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NUR 242 EXAM 3: MEDICAL-SURGICAL NURSING 2026 QUESTIONS
LATEST EDITION 2026 – 2027 VERSION SOLVED QUESTIONS &
ANSWERS
Summarized 10-Point Exam Coverage
Based on the NUR 242 course outline and exam guides, Exam 3 covers the following ten
core domains:
Perioperative and Postoperative Care: Preoperative assessment, surgical
complications, wound care, and postoperative monitoring.
Cardiovascular Disorders: Heart failure, hypertension, coronary artery disease,
dysrhythmias, and vascular disorders.
Respiratory Disorders: COPD, asthma, pneumonia, pulmonary embolism, and ARDS.
Gastrointestinal Disorders: Liver disease, pancreatitis, bowel obstruction, and GI
bleeding.
Renal and Genitourinary Disorders: Acute kidney injury, chronic kidney disease,
urinary tract infections, and dialysis.
Endocrine and Metabolic Disorders: Diabetes, thyroid disorders, adrenal disorders,
and DKA.
Neurological and Sensory Disorders: Stroke, seizures, meningitis, and sensory
impairments.
Musculoskeletal and Integumentary Disorders: Fractures, joint replacement, burns,
and wound care.
Oncology and Hematology: Leukemia, neutropenia, multiple myeloma, and blood
transfusions.
Comprehensive Review and Mixed Topics: Fluid and electrolytes, pharmacology,
patient education, and clinical judgment.
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Section 1: Perioperative and Postoperative Care (Questions 1–30)
1. A 68-year-old patient is admitted to the medical-surgical unit following a total knee
arthroplasty. Which assessment finding requires immediate intervention by the nurse?
A. Pain rating of 6/10 at the surgical site
B. Temperature of 99.2°F (37.3°C)
C. Oxygen saturation of 88% on room air
D. Heart rate of 88 beats per minute
Correct Answer: C
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention, such as administering supplemental oxygen and assessing respiratory
status. Pain, mild fever, and tachycardia are common postoperative findings that should
be monitored but do not require immediate intervention.
2. A postoperative patient reports sudden chest pain and shortness of breath. The nurse
suspects a pulmonary embolism. Which action should the nurse take first?
A. Administer oxygen
B. Notify the healthcare provider
C. Assess the client's vital signs
D. Elevate the head of the bed
Correct Answer: A
Rationale: Airway and breathing are the priority. Administering oxygen is the first action
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to address hypoxia. After stabilizing the airway and breathing, the nurse should notify
the provider and assess vital signs.
3. The nurse is preparing to administer an intramuscular injection using the Z-track
technique. Which action is correct when performing this procedure?
A. Use a 1-inch needle for the injection
B. Pull the skin laterally before injection
C. Massage the site after injection
D. Use a 90-degree angle only for the deltoid site
Correct Answer: B
Rationale: The Z-track technique involves pulling the skin laterally before injection to
seal the medication in the muscle and prevent leakage. The needle should be 1.5 inches
for most IM injections, and the site should not be massaged.
4. A patient is 24 hours postoperative following a bowel resection. The nurse notes
absent bowel sounds and abdominal distension. What is the priority nursing action?
A. Encourage oral intake of clear liquids
B. Notify the healthcare provider
C. Administer a laxative as prescribed
D. Increase the IV fluid rate
Correct Answer: B
Rationale: Absent bowel sounds and abdominal distension postoperatively may
indicate an ileus or obstruction. The healthcare provider should be notified for further
evaluation. Oral intake should be restricted until bowel function returns.
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5. A patient is scheduled for surgery and tells the nurse, "I am terrified I will not wake up
from the anesthesia." Which nursing response is most appropriate?
A. "There is nothing to worry about; this surgery is very safe."
B. "Tell me more about what you are feeling right now."
C. "You should discuss this with your surgeon, not me."
D. "Everyone feels that way before surgery."
Correct Answer: B
Rationale: Using an open-ended statement encourages the patient to express feelings
and allows the nurse to assess the patient's anxiety level and provide appropriate
emotional support and education.
6. A patient develops a fever of 102.4°F (39.1°C) on postoperative day 2 following
abdominal surgery. Which assessment finding is most concerning to the nurse?
A. The surgical incision is approximated and dry
B. The patient reports incisional pain at 5/10
C. The surgical wound is warm, red, and has purulent drainage
D. The patient has not had a bowel movement since surgery
Correct Answer: C
Rationale: A wound that is warm, red, and draining purulent material suggests a
surgical site infection, which requires immediate attention and possible wound culture
and antibiotic therapy.
7. A patient is being prepared for surgery and has a preoperative potassium level of 2.9
mEq/L. What is the most appropriate nursing action?
A. Proceed with surgery preparation as scheduled
NUR 242 EXAM 3: MEDICAL-SURGICAL NURSING 2026 QUESTIONS
LATEST EDITION 2026 – 2027 VERSION SOLVED QUESTIONS &
ANSWERS
Summarized 10-Point Exam Coverage
Based on the NUR 242 course outline and exam guides, Exam 3 covers the following ten
core domains:
Perioperative and Postoperative Care: Preoperative assessment, surgical
complications, wound care, and postoperative monitoring.
Cardiovascular Disorders: Heart failure, hypertension, coronary artery disease,
dysrhythmias, and vascular disorders.
Respiratory Disorders: COPD, asthma, pneumonia, pulmonary embolism, and ARDS.
Gastrointestinal Disorders: Liver disease, pancreatitis, bowel obstruction, and GI
bleeding.
Renal and Genitourinary Disorders: Acute kidney injury, chronic kidney disease,
urinary tract infections, and dialysis.
Endocrine and Metabolic Disorders: Diabetes, thyroid disorders, adrenal disorders,
and DKA.
Neurological and Sensory Disorders: Stroke, seizures, meningitis, and sensory
impairments.
Musculoskeletal and Integumentary Disorders: Fractures, joint replacement, burns,
and wound care.
Oncology and Hematology: Leukemia, neutropenia, multiple myeloma, and blood
transfusions.
Comprehensive Review and Mixed Topics: Fluid and electrolytes, pharmacology,
patient education, and clinical judgment.
, Page 2 of 133
Section 1: Perioperative and Postoperative Care (Questions 1–30)
1. A 68-year-old patient is admitted to the medical-surgical unit following a total knee
arthroplasty. Which assessment finding requires immediate intervention by the nurse?
A. Pain rating of 6/10 at the surgical site
B. Temperature of 99.2°F (37.3°C)
C. Oxygen saturation of 88% on room air
D. Heart rate of 88 beats per minute
Correct Answer: C
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention, such as administering supplemental oxygen and assessing respiratory
status. Pain, mild fever, and tachycardia are common postoperative findings that should
be monitored but do not require immediate intervention.
2. A postoperative patient reports sudden chest pain and shortness of breath. The nurse
suspects a pulmonary embolism. Which action should the nurse take first?
A. Administer oxygen
B. Notify the healthcare provider
C. Assess the client's vital signs
D. Elevate the head of the bed
Correct Answer: A
Rationale: Airway and breathing are the priority. Administering oxygen is the first action
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to address hypoxia. After stabilizing the airway and breathing, the nurse should notify
the provider and assess vital signs.
3. The nurse is preparing to administer an intramuscular injection using the Z-track
technique. Which action is correct when performing this procedure?
A. Use a 1-inch needle for the injection
B. Pull the skin laterally before injection
C. Massage the site after injection
D. Use a 90-degree angle only for the deltoid site
Correct Answer: B
Rationale: The Z-track technique involves pulling the skin laterally before injection to
seal the medication in the muscle and prevent leakage. The needle should be 1.5 inches
for most IM injections, and the site should not be massaged.
4. A patient is 24 hours postoperative following a bowel resection. The nurse notes
absent bowel sounds and abdominal distension. What is the priority nursing action?
A. Encourage oral intake of clear liquids
B. Notify the healthcare provider
C. Administer a laxative as prescribed
D. Increase the IV fluid rate
Correct Answer: B
Rationale: Absent bowel sounds and abdominal distension postoperatively may
indicate an ileus or obstruction. The healthcare provider should be notified for further
evaluation. Oral intake should be restricted until bowel function returns.
, Page 4 of 133
5. A patient is scheduled for surgery and tells the nurse, "I am terrified I will not wake up
from the anesthesia." Which nursing response is most appropriate?
A. "There is nothing to worry about; this surgery is very safe."
B. "Tell me more about what you are feeling right now."
C. "You should discuss this with your surgeon, not me."
D. "Everyone feels that way before surgery."
Correct Answer: B
Rationale: Using an open-ended statement encourages the patient to express feelings
and allows the nurse to assess the patient's anxiety level and provide appropriate
emotional support and education.
6. A patient develops a fever of 102.4°F (39.1°C) on postoperative day 2 following
abdominal surgery. Which assessment finding is most concerning to the nurse?
A. The surgical incision is approximated and dry
B. The patient reports incisional pain at 5/10
C. The surgical wound is warm, red, and has purulent drainage
D. The patient has not had a bowel movement since surgery
Correct Answer: C
Rationale: A wound that is warm, red, and draining purulent material suggests a
surgical site infection, which requires immediate attention and possible wound culture
and antibiotic therapy.
7. A patient is being prepared for surgery and has a preoperative potassium level of 2.9
mEq/L. What is the most appropriate nursing action?
A. Proceed with surgery preparation as scheduled
