Anaesthesia — Postoperative Care and Acute Pain, NMC MBBS licence examination syllabus (Nepal Medical Council).
NMC-style practice questions written for this site. They are not past questions, and no past paper has been reproduced.
One hour after surgery a patient is snoring loudly. The oxygen saturation is acceptable on supplemental oxygen. What should be done?
Answer: Treat it as partial airway obstruction: reposition the patient, apply a simple airway manoeuvre and reassess. Snoring after anaesthesia is obstruction rather than sleep, and supplemental oxygen holds the saturation up while ventilation is already inadequate — so the number is a late warning.
Why is the respiratory rate more useful than the oxygen saturation in a patient recovering from anaesthesia on oxygen?
Answer: Because oxygen maintains an acceptable saturation despite inadequate ventilation, so the saturation falls late. Residual opioid and anaesthetic depress the rate first, making a slow rate together with a patient who is difficult to rouse the earlier and more reliable sign.
A patient develops a fever on the sixth postoperative day, having been well since surgery. How does the timing direct the assessment?
Answer: A fever appearing late, or returning after settling, points to the operative site — a wound infection, a collection or a leak — rather than to the early causes of atelectasis or the surgical insult itself. The wound and the operative site should be examined rather than treating empirically. Venous thromboembolism remains possible at any stage.
Two days after abdominal surgery a patient's pain was improving but has become severe and constant, with a rising pulse. Why is increasing analgesia alone the wrong response?
Answer: Because pain that changes character or worsens against the expected pattern is a new diagnosis rather than inadequate analgesia. A leak, a collection or ischaemia present this way, and escalating analgesia without examining masks the deterioration until the patient is septic.
Give a clinical reason, beyond comfort, for controlling postoperative pain well.
Answer: A patient in pain does not breathe deeply, cough or mobilise, which produces retained secretions, chest infection and venous thromboembolism. Controlling pain is therefore part of preventing those complications rather than a separate kindness.
Create a free account to tick topics off, take notes as you read, watch the video lessons and get a day-by-day study plan built around your exam date.
Loading…