MSNCB Surgical Procedures & Postoperative Care 5

Question 1

A patient recovering from abdominal aortic aneurysm repair suddenly develops mottling of both lower extremities, absent pedal pulses, and severe pain. The nurse recognizes this as:

Accepted Answer

Acute limb ischemia from thromboembolism or graft occlusion

Answer

Absent pulses, mottling, and acute pain after vascular surgery indicate acute limb ischemia from graft occlusion or thromboembolism, a surgical emergency.

Question 2

Which nursing action is most important when a patient returns from surgery with a temporary pacemaker?

Accepted Answer

Ensure all electrical equipment is grounded and limit patient movement

Answer

Temporary pacemakers require electrical safety measures including grounding all equipment and limiting patient movement to prevent lead displacement.

Question 3

A nurse prepares a patient for discharge after a laparoscopic hernia repair. Which instruction is most important for the patient to receive?

Accepted Answer

Avoid lifting more than 10 lbs and report fever, chills, or worsening pain

Answer

Activity restriction and recognizing signs of infection or recurrence are the highest priority discharge instructions after hernia repair.

Question 4

During wound irrigation of a dehisced surgical wound, which action by the nurse is incorrect?

Accepted Answer

Packing wet-to-dry gauze tightly to absorb all moisture

Answer

Tight packing causes trauma to granulating tissue; moist wound healing requires loosely placed dressings that maintain a moist environment.

Question 5

A postoperative patient on hydromorphone PCA has a respiratory rate of 8 breaths/min and is difficult to arouse. The nurse should immediately:

Accepted Answer

Administer naloxone per protocol and apply supplemental oxygen

Answer

Respiratory rate <10 breaths/min with decreased level of consciousness indicates opioid-induced respiratory depression requiring naloxone reversal.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Surgical Procedures & Postoperative Care 5