Grade A+ Perioperative NCLEX style questions and answers 2025
The PURPOSE (key word!) of the incentive spirometer is that it will
encourage lung expansion, thus decreasing atelectasis.
Which teaching by the nurse during the preoperative period best
informs the patient regarding the primary purpose of an incentive Proper use entails holding the breath 3 to 5 seconds at a time,
spirometer? setting daily goals, and sealing the lips tightly around the mouth
piece are all directions on how to use the device, but do not
describe its function. (be careful of key words in question!)
The nurse interviews a patient scheduled to undergo general
D. The patient's father died after receiving general anesthesia for
anesthesia for a hernia repair. Which information is most impor-
abdominal surgery.
tant to communicate to the surgeon and anesthesiologist before
surgery?
The information about the patient's father suggests that there may
a. The patient drinks 3 or 4 cups of coffee every morning before be a family history of malignant hyperthermia and that precau-
going to work. tions may need to be taken to prevent this complication. Current
research indicates that having clear liquids 3 hours before surgery
b. The patient takes a baby aspirin daily but stopped taking aspirin does not increase the risk for aspiration in most patients. Patients
10 days ago.
are instructed to discontinue aspirin 1 to 2 weeks before surgery.
c. The patient drank 4 ounces of apple juice 3 hours before coming
The patient should be offered caffeinated beverages postopera-
to the hospital.
tively to prevent a caffeine-withdrawal headache, but this does not
d. The patient's father died after receiving general anesthesia for
have preoperative implications.
abdominal surgery.
A patient who takes a diuretic and a beta-blocker to control blood
d. Serum potassium 3.2 mEq/L
pressure is scheduled for breast reconstruction surgery. Which
ANS: D
patient information is most important to communicate to the health
The low potassium level may increase the risk for intraoperative
care provider before surgery?
complications such as dysrhythmias. Slightly elevated blood pres-
sure is common before surgery because of anxiety. The lower
a. Hematocrit 36%
heart rate would be expected in a patient taking a -blocker. The
b. Blood pressure 144/82
hematocrit is in the low normal range but does not require any
c. Pulse rate 58 beats/minute
intervention before surgery.
d. Serum potassium 3.2 mEq/L
d. Use of multiple herbs and supplements
Some herbs and supplements can interact with medications, so
this information needs to be reported as the priority. An allergy to
A preoperative nurse is assessing a client prior to surgery. Which
bee and wasp stings should not affect the client during surgery.
information would be most important for the nurse to relay to the
Lactose intolerance should also not affect the client during surgery
surgical team?
but will need to be noted before a postoperative diet is ordered.
a. Allergy to bee and wasp stings
Lack of experience with surgery may increase anxiety and may
b. History of lactose intolerance
require higher teaching needs, but is not the priority over client
c. No previous experience with surgery
safety.
d. Use of multiple herbs and supplements
***side note:pt taking St. John's wort may prolong the effects of
anesthetic agents and increase the time to waken completely after
surgery.**
d. "To prevent blood clots you need them a few more hours."
Ten hours after surgery, a postoperative client reports that the
antiembolism stockings and sequential compression devices itch
According to the Surgical Care Improvement Project (SCIP), any
and are too hot. The client asks the nurse to remove them. What
prophylactic measures to prevent thromboembolic events during
response by the nurse is best?
surgery are continued for 24 hours afterward. The nurse should
a. "Let me call the surgeon to see if you really need them."
explain this to the client. Calling the surgeon is not warranted.
b. "No, you have to use those for 24 hours after surgery."
Simply telling the client he or she has to wear the hose and com-
c. "OK, we can remove them since you are stable now."
pression devices does not educate the client. The nurse should
d. "To prevent blood clots you need them a few more hours."
not remove the devices.
An inpatient nurse brings an informed consent form to a client ANS: B Do not have the client sign the consent and call the
for an operation scheduled for tomorrow. The client asks about surgeon.
possible complications from the operation. What response by the
nurse is best? In order to give informed consent, the client needs sufficient
a. Answer the questions and document that teaching was done. information. Questions about potential complications should be
b. Do not have the client sign the consent and call the surgeon. answered by the surgeon. The nurse should notify the surgeon
c. Have the client sign the consent, then call the surgeon. to come back and answer the client's questions before the client
d. Remind the client of what teaching the surgeon has done. signs the consent form. The other actions are not appropriate.
, Grade A+ Perioperative NCLEX style questions and answers 2025
The most dangerous metabolic side effect of general anesthesia
that can occur during surgery is:
Hyperglycemia Hyperthermia
Hyperthermia
Hypoglycemia Explanation:
Hypothermia Malignant hyperthermia is the most dangerous metabolic side
Explanation: effect of general anesthesia.
Malignant hyperthermia is the most dangerous metabolic side
effect of general anesthesia.
Mr. Baltazar will be undergoing surgery with general anesthesia.
The client should be given which of the following instructions Expect nausea, vomiting, shivering, and pain postoperatively.
preoperatively?
Eat big breakfast Explanation:
Expect to be incontinent of urine postoperatively These responses should be expected, and the client should be
Double your medication doses prepared for them. Food is contraindicated before surgery. Urinary
Eat big breakfast retention, not incontinence is likely. Medication is more likely to be
Expect to be incontinent of urine postoperatively held on the day of surgery.
Expect nausea, vomiting, shivering, and pain postoperatively.
Which of the following statements about shivering is correct?
Shivering can occur in the absence of hypothermia
Shivering is a response controlled by the brainstem.
Shivering can occur in the absence of hypothermia.
Explanation:
Shivering is effectively treated with small doses of naloxone.
Shivering can also appear after surgery. This is known as
Shivering is an uncomfortable, though harmless, effect of anes-
postanesthetic shivering.
thesia.
The nurse receives the client in the postanesthesia care unit
(PACU) following a procedure requiring general anesthesia. The Respiratory status.
most important assessment made by the nurse relates to the Explanation:
client's: General anesthesia causes relaxation of all muscles, including
Level of consciousness. respiratory muscles, requiring mechanical ventilation. The client's
Pain. respiratory status must be monitored closely following general
Vital signs. anesthesia.
Respiratory status.
Stimulating opiate receptors
All narcotics, regardless of their origin, reduce pain by:
Explanation:
Stimulating opiate receptors It is the stimulation of cerebral opiate receptors that reduces pain.
Excitatory transmitters are not released during administration of
Promoting the release of excitatory transmitters
morphine. Endorphin release is not associated with narcotic pain
Releasing large quantities of endorphin
relief. The mu receptors mediate analgesia and are not blocked
Blocking the mu receptors
during narcotic administration.
ANS: C
Which nursing action or statement is most likely to reduce anxiety
Most anxious clients would feel some relief by having one or more
in a client being brought to the surgical suite?
familiar persons waiting with them until surgery begins. In addition,
A. Asking the client if he or she has talked with the hospital
asking the client what he or she wants allows the client to have
chaplain
more control over the situation. Asking the client if he or she has
B. Asking the client what specific surgery he or she is having done visited with the hospital chaplain and telling the client about the
today
advanced technology can imply to the client that the procedure
C. Asking the client if he or she wants family members to be with
is dangerous. Although the client must be asked what procedure
them in the holding area
he or she is having (to ascertain that the client does know what
D. Explaining to the client that the surgical area is the most
is to be done), this question may make the client worry about the
technologically advanced in the city
competency of the staff.
The anesthetized client with an open abdomen suddenly develops ANS: D
malignant hyperthermia. What intervention should the nurse be Dantrolene is a skeletal muscle relaxant and can help lower body
prepared to initiate or assist with? temperature by reducing metabolic heat production by the mus-
A. Discontinue mechanical ventilation. cles. Clients become hyperkalemic and hypercalcemic; therefore,
B. Administer intravenous potassium chloride. neither of these electrolytes should be administered. The client's
C. Administer intravenous calcium chloride. gas exchange is severely compromised. If the client is not already
D. Administer intravenous dantrolene (Dantrium). receiving mechanical ventilation, it is initiated.
What is the priority nursing diagnosis for the client under general
anesthesia during surgery?
A. Acute Pain related to surgical procedure
The PURPOSE (key word!) of the incentive spirometer is that it will
encourage lung expansion, thus decreasing atelectasis.
Which teaching by the nurse during the preoperative period best
informs the patient regarding the primary purpose of an incentive Proper use entails holding the breath 3 to 5 seconds at a time,
spirometer? setting daily goals, and sealing the lips tightly around the mouth
piece are all directions on how to use the device, but do not
describe its function. (be careful of key words in question!)
The nurse interviews a patient scheduled to undergo general
D. The patient's father died after receiving general anesthesia for
anesthesia for a hernia repair. Which information is most impor-
abdominal surgery.
tant to communicate to the surgeon and anesthesiologist before
surgery?
The information about the patient's father suggests that there may
a. The patient drinks 3 or 4 cups of coffee every morning before be a family history of malignant hyperthermia and that precau-
going to work. tions may need to be taken to prevent this complication. Current
research indicates that having clear liquids 3 hours before surgery
b. The patient takes a baby aspirin daily but stopped taking aspirin does not increase the risk for aspiration in most patients. Patients
10 days ago.
are instructed to discontinue aspirin 1 to 2 weeks before surgery.
c. The patient drank 4 ounces of apple juice 3 hours before coming
The patient should be offered caffeinated beverages postopera-
to the hospital.
tively to prevent a caffeine-withdrawal headache, but this does not
d. The patient's father died after receiving general anesthesia for
have preoperative implications.
abdominal surgery.
A patient who takes a diuretic and a beta-blocker to control blood
d. Serum potassium 3.2 mEq/L
pressure is scheduled for breast reconstruction surgery. Which
ANS: D
patient information is most important to communicate to the health
The low potassium level may increase the risk for intraoperative
care provider before surgery?
complications such as dysrhythmias. Slightly elevated blood pres-
sure is common before surgery because of anxiety. The lower
a. Hematocrit 36%
heart rate would be expected in a patient taking a -blocker. The
b. Blood pressure 144/82
hematocrit is in the low normal range but does not require any
c. Pulse rate 58 beats/minute
intervention before surgery.
d. Serum potassium 3.2 mEq/L
d. Use of multiple herbs and supplements
Some herbs and supplements can interact with medications, so
this information needs to be reported as the priority. An allergy to
A preoperative nurse is assessing a client prior to surgery. Which
bee and wasp stings should not affect the client during surgery.
information would be most important for the nurse to relay to the
Lactose intolerance should also not affect the client during surgery
surgical team?
but will need to be noted before a postoperative diet is ordered.
a. Allergy to bee and wasp stings
Lack of experience with surgery may increase anxiety and may
b. History of lactose intolerance
require higher teaching needs, but is not the priority over client
c. No previous experience with surgery
safety.
d. Use of multiple herbs and supplements
***side note:pt taking St. John's wort may prolong the effects of
anesthetic agents and increase the time to waken completely after
surgery.**
d. "To prevent blood clots you need them a few more hours."
Ten hours after surgery, a postoperative client reports that the
antiembolism stockings and sequential compression devices itch
According to the Surgical Care Improvement Project (SCIP), any
and are too hot. The client asks the nurse to remove them. What
prophylactic measures to prevent thromboembolic events during
response by the nurse is best?
surgery are continued for 24 hours afterward. The nurse should
a. "Let me call the surgeon to see if you really need them."
explain this to the client. Calling the surgeon is not warranted.
b. "No, you have to use those for 24 hours after surgery."
Simply telling the client he or she has to wear the hose and com-
c. "OK, we can remove them since you are stable now."
pression devices does not educate the client. The nurse should
d. "To prevent blood clots you need them a few more hours."
not remove the devices.
An inpatient nurse brings an informed consent form to a client ANS: B Do not have the client sign the consent and call the
for an operation scheduled for tomorrow. The client asks about surgeon.
possible complications from the operation. What response by the
nurse is best? In order to give informed consent, the client needs sufficient
a. Answer the questions and document that teaching was done. information. Questions about potential complications should be
b. Do not have the client sign the consent and call the surgeon. answered by the surgeon. The nurse should notify the surgeon
c. Have the client sign the consent, then call the surgeon. to come back and answer the client's questions before the client
d. Remind the client of what teaching the surgeon has done. signs the consent form. The other actions are not appropriate.
, Grade A+ Perioperative NCLEX style questions and answers 2025
The most dangerous metabolic side effect of general anesthesia
that can occur during surgery is:
Hyperglycemia Hyperthermia
Hyperthermia
Hypoglycemia Explanation:
Hypothermia Malignant hyperthermia is the most dangerous metabolic side
Explanation: effect of general anesthesia.
Malignant hyperthermia is the most dangerous metabolic side
effect of general anesthesia.
Mr. Baltazar will be undergoing surgery with general anesthesia.
The client should be given which of the following instructions Expect nausea, vomiting, shivering, and pain postoperatively.
preoperatively?
Eat big breakfast Explanation:
Expect to be incontinent of urine postoperatively These responses should be expected, and the client should be
Double your medication doses prepared for them. Food is contraindicated before surgery. Urinary
Eat big breakfast retention, not incontinence is likely. Medication is more likely to be
Expect to be incontinent of urine postoperatively held on the day of surgery.
Expect nausea, vomiting, shivering, and pain postoperatively.
Which of the following statements about shivering is correct?
Shivering can occur in the absence of hypothermia
Shivering is a response controlled by the brainstem.
Shivering can occur in the absence of hypothermia.
Explanation:
Shivering is effectively treated with small doses of naloxone.
Shivering can also appear after surgery. This is known as
Shivering is an uncomfortable, though harmless, effect of anes-
postanesthetic shivering.
thesia.
The nurse receives the client in the postanesthesia care unit
(PACU) following a procedure requiring general anesthesia. The Respiratory status.
most important assessment made by the nurse relates to the Explanation:
client's: General anesthesia causes relaxation of all muscles, including
Level of consciousness. respiratory muscles, requiring mechanical ventilation. The client's
Pain. respiratory status must be monitored closely following general
Vital signs. anesthesia.
Respiratory status.
Stimulating opiate receptors
All narcotics, regardless of their origin, reduce pain by:
Explanation:
Stimulating opiate receptors It is the stimulation of cerebral opiate receptors that reduces pain.
Excitatory transmitters are not released during administration of
Promoting the release of excitatory transmitters
morphine. Endorphin release is not associated with narcotic pain
Releasing large quantities of endorphin
relief. The mu receptors mediate analgesia and are not blocked
Blocking the mu receptors
during narcotic administration.
ANS: C
Which nursing action or statement is most likely to reduce anxiety
Most anxious clients would feel some relief by having one or more
in a client being brought to the surgical suite?
familiar persons waiting with them until surgery begins. In addition,
A. Asking the client if he or she has talked with the hospital
asking the client what he or she wants allows the client to have
chaplain
more control over the situation. Asking the client if he or she has
B. Asking the client what specific surgery he or she is having done visited with the hospital chaplain and telling the client about the
today
advanced technology can imply to the client that the procedure
C. Asking the client if he or she wants family members to be with
is dangerous. Although the client must be asked what procedure
them in the holding area
he or she is having (to ascertain that the client does know what
D. Explaining to the client that the surgical area is the most
is to be done), this question may make the client worry about the
technologically advanced in the city
competency of the staff.
The anesthetized client with an open abdomen suddenly develops ANS: D
malignant hyperthermia. What intervention should the nurse be Dantrolene is a skeletal muscle relaxant and can help lower body
prepared to initiate or assist with? temperature by reducing metabolic heat production by the mus-
A. Discontinue mechanical ventilation. cles. Clients become hyperkalemic and hypercalcemic; therefore,
B. Administer intravenous potassium chloride. neither of these electrolytes should be administered. The client's
C. Administer intravenous calcium chloride. gas exchange is severely compromised. If the client is not already
D. Administer intravenous dantrolene (Dantrium). receiving mechanical ventilation, it is initiated.
What is the priority nursing diagnosis for the client under general
anesthesia during surgery?
A. Acute Pain related to surgical procedure
