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ATI ADULT MEDICAL SURGICAL NURSING – UNIT 1 Perioperative, Fluid & Electrolytes,
Acid-Base, Pain, Cancer 120 Questions with Rationales
SECTION 1: PERIOPERATIVE NURSING (Q1–30)
1. A nurse is caring for a client who is scheduled for surgery and
has signed the informed consent. Which statement by the client
indicates understanding?
A. "The surgeon will tell me what to do, so I don't need to ask
questions."
B. "I understand the procedure, risks, benefits, and
alternatives."
C. "I can sign the consent after I receive preoperative sedation."
D. "The nurse will explain the procedure to me."
Answer: B
Rationale: Informed consent must be obtained before sedation;
the provider explains the procedure; the client must understand
risks, benefits, and alternatives.
2. Which client is at highest risk for surgical complications?
A. A 30-year-old with no medical history
B. A 70-year-old with diabetes, hypertension, and smoking
history
C. A 45-year-old with controlled asthma
D. A 25-year-old athlete
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Answer: B
Rationale: Advanced age, comorbidities, and smoking increase
surgical risk.
3. The nurse is preparing a client for surgery. Which action is
most important to prevent wrong-site surgery?
A. Marking the surgical site with the client
B. Administering preoperative antibiotics
C. Shaving the surgical area
D. Inserting an indwelling catheter
Answer: A
Rationale: Site marking with client involvement is part of the
Universal Protocol to prevent wrong-site surgery.
4. A client is NPO after midnight for surgery. Which statement
indicates the client understands the reason?
A. "It prevents nausea after surgery."
B. "It reduces the risk of aspiration during anesthesia."
C. "It keeps the bladder empty."
D. "It prevents constipation."
Answer: B
Rationale: NPO status reduces gastric contents and aspiration
risk.
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5. The nurse is completing a preoperative checklist. Which item
must be verified before the client is transported to the OR?
A. Client's favorite music
B. Signed informed consent, allergies, and identification band
C. Family phone number
D. Insurance card
Answer: B
Rationale: Informed consent, allergies, and correct
identification are critical safety checks.
6. A client is prescribed cefazolin 1 g IV 30 minutes before
surgery. The nurse understands the purpose is to:
A. Treat an existing infection
B. Prevent surgical site infection
C. Prevent deep vein thrombosis
D. Reduce postoperative pain
Answer: B
Rationale: Prophylactic antibiotics are given within 60 minutes
before incision to prevent SSI.
7. Which finding in a preoperative client requires immediate
notification of the provider?
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A. Temperature 100.8°F and productive cough
B. Blood pressure 130/80 mmHg
C. Heart rate 84 bpm
D. Mild anxiety
Answer: A
Rationale: Fever and productive cough may indicate infection;
surgery may be delayed.
8. The nurse is caring for a client who received preoperative
sedation. Which action is the priority?
A. Raise all side rails and place the bed in the lowest position
B. Allow the client to ambulate to the bathroom
C. Give the client a glass of water
D. Remove the identification band
Answer: A
Rationale: Sedated clients are at risk for falls; safety measures
include side rails and bed low.
9. A client is scheduled for surgery and is taking warfarin. The
nurse should anticipate which order?
A. Continue warfarin as scheduled
B. Hold warfarin and possibly bridge with heparin
ATI ADULT MEDICAL SURGICAL NURSING – UNIT 1 Perioperative, Fluid & Electrolytes,
Acid-Base, Pain, Cancer 120 Questions with Rationales
SECTION 1: PERIOPERATIVE NURSING (Q1–30)
1. A nurse is caring for a client who is scheduled for surgery and
has signed the informed consent. Which statement by the client
indicates understanding?
A. "The surgeon will tell me what to do, so I don't need to ask
questions."
B. "I understand the procedure, risks, benefits, and
alternatives."
C. "I can sign the consent after I receive preoperative sedation."
D. "The nurse will explain the procedure to me."
Answer: B
Rationale: Informed consent must be obtained before sedation;
the provider explains the procedure; the client must understand
risks, benefits, and alternatives.
2. Which client is at highest risk for surgical complications?
A. A 30-year-old with no medical history
B. A 70-year-old with diabetes, hypertension, and smoking
history
C. A 45-year-old with controlled asthma
D. A 25-year-old athlete
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Answer: B
Rationale: Advanced age, comorbidities, and smoking increase
surgical risk.
3. The nurse is preparing a client for surgery. Which action is
most important to prevent wrong-site surgery?
A. Marking the surgical site with the client
B. Administering preoperative antibiotics
C. Shaving the surgical area
D. Inserting an indwelling catheter
Answer: A
Rationale: Site marking with client involvement is part of the
Universal Protocol to prevent wrong-site surgery.
4. A client is NPO after midnight for surgery. Which statement
indicates the client understands the reason?
A. "It prevents nausea after surgery."
B. "It reduces the risk of aspiration during anesthesia."
C. "It keeps the bladder empty."
D. "It prevents constipation."
Answer: B
Rationale: NPO status reduces gastric contents and aspiration
risk.
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5. The nurse is completing a preoperative checklist. Which item
must be verified before the client is transported to the OR?
A. Client's favorite music
B. Signed informed consent, allergies, and identification band
C. Family phone number
D. Insurance card
Answer: B
Rationale: Informed consent, allergies, and correct
identification are critical safety checks.
6. A client is prescribed cefazolin 1 g IV 30 minutes before
surgery. The nurse understands the purpose is to:
A. Treat an existing infection
B. Prevent surgical site infection
C. Prevent deep vein thrombosis
D. Reduce postoperative pain
Answer: B
Rationale: Prophylactic antibiotics are given within 60 minutes
before incision to prevent SSI.
7. Which finding in a preoperative client requires immediate
notification of the provider?
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A. Temperature 100.8°F and productive cough
B. Blood pressure 130/80 mmHg
C. Heart rate 84 bpm
D. Mild anxiety
Answer: A
Rationale: Fever and productive cough may indicate infection;
surgery may be delayed.
8. The nurse is caring for a client who received preoperative
sedation. Which action is the priority?
A. Raise all side rails and place the bed in the lowest position
B. Allow the client to ambulate to the bathroom
C. Give the client a glass of water
D. Remove the identification band
Answer: A
Rationale: Sedated clients are at risk for falls; safety measures
include side rails and bed low.
9. A client is scheduled for surgery and is taking warfarin. The
nurse should anticipate which order?
A. Continue warfarin as scheduled
B. Hold warfarin and possibly bridge with heparin
