Below are 200 covering key topics for NUR 265 Exam 2: Perioperative Care, Shock,
Sepsis, Burns, and related medical-surgical concepts.
Perioperative & Postoperative Care
1. A patient is 2 hours post-op from abdominal surgery. Which finding requires
immediate notification of the surgeon?
A) Pain rated 5/10
B) Heart rate 110 bpm, BP 88/50
C) Urine output 40 mL/hr
D) Temperature 99.8°F (37.7°C)
Answer: B
Tachycardia with hypotension in the immediate post-op period suggests hypovolemia or
hemorrhage until proven otherwise. This requires immediate surgical notification .
2. A patient received general anesthesia. The nurse's priority in the immediate
post-op period is:
A) Pain management
B) Airway patency
C) Wound assessment
D) Fluid replacement
,Answer: B
Airway is always the first priority in the immediate post-operative period, as anesthesia
can cause airway obstruction and respiratory depression .
3. Which assessment finding indicates malignant hyperthermia?
A) Hypothermia and bradycardia
B) Muscle rigidity and hyperthermia
C) Hypotension and polyuria
D) Respiratory depression and miosis
Answer: B
Malignant hyperthermia is a life-threatening reaction to volatile anesthetics or
succinylcholine, characterized by muscle rigidity, hyperthermia, tachycardia, and
tachypnea .
4. A patient post-op has a Jackson-Pratt drain with 150 mL of bright red blood in 1
hour. What should the nurse do first?
A) Document as normal
B) Empty the drain
C) Notify the provider
D) Increase IV fluids
Answer: C
Output greater than 100 mL/hr of bright red blood from a surgical drain indicates active
hemorrhage. The provider must be notified immediately .
5. A patient post-op from a thyroidectomy reports tingling around the mouth and
muscle twitching. The nurse should prepare to administer:
A) Calcium gluconate
B) Levothyroxine
,C) Potassium chloride
D) Magnesium sulfate
Answer: A
Tetany (tingling, twitching) after thyroidectomy indicates hypocalcemia from accidental
parathyroid injury or removal. IV calcium gluconate is the treatment .
6. Which medication is given to reverse the effects of neuromuscular blockers?
A) Naloxone
B) Neostigmine
C) Flumazenil
D) Protamine sulfate
Answer: B
Neostigmine, an acetylcholinesterase inhibitor, is given with glycopyrrolate to reverse the
effects of non-depolarizing neuromuscular blockers .
7. A patient post-op has an order for enoxaparin (Lovenox). The nurse knows this
is given to:
A) Treat pain
B) Prevent DVT
C) Induce sedation
D) Control nausea
Answer: B
Enoxaparin is a low-molecular-weight heparin (LMWH) used for venous thromboembolism
(VTE) prophylaxis, including deep vein thrombosis (DVT) prevention after surgery .
8. A patient 6 hours post-op has not voided and reports bladder fullness. The
nurse percusses dullness over the bladder. What is the priority action?
, A) Encourage oral fluids
B) Perform a straight catheterization
C) Apply a warm compress to the perineum
D) Document as normal for 6 hours post-op
Answer: B
Bladder distention with inability to void 6 hours post-op indicates urinary retention.
Straight catheterization provides immediate relief and prevents bladder injury .
9. A patient post-op from a bowel resection has a nasogastric (NG) tube to low
intermittent suction. Which finding indicates the tube is functioning correctly?
A) Nausea and vomiting
B) Abdominal distention
C) Output of 800 mL green fluid in 8 hours
D) No bowel sounds
Answer: C
Green bilious drainage is expected from an NG tube post-abdominal surgery. Lack of
output or sudden cessation may indicate tube obstruction .
10. The nurse assesses a patient's surgical incision on post-op day 3. Which finding
requires immediate intervention?
A) Mild erythema at incision edges
B) Temperature 99.2°F (37.3°C)
C) Purulent drainage from incision
D) Pain rated 4/10 at incision site
Answer: C
Purulent (pus-like) drainage indicates wound infection, which requires prompt
intervention. Mild erythema and low-grade fever can be expected inflammatory
responses .
Sepsis, Burns, and related medical-surgical concepts.
Perioperative & Postoperative Care
1. A patient is 2 hours post-op from abdominal surgery. Which finding requires
immediate notification of the surgeon?
A) Pain rated 5/10
B) Heart rate 110 bpm, BP 88/50
C) Urine output 40 mL/hr
D) Temperature 99.8°F (37.7°C)
Answer: B
Tachycardia with hypotension in the immediate post-op period suggests hypovolemia or
hemorrhage until proven otherwise. This requires immediate surgical notification .
2. A patient received general anesthesia. The nurse's priority in the immediate
post-op period is:
A) Pain management
B) Airway patency
C) Wound assessment
D) Fluid replacement
,Answer: B
Airway is always the first priority in the immediate post-operative period, as anesthesia
can cause airway obstruction and respiratory depression .
3. Which assessment finding indicates malignant hyperthermia?
A) Hypothermia and bradycardia
B) Muscle rigidity and hyperthermia
C) Hypotension and polyuria
D) Respiratory depression and miosis
Answer: B
Malignant hyperthermia is a life-threatening reaction to volatile anesthetics or
succinylcholine, characterized by muscle rigidity, hyperthermia, tachycardia, and
tachypnea .
4. A patient post-op has a Jackson-Pratt drain with 150 mL of bright red blood in 1
hour. What should the nurse do first?
A) Document as normal
B) Empty the drain
C) Notify the provider
D) Increase IV fluids
Answer: C
Output greater than 100 mL/hr of bright red blood from a surgical drain indicates active
hemorrhage. The provider must be notified immediately .
5. A patient post-op from a thyroidectomy reports tingling around the mouth and
muscle twitching. The nurse should prepare to administer:
A) Calcium gluconate
B) Levothyroxine
,C) Potassium chloride
D) Magnesium sulfate
Answer: A
Tetany (tingling, twitching) after thyroidectomy indicates hypocalcemia from accidental
parathyroid injury or removal. IV calcium gluconate is the treatment .
6. Which medication is given to reverse the effects of neuromuscular blockers?
A) Naloxone
B) Neostigmine
C) Flumazenil
D) Protamine sulfate
Answer: B
Neostigmine, an acetylcholinesterase inhibitor, is given with glycopyrrolate to reverse the
effects of non-depolarizing neuromuscular blockers .
7. A patient post-op has an order for enoxaparin (Lovenox). The nurse knows this
is given to:
A) Treat pain
B) Prevent DVT
C) Induce sedation
D) Control nausea
Answer: B
Enoxaparin is a low-molecular-weight heparin (LMWH) used for venous thromboembolism
(VTE) prophylaxis, including deep vein thrombosis (DVT) prevention after surgery .
8. A patient 6 hours post-op has not voided and reports bladder fullness. The
nurse percusses dullness over the bladder. What is the priority action?
, A) Encourage oral fluids
B) Perform a straight catheterization
C) Apply a warm compress to the perineum
D) Document as normal for 6 hours post-op
Answer: B
Bladder distention with inability to void 6 hours post-op indicates urinary retention.
Straight catheterization provides immediate relief and prevents bladder injury .
9. A patient post-op from a bowel resection has a nasogastric (NG) tube to low
intermittent suction. Which finding indicates the tube is functioning correctly?
A) Nausea and vomiting
B) Abdominal distention
C) Output of 800 mL green fluid in 8 hours
D) No bowel sounds
Answer: C
Green bilious drainage is expected from an NG tube post-abdominal surgery. Lack of
output or sudden cessation may indicate tube obstruction .
10. The nurse assesses a patient's surgical incision on post-op day 3. Which finding
requires immediate intervention?
A) Mild erythema at incision edges
B) Temperature 99.2°F (37.3°C)
C) Purulent drainage from incision
D) Pain rated 4/10 at incision site
Answer: C
Purulent (pus-like) drainage indicates wound infection, which requires prompt
intervention. Mild erythema and low-grade fever can be expected inflammatory
responses .
