Galen College of Nursing NSG 3250 Adult Health 3 Exam
2 Study Guide: Review Questions and Rationales
(2026/2027)
SECTION 1: Perioperative & Postoperative Care (Questions 1–24)
Question 1
A nurse is performing a preoperative assessment on a client scheduled for
abdominal surgery. Which finding requires the MOST immediate intervention?
A) Client reports taking aspirin 81 mg daily
B) Client reports a history of smoking
C) Client reports an allergy to latex
D) Client reports anxiety about the surgery
Correct Answer: A) Client reports taking aspirin 81 mg daily
Rationale: Aspirin inhibits platelet aggregation and increases the risk of
intraoperative and postoperative bleeding. The healthcare provider must be
notified so aspirin can be discontinued, typically 7–10 days before surgery if safe
to do so. Smoking history and anxiety are important but do not pose an
immediate surgical risk. Latex allergy is significant but is managed through a latex-
free environment, not by delaying surgery.
Question 2
A client is 4 hours postoperative following abdominal surgery. Which assessment
finding requires the nurse to notify the healthcare provider immediately?
A) Blood pressure 110/70 mmHg
B) Heart rate 92 beats per minute
C) Urine output 20 mL over the past 2 hours
D) Temperature 37.2°C (99°F)
Correct Answer: C) Urine output 20 mL over the past 2 hours
Rationale: Urine output less than 30 mL/hour indicates inadequate renal
perfusion and may signal hypovolemia or shock. This requires immediate
,notification. Blood pressure of 110/70, heart rate of 92, and temperature of
37.2°C are within acceptable postoperative parameters.
Question 3 (SATA)
A nurse is teaching a client about postoperative deep vein thrombosis (DVT)
prevention. Which instructions should the nurse include? Select all that apply.
A) Perform ankle pumps every hour while awake
B) Cross your legs when sitting to improve circulation
C) Ambulate as soon as permitted by the provider
D) Drink adequate fluids unless otherwise restricted
E) Massage your calves firmly to prevent clots
Correct Answer: A, C, D
Rationale: Ankle pumps promote venous return, ambulation prevents
venous stasis, and adequate hydration reduces blood viscosity. Crossing the legs
impairs venous return and increases DVT risk. Massaging the calves is
contraindicated because it can dislodge a thrombus and cause pulmonary
embolism.
Question 4
A client who underwent general anesthesia is in the post-anesthesia care unit
(PACU). Which assessment is the PRIORITY?
A) Pain level
B) Airway patency
C) Surgical site dressing
D) Urinary output
Correct Answer: B) Airway patency
Rationale: Airway management is always the first priority in the
immediate postoperative period. General anesthesia can cause respiratory
depression, laryngospasm, and airway obstruction. Pain, dressing, and urinary
output are assessed after airway, breathing, and circulation are stabilized.
,Question 5
A nurse is caring for a postoperative client who had a colon resection 12 hours
ago. The nurse notes the client has a heart rate of 118 bpm and a blood pressure
of 92/58 mmHg. The client's baseline blood pressure was 128/76 mmHg. Which
action should the nurse take FIRST?
A) Administer prescribed pain medication
B) Increase the IV fluid rate per protocol
C) Assess the surgical incision for bleeding
D) Document the findings and reassess in 1 hour
Correct Answer: C) Assess the surgical incision for bleeding
Rationale: Tachycardia with hypotension suggests hypovolemia, possibly
from postoperative hemorrhage. The nurse should first assess the surgical site for
bleeding or drainage before implementing other interventions. Increasing IV fluids
may be appropriate but requires verification of the cause. Pain medication and
documentation are not the priority when signs of shock are present.
Question 6
A client is scheduled for surgery and asks the nurse why they must remain NPO
after midnight. Which response by the nurse is BEST?
A) "It prevents you from choking during anesthesia."
B) "It keeps your stomach empty to reduce the risk of aspiration."
C) "It helps the surgeon see your organs better."
D) "It prevents nausea after surgery."
Correct Answer: B) "It keeps your stomach empty to reduce the risk of
aspiration."
Rationale: NPO status reduces the risk of aspiration during induction of
anesthesia when protective airway reflexes are suppressed. While nausea
prevention and surgical visualization are beneficial, the primary rationale is
aspiration prevention.
, Question 7 (SATA)
A nurse is assessing a client on postoperative day 2 following major abdominal
surgery. Which findings indicate possible wound infection? Select all that apply.
A) Temperature 38.6°C (101.5°F)
B) Incisional pain rated 4/10
C) Purulent drainage from the incision
D) Incision edges approximated
E) WBC count 14,500/mm³
Correct Answer: A, C, E
Rationale: Fever, purulent drainage, and elevated WBC count are classic
signs of infection. Incisional pain is expected postoperatively. Approximated
incision edges indicate normal healing.
Question 8
A nurse is preparing a client for surgery. Which laboratory value should the nurse
report to the surgeon immediately?
A) Hemoglobin 13.2 g/dL
B) Platelet count 48,000/mm³
C) Serum potassium 4.2 mEq/L
D) Blood glucose 142 mg/dL
Correct Answer: B) Platelet count 48,000/mm³
Rationale: A platelet count below 50,000/mm³ significantly increases the
risk of intraoperative and postoperative hemorrhage. Surgery may need to be
postponed or platelets transfused. Hemoglobin of 13.2 g/dL, potassium of 4.2
mEq/L, and glucose of 142 mg/dL are acceptable for surgery, though glucose may
require management.
Question 9
A client is postoperative day 1 following total hip arthroplasty. Which intervention
is MOST important to prevent dislocation of the new hip?
2 Study Guide: Review Questions and Rationales
(2026/2027)
SECTION 1: Perioperative & Postoperative Care (Questions 1–24)
Question 1
A nurse is performing a preoperative assessment on a client scheduled for
abdominal surgery. Which finding requires the MOST immediate intervention?
A) Client reports taking aspirin 81 mg daily
B) Client reports a history of smoking
C) Client reports an allergy to latex
D) Client reports anxiety about the surgery
Correct Answer: A) Client reports taking aspirin 81 mg daily
Rationale: Aspirin inhibits platelet aggregation and increases the risk of
intraoperative and postoperative bleeding. The healthcare provider must be
notified so aspirin can be discontinued, typically 7–10 days before surgery if safe
to do so. Smoking history and anxiety are important but do not pose an
immediate surgical risk. Latex allergy is significant but is managed through a latex-
free environment, not by delaying surgery.
Question 2
A client is 4 hours postoperative following abdominal surgery. Which assessment
finding requires the nurse to notify the healthcare provider immediately?
A) Blood pressure 110/70 mmHg
B) Heart rate 92 beats per minute
C) Urine output 20 mL over the past 2 hours
D) Temperature 37.2°C (99°F)
Correct Answer: C) Urine output 20 mL over the past 2 hours
Rationale: Urine output less than 30 mL/hour indicates inadequate renal
perfusion and may signal hypovolemia or shock. This requires immediate
,notification. Blood pressure of 110/70, heart rate of 92, and temperature of
37.2°C are within acceptable postoperative parameters.
Question 3 (SATA)
A nurse is teaching a client about postoperative deep vein thrombosis (DVT)
prevention. Which instructions should the nurse include? Select all that apply.
A) Perform ankle pumps every hour while awake
B) Cross your legs when sitting to improve circulation
C) Ambulate as soon as permitted by the provider
D) Drink adequate fluids unless otherwise restricted
E) Massage your calves firmly to prevent clots
Correct Answer: A, C, D
Rationale: Ankle pumps promote venous return, ambulation prevents
venous stasis, and adequate hydration reduces blood viscosity. Crossing the legs
impairs venous return and increases DVT risk. Massaging the calves is
contraindicated because it can dislodge a thrombus and cause pulmonary
embolism.
Question 4
A client who underwent general anesthesia is in the post-anesthesia care unit
(PACU). Which assessment is the PRIORITY?
A) Pain level
B) Airway patency
C) Surgical site dressing
D) Urinary output
Correct Answer: B) Airway patency
Rationale: Airway management is always the first priority in the
immediate postoperative period. General anesthesia can cause respiratory
depression, laryngospasm, and airway obstruction. Pain, dressing, and urinary
output are assessed after airway, breathing, and circulation are stabilized.
,Question 5
A nurse is caring for a postoperative client who had a colon resection 12 hours
ago. The nurse notes the client has a heart rate of 118 bpm and a blood pressure
of 92/58 mmHg. The client's baseline blood pressure was 128/76 mmHg. Which
action should the nurse take FIRST?
A) Administer prescribed pain medication
B) Increase the IV fluid rate per protocol
C) Assess the surgical incision for bleeding
D) Document the findings and reassess in 1 hour
Correct Answer: C) Assess the surgical incision for bleeding
Rationale: Tachycardia with hypotension suggests hypovolemia, possibly
from postoperative hemorrhage. The nurse should first assess the surgical site for
bleeding or drainage before implementing other interventions. Increasing IV fluids
may be appropriate but requires verification of the cause. Pain medication and
documentation are not the priority when signs of shock are present.
Question 6
A client is scheduled for surgery and asks the nurse why they must remain NPO
after midnight. Which response by the nurse is BEST?
A) "It prevents you from choking during anesthesia."
B) "It keeps your stomach empty to reduce the risk of aspiration."
C) "It helps the surgeon see your organs better."
D) "It prevents nausea after surgery."
Correct Answer: B) "It keeps your stomach empty to reduce the risk of
aspiration."
Rationale: NPO status reduces the risk of aspiration during induction of
anesthesia when protective airway reflexes are suppressed. While nausea
prevention and surgical visualization are beneficial, the primary rationale is
aspiration prevention.
, Question 7 (SATA)
A nurse is assessing a client on postoperative day 2 following major abdominal
surgery. Which findings indicate possible wound infection? Select all that apply.
A) Temperature 38.6°C (101.5°F)
B) Incisional pain rated 4/10
C) Purulent drainage from the incision
D) Incision edges approximated
E) WBC count 14,500/mm³
Correct Answer: A, C, E
Rationale: Fever, purulent drainage, and elevated WBC count are classic
signs of infection. Incisional pain is expected postoperatively. Approximated
incision edges indicate normal healing.
Question 8
A nurse is preparing a client for surgery. Which laboratory value should the nurse
report to the surgeon immediately?
A) Hemoglobin 13.2 g/dL
B) Platelet count 48,000/mm³
C) Serum potassium 4.2 mEq/L
D) Blood glucose 142 mg/dL
Correct Answer: B) Platelet count 48,000/mm³
Rationale: A platelet count below 50,000/mm³ significantly increases the
risk of intraoperative and postoperative hemorrhage. Surgery may need to be
postponed or platelets transfused. Hemoglobin of 13.2 g/dL, potassium of 4.2
mEq/L, and glucose of 142 mg/dL are acceptable for surgery, though glucose may
require management.
Question 9
A client is postoperative day 1 following total hip arthroplasty. Which intervention
is MOST important to prevent dislocation of the new hip?
