A nurse is assessing a client’s health history as the client prepares to undergo surgery. The nurse learns that the client takes St. John’s wort. Which best describes why the client should not use this supplement before surgery?

The circulating nurse is taking a client to the operating room for a right knee replacement. The nurse is verifying everyone is ready for the procedure. Which of the following would cause a delay in surgery?

Which of the following describes the role of a circulator nurse in the peri-operative setting? Select all that apply.

Which of the following describes perioperative nursing? Select all that apply.

A client asks the nurse her role as a nurse first assist. Which of the following is the best explanation of a nurse first assist?

A nurse is applying for a position as a pre-operative nurse. Which of the following tasks would be appropriate for the nurse to learn? indicate working in the preoperative area?

The staff in the emergency room provide care and treatment for an unconscious client who was brought in by ambulance with no family present. In this emergency situation, the law allows for implied consent, which means which of the following?

A surgeon is telling a client about an upcoming surgical procedure so that the client can provide informed consent. Which of the following describes the concept of a reasonable client standard when signing informed consent? Select all that apply.

The nurse is caring for a client who is signing informed consent for a procedure. The nurse knows that the client needs to understand which of the following relating to informed consent? Select all that apply.

A 12-year-old client needs to have treatment that involves a surgical procedure that will save the child’s life. The parents refuse to give consent for the procedure based on their personal convictions. Which of the following is allowable for the healthcare team in response?

A nurse is preparing a client for a surgical procedure. At the last minute, the nurse realizes that the client has not signed an informed consent for the procedure. Which of the following actions of the nurse is most appropriate?

The nurse is interviewing a client going to the operating room for a total hip replacement. During the interview, the client is unable to state their name or birthdate. The client takes medication for dementia. The nurse would expect which of the following when obtaining the informed consent? Select all that apply.

An unconscious client is brought in to the emergency room and needs immediate surgery for bleeding from the chest. A staff member explains that surgery cannot be done because the client cannot consent. Which of the following is the best response by the nurse?

The nurse is having a conversation with the client who is scheduled to start their third round of chemotherapy. The client states “I do not want to do this, my spouse is forcing me.” The nurse knows that which of the following components of informed consent is being broken?

If the client provides informed consent the nurse knows that the client can explain all of the following regarding their procedure except which of the following?

The nurse is speaking with a client in the preoperative area before their scheduled cervical fusion. The client states they are planning on completing a triathlon next week. Which of the following is the best action for the nurse to take?

The client who is about to have surgery is complaining to the nurse that the hospital is “starving me to death”. Which of the following is the nurse’s best response to the client?

When the perioperative nurse assesses the client for surgery, the BMI is assessed as low. The nurse knows that which of the following could be a concern? Select all that apply.

An 88-year-old client from a local nursing home is having surgery for a bladder tumor. The nurse knows that which of the following are ways to assess the cognitive abilities of the client? Select all that apply

Clients who are allergic to bananas are also likely to be allergic to:

The pre-operative nurse is preparing a client for surgery. Which of the following actions should the nurse perform to ensure client readiness? Select all that apply.

A 30-year-old client is scheduled for an endometrial ablation and is concerned about “what everyone will see” during the procedure. The nurse knows that which of the following is the best response to this comment?

Your client is a 4-year-old scheduled for a tonsillectomy. During the preoperative assessment the mother informs the nurse that the client was eating fruit snacks on the way to the hospital. Because of this the surgery has been cancelled. The nurse knows that which of following is the best response to give the mother regarding NPO education?

The nurse knows that all of the following are goals of education for the surgical patient except which of the following?

The nurse knows that educating the surgical client is extremely important for client safety. The nurse knows that which of the following would be the priority to educate the client on prior to surgery?

The nurse is getting a client ready for a hysterectomy when the client asks, “Will I have a tube down my throat?” Which of the following is the best response?

The preoperative nurse is preparing a client for a robotic assisted cholecystectomy. The client is asked when they last had anything to eat or drink and admits to having eggs with coffee for breakfast. Which of the following risks is the nursing priority for the preoperative nurse?

The nurse knows that all are true of playing a role in preventing wrong-site surgery preoperatively except which of the following?

A nurse is working with a client who is preparing to have surgery for an umbilical hernia. The provider has discussed information about the procedure, the risks, benefits, and alternatives to the procedure with the client. After the provider has discussed the situation, the client decides against signing the consent and informs the nurse of the decision. Which of the following is the best example of the nurse acting as a client advocate in this situation?

A client is sitting in the preoperative holding area when they casually tell you that they aren’t really sure why they are having the procedure. As the preoperative nurse you should do which of the following?

The circulating nurse in the operating room realizes the client did not receive an antibiotic ordered to start preoperatively. Which of the following preoperative nursing priorities was overlooked?

A client is having difficulty breathing while coming out of anesthesia following surgery. The nurse inserts an oral airway to assist with this client’s breathing. Which of the following items that are true regarding placement of an oral airway? Select all that apply.

The nurse knows that ventilation and oxygenation are critical when the surgical client is under general anesthesia. The nurse knows that which of the following safety measures are taken to ensure client safety during intubation? Select all that apply.

A client is concerned that they won’t breathe during their surgery. Which of the following is the most appropriate response from the perioperative nurse?

A circulating nurse in the operating room is caring for a client scheduled to have a dental procedure under general anesthesia. What is the most appropriate type of intubation for this client?

A client has just been transferred from the OR into the recovery room and the nurse notes that the endotracheal tube is still in place. The client is beginning to breathe on her own but is not awake and alert yet. Which of the following interventions should the nurse perform next?

The nurse brings the client into the operating room to prepare for surgery. The anesthesia team starts to give the client anesthesia and the nurse knows that which of the following is the nursing priority? Select all that apply.

A nurse is assisting the anesthesiologist to prepare to intubate a client just before surgery. Which of the following injuries is most commonly associated with endotracheal intubation as part of general surgery?

While assessing the client for surgery the nurse notices the client has a cut on their upper lip. Which of the following is the most appropriate action as the circulating nurse?

A nurse in the ICU is caring for a client who is intubated and sedated on a ventilator after a motor vehicle collision. The client requires significant pain control, but is ready to be extubated. Which medication order should be clarified before the client is extubated?

The nurse is caring for a client who is in respiratory distress and is at a high risk of losing the airway. The doctor decides to intubate the client. The nurse knows that which medication will be given first?

The nurse is reviewing discharge instructions with a client to prepare them to go home after an outpatient hernia repair that was under general anesthesia. The client signs the discharge papers and the nurse gets a wheelchair to take the client out of the hospital. The client starts searching for the car keys and states “I wish my spouse could be here to take me home”. Which of the following is best response by the nurse to the client?

An 82-year-old client has returned to have a left knee replacement a year after having their right knee replaced. While inserting an IV the client states “I don’t think I was awake last time, I think they put my IV in after I was asleep.” Having an understanding of general anesthesia which of the following is the best response for the nurse to give the client?

The preoperative nurse is asked by the client when they will be able to leave. The nurse knows that which of the following is the best response to give the client?

You are the circulating nurse and receiving a client from the emergency room for surgery. During report from the emergency room nurse you are told that the client is American Society of Anesthesiologists (ASA) physical status classification VI. Which of the following clients would best describes the client you are going to take care of?

The PACU nurse is providing discharge teaching to a client who just underwent a bunionectomy under general anesthesia. The nurse knows that which of the following information should be provided regarding anesthesia? Select all that apply

The nurse is caring for a client with a prescription for fentanyl. Which of the following is a condition that is appropriate for this medication to treat?

The nurse is caring for a client scheduled to have general anesthesia. While reviewing their chart the nurse notices that the client told the preoperative nurse that one of their family members temperature “went up really high” during surgery. Which of the following is the best next action for the nurse to take?

While preparing your client for surgery the client tells you how afraid they are to feel pain while under anesthesia. Based on your knowledge of general anesthesia which of the following is the most appropriate response to the client?

Based on the nurse’s understanding of local anesthesia which of the following clients would give concern for the procedure? Select all that apply.

The preoperative nurse is preparing the client for surgery and the client asks you what will happen during surgery with local anesthesia. Which of the following is the best response by the nurse?

You are the preoperative nurse and you are getting your client ready for their procedure and realize the client does not understand that they are receiving local anesthesia when they say which of the following?

The perioperative nurse who is monitoring the client during the procedure has a good understanding of signs and symptoms associated with local anesthesia including local anesthesia systemic toxicity. The nurse knows that which of the following are signs of this issue? Select all that apply.

Based on the nurse’s knowledge of local anesthesia the nurse realizes that the type of local anesthesia is chosen by the provider with all of the following in mind except which of the following?

There are four clients in the preoperative holding area who are scheduled for a procedure under moderate sedation. The nurse knows that a client with which of the following would be most concerning to the anesthesiologist for proper ventilation during the procedure?

You are a perioperative nurse and have just been hired to work for private practice. The healthcare provider that you are working for has informed you that the next client will be under moderate sedation and you will be giving the drugs to the patient. Which of the following is the best next action to take?

A nurse providing moderate sedation to a client undergoing a surgical procedure is assessing vital signs, sedation level, and level of consciousness. The nurse realizes the client is not responding to the nurse’s questions. Which of the following administrations would be necessary? Select all that apply.

The perioperative nurse and you have been assigned as the preceptor for a nursing student. The student is observing the case of a client under moderate sedation. The nursing student understands that sedation levels must be assessed in these clients but does not know how. Which of the following is the best response by the nurse?

The preoperative nurse is doing a preoperative assessment on a client who is scheduled for a procedure under moderate sedation. The client state that they drink 8 beers a day. Which of the following is correct about alcohol and receiving moderate sedation?

You are the perioperative nurse caring for a client under general anesthesia. The nurse anesthetist is concerned that the client is showing signs of malignant hyperthermia. You would expect to see which of the following signs and symptoms? Select all that apply.

You are the circulating nurse and when speaking to the client they casually state that a long time ago their mother had to be “cooled down” during surgery. Having knowledge of the risks associated with malignant hyperthermia, which of the following would be the best next action?

There are four clients waiting in the surgical holding area and after the nurse reviews each of their charts which of the following would the nurse be most concerned about?

Your client has a known family history of malignant hyperthermia. The nurse knows that which of the following ways would keep the client safe? Select all that apply.

The preoperative nurse is preparing a client for a thyroidectomy. Which of the following comments makes the nurse concerned about malignant hyperthermia?

A nurse is orienting a new perioperative nurse in the operating room. After bringing the client into the OR the surgeon instructs the new nurse to shave the surgical site and the nurse asks you where they can find a razor. Which of the following is the best response? Select all that apply.

The client is sitting in the preoperative department as they are being prepared for surgery. They ask the nurse “why did I have to shower with that special soap last night?” Which of the following is the best response by the nurse?

A perioperative nurse works in surgery and is prepping a client for the procedure. The nurse understands that prepping the surgical site properly with no contaminated areas means which of the following?

A client is scheduled for abdominal surgery and during the preoperative assessment, it is revealed that the client has a stoma. The nurse knows that which of the following is important to do in terms of prepping this client? Select all that apply.

The nurse is caring for a client who is scheduled to have a total knee replacement. The nurse knows that which of the following preoperative instructions can play a role in possibly preventing surgical site infections? Select all that apply.

As the circulating nurse, it is important to maintain the sterile field in a procedure. Which of the following actions would require correction?

A student nurse is learning about sterile techniques. Which action demonstrated by the student indicates that learning has been effective?

The nurse is helping a medical student prepare for their first time scrubbed in a surgery. Which of the following should the nurse teach the medical student in terms of the sterile gown and maintaining a sterile field? Select all that apply

The nurse is about to bring the client into the operating room for surgery and knows all of the following are important to tell the client regarding possible infection, except which of the following?

The circulating nurse in the operating room notices that the surgeon touched his back against the scrub tech’s sterile hand as they were moving positions. The nurse knows that which of the following is the best immediate action?

The perioperative nurse is creating a sterile environment and is aware that sterile drapes create the sterile field. The nurse knows that which of the following is true of sterile drapes? Select all that apply.

A client is scheduled for a gynecological procedure and will be placed in the lithotomy position. The nurse knows that which of the following concerns is specific to this type of positioning?

The client is scheduled for laparoscopic surgery and the surgeon wants to place the client in reverse trendelenburg. The nurse knows that which of the following positioning devices are useful to prevent shearing in this position?

The circulating nurse understands the importance of intraoperative positioning and knows that which of the following is important to remember when positioning the client for surgery? Select all that apply

The surgeon working with the nurse has asked that the client be placed in the right lateral position. The nurse knows that which of the following positioning techniques can apply to this request? Select all that apply

A client is scheduled for a procedure that requires stirrup positioning. The perioperative nurse is aware that certain complications occur. Which of the following can result from this positioning? Select all that apply

The perioperative nurse is aware that surgical clients are at risk for complications associated with fluid volume and know the reasons why are which of the following? Select all that apply

Perioperative hypothermia is a complication that all surgical clients are at risk for and the nurse is aware of the importance of decreasing these complications because all except which of the following can occur?

The circulating nurse is prepping a client’s abdomen prior to an abdominal hysterectomy and notices there is a pool of betadine prep that ran under the client. Based on the nurse’s knowledge of intraoperative complications which of the following might the client be at risk for?

The surgical nurse is taking care of a client who is undergoing colon resection. The perioperative team recognizes that the client has lost an excessive amount of blood during the procedure. The nurse is aware that this complication can lead to which of the following? Select all that apply

A perioperative nurse is aware that surgical clients are at risk for injuries related to positioning. Decreasing this risk is an intraoperative nursing priority and the nurse knows that all except which of the following can be a result of improper positioning of the client?

A client is being taken back to the operating room when they surprisingly tell the nurse that they haven’t seen their surgeon since the first office visit. The nurse knows that which of the following is a risk for the client?

A client is asking about surgical history and assessed prior to surgery. The intraoperative nurse is aware that a thorough preoperative assessment is critical in decreasing the risk of which of the following?

The circulating nurse plays a huge role in protecting the client through intraoperative nursing priorities. Which of the following actions by the nurse decreases the risk of injury to the client? Select all that apply

The circulating nurse is orienting a new nurse who asks what a “time-out” is. The circulating nurse explains that the “time out” is a nursing priority that decreases the risk of which of the following?

The post-anesthesia care unit (PACU) nurse is receiving hand-off report from the peri-operative nurse. What information will the peri-operative nurse share about the client? Select all that apply

The PACU nurse is waiting for the client to arrive to the recovery unit from surgery. Based on nursing knowledge of postoperative clients, which of the following is the most important nursing action to perform first?

The post-anesthesia care unit (PACU) nurse caring for a client who just underwent a carpal tunnel procedure. The nurse completed the immediate admission assessment, initial assessment, implementation of interventions, and evaluation. The nurse knows that which of the following is one tool to evaluate the client’s readiness for discharge?

The nurse working in the PACU knows that which of the following can be expected to learn from the anesthesia provider during the hand-off report? Select all that apply

Postoperative nausea and vomiting (PONV) is a common complication in surgical clients and the nurse knows that all except which of the following increase the risk of PONV?

The nurse is caring for a client who has just been admitted to the floor following a knee replacement surgery. The client received a total of 100 mcg fentanyl in the PACU, of which 25 mcg were administered just before the trip to the floor. During the initial assessment, the nurse notes the client’s respirations are 8, he requires sternal pressure to open his eyes but then falls back asleep again, and his oxygen saturation is 82%. What is the nurse’s priority intervention at this time?

A nurse is caring for a client postoperatively that has just had abdominal surgery. The nurse knows that surgical clients are at risk for certain surgical issues like dehiscence. The nurse knows that which of the following statements are true regarding dehiscence? Select all that apply.

The nurse is preparing a 40-year-old client for surgery when they explain they are concerned about blood clots. Based on the nurse’s knowledge of postoperative complications which of the following statements is true? Select all that apply

A client with a hysterectomy is admitted to the surgical unit from the PACU. The nurse is concerned that this client is over sedated. Which of the following findings would NOT be consistent with the clinical presentation of over sedation?

A client who is recovering from surgery has developed a fever and the nurse notes that the client has significant pain and the incision site is red and warm. Which response from the nurse is most appropriate?

A client has just finished surgery and is coming to the PACU for recovery. Postoperative hypothermia is a complication of the surgical client and the nurse knows that which of the following is true regarding this complication? Select all that apply.

The nurse is caring for a client who had surgery yesterday afternoon. The client is now complaining of abdominal pain and the nurse notes the abdomen is firm. The nurse reviews the provider orders seen in the graphic. Which of the following is most likely the cause of the client’s condition?

The nurse receives a client to the unit from the post-anesthesia care unit for a craniotomy for a tumor biposy. The client was extubated approximately 45 minutes before arrival to the unit. The client has a right internal jugular central venous catheter and left radial arterial line that were placed during the case. The client’s vitals are SpO2 89%, BP 95/60, HR 123, temp 97.5F oral, and RR 29. The client reports moderate chest discomfort, rating 6/10. As the nurse completes the client assessment, accessory muscle use during inspiration and expiration is noted. What is should be the nurse’s first action?

A nurse is caring for a client in the recovery room who has developed post-operative nausea and vomiting as a result of anesthesia. Which of the following is a complication of post-operative nausea and vomiting? Select all that apply.

The circulating nurse in the operating room is assigned a client that is scheduled to have a thyroidectomy. Based on the nurse’s knowledge of surgical incisions, which of the following types of incisions would be expected to see in the client?

The circulating nurse in the operating room has a client scheduled for a c-section. Based on knowledge of surgical incisions, which of the following types of incisions does the nurse expect to see?

You are the PACU nurse for a client who just had abdominal surgery. During hand-off report from the circulating nurse, you are informed the client has a paramedian incision. As the nurse, you expect to see the incision in which of the following places?

The circulating nurse in the operating room receives notification that a client is coming from the emergency room for an open appendectomy procedure. With the nurse’s knowledge of surgical incisions, which of the following types of incisions would be expected for the surgeon to perform?

The client in the PACU is waking from anesthesia after having a bilateral mastectomy with drain placement. The nurse knows that which of the following is true regarding drains? Select all that apply.

The nurse is preparing to discharge the client after a carpal tunnel procedure. Which of the following is true regarding the discharge process of postoperative surgical clients? Select all that apply

The nurse is aware of the various postoperative complications that should be reported by the client. In discharge teaching the nurse should include all except which of the following signs to report?

The PACU nurse understands that the success of discharge teaching can depend greatly on which of the following? Select all that apply