Perioperative Nursing Pretest

A 64-year-old on clopidogrel for a coronary stent is booked for an elective open hernia repair; last dose was 3 days ago. What should you do?

• Proceed because it’s minor surgery

• Give vitamin K now

• Notify anesthesia/surgeon to reassess timing; clopidogrel hold is usually longer for elective cases

• Tell the patient to skip today’s dose only

Morning labs for an elective case show K⁺ 6.1 mmol/L without EKG on file. Your priority is to:

• Send to OR and monitor

• Escalate to anesthesia; expect treatment and delay until corrected

• Give a banana

• Start maintenance IV only

A known OSA patient brings a home CPAP. Best pre-op plan?

• Store CPAP at front desk

• Ensure CPAP is available; inform anesthesia and PACU

• Tell patient CPAP is not used peri-op

• Use only if oxygen saturation drops below 80%

A healthy adult asks about clear liquids before anesthesia. Correct teaching is:

• No liquids after midnight

• Clear liquids may be taken until 2 hours before anesthesia, per policy

• Clear liquids up to 30 minutes prior

• Only coffee with cream is allowed

You’re about to give ordered on-call lorazepam. Which verification must occur first?

• Family is present

• OR room is ready

• Informed consent is complete and filed

• Post-op diet is chosen

A patient takes metoprolol 50 mg daily; they are NPO. What’s appropriate?

• Hold all home meds

• Give the beta-blocker with a small sip of water per anesthesia plan

• Double the dose if anxious

• Switch to amlodipine

The same patient takes lisinopril every morning. Best action?

• Always administer

• Hold and clarify with anesthesia (risk of refractory hypotension)

• Replace with IV labetalol automatically

• Stop for one week

A patient on warfarin arrives for elective surgery with INR 3.0. Your next step:

• Proceed with careful hemostasis

• Give PCC now without orders

• Notify surgeon/anesthesia for reversal/bridge plan and likely delay

• Start heparin and continue

Skin hair removal is ordered at the incision site. Safest approach?

• Shave with a razor the night before

• Clip only if necessary, immediately pre-op

• Chemical depilatory at home

• Waxing 24 hours prior

A 24-year-old is unsure of pregnancy status; GA is planned. What should you do?

• Proceed; patient is low risk

• Obtain a pregnancy test per policy before anesthesia

• Ask the partner to confirm

• Test in PACU after surgery