CSFA Postoperative Patient Management 2

Question 1

A patient in the PACU develops a respiratory rate of 6 breaths/min and is difficult to arouse 30 minutes after receiving fentanyl intraoperatively. What is the most appropriate immediate intervention?

Accepted Answer

Administer naloxone (Narcan) IV

Answer

Naloxone reverses opioid-induced respiratory depression and is the priority intervention for a patient with signs of opioid overdose.

Question 2

Which assessment finding in the immediate postoperative period is MOST indicative of laryngospasm?

Accepted Answer

High-pitched crowing sound with paradoxical chest movement

Answer

Laryngospasm produces a high-pitched stridor or crowing noise accompanied by paradoxical chest and abdominal movement due to complete or partial glottic closure.

Question 3

A postoperative patient receiving morphine PCA complains of itching over the face and trunk without hives or hypotension. This reaction is MOST likely caused by:

Accepted Answer

Opioid-induced histamine release from mast cells

Answer

Morphine commonly causes non-allergic pruritus through direct mast cell histamine release, which is different from a true allergic reaction.

Question 4

During the immediate postoperative period, which parameter is the EARLIEST indicator of hemorrhagic shock?

Accepted Answer

Increased heart rate (tachycardia)

Answer

Tachycardia is the earliest compensatory response to hemorrhage as the body attempts to maintain cardiac output before blood pressure falls.

Question 5

A patient 2 hours postoperative from an abdominal procedure has a urine output of 15 mL over the past hour. The FIRST nursing action should be to:

Accepted Answer

Assess fluid intake, blood pressure, and catheter patency

Answer

Oliguria (less than 30 mL/hr) requires a systematic assessment of volume status, hemodynamics, and mechanical causes before any pharmacologic intervention.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Postoperative Patient Management 2