Question 1

Which medication has a direct myocardial depressant effect on the heart?

Accepted Answer

A)  Ketamine 
B)  Barbiturates 
C)  Succinylcholine 
D)  Opioids

Question 2

A patient was oversedated and required a dose of naloxone.How long would the nurse expect the duration of action of the medication to last?

Accepted Answer

A)  30 minutes to 1 hour 
B)  1 to 4 hours 
C)  4 to 6 hours 
D)  6 to 10 hours

Question 3

What are the causes of a postoperative fever?

Accepted Answer

A)  Medication reactions 
B)  Hypotension 
C)  Blood transfusion reaction 
D)  Pulmonary emboli 
E)  Atelectasis

Question 4

The nurse is caring for a patient immediately after surgery.The patient is requesting something to drink.The nurse knows that oral intake is prohibited after anesthesia until what occurs?

Accepted Answer

A)  The patient is ambulatory. 
B)  The patient is strong enough to hold a cup of water. 
C)  All nausea has ceased. 
D)  Laryngeal and pharyngeal reflexes are fully regained.

Question 5

The nurse is caring for a postoperative patient who is snoring and has stridor,nostril flaring,and intercostal retractions.The nurse knows that these findings are clinical manifestations of what problem?

Accepted Answer

A)  Angina 
B)  Airway obstruction 
C)  Pain 
D)  Oversedation

Question 6

What is the most effective treatment of postoperative nausea and vomiting?

Accepted Answer

A)  Prevention 
B)  Droperidol given immediately when nausea is reported 
C)  Phenergan given immediately when nausea is reported 
D)  Metoclopramide given immediately when nausea is reported

Question 7

A patient returns from the surgical suite and is hypothermic.The nurse understands that hypothermia can lead to which problem?

Accepted Answer

A)  Acute kidney failure 
B)  Metabolic alkalosis 
C)  Hypotension 
D)  Delayed emergence

Question 8

A nurse is administering a benzodiazepine to a patient to facilitate relaxation prior to surgery.Which benzodiazepine has a slow onset of action and long duration?

Accepted Answer

A)  Diazepam 
B)  Midazolam 
C)  Lorazepam 
D)  Droperidol

Question 9

What is the most common cause of hypoxemia in the immediate postoperative period?

Accepted Answer

A)  Pulmonary vasoconstriction 
B)  Airway obstruction 
C)  Intrapulmonary shunting 
D)  Ventilation/perfusion mismatching

Question 10

The nurse is caring for a postoperative patient who is complaining of being cold and shivering.The patient's temperature is normal.The nurse understands that shivering can occur in the normothermic patient for what reason?

Accepted Answer

A)  Dehydration 
B)  Delayed response to being hypothermic during surgery 
C)  Effects of anesthetic agents 
D)  Anxiety

Question 11

A postoperative patient is experiencing delayed arousal after a transurethral prostatectomy.To assist with finding the cause,the nurse would assess the patient's laboratory values for which finding?

Accepted Answer

A)  Hypercalcemia 
B)  Hyponatremia 
C)  Hyperkalemia 
D)  Hypermagnesemia

Question 12

Which of the following dysrhythmias are common in the postanesthetic period?

Accepted Answer

A)  Ventricular tachycardia 
B)  Ventricular fibrillation 
C)  Supraventricular tachydysrhythmias 
D)  Sinus bradycardia 
E)  Premature ventricular contractions

Question 13

A patient was transferred to the postanesthesia care unit from the operating room after the induction of halothane anesthesia.The patient has no significant medical history.On admission,the patient appeared comatose and extremely diaphoretic,with severe muscle rigidity and tremors.The patient's vital signs were heart rate,145 beats/min; monitor reveals sinus tachycardia; blood pressure,85/50 mm Hg; respiratory rate,35 breaths/min; and temperature,103.8° F.Arterial blood gases on 100% oxygen by ventilator were PaO₂,70%; PaCO₂,35 mm Hg; pH,7.21; HCO₃,16 mm Hg; and SaO₂,90%.Fluid resuscitation and vasoactive therapy were started.Initial abnormal laboratory results were BUN,66 mg/dL; sodium,155 mEq/L; potassium,5.5 mEq/L; glucose,68 mg/dL; creatinine,2.4 mg/dL; and creatine phosphokinase,1896 U/L.The nurse would anticipate a diagnosis of which condition?

Accepted Answer

A)  Noncardiogenic pulmonary edema 
B)  Sepsis 
C)  Malignant hyperthermia 
D)  Emergency delirium

Question 14

Management of an airway obstruction begins with immediate recognition and treatment.Place these nursing interventions in the appropriate order for initial care of a postanesthesia patient with airway obstruction.
1)Positive-pressure mask ventilation
2)Head-tilt/chin-lift maneuver (nonreactive patient)
3)Insertion of oropharyngeal or nasopharyngeal airway
4)Intubation with mechanical intubation
5)Stimulation of the patient

Accepted Answer

A)  1, 2, 3, 5, 4 
B)  5, 2, 3, 1, 4 
C)  2, 3, 1, 5, 4 
D)  4, 2, 3, 1, 5

Question 15

A postoperative patient has developed bronchospasms.What medication would the nurse anticipate being administered to the patient?

Accepted Answer

A)  Racemic epinephrine 
B)  Methylprednisolone 
C)  Albuterol 
D)  Morphine

Exam 41: The Perianesthesia Patient