Perioperative Nursing Exam 2 – Practice Version 2025/2026
1. Preoperative Assessment
Q1: A patient scheduled for laparoscopic cholecystectomy reports a history of severe allergic
reactions to shellfish. What is the most important immediate nursing action?
A: Notify the anesthesia provider and mark the allergy in the chart.
Rationale: Shellfish allergies may indicate a potential reaction to iodine-based antiseptics.
Preoperative identification is essential for patient safety.
Q2: Which laboratory value is most important to review before surgery in a patient on chronic
anticoagulant therapy?
A: International Normalized Ratio (INR)
Rationale: INR indicates coagulation status, and abnormal values increase the risk of
perioperative bleeding.
Q3: A patient expresses anxiety about an upcoming surgery. Which intervention is most
appropriate?
A: Provide clear information about the procedure and allow the patient to verbalize concerns.
Rationale: Patient education and emotional support reduce preoperative anxiety and improve
outcomes.
Q4: During preoperative assessment, the nurse notes that the patient has not fasted for 8 hours
as instructed. What is the priority action?
A: Notify the surgeon; surgery may need to be postponed.
Rationale: Fasting reduces the risk of aspiration during anesthesia.
Q5: Which medication should be withheld on the day of surgery due to its effect on bleeding?
A: Aspirin
Rationale: Aspirin inhibits platelet aggregation, increasing the risk of perioperative bleeding.
2. Intraoperative Nursing
Q6: What is the main role of the circulating nurse in the operating room?
A: Ensure patient safety, manage supplies, and document the procedure.
Rationale: The circulating nurse coordinates care and supports the sterile team without being
scrubbed in.
Q7: Which patient position increases the risk of hypotension during surgery?
A: Lithotomy
Rationale: Lithotomy position can decrease venous return, leading to hypotension.
, Q8: During surgery, the patient develops sudden tachycardia and hypotension. Which
complication should the nurse suspect first?
A: Hemorrhage
Rationale: Rapid blood loss is a common cause of intraoperative hypotension and tachycardia.
Q9: What is the purpose of surgical hand antisepsis for scrub nurses?
A: Reduce microbial count to prevent surgical site infection.
Rationale: Proper hand antisepsis is essential for infection control.
Q10: Which safety measure prevents retained surgical items?
A: Surgical count of instruments and sponges before and after the procedure.
Rationale: Accurate counting reduces the risk of retained foreign objects.
3. Postoperative Nursing
Q11: After abdominal surgery, a patient has a soft, distended abdomen and absent bowel
sounds. What is the priority action?
A: Assess for signs of paralytic ileus.
Rationale: Absent bowel sounds and distention may indicate ileus, requiring prompt nursing
evaluation.
Q12: Which intervention helps prevent postoperative pneumonia in an immobilized patient?
A: Encourage deep breathing and use of an incentive spirometer.
Rationale: Lung expansion and airway clearance reduce the risk of atelectasis and
pneumonia.
Q13: A patient’s surgical incision shows redness, warmth, and purulent drainage. What is the
best immediate nursing action?
A: Notify the surgeon and initiate wound care protocol.
Rationale: These are early signs of infection; prompt intervention is critical.
Q14: Which parameter is most important to monitor after a patient receives general anesthesia?
A: Respiratory rate and oxygen saturation
Rationale: Airway obstruction and hypoventilation are common post-anesthesia complications.
Q15: A patient develops a temperature of 38.5°C (101.3°F) 24 hours after surgery. What is the
most likely cause?
A: Early postoperative infection or inflammatory response
Rationale: Fever within the first 48 hours may indicate infection, atelectasis, or inflammatory
reaction.
4. Pain Management
1. Preoperative Assessment
Q1: A patient scheduled for laparoscopic cholecystectomy reports a history of severe allergic
reactions to shellfish. What is the most important immediate nursing action?
A: Notify the anesthesia provider and mark the allergy in the chart.
Rationale: Shellfish allergies may indicate a potential reaction to iodine-based antiseptics.
Preoperative identification is essential for patient safety.
Q2: Which laboratory value is most important to review before surgery in a patient on chronic
anticoagulant therapy?
A: International Normalized Ratio (INR)
Rationale: INR indicates coagulation status, and abnormal values increase the risk of
perioperative bleeding.
Q3: A patient expresses anxiety about an upcoming surgery. Which intervention is most
appropriate?
A: Provide clear information about the procedure and allow the patient to verbalize concerns.
Rationale: Patient education and emotional support reduce preoperative anxiety and improve
outcomes.
Q4: During preoperative assessment, the nurse notes that the patient has not fasted for 8 hours
as instructed. What is the priority action?
A: Notify the surgeon; surgery may need to be postponed.
Rationale: Fasting reduces the risk of aspiration during anesthesia.
Q5: Which medication should be withheld on the day of surgery due to its effect on bleeding?
A: Aspirin
Rationale: Aspirin inhibits platelet aggregation, increasing the risk of perioperative bleeding.
2. Intraoperative Nursing
Q6: What is the main role of the circulating nurse in the operating room?
A: Ensure patient safety, manage supplies, and document the procedure.
Rationale: The circulating nurse coordinates care and supports the sterile team without being
scrubbed in.
Q7: Which patient position increases the risk of hypotension during surgery?
A: Lithotomy
Rationale: Lithotomy position can decrease venous return, leading to hypotension.
, Q8: During surgery, the patient develops sudden tachycardia and hypotension. Which
complication should the nurse suspect first?
A: Hemorrhage
Rationale: Rapid blood loss is a common cause of intraoperative hypotension and tachycardia.
Q9: What is the purpose of surgical hand antisepsis for scrub nurses?
A: Reduce microbial count to prevent surgical site infection.
Rationale: Proper hand antisepsis is essential for infection control.
Q10: Which safety measure prevents retained surgical items?
A: Surgical count of instruments and sponges before and after the procedure.
Rationale: Accurate counting reduces the risk of retained foreign objects.
3. Postoperative Nursing
Q11: After abdominal surgery, a patient has a soft, distended abdomen and absent bowel
sounds. What is the priority action?
A: Assess for signs of paralytic ileus.
Rationale: Absent bowel sounds and distention may indicate ileus, requiring prompt nursing
evaluation.
Q12: Which intervention helps prevent postoperative pneumonia in an immobilized patient?
A: Encourage deep breathing and use of an incentive spirometer.
Rationale: Lung expansion and airway clearance reduce the risk of atelectasis and
pneumonia.
Q13: A patient’s surgical incision shows redness, warmth, and purulent drainage. What is the
best immediate nursing action?
A: Notify the surgeon and initiate wound care protocol.
Rationale: These are early signs of infection; prompt intervention is critical.
Q14: Which parameter is most important to monitor after a patient receives general anesthesia?
A: Respiratory rate and oxygen saturation
Rationale: Airway obstruction and hypoventilation are common post-anesthesia complications.
Q15: A patient develops a temperature of 38.5°C (101.3°F) 24 hours after surgery. What is the
most likely cause?
A: Early postoperative infection or inflammatory response
Rationale: Fever within the first 48 hours may indicate infection, atelectasis, or inflammatory
reaction.
4. Pain Management
