MSNCB Perioperative Nursing 4 — Questions and Answers
Question 1: A patient receiving spinal anesthesia develops sudden hypotension. What is the most likely cause?
- Anaphylaxis to the local anesthetic agent
- Sympathetic blockade causing vasodilation (Correct answer)
- Excessive fluid administration
- Parasympathetic stimulation from surgical manipulation
Correct answer: Sympathetic blockade causing vasodilation
Spinal anesthesia blocks sympathetic nerves, causing vasodilation and a drop in blood pressure, the most common complication of neuraxial anesthesia.
Question 2: Which action is most important when transferring a patient from the OR table to the PACU stretcher?
- Transfer quickly to minimize patient exposure time
- Ensure adequate personnel and protect the patient's airway during transfer (Correct answer)
- Remove all monitoring leads before initiating the transfer
- Place the patient in Trendelenburg position during the move
Correct answer: Ensure adequate personnel and protect the patient's airway during transfer
Safe patient transfer requires sufficient personnel to prevent falls and injury, and the airway must be protected throughout the move from OR to PACU.
Question 3: Which preoperative patient teaching point is most important for a patient undergoing general anesthesia?
- How to use a patient-controlled analgesia pump after surgery
- NPO (nothing by mouth) requirements and why they are necessary (Correct answer)
- The names of all medications that will be used during anesthesia
- Expected length of the surgical procedure
Correct answer: NPO (nothing by mouth) requirements and why they are necessary
NPO status is critical to prevent aspiration of gastric contents during anesthesia induction, which can cause aspiration pneumonia or death.
Question 4: The perioperative nurse notes the patient's preoperative consent form is not signed before the patient receives preoperative sedation. What should the nurse do?
- Have the patient sign the consent after sedation is given
- Notify the surgeon and hold preoperative medications until consent is obtained (Correct answer)
- Proceed with preparation as the surgeon is responsible for consent
- Ask a family member to sign on the patient's behalf immediately
Correct answer: Notify the surgeon and hold preoperative medications until consent is obtained
Informed consent must be obtained while the patient is alert and competent; sedation impairs decision-making capacity, so medication must be withheld until consent is signed.
Question 5: Which intervention is most effective for preventing deep vein thrombosis (DVT) in the perioperative patient?
- Administering aspirin postoperatively
- Applying sequential compression devices (SCDs) before and during surgery (Correct answer)
- Encouraging bed rest for 24 hours after surgery
- Keeping the patient NPO postoperatively
Correct answer: Applying sequential compression devices (SCDs) before and during surgery
Sequential compression devices improve venous return and reduce stasis, making them a primary mechanical intervention for DVT prevention in surgical patients.
Question 6: A surgical patient with a latex allergy is scheduled for the first case of the day. What is the most appropriate accommodation?
- Schedule the patient as the last case of the day
- Schedule the patient as the first case of the day in a latex-free environment (Correct answer)
- Use only sterile gloves during the procedure
- Premedicate with diphenhydramine and proceed normally
Correct answer: Schedule the patient as the first case of the day in a latex-free environment
Scheduling a latex-allergic patient first minimizes latex particle accumulation in the OR environment, reducing the risk of an allergic reaction.
Question 7: Which finding indicates a patient is ready for discharge from Phase I PACU recovery?
- Patient can walk without assistance to the waiting area
- Vital signs stable, patient awake and oriented, pain controlled, no active bleeding (Correct answer)
- Patient reports feeling completely back to normal
- Urine output has reached 500 mL since surgery
Correct answer: Vital signs stable, patient awake and oriented, pain controlled, no active bleeding
PACU discharge criteria include stable vital signs, adequate level of consciousness, controlled pain and nausea, and absence of surgical complications such as bleeding.
MSNCB Perioperative Nursing 4
A patient receiving spinal anesthesia develops sudden hypotension.
What is the most likely cause?