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HESI Attempt 2 Nursing Care Interventions: Postoperative Management Exam — Complete
Practice Questions & Detailed Rationales (Verified Update!!!!! 2026–2027 Edition)
Instructions: This comprehensive practice exam bank covers all core domains
tested on the HESI Postoperative Management exam. Each question includes four
answer choices, the correct answer, and a detailed rationale. Content is aligned
with the 2026–2027 HESI exit exam blueprint and current evidence-based
postoperative nursing standards.
Exam Blueprint:
✓ Content Area
✓ Immediate Postoperative Care (PACU)
✓ Pain Management
✓ Respiratory Complications
✓ Cardiovascular Complications
✓ Wound Complications
✓ Gastrointestinal Complications
✓ Genitourinary Complications
✓ VTE Prophylaxis & Complications
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✓ Content Area
✓ Surgery-Specific Care
✓ Discharge Teaching
SECTION 1: Immediate Postoperative Care — PACU (Questions)
1. A patient in the post-anesthesia care unit (PACU) is difficult
to arouse and has a respiratory rate of 8 breaths per minute.
What is the nurse's priority action?
A. Continue to monitor every 15 minutes
B. Raise the head of the bed
C. Stimulate the patient to breathe and notify the provider
D. Begin discharge instructions
Answer: C.
Rationale: Respiratory depression is a serious complication of
anesthesia or opioid use. Prompt stimulation and escalation are
required. Continuing to monitor (A) delays necessary
intervention, raising the head of the bed (B) does not address
the respiratory depression, and discharge instructions (D) are
inappropriate for an unstable patient.
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2. What is the most critical assessment during the first hour of
postoperative care?
A. Nausea and appetite
B. Vital signs and airway patency
C. Bowel sounds
D. Skin turgor
Answer: B.
Rationale: Airway, breathing, and circulation (ABCs) are top
priorities in early postoperative care to detect complications like
hypoxia or bleeding. Nausea (A), bowel sounds (C), and skin
turgor (D) are secondary assessments.
3. A nurse is caring for a client who is 2 hours postoperative
following a total hip arthroplasty. Which of the following
findings should the nurse report to the provider immediately?
A. The client reports pain at the incision site rated 6/10.
B. The client's affected leg is shortened and externally rotated.
C. The client has a urine output of 25 mL/hr.
D. The client's dressing has a small amount of serosanguinous
drainage.
Answer: B.
Rationale: A shortened and externally rotated leg is a classic
sign of hip prosthesis dislocation, which is an orthopedic
emergency requiring immediate provider notification. Pain at
the incision site (A), low urine output (C), and small amounts of
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serosanguinous drainage (D) are expected postoperative
findings that require monitoring but are not immediate
emergencies.
4. A nurse notes that a patient's surgical dressing has
saturated with blood 30 minutes after arrival to the PACU.
What should the nurse do first?
A. Remove the dressing
B. Apply pressure and notify the surgeon
C. Change the dressing
D. Increase the IV fluid rate
Answer: B.
Rationale: Saturated dressings may indicate hemorrhage.
Applying pressure and promptly notifying the surgeon are
critical steps. Removing the dressing (A) may disrupt clot
formation, changing the dressing (C) without provider
notification delays definitive management, and increasing IV
fluids (D) requires a provider order.
5. What is a common early sign of hypovolemic shock in a
postoperative patient?
A. Fever and chills
B. Hypertension and bounding pulse
C. Restlessness and tachycardia
D. Decreased respiratory rate
HESI Attempt 2 Nursing Care Interventions: Postoperative Management Exam — Complete
Practice Questions & Detailed Rationales (Verified Update!!!!! 2026–2027 Edition)
Instructions: This comprehensive practice exam bank covers all core domains
tested on the HESI Postoperative Management exam. Each question includes four
answer choices, the correct answer, and a detailed rationale. Content is aligned
with the 2026–2027 HESI exit exam blueprint and current evidence-based
postoperative nursing standards.
Exam Blueprint:
✓ Content Area
✓ Immediate Postoperative Care (PACU)
✓ Pain Management
✓ Respiratory Complications
✓ Cardiovascular Complications
✓ Wound Complications
✓ Gastrointestinal Complications
✓ Genitourinary Complications
✓ VTE Prophylaxis & Complications
, Page |2
✓ Content Area
✓ Surgery-Specific Care
✓ Discharge Teaching
SECTION 1: Immediate Postoperative Care — PACU (Questions)
1. A patient in the post-anesthesia care unit (PACU) is difficult
to arouse and has a respiratory rate of 8 breaths per minute.
What is the nurse's priority action?
A. Continue to monitor every 15 minutes
B. Raise the head of the bed
C. Stimulate the patient to breathe and notify the provider
D. Begin discharge instructions
Answer: C.
Rationale: Respiratory depression is a serious complication of
anesthesia or opioid use. Prompt stimulation and escalation are
required. Continuing to monitor (A) delays necessary
intervention, raising the head of the bed (B) does not address
the respiratory depression, and discharge instructions (D) are
inappropriate for an unstable patient.
, Page |3
2. What is the most critical assessment during the first hour of
postoperative care?
A. Nausea and appetite
B. Vital signs and airway patency
C. Bowel sounds
D. Skin turgor
Answer: B.
Rationale: Airway, breathing, and circulation (ABCs) are top
priorities in early postoperative care to detect complications like
hypoxia or bleeding. Nausea (A), bowel sounds (C), and skin
turgor (D) are secondary assessments.
3. A nurse is caring for a client who is 2 hours postoperative
following a total hip arthroplasty. Which of the following
findings should the nurse report to the provider immediately?
A. The client reports pain at the incision site rated 6/10.
B. The client's affected leg is shortened and externally rotated.
C. The client has a urine output of 25 mL/hr.
D. The client's dressing has a small amount of serosanguinous
drainage.
Answer: B.
Rationale: A shortened and externally rotated leg is a classic
sign of hip prosthesis dislocation, which is an orthopedic
emergency requiring immediate provider notification. Pain at
the incision site (A), low urine output (C), and small amounts of
, Page |4
serosanguinous drainage (D) are expected postoperative
findings that require monitoring but are not immediate
emergencies.
4. A nurse notes that a patient's surgical dressing has
saturated with blood 30 minutes after arrival to the PACU.
What should the nurse do first?
A. Remove the dressing
B. Apply pressure and notify the surgeon
C. Change the dressing
D. Increase the IV fluid rate
Answer: B.
Rationale: Saturated dressings may indicate hemorrhage.
Applying pressure and promptly notifying the surgeon are
critical steps. Removing the dressing (A) may disrupt clot
formation, changing the dressing (C) without provider
notification delays definitive management, and increasing IV
fluids (D) requires a provider order.
5. What is a common early sign of hypovolemic shock in a
postoperative patient?
A. Fever and chills
B. Hypertension and bounding pulse
C. Restlessness and tachycardia
D. Decreased respiratory rate
