MED SURG HESI EXAM 1 FINAL PAPER 2026
STUDY GUIDE DETAILED ANSWERS READY
◉ describe priority of assessments in the PACU.
Answer: -initial: ABC's (airway, breathing, circulation); watch for
stridor from edema or bronchospasms
-next: CV status
-vitals q 15 min until stable
-neuro: level of consciousness
-GI: n/v
-labs
◉ what are some major CV post-op complications?
Answer: -MI: elevated troponin levels, ST elevation or T wave
inversion for ischemia
-arrhythmias
-hypotension (orthostatic)
-DVT: clots on ultasound
◉ what are some major respiratory post-op complications?.
Answer: -atelectasis (CXR shows collapsed area)
-pneumonia (CXR shows area of infiltration)
,-pulmonary embolism (CXR shows wedge infiltrate)
◉ what are some major GI post-op complications?.
Answer: -N/V
-constipation (x-ray shows stool; slow/dec bowel sounds)
-paralytic ileus (x-ray shows gas in intestines; absent bowel sounds)
◉ what are the s/s of malignant hyperthermia?.
Answer: -tachycardia, tachypnea
-cyanosis
-fever
-muscle rigidity
-diaphoresis
-mottled skin
-hypotension
-dec UOP
-cardiac arrest
◉ what is the earliest sign of malignant hyperthermia?.
Answer: tachycardia
,◉ when should the nurse expect malignant hyperthermia to occur in
the peri-operative period?.
Answer: -10-20 after anesthesia started
-first 24 hrs post-op
◉ what are the s/s of hypovolemic shock?.
Answer: -pallor
-rapid weak thready pulse
-low BP
-rapid breathing
◉ how far in advance should a patient stop taking aspirin before
surgery?.
Answer: 7-10 days
◉ why is NPO status so important prior to surgery?.
Answer: to avoid aspiration
◉ s/s of IV infiltration.
Answer: -edema, discomfort/pain, redness, coolness at site, leakage
◉ s/s of extravasation of IV.
, Answer: -inflammation, blistering, & necrosis at site
◉ s/s of IV phlebitis.
Answer: -redness, tender/pain, swelling (inflammation of the vessel)
◉ when should a patient stop smoking prior to a scheduled surgery?
why?.
Answer: 4-8 wks to reduce pulmonary and wound healing
complications
◉ what are some indications to postpone a schedule surgery?.
Answer: -uncontrolled HTN
-pt intoxicated
-current infection
◉ first intention wound healing.
Answer: granulation not visible & scar formation minimal; cover w/
dry sterile dressing
◉ second intention wound healing.
Answer: granulation occurs in infected wounds or wounds w/ edges
not approximated; pack w/ moist sterile dressing & cover w/ dry
sterile dressing
STUDY GUIDE DETAILED ANSWERS READY
◉ describe priority of assessments in the PACU.
Answer: -initial: ABC's (airway, breathing, circulation); watch for
stridor from edema or bronchospasms
-next: CV status
-vitals q 15 min until stable
-neuro: level of consciousness
-GI: n/v
-labs
◉ what are some major CV post-op complications?
Answer: -MI: elevated troponin levels, ST elevation or T wave
inversion for ischemia
-arrhythmias
-hypotension (orthostatic)
-DVT: clots on ultasound
◉ what are some major respiratory post-op complications?.
Answer: -atelectasis (CXR shows collapsed area)
-pneumonia (CXR shows area of infiltration)
,-pulmonary embolism (CXR shows wedge infiltrate)
◉ what are some major GI post-op complications?.
Answer: -N/V
-constipation (x-ray shows stool; slow/dec bowel sounds)
-paralytic ileus (x-ray shows gas in intestines; absent bowel sounds)
◉ what are the s/s of malignant hyperthermia?.
Answer: -tachycardia, tachypnea
-cyanosis
-fever
-muscle rigidity
-diaphoresis
-mottled skin
-hypotension
-dec UOP
-cardiac arrest
◉ what is the earliest sign of malignant hyperthermia?.
Answer: tachycardia
,◉ when should the nurse expect malignant hyperthermia to occur in
the peri-operative period?.
Answer: -10-20 after anesthesia started
-first 24 hrs post-op
◉ what are the s/s of hypovolemic shock?.
Answer: -pallor
-rapid weak thready pulse
-low BP
-rapid breathing
◉ how far in advance should a patient stop taking aspirin before
surgery?.
Answer: 7-10 days
◉ why is NPO status so important prior to surgery?.
Answer: to avoid aspiration
◉ s/s of IV infiltration.
Answer: -edema, discomfort/pain, redness, coolness at site, leakage
◉ s/s of extravasation of IV.
, Answer: -inflammation, blistering, & necrosis at site
◉ s/s of IV phlebitis.
Answer: -redness, tender/pain, swelling (inflammation of the vessel)
◉ when should a patient stop smoking prior to a scheduled surgery?
why?.
Answer: 4-8 wks to reduce pulmonary and wound healing
complications
◉ what are some indications to postpone a schedule surgery?.
Answer: -uncontrolled HTN
-pt intoxicated
-current infection
◉ first intention wound healing.
Answer: granulation not visible & scar formation minimal; cover w/
dry sterile dressing
◉ second intention wound healing.
Answer: granulation occurs in infected wounds or wounds w/ edges
not approximated; pack w/ moist sterile dressing & cover w/ dry
sterile dressing
