PERIOPERATIVE

NURSING
QUESTIONS
 QUESTION 1
1. Which of the following items on a
client’s pre-surgery laboratory results
would indicate a need to contact the
surgeon?
• A. Platelet count of 250,000/cu.mm.
• B. Total cholesterol of 325 mg/dl.
• C. Blood urea nitrogen (BUN)) 17 mg/dl.
• D. Hemoglobin 9.5 mg/dl.
 QUESTION 2
2. To prevent complications of immobility, which
activities would help the nurse plan for the first
postoperative day after a colon resection?
• A. Turn, cough, and deep breathe every 30 minutes
around the clock.
• B. Get the client out of bed and ambulate to a
bedside chair.
• C. Provide a passive range of motion three times a
day.
• D. It is not necessary to worry about complications
of immobility on the first postoperative day.
 QUESTION 3
3. In the recovery room, the postoperative
client suddenly becomes cyanotic. What is the
most appropriate nursing action?
• A. Start administration of oxygen through a
nasal cannula.
• B. Call for assistance.
• C. Reposition the head and determine patency
of the airway.
• D. Insert an oral airway and suction the
nasopharynx.
 QUESTION 4
4. A client is scheduled for surgery in the
morning. Preoperative orders have been
written. What is most important to do before
surgery?
• A. Remove all jewelry or tape wedding ring.
• B. Verify that all laboratory work is
complete.
• C. Inform family or next of kin.
• D. Have all consent forms signed.
 QUESTION 5
5. The nurse is caring for a first-day
postoperative surgical client. Prioritize the
patient’s desired dietary progression. Arrange
in sequence the dietary progression from 1 to
4: 1. Full liquid; 2. NPO; 3. Clear liquid; 4. Soft
• A. 1, 2, 3, 4
• B. 2, 3, 1, 4
• C. 2, 1, 4, 3
• D. 4, 3, 2, 1
 QUESTION 6
6. A postoperative client receives a dinner
tray with gelatin, pudding, and vanilla ice
cream. Based on the foods on the client’s
tray, what would the nurse anticipate the
client’s current diet order to be:
• A. Bland diet
• B. Soft diet
• C. Full liquid diet
• D. Regular diet
 QUESTION 7
7. The nurse is preparing the preoperative client for a
morning surgery. The following statements indicate the
client is knowledgeable about his impending surgery,
except:
• A. “After surgery, I will need to wear the pneumatic
compression device while sitting in the chair.”
• B. “The skin prep area is going to be longer and wider
than the anticipated incision.”
• C. “I cannot have anything to drink or eat after
midnight on the night before the surgery.”
• D. “To ensure my safety, a ‘time out’ will be conducted
in the operating room.”
 QUESTION 8
8. Which of the following is the primary
purpose of maintaining NPO for 6 to 8 hours
before surgery?
• A. To prevent malnutrition.
• B. To prevent electrolyte imbalance.
• C. To prevent aspiration pneumonia.
• D. To prevent intestinal obstruction.
 QUESTION 9
9. The nurse will provide preoperative teaching
on deep breathing, coughing, and turning
exercises. When is the best time to provide the
preoperative teachings?
• A. Before administration of preoperative
medications.
• B. The afternoon or evening prior to surgery.
• C. Several days prior to surgery.
• D. Upon admission of the client in the
recovery room.
 QUESTION 10
10. Which of the following factors ensure the
validity of informed written consent, except:
• A. The patient is of legal age with a proper
mental disposition.
• B. If the patient is a child, secure consent
from the parents or legal guardian.
• C. The consent is secured before
administration of preoperative medications.
• D. If the patient is unable to write, the nurse
signs the consent for the patient.
 QUESTION 11
11. Which of the following drugs is
administered to minimize respiratory
secretions preoperatively?
• A. Valium (diazepam)
• B. Morphine sulfate
• C. Atropine sulfate
• D. Demerol (Meperidine)
 QUESTION 12
12. Which of the following is experienced by
the patient who is under general
anesthesia?
• A. The patient is unconscious.
• B. The patient is awake.
• C. The patient experiences slight pain.
• D. The patient experiences loss of
sensation in the lower half of the body.
 QUESTION 13
13. Which of the following is the most
dangerous complication during induction of
spinal anesthesia?
• A. Cardiac arrest
• B. Hypotension
• C. Hyperthermia
• D. Respiratory paralysis
 QUESTION 14
14. Which of the following postoperative patients
is at risk for respiratory complications?
• A. The obese patient with a long history of
smoking who had undergone upper abdominal
surgery.
• B. The patient with a normal pulmonary function
who had undergone upper abdominal surgery.
• C. An adolescent patient with diabetes mellitus
who had undergone cholecystectomy.
• D. A football player who had undergone knee
replacement surgery.
 QUESTION 15
15. The patient had undergone spinal
anesthesia for appendectomy. To prevent
spinal headaches, the nurse should place
the patient in which of the following
positions?
• A. Semi-Fowler’s.
• B. Flat on the bed for 6 to 8 hours.
• C. Prone position.
• D. Modified Trendelenburg position.
 QUESTION 16
16. The nurse is admitting a patient to the
operating room. Which of the following nursing
actions should be given the highest priority by
the nurse?
• A. Assessing the patient’s level of
consciousness.
• B. Checking the patient’s vital signs.
• C. Checking the patient’s identification and
correct operative permit.
• D. Positioning and performing skin preparation
to the patient.
 QUESTION 17
17. Which of the following assessment data is
most important to determine when caring for a
patient who has received spinal anesthesia?
• A. The time of the return of motion and
sensation in the patient’s legs and toes.
• B. The character of the patient’s respiration.
• C. The patient’s level of consciousness.
• D. The amount of wound drainage.
 QUESTION 18
18. The nurse is transferring the patient from the
postanesthesia care unit to the surgical unit.
Which of the following is the primary reason for
the gradual change of position of the patient?
• A. To prevent muscle injury.
• B. To prevent sudden drop of blood pressure.
• C. To prevent respiratory distress.
• D. To promote comfort.
 QUESTION 19
19. The nurse is caring for a patient who has
undergone exploratory laparotomy. Which of the
following postop findings should the nurse report
to the physician?
• A. The patient pushes out the oral airway with
his tongue.
• B. The patient’s urine output has been 20 ml/hr
for the past 2 hours.
• C. The patient’s vital signs are as follows: BP =
100/70 mmHg; PR = 95 bpm; RR = 14 minute; T
= 36.8°C.
• D. The patient’s wound drainage.
 QUESTION 20
20. The patient had undergone a
thyroidectomy. Which of the following are
the earliest signs of poor tissue perfusion
and poor respiratory function?
• A. Cyanosis, lethargy.
• B. Fast, thready pulse, bradypnea.
• C. Apprehension and restlessness.
• D. Faintness, pallor.
 QUESTION 21
21. The diabetic patient who had undergone
abdominal surgery experienced wound
evisceration. Which of the following is the
most appropriate immediate nursing action?
• A. Cover the wound with sterile gauze
moistened with sterile normal saline.
• B. Cover the wound with sterile dry gauze.
• C. Cover the wound with a water-soaked
gauze.
• D. Leave the wound uncovered and pull the
skin edges together.
•
 QUESTION 22
22. The patient had undergone a total hip
replacement. He complains of pain in the
operative site. Which of the following is the
appropriate initial nursing action?
• A. Administer the ordered analgesic.
• B. Instruct the patient to do deep breathing
and coughing exercises.
• C. Assess the patient’s pain level and vital
signs.
• D. Change the patient’s position.
 QUESTION 23
23. Which of the following are not members
of the sterile team in the operating room,
except:
• A. Surgeon
• B. Scrub nurse
• C. First assistant
• D. Circulating nurse
•
 QUESTION 24
24. The best position for kidney, chest, or
hip surgery is:
• A. Supine
• B. Trendelenburg
• C. Lithotomy
• D. Lateral
•
 QUESTION 25
25. A patient has just returned from the
postanesthesia care unit (PACU) from a
hemorrhidectomy. His postoperative orders
include sitz baths every morning. Nurse
Jungkook understands that sitz bath is used:
• A. To relieve tension
• B. To lower body temperature
• c. To increase swelling
• D. To promote healing
 QUESTION 26
26. The proper way to open an envelop-
wrapped sterile package after removing the
outer package or tape is to open the first
position of the wrapper:
• A. away from the body
• B. to the left of the body
• C. to the right of the body
• D. toward the body
•
 QUESTION 27
27. The nurse is providing postprocedure care for a client
who underwent percutaneous lithotripsy. In this
procedure, an ultrasonic probe inserted through a
nephrostomy tube into the renal pelvis generates ultra-
high-frequency sound waves to shatter renal calculi. The
nurse should instruct the client to:
A. limit oral fluid intake for 1 to 2 weeks
B. report the presence of fine, sandlike particles through
the nephrostomy tube.
C. Notify the physician about cloudy or foul smelling
urine
D. Report bright pink urine within 24 hours after the
procedure
 QUESTION 28
28. A 52 yr-old female tells the nurse that she
has found a painless lump in her right breast
during her monthly self-examination. Which
assessment finding would strongly suggest that
this client’s lump is cancerous?
A. eversion of the right nipple and a mobile
mass
B. nonmobile mass with irregular edges
C. mobile mass that is oft and easily
delineated
D. nonpalpable right axillary lymph nodes
 QUESTION 29
29. A 49-yer-old client was admitted for
surgical repair of a Colles’ fracture. An external
fixator was placed during surgery. The surgeon
explains that this method of repair:
A. has very low complication rate
B. maintains reduction and overall hand
function
C. is less bothersome than a cast
D. is best for older people
 QUESTION 30
30. A client is hospitalized with a diagnosis of
chronic renal failure. An arteriovenous fistula
was created in his left arm for hemodialysis.
When preparing the client for discharge, the
nurse should reinforce which dietary
instruction?
A. “Be sure to eat meat at every meal.”
B. “Monitor your fruit intake and eat plenty of
bananas.”
C. “Restrict your salt intake.”
D. “Drink plenty of fluids.”
 QUESTION 31
31. The nurse is performing wound care on a foot
ulcer in a client with type 1 diabetes mellitus.
Which technique demonstrates surgical asepsis?
A. Putting on sterile gloves then opening a
container of sterile saline.
B. Cleaning the wound with a circular motion,
moving from outer circles toward the center.
C. Changing the sterile field after sterile water is
spilled on it.
D. Placing a sterile dressing ½” (1.3 cm) from the
edge of the sterile field.
 QUESTION 32
32. A visiting nurse is performing home
assessment for a 59-yr old man recently
discharged after hip replacement surgery. Which
home assessment finding warrants health
promotion teaching from the nurse?
A. A bathroom with grab bars for the tub and
toilet
B. Items stored in the kitchen so that reaching up
and bending down aren’t necessary
C. Many small, unsecured area rugs
D. Sufficient stairwell lighting, with switches to
the top and bottom of the stairs
 QUESTION 33
33. For the first 72 hours after
thyroidectomy surgery, the nurse would
assess the client for Chvostek’s sign and
Trousseau’s sign because they indicate
which of the following?
A. hypocalcemia
B. hypercalcemia
C. hypokalemia
D. Hyperkalemia
 QUESTION 34
34. A client has sustained a fractured right
femur in a fall on stairs. Nurse Troy with the
emergency response team assess for signs of
circulatory impairment by:
A. Turning the client to side lying position
B. Asking the client to cough and deep
breathe
C. Taking the client’s pedal pulse in the
affected limb
D. Instructing the client to wiggle the toes of
the right foot
 QUESTION 35
35. When planning care with a client during
the postoperative recovery period following an
abdominal hysterectomy and bilateral
salpingo-oophorectomy, nurse Frida should
include the explanation that:
A. Surgical menopause will occur
B. Urinary retention is a common problem
C. Weight gain is expected, and dietary plan
are needed
D. Depression is normal and should be
expected
 QUESTION 36
36. The nurse is performing wound care
using surgical asepsis. Which of the
following practices violates surgical asepsis?
A. Holding sterile objects above the waist
B. Pouring solution onto a sterile field cloth
C. Considering a 1″ (2.5-cm) edge around
the sterile field contaminated
D. Opening the outermost flap of a sterile
package away from the body
 QUESTION 37
37. 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. Urine output of 20ml/hour
B. Temperature of 37.6 C
C. Blood pressure of 114/70
D. Serous drainage on the surgical dressing
 QUESTION 38
38. A postoperative client asks the nurse why it
is so important to deep-breathe and cough
after surgery. When formulating a response,
the nurse incorporates the understanding that
retained pulmonary secretions in a
postoperative client can lead to which
condition?
A. Pneumonia
B. Hypoxemia
C. Fluid imbalance
D. Pulmonary embolism
 QUESTION 39
39. The nurse is developing 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 BP or
pulse
 QUESTION 40
40. 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 with 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".
 QUESTION 41
41. 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
 QUESTION 42
42. 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 HCP about the need to
stop the aspirin before the scheduled surgery."
 QUESTION 43
43. The nurse assess 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
 QUESTION 44
44. A client who has undergone preadmission
testing, has had blood drawn for serum lab
studies, including a complete blood count,
coagulation studies and electrolytes and
creatine levels. Which lab result should be
reported to the surgeon's office by the nurse,
knowing that it could cause surgery to be
postponed?
A. Sodium, 141mEq/L
B. Hemoglobin, 8.0 g/dL
C. Platelets, 210,000/mm3
D. Serum creatinine, 0.8 mg/dL
 QUESTION 45
45. A client with a perforated 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. Obtain 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
BEST OF LUCK! FIGHTING!