1
RASMUSSEN COLLEGE MDC 2
EXAM 1 Actual Exam 2026/2027
Complete Questions and Verified Answers
Pass Guaranteed - A+ Graded
SECTION I: PERIOPERATIVE NURSING (Questions 1-20)
Preoperative Phase (Questions 1-8)
Question 1 A 68-year-old patient is scheduled for an elective total knee replacement. During the
preoperative assessment, the nurse notes the patient takes warfarin 5 mg daily for atrial
fibrillation. Which action should the nurse take first?
A. Document the medication and continue with the assessment
B. Notify the surgeon immediately about the anticoagulant use
C. Instruct the patient to stop taking the warfarin immediately
D. Check the patient's INR level and document the result
Correct Answer: B
Rationale: Anticoagulants significantly increase bleeding risk during surgery and typically
require management before elective procedures. While the INR should be checked (option D),
notifying the surgeon immediately is the priority because the surgeon must determine the
appropriate timing for discontinuing warfarin and whether bridging therapy with heparin is
needed. The nurse should never instruct a patient to stop anticoagulants independently (option
C), as this could precipitate thromboembolic events. Documentation alone (option A) does not
address the immediate safety concern.
Question 2 The nurse is providing preoperative teaching to a patient scheduled for abdominal
surgery. Which statement by the patient indicates understanding of deep breathing exercises?
A. "I should take a deep breath, hold it for 5 seconds, then exhale slowly through pursed lips"
B. "I need to breathe rapidly and shallowly to prevent dizziness"
C. "I should only do these exercises when I feel short of breath"
D. "Holding my breath for as long as possible will strengthen my lungs"
,2
Correct Answer: A
Rationale: Proper deep breathing technique involves taking a slow, deep breath through the
nose, holding it for 3-5 seconds to allow alveolar expansion, and exhaling slowly through pursed
lips. This technique maximizes lung expansion, prevents atelectasis, and promotes clearance of
secretions. Rapid shallow breathing (option B) does not adequately expand alveoli. Exercises
should be performed every 1-2 hours while awake, not just when dyspneic (option C). Prolonged
breath-holding (option D) can cause hyperventilation and is not recommended.
Question 3 A patient is scheduled for bowel surgery in the morning. The surgeon has ordered a
bowel prep with polyethylene glycol solution. The nurse should instruct the patient to:
A. Drink the solution quickly to minimize nausea
B. Consume clear liquids only after completing the prep
C. Expect frequent, watery bowel movements to begin within 1-2 hours
D. Take the medication with food to prevent stomach upset
Correct Answer: C
Rationale: Polyethylene glycol (PEG) solutions are osmotic laxatives that work by drawing
water into the intestinal lumen, producing frequent, watery bowel movements typically
beginning within 1-2 hours of ingestion. Patients should drink the solution slowly over the
prescribed time (usually 2-4 hours) to prevent nausea and vomiting (option A). Clear liquids are
usually permitted until 2 hours before surgery (option B varies by protocol). The solution should
be taken on an empty stomach (option D) for optimal effectiveness.
Question 4 During preoperative verification, the nurse discovers that the surgical consent form
lists the wrong procedure. Which action is most appropriate?
A. Have the patient cross out the incorrect procedure and initial the change
B. Contact the surgeon to obtain a new, corrected consent form
C. Proceed with preparation since the patient verbally confirmed the correct procedure
D. Ask the patient to sign the form and document the discrepancy in the chart
Correct Answer: B
Rationale: Surgical consent forms are legal documents that must accurately reflect the planned
procedure. Any discrepancy requires immediate notification of the surgeon to obtain a corrected
consent. Altering the form (option A) is not legally acceptable. Proceeding with an incorrect
consent (option C) violates patient rights and institutional policy. Having the patient sign an
incorrect form (option D) constitutes malpractice and places the patient, nurse, and institution at
significant legal risk.
,3
Question 5 A patient scheduled for surgery expresses anxiety and states, "I'm afraid I won't wake
up from the anesthesia." Which nursing response is most therapeutic?
A. "Don't worry, modern anesthesia is very safe and complications are rare"
B. "Tell me more about what specifically concerns you about the anesthesia"
C. "Your surgeon has done this procedure hundreds of times without problems"
D. "You should discuss these concerns with the anesthesiologist, not me"
Correct Answer: B
Rationale: Therapeutic communication requires exploring the patient's specific concerns to
provide targeted information and support. This open-ended response validates the patient's
feelings and allows the nurse to address particular fears. Dismissing concerns (option A) or
deflecting to the surgeon's experience (option C) does not address the patient's anxiety. Referring
the patient elsewhere (option D) misses the opportunity for immediate therapeutic intervention
and may increase anxiety.
Question 6 The nurse is administering preoperative medications. Which medication would the
nurse question if ordered to be given immediately before surgery?
A. Midazolam 2 mg IV
B. Gentamicin 80 mg IV
C. Metoprolol 50 mg PO
D. Aspirin 325 mg PO
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that increases bleeding risk and is typically
discontinued 7-10 days before elective surgery. The nurse should verify this order with the
surgeon. Midazolam (option A) is a common anxiolytic given preoperatively. Gentamicin (option
B) is an antibiotic that may be given within 60 minutes of incision for surgical prophylaxis.
Metoprolol (option C) is often continued perioperatively for cardiac protection in patients with
cardiovascular disease.
Question 7 A patient reports taking the herbal supplement Ginkgo biloba daily. What is the
nurse's priority action?
A. Document the supplement and proceed with routine care
B. Notify the anesthesia provider and surgeon immediately
, 4
C. Instruct the patient to stop taking it immediately
D. Administer vitamin K to counteract potential bleeding effects
Correct Answer: B
Rationale: Ginkgo biloba has antiplatelet effects that increase bleeding risk during surgery and
should be discontinued 2-3 weeks before elective procedures. The nurse must notify both the
anesthesia provider and surgeon to determine if the surgery should be postponed or if additional
bleeding precautions are needed. Documentation alone (option A) is insufficient. The nurse
should not independently instruct discontinuation (option C) or administer medications (option
D) without orders.
Question 8 The nurse is completing the preoperative checklist. Which finding requires
immediate intervention before the patient can be transported to the operating room?
A. The patient reports having a small sip of water 4 hours ago
B. The surgical site is marked with the surgeon's initials
C. The informed consent is signed but not witnessed
D. The patient is wearing a hospital gown and has removed jewelry
Correct Answer: C
Rationale: Informed consent must be properly witnessed to be legally valid. An unwitnessed
consent requires immediate correction—either having the witness sign or obtaining new consent.
A small sip of water 4 hours ago (option A) may be acceptable depending on institutional policy
and anesthesia guidelines (clear liquids are often permitted up to 2 hours before surgery). Site
marking with initials (option B) is appropriate. Proper attire (option D) indicates appropriate
preparation.
Intraoperative Phase (Questions 9-12)
Question 9 During a surgical procedure, the circulating nurse observes that a sterile team
member has contaminated their glove. Which action should the nurse take?
A. Immediately announce the break in sterile technique to the entire team
B. Wait until the procedure is completed to address the contamination
C. Quietly inform the scrub nurse to replace the contaminated glove
D. Document the incident in the operative record after surgery
Correct Answer: C
Rationale: When a break in sterile technique occurs, it should be addressed immediately but
discreetly to maintain the sterile field and minimize disruption. The circulating nurse should
RASMUSSEN COLLEGE MDC 2
EXAM 1 Actual Exam 2026/2027
Complete Questions and Verified Answers
Pass Guaranteed - A+ Graded
SECTION I: PERIOPERATIVE NURSING (Questions 1-20)
Preoperative Phase (Questions 1-8)
Question 1 A 68-year-old patient is scheduled for an elective total knee replacement. During the
preoperative assessment, the nurse notes the patient takes warfarin 5 mg daily for atrial
fibrillation. Which action should the nurse take first?
A. Document the medication and continue with the assessment
B. Notify the surgeon immediately about the anticoagulant use
C. Instruct the patient to stop taking the warfarin immediately
D. Check the patient's INR level and document the result
Correct Answer: B
Rationale: Anticoagulants significantly increase bleeding risk during surgery and typically
require management before elective procedures. While the INR should be checked (option D),
notifying the surgeon immediately is the priority because the surgeon must determine the
appropriate timing for discontinuing warfarin and whether bridging therapy with heparin is
needed. The nurse should never instruct a patient to stop anticoagulants independently (option
C), as this could precipitate thromboembolic events. Documentation alone (option A) does not
address the immediate safety concern.
Question 2 The nurse is providing preoperative teaching to a patient scheduled for abdominal
surgery. Which statement by the patient indicates understanding of deep breathing exercises?
A. "I should take a deep breath, hold it for 5 seconds, then exhale slowly through pursed lips"
B. "I need to breathe rapidly and shallowly to prevent dizziness"
C. "I should only do these exercises when I feel short of breath"
D. "Holding my breath for as long as possible will strengthen my lungs"
,2
Correct Answer: A
Rationale: Proper deep breathing technique involves taking a slow, deep breath through the
nose, holding it for 3-5 seconds to allow alveolar expansion, and exhaling slowly through pursed
lips. This technique maximizes lung expansion, prevents atelectasis, and promotes clearance of
secretions. Rapid shallow breathing (option B) does not adequately expand alveoli. Exercises
should be performed every 1-2 hours while awake, not just when dyspneic (option C). Prolonged
breath-holding (option D) can cause hyperventilation and is not recommended.
Question 3 A patient is scheduled for bowel surgery in the morning. The surgeon has ordered a
bowel prep with polyethylene glycol solution. The nurse should instruct the patient to:
A. Drink the solution quickly to minimize nausea
B. Consume clear liquids only after completing the prep
C. Expect frequent, watery bowel movements to begin within 1-2 hours
D. Take the medication with food to prevent stomach upset
Correct Answer: C
Rationale: Polyethylene glycol (PEG) solutions are osmotic laxatives that work by drawing
water into the intestinal lumen, producing frequent, watery bowel movements typically
beginning within 1-2 hours of ingestion. Patients should drink the solution slowly over the
prescribed time (usually 2-4 hours) to prevent nausea and vomiting (option A). Clear liquids are
usually permitted until 2 hours before surgery (option B varies by protocol). The solution should
be taken on an empty stomach (option D) for optimal effectiveness.
Question 4 During preoperative verification, the nurse discovers that the surgical consent form
lists the wrong procedure. Which action is most appropriate?
A. Have the patient cross out the incorrect procedure and initial the change
B. Contact the surgeon to obtain a new, corrected consent form
C. Proceed with preparation since the patient verbally confirmed the correct procedure
D. Ask the patient to sign the form and document the discrepancy in the chart
Correct Answer: B
Rationale: Surgical consent forms are legal documents that must accurately reflect the planned
procedure. Any discrepancy requires immediate notification of the surgeon to obtain a corrected
consent. Altering the form (option A) is not legally acceptable. Proceeding with an incorrect
consent (option C) violates patient rights and institutional policy. Having the patient sign an
incorrect form (option D) constitutes malpractice and places the patient, nurse, and institution at
significant legal risk.
,3
Question 5 A patient scheduled for surgery expresses anxiety and states, "I'm afraid I won't wake
up from the anesthesia." Which nursing response is most therapeutic?
A. "Don't worry, modern anesthesia is very safe and complications are rare"
B. "Tell me more about what specifically concerns you about the anesthesia"
C. "Your surgeon has done this procedure hundreds of times without problems"
D. "You should discuss these concerns with the anesthesiologist, not me"
Correct Answer: B
Rationale: Therapeutic communication requires exploring the patient's specific concerns to
provide targeted information and support. This open-ended response validates the patient's
feelings and allows the nurse to address particular fears. Dismissing concerns (option A) or
deflecting to the surgeon's experience (option C) does not address the patient's anxiety. Referring
the patient elsewhere (option D) misses the opportunity for immediate therapeutic intervention
and may increase anxiety.
Question 6 The nurse is administering preoperative medications. Which medication would the
nurse question if ordered to be given immediately before surgery?
A. Midazolam 2 mg IV
B. Gentamicin 80 mg IV
C. Metoprolol 50 mg PO
D. Aspirin 325 mg PO
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that increases bleeding risk and is typically
discontinued 7-10 days before elective surgery. The nurse should verify this order with the
surgeon. Midazolam (option A) is a common anxiolytic given preoperatively. Gentamicin (option
B) is an antibiotic that may be given within 60 minutes of incision for surgical prophylaxis.
Metoprolol (option C) is often continued perioperatively for cardiac protection in patients with
cardiovascular disease.
Question 7 A patient reports taking the herbal supplement Ginkgo biloba daily. What is the
nurse's priority action?
A. Document the supplement and proceed with routine care
B. Notify the anesthesia provider and surgeon immediately
, 4
C. Instruct the patient to stop taking it immediately
D. Administer vitamin K to counteract potential bleeding effects
Correct Answer: B
Rationale: Ginkgo biloba has antiplatelet effects that increase bleeding risk during surgery and
should be discontinued 2-3 weeks before elective procedures. The nurse must notify both the
anesthesia provider and surgeon to determine if the surgery should be postponed or if additional
bleeding precautions are needed. Documentation alone (option A) is insufficient. The nurse
should not independently instruct discontinuation (option C) or administer medications (option
D) without orders.
Question 8 The nurse is completing the preoperative checklist. Which finding requires
immediate intervention before the patient can be transported to the operating room?
A. The patient reports having a small sip of water 4 hours ago
B. The surgical site is marked with the surgeon's initials
C. The informed consent is signed but not witnessed
D. The patient is wearing a hospital gown and has removed jewelry
Correct Answer: C
Rationale: Informed consent must be properly witnessed to be legally valid. An unwitnessed
consent requires immediate correction—either having the witness sign or obtaining new consent.
A small sip of water 4 hours ago (option A) may be acceptable depending on institutional policy
and anesthesia guidelines (clear liquids are often permitted up to 2 hours before surgery). Site
marking with initials (option B) is appropriate. Proper attire (option D) indicates appropriate
preparation.
Intraoperative Phase (Questions 9-12)
Question 9 During a surgical procedure, the circulating nurse observes that a sterile team
member has contaminated their glove. Which action should the nurse take?
A. Immediately announce the break in sterile technique to the entire team
B. Wait until the procedure is completed to address the contamination
C. Quietly inform the scrub nurse to replace the contaminated glove
D. Document the incident in the operative record after surgery
Correct Answer: C
Rationale: When a break in sterile technique occurs, it should be addressed immediately but
discreetly to maintain the sterile field and minimize disruption. The circulating nurse should
