Saunders Comprehensive Review for the NCLEX-RN Exam Pre-op,
Intra-op, Post-op Questions and Answers
A nurse assesses a client's surgical incision for 4. Apply a sterile dressing soaked in providone-
signs of infection. Which finding by the nurse iodine (Betadine). - -3. Apply a sterile
would be interpreted as a normal finding at the dressing soaked with normal saline.
surgical site?
1. Red, hard skin Rationale: Wound dehiscence is the separation
2. Serous drainage of wound edges at the suture line. Signs and
3. Purulent drainage symptoms include increased drainage and the
4. Warm, tender skin - -2. Serous drainage appearance of underlying tissues. Dehiscence
usually occurs 6 to 8 days after surgery. The
Rationale: Serous drainage is an expected client should be instructed to remain quiet and
finding at a surgical site. The other options avoid coughing or straining. The client should be
indicate signs of wound infection. Signs and positioned to prevent further stress on the wound
symptoms of infection include warm, red, and (semi-Fowler's). Sterile dressings soaked with
tender skin around the incision. Wound infection sterile normal saline should be used to cover the
usually appears 3 to 6 days after surgery. The wound. The nurse must notify the physician after
client also may have a fever and chills. Purulent applying the initial dressing to the wound.
material may exit from drains or from separated Options 1, 2, and 4 are incorrect.
wound edges. Infection may be caused by poor
aseptic technique or a contaminated wound Test-taking strategy: Use the process of
before surgical exploration; existing client elimination. Eliminate option 1 first because this
conditions such as diabetes mellitus or action would dry the wound and also present a
immunocompromise may place the client at risk. risk of infection to the underlying tissues.
Eliminate options 2 and 4 next because a dry
Test-taking strategy: Use the process of dressing and a dressing soaked with providone-
elimination, noting the strategy words normal iodine will irritate the exposed body tissues.
finding. Recalling the signs of a wound infection Review initial nursing care when dehiscence or
and noting these strategy words will direct you to evisceration occurs if you had difficulty with this
option 2. Review the signs of a wound infection if question.
you had difficulty with this question.
A nurse is monitoring the status of a
When performing a surgical dressing change of a postoperative client. The nurse would become
client's abdominal dressing, a nurse notes an most concerned with which of the following signs
increase in the amount of drainage and that could indicate an evolving complication?
separation of the incision line. The underlying 1. Increasing restlessness
tissue is visible to the nurse. The nurse should 2. A negative Homans' sign
do which of the following in the initial care of this 3. Hypoactive bowel sounds in all four quadrants
wound? 4. Blood pressure of 110/70 mm Hg and a pulse
1. Leave the incision open to the air to dry the of 86 beats/min - -1. Increasing
area. restlessness
2. Irrigate the wound and apply a sterile dry
dressing. Rationale: Increasing restlessness is a sign that
3. Apply a sterile dressing soaked with normal requires continuous and close monitoring
saline. because it could indicate a potential complication,
1/9
, Saunders Comprehensive Review for the NCLEX-RN Exam Pre-op,
Intra-op, Post-op Questions and Answers
such as hemorrhage, shock, or pulmonary medications may be withheld before surgery
embolism. A blood pressure of 110/70 mm Hg without undue effects on the client.
with a pulse of 86 beats/minute is within normal
limits. Hypoactive bowel sounds heard in all four Test-Taking Strategy: Use the process of
quadrants are a normal occurrence, as is a elimination and knowledge about medications
negative Homans' sign (A positive Homans' sign that may have special implications for the
may indicate thrombophlebitis). surgical client. Focus on the subject, the
medication that should be administered in the
Test-Taking Strategy: Use the process of preoperative period. Remember that when stress
elimination and note the strategic word, "most". is severe, corticosteroids are essential to life.
Focus on the subject , "a manifestation of an Review the effects of corticosteroids if you had
evolving complication". Eliminate each of the difficulty with this question.
incorrect options because they are comparable
or alike and are normal expected findings. If you
had difficulty with this question, review the
normal expected postoperative findings and the A client who has undergone preadmission testing
signs and symptoms of postoperative has had blood drawn for serum laboratory
complications. studies, including a complete blood count,
coagulation studies, and electrolytes and
creatinine levels. Which of the following
laboratory results should be reported to the
A nurse is reviewing a physician's order sheet for surgeon's office by the nurse, knowing that it
a preoperative client that states that the client could cause surgery to be postponed?
must be NPO after midnight. The nurse would 1. Sodium, 141 mEq/L
telephone the physician to clarify whether which 2. Hemoglobin, 8.0 g/dL
of the following medications should be given to 3. Platelets, 210,000/mm3
the client and not withheld? 4. Serum creatinine, 0.8 mg/dL - -2.
1. Ferrous sulfate Hemoglobin, 8.0 g/dL
2. Prednisone (Deltasone)
3. Cycloenzaprine (Flexeril) Rationale: Routine screening tests include a
4. Conjugated estrogen (Premarin) - -2. complete blood count, serum electrolyte analysis,
Prednisone (Deltasone) coagulation studies, and a serum creatinine test.
The complete blood count includes the
Rationale: Prednisone is a corticosteroid. With hemoglobin analysis. All these values are within
prolonged use, corticosteroids cause adrenal normal range except for hemoglobin. If a client
atrophy, which reduces the ability of the body to has a low hemoglobin level, the surgery likely
withstand stress. When stress is severe, could be postponed by the surgeon.
corticosteroids are essential to life. Before and
during surgery, dosages may be increased Test-Taking Strategy: Focus on the subject , an
temporarily. Ferrous sulfate is an oral iron abnormal laboratory result that needs to be
preparation used to treat iron deficiency anemia. reported. Use knowledge of the normal laboratory
Cyclobenzaprine (Flexeril) is a skeletal muscle values to assist in answering correctly. The
relaxant. Conjugated estrogen (Premarin) is an hemoglobin value is the only incorrect laboratory
estrogen used for hormone replacement therapy finding. Review these laboratory values if you
in postmenopausal women. These last three had difficulty answering this question.
2/9
Intra-op, Post-op Questions and Answers
A nurse assesses a client's surgical incision for 4. Apply a sterile dressing soaked in providone-
signs of infection. Which finding by the nurse iodine (Betadine). - -3. Apply a sterile
would be interpreted as a normal finding at the dressing soaked with normal saline.
surgical site?
1. Red, hard skin Rationale: Wound dehiscence is the separation
2. Serous drainage of wound edges at the suture line. Signs and
3. Purulent drainage symptoms include increased drainage and the
4. Warm, tender skin - -2. Serous drainage appearance of underlying tissues. Dehiscence
usually occurs 6 to 8 days after surgery. The
Rationale: Serous drainage is an expected client should be instructed to remain quiet and
finding at a surgical site. The other options avoid coughing or straining. The client should be
indicate signs of wound infection. Signs and positioned to prevent further stress on the wound
symptoms of infection include warm, red, and (semi-Fowler's). Sterile dressings soaked with
tender skin around the incision. Wound infection sterile normal saline should be used to cover the
usually appears 3 to 6 days after surgery. The wound. The nurse must notify the physician after
client also may have a fever and chills. Purulent applying the initial dressing to the wound.
material may exit from drains or from separated Options 1, 2, and 4 are incorrect.
wound edges. Infection may be caused by poor
aseptic technique or a contaminated wound Test-taking strategy: Use the process of
before surgical exploration; existing client elimination. Eliminate option 1 first because this
conditions such as diabetes mellitus or action would dry the wound and also present a
immunocompromise may place the client at risk. risk of infection to the underlying tissues.
Eliminate options 2 and 4 next because a dry
Test-taking strategy: Use the process of dressing and a dressing soaked with providone-
elimination, noting the strategy words normal iodine will irritate the exposed body tissues.
finding. Recalling the signs of a wound infection Review initial nursing care when dehiscence or
and noting these strategy words will direct you to evisceration occurs if you had difficulty with this
option 2. Review the signs of a wound infection if question.
you had difficulty with this question.
A nurse is monitoring the status of a
When performing a surgical dressing change of a postoperative client. The nurse would become
client's abdominal dressing, a nurse notes an most concerned with which of the following signs
increase in the amount of drainage and that could indicate an evolving complication?
separation of the incision line. The underlying 1. Increasing restlessness
tissue is visible to the nurse. The nurse should 2. A negative Homans' sign
do which of the following in the initial care of this 3. Hypoactive bowel sounds in all four quadrants
wound? 4. Blood pressure of 110/70 mm Hg and a pulse
1. Leave the incision open to the air to dry the of 86 beats/min - -1. Increasing
area. restlessness
2. Irrigate the wound and apply a sterile dry
dressing. Rationale: Increasing restlessness is a sign that
3. Apply a sterile dressing soaked with normal requires continuous and close monitoring
saline. because it could indicate a potential complication,
1/9
, Saunders Comprehensive Review for the NCLEX-RN Exam Pre-op,
Intra-op, Post-op Questions and Answers
such as hemorrhage, shock, or pulmonary medications may be withheld before surgery
embolism. A blood pressure of 110/70 mm Hg without undue effects on the client.
with a pulse of 86 beats/minute is within normal
limits. Hypoactive bowel sounds heard in all four Test-Taking Strategy: Use the process of
quadrants are a normal occurrence, as is a elimination and knowledge about medications
negative Homans' sign (A positive Homans' sign that may have special implications for the
may indicate thrombophlebitis). surgical client. Focus on the subject, the
medication that should be administered in the
Test-Taking Strategy: Use the process of preoperative period. Remember that when stress
elimination and note the strategic word, "most". is severe, corticosteroids are essential to life.
Focus on the subject , "a manifestation of an Review the effects of corticosteroids if you had
evolving complication". Eliminate each of the difficulty with this question.
incorrect options because they are comparable
or alike and are normal expected findings. If you
had difficulty with this question, review the
normal expected postoperative findings and the A client who has undergone preadmission testing
signs and symptoms of postoperative has had blood drawn for serum laboratory
complications. studies, including a complete blood count,
coagulation studies, and electrolytes and
creatinine levels. Which of the following
laboratory results should be reported to the
A nurse is reviewing a physician's order sheet for surgeon's office by the nurse, knowing that it
a preoperative client that states that the client could cause surgery to be postponed?
must be NPO after midnight. The nurse would 1. Sodium, 141 mEq/L
telephone the physician to clarify whether which 2. Hemoglobin, 8.0 g/dL
of the following medications should be given to 3. Platelets, 210,000/mm3
the client and not withheld? 4. Serum creatinine, 0.8 mg/dL - -2.
1. Ferrous sulfate Hemoglobin, 8.0 g/dL
2. Prednisone (Deltasone)
3. Cycloenzaprine (Flexeril) Rationale: Routine screening tests include a
4. Conjugated estrogen (Premarin) - -2. complete blood count, serum electrolyte analysis,
Prednisone (Deltasone) coagulation studies, and a serum creatinine test.
The complete blood count includes the
Rationale: Prednisone is a corticosteroid. With hemoglobin analysis. All these values are within
prolonged use, corticosteroids cause adrenal normal range except for hemoglobin. If a client
atrophy, which reduces the ability of the body to has a low hemoglobin level, the surgery likely
withstand stress. When stress is severe, could be postponed by the surgeon.
corticosteroids are essential to life. Before and
during surgery, dosages may be increased Test-Taking Strategy: Focus on the subject , an
temporarily. Ferrous sulfate is an oral iron abnormal laboratory result that needs to be
preparation used to treat iron deficiency anemia. reported. Use knowledge of the normal laboratory
Cyclobenzaprine (Flexeril) is a skeletal muscle values to assist in answering correctly. The
relaxant. Conjugated estrogen (Premarin) is an hemoglobin value is the only incorrect laboratory
estrogen used for hormone replacement therapy finding. Review these laboratory values if you
in postmenopausal women. These last three had difficulty answering this question.
2/9
