WELCOME TO YOUR ULTIMATE
SURGICAL NURSING NCLEX
EXAM GUIDE
• Are you preparing for the NCLEX and
looking to master surgical nursing concepts
with confidence? You've come to the right
place! This comprehensive guide is designed
to help you understand key surgical nursing
principles, from preoperative care to
postoperative management, while
reinforcing critical thinking skills essential
for the exam.
• With well-structured notes, practice
questions, and clear explanations, you’ll be
able to tackle NCLEX-style questions with
ease. Whether you're reviewing anesthesia
considerations, wound healing, or patient
safety protocols, this resource will support
you every step of the way.
• Start studying today and take one step closer
to becoming a licensed nurse!
,Preoperative Nursing Care
1. A nurse is preparing a patient for surgery. Which preoperative instruction is most
important to prevent postoperative complications?
o a) Eat a light meal before surgery
o b) Perform deep breathing and coughing exercises ✅
o c) Remain in bed for 24 hours after surgery
o d) Avoid taking any pain medications after surgery
2. A patient scheduled for surgery states, "I don't understand what the surgeon will do."
What is the nurse’s best response?
o a) "Don't worry, everything will be fine."
o b) "I'll call the surgeon to explain it to you again." ✅
o c) "The anesthesiologist will explain everything in detail."
o d) "Let me explain the procedure to you."
3. A patient with a history of smoking is scheduled for surgery. What is the nurse’s priority
intervention?
o a) Encourage the patient to increase fluid intake
o b) Teach deep breathing and coughing exercises ✅
o c) Provide a nicotine patch
o d) Advise complete bed rest before surgery
4. The nurse is assessing a patient before surgery. Which finding should be reported to the
surgeon immediately?
o a) Blood pressure of 130/80 mmHg
o b) Blood glucose of 250 mg/dL ✅
o c) Pulse rate of 88 bpm
o d) Temperature of 98.2°F (36.8°C)
5. A patient is scheduled for surgery and is taking warfarin (Coumadin). What is the nurse’s
priority action?
o a) Administer the medication as prescribed
o b) Assess the patient for signs of bleeding ✅
o c) Give vitamin K before surgery
o d) Encourage the patient to increase vitamin K intake
,Intraoperative Nursing Care
6. During surgery, the patient develops malignant hyperthermia. What is the nurse’s priority
action?
o a) Administer dantrolene sodium ✅
o b) Increase the IV fluid rate
o c) Apply warm blankets
o d) Monitor the patient’s glucose levels
7. A nurse in the operating room notices a break in sterile technique. What should be the
nurse’s immediate action?
o a) Continue with the procedure to avoid delays
o b) Inform the surgeon immediately ✅
o c) Ignore it unless an infection develops
o d) Report it after the surgery is completed
8. A patient undergoing general anesthesia develops a sudden drop in blood pressure. What
should the nurse do first?
o a) Place the patient in the Trendelenburg position
o b) Administer IV fluids as prescribed ✅
o c) Stop the anesthesia immediately
o d) Encourage deep breathing
9. Which patient is at the highest risk for surgical complications?
o a) A 45-year-old with controlled diabetes
o b) A 67-year-old with a history of smoking ✅
o c) A 30-year-old who exercises regularly
o d) A 25-year-old with seasonal allergies
10. What is the priority nursing intervention to prevent aspiration during surgery?
• a) Keep the patient in a semi-Fowler’s position
• b) Ensure the patient has been NPO before surgery ✅
• c) Administer antacid medication before induction
• d) Insert a nasogastric tube before anesthesia
Postoperative Nursing Care
11. A patient is recovering from abdominal surgery. What is the best method to prevent
atelectasis?
, • a) Encourage early ambulation ✅
• b) Keep the patient on strict bed rest
• c) Administer IV pain medications only
• d) Limit fluid intake
12. A post-op patient reports pain 30 minutes after receiving IV morphine. What should the
nurse do first?
• a) Call the physician for additional pain medication
• b) Assess the patient’s pain level and surgical site ✅
• c) Give another dose of morphine
• d) Encourage deep breathing exercises
13. The nurse is caring for a patient with a PCA (patient-controlled analgesia) pump. Which
action is inappropriate?
• a) Encouraging the patient to use the PCA before pain becomes severe
• b) Teaching the family how to press the PCA button for the patient ✅
• c) Monitoring for signs of respiratory depression
• d) Assessing the patient’s pain regularly
14. A patient post-op day 2 after abdominal surgery has absent bowel sounds. What is the
priority nursing action?
• a) Notify the physician immediately
• b) Encourage early ambulation ✅
• c) Administer a stool softener
• d) Increase the IV fluid rate
15. A patient post-op from knee replacement surgery has a temperature of 101°F (38.3°C).
What should the nurse do first?
• a) Notify the surgeon
• b) Encourage the patient to use an incentive spirometer ✅
• c) Administer IV antibiotics
• d) Apply a cooling blanket
SURGICAL NURSING NCLEX
EXAM GUIDE
• Are you preparing for the NCLEX and
looking to master surgical nursing concepts
with confidence? You've come to the right
place! This comprehensive guide is designed
to help you understand key surgical nursing
principles, from preoperative care to
postoperative management, while
reinforcing critical thinking skills essential
for the exam.
• With well-structured notes, practice
questions, and clear explanations, you’ll be
able to tackle NCLEX-style questions with
ease. Whether you're reviewing anesthesia
considerations, wound healing, or patient
safety protocols, this resource will support
you every step of the way.
• Start studying today and take one step closer
to becoming a licensed nurse!
,Preoperative Nursing Care
1. A nurse is preparing a patient for surgery. Which preoperative instruction is most
important to prevent postoperative complications?
o a) Eat a light meal before surgery
o b) Perform deep breathing and coughing exercises ✅
o c) Remain in bed for 24 hours after surgery
o d) Avoid taking any pain medications after surgery
2. A patient scheduled for surgery states, "I don't understand what the surgeon will do."
What is the nurse’s best response?
o a) "Don't worry, everything will be fine."
o b) "I'll call the surgeon to explain it to you again." ✅
o c) "The anesthesiologist will explain everything in detail."
o d) "Let me explain the procedure to you."
3. A patient with a history of smoking is scheduled for surgery. What is the nurse’s priority
intervention?
o a) Encourage the patient to increase fluid intake
o b) Teach deep breathing and coughing exercises ✅
o c) Provide a nicotine patch
o d) Advise complete bed rest before surgery
4. The nurse is assessing a patient before surgery. Which finding should be reported to the
surgeon immediately?
o a) Blood pressure of 130/80 mmHg
o b) Blood glucose of 250 mg/dL ✅
o c) Pulse rate of 88 bpm
o d) Temperature of 98.2°F (36.8°C)
5. A patient is scheduled for surgery and is taking warfarin (Coumadin). What is the nurse’s
priority action?
o a) Administer the medication as prescribed
o b) Assess the patient for signs of bleeding ✅
o c) Give vitamin K before surgery
o d) Encourage the patient to increase vitamin K intake
,Intraoperative Nursing Care
6. During surgery, the patient develops malignant hyperthermia. What is the nurse’s priority
action?
o a) Administer dantrolene sodium ✅
o b) Increase the IV fluid rate
o c) Apply warm blankets
o d) Monitor the patient’s glucose levels
7. A nurse in the operating room notices a break in sterile technique. What should be the
nurse’s immediate action?
o a) Continue with the procedure to avoid delays
o b) Inform the surgeon immediately ✅
o c) Ignore it unless an infection develops
o d) Report it after the surgery is completed
8. A patient undergoing general anesthesia develops a sudden drop in blood pressure. What
should the nurse do first?
o a) Place the patient in the Trendelenburg position
o b) Administer IV fluids as prescribed ✅
o c) Stop the anesthesia immediately
o d) Encourage deep breathing
9. Which patient is at the highest risk for surgical complications?
o a) A 45-year-old with controlled diabetes
o b) A 67-year-old with a history of smoking ✅
o c) A 30-year-old who exercises regularly
o d) A 25-year-old with seasonal allergies
10. What is the priority nursing intervention to prevent aspiration during surgery?
• a) Keep the patient in a semi-Fowler’s position
• b) Ensure the patient has been NPO before surgery ✅
• c) Administer antacid medication before induction
• d) Insert a nasogastric tube before anesthesia
Postoperative Nursing Care
11. A patient is recovering from abdominal surgery. What is the best method to prevent
atelectasis?
, • a) Encourage early ambulation ✅
• b) Keep the patient on strict bed rest
• c) Administer IV pain medications only
• d) Limit fluid intake
12. A post-op patient reports pain 30 minutes after receiving IV morphine. What should the
nurse do first?
• a) Call the physician for additional pain medication
• b) Assess the patient’s pain level and surgical site ✅
• c) Give another dose of morphine
• d) Encourage deep breathing exercises
13. The nurse is caring for a patient with a PCA (patient-controlled analgesia) pump. Which
action is inappropriate?
• a) Encouraging the patient to use the PCA before pain becomes severe
• b) Teaching the family how to press the PCA button for the patient ✅
• c) Monitoring for signs of respiratory depression
• d) Assessing the patient’s pain regularly
14. A patient post-op day 2 after abdominal surgery has absent bowel sounds. What is the
priority nursing action?
• a) Notify the physician immediately
• b) Encourage early ambulation ✅
• c) Administer a stool softener
• d) Increase the IV fluid rate
15. A patient post-op from knee replacement surgery has a temperature of 101°F (38.3°C).
What should the nurse do first?
• a) Notify the surgeon
• b) Encourage the patient to use an incentive spirometer ✅
• c) Administer IV antibiotics
• d) Apply a cooling blanket
