NCLE-RNfSCIf101fEXAMf(Perioperativefcare)f2026-
2027fQUESTIONSfANDfANSWERS
1. The nurse is performing presurgical assessment of multiple clients. The nurs
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e determines that which client has the greatest risk for developing an infection p
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ostoperatively?
A. Thefclientfwithfnew-onsetfneutropeniafoffunknownfetiology
B. Thefclientfwithfthrombocytopeniafsecondaryftoftakingfaspirin
C. Thefchildfnewlyfdiagnosedfwithftypef1fdiabetesfmellitusf(DM)
D. Thefclientfwhofneedsfassistancefwithfambulationfdueftofarthritis
ANSWER:fA
A. Neutropeniafisfafreductionfinfneutrophils,fthefbody’sffirstflinefoffdefensefinfphagocytosisfoffinvadin
gfmicroorganisms.fNeutropeniafpredis-
fposesfthefclientftofinfectionfwithfnonpathogenicforganismsfthatfarefpresentfinfnormalfbodyfflorafas
fwellfasfopportunisticfpathogens.
B. Thrombocytopeniafisfafreductionfinfplatelets.fThrombocytopeniafpredisposesfthefclientftofbleeding
.
C. ThefclientfwithfDMfisfmorefsusceptibleftofinfectionsfbecauseftherefisfafdefectfinfthefmobilizationfoffi
nflammatoryfcellsfandfanfimpairmentfoffphagocytosisfbyfneutrophilsfandfmonocytes.fAlthoughfatfri
sk,fthefclientfwithfneutropeniafhasfafgreaterfrisk.
D. Iffassistancefisfprovidedfforfactivity,ftherefshouldfnotfbefanfincreasedfrisk.
2. The client being admitted for same-
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day surgery has inspiratory crackles and bilateral wheezes, and reports shortne
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ss of breath for several days. Which intervention should the nurse implement firs
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t?
A. Notifyfthefsurgeonfofftheffindings.
B. Documentfthefassessmentffindings.
C. Applyf4flitersfoxygenfbyfnasalfcannula.
D. Instructfonfusingfanfincentivefspirometerf(IS).
ANSWER:fA
A. Thef nursef shouldf notifyf thef surgeonf off unanticipatedf changesf inf thef healthf statusf off thefpreo
perativefclient.fSurgeryfmayfneedftofbefpostponed.
B. Thefnursefshouldffirstfnotifyfthefsurgeonfandfthenfdocumentftheffindingsfandfthefnotification.
C. Therefarefnofobjectivefdatafsupportingfthefneedfforfoxygen.
D. AlthoughfanfISfmayfbefprescribed,fnotifyingfthefsurgeonfisfthefpriority.
,3. The nurse determines that all of the following must be completed for the client
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being prepared for surgery. Which intervention should the nurse complete first
f f f f f f f f f f f
?
A. Completefthefpreoperativefchecklist
B. Assessfthefclient’sfpreoperativefvitalfsigns
C. Removefthefclient’sfrings,fgoldfchain,fandfwristwatch
D. Givef10fmEqfKCLfIVfforfafserumfpotassiumflevelfOff3.0fmEq/L
ANSWER:fD
A. Completingfthefpreoperativefchecklistfensuresfthatfallfrequirementsfarefcompleted.fThisfwouldfbef
thefsecondfintervention.
B. Althoughfimportant,fassessingfthefclient’sfpreoperativefVSfisfnotfthefpriority.
C. Althoughfimportant,fremovingfthefclient’sfrings,fgoldfchain,fandfwristwatchfisfnotfthefpriority.
D. GivingfKCLfisfpriority.fAbnormalitiesfmustfbefcorrectedfbeforefsurgery.fAflowfserumfpotassiumflevel
fcanfinducefcardiacfdysrhythmiasfandfdelayfsurgery.
4. The nurse is performing a presurgical admission assessment of the client. Whi
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ch client statement needs the most immediate follow-up?
f f f f f f f
A. “Iffeelfveryfhungry;fIfhaven’tfeatenffoodsforfhadfanyffluidsfforfthefpastf12fhours.”
B. “IfdonatedfmyfownfbloodfinfcasefIfneedfaftransfusion;ftheflastfdonationfwasf4fdaysfago-”
C. “Iftookfallfmyfmedsfincludingfwarfarinfandfatenololfwithfafsipfoffwaterfthisfmorning.”
D. “Ifbroughtfafcopyfoffmyfhealthfcarefdirectivefinfcasefmyfheartfstopsfduringfsurgery.”
ANSWER:fC
A. ThefexactfamountfofftimefthefclientfmustfbefNPOfbeforefsurgeryfisfcontroversial.fOlderfadultsfmayf
havefimbalancesfofffluids,felectrolytes,fandfbloodfglucoseflevelsffromffastingflonger.fHowever,fther
efisfnofindicationfinfthefquestionfthatfthisfisfafconcern.
B. Bloodfcanfbefdonatedfupftof72fhoursfbeforefthefscheduledfsurgery.
C. Warfarinf(Coumadin)fisfanfanticoagulant.fUsuallyfthisfisfstoppedfaffewfdaysfbeforefsurgeryfdueftofth
efincreasedfriskfoffbleeding.fThefnursefshouldfimmediatelyffollowfupfbyfnotifyingfthefHCP.
D. ClientsfshouldfbefencouragedftofbringfafcopyfoffthefHCDfsofothersfarefawarefoffthefclient’sfwishes.fT
hefnursefmayfwantftoffollowfupfregardingfthefclient’sfstatementf“infcasefmyfheartfstopsfduringfsurg
ery,”fbutfthisfisfnotfthefmostfimmediatefconcern.
5. The nurse is to witness the signature of a surgical consent for multiple clients
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scheduled for surgery the following day. After evaluating the health history of ea
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ch client, for which client should the nurse plan to obtain a signature from the ne
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xt of kin?
f f
A. Thef75-year-oldfclientfwhofisflegallyfblind
B. Thef60-year-oldfclientfwhofdoesfnotfunderstandfEnglish
, C. Thef50-year—oldfclientfwhofisfforgetfulfbutffullyforiented
D. Thef16-year-oldfclientfwhoffullyfunderstandsfthefsurgery
ANSWER:fD
A. Thefclientfwhofisflegallyfblindfmayfsignfhisforfherfsignaturefwithfanf“X”fasflongfasfthefclientfunder-
fstandsfthefnaturefandfreasonfforfsurgery,fwhofwillfperformfthefsurgery,favailablef options,fthefben
efitsfandfrisksfoffsurgery,fandfthefconsentfformfthatfisfreadftofthefclient.fAnotherfpersonfbesidesfthe
fnursefshouldfwitnessfthefclient’sf“X”fsignature.
B. Anfinterpreterfshouldfbefavailableftofreadfthefconsentfinfthefclient’sfnativeflanguage.fThefclientfcanf
thenfprovidefwrittenfconsentfinfthefpresencefofftwofwitnesses.
C. Thefclientfisfableftofsignfafconsentfformfunlessfdeterminedfincompetent.fIffthefclientfisffullyforiente
d,fafsignedfconsentfcanfbefobtainedffromfthefclient.
D. Theflegalfagefforfconsentfisf18fyearsfunlessfthefadolescentfhasfemancipatedfstatusfgrantedfbyfafjud
ge.
6 . The nurse receives the written laboratory results of a positive pregnancy test f
f f f f f f f f f f f f f f
or the client scheduled for an emergency appendectomy. Which intervention sh
f f f f f f f f f f
ould the nurse implement first?
f f f f
A. Callftheflaboratoryftofverifyftheftestfresults.
B. Informfthefclientfoffthefpregnancyftestfresults-
C. Reportfthefpregnancyftestfresultsftofthefsurgeon.
D. Notifyfthefclient’sfprimaryfcarefproviderfoffthefresults.
ANSWER:fC
A. Verifyingf laboratoryf resultsf isf unnecessary.f Somef hospitalsf mayf requiref repeatingf criticalf labo
ratoryftests.
B. DiscussingflaboratoryfresultsfwithfthefclientfisfthefHCP’sfresponsibility.
C. Thef surgeonf shouldf bef notifiedf becausef af positivef pregnancyf testf resultf couldf influencef thefch
oicefoffanestheticfagents,fmedications,fandfsurgicalfapproach.
D. Asfafcourtesy,fthefprimaryfcarefproviderfshouldfbefnotified.fHowever,fitfisfmorefimportantftof notif
yfthefsurgeon.
7. During a presurgical admission assessment, the client states, “I’ve told my sur
f f f f f f f f f f f
geon that I am Jehovah’s Witness and I won’t accept a blood transfusion.” Which s
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tatement by the nurse would be most appropriate?
f f f f f f f
A. “Tellfmefmorefaboutfyourffearfoffreceivingfafbloodftransfusion.”
B. “Yourfrequestfnotftofreceivefaftransfusionfwouldfbefhonored.”
C. “Don’tfworry;ftherefisflessfbloodflossfwithfourfnewerfequipment.”
D. “Arefyoufsurefyoufwouldn’tfwantfaftransfusionfiffonefisfneeded?”
ANSWER:fB
2027fQUESTIONSfANDfANSWERS
1. The nurse is performing presurgical assessment of multiple clients. The nurs
f f f f f f f f f f f
e determines that which client has the greatest risk for developing an infection p
f f f f f f f f f f f f f
ostoperatively?
A. Thefclientfwithfnew-onsetfneutropeniafoffunknownfetiology
B. Thefclientfwithfthrombocytopeniafsecondaryftoftakingfaspirin
C. Thefchildfnewlyfdiagnosedfwithftypef1fdiabetesfmellitusf(DM)
D. Thefclientfwhofneedsfassistancefwithfambulationfdueftofarthritis
ANSWER:fA
A. Neutropeniafisfafreductionfinfneutrophils,fthefbody’sffirstflinefoffdefensefinfphagocytosisfoffinvadin
gfmicroorganisms.fNeutropeniafpredis-
fposesfthefclientftofinfectionfwithfnonpathogenicforganismsfthatfarefpresentfinfnormalfbodyfflorafas
fwellfasfopportunisticfpathogens.
B. Thrombocytopeniafisfafreductionfinfplatelets.fThrombocytopeniafpredisposesfthefclientftofbleeding
.
C. ThefclientfwithfDMfisfmorefsusceptibleftofinfectionsfbecauseftherefisfafdefectfinfthefmobilizationfoffi
nflammatoryfcellsfandfanfimpairmentfoffphagocytosisfbyfneutrophilsfandfmonocytes.fAlthoughfatfri
sk,fthefclientfwithfneutropeniafhasfafgreaterfrisk.
D. Iffassistancefisfprovidedfforfactivity,ftherefshouldfnotfbefanfincreasedfrisk.
2. The client being admitted for same-
f f f f f
day surgery has inspiratory crackles and bilateral wheezes, and reports shortne
f f f f f f f f f f
ss of breath for several days. Which intervention should the nurse implement firs
f f f f f f f f f f f f
t?
A. Notifyfthefsurgeonfofftheffindings.
B. Documentfthefassessmentffindings.
C. Applyf4flitersfoxygenfbyfnasalfcannula.
D. Instructfonfusingfanfincentivefspirometerf(IS).
ANSWER:fA
A. Thef nursef shouldf notifyf thef surgeonf off unanticipatedf changesf inf thef healthf statusf off thefpreo
perativefclient.fSurgeryfmayfneedftofbefpostponed.
B. Thefnursefshouldffirstfnotifyfthefsurgeonfandfthenfdocumentftheffindingsfandfthefnotification.
C. Therefarefnofobjectivefdatafsupportingfthefneedfforfoxygen.
D. AlthoughfanfISfmayfbefprescribed,fnotifyingfthefsurgeonfisfthefpriority.
,3. The nurse determines that all of the following must be completed for the client
f f f f f f f f f f f f f
being prepared for surgery. Which intervention should the nurse complete first
f f f f f f f f f f f
?
A. Completefthefpreoperativefchecklist
B. Assessfthefclient’sfpreoperativefvitalfsigns
C. Removefthefclient’sfrings,fgoldfchain,fandfwristwatch
D. Givef10fmEqfKCLfIVfforfafserumfpotassiumflevelfOff3.0fmEq/L
ANSWER:fD
A. Completingfthefpreoperativefchecklistfensuresfthatfallfrequirementsfarefcompleted.fThisfwouldfbef
thefsecondfintervention.
B. Althoughfimportant,fassessingfthefclient’sfpreoperativefVSfisfnotfthefpriority.
C. Althoughfimportant,fremovingfthefclient’sfrings,fgoldfchain,fandfwristwatchfisfnotfthefpriority.
D. GivingfKCLfisfpriority.fAbnormalitiesfmustfbefcorrectedfbeforefsurgery.fAflowfserumfpotassiumflevel
fcanfinducefcardiacfdysrhythmiasfandfdelayfsurgery.
4. The nurse is performing a presurgical admission assessment of the client. Whi
f f f f f f f f f f f
ch client statement needs the most immediate follow-up?
f f f f f f f
A. “Iffeelfveryfhungry;fIfhaven’tfeatenffoodsforfhadfanyffluidsfforfthefpastf12fhours.”
B. “IfdonatedfmyfownfbloodfinfcasefIfneedfaftransfusion;ftheflastfdonationfwasf4fdaysfago-”
C. “Iftookfallfmyfmedsfincludingfwarfarinfandfatenololfwithfafsipfoffwaterfthisfmorning.”
D. “Ifbroughtfafcopyfoffmyfhealthfcarefdirectivefinfcasefmyfheartfstopsfduringfsurgery.”
ANSWER:fC
A. ThefexactfamountfofftimefthefclientfmustfbefNPOfbeforefsurgeryfisfcontroversial.fOlderfadultsfmayf
havefimbalancesfofffluids,felectrolytes,fandfbloodfglucoseflevelsffromffastingflonger.fHowever,fther
efisfnofindicationfinfthefquestionfthatfthisfisfafconcern.
B. Bloodfcanfbefdonatedfupftof72fhoursfbeforefthefscheduledfsurgery.
C. Warfarinf(Coumadin)fisfanfanticoagulant.fUsuallyfthisfisfstoppedfaffewfdaysfbeforefsurgeryfdueftofth
efincreasedfriskfoffbleeding.fThefnursefshouldfimmediatelyffollowfupfbyfnotifyingfthefHCP.
D. ClientsfshouldfbefencouragedftofbringfafcopyfoffthefHCDfsofothersfarefawarefoffthefclient’sfwishes.fT
hefnursefmayfwantftoffollowfupfregardingfthefclient’sfstatementf“infcasefmyfheartfstopsfduringfsurg
ery,”fbutfthisfisfnotfthefmostfimmediatefconcern.
5. The nurse is to witness the signature of a surgical consent for multiple clients
f f f f f f f f f f f f f f
scheduled for surgery the following day. After evaluating the health history of ea
f f f f f f f f f f f f
ch client, for which client should the nurse plan to obtain a signature from the ne
f f f f f f f f f f f f f f f
xt of kin?
f f
A. Thef75-year-oldfclientfwhofisflegallyfblind
B. Thef60-year-oldfclientfwhofdoesfnotfunderstandfEnglish
, C. Thef50-year—oldfclientfwhofisfforgetfulfbutffullyforiented
D. Thef16-year-oldfclientfwhoffullyfunderstandsfthefsurgery
ANSWER:fD
A. Thefclientfwhofisflegallyfblindfmayfsignfhisforfherfsignaturefwithfanf“X”fasflongfasfthefclientfunder-
fstandsfthefnaturefandfreasonfforfsurgery,fwhofwillfperformfthefsurgery,favailablef options,fthefben
efitsfandfrisksfoffsurgery,fandfthefconsentfformfthatfisfreadftofthefclient.fAnotherfpersonfbesidesfthe
fnursefshouldfwitnessfthefclient’sf“X”fsignature.
B. Anfinterpreterfshouldfbefavailableftofreadfthefconsentfinfthefclient’sfnativeflanguage.fThefclientfcanf
thenfprovidefwrittenfconsentfinfthefpresencefofftwofwitnesses.
C. Thefclientfisfableftofsignfafconsentfformfunlessfdeterminedfincompetent.fIffthefclientfisffullyforiente
d,fafsignedfconsentfcanfbefobtainedffromfthefclient.
D. Theflegalfagefforfconsentfisf18fyearsfunlessfthefadolescentfhasfemancipatedfstatusfgrantedfbyfafjud
ge.
6 . The nurse receives the written laboratory results of a positive pregnancy test f
f f f f f f f f f f f f f f
or the client scheduled for an emergency appendectomy. Which intervention sh
f f f f f f f f f f
ould the nurse implement first?
f f f f
A. Callftheflaboratoryftofverifyftheftestfresults.
B. Informfthefclientfoffthefpregnancyftestfresults-
C. Reportfthefpregnancyftestfresultsftofthefsurgeon.
D. Notifyfthefclient’sfprimaryfcarefproviderfoffthefresults.
ANSWER:fC
A. Verifyingf laboratoryf resultsf isf unnecessary.f Somef hospitalsf mayf requiref repeatingf criticalf labo
ratoryftests.
B. DiscussingflaboratoryfresultsfwithfthefclientfisfthefHCP’sfresponsibility.
C. Thef surgeonf shouldf bef notifiedf becausef af positivef pregnancyf testf resultf couldf influencef thefch
oicefoffanestheticfagents,fmedications,fandfsurgicalfapproach.
D. Asfafcourtesy,fthefprimaryfcarefproviderfshouldfbefnotified.fHowever,fitfisfmorefimportantftof notif
yfthefsurgeon.
7. During a presurgical admission assessment, the client states, “I’ve told my sur
f f f f f f f f f f f
geon that I am Jehovah’s Witness and I won’t accept a blood transfusion.” Which s
f f f f f f f f f f f f f f
tatement by the nurse would be most appropriate?
f f f f f f f
A. “Tellfmefmorefaboutfyourffearfoffreceivingfafbloodftransfusion.”
B. “Yourfrequestfnotftofreceivefaftransfusionfwouldfbefhonored.”
C. “Don’tfworry;ftherefisflessfbloodflossfwithfourfnewerfequipment.”
D. “Arefyoufsurefyoufwouldn’tfwantfaftransfusionfiffonefisfneeded?”
ANSWER:fB
