RN Targeted Medical-Surgical Perioperative Online
Practice 2023 LATEST ALL VERSIONS ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) | ALREADY
GRADED A+ 2026/2027 WITH FREE PRACTICE TEST
SETS.
ORIGINAL QUESTIONS WITH IMPROVED FORMAT
Question 1
A nurse is caring for a client following a total hip replacement. The client has a BMI of 39,
reports an allergy to eggs, and has a medical history of gout and obstructive sleep apnea. The
client has no personal surgical history and no knowledge of any family history of a reaction to
anesthesia.
Laboratory Results:
• Potassium 3.7 mEq/L (3.5 to 5 mEq/L)
• Urine uric acid level 375 mg/24 hr (250 to 750 mg/24 hr)
Preoperative Vital Signs:
• Temperature 37.5°C (99.5°F)
• Blood Pressure 148/82 mm Hg
• Heart Rate 90/min
• Respiratory Rate 22/min
, • Oxygen Saturation 95% on room air
30 Minutes Postoperative Vital Signs:
• Temperature 38.2°C (100.8°F)
• Blood Pressure 132/72 mm Hg
• Heart Rate 100/min
• Respiratory Rate 12/min
• Oxygen Saturation 95% on 4 L/min via nasal cannula
The client is greatest at risk for developing _______ due to _______.
A. Hypoxia; sleep disorder
B. Infection; elevated temperature
C. Hyperkalemia; gout history
D. Hypertension; elevated BMI
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ A. Hypoxia; sleep disorder
Rationale: When analyzing cues, the nurse should identify that a history of obstructive sleep
apnea places the client at risk for hypoxia postoperatively. The nurse should assess the client's
oxygen saturation levels to monitor for respiratory depression, provide supplemental oxygen as
needed, and position the client to promote a patent airway. The nurse should notify the
provider immediately of oxygen saturation levels of less than 95% despite supplemental oxygen
administration. The client's postoperative respiratory rate of 12/min is below the expected
reference range of 12 to 20/min and, combined with the history of OSA, significantly increases
the risk for respiratory depression and hypoxia.
Question 2
A nurse is caring for a female client who is scheduled for an appendectomy. The client reports a
2-day history of abdominal pain, anorexia, nausea, and vomiting. Client has no known allergies
to medications or foods.
,Preoperative Laboratory Results:
• Potassium 3.7 mEq/L (3.5 to 5 mEq/L)
• Hematocrit 52% (37% to 47%)
• Hemoglobin 18 g/dL (12 to 16 g/dL)
• WBC count 9,500/mm³ (5,000 to 10,000/mm³)
• Platelets 175,000/mm³ (150,000 to 400,000/mm³)
• Prealbumin 12 mg/dL (15 to 36 mg/dL)
Preoperative Vital Signs:
• Temperature 38°C (100.4°F)
• Blood pressure 104/56 mm Hg
• Heart rate 102/min
• Respiratory rate 18/min
• Oxygen saturation 96% on room air
Postoperative Vital Signs:
• Temperature 37.8°C (100°F)
• Blood pressure 100/50 mm Hg
• Heart rate 106/min
• Respiratory rate 22/min
• Oxygen saturation 95% on room air
The client is at risk for developing _______ and _______.
A. Hyperkalemia; infection
B. Hypotension; delayed wound healing
, C. Hypertension; respiratory distress
D. Hyperglycemia; dehiscence
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Hypotension; delayed wound healing
Rationale: When analyzing cues, the nurse should identify that the client has a prealbumin level
that is below the expected reference range (12 mg/dL, expected 15 to 36 mg/dL), which places
them at risk for delayed wound healing. The client has manifestations of hypovolemia, such as a
hemoglobin (18 g/dL) and hematocrit (52%) that are greater than the expected reference
ranges, and tachycardia (heart rate 102/min preoperatively and 106/min postoperatively).
Hypovolemia places the client at risk for hypotension and delayed wound healing. The nurse
should monitor the client's intake, output, and blood pressure, and establish fluid balance to
increase perfusion. The nurse should increase protein intake to promote wound healing. The
nurse should monitor the wound for impaired healing and take precautions to reduce the risk of
skin breakdown, such as padding bony prominences and frequent turning and repositioning.
Question 3
A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. The client
has been vomiting for the past 24 hr and reports a pain level of 8 on a 0 to 10 scale. The nurse
notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider,
which of the following actions should the nurse take first?
A. Draw the client's blood for electrolytes
B. Insert an NG tube
C. Administer pain medication
D. Initiate intake and output
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Insert an NG tube
Rationale: The greatest risk to the client is fluid and electrolyte imbalance as a result of
accumulated fluid and gas in the gastrointestinal tract. The first action the nurse should take is
to insert an NG tube to begin decompression of the bowel. This intervention addresses the
immediate physiological need by relieving the distention and preventing further complications
such as aspiration or bowel ischemia. Drawing blood for electrolytes, administering pain
Practice 2023 LATEST ALL VERSIONS ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) | ALREADY
GRADED A+ 2026/2027 WITH FREE PRACTICE TEST
SETS.
ORIGINAL QUESTIONS WITH IMPROVED FORMAT
Question 1
A nurse is caring for a client following a total hip replacement. The client has a BMI of 39,
reports an allergy to eggs, and has a medical history of gout and obstructive sleep apnea. The
client has no personal surgical history and no knowledge of any family history of a reaction to
anesthesia.
Laboratory Results:
• Potassium 3.7 mEq/L (3.5 to 5 mEq/L)
• Urine uric acid level 375 mg/24 hr (250 to 750 mg/24 hr)
Preoperative Vital Signs:
• Temperature 37.5°C (99.5°F)
• Blood Pressure 148/82 mm Hg
• Heart Rate 90/min
• Respiratory Rate 22/min
, • Oxygen Saturation 95% on room air
30 Minutes Postoperative Vital Signs:
• Temperature 38.2°C (100.8°F)
• Blood Pressure 132/72 mm Hg
• Heart Rate 100/min
• Respiratory Rate 12/min
• Oxygen Saturation 95% on 4 L/min via nasal cannula
The client is greatest at risk for developing _______ due to _______.
A. Hypoxia; sleep disorder
B. Infection; elevated temperature
C. Hyperkalemia; gout history
D. Hypertension; elevated BMI
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ A. Hypoxia; sleep disorder
Rationale: When analyzing cues, the nurse should identify that a history of obstructive sleep
apnea places the client at risk for hypoxia postoperatively. The nurse should assess the client's
oxygen saturation levels to monitor for respiratory depression, provide supplemental oxygen as
needed, and position the client to promote a patent airway. The nurse should notify the
provider immediately of oxygen saturation levels of less than 95% despite supplemental oxygen
administration. The client's postoperative respiratory rate of 12/min is below the expected
reference range of 12 to 20/min and, combined with the history of OSA, significantly increases
the risk for respiratory depression and hypoxia.
Question 2
A nurse is caring for a female client who is scheduled for an appendectomy. The client reports a
2-day history of abdominal pain, anorexia, nausea, and vomiting. Client has no known allergies
to medications or foods.
,Preoperative Laboratory Results:
• Potassium 3.7 mEq/L (3.5 to 5 mEq/L)
• Hematocrit 52% (37% to 47%)
• Hemoglobin 18 g/dL (12 to 16 g/dL)
• WBC count 9,500/mm³ (5,000 to 10,000/mm³)
• Platelets 175,000/mm³ (150,000 to 400,000/mm³)
• Prealbumin 12 mg/dL (15 to 36 mg/dL)
Preoperative Vital Signs:
• Temperature 38°C (100.4°F)
• Blood pressure 104/56 mm Hg
• Heart rate 102/min
• Respiratory rate 18/min
• Oxygen saturation 96% on room air
Postoperative Vital Signs:
• Temperature 37.8°C (100°F)
• Blood pressure 100/50 mm Hg
• Heart rate 106/min
• Respiratory rate 22/min
• Oxygen saturation 95% on room air
The client is at risk for developing _______ and _______.
A. Hyperkalemia; infection
B. Hypotension; delayed wound healing
, C. Hypertension; respiratory distress
D. Hyperglycemia; dehiscence
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Hypotension; delayed wound healing
Rationale: When analyzing cues, the nurse should identify that the client has a prealbumin level
that is below the expected reference range (12 mg/dL, expected 15 to 36 mg/dL), which places
them at risk for delayed wound healing. The client has manifestations of hypovolemia, such as a
hemoglobin (18 g/dL) and hematocrit (52%) that are greater than the expected reference
ranges, and tachycardia (heart rate 102/min preoperatively and 106/min postoperatively).
Hypovolemia places the client at risk for hypotension and delayed wound healing. The nurse
should monitor the client's intake, output, and blood pressure, and establish fluid balance to
increase perfusion. The nurse should increase protein intake to promote wound healing. The
nurse should monitor the wound for impaired healing and take precautions to reduce the risk of
skin breakdown, such as padding bony prominences and frequent turning and repositioning.
Question 3
A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. The client
has been vomiting for the past 24 hr and reports a pain level of 8 on a 0 to 10 scale. The nurse
notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider,
which of the following actions should the nurse take first?
A. Draw the client's blood for electrolytes
B. Insert an NG tube
C. Administer pain medication
D. Initiate intake and output
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Insert an NG tube
Rationale: The greatest risk to the client is fluid and electrolyte imbalance as a result of
accumulated fluid and gas in the gastrointestinal tract. The first action the nurse should take is
to insert an NG tube to begin decompression of the bowel. This intervention addresses the
immediate physiological need by relieving the distention and preventing further complications
such as aspiration or bowel ischemia. Drawing blood for electrolytes, administering pain
