,NUR 201 Exam 1 Medical-Surgical Nursing I Questions And Answers
2026/2027 Jersey College
Q1. Which assessment provides the most reliable information about
the presence and intensity of a patient's pain?
A) Changes in blood pressure and pulse
B) Facial expressions during movement
C) Protective or guarding behavior
D) The patient's description of the pain
Correct Answer: D) The patient's description of the pain
Rationale: Pain is subjective, so the patient's self-report is the most reliable
indicator. Physiologic and behavioral responses can support the assessment
but may be absent or influenced by other factors.
Q2. Uncontrolled acute pain activates the sympathetic nervous
system. Which response is most consistent with this activation?
A) Decreased respiratory rate
B) Increased heart rate and blood pressure
C) Increased gastrointestinal motility
D) Decreased circulating catecholamines
Correct Answer: B) Increased heart rate and blood pressure
Rationale: Sympathetic stimulation releases catecholamines, producing
tachycardia, increased blood pressure, increased respiratory rate, and other
stress responses.
Q3. A patient's family members strongly disagree with one another
about continuing a proposed treatment, and the conflict remains
unresolved after discussion with the healthcare team. Which
resource is most appropriate?
A) Hospital security
B) Risk management solely to determine liability
C) An interdisciplinary ethics consultation
D) The billing department
Correct Answer: C) An interdisciplinary ethics consultation
Rationale: An ethics consultation can help patients, families, and clinicians
examine competing values, patient preferences, ethical principles, and
treatment options when significant ethical conflict persists.
,Q4. Before a scheduled procedure, the patient tells the nurse, “I
signed the form, but I still don't understand what the procedure will
accomplish.” What is the most appropriate nursing action?
A) Explain the technical details of the procedure independently
B) Ask a family member to explain the procedure
C) Notify the provider performing the procedure that additional explanation is
required
D) Administer the prescribed preoperative sedative
Correct Answer: C) Notify the provider performing the procedure that
additional explanation is required
Rationale: The clinician performing the procedure is responsible for
explaining its purpose, risks, benefits, and alternatives. The nurse should
recognize inadequate understanding and facilitate further discussion before
the procedure proceeds.
Q5. An adult with advanced dementia lacks decision-making
capacity and requires a nonemergency surgical procedure. Who
should generally provide authorization when no valid advance
directive specifically addresses the procedure?
A) Any available staff nurse
B) The hospital administrator
C) A close friend selected by the healthcare team
D) The legally authorized surrogate or representative
Correct Answer: D) The legally authorized surrogate or representative
Rationale: When a patient lacks decision-making capacity, healthcare
decisions are generally made by the legally recognized surrogate according
to applicable law and the patient's known preferences or best interests.
Q6. Surgery is performed primarily to decrease severe pain caused
by an unresectable malignant mass rather than to cure the cancer.
How is the purpose of the surgery best classified?
A) Diagnostic
B) Reconstructive
C) Palliative
D) Prophylactic
Correct Answer: C) Palliative
, Rationale: Palliative procedures are intended to relieve symptoms, reduce
suffering, or improve quality of life when elimination of the underlying
disease is not the primary objective.
Q7. Which preoperative history finding requires particular attention
because abrupt cessation may produce a serious withdrawal
syndrome after hospitalization?
A) Seasonal allergic rhinitis
B) Remote appendectomy
C) Corrective eyeglass use
D) Heavy daily alcohol consumption
Correct Answer: D) Heavy daily alcohol consumption
Rationale: Physiologic dependence on alcohol can lead to withdrawal after
abrupt cessation. Severe withdrawal may include autonomic instability,
seizures, hallucinations, and delirium tremens.
Q8. A patient arrives in the postanesthesia care unit immediately
after general anesthesia. Which assessment has the highest initial
priority?
A) Airway patency and adequacy of ventilation
B) Readiness for discharge teaching
C) Long-term nutritional needs
D) Bowel elimination pattern
Correct Answer: A) Airway patency and adequacy of ventilation
Rationale: Airway and breathing take priority immediately after anesthesia
because residual anesthetic effects, airway obstruction, hypoventilation, and
impaired protective reflexes can rapidly cause hypoxemia.
Q9. Which postoperative intervention most directly reduces
complications associated with prolonged immobility?
A) Limiting oral fluid intake
B) Early progressive ambulation when clinically appropriate
C) Maintaining continuous bed rest
D) Keeping both knees flexed while supine
Correct Answer: B) Early progressive ambulation when clinically appropriate
2026/2027 Jersey College
Q1. Which assessment provides the most reliable information about
the presence and intensity of a patient's pain?
A) Changes in blood pressure and pulse
B) Facial expressions during movement
C) Protective or guarding behavior
D) The patient's description of the pain
Correct Answer: D) The patient's description of the pain
Rationale: Pain is subjective, so the patient's self-report is the most reliable
indicator. Physiologic and behavioral responses can support the assessment
but may be absent or influenced by other factors.
Q2. Uncontrolled acute pain activates the sympathetic nervous
system. Which response is most consistent with this activation?
A) Decreased respiratory rate
B) Increased heart rate and blood pressure
C) Increased gastrointestinal motility
D) Decreased circulating catecholamines
Correct Answer: B) Increased heart rate and blood pressure
Rationale: Sympathetic stimulation releases catecholamines, producing
tachycardia, increased blood pressure, increased respiratory rate, and other
stress responses.
Q3. A patient's family members strongly disagree with one another
about continuing a proposed treatment, and the conflict remains
unresolved after discussion with the healthcare team. Which
resource is most appropriate?
A) Hospital security
B) Risk management solely to determine liability
C) An interdisciplinary ethics consultation
D) The billing department
Correct Answer: C) An interdisciplinary ethics consultation
Rationale: An ethics consultation can help patients, families, and clinicians
examine competing values, patient preferences, ethical principles, and
treatment options when significant ethical conflict persists.
,Q4. Before a scheduled procedure, the patient tells the nurse, “I
signed the form, but I still don't understand what the procedure will
accomplish.” What is the most appropriate nursing action?
A) Explain the technical details of the procedure independently
B) Ask a family member to explain the procedure
C) Notify the provider performing the procedure that additional explanation is
required
D) Administer the prescribed preoperative sedative
Correct Answer: C) Notify the provider performing the procedure that
additional explanation is required
Rationale: The clinician performing the procedure is responsible for
explaining its purpose, risks, benefits, and alternatives. The nurse should
recognize inadequate understanding and facilitate further discussion before
the procedure proceeds.
Q5. An adult with advanced dementia lacks decision-making
capacity and requires a nonemergency surgical procedure. Who
should generally provide authorization when no valid advance
directive specifically addresses the procedure?
A) Any available staff nurse
B) The hospital administrator
C) A close friend selected by the healthcare team
D) The legally authorized surrogate or representative
Correct Answer: D) The legally authorized surrogate or representative
Rationale: When a patient lacks decision-making capacity, healthcare
decisions are generally made by the legally recognized surrogate according
to applicable law and the patient's known preferences or best interests.
Q6. Surgery is performed primarily to decrease severe pain caused
by an unresectable malignant mass rather than to cure the cancer.
How is the purpose of the surgery best classified?
A) Diagnostic
B) Reconstructive
C) Palliative
D) Prophylactic
Correct Answer: C) Palliative
, Rationale: Palliative procedures are intended to relieve symptoms, reduce
suffering, or improve quality of life when elimination of the underlying
disease is not the primary objective.
Q7. Which preoperative history finding requires particular attention
because abrupt cessation may produce a serious withdrawal
syndrome after hospitalization?
A) Seasonal allergic rhinitis
B) Remote appendectomy
C) Corrective eyeglass use
D) Heavy daily alcohol consumption
Correct Answer: D) Heavy daily alcohol consumption
Rationale: Physiologic dependence on alcohol can lead to withdrawal after
abrupt cessation. Severe withdrawal may include autonomic instability,
seizures, hallucinations, and delirium tremens.
Q8. A patient arrives in the postanesthesia care unit immediately
after general anesthesia. Which assessment has the highest initial
priority?
A) Airway patency and adequacy of ventilation
B) Readiness for discharge teaching
C) Long-term nutritional needs
D) Bowel elimination pattern
Correct Answer: A) Airway patency and adequacy of ventilation
Rationale: Airway and breathing take priority immediately after anesthesia
because residual anesthetic effects, airway obstruction, hypoventilation, and
impaired protective reflexes can rapidly cause hypoxemia.
Q9. Which postoperative intervention most directly reduces
complications associated with prolonged immobility?
A) Limiting oral fluid intake
B) Early progressive ambulation when clinically appropriate
C) Maintaining continuous bed rest
D) Keeping both knees flexed while supine
Correct Answer: B) Early progressive ambulation when clinically appropriate
