MED SURG EXAM 1 REVIEW (LATEST 2026/2027
UPDATE) | COMPLETE Q&A WITH VERIFIED
ANSWERS AND DETAILED RATIONALES |
PERIOPERATIVE CARE, FLUID & ELECTROLYTES | A+
GRADED]
MED SURG EXAM 1 REVIEW (LATEST 2026/2027 UPDATE)
COMPLETE Q&A WITH VERIFIED ANSWERS AND DETAILED RATIONALES |
PERIOPERATIVE CARE, FLUID & ELECTROLYTES | A+ GRADED
SECTION 1: PERIOPERATIVE CARE
Question 1: The nurse is performing a preoperative assessment. Which patient
statement requires immediate follow-up?
A. "I took my blood pressure medication this morning."
B. "I had a cup of coffee about 4 hours ago."
C. "I take a garlic supplement every day."
D. "I have a history of seasonal allergies."
Answer: C. "I take a garlic supplement every day."
Rationale: Garlic supplements have anticoagulant properties and can increase the
risk of bleeding during surgery. Many herbal supplements, including garlic, ginkgo,
and ginseng, should be discontinued 7-14 days before surgery due to their effects
on platelet function and bleeding risk .
,Question 2: Which assessment finding is the priority in the immediate
postoperative period?
A. Patient reports pain level of 6 on a 0-10 scale
B. Patient's oxygen saturation is 89% on room air
C. Patient has a small amount of serosanguineous drainage on the dressing
D. Patient's temperature is 99.2°F (37.3°C)
Answer: B. Patient's oxygen saturation is 89% on room air
Rationale: Airway and oxygenation are the first priorities in postoperative care. An
SpO2 of 89% indicates hypoxemia and requires immediate intervention, such as
supplemental oxygen and assessment of respiratory status. This follows the ABC
(Airway, Breathing, Circulation) priority framework .
Question 3: A patient returns from surgery with a patient-controlled analgesia
(PCA) pump. What is the primary nursing responsibility regarding PCA
management?
A. Administer PCA boluses as needed for breakthrough pain
B. Assess the patient's pain level and sedation status regularly
C. Change the PCA settings based on the patient's vital signs
D. Provide the PCA button to the patient's family for administration
Answer: B. Assess the patient's pain level and sedation status regularly
Rationale: PCA allows patients to self-administer analgesic doses within preset
limits. The nurse's primary responsibility is ongoing assessment of pain relief
effectiveness and monitoring for adverse effects, particularly respiratory
depression and oversedation. Only the patient should press the PCA button .
Question 4: The nurse is assessing a patient 2 hours after total hip arthroplasty.
Which finding suggests malignant hyperthermia?
, A. Blood pressure 110/70 mmHg, heart rate 88 bpm
B. Temperature 103°F (39.4°C) with muscle rigidity
C. Respiratory rate 16 breaths/min, SpO2 96%
D. Urine output 40 mL/hour
Answer: B. Temperature 103°F (39.4°C) with muscle rigidity
Rationale: Malignant hyperthermia is a life-threatening complication of
anesthesia characterized by hyperthermia, muscle rigidity, tachycardia, tachypnea,
and metabolic acidosis. The classic presentation includes rapid temperature
elevation and muscle rigidity. Treatment involves dantrolene sodium .
Question 5: A patient is 12 hours postoperative and has not voided. The nurse
palpates a distended bladder. What is the priority nursing intervention?
A. Encourage oral fluid intake
B. Insert a urinary catheter
C. Perform a bladder scan
D. Apply warm compresses to the lower abdomen
Answer: C. Perform a bladder scan
Rationale: Urinary retention is a common postoperative complication. The first
step is to use a bladder scanner to assess the volume of urine in the bladder
before considering catheterization. This noninvasive assessment guides
appropriate intervention .
Question 6: Which of the following is a high-risk finding in the preoperative
assessment for a patient scheduled for surgery?
A. History of smoking, quit 5 years ago
B. BMI 27
C. History of obstructive sleep apnea
D. Regular exercise 3 times weekly
UPDATE) | COMPLETE Q&A WITH VERIFIED
ANSWERS AND DETAILED RATIONALES |
PERIOPERATIVE CARE, FLUID & ELECTROLYTES | A+
GRADED]
MED SURG EXAM 1 REVIEW (LATEST 2026/2027 UPDATE)
COMPLETE Q&A WITH VERIFIED ANSWERS AND DETAILED RATIONALES |
PERIOPERATIVE CARE, FLUID & ELECTROLYTES | A+ GRADED
SECTION 1: PERIOPERATIVE CARE
Question 1: The nurse is performing a preoperative assessment. Which patient
statement requires immediate follow-up?
A. "I took my blood pressure medication this morning."
B. "I had a cup of coffee about 4 hours ago."
C. "I take a garlic supplement every day."
D. "I have a history of seasonal allergies."
Answer: C. "I take a garlic supplement every day."
Rationale: Garlic supplements have anticoagulant properties and can increase the
risk of bleeding during surgery. Many herbal supplements, including garlic, ginkgo,
and ginseng, should be discontinued 7-14 days before surgery due to their effects
on platelet function and bleeding risk .
,Question 2: Which assessment finding is the priority in the immediate
postoperative period?
A. Patient reports pain level of 6 on a 0-10 scale
B. Patient's oxygen saturation is 89% on room air
C. Patient has a small amount of serosanguineous drainage on the dressing
D. Patient's temperature is 99.2°F (37.3°C)
Answer: B. Patient's oxygen saturation is 89% on room air
Rationale: Airway and oxygenation are the first priorities in postoperative care. An
SpO2 of 89% indicates hypoxemia and requires immediate intervention, such as
supplemental oxygen and assessment of respiratory status. This follows the ABC
(Airway, Breathing, Circulation) priority framework .
Question 3: A patient returns from surgery with a patient-controlled analgesia
(PCA) pump. What is the primary nursing responsibility regarding PCA
management?
A. Administer PCA boluses as needed for breakthrough pain
B. Assess the patient's pain level and sedation status regularly
C. Change the PCA settings based on the patient's vital signs
D. Provide the PCA button to the patient's family for administration
Answer: B. Assess the patient's pain level and sedation status regularly
Rationale: PCA allows patients to self-administer analgesic doses within preset
limits. The nurse's primary responsibility is ongoing assessment of pain relief
effectiveness and monitoring for adverse effects, particularly respiratory
depression and oversedation. Only the patient should press the PCA button .
Question 4: The nurse is assessing a patient 2 hours after total hip arthroplasty.
Which finding suggests malignant hyperthermia?
, A. Blood pressure 110/70 mmHg, heart rate 88 bpm
B. Temperature 103°F (39.4°C) with muscle rigidity
C. Respiratory rate 16 breaths/min, SpO2 96%
D. Urine output 40 mL/hour
Answer: B. Temperature 103°F (39.4°C) with muscle rigidity
Rationale: Malignant hyperthermia is a life-threatening complication of
anesthesia characterized by hyperthermia, muscle rigidity, tachycardia, tachypnea,
and metabolic acidosis. The classic presentation includes rapid temperature
elevation and muscle rigidity. Treatment involves dantrolene sodium .
Question 5: A patient is 12 hours postoperative and has not voided. The nurse
palpates a distended bladder. What is the priority nursing intervention?
A. Encourage oral fluid intake
B. Insert a urinary catheter
C. Perform a bladder scan
D. Apply warm compresses to the lower abdomen
Answer: C. Perform a bladder scan
Rationale: Urinary retention is a common postoperative complication. The first
step is to use a bladder scanner to assess the volume of urine in the bladder
before considering catheterization. This noninvasive assessment guides
appropriate intervention .
Question 6: Which of the following is a high-risk finding in the preoperative
assessment for a patient scheduled for surgery?
A. History of smoking, quit 5 years ago
B. BMI 27
C. History of obstructive sleep apnea
D. Regular exercise 3 times weekly
