NURS 462 Perioperative Nursing
Final Exam Review
(Questions & Solutions)
2025
1
, Case Scenario: A 45-year-old male with an ASA II status is scheduled for
a laparoscopic cholecystectomy. Standard prophylaxis is planned.
Question: Which prophylactic antibiotic is most appropriate for this
procedure?
Options:
a) Cefazolin
b) Vancomycin
c) Clindamycin
d) Ciprofloxacin
Correct ANS: a) Cefazolin
Rationale: Cefazolin is a first-generation cephalosporin which is widely
recommended for surgical prophylaxis in clean-contaminated
procedures. It covers the common skin flora and has a favorable safety
profile compared with alternatives reserved for patients with allergies or
resistant organisms.
---
2. [Fill-in-the-Blank]
Case Scenario: During the preoperative screening of a patient with a
suspected coagulopathy...
Question: _During the preoperative screening, the test most valuable
in evaluating the integrity of the extrinsic coagulation pathway is the
__________ test._
Correct ANS: prothrombin time (PT)
Rationale: The prothrombin time test assesses the extrinsic and
common coagulation pathways and is critical in evaluating patients who
2
,might have clotting disorders before surgery.
---
3. [True/False]
Case Scenario: While reviewing intraoperative protocols, you consider
advanced warming devices.
Question: _In perioperative nursing, the use of forced-air warming
systems has been conclusively shown to increase the risk of surgical site
infections._
Correct ANS: False
Rationale: Research supports the safe use of forced-air warming
systems; when applied according to guidelines, they maintain
normothermia without increasing surgical site infection rates.
---
4. [Multiple Response]
Case Scenario: A patient’s OR environment is being optimized to
prevent hypothermia.
Question: _Which of the following interventions are recommended for
preventing perioperative hypothermia? (Select all that apply)_
Options:
a) Forced-air warming
b) Intravenous fluid warming
c) Ambient room heating
d) Forced cold air convection
Correct ANSs: a), b), and c)
3
, Rationale: Forced-air warming, warming IV fluids, and regulating the
ambient temperature are proven strategies to maintain normothermia in
patients. Forced cold air convection is counterproductive and can lower
the patient’s core temperature.
---
5. [Multiple Choice]
Case Scenario: During an orthopedic procedure, a patient suddenly
exhibits signs of malignant hyperthermia.
Question: _Which of the following is the first-line treatment for
malignant hyperthermia?_
Options:
a) Dantrolene
b) Propranolol
c) Calcium channel blockers
d) Diazepam
Correct ANS: a) Dantrolene
Rationale: Dantrolene is the established, first-line treatment for
malignant hyperthermia. It acts by reducing calcium release from the
sarcoplasmic reticulum in skeletal muscles, thereby mitigating the
hypermetabolic state.
---
6. [Fill-in-the-Blank]
Case Scenario: Just before incision, the surgical team pauses for a
timeout.
Question: _The primary goal of the surgical “time-out” is to verify the
4
Final Exam Review
(Questions & Solutions)
2025
1
, Case Scenario: A 45-year-old male with an ASA II status is scheduled for
a laparoscopic cholecystectomy. Standard prophylaxis is planned.
Question: Which prophylactic antibiotic is most appropriate for this
procedure?
Options:
a) Cefazolin
b) Vancomycin
c) Clindamycin
d) Ciprofloxacin
Correct ANS: a) Cefazolin
Rationale: Cefazolin is a first-generation cephalosporin which is widely
recommended for surgical prophylaxis in clean-contaminated
procedures. It covers the common skin flora and has a favorable safety
profile compared with alternatives reserved for patients with allergies or
resistant organisms.
---
2. [Fill-in-the-Blank]
Case Scenario: During the preoperative screening of a patient with a
suspected coagulopathy...
Question: _During the preoperative screening, the test most valuable
in evaluating the integrity of the extrinsic coagulation pathway is the
__________ test._
Correct ANS: prothrombin time (PT)
Rationale: The prothrombin time test assesses the extrinsic and
common coagulation pathways and is critical in evaluating patients who
2
,might have clotting disorders before surgery.
---
3. [True/False]
Case Scenario: While reviewing intraoperative protocols, you consider
advanced warming devices.
Question: _In perioperative nursing, the use of forced-air warming
systems has been conclusively shown to increase the risk of surgical site
infections._
Correct ANS: False
Rationale: Research supports the safe use of forced-air warming
systems; when applied according to guidelines, they maintain
normothermia without increasing surgical site infection rates.
---
4. [Multiple Response]
Case Scenario: A patient’s OR environment is being optimized to
prevent hypothermia.
Question: _Which of the following interventions are recommended for
preventing perioperative hypothermia? (Select all that apply)_
Options:
a) Forced-air warming
b) Intravenous fluid warming
c) Ambient room heating
d) Forced cold air convection
Correct ANSs: a), b), and c)
3
, Rationale: Forced-air warming, warming IV fluids, and regulating the
ambient temperature are proven strategies to maintain normothermia in
patients. Forced cold air convection is counterproductive and can lower
the patient’s core temperature.
---
5. [Multiple Choice]
Case Scenario: During an orthopedic procedure, a patient suddenly
exhibits signs of malignant hyperthermia.
Question: _Which of the following is the first-line treatment for
malignant hyperthermia?_
Options:
a) Dantrolene
b) Propranolol
c) Calcium channel blockers
d) Diazepam
Correct ANS: a) Dantrolene
Rationale: Dantrolene is the established, first-line treatment for
malignant hyperthermia. It acts by reducing calcium release from the
sarcoplasmic reticulum in skeletal muscles, thereby mitigating the
hypermetabolic state.
---
6. [Fill-in-the-Blank]
Case Scenario: Just before incision, the surgical team pauses for a
timeout.
Question: _The primary goal of the surgical “time-out” is to verify the
4
