MEDICAL-SURGICAL NURSING: CONCEPTS AND
PRACTICE, 6TH EDITION — POST-OPERATIVE AND
CRITICAL RECOVERY ACTUAL EXAM [QUESTION 1- 200]
AND ANSWERS UPDATED 2026/2027| 100%
VERIFIED|DETAILED RATIONALES –PASS GUARANTEED
A+ GRADED |INSTANT DOWNLOAD
Core Domains Tested in Medical-Surgical Nursing: Post-
Operative and Critical Recovery
Immediate postoperative assessment and stabilization
Airway, breathing, and oxygenation
Hemodynamic and cardiovascular monitoring
Fluid, electrolyte, and acid-base management
Postoperative pain and multimodal analgesia
Surgical wound and infection management
Hemorrhage and postoperative shock
Gastrointestinal and genitourinary recovery
Mobility, thromboembolism prevention, and pressure-injury prevention
Recognition and management of postoperative complications
Content Area Table
% of
Approx. # of
Content Domain Practice Key Topics Covered
Questions
Bank
Immediate postoperative PACU assessment, airway,
15% 30
assessment vital signs, neurologic status
Atelectasis, hypoxemia,
Respiratory complications 15% 30 aspiration, respiratory
depression
Cardiovascular/hemodynamic Hemorrhage, shock,
15% 30
complications hypotension, dysrhythmias
IV therapy, electrolyte
Fluids and electrolytes 10% 20
imbalance, fluid shifts
Opioids, multimodal
Pain management 10% 20 analgesia, assessment and
reassessment
, % of
Approx. # of
Content Domain Practice Key Topics Covered
Questions
Bank
Incisions, drains, surgical-site
Wound/infection management 10% 20
infection, sepsis
Ileus, nausea, urinary
GI/GU recovery 10% 20
retention, bowel function
Early ambulation, DVT, PE,
Mobility/VTE prevention 10% 20
prophylaxis
Rapid clinical deterioration,
Critical postoperative deterioration 5% 10
prioritization, escalation
QUESTIONS 1–200
Q1: A patient is transferred to the PACU after abdominal surgery under general
anesthesia. The patient is difficult to arouse, has snoring respirations, and an oxygen
saturation of 86% despite oxygen at 4 L/min by nasal cannula. Which action should the
nurse take first?
A) Administer the prescribed opioid reversal medication
B) Reposition the patient's airway and assess airway patency
C) Obtain a postoperative chest radiograph
D) Increase oxygen flow to 10 L/min
Correct Answer: B
Rationale: Airway obstruction is the immediate priority. Snoring respirations and decreased
oxygen saturation in a recently anesthetized patient strongly suggest partial upper-airway
obstruction caused by decreased pharyngeal muscle tone. The nurse should first reposition the
airway, such as with a head-tilt/chin-lift when appropriate, and assess whether airflow improves.
Naloxone may be necessary if opioid-induced respiratory depression is present, but the airway
should first be assessed and supported. A chest radiograph does not address the immediate
threat, and simply increasing oxygen without correcting obstruction may delay definitive
intervention.
Q2: A patient is 2 hours postoperative following bowel surgery. The nurse notes a
respiratory rate of 8/min, pinpoint pupils, oxygen saturation of 89%, and increasing
somnolence after receiving IV morphine. Which intervention is the priority?
A) Encourage the patient to cough and deep breathe
B) Support ventilation and prepare to administer naloxone as prescribed
C) Place the patient in Trendelenburg position
D) Administer another dose of prescribed analgesic
,Correct Answer: B
Rationale: The combination of profound sedation, bradypnea, hypoxemia, and pinpoint pupils is
consistent with opioid-induced respiratory depression. The immediate priorities are airway and
ventilation support, followed by administration of naloxone according to the
prescription/protocol. Coughing and deep breathing are inappropriate while the patient cannot
maintain adequate ventilation. Trendelenburg does not correct opioid respiratory depression
and may impair breathing. Additional opioid administration could worsen the condition.
Q3: A patient recovering from abdominal surgery suddenly becomes restless and reports
difficulty breathing. Oxygen saturation falls from 97% to 88%, and the respiratory rate
increases from 18/min to 30/min. Which finding requires the nurse's immediate attention?
A) Mild incisional pain
B) Temperature of 37.6°C (99.7°F)
C) Acute change in oxygen saturation and respiratory rate
D) Decreased appetite
Correct Answer: C
Rationale: An acute decline in oxygen saturation accompanied by tachypnea indicates possible
respiratory compromise. Causes may include atelectasis, aspiration, pulmonary edema,
pulmonary embolism, or other acute pulmonary problems. The nurse should immediately assess
airway and breathing and escalate care as indicated. Mild pain, a minimally elevated
postoperative temperature, and poor appetite are lower priorities in this clinical situation.
Q4: A patient is postoperative day 1 after upper-abdominal surgery. The patient has
shallow respirations, diminished breath sounds at the bases, and an oxygen saturation of
92% on room air. Which intervention is most appropriate?
A) Maintain strict bed rest
B) Encourage incentive spirometry and early mobilization
C) Restrict oral fluids
D) Administer a sedative before ambulation
Correct Answer: B
Rationale: Upper-abdominal surgery, pain, anesthesia, and immobility increase the risk of
atelectasis. Incentive spirometry, adequate pain control, coughing and deep breathing,
repositioning, and early ambulation promote lung expansion. Bed rest increases pulmonary
complication risk. Fluid restriction is not routinely indicated for uncomplicated postoperative
atelectasis, and sedatives can further depress respiratory function.
, Q5: A patient 6 hours after surgery becomes pale, cool, and anxious. Blood pressure
decreases from 124/76 mm Hg to 92/58 mm Hg, heart rate increases from 88/min to
124/min, and urine output is 15 mL during the previous hour. Which complication should
the nurse suspect first?
A) Urinary tract infection
B) Atelectasis
C) Hypovolemia from postoperative blood loss
D) Medication-related constipation
Correct Answer: C
Rationale: Tachycardia, hypotension, pallor, cool skin, anxiety, and declining urine output are
concerning for inadequate circulating volume. In the immediate postoperative period, occult
hemorrhage must be considered. The nurse should rapidly assess the surgical site, drains,
dressings, abdominal findings, and other sources of blood loss while escalating care. Atelectasis
does not explain the hemodynamic pattern, and constipation or urinary infection would not
produce this acute circulatory deterioration.
Q6: A patient who underwent hip surgery reports sudden pleuritic chest pain and
shortness of breath. The respiratory rate is 32/min and oxygen saturation is 86%. Which
action is most appropriate?
A) Encourage ambulation to improve circulation
B) Apply oxygen and immediately activate the appropriate emergency response
C) Massage the affected leg
D) Offer oral fluids
Correct Answer: B
Rationale: Sudden dyspnea, pleuritic chest pain, and hypoxemia following orthopedic surgery
are concerning for pulmonary embolism. The patient requires immediate oxygenation and urgent
clinical evaluation. Ambulation could worsen the patient's condition, and massaging a
potentially thrombosed extremity could theoretically dislodge thrombotic material. Oral fluids
do not address the immediate respiratory emergency.
Q7: A postoperative patient has a urinary catheter that has produced only 10 mL of urine
during the past hour. The patient's blood pressure is 88/54 mm Hg and heart rate is
118/min. Which interpretation is most appropriate?
PRACTICE, 6TH EDITION — POST-OPERATIVE AND
CRITICAL RECOVERY ACTUAL EXAM [QUESTION 1- 200]
AND ANSWERS UPDATED 2026/2027| 100%
VERIFIED|DETAILED RATIONALES –PASS GUARANTEED
A+ GRADED |INSTANT DOWNLOAD
Core Domains Tested in Medical-Surgical Nursing: Post-
Operative and Critical Recovery
Immediate postoperative assessment and stabilization
Airway, breathing, and oxygenation
Hemodynamic and cardiovascular monitoring
Fluid, electrolyte, and acid-base management
Postoperative pain and multimodal analgesia
Surgical wound and infection management
Hemorrhage and postoperative shock
Gastrointestinal and genitourinary recovery
Mobility, thromboembolism prevention, and pressure-injury prevention
Recognition and management of postoperative complications
Content Area Table
% of
Approx. # of
Content Domain Practice Key Topics Covered
Questions
Bank
Immediate postoperative PACU assessment, airway,
15% 30
assessment vital signs, neurologic status
Atelectasis, hypoxemia,
Respiratory complications 15% 30 aspiration, respiratory
depression
Cardiovascular/hemodynamic Hemorrhage, shock,
15% 30
complications hypotension, dysrhythmias
IV therapy, electrolyte
Fluids and electrolytes 10% 20
imbalance, fluid shifts
Opioids, multimodal
Pain management 10% 20 analgesia, assessment and
reassessment
, % of
Approx. # of
Content Domain Practice Key Topics Covered
Questions
Bank
Incisions, drains, surgical-site
Wound/infection management 10% 20
infection, sepsis
Ileus, nausea, urinary
GI/GU recovery 10% 20
retention, bowel function
Early ambulation, DVT, PE,
Mobility/VTE prevention 10% 20
prophylaxis
Rapid clinical deterioration,
Critical postoperative deterioration 5% 10
prioritization, escalation
QUESTIONS 1–200
Q1: A patient is transferred to the PACU after abdominal surgery under general
anesthesia. The patient is difficult to arouse, has snoring respirations, and an oxygen
saturation of 86% despite oxygen at 4 L/min by nasal cannula. Which action should the
nurse take first?
A) Administer the prescribed opioid reversal medication
B) Reposition the patient's airway and assess airway patency
C) Obtain a postoperative chest radiograph
D) Increase oxygen flow to 10 L/min
Correct Answer: B
Rationale: Airway obstruction is the immediate priority. Snoring respirations and decreased
oxygen saturation in a recently anesthetized patient strongly suggest partial upper-airway
obstruction caused by decreased pharyngeal muscle tone. The nurse should first reposition the
airway, such as with a head-tilt/chin-lift when appropriate, and assess whether airflow improves.
Naloxone may be necessary if opioid-induced respiratory depression is present, but the airway
should first be assessed and supported. A chest radiograph does not address the immediate
threat, and simply increasing oxygen without correcting obstruction may delay definitive
intervention.
Q2: A patient is 2 hours postoperative following bowel surgery. The nurse notes a
respiratory rate of 8/min, pinpoint pupils, oxygen saturation of 89%, and increasing
somnolence after receiving IV morphine. Which intervention is the priority?
A) Encourage the patient to cough and deep breathe
B) Support ventilation and prepare to administer naloxone as prescribed
C) Place the patient in Trendelenburg position
D) Administer another dose of prescribed analgesic
,Correct Answer: B
Rationale: The combination of profound sedation, bradypnea, hypoxemia, and pinpoint pupils is
consistent with opioid-induced respiratory depression. The immediate priorities are airway and
ventilation support, followed by administration of naloxone according to the
prescription/protocol. Coughing and deep breathing are inappropriate while the patient cannot
maintain adequate ventilation. Trendelenburg does not correct opioid respiratory depression
and may impair breathing. Additional opioid administration could worsen the condition.
Q3: A patient recovering from abdominal surgery suddenly becomes restless and reports
difficulty breathing. Oxygen saturation falls from 97% to 88%, and the respiratory rate
increases from 18/min to 30/min. Which finding requires the nurse's immediate attention?
A) Mild incisional pain
B) Temperature of 37.6°C (99.7°F)
C) Acute change in oxygen saturation and respiratory rate
D) Decreased appetite
Correct Answer: C
Rationale: An acute decline in oxygen saturation accompanied by tachypnea indicates possible
respiratory compromise. Causes may include atelectasis, aspiration, pulmonary edema,
pulmonary embolism, or other acute pulmonary problems. The nurse should immediately assess
airway and breathing and escalate care as indicated. Mild pain, a minimally elevated
postoperative temperature, and poor appetite are lower priorities in this clinical situation.
Q4: A patient is postoperative day 1 after upper-abdominal surgery. The patient has
shallow respirations, diminished breath sounds at the bases, and an oxygen saturation of
92% on room air. Which intervention is most appropriate?
A) Maintain strict bed rest
B) Encourage incentive spirometry and early mobilization
C) Restrict oral fluids
D) Administer a sedative before ambulation
Correct Answer: B
Rationale: Upper-abdominal surgery, pain, anesthesia, and immobility increase the risk of
atelectasis. Incentive spirometry, adequate pain control, coughing and deep breathing,
repositioning, and early ambulation promote lung expansion. Bed rest increases pulmonary
complication risk. Fluid restriction is not routinely indicated for uncomplicated postoperative
atelectasis, and sedatives can further depress respiratory function.
, Q5: A patient 6 hours after surgery becomes pale, cool, and anxious. Blood pressure
decreases from 124/76 mm Hg to 92/58 mm Hg, heart rate increases from 88/min to
124/min, and urine output is 15 mL during the previous hour. Which complication should
the nurse suspect first?
A) Urinary tract infection
B) Atelectasis
C) Hypovolemia from postoperative blood loss
D) Medication-related constipation
Correct Answer: C
Rationale: Tachycardia, hypotension, pallor, cool skin, anxiety, and declining urine output are
concerning for inadequate circulating volume. In the immediate postoperative period, occult
hemorrhage must be considered. The nurse should rapidly assess the surgical site, drains,
dressings, abdominal findings, and other sources of blood loss while escalating care. Atelectasis
does not explain the hemodynamic pattern, and constipation or urinary infection would not
produce this acute circulatory deterioration.
Q6: A patient who underwent hip surgery reports sudden pleuritic chest pain and
shortness of breath. The respiratory rate is 32/min and oxygen saturation is 86%. Which
action is most appropriate?
A) Encourage ambulation to improve circulation
B) Apply oxygen and immediately activate the appropriate emergency response
C) Massage the affected leg
D) Offer oral fluids
Correct Answer: B
Rationale: Sudden dyspnea, pleuritic chest pain, and hypoxemia following orthopedic surgery
are concerning for pulmonary embolism. The patient requires immediate oxygenation and urgent
clinical evaluation. Ambulation could worsen the patient's condition, and massaging a
potentially thrombosed extremity could theoretically dislodge thrombotic material. Oral fluids
do not address the immediate respiratory emergency.
Q7: A postoperative patient has a urinary catheter that has produced only 10 mL of urine
during the past hour. The patient's blood pressure is 88/54 mm Hg and heart rate is
118/min. Which interpretation is most appropriate?
