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NCLEX PN Exam Bank Preoperative and
Postoperative Care Planning
Table of Contents
Subtopic 1: Preoperative Assessment and Patient Preparation (Questions 1–20) ............... 2
Subtopic 2: Intraoperative Considerations and Roles of the Nurse (Questions 21–40) ...... 10
Subtopic 3: Immediate Postoperative Recovery and PACU Care (Questions 41–60) .......... 18
Subtopic 4: Pain Management and Comfort Measures Post-Surgery (Questions 61–80) .... 25
Subtopic 5: Pain Management and Comfort Measures in the Surgical Patient .................. 33
Subtopic 6: Infection Prevention and Aseptic Techniques in Surgical Care....................... 40
Subtopic 7: Prevention and Management of Postoperative Infections and Complications . 49
Subtopic 8: Pain Management and Comfort Promotion in Surgical Clients ...................... 57
Subtopic 9: Prevention, Identification, and Management of Surgical Site Infections (SSIs) 65
Subtopic 10: Cultural Considerations and Ethical Issues in Perioperative Nursing Care .... 73
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Subtopic 1: Preoperative Assessment and Patient
Preparation (Questions 1–20)
1. A nurse is preparing a patient for elective surgery. Which preoperative laboratory value
should be reported to the surgeon immediately?
A. Hemoglobin 14.5 g/dL
B. Platelet count 90,000/mm³
C. White blood cell count 8,000/mm³
D. Blood glucose 100 mg/dL
Correct Answer: B. Platelet count 90,000/mm³
Rationale: A low platelet count increases the risk of bleeding during surgery. Normal
platelet range is 150,000–400,000/mm³. This finding requires immediate notification.
2. Which instruction should the nurse include when teaching a client scheduled for
abdominal surgery about incentive spirometry?
A. Use the device once daily before bed
B. Inhale slowly and deeply to raise the piston
C. Exhale quickly into the device
D. Avoid using the device for the first 24 hours post-op
Correct Answer: B. Inhale slowly and deeply to raise the piston
Rationale: Incentive spirometry promotes lung expansion and prevents atelectasis.
Instructing the client to inhale slowly maximizes effectiveness.
3. A patient scheduled for surgery says, “I’m not sure I want to go through with this.” What is
the nurse’s best response?
A. “Don’t worry, everything will go fine.”
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B. “It’s too late to cancel now.”
C. “Would you like to speak to your surgeon again?”
D. “This procedure is very common and safe.”
Correct Answer: C. “Would you like to speak to your surgeon again?”
Rationale: The nurse must notify the provider if the patient expresses doubts or questions
consent. Patients must voluntarily consent without pressure.
4. What is the nurse’s priority action before administering a preoperative sedative?
A. Administer on an empty stomach
B. Check the surgical site
C. Ensure the informed consent is signed
D. Explain post-op activity restrictions
Correct Answer: C. Ensure the informed consent is signed
Rationale: Consent must be obtained before sedatives are given, as sedation may impair
decision-making capacity.
5. Which finding in a preoperative patient requires immediate attention?
A. Reports allergy to latex
B. Age over 65
C. Anxiety about the procedure
D. Mild elevated blood pressure
Correct Answer: A. Reports allergy to latex
Rationale: Latex allergy increases the risk for anaphylaxis during surgery. Immediate
precautions are needed.
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6. The nurse teaches a preoperative client how to perform coughing and deep breathing
exercises. Which statement indicates effective learning?
A. “I’ll breathe rapidly to clear my lungs.”
B. “I’ll support my incision with a pillow while coughing.”
C. “I should hold my breath for 10 seconds before coughing.”
D. “I’ll do this only if I start wheezing.”
Correct Answer: B. “I’ll support my incision with a pillow while coughing.”
Rationale: Splinting with a pillow reduces pain and supports the incision during coughing to
clear secretions.
7. Which client is at the greatest risk for complications from general anesthesia?
A. A 22-year-old scheduled for an appendectomy
B. A 78-year-old with COPD and heart failure
C. A 45-year-old with controlled diabetes
D. A 60-year-old with seasonal allergies
Correct Answer: B. A 78-year-old with COPD and heart failure
Rationale: Older adults with respiratory and cardiac conditions are more susceptible to
complications under anesthesia.
8. A patient has been NPO since midnight for surgery. What is the nurse’s priority action if
the patient requests water for dry mouth?
A. Offer a small amount of water to swish and spit
B. Allow one sip of water
C. Give ice chips
NCLEX PN Exam Bank Preoperative and
Postoperative Care Planning
Table of Contents
Subtopic 1: Preoperative Assessment and Patient Preparation (Questions 1–20) ............... 2
Subtopic 2: Intraoperative Considerations and Roles of the Nurse (Questions 21–40) ...... 10
Subtopic 3: Immediate Postoperative Recovery and PACU Care (Questions 41–60) .......... 18
Subtopic 4: Pain Management and Comfort Measures Post-Surgery (Questions 61–80) .... 25
Subtopic 5: Pain Management and Comfort Measures in the Surgical Patient .................. 33
Subtopic 6: Infection Prevention and Aseptic Techniques in Surgical Care....................... 40
Subtopic 7: Prevention and Management of Postoperative Infections and Complications . 49
Subtopic 8: Pain Management and Comfort Promotion in Surgical Clients ...................... 57
Subtopic 9: Prevention, Identification, and Management of Surgical Site Infections (SSIs) 65
Subtopic 10: Cultural Considerations and Ethical Issues in Perioperative Nursing Care .... 73
, 2
Subtopic 1: Preoperative Assessment and Patient
Preparation (Questions 1–20)
1. A nurse is preparing a patient for elective surgery. Which preoperative laboratory value
should be reported to the surgeon immediately?
A. Hemoglobin 14.5 g/dL
B. Platelet count 90,000/mm³
C. White blood cell count 8,000/mm³
D. Blood glucose 100 mg/dL
Correct Answer: B. Platelet count 90,000/mm³
Rationale: A low platelet count increases the risk of bleeding during surgery. Normal
platelet range is 150,000–400,000/mm³. This finding requires immediate notification.
2. Which instruction should the nurse include when teaching a client scheduled for
abdominal surgery about incentive spirometry?
A. Use the device once daily before bed
B. Inhale slowly and deeply to raise the piston
C. Exhale quickly into the device
D. Avoid using the device for the first 24 hours post-op
Correct Answer: B. Inhale slowly and deeply to raise the piston
Rationale: Incentive spirometry promotes lung expansion and prevents atelectasis.
Instructing the client to inhale slowly maximizes effectiveness.
3. A patient scheduled for surgery says, “I’m not sure I want to go through with this.” What is
the nurse’s best response?
A. “Don’t worry, everything will go fine.”
, 3
B. “It’s too late to cancel now.”
C. “Would you like to speak to your surgeon again?”
D. “This procedure is very common and safe.”
Correct Answer: C. “Would you like to speak to your surgeon again?”
Rationale: The nurse must notify the provider if the patient expresses doubts or questions
consent. Patients must voluntarily consent without pressure.
4. What is the nurse’s priority action before administering a preoperative sedative?
A. Administer on an empty stomach
B. Check the surgical site
C. Ensure the informed consent is signed
D. Explain post-op activity restrictions
Correct Answer: C. Ensure the informed consent is signed
Rationale: Consent must be obtained before sedatives are given, as sedation may impair
decision-making capacity.
5. Which finding in a preoperative patient requires immediate attention?
A. Reports allergy to latex
B. Age over 65
C. Anxiety about the procedure
D. Mild elevated blood pressure
Correct Answer: A. Reports allergy to latex
Rationale: Latex allergy increases the risk for anaphylaxis during surgery. Immediate
precautions are needed.
, 4
6. The nurse teaches a preoperative client how to perform coughing and deep breathing
exercises. Which statement indicates effective learning?
A. “I’ll breathe rapidly to clear my lungs.”
B. “I’ll support my incision with a pillow while coughing.”
C. “I should hold my breath for 10 seconds before coughing.”
D. “I’ll do this only if I start wheezing.”
Correct Answer: B. “I’ll support my incision with a pillow while coughing.”
Rationale: Splinting with a pillow reduces pain and supports the incision during coughing to
clear secretions.
7. Which client is at the greatest risk for complications from general anesthesia?
A. A 22-year-old scheduled for an appendectomy
B. A 78-year-old with COPD and heart failure
C. A 45-year-old with controlled diabetes
D. A 60-year-old with seasonal allergies
Correct Answer: B. A 78-year-old with COPD and heart failure
Rationale: Older adults with respiratory and cardiac conditions are more susceptible to
complications under anesthesia.
8. A patient has been NPO since midnight for surgery. What is the nurse’s priority action if
the patient requests water for dry mouth?
A. Offer a small amount of water to swish and spit
B. Allow one sip of water
C. Give ice chips
