CMSRN FREE CMSRN Perioperative Questions and Answers 2 — Questions and Answers
Question 1: A patient scheduled for a total knee arthroplasty reports taking aspirin 325 mg daily. What is the priority nursing action during the preoperative phase?
- Administer the aspirin as scheduled
- Notify the surgeon about the aspirin use (Correct answer)
- Instruct the patient to double the dose before surgery
- Document the aspirin use and proceed with preparation
Correct answer: Notify the surgeon about the aspirin use
Aspirin inhibits platelet aggregation and increases surgical bleeding risk, so the surgeon must be notified to determine when to discontinue it preoperatively.
Question 2: Which assessment finding in a postoperative patient most strongly suggests the development of malignant hyperthermia?
- Temperature of 99.8°F with mild shivering
- Unexplained rapid rise in end-tidal CO2 and muscle rigidity (Correct answer)
- Bradycardia with hypotension
- Decreased urine output with clear urine
Correct answer: Unexplained rapid rise in end-tidal CO2 and muscle rigidity
A rapid, unexplained rise in end-tidal CO2 combined with skeletal muscle rigidity is the earliest and most reliable indicator of malignant hyperthermia.
Question 3: A nurse is caring for a patient in the PACU who underwent abdominal surgery under general anesthesia. Which intervention best prevents postoperative atelectasis?
- Keeping the patient in a supine position
- Encouraging early use of incentive spirometry (Correct answer)
- Restricting oral fluids for 24 hours
- Administering a sedative to promote rest
Correct answer: Encouraging early use of incentive spirometry
Incentive spirometry promotes deep breathing and sustained maximal inspiration, which helps re-expand alveoli and prevent atelectasis after general anesthesia.
Question 4: During the intraoperative phase, the circulating nurse notices a break in sterile technique by a surgical team member. What is the appropriate immediate action?
- Wait until the procedure is complete to report the break
- Document the incident in the patient's chart without intervention
- Immediately notify the team member and the surgeon of the break (Correct answer)
- Replace all surgical instruments on the field
Correct answer: Immediately notify the team member and the surgeon of the break
The circulating nurse is responsible for monitoring sterile technique and must immediately communicate any break to the team so corrective action can be taken to prevent surgical site infection.
Question 5: A patient with a history of obstructive sleep apnea is recovering from surgery. Which postoperative concern should the nurse prioritize?
- Increased risk of postoperative nausea
- Risk of airway obstruction and respiratory depression (Correct answer)
- Higher likelihood of urinary retention
- Elevated risk of surgical wound dehiscence
Correct answer: Risk of airway obstruction and respiratory depression
Patients with obstructive sleep apnea are at significantly increased risk for airway obstruction and respiratory depression postoperatively, especially when receiving opioid analgesics and sedatives.
Question 6: Which laboratory value should the nurse verify before a patient is cleared for surgery requiring regional anesthesia with an epidural catheter?
- Serum potassium level
- Platelet count and coagulation studies (Correct answer)
- Fasting blood glucose
- Serum creatinine
Correct answer: Platelet count and coagulation studies
Platelet count and coagulation studies must be within acceptable limits before epidural placement to minimize the risk of epidural hematoma, a potentially devastating complication.
CMSRN FREE CMSRN Perioperative Questions and Answers 2
A patient scheduled for a total knee arthroplasty reports taking aspirin 325 mg daily.
What is the priority nursing action during the preoperative phase?