NORCET Nursing Foundation – Perioperative Nursing

Test 01 • 50 MCQs • 50 Marks • 30 Minutes

Conceptual + Clinical + Case-Based + Scenario-Based Questions

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Q1. The preoperative period begins when:

A. The patient enters the operating room B. The decision for surgery is made C. Anesthesia is administered D. The surgical incision is made

Answer: B. The decision for surgery is made
The preoperative period begins when the decision or indication for surgery is established and continues until the patient enters the operating phase.

Q2. Which phase of perioperative nursing occurs during the surgical procedure?

A. Preoperative phase B. Intraoperative phase C. Recovery phase only D. Rehabilitation phase

Answer: B. Intraoperative phase
The intraoperative phase begins when the patient enters the operating room and continues until transfer to the post-anesthesia/recovery area.

Q3. The postoperative phase begins:

A. When the surgical procedure is planned B. When the patient enters the operating room C. After completion of surgery and transfer toward recovery D. Before anesthesia

Answer: C. After completion of surgery and transfer toward recovery
Postoperative care begins after surgery and includes recovery from anesthesia, monitoring, prevention of complications and continued rehabilitation.

Q4. Which is a major purpose of preoperative assessment?

A. To identify factors that may increase surgical or anesthetic risk B. To delay all surgeries C. To replace the surgeon's assessment D. To eliminate the need for monitoring

Answer: A. To identify factors that may increase surgical or anesthetic risk
Preoperative assessment identifies medical conditions, medications, allergies, nutritional status, airway concerns and other factors relevant to perioperative safety.

Q5. Which item is essential to verify before a patient undergoes surgery?

A. Patient identity, procedure and surgical site B. Favorite food C. Preferred television program D. Hair style

Answer: A. Patient identity, procedure and surgical site
Correct patient identification, procedure and site verification are fundamental components of surgical safety.

Q6. Why is informed consent important before surgery?

A. It documents the patient's informed agreement after receiving relevant information B. It allows the nurse to perform surgery C. It eliminates all surgical risks D. It replaces patient identification

Answer: A. It documents the patient's informed agreement after receiving relevant information
Informed consent is a legal and ethical process in which the patient receives appropriate information and voluntarily agrees to the procedure.

Q7. What should the nurse do if a patient says, "I do not understand what surgery I am going to have," immediately before surgery?

A. Explain the surgical procedure independently in place of the authorized provider B. Notify the appropriate surgical provider and ensure the patient's questions are addressed C. Tell the patient to sign anyway D. Ignore the statement

Answer: B. Notify the appropriate surgical provider and ensure the patient's questions are addressed
The patient should understand the procedure before giving informed consent. The nurse should facilitate clarification by the appropriate provider rather than providing unauthorized explanations.

Q8. Which preoperative instruction helps reduce postoperative pulmonary complications?

A. Deep breathing, coughing and incentive spirometry as appropriate B. Avoiding all movement after surgery C. Restricting breathing exercises D. Continuous bed rest

Answer: A. Deep breathing, coughing and incentive spirometry as appropriate
Teaching pulmonary exercises before surgery helps the patient perform them effectively after surgery and can reduce postoperative pulmonary complications.

Q9. Which intervention helps reduce the risk of postoperative venous thromboembolism?

A. Early mobilization when clinically appropriate B. Prolonged immobility C. Dehydration D. Avoiding leg exercises

Answer: A. Early mobilization when clinically appropriate
Early mobilization, leg exercises, hydration when appropriate and prescribed mechanical/pharmacological prophylaxis can reduce thromboembolic risk.

Q10. A patient scheduled for surgery is instructed to remain NPO. The primary reason is to reduce the risk of:

A. Aspiration B. Hypertension only C. Skin breakdown D. Wound infection directly

Answer: A. Aspiration
Fasting before anesthesia is intended primarily to reduce the risk of regurgitation and aspiration. Specific fasting instructions depend on the procedure, anesthesia plan and current clinical guidelines.

Q11. Which medication history is particularly important during preoperative assessment?

A. Anticoagulant and antiplatelet use B. Favorite analgesic flavor C. Preferred meal only D. Hair products only

Answer: A. Anticoagulant and antiplatelet use
These medications may affect bleeding risk and perioperative planning. All prescribed, over-the-counter and herbal medications should be reviewed.

Q12. Which finding should the nurse report before elective surgery?

A. Newly developed fever or suspected infection B. Normal vital signs C. Completed preoperative checklist D. Patient understanding of instructions

Answer: A. Newly developed fever or suspected infection
An acute infection or unexplained fever may affect surgical risk and should be assessed and reported before elective surgery.

Q13. Which action is appropriate immediately before transferring a patient to the operating room?

A. Verify identity, procedure, consent/status, allergies and required checklist items B. Remove identification band C. Ignore allergies D. Allow the patient to eat without an order

Answer: A. Verify identity, procedure, consent/status, allergies and required checklist items
A final preoperative verification helps prevent wrong-patient, wrong-procedure and other preventable errors.

Q14. Which type of anesthesia produces loss of consciousness?

A. General anesthesia B. Local anesthesia C. Topical anesthesia only D. Local infiltration only

Answer: A. General anesthesia
General anesthesia produces a controlled state of unconsciousness with loss of protective reflexes and requires close airway and physiological monitoring.

Q15. Local anesthesia primarily produces:

A. Loss of sensation in a specific area B. Complete unconsciousness C. Permanent paralysis D. General amnesia in every patient

Answer: A. Loss of sensation in a specific area
Local anesthesia blocks sensation in a localized area while the patient generally remains conscious.

Q16. Which position is commonly used for abdominal surgery?

A. Supine B. Prone only C. Lithotomy only D. Sitting only

Answer: A. Supine
The supine position is commonly used for many abdominal procedures, although the exact position depends on the surgical procedure.

Q17. Which position is commonly associated with procedures involving the perineal or pelvic area?

A. Lithotomy B. Prone C. Lateral only D. Trendelenburg only

Answer: A. Lithotomy
Lithotomy position provides access to the perineal, rectal and gynecological areas. Proper padding and positioning are essential to prevent nerve and pressure injuries.

Q18. The primary purpose of surgical positioning is to:

A. Provide surgical access while protecting the patient from injury B. Maximize pressure on bony prominences C. Restrict circulation D. Increase nerve compression

Answer: A. Provide surgical access while protecting the patient from injury
Safe positioning balances surgical exposure with protection of skin, nerves, joints, circulation and respiratory function.

Q19. Why are pressure points padded during surgery?

A. To reduce pressure-related tissue and nerve injury B. To increase pressure C. To decrease oxygen delivery D. To cause skin redness

Answer: A. To reduce pressure-related tissue and nerve injury
Padding and appropriate positioning help protect bony prominences, peripheral nerves and soft tissues.

Q20. Which nursing action helps maintain asepsis in the operating room?

A. Maintaining sterile technique and avoiding contamination of sterile fields B. Touching sterile items with unsterile gloves C. Turning away from an open sterile field D. Allowing unnecessary movement around the sterile field

Answer: A. Maintaining sterile technique and avoiding contamination
Strict aseptic technique is essential to reduce the risk of surgical site infection.

Q21. A sterile package becomes wet before use. What should the nurse do?

A. Consider it contaminated and replace it according to policy B. Use it immediately C. Dry it with a towel and use it D. Place it under a fan

Answer: A. Consider it contaminated and replace it according to policy
Moisture can allow microorganisms to pass through packaging. A wet sterile package is considered contaminated.

Q22. The surgical count commonly includes:

A. Sponges, needles and instruments as applicable B. Only medications C. Only surgical gloves D. Only dressings after discharge

Answer: A. Sponges, needles and instruments as applicable
Surgical counts are performed to prevent retained surgical items and should follow institutional policy and surgical safety protocols.

Q23. What should the team do if the final surgical count is incorrect?

A. Immediately communicate the discrepancy and follow the established missing-item protocol B. Ignore it if the patient is stable C. Document it only after discharge D. Throw away the count sheet

Answer: A. Immediately communicate the discrepancy and follow the established missing-item protocol
A count discrepancy is a serious patient-safety issue requiring immediate communication, recounting and further steps according to policy.

Q24. Which statement about surgical site infection prevention is correct?

A. Appropriate hand hygiene and aseptic technique are essential B. Sterility is unnecessary for minor procedures C. Antibiotics replace aseptic technique D. Wound assessment is unnecessary

Answer: A. Appropriate hand hygiene and aseptic technique are essential
Hand hygiene, appropriate skin preparation, aseptic technique and other evidence-based measures help reduce surgical site infections.

Q25. A patient arrives in the PACU after general anesthesia. Which assessment has the highest priority?

A. Airway and breathing B. Appetite C. Bowel movement history D. Sleep preference

Answer: A. Airway and breathing
Immediately after anesthesia, airway patency and adequate ventilation/oxygenation are priority assessments because anesthetic effects can compromise respiratory function.

Q26. Which finding in the PACU requires immediate attention?

A. Airway obstruction with decreasing oxygen saturation B. Mild thirst C. Request for a blanket D. Mild anxiety with stable vital signs

Answer: A. Airway obstruction with decreasing oxygen saturation
Airway compromise is an immediate threat to life and requires prompt intervention.

Q27. Which postoperative complication is characterized by sudden respiratory difficulty, chest pain and possible hypoxemia?

A. Pulmonary embolism B. Constipation C. Mild incisional pain D. Normal fatigue

Answer: A. Pulmonary embolism
Pulmonary embolism can cause sudden dyspnea, chest pain, tachycardia and hypoxemia and is a medical emergency.

Q28. Which postoperative finding may indicate hemorrhage?

A. Increasing tachycardia, hypotension and excessive wound drainage B. Stable vital signs C. Warm dry skin with normal pulse D. Normal urine output

Answer: A. Increasing tachycardia, hypotension and excessive wound drainage
These findings can indicate significant blood loss and require urgent assessment and intervention.

Q29. Which intervention helps prevent postoperative atelectasis?

A. Deep breathing, coughing, incentive spirometry and early mobilization as appropriate B. Prolonged bed rest C. Avoiding coughing completely D. Restricting respiratory exercises

Answer: A. Deep breathing, coughing, incentive spirometry and early mobilization as appropriate
These measures promote lung expansion, improve ventilation and help prevent postoperative atelectasis.

Q30. Which postoperative intervention promotes intestinal function?

A. Early ambulation when appropriate B. Continuous bed rest C. Avoiding all movement D. Unnecessary fluid restriction

Answer: A. Early ambulation when appropriate
Early mobilization can promote gastrointestinal motility and reduce complications associated with prolonged immobility.

Q31. A postoperative patient reports severe pain. What should the nurse do first?

A. Assess the pain and patient status, then provide appropriate prescribed intervention B. Ignore the complaint C. Tell the patient severe pain is always normal D. Give any medication without checking the order

Answer: A. Assess the pain and patient status, then provide appropriate prescribed intervention
Pain should be assessed systematically, including severity, location, quality and associated findings, followed by appropriate intervention and reassessment.

Q32. Which medication-related factor should be assessed before administering an opioid analgesic?

A. Respiratory status and level of consciousness B. Hair color C. Favorite food D. Room decoration

Answer: A. Respiratory status and level of consciousness
Opioids can cause respiratory depression and sedation, so respiratory rate, oxygenation, level of consciousness and other relevant parameters should be assessed.

Q33. Which postoperative wound finding should be reported promptly?

A. Increasing redness, warmth, swelling and purulent drainage B. Clean incision with expected mild tenderness C. Intact dressing with minimal expected drainage D. Improving pain

Answer: A. Increasing redness, warmth, swelling and purulent drainage
These findings may indicate surgical site infection and require prompt clinical assessment.

Q34. What is dehiscence?

A. Separation of wound edges B. Normal wound healing C. Formation of healthy granulation tissue D. Normal scar maturation

Answer: A. Separation of wound edges
Dehiscence refers to partial or complete separation of previously approximated wound edges.

Q35. What is evisceration?

A. Protrusion of internal organs or viscera through a wound opening B. Mild postoperative pain C. Normal wound closure D. Skin dryness

Answer: A. Protrusion of internal organs or viscera through a wound opening
Evisceration is a surgical emergency requiring immediate intervention.

Q36. A patient develops evisceration after abdominal surgery. What is the priority nursing action?

A. Cover the exposed organs with sterile saline-moistened dressings and notify the surgical team immediately B. Push the organs back into the abdomen C. Leave the wound uncovered D. Ask the patient to walk

Answer: A. Cover the exposed organs with sterile saline-moistened dressings and notify the surgical team immediately
Do not attempt to replace the organs. Protect exposed tissue with sterile saline-moistened dressings and obtain immediate surgical assistance.

Q37. Which postoperative intervention helps prevent pressure injury?

A. Repositioning and pressure redistribution B. Keeping the patient in one position C. Dragging the patient across the bed D. Ignoring skin assessment

Answer: A. Repositioning and pressure redistribution
Patients with limited mobility after surgery are at increased risk for pressure injury. Repositioning and pressure redistribution are important preventive measures.

Q38. Which postoperative finding may indicate urinary retention?

A. Bladder distension with inability to void B. Adequate urine output C. Normal bladder sensation D. Frequent normal urination

Answer: A. Bladder distension with inability to void
Anesthesia, opioids and immobility can contribute to urinary retention. Bladder assessment and appropriate intervention may be required.

Q39. Which postoperative measure helps reduce constipation?

A. Adequate fluids, mobility and appropriate dietary measures when permitted B. Prolonged bed rest C. Unnecessary fluid restriction D. Avoiding all activity

Answer: A. Adequate fluids, mobility and appropriate dietary measures
When not contraindicated, hydration, mobility and appropriate fiber/dietary intake can support bowel function.

Q40. Case Scenario: A patient returns from abdominal surgery. The nurse notes a respiratory rate of 8/min, shallow breathing and increasing drowsiness after opioid administration. What is the priority?

A. Assess and support airway/breathing and urgently respond to suspected opioid-induced respiratory depression B. Give another opioid C. Encourage the patient to sleep D. Ignore the respiratory rate

Answer: A. Assess and support airway/breathing and urgently respond to suspected opioid-induced respiratory depression
A respiratory rate of 8/min with increasing sedation is concerning for opioid-induced respiratory depression. Airway and breathing take priority, with further management according to protocol.

Q41. Case Scenario: Before surgery, a patient says, "I have a severe allergy to latex." What should the nurse do?

A. Clearly document and communicate the allergy and ensure appropriate latex precautions B. Ignore it because surgery is urgent C. Remove the allergy from the record D. Tell the patient allergies do not matter during surgery

Answer: A. Clearly document and communicate the allergy and ensure appropriate latex precautions
A severe latex allergy can cause serious reactions. The healthcare team must be informed and appropriate precautions implemented.

Q42. Case Scenario: During the surgical safety check, the consent identifies the left leg, but the operating schedule states the right leg. What should happen?

A. Stop and resolve the discrepancy before proceeding B. Proceed with whichever side is listed on the schedule C. Ask another patient D. Ignore the discrepancy

Answer: A. Stop and resolve the discrepancy before proceeding
Any discrepancy involving patient identity, procedure or surgical site must be resolved before surgery to prevent wrong-site surgery.

Q43. Case Scenario: A postoperative patient suddenly becomes restless, pale and tachycardic. The blood pressure is falling and the surgical dressing is rapidly becoming soaked. What should the nurse suspect?

A. Postoperative hemorrhage B. Normal recovery C. Mild constipation D. Normal wound healing

Answer: A. Postoperative hemorrhage
Pallor, tachycardia, falling blood pressure and rapidly increasing wound drainage are concerning for hemorrhage and require immediate response.

Q44. Case Scenario: A patient in the PACU has noisy breathing, decreased oxygen saturation and reduced consciousness. What is the priority nursing action?

A. Assess and maintain airway patency and support breathing B. Offer oral fluids C. Ask about bowel habits D. Encourage the patient to walk

Answer: A. Assess and maintain airway patency and support breathing
Noisy breathing, reduced consciousness and falling oxygen saturation indicate possible airway obstruction. Airway and breathing are immediate priorities.

Q45. Case Scenario: A postoperative patient refuses to cough because of incisional pain. Which intervention is most appropriate?

A. Provide appropriate pain control and teach incision splinting during coughing B. Tell the patient never to cough C. Keep the patient completely immobile D. Withhold all analgesia

Answer: A. Provide appropriate pain control and teach incision splinting
Adequate pain control and splinting the incision can make coughing more tolerable while supporting effective pulmonary hygiene.

Q46. Case Scenario: A patient who had lower-limb surgery is reluctant to move because of discomfort. Which intervention is most appropriate for preventing venous stasis?

A. Encourage prescribed leg exercises and early mobilization when safe B. Maintain complete bed rest indefinitely C. Avoid all leg movement D. Restrict fluids without indication

Answer: A. Encourage prescribed leg exercises and early mobilization when safe
Leg exercises and mobilization improve venous return and help reduce venous stasis when permitted by the surgical plan.

Q47. Which finding indicates that a patient may be ready for transfer from the PACU?

A. Stable vital signs, adequate oxygenation, appropriate level of consciousness and controlled pain/nausea according to criteria B. Severe respiratory depression C. Uncontrolled bleeding D. Unstable blood pressure

Answer: A. Stable vital signs, adequate oxygenation, appropriate consciousness and controlled symptoms
PACU discharge or transfer is based on established recovery criteria and the patient's clinical stability.

Q48. Which postoperative intervention is most appropriate for reducing the risk of deep vein thrombosis?

A. Early ambulation and prescribed VTE prophylaxis B. Prolonged immobility C. Dehydration D. Avoiding all lower-limb movement

Answer: A. Early ambulation and prescribed VTE prophylaxis
Early mobilization and appropriate mechanical or pharmacological prophylaxis reduce venous thromboembolism risk.

Q49. Which nursing diagnosis is particularly relevant for a patient immediately after major surgery?

A. Risk for infection B. Improved tissue integrity C. Increased mobility as a certainty D. Absence of all pain

Answer: A. Risk for infection
Surgical incisions and invasive procedures increase infection risk. Other diagnoses such as acute pain, impaired physical mobility and risk for bleeding may also be relevant depending on assessment findings.

Q50. Case Scenario: A patient is 6 hours after abdominal surgery. The patient is alert, oxygen saturation is stable, but reports increasing abdominal pain and has a rigid, distended abdomen with a rapidly increasing pulse. What is the nurse's priority?

A. Recognize possible postoperative complication and urgently notify the surgical team while continuing assessment and supportive care B. Assume the pain is normal and ignore it C. Give unlimited oral fluids D. Encourage vigorous exercise

Answer: A. Recognize possible postoperative complication and urgently notify the surgical team
Increasing abdominal pain, rigidity, distension and tachycardia are concerning findings after abdominal surgery. The patient requires prompt assessment and escalation rather than assuming the symptoms are routine postoperative pain.

NORCET Exams Preparation Series - Daily 4 ( Perioperative Nursing MCQs Practice )