1. The nurse has just reassessed the condition
of a postoperative client who was admitted 1
hour ago to the surgical unit. The nurse plans
to monitor which parameter most carefully
during the next hour?
A. Urinary output of 20 mL/hr
B. Temperature of 37.6° C (99.6° F)
C. Blood pressure of 100/70 mm Hg
D. Serous drainage on the surgical dressing
2. The nurse is teaching a client about
coughing and deep-breathing techniques to
prevent postoperative complications. Which
statement is most appropriate for the nurse to
make to the client currently as it relates to
these techniques?
A. “Use of an incentive spirometer will help
prevent pneumonia.”
B. “Close monitoring of your oxygen
saturation will detect hypoxemia.”
C. “Administration of intravenous fluids
will prevent or treat fluid imbalance.”
D. “Early ambulation and administration of
blood thinners will prevent pulmonary
embolism.”
3. The nurse is creating a plan of care for a
client scheduled for surgery. The nurse should
include which activity in the nursing care plan
for the client on the day of surgery?
A. Avoid oral hygiene and rinsing with
mouthwash.
B. Verify that the client has not eaten for the
last 24 hours.
C. Have the client void immediately before
going into surgery.
D. Report immediately any slight increase in
blood pressure or pulse.
4. A client with a gastric ulcer is scheduled for
surgery. The client cannot sign the operative
consent form because of sedation from opioid
analgesics that have been administered. The
nurse should take which most appropriate
action in the care of this client?
A. 1Obtain a court order for the surgery.
B. Have the charge nurse sign the informed
consent immediately.
C. Send the client to surgery without the
consent form being signed.
D. Obtain a telephone consent from a family
member, following agency policy.
5. A preoperative client expresses anxiety to
the nurse about upcoming surgery. Which
response by the nurse is most likely to stimulate
further discussion between the client and the
nurse?
A. “If it’s any help, everyone is nervous
before surgery.”
B. “I will be happy to explain the entire
surgical procedure to you.”
C. “Can you share with me what you’ve
been told about your surgery?”
D. “Let me tell you about the care you’ll
receive after surgery and the amount of
pain you can anticipate.”
6. The nurse is conducting preoperative
teaching with a client about the use of an
incentive spirometer. The nurse should
include which piece of information in
discussions with the client?
A. Inhale as rapidly as possible.
B. Keep a loose seal between the lips and the
mouthpiece.
C. After maximum inspiration, hold the
breath for 15 seconds and exhale.
D. The best results are achieved when sitting
up or with the head of the bed elevated
45 to 90 degrees.
7. The nurse has conducted preoperative
teaching for a client scheduled for surgery in 1
week. The client has a history of arthritis and
has been taking acetylsalicylic acid. The nurse
determines that the client needs additional
teaching if the client makes which statement?
 A. “Aspirin can cause bleeding after
surgery.”
B. “Aspirin can cause my ability to clot
blood to be abnormal.”
C. “I need to continue to take the aspirin
until the day of surgery.”
D. “I need to check with my doctor about
the need to stop the aspirin before the
scheduled surgery.”
8. The nurse assesses a client’s surgical
incision for signs of infection. Which finding
by the nurse would be interpreted as a normal
finding at the surgical site?
A. Red, hard skin
B. Serous drainage
C. Purulent drainage
D. Warm, tender skin
9. The nurse is monitoring the status of a
postoperative client in the immediate
postoperative period. The nurse would become
most concerned with which sign that could
indicate an evolving complication?
A. Increasing restlessness
B. A pulse of 86 beats per minute
C. Blood pressure of 110/70 mm Hg
D. Hypoactive bowel sounds in all 4
quadrants
10. A client who has had abdominal surgery
complains of feeling as though “something
gave way” in the incisional site. The nurse
removes the dressing and notes the presence of
a loop of bowel protruding through the
incision. Which interventions should the nurse
take? Select all that apply.
A. Contact the surgeon.
B. Instruct the client to remain quiet.
C. Prepare the client for wound closure
D. Document the findings and actions taken.
E. Place a sterile saline dressing and ice
packs over the wound.
F. Place the client in a supine position
without a pillow under the head.
11. A client who has undergone preadmission
testing has had blood drawn for serum
laboratory studies, including a complete blood
count, coagulation studies, and electrolytes and
creatinine levels. Which laboratory result
should be reported to the surgeon’s office by
the nurse, knowing that it could cause surgery
to be postponed?
A. Hemoglobin, 8.0 g/dL (80 mmol/L)
B. Sodium, 145 mEq/L (145 mmol/L)
C. Serum creatinine, 0.8 mg/dL (70.6
mcmol/L)
D. Platelets, 210,000 cells/mm3 (210 × 109/L)
12. The nurse receives a telephone call from the
postanesthesia care unit stating that a client is
being transferred to the surgical unit. The
nurse plans to take which action first on arrival
of the client?
A. Assess the patency of the airway.
B. Check tubes or drains for patency.
C. Check the dressing to assess for bleeding.
D. Assess the vital signs to compare with
preoperative measurements.
13. The nurse is reviewing a surgeon’s
prescription sheet for a preoperative client that
states that the client must be nothing by mouth
(NPO) after midnight. The nurse should call
the surgeon to clarify that which medication
should be given to the client and not withheld?
A. Prednisone
B. Ferrous sulfate
C. Cyclobenzaprine
D. Conjugated estrogen