1
ATI Medical Surgical Perioperative Nursing
Exam Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
[SECTION 1: Preoperative Nursing Care — Questions 1-12]
Q1: The nurse is preparing a client for surgery scheduled for 0800. The client reports drinking
water at 0600. What is the nurse's priority action?
A. Administer a prescribed antiemetic immediately.
B. Report the intake to the anesthesia provider.
C. Cancel the surgery and reschedule for the next day.
D. Encourage the client to drink more water to facilitate IV start.
Correct Answer: B
Rationale: While preoperative guidelines typically allow clear liquids up to 2 hours before
surgery (NPO status for 6-8 hours applies to solids and heavy meals), the specific NPO order
may vary based on provider preference or patient risk factors. The nurse must report the intake to
the anesthesia provider so they can assess the risk of aspiration and determine if the procedure
should proceed or be delayed. Cancelling the surgery (C) is beyond the nurse's scope without a
provider's order, and administering antiemetics (A) or encouraging more fluids (D) are
inappropriate responses to a potential NPO violation.
Q2: A client asks the nurse to explain the risks of the scheduled surgery. The nurse’s best
response is:
A. "I cannot explain the risks; you will need to sign the consent anyway."
B. "I will go over the risks with you right now in detail."
C. "The surgeon is the best person to explain the specific risks and benefits of your procedure."
D. "There are no risks; this is a routine surgery."
,2
Correct Answer: C
Rationale: Informed consent is the legal responsibility of the provider performing the procedure;
they must explain the risks, benefits, and alternatives to ensure the patient understands them. The
nurse can witness the signature and clarify general information, but explaining specific surgical
risks is outside the nurse's scope and constitutes practicing medicine without a license. Options A
and D are dismissive and untrue, while B assumes responsibility that belongs to the physician.
Q3: The nurse is reviewing medications for a preoperative client with a history of atrial
fibrillation. The client takes warfarin (Coumadin) daily. Which instruction regarding this
medication is most critical?
A. "Take your usual dose of warfarin the morning of surgery with a sip of water."
B. "Stop taking warfarin 3 to 5 days prior to surgery as directed by your provider."
C. "Double your dose of warfarin the day before surgery to prevent clotting."
D. "Replace warfarin with aspirin 1 week before the surgery date."
Correct Answer: B
Rationale: Warfarin is an anticoagulant that increases the risk of intraoperative bleeding;
therefore, it typically must be discontinued several days before surgery to allow the INR to
normalize. The provider may also "bridge" the patient with a short-acting anticoagulant like
heparin. Continuing the dose (A) or doubling it (C) significantly increases bleeding risk, and
aspirin (D) is also an antiplatelet that usually requires holding, not replacing warfarin without
specific instruction.
Q4: Which preoperative teaching intervention is most effective for preventing postoperative
atelectasis?
A. Administering prescribed narcotic analgesics around the clock.
B. Teaching the client how to use an incentive spirometer and deep breathing exercises.
C. Restricting fluid intake to prevent pulmonary edema.
D. Placing the client in high Fowler's position immediately upon admission.
Correct Answer: B
, 3
Rationale: Atelectasis is caused by alveolar collapse due to shallow breathing and anesthesia
effects. Using an incentive spirometer 10 times every hour while awake, along with deep
breathing and coughing, expands the alveoli and clears secretions. Narcotics (A) can depress
respirations and worsen atelectasis. Fluid restriction (C) and positioning (D) do not actively
prevent lung collapse like lung expansion exercises do.
Q5: The nurse is performing a preoperative assessment on a client with diabetes mellitus. Which
laboratory value is most critical for the nurse to monitor?
A. Serum potassium
B. Hemoglobin A1c
C. Fasting blood glucose
D. Serum creatinine
Correct Answer: C
Rationale: While all values are important, monitoring fasting blood glucose immediately prior to
surgery is critical to prevent hypoglycemia or hyperglycemia during the perioperative period, as
these conditions can cause complications such as delayed healing or infection. Poorly controlled
blood glucose (hyperglycemia) increases infection risk, while hypoglycemia can cause
neurological compromise. H1c (B) shows long-term control, and creatinine/potassium (A, D) are
monitored for renal function but glucose is the immediate priority for stability.
Q6: A client is scheduled for a right total knee replacement. Which action verifies the correct
surgical site?
A. The nurse marks the site "Yes" with a permanent marker.
B. The client marks the site with "No" on the left leg.
C. The surgeon marks the surgical site while the client is awake and aware.
D. The anesthesia provider marks the site after the client is sedated.
Correct Answer: C
Rationale: Universal Protocol for preventing wrong-site surgery requires the surgeon (or
designated licensed provider) to mark the site with an indelible marker before the client is
ATI Medical Surgical Perioperative Nursing
Exam Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
[SECTION 1: Preoperative Nursing Care — Questions 1-12]
Q1: The nurse is preparing a client for surgery scheduled for 0800. The client reports drinking
water at 0600. What is the nurse's priority action?
A. Administer a prescribed antiemetic immediately.
B. Report the intake to the anesthesia provider.
C. Cancel the surgery and reschedule for the next day.
D. Encourage the client to drink more water to facilitate IV start.
Correct Answer: B
Rationale: While preoperative guidelines typically allow clear liquids up to 2 hours before
surgery (NPO status for 6-8 hours applies to solids and heavy meals), the specific NPO order
may vary based on provider preference or patient risk factors. The nurse must report the intake to
the anesthesia provider so they can assess the risk of aspiration and determine if the procedure
should proceed or be delayed. Cancelling the surgery (C) is beyond the nurse's scope without a
provider's order, and administering antiemetics (A) or encouraging more fluids (D) are
inappropriate responses to a potential NPO violation.
Q2: A client asks the nurse to explain the risks of the scheduled surgery. The nurse’s best
response is:
A. "I cannot explain the risks; you will need to sign the consent anyway."
B. "I will go over the risks with you right now in detail."
C. "The surgeon is the best person to explain the specific risks and benefits of your procedure."
D. "There are no risks; this is a routine surgery."
,2
Correct Answer: C
Rationale: Informed consent is the legal responsibility of the provider performing the procedure;
they must explain the risks, benefits, and alternatives to ensure the patient understands them. The
nurse can witness the signature and clarify general information, but explaining specific surgical
risks is outside the nurse's scope and constitutes practicing medicine without a license. Options A
and D are dismissive and untrue, while B assumes responsibility that belongs to the physician.
Q3: The nurse is reviewing medications for a preoperative client with a history of atrial
fibrillation. The client takes warfarin (Coumadin) daily. Which instruction regarding this
medication is most critical?
A. "Take your usual dose of warfarin the morning of surgery with a sip of water."
B. "Stop taking warfarin 3 to 5 days prior to surgery as directed by your provider."
C. "Double your dose of warfarin the day before surgery to prevent clotting."
D. "Replace warfarin with aspirin 1 week before the surgery date."
Correct Answer: B
Rationale: Warfarin is an anticoagulant that increases the risk of intraoperative bleeding;
therefore, it typically must be discontinued several days before surgery to allow the INR to
normalize. The provider may also "bridge" the patient with a short-acting anticoagulant like
heparin. Continuing the dose (A) or doubling it (C) significantly increases bleeding risk, and
aspirin (D) is also an antiplatelet that usually requires holding, not replacing warfarin without
specific instruction.
Q4: Which preoperative teaching intervention is most effective for preventing postoperative
atelectasis?
A. Administering prescribed narcotic analgesics around the clock.
B. Teaching the client how to use an incentive spirometer and deep breathing exercises.
C. Restricting fluid intake to prevent pulmonary edema.
D. Placing the client in high Fowler's position immediately upon admission.
Correct Answer: B
, 3
Rationale: Atelectasis is caused by alveolar collapse due to shallow breathing and anesthesia
effects. Using an incentive spirometer 10 times every hour while awake, along with deep
breathing and coughing, expands the alveoli and clears secretions. Narcotics (A) can depress
respirations and worsen atelectasis. Fluid restriction (C) and positioning (D) do not actively
prevent lung collapse like lung expansion exercises do.
Q5: The nurse is performing a preoperative assessment on a client with diabetes mellitus. Which
laboratory value is most critical for the nurse to monitor?
A. Serum potassium
B. Hemoglobin A1c
C. Fasting blood glucose
D. Serum creatinine
Correct Answer: C
Rationale: While all values are important, monitoring fasting blood glucose immediately prior to
surgery is critical to prevent hypoglycemia or hyperglycemia during the perioperative period, as
these conditions can cause complications such as delayed healing or infection. Poorly controlled
blood glucose (hyperglycemia) increases infection risk, while hypoglycemia can cause
neurological compromise. H1c (B) shows long-term control, and creatinine/potassium (A, D) are
monitored for renal function but glucose is the immediate priority for stability.
Q6: A client is scheduled for a right total knee replacement. Which action verifies the correct
surgical site?
A. The nurse marks the site "Yes" with a permanent marker.
B. The client marks the site with "No" on the left leg.
C. The surgeon marks the surgical site while the client is awake and aware.
D. The anesthesia provider marks the site after the client is sedated.
Correct Answer: C
Rationale: Universal Protocol for preventing wrong-site surgery requires the surgeon (or
designated licensed provider) to mark the site with an indelible marker before the client is
