Perioperative Nursing Care in Surgery (145 Exam Questions) – Preoperative Assessment, Anesthesia, Postoperative Complications & NCLEX Review | Medical-Surgical Nursing 2026 Exam

This comprehensive Medical-Surgical Nursing review guide contains 145 exam-style questions and detailed answers covering the full continuum of perioperative nursing care, from preoperative assessment and surgical preparation to intraoperative responsibilities and postoperative recovery management. Developed for nursing students and licensure candidates, the material emphasizes evidence-based interventions, clinical prioritization, patient safety, and complication prevention using realistic question-and-answer scenarios designed to strengthen critical thinking and improve examination performance. The structured format promotes active recall while helping learners apply theoretical concepts to the complex decision-making processes required in perioperative nursing practice. The guide begins with an extensive review of the preoperative phase, defined as the period beginning with the client's decision to undergo surgery and continuing until transfer to the operating suite. Students examine comprehensive preoperative assessments, including head-to-toe examinations, health history collection, medication reconciliation, allergy verification, laboratory interpretation, identification band confirmation, and risk-factor recognition. Particular attention is given to identifying conditions that increase perioperative risk, such as cardiovascular disease, chronic pulmonary disorders, obesity, smoking history, alcohol use, and previous experiences with anesthesia-related complications, including malignant hyperthermia. Learners also explore cultural considerations, spiritual beliefs, emotional responses to surgery, and strategies nurses use to reduce anxiety and improve patient outcomes. A substantial portion of the material focuses on informed consent, patient education, and perioperative communication. Students review the legal and ethical principles surrounding informed consent, including the provider's responsibility to explain procedures and risks and the nurse's responsibility to verify competency and witness signatures. The guide highlights essential teaching topics such as NPO requirements, skin preparation, medication modifications, postoperative expectations, family support, smoking cessation, and methods used to empower patients through education. The use of standardized safety tools, including AORN's Comprehensive Surgical Checklist and preoperative verification processes, reinforces the importance of interdisciplinary communication and error prevention. The resource provides in-depth coverage of intraoperative nursing principles and the surgical environment. Topics include the responsibilities of the circulating nurse, Certified Surgical Technologist (CST), and broader perioperative team members; maintenance of sterile technique; aseptic principles; environmental controls that minimize contamination; skin preparation procedures; surgical attire requirements; and the implementation of The Joint Commission's Universal Protocol and surgical time-out procedures to prevent wrong-site, wrong-procedure, and wrong-patient events. Students gain a clear understanding of the systems and safeguards required to promote patient safety throughout the operative experience. Extensive emphasis is placed on anesthesia and sedation concepts frequently tested in nursing examinations. Learners differentiate among local, regional, and general anesthesia while examining examples of each modality and their clinical applications. Additional content addresses moderate sedation, commonly used sedative agents, monitoring requirements, airway considerations, and nursing responsibilities during the peri-anesthetic period. The guide also discusses malignant hyperthermia recognition and preventive strategies for high-risk patients undergoing anesthesia. The postoperative sections focus heavily on assessment priorities and the early recognition of complications. Using the ABC framework, students learn to evaluate airway patency, respiratory status, oxygenation, circulation, neurological responsiveness, fluid balance, wound integrity, gastrointestinal function, urinary output, and pain control immediately following surgery. Coverage includes the use of the Aldrete Score for postanesthesia evaluation, incentive spirometry protocols, splinting techniques, coughing and deep-breathing exercises, patient-controlled analgesia (PCA), opioid administration, and nonpharmacological pain management interventions designed to support recovery and improve patient comfort. A major strength of this resource is its comprehensive review of postoperative complications and evidence-based interventions. Students explore venous thromboembolism (VTE), deep vein thrombosis (DVT), pulmonary embolism (PE), atelectasis, aspiration, hypovolemia, hypervolemia, surgical site infections (SSIs), ileus, dehiscence, evisceration, oliguria, postoperative delirium, and postoperative cognitive dysfunction (POCD). Clinical manifestations, risk factors, nursing assessments, and management strategies are integrated throughout the review to strengthen prioritization skills and facilitate early intervention. Special consideration is given to the perioperative needs of older adults and individuals with chronic illnesses, emphasizing comprehensive geriatric assessment and individualized care planning. The concepts presented align closely with Medical-Surgical Nursing curricula and reflect content commonly tested on NCLEX-RN examinations, ATI assessments, HESI examinations, and undergraduate nursing competency evaluations. This review guide serves as a valuable study resource for mastering perioperative nursing concepts while enhancing clinical reasoning, patient safety awareness, and evidence-based nursing practice. Referenced Academic Sources: • Lewis SL, Bucher L, Heitkemper MM, Harding MM, Kwong J, Roberts D. Medical-Surgical Nursing: Assessment and Management of Clinical Problems. Elsevier. • Hinkle JL, Cheever KH. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. Wolters Kluwer. • Ignatavicius DD, Workman ML, Rebar CR. Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care. Elsevier. • Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. Elsevier. • Association of periOperative Registered Nurses (AORN). Guidelines for Perioperative Practice. • American Society of PeriAnesthesia Nurses (ASPAN). Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements. • The Joint Commission. Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery. • National Council of State Boards of Nursing (NCSBN). NCLEX-RN Test Plan. Relevant Students: This document is highly recommended for Bachelor of Science in Nursing (BSN) students, Associate Degree Nursing (ADN) students, Licensed Practical/Vocational Nursing (LPN/LVN) students, Medical-Surgical Nursing students, perioperative nursing students, surgical nursing clinical learners, fundamentals of nursing students, ATI examination candidates, HESI examination candidates, NCLEX-RN candidates, NCLEX-PN candidates, nurse residency participants, transition-to-practice nurses, and healthcare professionals seeking a comprehensive review of perioperative nursing assessment, surgical safety, anesthesia principles, and postoperative complication management. Keywords: Perioperative Nursing Care, Preoperative Nursing, Postoperative Nursing, Intraoperative Nursing, Medical Surgical Nursing, Med Surg Exam Questions, NCLEX Review, ATI Nursing, HESI Nursing, Preoperative Assessment, Surgical Risk Assessment, Informed Consent, Surgical Checklist, AORN Guidelines, Universal Protocol, Surgical Time Out, Circulating Nurse, Certified Surgical Technologist, Sterile Technique, Aseptic Technique, Surgical Safety, Malignant Hyperthermia, Anesthesia Nursing, Local Anesthesia, Regional Anesthesia, General Anesthesia, Moderate Sedation, Aldrete Score, Airway Management, Incentive Spirometry, Patient Controlled Analgesia, PCA Pump, Pain Management, Deep Breathing Exercises, Splinting, Atelectasis, Venous Thromboembolism, VTE, Deep Vein Thrombosis, DVT, Pulmonary Embolism, PE, Hypovolemia, Hypervolemia, Surgical Site Infection, SSI, Dehiscence, Evisceration, Ileus, Oliguria, Postoperative Delirium, Postoperative Cognitive Dysfunction, POCD, Geriatric Surgical Care, Wound Assessment, Fluid and Electrolyte Balance, Early Ambulation, Nursing Documentation, Perioperative Patient Safety, NCLEX Preparation