COMSAE Phase 1 Form 113 Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
Question 1
The perianesthesia nurse demonstrates understanding that language and readable
instructions are important to patient safety after discharge by ensuring patient
discharge instructions are written at the vocabulary of which grade level?
A) 3rd grade
B) 5th grade
C) 9th grade
D) 12th grade
Rationale & Explanation:
Health literacy guidelines from the National Institutes of Health (NIH) and the
American Medical Association (AMA) recommend that patient discharge
instructions be written at a 5th-grade reading level to ensure comprehension and
safety after discharge. Higher reading levels may not be understood by all patients,
increasing the risk of non-adherence, medication errors, and complications. Studies
show that nearly half of American adults have limited health literacy, meaning they
struggle to understand and act upon medical instructions written at higher grade
,levels. The 5th-grade standard balances comprehensibility with the necessary detail
for safe home care.
Question 2
While assessing an elderly patient who is anxious and fearful, a perianesthesia
nurse observes old and new bruises with torn skin on the patient's arms, face, and
hairline. The perianesthesia nurse's best action is to:
A) Approach the family about possible abuse
B) Evaluate, observe, and further assess the patient
C) Use appropriate paper tape on the patient's skin
D) Report this information to social services
Rationale & Explanation:
The nurse has a legal and ethical obligation to report suspected elder abuse. The
findings of old and new bruises with torn skin in a fearful patient are highly
concerning for abuse. The pattern is suspicious because:
• Old and new bruises suggest repeated trauma over time
• Torn skin indicates possible physical force
• Anxious and fearful demeanor is a behavioral red flag
Reporting to social services ensures proper investigation and protection of the
patient. The nurse should not confront the family directly, as this could escalate
danger to the patient. Further assessment is important but should not delay
reporting. In most states, healthcare providers are mandated reporters required by
law to report suspected abuse immediately.
,Question 3
The perianesthesia nurse instructs a patient scheduled for a laparoscopic
cholecystectomy to remove body piercings prior to arrival as they may cause:
A) Injury and infection
B) Increased pain in the incision site
C) Adverse medication interaction
D) EKG monitoring interference
Rationale & Explanation:
Body piercings can cause:
• Injury during surgery from electrocautery (metal piercings can act as
electrical conductors, causing burns at the piercing site)
• Infection risk because piercings create a direct portal of entry for bacteria,
and surgical sites are kept sterile
• Interference with surgical positioning (e.g., oral piercings can become
dislodged into the airway)
• Thermal burns if metal comes into contact with electrosurgical equipment
While piercings can also interfere with EKG monitoring, this is not the primary
safety concern cited for removal prior to arrival. The key risks are physical injury
and infection.
Question 4
The perianesthesia nurse suspects a Type IV latex allergy in a patient exhibiting:
A) Tachyphylaxis
B) Erythema
, C) Urticaria
D) Wheezing
Rationale & Explanation:
Type IV hypersensitivity (delayed-type, cell-mediated) reactions to latex present
as contact dermatitis—erythema, itching, vesicles, and dry, crusted lesions
typically appearing 24-48 hours after exposure. This reaction is mediated by T
lymphocytes and macrophages, not IgE antibodies.
In contrast:
• Urticaria (hives) and wheezing are manifestations of Type I
hypersensitivity (immediate, IgE-mediated) reactions to latex, which can
progress to anaphylaxis
• Tachyphylaxis refers to rapid development of tolerance to a drug, not a
hypersensitivity reaction
Differentiating between Type I and Type IV latex reactions is critical for
perioperative safety: Type I requires immediate intervention and future avoidance
of all latex products, while Type IV requires avoidance of latex gloves but may
tolerate other latex-containing devices.
Question 5
During a preoperative assessment, a patient reports a history of malignant
hyperthermia in a sibling during general anesthesia. Which medication should be
avoided?
A) Propofol
B) Etomidate
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
Question 1
The perianesthesia nurse demonstrates understanding that language and readable
instructions are important to patient safety after discharge by ensuring patient
discharge instructions are written at the vocabulary of which grade level?
A) 3rd grade
B) 5th grade
C) 9th grade
D) 12th grade
Rationale & Explanation:
Health literacy guidelines from the National Institutes of Health (NIH) and the
American Medical Association (AMA) recommend that patient discharge
instructions be written at a 5th-grade reading level to ensure comprehension and
safety after discharge. Higher reading levels may not be understood by all patients,
increasing the risk of non-adherence, medication errors, and complications. Studies
show that nearly half of American adults have limited health literacy, meaning they
struggle to understand and act upon medical instructions written at higher grade
,levels. The 5th-grade standard balances comprehensibility with the necessary detail
for safe home care.
Question 2
While assessing an elderly patient who is anxious and fearful, a perianesthesia
nurse observes old and new bruises with torn skin on the patient's arms, face, and
hairline. The perianesthesia nurse's best action is to:
A) Approach the family about possible abuse
B) Evaluate, observe, and further assess the patient
C) Use appropriate paper tape on the patient's skin
D) Report this information to social services
Rationale & Explanation:
The nurse has a legal and ethical obligation to report suspected elder abuse. The
findings of old and new bruises with torn skin in a fearful patient are highly
concerning for abuse. The pattern is suspicious because:
• Old and new bruises suggest repeated trauma over time
• Torn skin indicates possible physical force
• Anxious and fearful demeanor is a behavioral red flag
Reporting to social services ensures proper investigation and protection of the
patient. The nurse should not confront the family directly, as this could escalate
danger to the patient. Further assessment is important but should not delay
reporting. In most states, healthcare providers are mandated reporters required by
law to report suspected abuse immediately.
,Question 3
The perianesthesia nurse instructs a patient scheduled for a laparoscopic
cholecystectomy to remove body piercings prior to arrival as they may cause:
A) Injury and infection
B) Increased pain in the incision site
C) Adverse medication interaction
D) EKG monitoring interference
Rationale & Explanation:
Body piercings can cause:
• Injury during surgery from electrocautery (metal piercings can act as
electrical conductors, causing burns at the piercing site)
• Infection risk because piercings create a direct portal of entry for bacteria,
and surgical sites are kept sterile
• Interference with surgical positioning (e.g., oral piercings can become
dislodged into the airway)
• Thermal burns if metal comes into contact with electrosurgical equipment
While piercings can also interfere with EKG monitoring, this is not the primary
safety concern cited for removal prior to arrival. The key risks are physical injury
and infection.
Question 4
The perianesthesia nurse suspects a Type IV latex allergy in a patient exhibiting:
A) Tachyphylaxis
B) Erythema
, C) Urticaria
D) Wheezing
Rationale & Explanation:
Type IV hypersensitivity (delayed-type, cell-mediated) reactions to latex present
as contact dermatitis—erythema, itching, vesicles, and dry, crusted lesions
typically appearing 24-48 hours after exposure. This reaction is mediated by T
lymphocytes and macrophages, not IgE antibodies.
In contrast:
• Urticaria (hives) and wheezing are manifestations of Type I
hypersensitivity (immediate, IgE-mediated) reactions to latex, which can
progress to anaphylaxis
• Tachyphylaxis refers to rapid development of tolerance to a drug, not a
hypersensitivity reaction
Differentiating between Type I and Type IV latex reactions is critical for
perioperative safety: Type I requires immediate intervention and future avoidance
of all latex products, while Type IV requires avoidance of latex gloves but may
tolerate other latex-containing devices.
Question 5
During a preoperative assessment, a patient reports a history of malignant
hyperthermia in a sibling during general anesthesia. Which medication should be
avoided?
A) Propofol
B) Etomidate
