NURS 120 | Perioperative Nursing & Surgical Care Exam 2026 |WCU
1. A patient is in the operating room undergoing general anesthesia. The nurse
monitor notes a sudden, sharp rise in end-tidal CO2 and muscle rigidity. What is
the nurse’s immediate priority?
A. Administer IV epinephrine to support blood pressure
B. Apply ice packs to the patient’s groin and axilla
C. Administer IV dantrolene sodium per protocol
D. Check the patient’s temperature for a fever
Answer: C
Rationale: The symptoms indicate Malignant Hyperthermia (MH), a life-threatening
emergency. While cooling measures are used, the definitive treatment is IV dantrolene, a
skeletal muscle relaxant.
2. A patient expresses concern about the surgical procedure and states, ‘I don’t
really understand why they need to remove my gallbladder.’ The surgeon has
already obtained consent. What is the nurse’s priority action?
A. Re-explain the procedure to the patient in simpler terms
B. Inform the patient that the surgeon is the expert and they should trust him
C. Document that the patient has cold feet and proceed with pre-op prep
D. Notify the surgeon that the patient needs further explanation of the procedure
Answer: D
Rationale: The nurse witnesses the signature, but the surgeon is responsible for providing
the explanation. If the patient does not understand, the nurse must advocate by calling the
surgeon back.
,3. When assessing a preoperative patient with a known latex allergy, which food
allergy reported by the patient should the nurse find most concerning?
A. Shellfish and shrimp
B. Avocados and bananas
C. Eggs and poultry
D. Peanuts and tree nuts
Answer: B
Rationale: There is a cross-reactivity between latex and certain foods like avocados,
bananas, kiwi, and chestnuts due to similar protein structures.
4. A nurse is preparing a patient for surgery who takes aspirin 81mg daily for
heart health. Which instruction is most appropriate regarding this medication?
A. Stop taking aspirin at least 7 to 10 days before surgery
B. Continue the aspirin until the morning of surgery
C. Double the dose the day before surgery to prevent clots
D. Switch to ibuprofen for the week leading up to surgery
Answer: A
Rationale: Aspirin inhibits platelet aggregation irreversibly and should be stopped 7-10
days before surgery to reduce the risk of intraoperative bleeding.
5. During the ‘Time-Out’ in the operating room, which of the following must be
verified by the entire surgical team?
A. Patient identity, surgical site, and procedure to be performed
B. Patient’s next of kin and insurance provider
C. The surgeon’s credentials and years of experience
D. The exact time the patient last ate a meal
Answer: A
Rationale: The Universal Protocol Time-Out is a safety measure to prevent wrong-site,
wrong-procedure, and wrong-person surgery.
, 6. Which role is primarily responsible for maintaining the sterile field, passing
instruments to the surgeon, and performing the surgical count with the
circulator?
A. Circulating Nurse
B. Scrub Nurse or Surgical Technologist
C. Anesthesiologist
D. Post-Anesthesia Care Unit (PACU) Nurse
Answer: B
Rationale: The scrub nurse works within the sterile field, managing instruments and
ensuring sterile technique is maintained.
7. A postoperative patient’s abdominal wound has eviscerated. What is the
nurse’s immediate action?
A. Cover the protruding organs with sterile gauze moistened with sterile normal saline
B. Apply a dry, sterile dressing and secure it tightly with tape
C. Attempt to gently push the organs back into the abdominal cavity
D. Place the patient in a high-Fowler’s position to assist breathing
Answer: A
Rationale: Evisceration is a surgical emergency. The organs must be kept moist with
sterile saline-soaked dressings while preparing for emergency surgery.
8. What is the primary reason for keeping a patient NPO (nothing by mouth) for
6 to 8 hours before general anesthesia?
A. To prevent postoperative constipation
B. To prevent the patient from having to urinate during the procedure
C. To ensure the patient loses weight before surgery
D. To minimize the risk of aspiration during induction
Answer: D
1. A patient is in the operating room undergoing general anesthesia. The nurse
monitor notes a sudden, sharp rise in end-tidal CO2 and muscle rigidity. What is
the nurse’s immediate priority?
A. Administer IV epinephrine to support blood pressure
B. Apply ice packs to the patient’s groin and axilla
C. Administer IV dantrolene sodium per protocol
D. Check the patient’s temperature for a fever
Answer: C
Rationale: The symptoms indicate Malignant Hyperthermia (MH), a life-threatening
emergency. While cooling measures are used, the definitive treatment is IV dantrolene, a
skeletal muscle relaxant.
2. A patient expresses concern about the surgical procedure and states, ‘I don’t
really understand why they need to remove my gallbladder.’ The surgeon has
already obtained consent. What is the nurse’s priority action?
A. Re-explain the procedure to the patient in simpler terms
B. Inform the patient that the surgeon is the expert and they should trust him
C. Document that the patient has cold feet and proceed with pre-op prep
D. Notify the surgeon that the patient needs further explanation of the procedure
Answer: D
Rationale: The nurse witnesses the signature, but the surgeon is responsible for providing
the explanation. If the patient does not understand, the nurse must advocate by calling the
surgeon back.
,3. When assessing a preoperative patient with a known latex allergy, which food
allergy reported by the patient should the nurse find most concerning?
A. Shellfish and shrimp
B. Avocados and bananas
C. Eggs and poultry
D. Peanuts and tree nuts
Answer: B
Rationale: There is a cross-reactivity between latex and certain foods like avocados,
bananas, kiwi, and chestnuts due to similar protein structures.
4. A nurse is preparing a patient for surgery who takes aspirin 81mg daily for
heart health. Which instruction is most appropriate regarding this medication?
A. Stop taking aspirin at least 7 to 10 days before surgery
B. Continue the aspirin until the morning of surgery
C. Double the dose the day before surgery to prevent clots
D. Switch to ibuprofen for the week leading up to surgery
Answer: A
Rationale: Aspirin inhibits platelet aggregation irreversibly and should be stopped 7-10
days before surgery to reduce the risk of intraoperative bleeding.
5. During the ‘Time-Out’ in the operating room, which of the following must be
verified by the entire surgical team?
A. Patient identity, surgical site, and procedure to be performed
B. Patient’s next of kin and insurance provider
C. The surgeon’s credentials and years of experience
D. The exact time the patient last ate a meal
Answer: A
Rationale: The Universal Protocol Time-Out is a safety measure to prevent wrong-site,
wrong-procedure, and wrong-person surgery.
, 6. Which role is primarily responsible for maintaining the sterile field, passing
instruments to the surgeon, and performing the surgical count with the
circulator?
A. Circulating Nurse
B. Scrub Nurse or Surgical Technologist
C. Anesthesiologist
D. Post-Anesthesia Care Unit (PACU) Nurse
Answer: B
Rationale: The scrub nurse works within the sterile field, managing instruments and
ensuring sterile technique is maintained.
7. A postoperative patient’s abdominal wound has eviscerated. What is the
nurse’s immediate action?
A. Cover the protruding organs with sterile gauze moistened with sterile normal saline
B. Apply a dry, sterile dressing and secure it tightly with tape
C. Attempt to gently push the organs back into the abdominal cavity
D. Place the patient in a high-Fowler’s position to assist breathing
Answer: A
Rationale: Evisceration is a surgical emergency. The organs must be kept moist with
sterile saline-soaked dressings while preparing for emergency surgery.
8. What is the primary reason for keeping a patient NPO (nothing by mouth) for
6 to 8 hours before general anesthesia?
A. To prevent postoperative constipation
B. To prevent the patient from having to urinate during the procedure
C. To ensure the patient loses weight before surgery
D. To minimize the risk of aspiration during induction
Answer: D
