Saunders NCLEX RN - Preoperative Care Exams Questions & Answers with Correct Detailed Rationales

Saunders NCLEX RN - Preoperative Care Exams
Questions & Answers with Correct Detailed
Rationales Latest Versions
2025-2026

Substances That Can Affect The Client in Surgery

1. Antibiotics potentiate the action of?
anesthetic agents
Substances That Can Affect The Client in Surgery

2. Anticholinergics like atropine, diphenhydramine,
oxybutynin, doxylamine potentiate the action of?
Tachycardia (Block the action of the PSNS and can cause
tachycardia)

Intestinal Hypotonicity & Hypomotility (Block PSNS so at risk for
paralytic ileus and constipation)

CNS Effects (Confusion, irritability, agitation, hallucinations)
Substances That Can Affect The Client in Surgery

3. Anticoagulants, Antiplatelets, and Thrombolytics increase
the risk for?
Bleeding/Hemorrhaging
-these medications would be discontinued at least 48 hours
before surgery or as specified by the surgeon. Clopidogrel should
be discontinued 5 days before surgery.
Substances That Can Affect The Client in Surgery

Clopidogrel should be discontinued how many days before
surgery?
5 days before surgery

,Substances That Can Affect The Client in Surgery

Other anticoagulants and antiplatelets should be
discontinued how long before surgery?
48 hours before surgery
Substances That Can Affect The Client in Surgery

Anticonvulsants can have what operative effect?
Long term use of certain anticonvulsants can alter the metabolism
of anesthetic agents
Substances That Can Affect The Client in Surgery

Antidepressant Agents can have what operative effect?
May lower blood pressure because of their CNS effects
Substances That Can Affect The Client in Surgery

Antidysrhythmic may have what operative effect?
Reduce cardiac contractility and consequently impair cardiac
conduction during anesthesia
Substances That Can Affect The Client in Surgery

Antihypertensives may have what operative effect?
May interact with anesthetic agents potentiating their effects of
bradycardia, hypotension, and impaired circulation.
Substances That Can Affect The Client in Surgery

Corticosteroids may have what operative effect?
Can cause adrenal atrophy and hence effect how well the body
can handle the stress of surgery since the adrenal gland is
involved in releasing the stress hormones. - before and after
surgery dosages may be increased temporarily.
Substances That Can Affect The Client in Surgery

Diuretics can potentiate what operative effect?
electrolyte imbalances during and after surgery.

, Substances That Can Affect The Client in Surgery

Herbal Substances can have what operative effect?
Herbal substances can interact with anesthesia and cause a
variety of adverse effects - these substances need to stopped at a
specific time before surgery. During the preoperative period, the
client needs to eb asked whether they are taking an herbal
substance.
Substances That Can Affect The Client in Surgery

Insulin - can have what operative effect?
The need for insulin after surgery in a diabetic may be reduced
because the clients nutritional intake is decreased before eating
(remember they were NPO).

OR

the need for insulin may be increased because of the stress
response and IV administration of glucose solutions. Stress
activates the HPA axis which causes the hypothalamus -->
pituitary --> adrenal glands --> cortisol release -->
gluconeogenesis (making glucose from proteins in the liver), also
releases EPI and Noreepi --> glycogenolysis (breaking down
stored glycogen and glucose) & lipolysis (breaking down fat for
energy).
Arrival in the Operating Room

What are the 3 safety precautions in place to prevent wrong
site and wrong procedure surgery?
A. Surgeon meets patient and uses the preoperative marker to
mark operative site

B. Once in the OR the nurse and surgeon reconfirm the operative
site has been appropriately marked