ATI MED-SURG: PERIOPERATIVE NURSING EXAM (2026/2027) | QUESTIONS WITH
VERIFIED DEFINITIONS UPDATED | GRADED A+ | GUARANTEED PASS
ATI Medical-Surgical: Perioperative Nursing Comprehensive Examination | Core Domains:
Preoperative Assessment & Patient Preparation, Intraoperative Roles & Responsibilities, Postoperative
Care & Complication Management, Surgical Asepsis & Sterile Technique, Anesthesia Types & Nursing
Implications, Pain Management & Patient Education, Wound Care & Infection Prevention, and
Legal/Ethical Considerations in Surgery | Perioperative Nursing Focus | Comprehensive Specialty
Exam Format
Exam Structure
The ATI Med-Surg: Perioperative Nursing Exam for the 2026/2027 academic cycle is a 60-question,
multiple-choice question (MCQ) examination.
Introduction
This ATI Med-Surg: Perioperative Nursing Exam guide for the 2026/2027 cycle prepares nursing
students for the specialized assessment of surgical patient care across all three phases: preoperative,
intraoperative, and postoperative. The content emphasizes evidence-based practices for patient safety,
infection control, complication prevention, and holistic support throughout the surgical experience.
Answer Format
All correct answers and perioperative nursing actions must be presented in bold and green, followed by
detailed rationales that define key surgical terminology, explain the nursing responsibilities in each
surgical phase, justify interventions based on surgical risk factors, apply principles of sterile technique
and wound management, and outline patient education for recovery and discharge.
Questions (60 Total)
1. Which assessment finding in the preoperative period requires immediate notification of the surgeon?
A. Blood pressure 138/84 mm Hg
B. History of obstructive sleep apnea
C. Mild anxiety about surgery
D. Fasting since midnight
Rationale: Obstructive sleep apnea increases the risk of postoperative respiratory depression,
especially with opioids and sedatives. The anesthesia team must be alerted to plan for extended
monitoring or non-opioid pain strategies. Hypertension within normal limits, mild anxiety, and
appropriate NPO status are expected findings.
2. During the intraoperative phase, the circulating nurse is responsible for:
A. Maintaining the sterile field
B. Ensuring patient safety, managing documentation, and coordinating supplies
,C. Performing the surgical scrub
D. Administering anesthesia
Rationale: The circulating nurse is a non-sterile team member who advocates for the patient, verifies
consent and site marking, manages equipment, documents the procedure, and ensures adherence to
safety protocols (e.g., time-outs). The scrub nurse maintains the sterile field; the anesthesiologist
administers anesthesia.
3. A patient received spinal anesthesia for a transurethral resection of the prostate (TURP).
Postoperatively, the patient reports a severe headache. What is the priority intervention?
A. Administer morphine IV
B. Place the patient in supine position and increase fluid intake
C. Encourage ambulation
D. Apply ice packs to the head
Rationale: Post-dural puncture headache (PDPH) occurs due to CSF leakage after spinal anesthesia. It
worsens with sitting or standing. Treatment includes bed rest in supine position, hydration, caffeine,
and analgesics. Ambulation exacerbates the headache. Severe cases may require an epidural blood
patch.
4. Which action demonstrates proper surgical asepsis when opening a sterile pack?
A. Touching the inside of the wrapper
B. Holding the pack away from the body and opening flaps away from the user
C. Placing the pack on a wet surface
D. Reaching over the sterile field to open it
Rationale: To maintain sterility, hold the pack at waist level, away from the body, and open the top
flap away from you, then side flaps outward. Never reach over the sterile field, touch inner surfaces, or
place on a damp surface—moisture wicks microorganisms into the field.
5. Two hours after abdominal surgery, a patient’s abdominal dressing is saturated with bright red blood.
What should the nurse do first?
A. Remove the dressing to assess the wound
B. Apply direct pressure and notify the provider immediately
C. Document the finding and continue monitoring
D. Increase IV fluids
, Rationale: Saturated bright red drainage suggests active hemorrhage. Apply firm, direct pressure to
control bleeding and notify the surgeon immediately. Do not remove the dressing—this can disrupt clots.
This is a surgical emergency requiring prompt intervention.
6. A patient is scheduled for elective surgery. Which statement indicates understanding of preoperative
teaching?
A. “I’ll take my warfarin the morning of surgery.”
B. “I will stop taking aspirin 7 days before surgery as instructed.”
C. “I can eat a light breakfast before the procedure.”
D. “I don’t need to bring my list of medications.”
Rationale: Aspirin increases bleeding risk and is typically held 5–7 days pre-op. Warfarin is also
discontinued per protocol. NPO guidelines usually require no food after midnight. Patients should bring
an updated medication list. Accurate adherence prevents complications.
7. In the PACU, a patient has a respiratory rate of 8 breaths per minute and SpO₂ of 89% on room air.
What is the priority action?
A. Encourage deep breathing
B. Administer naloxone and prepare for possible intubation
C. Offer sips of water
D. Elevate the head of bed
Rationale: Bradypnea and hypoxia suggest opioid-induced respiratory depression. Naloxone (an
opioid antagonist) is indicated. Prepare for airway support if unresponsive. Deep breathing is
ineffective if the patient is too sedated. Head elevation alone won’t reverse CNS depression.
8. Which patient is at highest risk for postoperative wound dehiscence?
A. A 25-year-old with laparoscopic appendectomy
B. A 68-year-old with malnutrition and abdominal incision
C. A 40-year-old with arthroscopic knee surgery
D. A 30-year-old with dental extraction
Rationale: Wound dehiscence (partial or total separation of wound layers) is more likely with poor
nutrition, obesity, infection, advanced age, and abdominal surgeries due to tension on the incision.
Malnutrition impairs collagen synthesis and healing.
9. When teaching a patient about postoperative leg exercises, the nurse explains that they help prevent:
VERIFIED DEFINITIONS UPDATED | GRADED A+ | GUARANTEED PASS
ATI Medical-Surgical: Perioperative Nursing Comprehensive Examination | Core Domains:
Preoperative Assessment & Patient Preparation, Intraoperative Roles & Responsibilities, Postoperative
Care & Complication Management, Surgical Asepsis & Sterile Technique, Anesthesia Types & Nursing
Implications, Pain Management & Patient Education, Wound Care & Infection Prevention, and
Legal/Ethical Considerations in Surgery | Perioperative Nursing Focus | Comprehensive Specialty
Exam Format
Exam Structure
The ATI Med-Surg: Perioperative Nursing Exam for the 2026/2027 academic cycle is a 60-question,
multiple-choice question (MCQ) examination.
Introduction
This ATI Med-Surg: Perioperative Nursing Exam guide for the 2026/2027 cycle prepares nursing
students for the specialized assessment of surgical patient care across all three phases: preoperative,
intraoperative, and postoperative. The content emphasizes evidence-based practices for patient safety,
infection control, complication prevention, and holistic support throughout the surgical experience.
Answer Format
All correct answers and perioperative nursing actions must be presented in bold and green, followed by
detailed rationales that define key surgical terminology, explain the nursing responsibilities in each
surgical phase, justify interventions based on surgical risk factors, apply principles of sterile technique
and wound management, and outline patient education for recovery and discharge.
Questions (60 Total)
1. Which assessment finding in the preoperative period requires immediate notification of the surgeon?
A. Blood pressure 138/84 mm Hg
B. History of obstructive sleep apnea
C. Mild anxiety about surgery
D. Fasting since midnight
Rationale: Obstructive sleep apnea increases the risk of postoperative respiratory depression,
especially with opioids and sedatives. The anesthesia team must be alerted to plan for extended
monitoring or non-opioid pain strategies. Hypertension within normal limits, mild anxiety, and
appropriate NPO status are expected findings.
2. During the intraoperative phase, the circulating nurse is responsible for:
A. Maintaining the sterile field
B. Ensuring patient safety, managing documentation, and coordinating supplies
,C. Performing the surgical scrub
D. Administering anesthesia
Rationale: The circulating nurse is a non-sterile team member who advocates for the patient, verifies
consent and site marking, manages equipment, documents the procedure, and ensures adherence to
safety protocols (e.g., time-outs). The scrub nurse maintains the sterile field; the anesthesiologist
administers anesthesia.
3. A patient received spinal anesthesia for a transurethral resection of the prostate (TURP).
Postoperatively, the patient reports a severe headache. What is the priority intervention?
A. Administer morphine IV
B. Place the patient in supine position and increase fluid intake
C. Encourage ambulation
D. Apply ice packs to the head
Rationale: Post-dural puncture headache (PDPH) occurs due to CSF leakage after spinal anesthesia. It
worsens with sitting or standing. Treatment includes bed rest in supine position, hydration, caffeine,
and analgesics. Ambulation exacerbates the headache. Severe cases may require an epidural blood
patch.
4. Which action demonstrates proper surgical asepsis when opening a sterile pack?
A. Touching the inside of the wrapper
B. Holding the pack away from the body and opening flaps away from the user
C. Placing the pack on a wet surface
D. Reaching over the sterile field to open it
Rationale: To maintain sterility, hold the pack at waist level, away from the body, and open the top
flap away from you, then side flaps outward. Never reach over the sterile field, touch inner surfaces, or
place on a damp surface—moisture wicks microorganisms into the field.
5. Two hours after abdominal surgery, a patient’s abdominal dressing is saturated with bright red blood.
What should the nurse do first?
A. Remove the dressing to assess the wound
B. Apply direct pressure and notify the provider immediately
C. Document the finding and continue monitoring
D. Increase IV fluids
, Rationale: Saturated bright red drainage suggests active hemorrhage. Apply firm, direct pressure to
control bleeding and notify the surgeon immediately. Do not remove the dressing—this can disrupt clots.
This is a surgical emergency requiring prompt intervention.
6. A patient is scheduled for elective surgery. Which statement indicates understanding of preoperative
teaching?
A. “I’ll take my warfarin the morning of surgery.”
B. “I will stop taking aspirin 7 days before surgery as instructed.”
C. “I can eat a light breakfast before the procedure.”
D. “I don’t need to bring my list of medications.”
Rationale: Aspirin increases bleeding risk and is typically held 5–7 days pre-op. Warfarin is also
discontinued per protocol. NPO guidelines usually require no food after midnight. Patients should bring
an updated medication list. Accurate adherence prevents complications.
7. In the PACU, a patient has a respiratory rate of 8 breaths per minute and SpO₂ of 89% on room air.
What is the priority action?
A. Encourage deep breathing
B. Administer naloxone and prepare for possible intubation
C. Offer sips of water
D. Elevate the head of bed
Rationale: Bradypnea and hypoxia suggest opioid-induced respiratory depression. Naloxone (an
opioid antagonist) is indicated. Prepare for airway support if unresponsive. Deep breathing is
ineffective if the patient is too sedated. Head elevation alone won’t reverse CNS depression.
8. Which patient is at highest risk for postoperative wound dehiscence?
A. A 25-year-old with laparoscopic appendectomy
B. A 68-year-old with malnutrition and abdominal incision
C. A 40-year-old with arthroscopic knee surgery
D. A 30-year-old with dental extraction
Rationale: Wound dehiscence (partial or total separation of wound layers) is more likely with poor
nutrition, obesity, infection, advanced age, and abdominal surgeries due to tension on the incision.
Malnutrition impairs collagen synthesis and healing.
9. When teaching a patient about postoperative leg exercises, the nurse explains that they help prevent:
