
  4. Prevent allergic reaction to preoperative antibiotics

Explanation

Chlorhexidine showers reduce the bacterial burden on the skin and help lower surgical site infection risk. They do not sterilize the skin, so a formal surgical prep is still required. They also do not affect antibiotic allergy risk.

Question 32Preoperative Preparation

Before entering the operating room, a patient wearing contact lenses should be instructed to:

  1. Remove the lenses and store them in a labeled case Correct answer.
  2. Remove them only if surgery is on the head or neck
  3. Keep them in to protect the cornea during surgery
  4. Rinse them with saline and reinsert after induction

Explanation

Contact lenses should be removed before surgery to prevent corneal injury and because the eyes may remain closed or be taped during the procedure. They should be stored safely and labeled. Reinsertion during induction is not appropriate.

Question 33Preoperative Preparation

Which document records a patient's preferences for future medical care if the patient becomes unable to communicate?

  1. Informed consent form
  2. Preoperative checklist
  3. Advance directive Correct answer.
  4. Operative report

Explanation

An advance directive states a patient's wishes for future medical care if the patient loses decision-making capacity. It may include a living will or durable power of attorney for health care. An operative report and consent form document different aspects of care.

Question 34Preoperative Preparation

A patient reports daily use of ginkgo biloba and is scheduled for a procedure with a high risk of bleeding. What should the technologist recognize?

  1. Ginkgo should be doubled on the morning of surgery
  2. It may increase bleeding and should be reviewed Correct answer.
  3. Ginkgo reliably reverses the effect of anticoagulant drugs
  4. Ginkgo has no known effect on bleeding or clotting

Explanation

Ginkgo biloba can inhibit platelet function and has been associated with increased bleeding risk. Its use should be reviewed with the surgeon and anesthesia team before surgery. It does not reverse anticoagulation and is not continued in increased doses.

Question 35Preoperative Preparation

A patient takes a beta blocker daily for angina. What is the usual perioperative management?

  1. Hold it on the morning of surgery
  2. Stop it one week before surgery
  3. Continue the beta blocker through surgery Correct answer.
  4. Replace it with a calcium channel blocker

Explanation

Beta blockers are generally continued perioperatively to avoid rebound tachycardia, hypertension, and myocardial ischemia. Abrupt withdrawal can be harmful. The surgical and anesthesia teams individualize the plan when needed.

Question 36Preoperative Preparation

A patient with obstructive sleep apnea uses CPAP at home. What should the technologist ensure before surgery?

  1. The CPAP device is available for postoperative use Correct answer.
  2. Sedatives are given to improve sleep quality
  3. The patient is scheduled as the last case of the day
  4. The patient is positioned prone during recovery

Explanation

Patients with obstructive sleep apnea are at risk for airway obstruction and respiratory depression after anesthesia. Their own CPAP device or an equivalent should be available for postoperative use. Sedatives can worsen obstruction and are not given to improve sleep quality.

Question 37Preoperative Preparation

For a female patient of childbearing age scheduled for elective surgery, which preoperative test is commonly required?

  1. Pregnancy test Correct answer.
  2. Bone density scan
  3. Genetic screening
  4. HIV viral load

Explanation

Pregnancy testing is commonly required before elective surgery in patients of childbearing age because anesthesia and surgery may affect the pregnancy. The result influences timing and anesthetic planning. Genetic screening and bone density scans are not routine preoperative tests.

Question 38Preoperative Preparation

A 4-year-old is scheduled for surgery. Which approach best supports preoperative preparation?

  1. Separate the child from the parent on arrival
  2. Avoid explaining the procedure to the child
  3. Obtain informed consent directly from the child
  4. Allow a parent to stay until induction Correct answer.

Explanation

Young children benefit from parental presence during induction to reduce anxiety and improve cooperation. Consent is obtained from a parent or guardian, not the child. Age-appropriate explanation can also reduce fear.

Question 39Preoperative Preparation

A patient who smokes asks how long before surgery to stop. Which timeframe is most associated with reduced pulmonary complications?

  1. The night before surgery
  2. One week before surgery
  3. At least 4 weeks before surgery Correct answer.
  4. Only on the day of surgery

Explanation

Stopping smoking at least 4 weeks before surgery is associated with fewer pulmonary complications. Longer abstinence is better, but even several weeks helps. Stopping only immediately before surgery may not provide the same benefit.

Question 40Preoperative Preparation

During preoperative skin assessment, the technologist notes a rash near the planned incision site. What is the best action?

  1. Mark the rash as the planned incision site
  2. Proceed and recheck the rash after induction
  3. Notify the surgeon and document it Correct answer.
  4. Apply the skin prep directly over the rash

Explanation

A rash near the incision site may indicate infection or another skin problem that affects surgical planning. It should be reported to the surgeon and documented. Skin prep should not be applied over an undiagnosed rash without evaluation.

Question 41Preoperative Preparation

An adult scheduled for elective surgery has a new fever, productive cough, and purulent sputum. What should the technologist expect?

  1. The surgery will proceed without any changes
  2. The surgery may be postponed after evaluation Correct answer.
  3. The patient will be transferred directly to the OR
  4. Only a preoperative antibiotic will be added

Explanation

These findings suggest an acute respiratory infection, which can increase anesthetic risk and postoperative complications. Elective surgery is often postponed until the patient is evaluated and improves. A new antibiotic alone does not make proceeding safe.

Question 42Preoperative Preparation

A patient with limited English proficiency needs preoperative education. Which action is best?

  1. Use gestures and written English instructions
  2. Ask a family member to interpret all details
  3. Use a qualified medical interpreter Correct answer.
  4. Skip education to avoid delaying the case

Explanation

A qualified medical interpreter ensures accurate communication and supports informed consent and patient safety. Family members may misinterpret or omit information and should not be used for complex medical discussions. Education should not be skipped.

Question 43Preoperative Preparation

A patient arrives with a wedding ring that cannot be removed. What should the technologist do?

  1. Leave it uncovered so the team can see it
  2. Send the patient home to remove the ring
  3. Cover the ring with tape and document it Correct answer.
  4. Cut the ring off without the patient's consent

Explanation

If a ring cannot be removed, it may be taped securely to reduce the risk of injury or electrical conduction, and the action should be documented. Cutting a ring requires consent and is not a first step. Uncovered metal poses a hazard.

Question 44Preoperative Preparation

A patient with diabetes has a preoperative blood glucose of 320 mg/dL and ketones in the urine. What should the technologist expect?

  1. The patient should fast for a longer period
  2. Oral hypoglycemics should be given immediately
  3. Surgery may be delayed for treatment Correct answer.
  4. Surgery will proceed because glucose is below 400

Explanation

Hyperglycemia with ketones suggests poor diabetic control and possible ketoacidosis, which increases surgical risk. Surgery is often delayed for treatment and stabilization. Additional fasting or oral agents alone is not appropriate management.

Question 45Preoperative Preparation

An anxious patient asks repeated questions before surgery. Which response is best?

  1. Ignore the questions to avoid delaying the case
  2. Tell the patient to stop worrying about surgery
  3. Answer calmly and clarify remaining questions Correct answer.
  4. Give detailed surgical instructions beyond your role

Explanation

Anxiety is common before surgery, and calm, honest clarification can reduce distress. The technologist should answer within scope and refer medical questions to the appropriate provider. Dismissing or ignoring the patient increases anxiety.

Question 46Preoperative Preparation

A patient with a do-not-resuscitate order is scheduled for surgery requiring general anesthesia. What is the most appropriate preoperative action?

  1. Cancel the surgery automatically
  2. Honor the order unchanged in the operating room
  3. Review the order with the patient and team Correct answer.
  4. Suspend the order without discussion

Explanation

A do-not-resuscitate order requires individualized review before surgery because anesthesia and surgery alter resuscitation needs. The patient, surgeon, and anesthesia team should discuss the plan and document any modifications. Automatically canceling or suspending the order without discussion is inappropriate.

Question 47Preoperative Preparation

A Jehovah's Witness patient requests bloodless surgery. Which preoperative action is most important?

  1. Document the patient's specific transfusion preferences Correct answer.
  2. Assume all blood products, including albumin, are refused
  3. Transfuse blood if the hemoglobin falls below 7 g/dL
  4. Cancel every elective procedure for this patient

Explanation

Jehovah's Witness patients may accept or refuse different blood products, so their specific preferences must be documented and communicated. Assumptions can lead to inappropriate care. The surgical plan should respect the patient's documented wishes.

Question 48Preoperative Preparation

A patient with chronic adrenal insufficiency takes prednisone daily. Which preoperative preparation is most important?

  1. Withhold all steroids until after surgery
  2. Give potassium-sparing diuretics before surgery
  3. Give stress-dose corticosteroids as ordered Correct answer.
  4. Stop prednisone abruptly before surgery

Explanation

Patients with adrenal insufficiency cannot mount a normal stress response and may need stress-dose corticosteroids during surgery. Steroids should not be stopped abruptly. The dose and route are ordered by the managing team.

Question 49Preoperative Preparation

A patient reports prolonged paralysis after a previous surgery with succinylcholine. Which preoperative concern is most important?

  1. Possible pseudocholinesterase deficiency Correct answer.
  2. A severe latex allergy
  3. Heparin-induced thrombocytopenia with thrombosis
  4. Susceptibility to malignant hyperthermia

Explanation

Prolonged paralysis after succinylcholine suggests pseudocholinesterase deficiency, which slows metabolism of the drug. This history should be communicated so the anesthetic plan can avoid or adjust triggering agents. Malignant hyperthermia and latex allergy have different clinical presentations.

Question 50Preoperative Preparation

A patient with acute intermittent porphyria is scheduled for surgery. Which class of drugs should be avoided preoperatively?

  1. Crystalloid fluids
  2. Opioid analgesics
  3. Beta blockers
  4. Barbiturates Correct answer.

Explanation

Barbiturates are porphyrinogenic and can precipitate an acute porphyria attack. Preoperative medications should be reviewed for safety in porphyria. Beta blockers, opioids, and crystalloid fluids are not classic triggering agents in the same way.