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SHADOW HEALTH PATIENT CARE ROUNDS: POSTOPERATIVE
CHECK-IN NURS 2121 FUNDAMENTALS EXAM QUESTIONS
WITH RATIONALES LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
SHADOW HEALTH PATIENT CARE ROUNDS: POSTOPERATIVE CHECK-IN
NURS 2121 Fundamentals – 250 Questions with Rationales
SECTION 1: PREOPERATIVE ASSESSMENT & PREPARATION (Questions 1-50)
Question 1
The nurse is reviewing the preoperative checklist for a patient scheduled for a
below-knee amputation. Which item on the checklist is essential to verify before
the patient is transported to the operating room?
A) The patient has eaten a light breakfast
B) The patient's vital signs are stable and all consent forms are signed
C) The patient has removed all nail polish and makeup
D) The patient has been given a sleeping aid
Rationale: The correct answer is B. A stable set of vital signs and signed consent forms
are essential and are key verification steps before the patient is transported to the OR .
While removing nail polish and makeup is also part of pre-op preparation, it is the
completion of the surgical "time out" and verification of the correct patient, procedure,
and site that is the ultimate safety priority.
Question 2
The patient asks the nurse, "Do I have any other options besides the surgery?"
What is the nurse's most appropriate response?
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A) "No, this is the only option at this point."
B) "I can schedule a meeting with a specialist for you to discuss alternatives."
C) "That is a question you should have asked your surgeon before today."
D) "Let me get your surgeon; they are the best person to discuss that with you."
Rationale: The correct answer is D. The nurse cannot provide information about
alternative treatments or make clinical decisions about a patient's care plan . The
surgeon is the appropriate person to discuss treatment options and alternatives with
the patient, and the nurse's role is to facilitate that communication .
Question 3
A patient with diabetes is scheduled for surgery. The nurse notes a blood glucose
level of 130 mg/dL. What is the most appropriate nursing action?
A) Administer insulin per sliding scale immediately
B) Document the finding in the EHR and continue to monitor
C) Notify the provider immediately
D) Encourage the patient to eat a snack
Rationale: The correct answer is B. A blood glucose of 130 mg/dL is slightly elevated but
generally within an acceptable range preoperatively and does not require immediate
insulin intervention . The priority is to document the finding and continue to monitor it,
as managing diabetes is crucial for wound healing, but this level is not an emergency .
Question 4
Which statement is true regarding the nurse's role in obtaining informed consent
for surgery?
A) The nurse is responsible for explaining the surgical procedure to the patient
B) The nurse's role is to verify that the patient understands the procedure and has
signed the consent form
C) The nurse can obtain the consent if the surgeon is unavailable
D) Informed consent is only required for major surgeries
Rationale: The correct answer is B. The RN's role is to verify that the patient
understands the procedure and has signed the consent form . The patient cannot go to
the OR until they are fully informed. The surgeon is responsible for explaining the
procedure, risks, benefits, and alternatives .
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Question 5
The nurse is performing the "time out" before a patient's surgery. What is the
primary purpose of this procedure?
A) To give the patient one last chance to ask questions
B) To ensure the correct patient, procedure, and site
C) To review the patient's past medical history
D) To check the patient's baseline vital signs
Rationale: The correct answer is B. The "time out" or surgical pause is a critical safety
measure used to perform a final verification of the correct patient, the correct surgical
procedure, and the correct surgical site with the entire team . This process is designed
to prevent wrong-site, wrong-patient, and wrong-procedure errors .
Question 6
A patient is scheduled for surgery and is currently taking warfarin. What is the
nurse's priority action?
A) Administer the warfarin as scheduled
B) Notify the provider and hold the medication
C) Document the medication in the chart
D) Instruct the patient to stop the medication one week after surgery
Rationale: The correct answer is B. Medications that increase the risk of bleeding,
including blood thinners, anticoagulants, and antiplatelets, must be held or adjusted
prior to surgery . The anesthesia provider needs to be notified to determine if surgery
should proceed or if the patient requires intervention.
Question 7
The patient reports feeling thirsty before surgery. What is the nurse's best
response?
A) "I will bring you a small cup of water right now."
B) "It is normal to feel thirsty, but you must remain NPO before your surgery to prevent
complications."
C) "You can have ice chips, but only a few."
D) "You should not be thirsty, your IV fluids are providing hydration."
Rationale: The correct answer is B. While it is normal to feel thirst even though
hydration is maintained by IV fluids, it is important to remain NPO before surgery to
prevent aspiration . The nurse should acknowledge the patient's concern while
reinforcing the safety rationale .
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Question 8
A patient is scheduled for a below-knee amputation. Which medication from the
patient's home regimen would the nurse likely need to hold before surgery?
A) Acetaminophen
B) Metformin
C) Metoprolol
D) Warfarin
Rationale: The correct answer is D. Warfarin is a blood thinner that increases the risk of
bleeding during surgery and must be held or adjusted preoperatively . Diabetes
medications, blood pressure medications, and herbal supplements may also need to
be held, but warfarin is a priority due to bleeding risk.
Question 9
What is the most important action the nurse should take when preparing a patient
for surgery if the patient cannot state what surgery they are scheduled for?
A) Proceed with preparation and document the finding
B) Notify the surgeon immediately and do not proceed
C) Review the consent form with the patient again
D) Ask the family member to confirm the surgery type
Rationale: The correct answer is B. If the patient cannot state what surgery they are
having, the patient cannot go to the OR until they are fully informed . The surgeon must
be notified immediately to discuss the procedure with the patient again.
Question 10
A patient is scheduled for surgery and has a history of penicillin allergy. What is the
most appropriate nursing action?
A) Administer the ordered antibiotic and monitor for reaction
B) Notify the provider and clarify the antibiotic order
C) Document the allergy and proceed with the medication
D) Administer the antibiotic with an antihistamine
Rationale: The correct answer is B. The provider should be notified to select an
appropriate alternative antibiotic . The nurse should also check for cross-sensitivity with
cephalosporins. Documenting alone is insufficient; this finding requires immediate
communication .
SHADOW HEALTH PATIENT CARE ROUNDS: POSTOPERATIVE
CHECK-IN NURS 2121 FUNDAMENTALS EXAM QUESTIONS
WITH RATIONALES LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
SHADOW HEALTH PATIENT CARE ROUNDS: POSTOPERATIVE CHECK-IN
NURS 2121 Fundamentals – 250 Questions with Rationales
SECTION 1: PREOPERATIVE ASSESSMENT & PREPARATION (Questions 1-50)
Question 1
The nurse is reviewing the preoperative checklist for a patient scheduled for a
below-knee amputation. Which item on the checklist is essential to verify before
the patient is transported to the operating room?
A) The patient has eaten a light breakfast
B) The patient's vital signs are stable and all consent forms are signed
C) The patient has removed all nail polish and makeup
D) The patient has been given a sleeping aid
Rationale: The correct answer is B. A stable set of vital signs and signed consent forms
are essential and are key verification steps before the patient is transported to the OR .
While removing nail polish and makeup is also part of pre-op preparation, it is the
completion of the surgical "time out" and verification of the correct patient, procedure,
and site that is the ultimate safety priority.
Question 2
The patient asks the nurse, "Do I have any other options besides the surgery?"
What is the nurse's most appropriate response?
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A) "No, this is the only option at this point."
B) "I can schedule a meeting with a specialist for you to discuss alternatives."
C) "That is a question you should have asked your surgeon before today."
D) "Let me get your surgeon; they are the best person to discuss that with you."
Rationale: The correct answer is D. The nurse cannot provide information about
alternative treatments or make clinical decisions about a patient's care plan . The
surgeon is the appropriate person to discuss treatment options and alternatives with
the patient, and the nurse's role is to facilitate that communication .
Question 3
A patient with diabetes is scheduled for surgery. The nurse notes a blood glucose
level of 130 mg/dL. What is the most appropriate nursing action?
A) Administer insulin per sliding scale immediately
B) Document the finding in the EHR and continue to monitor
C) Notify the provider immediately
D) Encourage the patient to eat a snack
Rationale: The correct answer is B. A blood glucose of 130 mg/dL is slightly elevated but
generally within an acceptable range preoperatively and does not require immediate
insulin intervention . The priority is to document the finding and continue to monitor it,
as managing diabetes is crucial for wound healing, but this level is not an emergency .
Question 4
Which statement is true regarding the nurse's role in obtaining informed consent
for surgery?
A) The nurse is responsible for explaining the surgical procedure to the patient
B) The nurse's role is to verify that the patient understands the procedure and has
signed the consent form
C) The nurse can obtain the consent if the surgeon is unavailable
D) Informed consent is only required for major surgeries
Rationale: The correct answer is B. The RN's role is to verify that the patient
understands the procedure and has signed the consent form . The patient cannot go to
the OR until they are fully informed. The surgeon is responsible for explaining the
procedure, risks, benefits, and alternatives .
, Page 3 of 80
Question 5
The nurse is performing the "time out" before a patient's surgery. What is the
primary purpose of this procedure?
A) To give the patient one last chance to ask questions
B) To ensure the correct patient, procedure, and site
C) To review the patient's past medical history
D) To check the patient's baseline vital signs
Rationale: The correct answer is B. The "time out" or surgical pause is a critical safety
measure used to perform a final verification of the correct patient, the correct surgical
procedure, and the correct surgical site with the entire team . This process is designed
to prevent wrong-site, wrong-patient, and wrong-procedure errors .
Question 6
A patient is scheduled for surgery and is currently taking warfarin. What is the
nurse's priority action?
A) Administer the warfarin as scheduled
B) Notify the provider and hold the medication
C) Document the medication in the chart
D) Instruct the patient to stop the medication one week after surgery
Rationale: The correct answer is B. Medications that increase the risk of bleeding,
including blood thinners, anticoagulants, and antiplatelets, must be held or adjusted
prior to surgery . The anesthesia provider needs to be notified to determine if surgery
should proceed or if the patient requires intervention.
Question 7
The patient reports feeling thirsty before surgery. What is the nurse's best
response?
A) "I will bring you a small cup of water right now."
B) "It is normal to feel thirsty, but you must remain NPO before your surgery to prevent
complications."
C) "You can have ice chips, but only a few."
D) "You should not be thirsty, your IV fluids are providing hydration."
Rationale: The correct answer is B. While it is normal to feel thirst even though
hydration is maintained by IV fluids, it is important to remain NPO before surgery to
prevent aspiration . The nurse should acknowledge the patient's concern while
reinforcing the safety rationale .
, Page 4 of 80
Question 8
A patient is scheduled for a below-knee amputation. Which medication from the
patient's home regimen would the nurse likely need to hold before surgery?
A) Acetaminophen
B) Metformin
C) Metoprolol
D) Warfarin
Rationale: The correct answer is D. Warfarin is a blood thinner that increases the risk of
bleeding during surgery and must be held or adjusted preoperatively . Diabetes
medications, blood pressure medications, and herbal supplements may also need to
be held, but warfarin is a priority due to bleeding risk.
Question 9
What is the most important action the nurse should take when preparing a patient
for surgery if the patient cannot state what surgery they are scheduled for?
A) Proceed with preparation and document the finding
B) Notify the surgeon immediately and do not proceed
C) Review the consent form with the patient again
D) Ask the family member to confirm the surgery type
Rationale: The correct answer is B. If the patient cannot state what surgery they are
having, the patient cannot go to the OR until they are fully informed . The surgeon must
be notified immediately to discuss the procedure with the patient again.
Question 10
A patient is scheduled for surgery and has a history of penicillin allergy. What is the
most appropriate nursing action?
A) Administer the ordered antibiotic and monitor for reaction
B) Notify the provider and clarify the antibiotic order
C) Document the allergy and proceed with the medication
D) Administer the antibiotic with an antihistamine
Rationale: The correct answer is B. The provider should be notified to select an
appropriate alternative antibiotic . The nurse should also check for cross-sensitivity with
cephalosporins. Documenting alone is insufficient; this finding requires immediate
communication .
