CMSRN Perioperative 2

Question 1

A patient is receiving epidural analgesia postoperatively. Which assessment finding requires immediate intervention?

Accepted Answer

Blood pressure 90/58 mmHg

Answer

Hypotension (BP 90/58) is a serious complication of epidural analgesia due to sympathetic blockade and requires immediate intervention.

Question 2

During the immediate postoperative period, a patient begins shivering uncontrollably. What is the priority nursing action?

Accepted Answer

Apply warm blankets and active warming measures

Answer

Postoperative shivering is commonly caused by hypothermia from operating room exposure; applying warm blankets is the priority intervention.

Question 3

A patient is 6 hours post-abdominal surgery and has not voided. Which assessment is most important before intervening?

Accepted Answer

Bladder scan for urinary retention

Answer

A bladder scan should be performed first to determine if urinary retention is present before any urinary intervention is initiated.

Question 4

Which laboratory value is most critical to assess before a patient is taken to the operating room for an elective procedure?

Accepted Answer

Serum potassium of 2.9 mEq/L

Answer

Hypokalemia (K+ 2.9 mEq/L) increases the risk of dangerous cardiac arrhythmias during anesthesia and must be corrected preoperatively.

Question 5

A patient scheduled for surgery reports taking aspirin daily for cardiac prophylaxis. The nurse's most appropriate action is to:

Accepted Answer

Document and notify the anesthesiologist and surgeon

Answer

Aspirin's antiplatelet effects increase bleeding risk; the surgical and anesthesia teams must be notified to determine if surgery should be delayed.

CMSRN - Medical-Surgical Nursing Practice Test