EXAM 2026/2027 | CMN 152V
Communication Studies | Verified
Q&A | Pass Guaranteed - A+ Graded
Section 1: Perioperative Nursing
Q1: A client is scheduled for open cholecystectomy at 0800. The client takes metformin 1000 mg BID,
lisinopril 10 mg daily, and warfarin 5 mg daily. Which medication order should the nurse question the
day before surgery?
A. Metformin 1000 mg with breakfast
B. Lisinopril 10 mg daily
C. Warfarin 5 mg daily [CORRECT]
D. Hold all oral medications after midnight
Correct Answer: C
Rationale: [CORRECT] Warfarin is an anticoagulant that significantly increases the risk of intraoperative
and postoperative hemorrhage. It is typically held 3–5 days prior to surgery (with potential bridging
therapy using heparin or LMWH).
A – Metformin is often held the morning of surgery or the day prior if contrast is expected, but Warfarin
poses a more immediate surgical risk regarding bleeding.
B – ACE inhibitors like lisinopril are often held the morning of surgery to reduce the risk of intraoperative
hypotension, but questioning them the day before is less critical than anticoagulants.
D – This is a standard NPO/preoperative instruction.
Q2: The nurse is performing a preoperative assessment on a client scheduled for a total knee
arthroplasty. Which statement by the client requires immediate follow-up?
,A. "I stopped taking my aspirin 5 days ago."
B. "I have a loose crown on my back molar." [CORRECT]
C. "I haven't had anything to eat or drink since midnight."
D. "I am very nervous about the anesthesia."
Correct Answer: B
Rationale: [CORRECT] A loose tooth poses a significant aspiration risk during intubation for general
anesthesia. The anesthesiologist must be notified immediately to prevent dislodgement and aspiration
of the tooth.
A – Aspirin is typically stopped 5–7 days before surgery to reduce bleeding risk; this is the correct action.
C – NPO status is confirmed as appropriate.
D – Anxiety is normal; while it requires intervention (teaching/comfort), it is not an immediate physical
safety threat like an airway obstruction risk.
Q3: A client is in the PACU following a hernia repair. The client is drowsy but arousable. The nurse notes
the following vital signs: BP 90/60 mm Hg, HR 110 bpm, RR 14/min, SpO2 96% on 2L NC. The nurse
suspects which immediate postoperative complication?
A. Malignant hyperthermia
B. Hypovolemic shock/Hemorrhage [CORRECT]
C. Respiratory depression
D. Urinary retention
Correct Answer: B
Rationale: [CORRECT] Hypotension (BP 90/60) and tachycardia (HR 110) are classic signs of fluid volume
deficit or early shock, likely due to hemorrhage or third-spacing of fluids postoperatively.
A – Malignant hyperthermia presents with hyperthermia, muscle rigidity, and metabolic/respiratory
acidosis, not typically hypotension as the earliest isolated sign.
C – Respiratory rate is 14 and SpO2 is 96%; there is no indication of respiratory depression.
D – Urinary retention causes bladder distention and hypertension/bradycardia (not
hypotension/tachycardia) via the Cushing reflex or simply discomfort.
,Q4: A postoperative client reports a sudden "popping" sensation in the abdominal incision followed by a
gush of serosanguineous fluid. The nurse visualizes the wound and sees bowel protruding. Which action
should the nurse take first?
A. Cover the wound with a sterile dry gauze dressing.
B. Place the client in Trendelenburg position.
C. Cover the wound with a sterile saline-moistened gauze dressing. [CORRECT]
D. Apply an abdominal binder to hold the edges together.
Correct Answer: C
Rationale: [CORRECT] This describes wound evisceration, a surgical emergency. The priority is to prevent
drying of the exposed organs and infection. The nurse should cover the wound with a sterile dressing
soaked in sterile normal saline to keep the viscera moist.
A – A dry gauze allows the bowel to dry and adhere to the gauze, causing damage upon removal.
B – Trendelenburg increases pressure on the diaphragm and does not help the wound; Low Fowler's
(knees bent) reduces abdominal tension.
D – An abdominal binder applies pressure to the exposed bowel, which is contraindicated.
Q5: The nurse is educating a client on the use of an incentive spirometer following abdominal surgery.
Which instruction is most accurate?
A. "Inhale slowly and deeply to raise the piston, then hold your breath for 3–5 seconds." [CORRECT]
B. "Exhale rapidly into the device to move the ball to the top."
C. "Use the device once every 4 hours before meals."
D. "Cough forcefully after each use to clear secretions."
Correct Answer: A
Rationale: [CORRECT] Incentive spirometry encourages deep inhalation to prevent atelectasis. The client
should inhale slowly to elevate the piston/flow indicator, sustaining the breath to open alveoli.
B – The device measures inspiratory volume, not expiratory force (peak flow measures expiration).
C – Use is recommended frequently, typically 5–10 breaths every 1–2 hours, not just once every 4 hours.
D – While coughing may be necessary, the primary purpose of the IS is deep breathing; encouraging
coughing immediately after every set can be exhausting and painful for abdominal surgery patients.
, Q6: A client is transferred from the OR to the PACU. Which assessment finding requires the nurse’s
immediate intervention?
A. Urine output of 100 mL in the last 4 hours.
B. Temperature of 96.8°F (36°C).
C. Stridor and audible wheezing. [CORRECT]
D. Pain rating of 6/10.
Correct Answer: C
Rationale: [CORRECT] Stridor and wheezing indicate laryngospasm or bronchospasm, which
compromises the airway (ABC priority). This requires immediate intervention (oxygen, positioning,
potential rapid sequence intubation or medication).
A – 100 mL over 4 hours is 25 mL/hr, which is slightly low (minimum 30 mL/hr) but not an immediate
airway emergency.
B – Mild hypothermia is common post-anesthesia; rewarming is needed, but it is not the priority over an
obstructed airway.
D – Pain is a priority but follows airway and breathing in the ABC hierarchy.
Q7: Which type of anesthesia involves the injection of a local anesthetic into the subarachnoid space to
block nerve roots?
A. Epidural block
B. Spinal block [CORRECT]
C. General anesthesia
D. Bier block
Correct Answer: B
Rationale: [CORRECT] A spinal block involves injecting anesthetic into the subarachnoid space (CSF),
affecting the nerve roots. It results in a dense motor and sensory block.
A – Epidural block places medication in the epidural space (outside the dura mater).
C – General anesthesia involves induced unconsciousness via IV or inhalation agents.