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MEDICAL-SURGICAL NURSING I COMPREHENSIVE EXAM QUESTIONS
AND CORRECT ANSWERS LATEST EDITION 2026
Medical-Surgical Nursing I Comprehensive Exam — Questions
SECTION 1: FOUNDATIONS, PERIOPERATIVE CARE & MEDICATION ADMINISTRATION
(Questions 1–40)
1. The nurse is preparing to administer a proton pump inhibitor (PPI) through a nasogastric
(NG) tube that is on low intermittent suction. Which action is most important for the nurse to
take to ensure effective absorption?
A. Prepare the medication by thoroughly shaking prior to administration.
B. Flush NG tube with only 10-15 mL of water after all medications have been administered.
C. Position the client in the supine position for 30 minutes to 1 hour after administration.
D. Clamp the NG tube for 30 minutes to 1 hour after medication administration.
Answer: D
Rationale: Clamping the NG tube for 30-60 minutes permits the medication to be absorbed
before suction removes it from the stomach .
2. The nurse is reviewing a hand-written order for phenytoin 500 mg IM q3-4h PRN for pain.
The nurse believes the provider may have meant to write hydromorphone. Which action
should the nurse take next?
A. Administer the medication as written.
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B. Clarify the order with the prescribing provider before administration.
C. Ask the charge nurse to sign off on the change.
D. Administer hydromorphone instead.
Answer: B
Rationale: When a medication order is unclear or potentially incorrect, the nurse must clarify
with the prescriber before administration to prevent a medication error .
3. While giving a client an IM injection of a corticosteroid, the nurse aspirates by pulling back
slightly on the plunger. The rationale behind aspiration is to:
A. Make sure the needle is in a muscle.
B. Reduce the discomfort of the injection.
C. Decrease the force of the injection.
D. Reduce the chance of injecting into a blood vessel.
Answer: D
Rationale: Aspiration helps confirm that the needle is not in a blood vessel by checking for
blood return before injecting .
4. The nurse is giving an IM injection of methylprednisolone. Upon aspiration, the nurse
notices blood return in the syringe. What should the nurse do next?
A. Withdraw the needle, discard it, and start from the beginning.
B. There is no longer a need to aspirate any IM injections.
C. Pull the needle back slightly and inject the medication.
D. Withdraw the needle and select a different injection site.
Answer: D
Rationale: Blood return indicates the needle is in a vessel, so the nurse must withdraw and
select a different injection site to avoid intravascular injection .
5. The nurse is preparing to give an IM antibiotic injection to a 72-year-old client. Which is the
preferred site for the injection?
A. Dorsal gluteal.
B. Vastus lateralis.
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C. Deltoid.
D. Ventrogluteal.
Answer: D
Rationale: The ventrogluteal site is the safest and preferred site in adults, especially older
adults, due to proximity to major nerves and vessels and good muscle mass .
6. A client is 2 hours post-operative following abdominal surgery. Which assessment finding
requires immediate intervention?
A. Heart rate 88 beats per minute.
B. Blood pressure 110/70 mm Hg.
C. Respiratory rate of 10 breaths per minute.
D. Oxygen saturation of 95% on room air.
Answer: C
Rationale: A respiratory rate of 10 is below the normal range (12-20) and may indicate
respiratory depression from anesthesia or opioids .
7. A nurse is providing post-operative care to a client following a hip replacement. Which
intervention is most important to prevent DVT?
A. Apply sequential compression devices (SCDs).
B. Encourage the client to cross legs while sitting.
C. Place pillows under the client's knees.
D. Restrict fluid intake.
Answer: A
Rationale: SCDs promote venous return and prevent DVT. Crossing legs and pillows under knees
impede venous return .
8. A nurse is teaching a preoperative client about postoperative leg exercises. What is the
primary purpose?
A. To strengthen leg muscles.
B. To prevent deep vein thrombosis.
C. To improve balance.
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D. To reduce pain.
Answer: B
Rationale: Leg exercises promote venous return and prevent venous stasis, reducing DVT risk.
9. A client is scheduled for surgery and reports taking aspirin daily. Which action should the
nurse take?
A. Continue aspirin as prescribed.
B. Notify the surgeon because aspirin increases bleeding risk.
C. Administer vitamin K.
D. Increase the dose.
Answer: B
Rationale: Aspirin inhibits platelet aggregation and increases bleeding risk during surgery.
10. A postoperative client is at risk for atelectasis. Which nursing intervention is most effective
in preventing this complication?
A. Administering pain medication.
B. Encouraging incentive spirometry every hour while awake.
C. Maintaining bed rest.
D. Restricting fluid intake.
Answer: B
Rationale: Incentive spirometry promotes lung expansion and prevents alveolar collapse.
11. A client is NPO for surgery and requests water 1 hour before the procedure. What is the
nurse's best response?
A. Provide a small sip of water.
B. Remind the client of NPO status and explain aspiration risk.
C. Call the surgeon for permission.
D. Give the water and document it.
Answer: B
Rationale: NPO status prevents aspiration during anesthesia.
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MEDICAL-SURGICAL NURSING I COMPREHENSIVE EXAM QUESTIONS
AND CORRECT ANSWERS LATEST EDITION 2026
Medical-Surgical Nursing I Comprehensive Exam — Questions
SECTION 1: FOUNDATIONS, PERIOPERATIVE CARE & MEDICATION ADMINISTRATION
(Questions 1–40)
1. The nurse is preparing to administer a proton pump inhibitor (PPI) through a nasogastric
(NG) tube that is on low intermittent suction. Which action is most important for the nurse to
take to ensure effective absorption?
A. Prepare the medication by thoroughly shaking prior to administration.
B. Flush NG tube with only 10-15 mL of water after all medications have been administered.
C. Position the client in the supine position for 30 minutes to 1 hour after administration.
D. Clamp the NG tube for 30 minutes to 1 hour after medication administration.
Answer: D
Rationale: Clamping the NG tube for 30-60 minutes permits the medication to be absorbed
before suction removes it from the stomach .
2. The nurse is reviewing a hand-written order for phenytoin 500 mg IM q3-4h PRN for pain.
The nurse believes the provider may have meant to write hydromorphone. Which action
should the nurse take next?
A. Administer the medication as written.
1|Page
,Page 2 of 85
B. Clarify the order with the prescribing provider before administration.
C. Ask the charge nurse to sign off on the change.
D. Administer hydromorphone instead.
Answer: B
Rationale: When a medication order is unclear or potentially incorrect, the nurse must clarify
with the prescriber before administration to prevent a medication error .
3. While giving a client an IM injection of a corticosteroid, the nurse aspirates by pulling back
slightly on the plunger. The rationale behind aspiration is to:
A. Make sure the needle is in a muscle.
B. Reduce the discomfort of the injection.
C. Decrease the force of the injection.
D. Reduce the chance of injecting into a blood vessel.
Answer: D
Rationale: Aspiration helps confirm that the needle is not in a blood vessel by checking for
blood return before injecting .
4. The nurse is giving an IM injection of methylprednisolone. Upon aspiration, the nurse
notices blood return in the syringe. What should the nurse do next?
A. Withdraw the needle, discard it, and start from the beginning.
B. There is no longer a need to aspirate any IM injections.
C. Pull the needle back slightly and inject the medication.
D. Withdraw the needle and select a different injection site.
Answer: D
Rationale: Blood return indicates the needle is in a vessel, so the nurse must withdraw and
select a different injection site to avoid intravascular injection .
5. The nurse is preparing to give an IM antibiotic injection to a 72-year-old client. Which is the
preferred site for the injection?
A. Dorsal gluteal.
B. Vastus lateralis.
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C. Deltoid.
D. Ventrogluteal.
Answer: D
Rationale: The ventrogluteal site is the safest and preferred site in adults, especially older
adults, due to proximity to major nerves and vessels and good muscle mass .
6. A client is 2 hours post-operative following abdominal surgery. Which assessment finding
requires immediate intervention?
A. Heart rate 88 beats per minute.
B. Blood pressure 110/70 mm Hg.
C. Respiratory rate of 10 breaths per minute.
D. Oxygen saturation of 95% on room air.
Answer: C
Rationale: A respiratory rate of 10 is below the normal range (12-20) and may indicate
respiratory depression from anesthesia or opioids .
7. A nurse is providing post-operative care to a client following a hip replacement. Which
intervention is most important to prevent DVT?
A. Apply sequential compression devices (SCDs).
B. Encourage the client to cross legs while sitting.
C. Place pillows under the client's knees.
D. Restrict fluid intake.
Answer: A
Rationale: SCDs promote venous return and prevent DVT. Crossing legs and pillows under knees
impede venous return .
8. A nurse is teaching a preoperative client about postoperative leg exercises. What is the
primary purpose?
A. To strengthen leg muscles.
B. To prevent deep vein thrombosis.
C. To improve balance.
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D. To reduce pain.
Answer: B
Rationale: Leg exercises promote venous return and prevent venous stasis, reducing DVT risk.
9. A client is scheduled for surgery and reports taking aspirin daily. Which action should the
nurse take?
A. Continue aspirin as prescribed.
B. Notify the surgeon because aspirin increases bleeding risk.
C. Administer vitamin K.
D. Increase the dose.
Answer: B
Rationale: Aspirin inhibits platelet aggregation and increases bleeding risk during surgery.
10. A postoperative client is at risk for atelectasis. Which nursing intervention is most effective
in preventing this complication?
A. Administering pain medication.
B. Encouraging incentive spirometry every hour while awake.
C. Maintaining bed rest.
D. Restricting fluid intake.
Answer: B
Rationale: Incentive spirometry promotes lung expansion and prevents alveolar collapse.
11. A client is NPO for surgery and requests water 1 hour before the procedure. What is the
nurse's best response?
A. Provide a small sip of water.
B. Remind the client of NPO status and explain aspiration risk.
C. Call the surgeon for permission.
D. Give the water and document it.
Answer: B
Rationale: NPO status prevents aspiration during anesthesia.
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