perioperative care (med surg) Exam Questions and Answers With Verified
Solutions 2025
1. A nurse has administered midazolam (Versed) IV bolus to a client before a procedure. The client's
blood pressure is 86/40 mm Hg and pulse is 134/min. Which of the following is an appropriate action by
the nurse?
A. Administer naloxone (Narcan) IV.
B. Administer morphine IV.
C. Administer 0.9% sodium chloride IV bolus.
D. Administer atropine IV - ✔✔A. INCORRECT: Naloxone is administered for respiratory depression
caused by an opioid medication. This is not an appropriate action by the nurse.
B. INCORRECT: Morphine sulfate is administered for pain and can cause hypotension and respiratory
depression. This is not an appropriate action by the nurse.
C. CORRECT: An IV fluid bolus should increase the client's hypotension and tachycardia to promote
adequate cardiac output and tissue perfusion.
D. INCORRECT: Atropine sulfate is administered for bradycardia. This is not an appropriate action by the
nurse
2. A nurse is assisting an anesthesiologist in the delivery of nitrous oxide per face mask to a client during
the induction of anesthesia. Which of the following is a priority nursing action?
A. Assess oxygen saturation.
B. Obtain blood pressure.
C. Palpate heart rate.
D. Check temperature. - ✔✔A. CORRECT: The greatest risk for the client is injury from hypoxia. The first
action is to assess the client's oxygen saturations.
B. INCORRECT: Obtaining blood pressure is important but is not the priority action by the nurse.
C. INCORRECT: Palpating heart rate is important but is not the priority action by the nurse.
D. INCORRECT: Checking temperature at the time of induction is not the priority action by the nurse.
3. A nurse is providing information to a group of surgical nurses for the treatment of malignant
hyperthermia. Which of the following should the nurse include in the information?
A. Infuse iced IV fluids.
, B. Provide 100% oxygen.
C. Place on a cooling blanket.
D. Treat the condition while continuing surgery.
E. Administer IV dantrolene (Dantrium). - ✔✔A. CORRECT: Infusing iced IV fluids should help lower the
client's rapidly rising temperature.
B. CORRECT: Providing 100% oxygen will help to prevent hypoxia due to muscle tremors and rigidity
from increased lactic acid.
C. CORRECT: Placing the client on a cooling blanket will help lower the rapidly rising temperature.
D. INCORRECT: Terminating surgery should occur as soon as malignant hyperthermia is suspected.
E. CORRECT: Dantrolene IV is a muscle relaxant used to treat malignant hyperthermia
4. A nurse is caring for a client who displays systemic toxic reaction following a regional block. Which of
the following actions by the nurse is appropriate?
A. Monitor serum creatinine levels.
B. Prepare to administer IV thiopental (Pentothal).
C. Turn client to the right side.
D. Administration 0.9% sodium chloride 500 mL IV bolus - ✔✔A. INCORRECT: ABGs, CBC, and
electrolytes, not serum creatinine levels, are monitored for systemic toxic reaction to a regional block
B. CORRECT: Thiopental is a fast-acting barbiturate administered by an anesthesiologist for treatment of
systemic toxic reaction to a spinal block.
C. INCORRECT: Turning the client to the right side is not indicated as a treatment for systemic toxic
reaction to a regional block.
D. INCORRECT: Clinical manifestations of systemic toxic reaction include hypertension.
Administration of a 500 mL IV bolus would exacerbate the problem.
5. A nurse is caring for a client who reports a headache following an epidural regional nerve block.
Which of the following is an appropriate nursing action?
A. Decrease the client's fluid intake.
B. Apply pressure to the puncture site.
C. Place the client's head of bed flat.
D. Instruct the client to lie prone - ✔✔A. INCORRECT: Increase fluid intake to keep the client well-
hydrated and to help replace the cerebral spinal fluid.
Solutions 2025
1. A nurse has administered midazolam (Versed) IV bolus to a client before a procedure. The client's
blood pressure is 86/40 mm Hg and pulse is 134/min. Which of the following is an appropriate action by
the nurse?
A. Administer naloxone (Narcan) IV.
B. Administer morphine IV.
C. Administer 0.9% sodium chloride IV bolus.
D. Administer atropine IV - ✔✔A. INCORRECT: Naloxone is administered for respiratory depression
caused by an opioid medication. This is not an appropriate action by the nurse.
B. INCORRECT: Morphine sulfate is administered for pain and can cause hypotension and respiratory
depression. This is not an appropriate action by the nurse.
C. CORRECT: An IV fluid bolus should increase the client's hypotension and tachycardia to promote
adequate cardiac output and tissue perfusion.
D. INCORRECT: Atropine sulfate is administered for bradycardia. This is not an appropriate action by the
nurse
2. A nurse is assisting an anesthesiologist in the delivery of nitrous oxide per face mask to a client during
the induction of anesthesia. Which of the following is a priority nursing action?
A. Assess oxygen saturation.
B. Obtain blood pressure.
C. Palpate heart rate.
D. Check temperature. - ✔✔A. CORRECT: The greatest risk for the client is injury from hypoxia. The first
action is to assess the client's oxygen saturations.
B. INCORRECT: Obtaining blood pressure is important but is not the priority action by the nurse.
C. INCORRECT: Palpating heart rate is important but is not the priority action by the nurse.
D. INCORRECT: Checking temperature at the time of induction is not the priority action by the nurse.
3. A nurse is providing information to a group of surgical nurses for the treatment of malignant
hyperthermia. Which of the following should the nurse include in the information?
A. Infuse iced IV fluids.
, B. Provide 100% oxygen.
C. Place on a cooling blanket.
D. Treat the condition while continuing surgery.
E. Administer IV dantrolene (Dantrium). - ✔✔A. CORRECT: Infusing iced IV fluids should help lower the
client's rapidly rising temperature.
B. CORRECT: Providing 100% oxygen will help to prevent hypoxia due to muscle tremors and rigidity
from increased lactic acid.
C. CORRECT: Placing the client on a cooling blanket will help lower the rapidly rising temperature.
D. INCORRECT: Terminating surgery should occur as soon as malignant hyperthermia is suspected.
E. CORRECT: Dantrolene IV is a muscle relaxant used to treat malignant hyperthermia
4. A nurse is caring for a client who displays systemic toxic reaction following a regional block. Which of
the following actions by the nurse is appropriate?
A. Monitor serum creatinine levels.
B. Prepare to administer IV thiopental (Pentothal).
C. Turn client to the right side.
D. Administration 0.9% sodium chloride 500 mL IV bolus - ✔✔A. INCORRECT: ABGs, CBC, and
electrolytes, not serum creatinine levels, are monitored for systemic toxic reaction to a regional block
B. CORRECT: Thiopental is a fast-acting barbiturate administered by an anesthesiologist for treatment of
systemic toxic reaction to a spinal block.
C. INCORRECT: Turning the client to the right side is not indicated as a treatment for systemic toxic
reaction to a regional block.
D. INCORRECT: Clinical manifestations of systemic toxic reaction include hypertension.
Administration of a 500 mL IV bolus would exacerbate the problem.
5. A nurse is caring for a client who reports a headache following an epidural regional nerve block.
Which of the following is an appropriate nursing action?
A. Decrease the client's fluid intake.
B. Apply pressure to the puncture site.
C. Place the client's head of bed flat.
D. Instruct the client to lie prone - ✔✔A. INCORRECT: Increase fluid intake to keep the client well-
hydrated and to help replace the cerebral spinal fluid.
