LATEST NR 324 ADULT HEALTH I:
POSTOPERATIVE COMPLICATIONS EXAM|
COMPLETE QUESTION BANK WITH
CORRECT ANSWERS WITH RATIONALES
1. A 68-year-old patient is 24 hours post-operative
following a total hip replacement. The patient
suddenly develops shortness of breath, chest pain,
and is diaphoretic. The patient's oxygen saturation is
88% on room air, and heart rate is 120 bpm. What is
the most likely diagnosis?
A) Atelectasis
B) Pulmonary embolism
C) Pneumonia
D) Myocardial infarction
Answer: B
Rationale: The sudden onset of shortness of breath,
chest pain, hypoxia, and tachycardia in a post-
operative patient is classic for a pulmonary
embolism, especially following orthopedic surgery.
2. A patient is 48 hours post-operative following an
abdominal hysterectomy. The patient reports nausea,
,vomiting, and abdominal distension. Bowel sounds
are absent. What is the most likely diagnosis?
A) Paralytic ileus
B) Small bowel obstruction
C) Gastroenteritis
D) Constipation
Answer: A
Rationale: Paralytic ileus is a common postoperative
complication characterized by the absence of bowel
sounds, nausea, vomiting, and abdominal distension
due to decreased gastrointestinal motility.
3. A patient is 3 days post-operative following a colon
resection. The patient's wound edges are separated,
and the wound is draining purulent material. The
patient has a fever of 101.5°F. What is the most likely
diagnosis?
A) Wound dehiscence
B) Wound evisceration
C) Surgical site infection
D) Seroma
Answer: C
,Rationale: A surgical site infection is characterized
by purulent drainage, fever, and wound separation.
The presence of purulent material indicates infection.
4. A patient is 5 days post-operative following a
coronary artery bypass grafting (CABG). The patient
reports sudden, sharp chest pain that is worse with
inspiration. On examination, the patient has a
pericardial friction rub. What is the most likely
diagnosis?
A) Myocardial infarction
B) Pleuritis
C) Postpericardiotomy syndrome
D) Pulmonary embolism
Answer: C
Rationale: Postpericardiotomy syndrome is a
complication of cardiac surgery characterized by
chest pain, fever, and a pericardial friction rub due to
inflammation of the pericardium.
5. A patient is 12 hours post-operative following a
laparoscopic cholecystectomy. The patient reports
severe right shoulder pain. What is the most likely
cause of this pain?
, A) Referred pain from the surgical site
B) Pneumoperitoneum
C) Myocardial infarction
D) Pulmonary embolism
Answer: B
Rationale: Right shoulder pain after laparoscopic
surgery is common due to diaphragmatic irritation
from carbon dioxide gas used during insufflation
(pneumoperitoneum).
6. A patient is 2 days post-operative following a total
knee arthroplasty. The patient reports calf pain and
swelling in the operative leg. On examination, the calf
is tender and erythematous. What is the most
important diagnostic test to order?
A) D-dimer
B) Lower extremity venous duplex ultrasound
C) CT pulmonary angiogram
D) Venography
Answer: B
Rationale: Calf pain, swelling, and erythema in a post-
operative patient are concerning for deep vein
thrombosis (DVT). A lower extremity venous duplex
POSTOPERATIVE COMPLICATIONS EXAM|
COMPLETE QUESTION BANK WITH
CORRECT ANSWERS WITH RATIONALES
1. A 68-year-old patient is 24 hours post-operative
following a total hip replacement. The patient
suddenly develops shortness of breath, chest pain,
and is diaphoretic. The patient's oxygen saturation is
88% on room air, and heart rate is 120 bpm. What is
the most likely diagnosis?
A) Atelectasis
B) Pulmonary embolism
C) Pneumonia
D) Myocardial infarction
Answer: B
Rationale: The sudden onset of shortness of breath,
chest pain, hypoxia, and tachycardia in a post-
operative patient is classic for a pulmonary
embolism, especially following orthopedic surgery.
2. A patient is 48 hours post-operative following an
abdominal hysterectomy. The patient reports nausea,
,vomiting, and abdominal distension. Bowel sounds
are absent. What is the most likely diagnosis?
A) Paralytic ileus
B) Small bowel obstruction
C) Gastroenteritis
D) Constipation
Answer: A
Rationale: Paralytic ileus is a common postoperative
complication characterized by the absence of bowel
sounds, nausea, vomiting, and abdominal distension
due to decreased gastrointestinal motility.
3. A patient is 3 days post-operative following a colon
resection. The patient's wound edges are separated,
and the wound is draining purulent material. The
patient has a fever of 101.5°F. What is the most likely
diagnosis?
A) Wound dehiscence
B) Wound evisceration
C) Surgical site infection
D) Seroma
Answer: C
,Rationale: A surgical site infection is characterized
by purulent drainage, fever, and wound separation.
The presence of purulent material indicates infection.
4. A patient is 5 days post-operative following a
coronary artery bypass grafting (CABG). The patient
reports sudden, sharp chest pain that is worse with
inspiration. On examination, the patient has a
pericardial friction rub. What is the most likely
diagnosis?
A) Myocardial infarction
B) Pleuritis
C) Postpericardiotomy syndrome
D) Pulmonary embolism
Answer: C
Rationale: Postpericardiotomy syndrome is a
complication of cardiac surgery characterized by
chest pain, fever, and a pericardial friction rub due to
inflammation of the pericardium.
5. A patient is 12 hours post-operative following a
laparoscopic cholecystectomy. The patient reports
severe right shoulder pain. What is the most likely
cause of this pain?
, A) Referred pain from the surgical site
B) Pneumoperitoneum
C) Myocardial infarction
D) Pulmonary embolism
Answer: B
Rationale: Right shoulder pain after laparoscopic
surgery is common due to diaphragmatic irritation
from carbon dioxide gas used during insufflation
(pneumoperitoneum).
6. A patient is 2 days post-operative following a total
knee arthroplasty. The patient reports calf pain and
swelling in the operative leg. On examination, the calf
is tender and erythematous. What is the most
important diagnostic test to order?
A) D-dimer
B) Lower extremity venous duplex ultrasound
C) CT pulmonary angiogram
D) Venography
Answer: B
Rationale: Calf pain, swelling, and erythema in a post-
operative patient are concerning for deep vein
thrombosis (DVT). A lower extremity venous duplex
