Page 1 of 40
KAPLAN PERIOPERATIVE NURSING ASSESSMENT
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURSING
Prepare for the Kaplan Perioperative Nursing Assessment with a focused study
resource covering essential concepts in preoperative, intraoperative, and
postoperative nursing care. It supports review of surgical preparation, patient safety,
infection prevention, anesthesia considerations, postoperative monitoring,
complications, and nursing interventions. Use the material to reinforce key
knowledge, strengthen clinical judgment, and identify areas that may require
additional review. This resource is best suited for nursing students and NCLEX
candidates preparing for perioperative nursing assessments.
MULTIPLE CHOICE.
SECTION 1: PREOPERATIVE NURSING CARE (Questions 1-15)
1. A client is scheduled for surgery tomorrow morning. Which assessment
finding should the nurse report to the surgeon and anesthesiologist
immediately?
a) The client reports a headache and feels anxious
b) The client's blood pressure is 138/88 mmHg
c) The client reports chest pain and shortness of breath
d) The client's temperature is 99.2°F (37.3°C)
Answer: c) The client reports chest pain and shortness of breath
Rationale: Chest pain and shortness of breath are acute findings that may
indicate a cardiac or pulmonary event that could significantly increase
surgical risk. These symptoms require immediate evaluation and may
necessitate delaying surgery. Mild anxiety, slightly elevated blood pressure,
and low-grade fever are not as urgent but should still be monitored.
, Page 2 of 40
2. A client is NPO (nothing by mouth) for surgery. The client reports taking
a sip of water 2 hours ago. Which action should the nurse take?
a) Administer the preoperative medication as scheduled
b) Notify the surgeon and anesthesiologist
c) Proceed with the surgery as planned
d) Encourage the client to drink more water to stay hydrated
Answer: b) Notify the surgeon and anesthesiologist
Rationale: The client should have been NPO for at least 6-8 hours for solids
and 2-4 hours for clear liquids before surgery, depending on the type of
surgery and anesthesia. The anesthesiologist and surgeon must be notified
because the client is at increased risk for aspiration during induction of
anesthesia. The surgery may be delayed.
3. The nurse is reviewing the preoperative checklist for a client. Which
item is most important to verify before sending the client to the operating
room?
a) The client has signed the informed consent form
b) The client has a completed history and physical exam
c) The client has voided
d) The client has removed jewelry and dentures
Answer: a) The client has signed the informed consent form
Rationale: Informed consent is a legal and ethical requirement before
surgery. The nurse must ensure that the consent form is signed, witnessed,
and placed in the client's chart. Without a signed consent, surgery cannot
proceed. The other items are also important but are not legal prerequisites.
4. A client who is scheduled for surgery reports that they take herbal
supplements daily. Which supplement should the nurse identify as
increasing bleeding risk?
a) Vitamin C
b) St. John's wort
c) Echinacea
d) Garlic
, Page 3 of 40
Answer: d) Garlic
Rationale: Garlic has antiplatelet effects and increases the risk of bleeding
during surgery. St. John's wort can interact with anesthetic agents and affect
drug metabolism. Echinacea can affect immune function. Vitamin C is
generally safe. All herbal supplements should be reported to the provider, and
most should be discontinued 2-3 weeks before surgery.
5. A client scheduled for surgery has a history of smoking. The nurse
should teach the client that smoking should be discontinued at least how
long before surgery?
a) 24 hours
b) 48 hours
c) 1 week
d) 1 month
Answer: d) 1 month
Rationale: Smoking should ideally be discontinued at least 1 month before
surgery to improve pulmonary function, decrease secretions, and reduce the
risk of postoperative complications (atelectasis, pneumonia, and wound
infection). Even shorter-term cessation (24-48 hours) is beneficial, but 1
month is optimal.
6. A client is receiving preoperative teaching. The nurse instructs the
client to use incentive spirometry after surgery. Which statement by the
client indicates understanding?
a) "I will use the incentive spirometer every 2 hours while awake."
b) "I will use the incentive spirometer only when I feel short of breath."
c) "I will use the incentive spirometer after I eat."
d) "I will use the incentive spirometer once a day."
Answer: a) "I will use the incentive spirometer every 2 hours while awake."
Rationale: Incentive spirometry should be used every 1-2 hours while awake
to promote deep breathing, lung expansion, and prevent atelectasis. It should
not be used only when short of breath. The frequency of use is important for
effectiveness.
, Page 4 of 40
7. The nurse is preparing a client for surgery. Which client statement
indicates the need for further teaching?
a) "I will not eat or drink anything after midnight."
b) "I will remove my jewelry and leave it with my family."
c) "I will take my daily dose of aspirin this morning as usual."
d) "I will tell the anesthesiologist about my allergies."
Answer: c) "I will take my daily dose of aspirin this morning as usual."
Rationale: Aspirin and other anticoagulants should be discontinued before
surgery (as directed by the provider) because they increase the risk of
bleeding. The client should have been instructed to hold aspirin for at least 7
days before surgery. The other statements reflect correct understanding of
preoperative instructions.
8. A client is scheduled for surgery and has a Do Not Resuscitate (DNR)
order. The nurse should:
a) Honor the DNR order during surgery
b) Suspend the DNR order during the perioperative period
c) Ask the family to make the decision
d) Ignore the DNR order
Answer: b) Suspend the DNR order during the perioperative period
Rationale: In most institutions, DNR orders are suspended during the
perioperative period because interventions such as intubation, mechanical
ventilation, and resuscitation may be necessary to address the effects of
anesthesia and surgery. The client or family should be informed of this policy
and given the option to modify or reaffirm the DNR order. A "required
reconsideration" policy is typically in place.
9. The nurse is reviewing a client's preoperative laboratory results. Which
finding should be reported to the provider?
a) Hemoglobin of 12.0 g/dL
b) White blood cell count of 8,000/mm³
c) Potassium of 5.8 mEq/L
KAPLAN PERIOPERATIVE NURSING ASSESSMENT
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURSING
Prepare for the Kaplan Perioperative Nursing Assessment with a focused study
resource covering essential concepts in preoperative, intraoperative, and
postoperative nursing care. It supports review of surgical preparation, patient safety,
infection prevention, anesthesia considerations, postoperative monitoring,
complications, and nursing interventions. Use the material to reinforce key
knowledge, strengthen clinical judgment, and identify areas that may require
additional review. This resource is best suited for nursing students and NCLEX
candidates preparing for perioperative nursing assessments.
MULTIPLE CHOICE.
SECTION 1: PREOPERATIVE NURSING CARE (Questions 1-15)
1. A client is scheduled for surgery tomorrow morning. Which assessment
finding should the nurse report to the surgeon and anesthesiologist
immediately?
a) The client reports a headache and feels anxious
b) The client's blood pressure is 138/88 mmHg
c) The client reports chest pain and shortness of breath
d) The client's temperature is 99.2°F (37.3°C)
Answer: c) The client reports chest pain and shortness of breath
Rationale: Chest pain and shortness of breath are acute findings that may
indicate a cardiac or pulmonary event that could significantly increase
surgical risk. These symptoms require immediate evaluation and may
necessitate delaying surgery. Mild anxiety, slightly elevated blood pressure,
and low-grade fever are not as urgent but should still be monitored.
, Page 2 of 40
2. A client is NPO (nothing by mouth) for surgery. The client reports taking
a sip of water 2 hours ago. Which action should the nurse take?
a) Administer the preoperative medication as scheduled
b) Notify the surgeon and anesthesiologist
c) Proceed with the surgery as planned
d) Encourage the client to drink more water to stay hydrated
Answer: b) Notify the surgeon and anesthesiologist
Rationale: The client should have been NPO for at least 6-8 hours for solids
and 2-4 hours for clear liquids before surgery, depending on the type of
surgery and anesthesia. The anesthesiologist and surgeon must be notified
because the client is at increased risk for aspiration during induction of
anesthesia. The surgery may be delayed.
3. The nurse is reviewing the preoperative checklist for a client. Which
item is most important to verify before sending the client to the operating
room?
a) The client has signed the informed consent form
b) The client has a completed history and physical exam
c) The client has voided
d) The client has removed jewelry and dentures
Answer: a) The client has signed the informed consent form
Rationale: Informed consent is a legal and ethical requirement before
surgery. The nurse must ensure that the consent form is signed, witnessed,
and placed in the client's chart. Without a signed consent, surgery cannot
proceed. The other items are also important but are not legal prerequisites.
4. A client who is scheduled for surgery reports that they take herbal
supplements daily. Which supplement should the nurse identify as
increasing bleeding risk?
a) Vitamin C
b) St. John's wort
c) Echinacea
d) Garlic
, Page 3 of 40
Answer: d) Garlic
Rationale: Garlic has antiplatelet effects and increases the risk of bleeding
during surgery. St. John's wort can interact with anesthetic agents and affect
drug metabolism. Echinacea can affect immune function. Vitamin C is
generally safe. All herbal supplements should be reported to the provider, and
most should be discontinued 2-3 weeks before surgery.
5. A client scheduled for surgery has a history of smoking. The nurse
should teach the client that smoking should be discontinued at least how
long before surgery?
a) 24 hours
b) 48 hours
c) 1 week
d) 1 month
Answer: d) 1 month
Rationale: Smoking should ideally be discontinued at least 1 month before
surgery to improve pulmonary function, decrease secretions, and reduce the
risk of postoperative complications (atelectasis, pneumonia, and wound
infection). Even shorter-term cessation (24-48 hours) is beneficial, but 1
month is optimal.
6. A client is receiving preoperative teaching. The nurse instructs the
client to use incentive spirometry after surgery. Which statement by the
client indicates understanding?
a) "I will use the incentive spirometer every 2 hours while awake."
b) "I will use the incentive spirometer only when I feel short of breath."
c) "I will use the incentive spirometer after I eat."
d) "I will use the incentive spirometer once a day."
Answer: a) "I will use the incentive spirometer every 2 hours while awake."
Rationale: Incentive spirometry should be used every 1-2 hours while awake
to promote deep breathing, lung expansion, and prevent atelectasis. It should
not be used only when short of breath. The frequency of use is important for
effectiveness.
, Page 4 of 40
7. The nurse is preparing a client for surgery. Which client statement
indicates the need for further teaching?
a) "I will not eat or drink anything after midnight."
b) "I will remove my jewelry and leave it with my family."
c) "I will take my daily dose of aspirin this morning as usual."
d) "I will tell the anesthesiologist about my allergies."
Answer: c) "I will take my daily dose of aspirin this morning as usual."
Rationale: Aspirin and other anticoagulants should be discontinued before
surgery (as directed by the provider) because they increase the risk of
bleeding. The client should have been instructed to hold aspirin for at least 7
days before surgery. The other statements reflect correct understanding of
preoperative instructions.
8. A client is scheduled for surgery and has a Do Not Resuscitate (DNR)
order. The nurse should:
a) Honor the DNR order during surgery
b) Suspend the DNR order during the perioperative period
c) Ask the family to make the decision
d) Ignore the DNR order
Answer: b) Suspend the DNR order during the perioperative period
Rationale: In most institutions, DNR orders are suspended during the
perioperative period because interventions such as intubation, mechanical
ventilation, and resuscitation may be necessary to address the effects of
anesthesia and surgery. The client or family should be informed of this policy
and given the option to modify or reaffirm the DNR order. A "required
reconsideration" policy is typically in place.
9. The nurse is reviewing a client's preoperative laboratory results. Which
finding should be reported to the provider?
a) Hemoglobin of 12.0 g/dL
b) White blood cell count of 8,000/mm³
c) Potassium of 5.8 mEq/L
