ATI RN Targeted Medical-Surgical
Perioperative Proctored Examination
Comprehensive Practice Assessment (65 Questions)
────────────────────────────────────────────────────────────
Examination Type: RN Targeted Medical-Surgical: Perioperative
Number of Questions: 65 Multiple-Choice Questions
Question Format: NCLEX-Style with Evidence-Based Rationales
Content Coverage: Preoperative, Intraoperative, Postoperative,
Advanced Topics
Academic Alignment: ATI Testing Standards and NCLEX-RN Blueprint
, ATI RN Perioperative Practice Examination
1. Introduction
This comprehensive practice examination assesses nursing knowledge and clinical competency in
perioperative care across the preoperative, intraoperative, and postoperative phases. Aligned with the
ATI RN Targeted Medical-Surgical examination framework and NCLEX-RN test plan, it covers
essential concepts for providing safe, evidence-based surgical care.
Perioperative nursing requires deep understanding of patient assessment, surgical pathophysiology,
anesthesia modalities, pharmacological management, infection prevention, and patient safety
protocols. Nurses play critical roles throughout the surgical continuum, from preoperative assessment
through postoperative recovery. Competency directly impacts outcomes including prevention of
infection, hemorrhage, thromboembolism, and thermoregulation complications.
This examination contains 65 multiple-choice questions organized across four content domains:
preoperative care (Questions 1-15), intraoperative care (Questions 16-35), postoperative care
(Questions 36-50), and advanced perioperative topics (Questions 51-65). Each question includes a
detailed evidence-based rationale incorporating current best practices from AORN, ASA, and CDC.
2. Content Domains Overview
Domain Questions Key Topics
Preoperative Care 1–15 Patient assessment, informed
consent, NPO guidelines,
medication management, ASA
classification, herbal supplements,
DVT prophylaxis
Intraoperative Care 16–35 Sterile field, anesthesia types,
positioning, malignant
hyperthermia, surgical counts,
hemodynamic monitoring,
neuromuscular blockade,
hypothermia
Postoperative Care 36–50 PACU/Aldrete score, wound
healing, pain management, DVT
recognition, SSI prevention, drain
management, discharge criteria
Advanced Topics 51–65 SSI management, PE, chest tubes,
MH protocol, latex allergy, CKD
considerations, geriatric delirium,
sterile technique
Page 2
, ATI RN Perioperative Practice Examination
3. Examination Questions
The following 65 questions are in NCLEX-style format. Correct answers are in bold green, followed by
detailed evidence-based rationales.
3.1 Preoperative Care
Questions 1–15
Question 1. A nurse is preparing a client for surgery. Which of the following is the most
important action to verify the correct surgical site?
A) Ask the client to state their full name and date of birth
B) Verify the surgical site marking with the client and the surgical team during the
time-out
C) Review the consent form for the surgeon's signature
D) Confirm the client's allergies in the electronic health record
Rationale: The Joint Commission's Universal Protocol requires a pre-procedure verification
process, surgical site marking, and a time-out immediately before the procedure. The time-out
involves the entire surgical team and must include active communication to verify the correct
patient, procedure, and site. While all listed actions are important, verification during the time-
out with the entire team is the most critical safety measure per AORN guidelines.
··················
Question 2. A nurse is obtaining informed consent from a client scheduled for surgery.
Which action should the nurse take?
A) Explain the surgical procedure in detail to the client
B) Witness the client's signature and ensure the consent form is complete
C) Advise the client on the best surgical option
D) Contact the facility's legal department for approval
Rationale: The nurse's role in informed consent is to witness the client's signature and ensure
the consent form is complete and accurate. It is the surgeon's responsibility to explain the
procedure, risks, benefits, and alternatives. The nurse should verify that the client appears to
understand the information and has had the opportunity to ask questions.
··················
Question 3. A client scheduled for elective surgery takes warfarin daily. The provider
instructs the client to stop the medication 5 days before surgery. Which laboratory
value should the nurse anticipate the provider will monitor?
A) Partial thromboplastin time (PTT)
B) International Normalized Ratio (INR)
C) Bleeding time
Page 3
Perioperative Proctored Examination
Comprehensive Practice Assessment (65 Questions)
────────────────────────────────────────────────────────────
Examination Type: RN Targeted Medical-Surgical: Perioperative
Number of Questions: 65 Multiple-Choice Questions
Question Format: NCLEX-Style with Evidence-Based Rationales
Content Coverage: Preoperative, Intraoperative, Postoperative,
Advanced Topics
Academic Alignment: ATI Testing Standards and NCLEX-RN Blueprint
, ATI RN Perioperative Practice Examination
1. Introduction
This comprehensive practice examination assesses nursing knowledge and clinical competency in
perioperative care across the preoperative, intraoperative, and postoperative phases. Aligned with the
ATI RN Targeted Medical-Surgical examination framework and NCLEX-RN test plan, it covers
essential concepts for providing safe, evidence-based surgical care.
Perioperative nursing requires deep understanding of patient assessment, surgical pathophysiology,
anesthesia modalities, pharmacological management, infection prevention, and patient safety
protocols. Nurses play critical roles throughout the surgical continuum, from preoperative assessment
through postoperative recovery. Competency directly impacts outcomes including prevention of
infection, hemorrhage, thromboembolism, and thermoregulation complications.
This examination contains 65 multiple-choice questions organized across four content domains:
preoperative care (Questions 1-15), intraoperative care (Questions 16-35), postoperative care
(Questions 36-50), and advanced perioperative topics (Questions 51-65). Each question includes a
detailed evidence-based rationale incorporating current best practices from AORN, ASA, and CDC.
2. Content Domains Overview
Domain Questions Key Topics
Preoperative Care 1–15 Patient assessment, informed
consent, NPO guidelines,
medication management, ASA
classification, herbal supplements,
DVT prophylaxis
Intraoperative Care 16–35 Sterile field, anesthesia types,
positioning, malignant
hyperthermia, surgical counts,
hemodynamic monitoring,
neuromuscular blockade,
hypothermia
Postoperative Care 36–50 PACU/Aldrete score, wound
healing, pain management, DVT
recognition, SSI prevention, drain
management, discharge criteria
Advanced Topics 51–65 SSI management, PE, chest tubes,
MH protocol, latex allergy, CKD
considerations, geriatric delirium,
sterile technique
Page 2
, ATI RN Perioperative Practice Examination
3. Examination Questions
The following 65 questions are in NCLEX-style format. Correct answers are in bold green, followed by
detailed evidence-based rationales.
3.1 Preoperative Care
Questions 1–15
Question 1. A nurse is preparing a client for surgery. Which of the following is the most
important action to verify the correct surgical site?
A) Ask the client to state their full name and date of birth
B) Verify the surgical site marking with the client and the surgical team during the
time-out
C) Review the consent form for the surgeon's signature
D) Confirm the client's allergies in the electronic health record
Rationale: The Joint Commission's Universal Protocol requires a pre-procedure verification
process, surgical site marking, and a time-out immediately before the procedure. The time-out
involves the entire surgical team and must include active communication to verify the correct
patient, procedure, and site. While all listed actions are important, verification during the time-
out with the entire team is the most critical safety measure per AORN guidelines.
··················
Question 2. A nurse is obtaining informed consent from a client scheduled for surgery.
Which action should the nurse take?
A) Explain the surgical procedure in detail to the client
B) Witness the client's signature and ensure the consent form is complete
C) Advise the client on the best surgical option
D) Contact the facility's legal department for approval
Rationale: The nurse's role in informed consent is to witness the client's signature and ensure
the consent form is complete and accurate. It is the surgeon's responsibility to explain the
procedure, risks, benefits, and alternatives. The nurse should verify that the client appears to
understand the information and has had the opportunity to ask questions.
··················
Question 3. A client scheduled for elective surgery takes warfarin daily. The provider
instructs the client to stop the medication 5 days before surgery. Which laboratory
value should the nurse anticipate the provider will monitor?
A) Partial thromboplastin time (PTT)
B) International Normalized Ratio (INR)
C) Bleeding time
Page 3
