MSNCB Surgical Procedures & Postoperative Care 2

Question 1

A patient returns from abdominal surgery with a Jackson-Pratt drain. The nurse notes 150 mL of bright red drainage in the first hour. What is the priority action?

Accepted Answer

Notify the surgeon immediately

Answer

Bright red drainage exceeding 100 mL/hr from a JP drain suggests active hemorrhage and requires immediate surgical notification.

Question 2

Which positioning is most appropriate for a patient after a right-sided pneumonectomy to facilitate lung expansion?

Accepted Answer

Right lateral decubitus or semi-Fowler's

Answer

Positioning on the operative side (right) or semi-Fowler's prevents mediastinal shift and supports the remaining lung.

Question 3

A postoperative patient's urine output drops to 20 mL/hr for 2 consecutive hours. The nurse should first:

Accepted Answer

Assess fluid status and check for kinked catheter tubing

Answer

Oliguria (<30 mL/hr) first warrants assessment of volume status and mechanical causes before pharmacologic intervention.

Question 4

Following a laparoscopic cholecystectomy, a patient complains of right shoulder pain. The nurse correctly explains this is due to:

Accepted Answer

Referred pain from diaphragmatic irritation by residual CO2

Answer

Residual CO2 gas used during laparoscopy irritates the diaphragm, causing referred pain to the shoulder via the phrenic nerve.

Question 5

A nurse is assessing a postoperative patient for malignant hyperthermia. The earliest sign is typically:

Accepted Answer

Masseter muscle rigidity

Answer

Masseter spasm (jaw rigidity) after succinylcholine is often the earliest clinical sign of malignant hyperthermia.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Surgical Procedures & Postoperative Care 2