Chapter 50 Perioperative Nursing Care Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationales

1. A nurse is preparing a patient for surgery. Which action best ensures patient safety during the perioperative period? A) Confirming the procedure with the patient’s family B) Ensuring the patient has signed the surgical consent C) Asking the surgeon to explain the risks again D) Administering preoperative medication before consent Answer: B Rationale: The nurse must verify that informed consent is obtained and documented before administering sedatives or transferring to surgery. ________________________________________ 2. Which of the following patients is most at risk for perioperative complications? A) A 32-year-old marathon runner B) A 50-year-old smoker with diabetes C) A 25-year-old pregnant woman D) A 40-year-old who takes vitamins Answer: B Rationale: Smoking and diabetes increase the risk of infection, delayed healing, and respiratory complications after surgery. ________________________________________ 3. A nurse is conducting preoperative teaching. Which statement by the patient indicates a need for further instruction? A) “I’ll need to deep breathe and cough after surgery.” B) “I should avoid eating after midnight before surgery.” C) “I can wear my contact lenses into the operating room.” D) “I should stop taking aspirin before surgery.” Answer: C Rationale: Contact lenses must be removed preoperatively to prevent corneal injury or loss. ________________________________________ 4. What is the nurse’s priority action immediately after a patient is transferred to the post-anesthesia care unit (PACU)? A) Assess the surgical site B) Check for bowel sounds C) Monitor airway and respirations D) Ask about pain level Answer: C Rationale: The airway is the priority in the immediate postoperative phase to prevent hypoxia or obstruction. ________________________________________ 5. A patient is undergoing abdominal surgery. Which preoperative nursing action best reduces the risk of venous thromboembolism (VTE)? A) Placing pillows under the knees B) Encouraging coughing exercises C) Teaching the use of incentive spirometry D) Applying sequential compression devices Answer: D Rationale: Sequential compression devices improve venous return and reduce the risk of blood clots during and after surgery. ________________________________________ 6. A nurse is reviewing a patient’s medication list before surgery. Which drug is most concerning? A) Acetaminophen B) Multivitamins C) Warfarin D) Omeprazole Answer: C Rationale: Warfarin is an anticoagulant and increases bleeding risk; it must be managed preoperatively. ________________________________________ 7. A patient signs a surgical consent but later states they don’t understand the procedure. What is the nurse’s next step? A) Have the patient sign again B) Cancel the surgery C) Notify the surgeon to explain again D) Proceed with the surgery Answer: C Rationale: The surgeon must provide complete and understandable information for informed consent to be valid. ________________________________________ 8. What is the purpose of NPO status before surgery? A) To lower blood pressure B) To prevent aspiration during anesthesia C) To maintain hydration D) To reduce pain Answer: B Rationale: Fasting reduces the risk of regurgitation and aspiration when anesthesia is administered. ________________________________________ 9. Which finding requires immediate intervention before surgery? A) Hemoglobin 13.0 g/dL B) Platelet count 50,000/mm³ C) Temperature 98.7°F (37.1°C) D) Blood pressure 128/82 mm Hg Answer: B Rationale: A low platelet count increases bleeding risk and may necessitate delaying surgery.