NUR 242 FINAL EXAM QUESTIONS AND
VERIFIED ANSWERS | UPDATED 2026-2027 |
GRADED A+ | NEW VERSION | GALEN
1|Page
,NUR 242 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS | UPDATED 2026-2027 | GRADED A+ |
NEW VERSION | GALEN
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: PERIOPERATIVE NURSING CARE
Questions 1–25
Q1. A nurse is reviewing a preoperative client's laboratory results. Which value should be
reported to the provider before surgery?
A. Hemoglobin 13.5 g/dL
B. Potassium 3.0 mEq/L
C. Platelet count 180,000/mm³
D. Blood glucose 110 mg/dL
Correct Answer: B. Potassium 3.0 mEq/L
Rationale: Hypokalemia increases the risk for cardiac dysrhythmias during anesthesia and
surgery. Normal potassium is 3.5–5.0 mEq/L. A value of 3.0 mEq/L requires correction before an
elective procedure. The other values are within acceptable ranges and do not pose immediate
surgical risks.
Q2. During the immediate postoperative period, a client has a respiratory rate of 8 breaths per
minute and is difficult to arouse. Which action should the nurse take first?
A. Document the findings and reassess in 15 minutes
B. Administer prescribed opioid analgesia
C. Stimulate the client and assess oxygenation
D. Position the client supine and elevate the legs
Correct Answer: C. Stimulate the client and assess oxygenation
Rationale: A respiratory rate of 8 with decreased consciousness suggests respiratory depression,
commonly from anesthesia or opioids. The priority is to stimulate the client and assess airway,
breathing, and oxygenation before other interventions. Documenting without action delays
necessary care.
Q3. A client scheduled for surgery tells the nurse, "I stopped taking my blood thinner last week."
Which response by the nurse is most appropriate?
A. "That was the right decision before surgery."
B. "I need to notify the surgeon about this right away."
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,C. "You should have continued taking it as prescribed."
D. "This will not affect your surgery."
Correct Answer: B. "I need to notify the surgeon about this right away."
Rationale: Anticoagulant use significantly increases surgical bleeding risk. The surgeon must be
notified so the surgical plan can be adjusted or the procedure postponed if necessary. Affirming the
client's action or dismissing the concern is inappropriate.
Q4. A postoperative client reports sudden shortness of breath and chest pain. Which
complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
Correct Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea with chest pain in a postoperative client is characteristic of
pulmonary embolism, especially after orthopedic or abdominal surgery. Atelectasis and pneumonia
typically develop more gradually with fever and productive cough.
Q5. A nurse is caring for a client who received general anesthesia. Which assessment finding
requires immediate intervention?
A. Blood pressure 110/70 mmHg
B. Heart rate 88 beats/min
C. Oxygen saturation 88% on room air
D. Temperature 99.1°F (37.3°C)
Correct Answer: C. Oxygen saturation 88% on room air
Rationale: An oxygen saturation below 90% indicates hypoxemia and requires immediate
intervention, such as supplemental oxygen and further respiratory assessment. The other vital signs
are within acceptable limits.
Q6. A client is being taught to use an incentive spirometer after surgery. Which statement
indicates correct understanding?
A. "I will use it only when I feel short of breath."
B. "I will take slow, deep breaths and hold them."
C. "I will exhale forcefully into the device."
D. "I will use it once daily."
Correct Answer: B. "I will take slow, deep breaths and hold them."
Rationale: Incentive spirometry encourages sustained maximal inspiration to prevent atelectasis.
The client should inhale slowly and deeply, hold the breath briefly, then exhale normally. It should
be used regularly, not just when symptomatic.
Q7. A postoperative client has a Jackson-Pratt drain in place. Which action by the nurse is
correct?
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, A. Irrigate the drain with sterile saline daily
B. Maintain the drain below the level of the wound
C. Clamp the drain during ambulation
D. Empty the drain only when it is completely full
Correct Answer: B. Maintain the drain below the level of the wound
Rationale: Gravity drainage requires the collection device to be below the wound to prevent
fluid backflow and infection. Drains are not routinely irrigated, should not be clamped during
ambulation unless ordered, and are emptied regularly before becoming full.
Q8. A client is 24 hours postoperative following abdominal surgery. Which assessment finding is
most concerning?
A. Incisional pain rated 5/10
B. Serosanguineous drainage on the dressing
C. Temperature of 100.8°F (38.2°C)
D. Absent bowel sounds
Correct Answer: D. Absent bowel sounds
Rationale: Absent bowel sounds 24 hours after abdominal surgery may indicate paralytic ileus, a
common complication requiring intervention. Mild pain and small amounts of serosanguineous
drainage are expected. A low-grade fever may occur postoperatively from inflammation.
Q9. A nurse is preparing a client for surgery. Which action is the priority before administering
preoperative sedation?
A. Verify the informed consent is signed
B. Ensure the client has voided
C. Remove the client's dentures
D. Document the client's weight
Correct Answer: A. Verify the informed consent is signed
Rationale: Informed consent must be verified before administering preoperative sedation, as
sedatives impair the client's ability to make decisions. Consent verification is a critical safety and
legal requirement before proceeding with surgery.
Q10. A client who had spinal anesthesia reports a severe headache when sitting up. Which
intervention should the nurse anticipate?
A. Administer oral analgesics
B. Encourage the client to lie flat
C. Apply ice to the forehead
D. Increase oral fluid intake
Correct Answer: B. Encourage the client to lie flat
Rationale: Post-spinal headache (post-dural puncture headache) is worsened by upright
positioning and relieved by lying flat. Treatment includes bed rest in a flat position, hydration, and
sometimes a blood patch. Analgesics alone are often ineffective.
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VERIFIED ANSWERS | UPDATED 2026-2027 |
GRADED A+ | NEW VERSION | GALEN
1|Page
,NUR 242 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS | UPDATED 2026-2027 | GRADED A+ |
NEW VERSION | GALEN
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: PERIOPERATIVE NURSING CARE
Questions 1–25
Q1. A nurse is reviewing a preoperative client's laboratory results. Which value should be
reported to the provider before surgery?
A. Hemoglobin 13.5 g/dL
B. Potassium 3.0 mEq/L
C. Platelet count 180,000/mm³
D. Blood glucose 110 mg/dL
Correct Answer: B. Potassium 3.0 mEq/L
Rationale: Hypokalemia increases the risk for cardiac dysrhythmias during anesthesia and
surgery. Normal potassium is 3.5–5.0 mEq/L. A value of 3.0 mEq/L requires correction before an
elective procedure. The other values are within acceptable ranges and do not pose immediate
surgical risks.
Q2. During the immediate postoperative period, a client has a respiratory rate of 8 breaths per
minute and is difficult to arouse. Which action should the nurse take first?
A. Document the findings and reassess in 15 minutes
B. Administer prescribed opioid analgesia
C. Stimulate the client and assess oxygenation
D. Position the client supine and elevate the legs
Correct Answer: C. Stimulate the client and assess oxygenation
Rationale: A respiratory rate of 8 with decreased consciousness suggests respiratory depression,
commonly from anesthesia or opioids. The priority is to stimulate the client and assess airway,
breathing, and oxygenation before other interventions. Documenting without action delays
necessary care.
Q3. A client scheduled for surgery tells the nurse, "I stopped taking my blood thinner last week."
Which response by the nurse is most appropriate?
A. "That was the right decision before surgery."
B. "I need to notify the surgeon about this right away."
2|Page
,C. "You should have continued taking it as prescribed."
D. "This will not affect your surgery."
Correct Answer: B. "I need to notify the surgeon about this right away."
Rationale: Anticoagulant use significantly increases surgical bleeding risk. The surgeon must be
notified so the surgical plan can be adjusted or the procedure postponed if necessary. Affirming the
client's action or dismissing the concern is inappropriate.
Q4. A postoperative client reports sudden shortness of breath and chest pain. Which
complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
Correct Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea with chest pain in a postoperative client is characteristic of
pulmonary embolism, especially after orthopedic or abdominal surgery. Atelectasis and pneumonia
typically develop more gradually with fever and productive cough.
Q5. A nurse is caring for a client who received general anesthesia. Which assessment finding
requires immediate intervention?
A. Blood pressure 110/70 mmHg
B. Heart rate 88 beats/min
C. Oxygen saturation 88% on room air
D. Temperature 99.1°F (37.3°C)
Correct Answer: C. Oxygen saturation 88% on room air
Rationale: An oxygen saturation below 90% indicates hypoxemia and requires immediate
intervention, such as supplemental oxygen and further respiratory assessment. The other vital signs
are within acceptable limits.
Q6. A client is being taught to use an incentive spirometer after surgery. Which statement
indicates correct understanding?
A. "I will use it only when I feel short of breath."
B. "I will take slow, deep breaths and hold them."
C. "I will exhale forcefully into the device."
D. "I will use it once daily."
Correct Answer: B. "I will take slow, deep breaths and hold them."
Rationale: Incentive spirometry encourages sustained maximal inspiration to prevent atelectasis.
The client should inhale slowly and deeply, hold the breath briefly, then exhale normally. It should
be used regularly, not just when symptomatic.
Q7. A postoperative client has a Jackson-Pratt drain in place. Which action by the nurse is
correct?
3|Page
, A. Irrigate the drain with sterile saline daily
B. Maintain the drain below the level of the wound
C. Clamp the drain during ambulation
D. Empty the drain only when it is completely full
Correct Answer: B. Maintain the drain below the level of the wound
Rationale: Gravity drainage requires the collection device to be below the wound to prevent
fluid backflow and infection. Drains are not routinely irrigated, should not be clamped during
ambulation unless ordered, and are emptied regularly before becoming full.
Q8. A client is 24 hours postoperative following abdominal surgery. Which assessment finding is
most concerning?
A. Incisional pain rated 5/10
B. Serosanguineous drainage on the dressing
C. Temperature of 100.8°F (38.2°C)
D. Absent bowel sounds
Correct Answer: D. Absent bowel sounds
Rationale: Absent bowel sounds 24 hours after abdominal surgery may indicate paralytic ileus, a
common complication requiring intervention. Mild pain and small amounts of serosanguineous
drainage are expected. A low-grade fever may occur postoperatively from inflammation.
Q9. A nurse is preparing a client for surgery. Which action is the priority before administering
preoperative sedation?
A. Verify the informed consent is signed
B. Ensure the client has voided
C. Remove the client's dentures
D. Document the client's weight
Correct Answer: A. Verify the informed consent is signed
Rationale: Informed consent must be verified before administering preoperative sedation, as
sedatives impair the client's ability to make decisions. Consent verification is a critical safety and
legal requirement before proceeding with surgery.
Q10. A client who had spinal anesthesia reports a severe headache when sitting up. Which
intervention should the nurse anticipate?
A. Administer oral analgesics
B. Encourage the client to lie flat
C. Apply ice to the forehead
D. Increase oral fluid intake
Correct Answer: B. Encourage the client to lie flat
Rationale: Post-spinal headache (post-dural puncture headache) is worsened by upright
positioning and relieved by lying flat. Treatment includes bed rest in a flat position, hydration, and
sometimes a blood patch. Analgesics alone are often ineffective.
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