A few hours after surgery, a patient has a rising pulse, falling blood pressure and cool, pale skin. What should the nurse suspect and do?

Suspect bleeding or shock, assess ABCDE and escalate urgently

Assume it is normal after surgery and wait

Encourage them to sit up and walk

Give them a large drink and recheck tomorrow

What is an appropriate measure to prevent venous thromboembolism after surgery?

Early mobilisation and prescribed prophylaxis after risk assessment

Strict bed rest for as long as possible

Avoiding any anticoagulation routinely

A post-operative patient reports they have not passed urine for many hours and feels uncomfortable in the lower abdomen. What should the nurse consider?

Urinary retention, which is common after surgery and needs assessment

That this is always normal and needs no action

That they should simply drink less

That it can safely wait until discharge

Why does a nurse perform regular observations on a stable-looking post-operative patient?

To detect a deteriorating trend early, before it becomes critical

Only because it is routine paperwork

Because stable patients never deteriorate

To avoid speaking with the patient

Part B4 of 8 Providing and Evaluating Care Chapter 53 of 75

Post-Operative Care and Recovery Questions

NMC CBT post-operative practice: recognising bleeding and shock, observations, pain and nausea, VTE prevention, and worked scenario answers.

Start reading ← Back to all parts ~5 min read

By JobLabs Editorial · UK healthcare reference editorial team

· July 16, 2026 · Updated Jul 17, 2026 · 2 min read

The hours after surgery are when preventable complications, bleeding, shock, clots, retention, most often appear, and close monitoring is what catches them. The CBT tests whether you can spot these early and act.

Watch the trend

Post-operative patients are observed regularly, and the point is the trend. A single set of observations may look fine, but a series using NEWS2 can reveal bleeding, infection or deterioration in time to act. A nurse who understands that a stable-looking patient still needs monitoring, because they can deteriorate, is answering these questions correctly.

Recognising bleeding and shock

The most important recognition skill is spotting hypovolaemia from bleeding early. The signs are a rising pulse and a falling blood pressure, with pallor, cool clammy skin, restlessness and reduced urine output. The key detail, tested often, is that the body compensates first by speeding the heart, so a rising pulse usually appears before the blood pressure drops. That early tachycardia is your window to assess ABCDE and escalate urgently, rather than waiting for the blood pressure to fall.

Pain, nausea and retention

Comfort matters too. Pain and post-operative nausea are assessed and managed, not left. And urinary retention is a common complication after surgery and anaesthesia: a patient who has not passed urine for hours with lower abdominal discomfort should be assessed, often with a bladder scan, rather than told to drink less or wait.

Preventing clots

Surgery and immobility raise the risk of venous thromboembolism, so prevention is planned for every surgical patient. It combines risk assessment with measures such as early mobilisation, anti-embolism stockings or compression devices, and prophylactic anticoagulation where appropriate. Prolonged bed rest is the wrong instinct; getting patients moving safely is part of prevention. Next: infection prevention and control. Five post-operative scenarios first.

Sources & further reading

Key takeaway from Post-Operative Care and Recovery Questions

Frequently asked questions

What are early signs of post-operative bleeding or shock?

A rising pulse and falling blood pressure, along with pallor, cool clammy skin, restlessness, reduced urine output and visible or concealed blood loss. A fast pulse often appears before the blood pressure falls, so it is an early warning to act on.

How is venous thromboembolism prevented after surgery?

Through risk assessment and measures such as early mobilisation, anti-embolism stockings or intermittent compression, and often prophylactic anticoagulation. Surgery and immobility raise clot risk, so prevention is planned for every surgical patient.

Why are regular observations important after surgery?

They detect complications early, before they become critical. A trend in the vital signs, using NEWS2, can reveal bleeding, infection or deterioration in time to act. Post-operative patients are monitored closely for exactly this reason.

Check your understanding

Quick quiz: Post-Operative Care and Recovery Questions

5questions. Click an answer to see the explanation. Your score is saved on this device only.

1
A few hours after surgery, a patient has a rising pulse, falling blood pressure and cool, pale skin. What should the nurse suspect and do?
A rising pulse with falling blood pressure and cool, pale skin points to hypovolaemia from bleeding. This needs urgent ABCDE assessment and escalation. A fast pulse often precedes the blood pressure drop, so waiting, mobilising or dismissing it risks missing a haemorrhage.
2
Which sign often appears earliest in post-operative haemorrhage?
The body compensates for blood loss by increasing the heart rate, so a rising pulse (tachycardia) often appears before the blood pressure falls. Recognising early tachycardia gives you the chance to act before the patient decompensates.
3
What is an appropriate measure to prevent venous thromboembolism after surgery?
VTE is prevented through risk assessment and measures such as early mobilisation, compression stockings or devices, and prophylactic anticoagulation where appropriate. Prolonged bed rest actually raises clot risk, and dehydration does too, so those are the wrong approach.
4
A post-operative patient reports they have not passed urine for many hours and feels uncomfortable in the lower abdomen. What should the nurse consider?
Urinary retention is a recognised post-operative complication, especially after certain surgery or anaesthesia. Not passing urine with lower abdominal discomfort should be assessed, for example with a bladder scan, rather than dismissed. Left untreated it causes pain and can harm the bladder.
5
Why does a nurse perform regular observations on a stable-looking post-operative patient?
Regular observations track the trend and catch early deterioration, bleeding or infection before it becomes an emergency. A patient who looks stable now can deteriorate, so monitoring is about early detection, not just paperwork.