Under the Universal Protocol, the surgical site should be marked:

By the person doing the procedure, with the patient involved

By the patient alone with a skin marker

By the ward nurse on the night before surgery

By the theatre nurse once the patient is anaesthetised

A motorcyclist arrives after a crash with bright red blood spurting from a deep thigh wound, GCS 14, RR 24/min, SpO2 95% on air and an open tibial fracture. What should the team do first?

Control the thigh bleeding with pressure or a tourniquet

Splint the open tibial fracture

Complete a full head-to-toe secondary survey

Apply high-flow oxygen by non-rebreather mask

A Muslim woman needs a dressing to a perineal wound and asks for a female nurse. What is the best response?

Arrange a female nurse where possible and keep her covered

Ask her husband to change the dressing instead

Explain that gender cannot be considered on a busy ward

Postpone the dressing until the next day

When estimating scattered small burns, the patient's own palm including the fingers is taken as about:

0.5% of total body surface area

Perioperative, wound, burns and critical care

56 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Perioperative, wound, burns and critical care, part of Adult Health Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
Under the Universal Protocol, the surgical site should be marked:
1. ABy the patient alone with a skin marker
2. BBy the ward nurse on the night before surgery
3. CBy the theatre nurse once the patient is anaesthetised
4. DBy the person doing the procedure, with the patient involved
Show answerHide answer
Answer: D · By the person doing the procedure, with the patient involved
Site marking prevents wrong-site surgery and is part of the JCI goal on correct site, procedure and patient. The person who will do the procedure marks it before the patient goes to theatre, ideally while the patient is awake and can confirm. The mark must be visible after prepping and draping. The Time Out then confirms it again.
- A: The patient takes part but does not mark the site alone.
- B: The nurse does not mark, because the surgeon is accountable for the site.
- C: Marking after anaesthesia removes the patient's chance to confirm the site.
Question 2 · Hard
A motorcyclist arrives after a crash with bright red blood spurting from a deep thigh wound, GCS 14, RR 24/min, SpO2 95% on air and an open tibial fracture. What should the team do first?
1. ASplint the open tibial fracture
2. BControl the thigh bleeding with pressure or a tourniquet
3. CComplete a full head-to-toe secondary survey
4. DApply high-flow oxygen by non-rebreather mask
Show answerHide answer
Answer: B · Control the thigh bleeding with pressure or a tourniquet
Catastrophic external bleeding kills within minutes, so it is controlled first, before airway and breathing (the cABCDE sequence). Direct pressure is applied, and a tourniquet is placed above the wound if pressure fails on a limb. The airway with cervical spine protection, breathing and circulation are then assessed. Splinting and the secondary survey come later.
- A: The fracture is managed after life threats are controlled.
- C: The secondary survey comes after the primary survey and resuscitation.
- D: Oxygen is important but the patient is maintaining saturation while bleeding out.
Question 3 · Medium
A Muslim woman needs a dressing to a perineal wound and asks for a female nurse. What is the best response?
1. AArrange a female nurse where possible and keep her covered
2. BAsk her husband to change the dressing instead
3. CExplain that gender cannot be considered on a busy ward
4. DPostpone the dressing until the next day
Show answerHide answer
Answer: A · Arrange a female nurse where possible and keep her covered
Modesty and same-gender care matter greatly to many Muslim patients, and respecting the request supports dignity and trust. The nurse arranges a female colleague when possible and exposes only the area being treated. If none is available, the nurse explains, gains consent and keeps a chaperone. Delaying needed wound care is not acceptable.
- B: Clinical wound care should not be handed to a relative.
- C: Refusing to consider the request ignores the patient's cultural and religious needs.
- D: A delay may harm the wound when a solution is usually available.
Question 4 · Hard
A day after a chest drain was inserted for a pneumothorax, the water seal no longer rises and falls with breathing and does not bubble. Breath sounds are now equal on both sides and the patient is comfortable. What is the most likely explanation?
1. AThe lung has re-expanded
2. BThere is a new air leak
3. CThe suction is set too high
4. DThe drain is kinked or blocked
Show answerHide answer
Answer: A · The lung has re-expanded
The water level swings with breathing while the pleural space still communicates with the drain. When the lung re-expands and seals, the swing and bubbling stop. Equal breath sounds and a comfortable patient fit re-expansion, which is then confirmed by chest X-ray before removal. A kinked or blocked drain also stops the swing, but the patient would usually worsen, so the tubing is still checked.
- B: An air leak causes bubbling, not its absence.
- C: Suction affects the suction chamber, not the swing in a re-expanded lung.
- D: A blocked drain usually comes with returning breathlessness and reduced breath sounds.
Question 5 · Easy
When estimating scattered small burns, the patient's own palm including the fingers is taken as about:
1. A5% of total body surface area
2. B9% of total body surface area
3. C1% of total body surface area
4. D0.5% of total body surface area
Show answerHide answer
Answer: C · 1% of total body surface area
The palmar method uses the patient's whole hand, palm and fingers, as roughly 1% of the total body surface area. It is quick for irregular or patchy burns where the rule of nines fits poorly. It works for adults and children because it scales with the patient's own size. Erythema alone (superficial burns) is not counted in the TBSA used for fluid formulas.
- A: Five percent is far larger than one hand in an adult.
- B: Nine percent is the rule-of-nines value for a whole arm or the head.
- D: Half a percent is roughly the palm without the fingers.
Question 6 · Medium
To prevent a flexion contracture in a patient with burns to the front of the neck, the nurse should position the patient:
1. AOn two pillows so the neck is kept flexed
2. BWithout a pillow, neck slightly extended
3. CProne, with the head turned to one side
4. DWith the head turned toward the burn
Answer and explanation in LearnFree account
Question 7 · Easy
For an adult with anaphylactic shock, the first-line dose and route of adrenaline (1 mg/mL) is:
1. A0.5 mg subcutaneously into the upper arm
2. B0.1 mg intramuscularly into the buttock
3. C1 mg intravenously as a rapid push
4. D0.5 mg intramuscularly into the outer thigh
Answer and explanation in LearnFree account
Question 8 · Easy
Which finding is one of the three qSOFA criteria?
1. ATemperature above 38.3 °C
2. BWhite cell count above 12 x10^9/L
3. CRespiratory rate of 22/min or more
4. DHeart rate above 90/min
Answer and explanation in LearnFree account
Question 9 · Easy
Under ASA fasting guidance, a healthy adult having elective surgery may drink clear fluids such as water up to:
1. A2 hours before anaesthesia
2. B6 hours before anaesthesia
3. C8 hours before anaesthesia
4. D4 hours before anaesthesia
Answer and explanation in LearnFree account
Question 10 · Medium
Seven days after a two-unit red cell transfusion, a patient has jaundice, dark urine and a haemoglobin lower than before the transfusion. This most likely represents:
1. AA febrile non-haemolytic reaction
2. BTransfusion-transmitted hepatitis B
3. CTransfusion-associated circulatory overload
4. DA delayed haemolytic transfusion reaction
Answer and explanation in LearnFree account
Question 11 · Hard
A patient with a thoracic epidural infusion after a laparotomy has BP 84/50 mmHg (baseline 130/80), numbness up to the nipple line spreading to the fingers, and weak hand grip. What should the nurse do first?
1. AIncrease the epidural rate to control the pain
2. BSit the patient upright to ease her breathing
3. CStop the epidural infusion and call the anaesthetist
4. DRemove the epidural catheter at the bedside
Answer and explanation in LearnFree account
Question 12 · Medium
Under the 2021 Surviving Sepsis Campaign guidance, IV antibiotics for an adult with possible septic shock should be started:
1. AWithin 3 hours of recognition
2. BWithin 1 hour of recognition
3. CWithin 6 hours of recognition
4. DOnce culture results are back
Answer and explanation in LearnFree account
Question 13 · Easy
Before diathermy is used in theatre, the dispersive (return) electrode pad should be placed on:
1. AA bony prominence close to the incision
2. BA hairy, scarred area of the upper back
3. CClean, dry skin over a large muscle mass
4. DSkin directly over a metal hip implant
Answer and explanation in LearnFree account
Question 14 · Medium
In the recovery room, a woman's temperature is 35.2 °C and she is shivering after a 3-hour abdominal operation. What is the best nursing intervention?
1. AWarm her with a forced-air warming blanket
2. BRemove the blankets to assess the skin
3. CGive an extra dose of morphine for comfort
4. DGive cold IV fluids to stop the shivering
Answer and explanation in LearnFree account
Question 15 · Medium
During wound closure, the circulating nurse's sponge count is one short. What should happen first?
1. AComplete an incident report and close the wound
2. BRecount once the patient reaches recovery
3. CRecord the shortfall and let closure continue
4. DTell the surgeon at once and search before closure
Answer and explanation in LearnFree account
Question 16 · Easy
Hypotension, muffled heart sounds and distended neck veins after a stab wound to the chest suggest:
1. ACardiac tamponade
2. BMassive haemothorax
3. CTension pneumothorax
4. DFlail chest
Answer and explanation in LearnFree account
Question 17 · Medium
A worker arrives with dry lime powder (calcium oxide) on his arm. Before irrigating the skin, the nurse should:
1. ANeutralise it with vinegar
2. BBrush off the dry powder
3. CCover it with a damp towel
4. DApply silver sulfadiazine
Answer and explanation in LearnFree account
Question 18 · Hard
A patient with septic shock has BP 84/42 mmHg. The target is a mean arterial pressure of at least 65 mmHg. What is the patient's MAP?
1. A63 mmHg
2. B56 mmHg
3. C42 mmHg
4. D70 mmHg
Answer and explanation in LearnFree account
Question 19 · Easy
A prophylactic antibiotic such as cefazolin works best against surgical site infection when it is given:
1. ADaily for the five days after the operation
2. BIn the recovery room after the operation
3. CWithin 60 minutes before the skin incision
4. DThe evening before the day of surgery
Answer and explanation in LearnFree account
Question 20 · Hard
An 80 kg man has 25% TBSA partial- and full-thickness burns. Using the Parkland formula (4 mL x kg x %TBSA), at what rate should Ringer's lactate run during hours 9 to 24 after the burn?
1. A250 mL/h
2. B333 mL/h
3. C500 mL/h
4. D167 mL/h
Answer and explanation in LearnFree account
Question 21 · Medium
A patient on IV morphine after surgery keeps drifting off to sleep mid-sentence (Pasero sedation level 3); respiratory rate is 12/min. What should the nurse do first?
1. AGive the next morphine dose as prescribed
2. BDocument it and reassess at the next 4-hour check
3. CWithhold further opioid and monitor sedation and breathing closely
4. DGive naloxone 0.4 mg as a rapid IV push
Answer and explanation in LearnFree account
Question 22 · Medium
Eight hours after a hernia repair under spinal anaesthesia, a man has not passed urine and feels lower abdominal fullness. What is the most appropriate next step?
1. AInsert an indwelling catheter at once
2. BGive a diuretic to stimulate urine flow
3. CAssess the bladder with a bladder scanner
4. DRestrict his oral fluids until he has voided
Answer and explanation in LearnFree account
Question 23 · Medium
After naloxone reverses opioid-induced respiratory depression, the patient must be watched closely for the next few hours because:
1. ANaloxone often causes seizures some hours later
2. BNaloxone wears off sooner than most opioids
3. CNaloxone accumulates and stops breathing
4. DNaloxone raises blood glucose sharply
Answer and explanation in LearnFree account
Question 24 · Medium
A scald on the forearm is pink, moist and blistered, blanches on pressure and is very painful. This burn is classified as:
1. ADeep partial-thickness
2. BSuperficial (epidermal)
3. CSuperficial partial-thickness
4. DFull-thickness
Answer and explanation in LearnFree account
Question 25 · Easy
A clean surgical incision whose edges are closed with sutures heals by:
1. ASecondary intention
2. BPrimary intention
3. CTertiary intention
4. DDelayed epithelial grafting
Answer and explanation in LearnFree account

31 more Perioperative, wound, burns and critical care questions

Answer them one by one, keep your score and see your weak topics in Learn. Signed-out visitors try 25 per exam; sign in with Google to see them all.

Study Adult Health Nursing

Perioperative, wound, burns and critical care

Under the Universal Protocol, the surgical site should be marked:

A motorcyclist arrives after a crash with bright red blood spurting from a deep thigh wound, GCS 14, RR 24/min, SpO2 95% on air and an open tibial fracture. What should the team do first?

A Muslim woman needs a dressing to a perineal wound and asks for a female nurse. What is the best response?

A day after a chest drain was inserted for a pneumothorax, the water seal no longer rises and falls with breathing and does not bubble. Breath sounds are now equal on both sides and the patient is comfortable. What is the most likely explanation?

When estimating scattered small burns, the patient's own palm including the fingers is taken as about:

To prevent a flexion contracture in a patient with burns to the front of the neck, the nurse should position the patient:

For an adult with anaphylactic shock, the first-line dose and route of adrenaline (1 mg/mL) is:

Which finding is one of the three qSOFA criteria?

Under ASA fasting guidance, a healthy adult having elective surgery may drink clear fluids such as water up to:

Seven days after a two-unit red cell transfusion, a patient has jaundice, dark urine and a haemoglobin lower than before the transfusion. This most likely represents:

A patient with a thoracic epidural infusion after a laparotomy has BP 84/50 mmHg (baseline 130/80), numbness up to the nipple line spreading to the fingers, and weak hand grip. What should the nurse do first?

Under the 2021 Surviving Sepsis Campaign guidance, IV antibiotics for an adult with possible septic shock should be started:

Before diathermy is used in theatre, the dispersive (return) electrode pad should be placed on:

In the recovery room, a woman's temperature is 35.2 °C and she is shivering after a 3-hour abdominal operation. What is the best nursing intervention?

During wound closure, the circulating nurse's sponge count is one short. What should happen first?

Hypotension, muffled heart sounds and distended neck veins after a stab wound to the chest suggest:

A worker arrives with dry lime powder (calcium oxide) on his arm. Before irrigating the skin, the nurse should:

A patient with septic shock has BP 84/42 mmHg. The target is a mean arterial pressure of at least 65 mmHg. What is the patient's MAP?

A prophylactic antibiotic such as cefazolin works best against surgical site infection when it is given:

An 80 kg man has 25% TBSA partial- and full-thickness burns. Using the Parkland formula (4 mL x kg x %TBSA), at what rate should Ringer's lactate run during hours 9 to 24 after the burn?

A patient on IV morphine after surgery keeps drifting off to sleep mid-sentence (Pasero sedation level 3); respiratory rate is 12/min. What should the nurse do first?

Eight hours after a hernia repair under spinal anaesthesia, a man has not passed urine and feels lower abdominal fullness. What is the most appropriate next step?

After naloxone reverses opioid-induced respiratory depression, the patient must be watched closely for the next few hours because:

A scald on the forearm is pink, moist and blistered, blanches on pressure and is very painful. This burn is classified as:

A clean surgical incision whose edges are closed with sutures heals by: