Tiêu đề COMPRE - POST TEST - PERIOP (Dr. Flores) SC ✅

TOP RANK REVIEW ACADEMY, INC. Page 2 | 1 D. “You don’t need to worry about that; the team has it covered.” 8) Why is it important to assess Ms. Cruz’s support system preoperatively? A. To determine who will sign her informed consent. B. To identify who will pay for her hospital bills. C. To evaluate if discharge will be delayed. D. To ensure she has assistance for postoperative care and emotional support. 9) She says, “I don’t think my family cares if I make it.” What is the nurse’s BEST response? A. “Of course they care; they wouldn’t leave you alone.” B. “Why do you feel that way? Can you tell me more?” C. “Try not to think about that; focus on getting better.” D. “If you’d like, I can call your family to come visit you now.” 10) Which of the following is the most appropriate expected outcome for Ms. Cruz before surgery? A. The patient states she understands the surgical procedure and postoperative care plan. B. The patient verbalizes no fear or anxiety about surgery. C. The patient signs consent without hesitation. D. The patient’s vital signs remain within normal limits throughout admission. Case: Mr. Daniel Reyes, 72, is admitted for a ventral hernia repair. He has COPD, a 40-pack-year smoking history, and a BMI of 34 kg/m². He is anxious about the procedure and repeatedly asks for water despite being NPO. During assessment, you note diminished breath sounds in the bases, productive cough, and SpO₂ 92% on room air. He says, “I just want to get this over with so I can go back to work.” 11) Which preoperative finding requires immediate attention? A. SpO₂ of 92% on room air. B. Anxiety about returning to work. C. Productive cough and diminished breath sounds. D. BMI of 34 kg/m². 12) Why is it important to emphasize pulmonary hygiene (e.g., incentive spirometry) to Mr. Reyes? A. To prevent intraoperative hypothermia. B. To reduce risk of postoperative pneumonia and atelectasis. C. To reduce anxiety before surgery. D. To ensure oxygen saturation remains at 92%. 13) What is the best explanation for why he must remain NPO before surgery? A. To prevent dehydration during surgery. B. To prevent aspiration of gastric contents under anesthesia. C. To avoid increasing blood glucose levels. D. To prevent bowel perforation during hernia repair. 14) Which preoperative teaching point is most appropriate for Mr. Reyes? A. “We’ll start you walking as soon as possible after surgery.” B. “We’ll restrict your fluid intake for 48 hours after surgery.” C. “You can resume smoking gradually after discharge.” D. “You won’t need to worry about doing exercises after surgery.” 15) Why is his BMI of 34 kg/m² significant for his surgical risk? A. It has no impact as long as his vital signs are stable. B. Obesity increases risk of wound dehiscence, infection, and respiratory compromise. C. Obesity accelerates healing because of extra adipose tissue. D. It means he may need to stay NPO longer after surgery. Case: Ms. Teresa Lim, 36, is admitted for an emergency Cesarean section due to non-reassuring fetal heart rate. She reports a history of urticaria and throat tightness after using latex gloves at work. She appears anxious and asks, “Will I or my baby die?” On assessment, her BP is 124/76, HR 98, RR 22, SpO₂ 98%. In the OR, latex-free gloves and equipment are prepared. During the procedure, she suddenly develops hypotension, tachycardia, and wheezing. 16) What is the MOST likely cause of Ms. Lim’s sudden symptoms? A. Amniotic fluid embolism. B. Latex-induced anaphylaxis. C. Pulmonary embolism. D. Hemorrhagic shock. 17) What is the priority immediate nursing action? A. Position her in Trendelenburg to improve BP. B. Stop the procedure and call a code blue. C. Administer epinephrine and support the airway. D. Start rapid blood transfusion. 18) What OR practice helps prevent latex reactions? A. Washing hands thoroughly before surgery. B. Using non-sterile gloves and equipment. C. Scheduling latex-sensitive patients first in the day. D. Pre-medicating all patients with antihistamines. 19) Which symptom BEST differentiates anaphylaxis from other intraoperative complications? A. Hypotension with tachycardia. B. Bronchospasm with urticaria and angioedema. C. Hypothermia with bradycardia. D. Decreased urine output. 20) What should the nurse include in post-op teaching for Ms. Lim? A. “You should avoid all fruits and nuts in the future.”
TOP RANK REVIEW ACADEMY, INC. Page 3 | 1 B. “Make sure all future medical records clearly state your latex allergy.” C. “You can tolerate minimal exposure as long as you take antihistamines.” D. “You will no longer require latex precautions after pregnancy.” Case : Mr. Albert Tan, 62, undergoes an emergency colectomy due to bowel perforation. Surgery lasts over 4 hours, with large fluid replacement and significant blood loss. In the PACU, he is pale, shivering, BP 88/54, HR 120, RR 28, temp 35 °C, and has irregular heartbeats on the monitor. 21) Which condition is MOST likely causing Mr. Tan’s presentation? A. Septic shock. B. Hypovolemic shock. C. Hypothermia-induced arrhythmias. D. Pulmonary embolism. 22) What is the most appropriate nursing intervention? A. Apply warm blankets and gradually rewarm. B. Infuse cold fluids and monitor for fever. C. Increase OR temperature immediately. D. Encourage vigorous shivering to generate heat. 23) Why should warming occur gradually rather than rapidly? A. To allow clotting factors to activate properly. B. To avoid rebound hyperthermia. C. To prevent cardiovascular collapse due to vasodilation. D. To prevent hypoglycemia from increased metabolism. 24) Which intraoperative factor most predisposed him to hypothermia? A. Use of general anesthesia. B. High OR temperature. C. Short surgical time. D. Use of local anesthesia. 25) What is the desired minimum core body temperature during surgery to minimize complications? A. 34 °C B. 35 °C C. 36 °C D. 37 °C Case : Ms. Liza Ramos, 45, undergoes a total thyroidectomy for multinodular goiter. In the PACU, she complains of tightness in her throat, tingling in her fingers and lips, and difficulty speaking. Her BP is 104/68, HR 112, RR 26, and she has audible stridor. 26) Which postoperative complication is MOST likely? A. Hemorrhage causing tracheal compression. B. Laryngeal nerve injury. C. Acute hypocalcemia due to parathyroid injury. D. Allergic reaction to anesthesia. 27) What is the priority immediate nursing action? A. Suction the airway and administer oxygen. B. Prepare IV calcium gluconate and notify the provider. C. Reassure the patient and elevate head of bed. D. Perform a jaw thrust to maintain airway. 28) Which sign further supports hypocalcemia? A. Positive Trousseau’s or Chvostek’s sign. B. Hyperreflexia with dilated pupils. C. Bradycardia and hypotension. D. Decreased bowel sounds. 29) Why is it important to inspect the neck dressing frequently after thyroidectomy? A. To detect signs of infection early. B. To prevent accidental extubation. C. To identify hematoma formation compressing the airway. D. To ensure sterile technique is maintained. 30) What is the rationale for keeping a tracheostomy set at the bedside? A. To manage expected laryngeal edema. B. To address potential airway obstruction. C. To suction excessive secretions. D. To assist in routine respiratory care. Case : Mr. Joseph Mendoza, 39, underwent an open reduction and internal fixation (ORIF) of his right femur following a motor vehicle accident. He is now on bedrest with a PCA morphine pump and a Foley catheter. After 16 hours, he becomes increasingly restless, confused, and tachypneic. His SpO₂ drops to 85% despite oxygen at 6 L/min. You also notice petechiae on his upper chest and conjunctiva. His BP is 100/60, HR 128, RR 34, and temperature 38.4 °C. 31) Which postoperative complication is MOST likely? A. Pulmonary embolism (PE). B. Acute respiratory distress syndrome (ARDS). C. Fat embolism syndrome (FES). D. Sepsis from wound infection. 32) What is the PRIORITY nursing action? A. Administer IV antibiotics stat. B. Prepare for mechanical ventilation and support oxygenation. C. Begin chest compressions and call a code blue. D. Increase PCA dose to reduce restlessness. 33) What is the pathophysiology of petechiae in FES? A. Disseminated intravascular coagulation (DIC) following trauma. B. Fat droplets occlude dermal capillaries causing microhemorrhages. C. Septic emboli lodge in skin capillaries. D. Allergic reaction to antibiotics. 34) What is an important preventive measure for FES in high- risk patients? A. Delay fracture stabilization to allow marrow to heal. B. Early immobilization and surgical fixation of the fracture.