NSG 3100 Exam 4 Comprehensive Review
Guide Galen College of Nursing Actual Exam
2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass
Guaranteed – A+ Graded
---
## SECTION 1: PERIOPERATIVE NURSING CARE (Questions 1–13)
**Q1: A patient scheduled for a cholecystectomy tells the nurse, "The surgeon didn't really
explain what could go wrong." Which action by the nurse is most appropriate?**
A. Explain the surgical risks and have the patient sign the consent form.
B. Notify the surgeon that the patient needs clarification before signing the consent.
[CORRECT]
C. Ask the patient to sign the consent form before preoperative medications are given.
D. Document that the patient verbally agreed to proceed with the surgery.
Correct Answer: B
Rationale: The surgeon is legally responsible for explaining the procedure, risks, benefits, and
alternatives; the nurse's role in the preoperative phase is to witness the signature and verify
understanding, so the surgeon must be notified when clarification is needed.
---
**Q2: A patient is scheduled for surgery at 0900. At 0730, the patient tells the nurse he drank a
cup of coffee with cream at 0600. Which action should the nurse take first?**
A. Document the intake and continue with routine preoperative preparation.
B. Encourage the patient to ambulate to promote gastric emptying.
C. Notify the surgeon and anesthesia provider of the oral intake. [CORRECT]
D. Administer the prescribed preoperative medications as scheduled.
Correct Answer: C
Rationale: In the preoperative phase, milk products are treated as solids requiring 6–8 hours of
NPO status; because aspiration risk exists, the surgeon and anesthesia provider must be
notified before the procedure proceeds.
---
,**Q3: Which statement by a preoperative patient indicates correct understanding of incentive
spirometer use?**
A. "I will inhale slowly, hold my breath for 3 to 5 seconds, and then exhale." [CORRECT]
B. "I will blow out forcefully into the mouthpiece as fast as I can."
C. "I will use the device one time each day before going to sleep."
D. "I will take shallow, quick breaths between each use."
Correct Answer: A
Rationale: This matches NSG 3100 Exam 4 content on preoperative teaching: slow, deep
inhalation with a 3–5 second breath-hold promotes alveolar expansion and prevents atelectasis,
with the device used about 10 times per hour while awake.
---
**Q4: After receiving midazolam preoperatively, the patient states he needs to urinate. Which
action should the nurse take?**
A. Assist the patient to walk to the bathroom with a gait belt.
B. Instruct the patient to wait until he arrives in the operating room.
C. Encourage the patient to hold his urine until after surgery.
D. Provide a urinal or bedpan while keeping the side rails raised. [CORRECT]
Correct Answer: D
Rationale: This matches NSG 3100 Exam 4 content: after preoperative sedation, the patient is a
fall risk and must remain on bed rest with an eliminated environment (urinal/bedpan) and safety
measures such as raised side rails.
---
**Q5: A patient arrives in the PACU following an open appendectomy. Which assessment is the
nurse's first priority?**
A. Airway patency and respiratory status. [CORRECT]
B. Pain intensity using a 0-to-10 numeric scale.
C. Amount of drainage on the surgical dressing.
D. Placement of an indwelling urinary catheter.
Correct Answer: A
Rationale: The priority action in postoperative PACU care follows the ABCs: anesthesia
depresses airway reflexes and respirations, so airway and breathing are assessed before pain,
dressing, or elimination needs.
---
, **Q6: During the intraoperative phase, a patient receiving a volatile anesthetic develops
tachycardia, skeletal muscle rigidity, and a rapidly rising end-tidal CO₂. Which action should the
nurse take?**
A. Notify the surgeon that the procedure must be rescheduled.
B. Increase the volatile anesthetic to deepen the anesthesia level.
C. Prepare dantrolene sodium for immediate administration. [CORRECT]
D. Apply a cooling blanket and recheck the temperature in 30 minutes.
Correct Answer: C
Rationale: The pathophysiologic mechanism is malignant hyperthermia, a hypermetabolic crisis
triggered by volatile anesthetics; dantrolene sodium is the antidote and must be administered
immediately along with stopping the agent and cooling measures.
---
**Q7: On the first postoperative day, a patient states, "I don't see why I have to get out of bed so
soon." Which response by the nurse is best?**
A. "The charge nurse expects every patient to ambulate on day one."
B. "Walking helps prevent pneumonia, blood clots, and intestinal problems." [CORRECT]
C. "You will heal faster if you stay in bed and get plenty of rest."
D. "Ambulation is only necessary if you had abdominal surgery."
Correct Answer: B
Rationale: This matches NSG 3100 Exam 4 postoperative content: early ambulation is a key
preventive measure against atelectasis, pneumonia, DVT and pulmonary embolism, and
paralytic ileus.
---
**Q8: Six hours postoperatively, a patient's heart rate has risen from 82 to 118/min and blood
pressure has fallen from 128/78 to 94/58 mmHg. The surgical dressing is saturated with bright
red drainage. Which complication should the nurse suspect?**
A. Paralytic ileus.
B. Pulmonary embolism.
C. Urinary retention.
D. Hypovolemic shock from hemorrhage. [CORRECT]
Correct Answer: D
Rationale: The combination of tachycardia, falling blood pressure, and saturated bright red
drainage indicates postoperative hemorrhage; the nurse should notify the provider immediately
and anticipate IV fluid resuscitation.
---
Guide Galen College of Nursing Actual Exam
2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass
Guaranteed – A+ Graded
---
## SECTION 1: PERIOPERATIVE NURSING CARE (Questions 1–13)
**Q1: A patient scheduled for a cholecystectomy tells the nurse, "The surgeon didn't really
explain what could go wrong." Which action by the nurse is most appropriate?**
A. Explain the surgical risks and have the patient sign the consent form.
B. Notify the surgeon that the patient needs clarification before signing the consent.
[CORRECT]
C. Ask the patient to sign the consent form before preoperative medications are given.
D. Document that the patient verbally agreed to proceed with the surgery.
Correct Answer: B
Rationale: The surgeon is legally responsible for explaining the procedure, risks, benefits, and
alternatives; the nurse's role in the preoperative phase is to witness the signature and verify
understanding, so the surgeon must be notified when clarification is needed.
---
**Q2: A patient is scheduled for surgery at 0900. At 0730, the patient tells the nurse he drank a
cup of coffee with cream at 0600. Which action should the nurse take first?**
A. Document the intake and continue with routine preoperative preparation.
B. Encourage the patient to ambulate to promote gastric emptying.
C. Notify the surgeon and anesthesia provider of the oral intake. [CORRECT]
D. Administer the prescribed preoperative medications as scheduled.
Correct Answer: C
Rationale: In the preoperative phase, milk products are treated as solids requiring 6–8 hours of
NPO status; because aspiration risk exists, the surgeon and anesthesia provider must be
notified before the procedure proceeds.
---
,**Q3: Which statement by a preoperative patient indicates correct understanding of incentive
spirometer use?**
A. "I will inhale slowly, hold my breath for 3 to 5 seconds, and then exhale." [CORRECT]
B. "I will blow out forcefully into the mouthpiece as fast as I can."
C. "I will use the device one time each day before going to sleep."
D. "I will take shallow, quick breaths between each use."
Correct Answer: A
Rationale: This matches NSG 3100 Exam 4 content on preoperative teaching: slow, deep
inhalation with a 3–5 second breath-hold promotes alveolar expansion and prevents atelectasis,
with the device used about 10 times per hour while awake.
---
**Q4: After receiving midazolam preoperatively, the patient states he needs to urinate. Which
action should the nurse take?**
A. Assist the patient to walk to the bathroom with a gait belt.
B. Instruct the patient to wait until he arrives in the operating room.
C. Encourage the patient to hold his urine until after surgery.
D. Provide a urinal or bedpan while keeping the side rails raised. [CORRECT]
Correct Answer: D
Rationale: This matches NSG 3100 Exam 4 content: after preoperative sedation, the patient is a
fall risk and must remain on bed rest with an eliminated environment (urinal/bedpan) and safety
measures such as raised side rails.
---
**Q5: A patient arrives in the PACU following an open appendectomy. Which assessment is the
nurse's first priority?**
A. Airway patency and respiratory status. [CORRECT]
B. Pain intensity using a 0-to-10 numeric scale.
C. Amount of drainage on the surgical dressing.
D. Placement of an indwelling urinary catheter.
Correct Answer: A
Rationale: The priority action in postoperative PACU care follows the ABCs: anesthesia
depresses airway reflexes and respirations, so airway and breathing are assessed before pain,
dressing, or elimination needs.
---
, **Q6: During the intraoperative phase, a patient receiving a volatile anesthetic develops
tachycardia, skeletal muscle rigidity, and a rapidly rising end-tidal CO₂. Which action should the
nurse take?**
A. Notify the surgeon that the procedure must be rescheduled.
B. Increase the volatile anesthetic to deepen the anesthesia level.
C. Prepare dantrolene sodium for immediate administration. [CORRECT]
D. Apply a cooling blanket and recheck the temperature in 30 minutes.
Correct Answer: C
Rationale: The pathophysiologic mechanism is malignant hyperthermia, a hypermetabolic crisis
triggered by volatile anesthetics; dantrolene sodium is the antidote and must be administered
immediately along with stopping the agent and cooling measures.
---
**Q7: On the first postoperative day, a patient states, "I don't see why I have to get out of bed so
soon." Which response by the nurse is best?**
A. "The charge nurse expects every patient to ambulate on day one."
B. "Walking helps prevent pneumonia, blood clots, and intestinal problems." [CORRECT]
C. "You will heal faster if you stay in bed and get plenty of rest."
D. "Ambulation is only necessary if you had abdominal surgery."
Correct Answer: B
Rationale: This matches NSG 3100 Exam 4 postoperative content: early ambulation is a key
preventive measure against atelectasis, pneumonia, DVT and pulmonary embolism, and
paralytic ileus.
---
**Q8: Six hours postoperatively, a patient's heart rate has risen from 82 to 118/min and blood
pressure has fallen from 128/78 to 94/58 mmHg. The surgical dressing is saturated with bright
red drainage. Which complication should the nurse suspect?**
A. Paralytic ileus.
B. Pulmonary embolism.
C. Urinary retention.
D. Hypovolemic shock from hemorrhage. [CORRECT]
Correct Answer: D
Rationale: The combination of tachycardia, falling blood pressure, and saturated bright red
drainage indicates postoperative hemorrhage; the nurse should notify the provider immediately
and anticipate IV fluid resuscitation.
---
