NU 155 EXAM 3 MEDICAL-SURGICAL NURSING I (2026) PDF | GALEN COLLEGE OF NURSING
– COMPREHENSIVE QUESTIONS AND ANSWERS | VERIFIED AND WELLDETAILED ANSWERS
| DETAILED EXPLANATIONS AND RATIONALES | COMPLETE EXAM PREPARATION STUDY
GUIDE | PRACTICE QUESTIONS | LATEST EXAM UPDATE
*
*
* CORE DOMAINS *
*
*
• Perioperative Nursing and Postoperative Care
• Wound, Pressure Injury, and Skin Integrity Management
• Pain Assessment and Pain Management
• Cardiovascular and Peripheral Vascular Disorders
• Gastrointestinal and Hepatobiliary Disorders
• Diabetes Mellitus and Endocrine Nursing Care
• Respiratory Assessment, Oxygenation, and Airway Management
• Infection Prevention, Isolation, and Patient Safety
• Clinical Judgment, Prioritization, and Patient Education
*
*
* INTRODUCTION *
*
*
This comprehensive assessment is designed to reinforce the knowledge and clinical reasoning
expected in Medical-Surgical Nursing I. The questions evaluate foundational concepts,
assessment findings, pathophysiology, nursing interventions, safety, patient education,
pharmacologic considerations, and clinical decision-making. Multiple-choice questions
emphasize both recognition of essential facts and application of those facts to realistic
patient situations. Effective preparation requires understanding why an intervention is
appropriate rather than simply memorizing answers. The assessment therefore includes
varying levels of difficulty and emphasizes prioritization, interpretation of findings,
prevention of complications, and safe, patient-centered nursing care. Publicly available
descriptions of NU 155 identify adult medical-surgical care, pathophysiology, pharmacology,
nutrition, legal/ethical concepts, clinical skills, and systematic problem-solving as important
course components; publicly available Exam 3 study-resource previews also emphasize
postoperative care, wounds, pain, cardiovascular, gastrointestinal, diabetes, and infection-
related concepts.
SECTION ONE: QUESTIONS 1–100
,Question 1.
A nurse assessing a partial-thickness wound observes a moist, beefy-red wound bed. Which
interpretation is most appropriate?
A. The wound demonstrates healthy granulation tissue.
B. The wound is showing evidence of necrotic tissue.
C. The wound is developing an anaerobic infection.
D. The wound has progressed to full-thickness tissue loss.
Correct Answer: A. The wound demonstrates healthy granulation tissue.
Explanation: A moist, beefy-red wound bed is characteristic of healthy granulation tissue
and indicates progression toward healing. Necrotic tissue is generally yellow, brown, gray, or
black rather than healthy red tissue.
Question 2.
Which finding most strongly suggests wound dehiscence?
A. A small amount of serous drainage
B. Separation of previously approximated wound edges
C. Mild incisional tenderness during movement
D. Pink tissue surrounding the incision
Correct Answer: B. Separation of previously approximated wound edges
Explanation: Dehiscence is partial or complete separation of wound edges. It requires
prompt assessment and intervention because further separation can increase the risk of
evisceration and infection.
Question 3.
A postoperative client's abdominal incision suddenly separates and abdominal organs are
visible. Which action should the nurse take first?
A. Attempt to gently push the organs back into the abdomen.
B. Place a dry gauze dressing over the incision.
C. Cover the exposed organs with sterile saline-moistened dressings.
D. Position the client upright to decrease abdominal pressure.
Correct Answer: C. Cover the exposed organs with sterile saline-moistened dressings.
Explanation: Evisceration is a surgical emergency. The exposed organs should be protected
with sterile dressings moistened with normal saline, while the nurse immediately obtains
assistance and notifies the appropriate provider.
Question 4.
,Which patient is at greatest risk for delayed surgical wound healing?
A. A client who walks twice daily
B. A client with adequate protein intake
C. A client with diabetes mellitus and poor glucose control
D. A client who maintains adequate hydration
Correct Answer: C. A client with diabetes mellitus and poor glucose control
Explanation: Hyperglycemia impairs immune function, circulation, and tissue repair,
increasing the risk of infection and delayed wound healing.
Question 5.
A nurse is caring for a client with a heavily exudating stage 3 pressure injury. Which dressing
is most appropriate?
A. Transparent film
B. Alginate dressing
C. Dry cotton gauze only
D. Occlusive adhesive tape directly over the wound
Correct Answer: B. Alginate dressing
Explanation: Alginate dressings are highly absorbent and can help manage moderate-to-
heavy exudate while maintaining an appropriate moist wound environment.
Question 6.
Which finding is most consistent with a stage 1 pressure injury?
A. Full-thickness tissue loss
B. Exposed muscle and tendon
C. Nonblanchable erythema over intact skin
D. A deep crater containing slough
Correct Answer: C. Nonblanchable erythema over intact skin
Explanation: Stage 1 pressure injury involves intact skin with persistent, nonblanchable
discoloration, usually over a pressure point.
Question 7.
Which intervention best reduces shear when repositioning an immobile client?
A. Pulling the client directly across the bed
B. Raising the head of the bed as high as possible
C. Using a lift sheet or mechanical lift when appropriate
D. Massaging reddened areas after repositioning
, Correct Answer: C. Using a lift sheet or mechanical lift when appropriate
Explanation: Shearing occurs when skin remains stationary while underlying tissues move.
Lift devices reduce friction and shearing forces during repositioning.
Question 8.
A wound produces clear, watery drainage. How should the nurse document the drainage?
A. Purulent
B. Serosanguineous
C. Sanguineous
D. Serous
Correct Answer: D. Serous
Explanation: Serous drainage is clear to pale yellow and watery. Sanguineous drainage is
primarily blood, while purulent drainage is thick and commonly associated with infection.
Question 9.
Which wound finding requires the nurse to notify the healthcare provider?
A. Small amount of serous drainage
B. Pink granulation tissue
C. Increasing purulent drainage with foul odor
D. Mild tenderness during dressing changes
Correct Answer: C. Increasing purulent drainage with foul odor
Explanation: Increasing purulent, foul-smelling drainage suggests infection and requires
further assessment and treatment.
Question 10.
When obtaining a wound culture, which technique is most appropriate?
A. Culture pooled drainage from the surface.
B. Collect pus from the old dressing.
C. Cleanse the wound and obtain the specimen according to the prescribed technique.
D. Swab surrounding intact skin.
Correct Answer: C. Cleanse the wound and obtain the specimen according to the
prescribed technique.
Explanation: Surface drainage may contain colonizing organisms and may not represent
organisms in the wound bed. Proper cleansing and specimen collection improve the
usefulness of the culture.
Question 11.
– COMPREHENSIVE QUESTIONS AND ANSWERS | VERIFIED AND WELLDETAILED ANSWERS
| DETAILED EXPLANATIONS AND RATIONALES | COMPLETE EXAM PREPARATION STUDY
GUIDE | PRACTICE QUESTIONS | LATEST EXAM UPDATE
*
*
* CORE DOMAINS *
*
*
• Perioperative Nursing and Postoperative Care
• Wound, Pressure Injury, and Skin Integrity Management
• Pain Assessment and Pain Management
• Cardiovascular and Peripheral Vascular Disorders
• Gastrointestinal and Hepatobiliary Disorders
• Diabetes Mellitus and Endocrine Nursing Care
• Respiratory Assessment, Oxygenation, and Airway Management
• Infection Prevention, Isolation, and Patient Safety
• Clinical Judgment, Prioritization, and Patient Education
*
*
* INTRODUCTION *
*
*
This comprehensive assessment is designed to reinforce the knowledge and clinical reasoning
expected in Medical-Surgical Nursing I. The questions evaluate foundational concepts,
assessment findings, pathophysiology, nursing interventions, safety, patient education,
pharmacologic considerations, and clinical decision-making. Multiple-choice questions
emphasize both recognition of essential facts and application of those facts to realistic
patient situations. Effective preparation requires understanding why an intervention is
appropriate rather than simply memorizing answers. The assessment therefore includes
varying levels of difficulty and emphasizes prioritization, interpretation of findings,
prevention of complications, and safe, patient-centered nursing care. Publicly available
descriptions of NU 155 identify adult medical-surgical care, pathophysiology, pharmacology,
nutrition, legal/ethical concepts, clinical skills, and systematic problem-solving as important
course components; publicly available Exam 3 study-resource previews also emphasize
postoperative care, wounds, pain, cardiovascular, gastrointestinal, diabetes, and infection-
related concepts.
SECTION ONE: QUESTIONS 1–100
,Question 1.
A nurse assessing a partial-thickness wound observes a moist, beefy-red wound bed. Which
interpretation is most appropriate?
A. The wound demonstrates healthy granulation tissue.
B. The wound is showing evidence of necrotic tissue.
C. The wound is developing an anaerobic infection.
D. The wound has progressed to full-thickness tissue loss.
Correct Answer: A. The wound demonstrates healthy granulation tissue.
Explanation: A moist, beefy-red wound bed is characteristic of healthy granulation tissue
and indicates progression toward healing. Necrotic tissue is generally yellow, brown, gray, or
black rather than healthy red tissue.
Question 2.
Which finding most strongly suggests wound dehiscence?
A. A small amount of serous drainage
B. Separation of previously approximated wound edges
C. Mild incisional tenderness during movement
D. Pink tissue surrounding the incision
Correct Answer: B. Separation of previously approximated wound edges
Explanation: Dehiscence is partial or complete separation of wound edges. It requires
prompt assessment and intervention because further separation can increase the risk of
evisceration and infection.
Question 3.
A postoperative client's abdominal incision suddenly separates and abdominal organs are
visible. Which action should the nurse take first?
A. Attempt to gently push the organs back into the abdomen.
B. Place a dry gauze dressing over the incision.
C. Cover the exposed organs with sterile saline-moistened dressings.
D. Position the client upright to decrease abdominal pressure.
Correct Answer: C. Cover the exposed organs with sterile saline-moistened dressings.
Explanation: Evisceration is a surgical emergency. The exposed organs should be protected
with sterile dressings moistened with normal saline, while the nurse immediately obtains
assistance and notifies the appropriate provider.
Question 4.
,Which patient is at greatest risk for delayed surgical wound healing?
A. A client who walks twice daily
B. A client with adequate protein intake
C. A client with diabetes mellitus and poor glucose control
D. A client who maintains adequate hydration
Correct Answer: C. A client with diabetes mellitus and poor glucose control
Explanation: Hyperglycemia impairs immune function, circulation, and tissue repair,
increasing the risk of infection and delayed wound healing.
Question 5.
A nurse is caring for a client with a heavily exudating stage 3 pressure injury. Which dressing
is most appropriate?
A. Transparent film
B. Alginate dressing
C. Dry cotton gauze only
D. Occlusive adhesive tape directly over the wound
Correct Answer: B. Alginate dressing
Explanation: Alginate dressings are highly absorbent and can help manage moderate-to-
heavy exudate while maintaining an appropriate moist wound environment.
Question 6.
Which finding is most consistent with a stage 1 pressure injury?
A. Full-thickness tissue loss
B. Exposed muscle and tendon
C. Nonblanchable erythema over intact skin
D. A deep crater containing slough
Correct Answer: C. Nonblanchable erythema over intact skin
Explanation: Stage 1 pressure injury involves intact skin with persistent, nonblanchable
discoloration, usually over a pressure point.
Question 7.
Which intervention best reduces shear when repositioning an immobile client?
A. Pulling the client directly across the bed
B. Raising the head of the bed as high as possible
C. Using a lift sheet or mechanical lift when appropriate
D. Massaging reddened areas after repositioning
, Correct Answer: C. Using a lift sheet or mechanical lift when appropriate
Explanation: Shearing occurs when skin remains stationary while underlying tissues move.
Lift devices reduce friction and shearing forces during repositioning.
Question 8.
A wound produces clear, watery drainage. How should the nurse document the drainage?
A. Purulent
B. Serosanguineous
C. Sanguineous
D. Serous
Correct Answer: D. Serous
Explanation: Serous drainage is clear to pale yellow and watery. Sanguineous drainage is
primarily blood, while purulent drainage is thick and commonly associated with infection.
Question 9.
Which wound finding requires the nurse to notify the healthcare provider?
A. Small amount of serous drainage
B. Pink granulation tissue
C. Increasing purulent drainage with foul odor
D. Mild tenderness during dressing changes
Correct Answer: C. Increasing purulent drainage with foul odor
Explanation: Increasing purulent, foul-smelling drainage suggests infection and requires
further assessment and treatment.
Question 10.
When obtaining a wound culture, which technique is most appropriate?
A. Culture pooled drainage from the surface.
B. Collect pus from the old dressing.
C. Cleanse the wound and obtain the specimen according to the prescribed technique.
D. Swab surrounding intact skin.
Correct Answer: C. Cleanse the wound and obtain the specimen according to the
prescribed technique.
Explanation: Surface drainage may contain colonizing organisms and may not represent
organisms in the wound bed. Proper cleansing and specimen collection improve the
usefulness of the culture.
Question 11.
