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ATI Medical-Surgical Perioperative Nursing Exam
2026/2027 Actual Exam | Comprehensive Specialty
Exam with Verified Definitions | Nursing Program |
Pass Guaranteed - A+ Graded
Section 1: Preoperative Nursing Care (15 Questions)
Q1: A nurse is obtaining informed consent for a surgical procedure. Which of the following
elements is essential for valid informed consent?
A. Consent obtained by the circulating nurse
B. Consent signed after the patient receives preoperative sedation
C. Explanation of the procedure, risks, benefits, and alternatives by the surgeon [CORRECT]
D. Consent signed by a family member without patient involvement
Correct Answer: C
Rationale: Valid informed consent requires that the surgeon (or provider performing the
procedure) explain the procedure, risks, benefits, and alternatives to the patient. The patient must
be competent, give voluntary consent without coercion, and have decision-making capacity.
Option A is incorrect—the nurse may witness consent but cannot obtain it; this is the surgeon's
responsibility. Option B is incorrect—sedation impairs judgment and decision-making capacity,
making consent invalid. Option D is incorrect unless the patient lacks decision-making capacity
and has a legally authorized surrogate.
Client Need: Management of Care
Cognitive Level: Recall
Q2: A patient is scheduled for abdominal surgery and reports taking warfarin daily. Which of the
following actions should the nurse take?
A. Administer warfarin as usual on the morning of surgery
B. Notify the surgeon and anesthesia provider about the warfarin use [CORRECT]
C. Double the next dose to compensate for missed doses
,2
D. Stop warfarin without notifying anyone
Correct Answer: B
Rationale: Anticoagulants like warfarin significantly increase bleeding risk during surgery. The
nurse must notify the surgeon and anesthesia provider for specific orders regarding perioperative
management (typically holding warfarin 5-7 days preoperatively, with possible bridging
therapy). Option A increases bleeding risk. Option C is dangerous and could cause hemorrhage.
Option D is unsafe as it requires provider orders and monitoring.
Client Need: Reduction of Risk Potential
Cognitive Level: Application
Q3: A nurse is providing preoperative teaching to a patient scheduled for abdominal surgery.
Which of the following instructions about incentive spirometry is correct?
A. "Use the incentive spirometer every 2 hours while awake." [CORRECT]
B. "Exhale forcefully into the device to make the balls rise."
C. "Only use the spirometer if you feel short of breath."
D. "Place the mouthpiece between your teeth and blow quickly."
Correct Answer: A
Rationale: Incentive spirometry should be performed every 1-2 hours while awake (10 times per
hour) to prevent atelectasis and postoperative pneumonia. Option B is incorrect—patients inhale
slowly and deeply to raise the balls/bellows, not exhale. Option C is incorrect—prophylactic
routine use is required, not PRN use. Option D is incorrect—patients should inhale slowly and
hold for 3-5 seconds, not blow quickly.
Client Need: Reduction of Risk Potential
Cognitive Level: Application
Q4: A patient who is NPO for surgery asks why they cannot drink water. The nurse's response is
based on the understanding that NPO status reduces the risk of:
A. Dehydration
B. Aspiration during anesthesia [CORRECT]
C. Hypoglycemia
D. Nausea after surgery
, 3
Correct Answer: B
Rationale: NPO (nothing by mouth) status before surgery reduces the risk of aspiration of
gastric contents during anesthesia induction, which can cause aspiration pneumonia, hypoxia, or
death. Standard guidelines: clear liquids up to 2 hours before, light meal 6 hours before, fatty
meal 8 hours before. Options A, C, and D are not the primary rationale for NPO status; in fact,
NPO may cause mild dehydration but this is managed with IV fluids.
Client Need: Reduction of Risk Potential
Cognitive Level: Recall
Q5: A nurse is reviewing a patient's preoperative laboratory results. Which of the following
findings is MOST important to report to the surgeon?
A. Hemoglobin 12.5 g/dL
B. Potassium 3.2 mEq/L [CORRECT]
C. White blood cell count 8,000/mm³
D. Platelets 250,000/mm³
Correct Answer: B
Rationale: Hypokalemia (K⁺ <3.5 mEq/L) significantly increases the risk of cardiac
dysrhythmias during surgery and anesthesia and should be corrected preoperatively. This finding
requires immediate communication with the surgeon for potassium replacement. Option A is
within normal range for females (12-16 g/dL). Option C is within normal range (4,500-
11,000/mm³). Option D is within normal range (150,000-400,000/mm³).
Client Need: Reduction of Risk Potential
Cognitive Level: Analysis
Q6: A nurse is preparing a patient for surgery. The patient states, "I don't want any blood
transfusions because of my religious beliefs." Which of the following actions should the nurse
take?
A. Explain that transfusions may be necessary to save the patient's life
B. Notify the surgeon and document the patient's wishes [CORRECT]
C. Ask the patient to reconsider and sign a different consent
D. Assume the patient will accept blood if unconscious
ATI Medical-Surgical Perioperative Nursing Exam
2026/2027 Actual Exam | Comprehensive Specialty
Exam with Verified Definitions | Nursing Program |
Pass Guaranteed - A+ Graded
Section 1: Preoperative Nursing Care (15 Questions)
Q1: A nurse is obtaining informed consent for a surgical procedure. Which of the following
elements is essential for valid informed consent?
A. Consent obtained by the circulating nurse
B. Consent signed after the patient receives preoperative sedation
C. Explanation of the procedure, risks, benefits, and alternatives by the surgeon [CORRECT]
D. Consent signed by a family member without patient involvement
Correct Answer: C
Rationale: Valid informed consent requires that the surgeon (or provider performing the
procedure) explain the procedure, risks, benefits, and alternatives to the patient. The patient must
be competent, give voluntary consent without coercion, and have decision-making capacity.
Option A is incorrect—the nurse may witness consent but cannot obtain it; this is the surgeon's
responsibility. Option B is incorrect—sedation impairs judgment and decision-making capacity,
making consent invalid. Option D is incorrect unless the patient lacks decision-making capacity
and has a legally authorized surrogate.
Client Need: Management of Care
Cognitive Level: Recall
Q2: A patient is scheduled for abdominal surgery and reports taking warfarin daily. Which of the
following actions should the nurse take?
A. Administer warfarin as usual on the morning of surgery
B. Notify the surgeon and anesthesia provider about the warfarin use [CORRECT]
C. Double the next dose to compensate for missed doses
,2
D. Stop warfarin without notifying anyone
Correct Answer: B
Rationale: Anticoagulants like warfarin significantly increase bleeding risk during surgery. The
nurse must notify the surgeon and anesthesia provider for specific orders regarding perioperative
management (typically holding warfarin 5-7 days preoperatively, with possible bridging
therapy). Option A increases bleeding risk. Option C is dangerous and could cause hemorrhage.
Option D is unsafe as it requires provider orders and monitoring.
Client Need: Reduction of Risk Potential
Cognitive Level: Application
Q3: A nurse is providing preoperative teaching to a patient scheduled for abdominal surgery.
Which of the following instructions about incentive spirometry is correct?
A. "Use the incentive spirometer every 2 hours while awake." [CORRECT]
B. "Exhale forcefully into the device to make the balls rise."
C. "Only use the spirometer if you feel short of breath."
D. "Place the mouthpiece between your teeth and blow quickly."
Correct Answer: A
Rationale: Incentive spirometry should be performed every 1-2 hours while awake (10 times per
hour) to prevent atelectasis and postoperative pneumonia. Option B is incorrect—patients inhale
slowly and deeply to raise the balls/bellows, not exhale. Option C is incorrect—prophylactic
routine use is required, not PRN use. Option D is incorrect—patients should inhale slowly and
hold for 3-5 seconds, not blow quickly.
Client Need: Reduction of Risk Potential
Cognitive Level: Application
Q4: A patient who is NPO for surgery asks why they cannot drink water. The nurse's response is
based on the understanding that NPO status reduces the risk of:
A. Dehydration
B. Aspiration during anesthesia [CORRECT]
C. Hypoglycemia
D. Nausea after surgery
, 3
Correct Answer: B
Rationale: NPO (nothing by mouth) status before surgery reduces the risk of aspiration of
gastric contents during anesthesia induction, which can cause aspiration pneumonia, hypoxia, or
death. Standard guidelines: clear liquids up to 2 hours before, light meal 6 hours before, fatty
meal 8 hours before. Options A, C, and D are not the primary rationale for NPO status; in fact,
NPO may cause mild dehydration but this is managed with IV fluids.
Client Need: Reduction of Risk Potential
Cognitive Level: Recall
Q5: A nurse is reviewing a patient's preoperative laboratory results. Which of the following
findings is MOST important to report to the surgeon?
A. Hemoglobin 12.5 g/dL
B. Potassium 3.2 mEq/L [CORRECT]
C. White blood cell count 8,000/mm³
D. Platelets 250,000/mm³
Correct Answer: B
Rationale: Hypokalemia (K⁺ <3.5 mEq/L) significantly increases the risk of cardiac
dysrhythmias during surgery and anesthesia and should be corrected preoperatively. This finding
requires immediate communication with the surgeon for potassium replacement. Option A is
within normal range for females (12-16 g/dL). Option C is within normal range (4,500-
11,000/mm³). Option D is within normal range (150,000-400,000/mm³).
Client Need: Reduction of Risk Potential
Cognitive Level: Analysis
Q6: A nurse is preparing a patient for surgery. The patient states, "I don't want any blood
transfusions because of my religious beliefs." Which of the following actions should the nurse
take?
A. Explain that transfusions may be necessary to save the patient's life
B. Notify the surgeon and document the patient's wishes [CORRECT]
C. Ask the patient to reconsider and sign a different consent
D. Assume the patient will accept blood if unconscious
