Jersey Med Surg 1 Study Guide Exam
with Actual Answers 2025/2026
Update.
1. A patient is being admitted to the hospital on the day before a scheduled surgery. What is the
most appropriate initial question for the nurse to ask this preoperative patient?
a) "What did your surgeon say to you about the type of surgery you are having?"
b) "What questions do you have about your surgery?"
c) "What type of surgery are you having and why are you having it done?"
d) "What do you know about what will be done to you?" - Answer c) "What type of surgery
are you having and why are you having it done?"
2. A benzodiazepine has been administered to a patient preoperatively. After the drug has been
administered, the nurse plans to monitor the patient for which side effects? Select all that apply.
a) Anxiety
b) Hypotension
c) Hypocalcemia
d) Level of Consciousness
e) Sedation - Answer a) Anxiety
d) Level of Consciousness
e) Sedation
3. A preoperative patient has an elevated hemoglobin and hematocrit. What would the nurse
suspect regarding the significance of this increased value?
a) Immune deficiency
b) Kidney dysfunction
c) Malignancy
d) Dehydration - Answer d) Dehydration
4. Which activities should the nurse carry out in the preoperative period for a client scheduled
for surgery? Select all that apply.
a) Identify potential or actual health problems.
b) Verify the presence of a signed consent form.
c) Assess patient's response to interventions.
d) Intervene to prevent complications.
,e) Assess effectiveness of teaching related to postoperative recovery. - Answer a) Identify
potential or actual health problems.
b) Verify the presence of a signed consent form.
e) Assess effectiveness of teaching related to postoperative recovery.
5. A patient having surgery has a degree of risk associated with the surgery. The nurse would
evaluate which patient-related factors as contributing to a high degree of risk associated with
surgery? Select all that apply.
a) Type of institution where surgery is performed
b) Involvement of vital organs
c) Average nutritional status
d) Low likelihood of procedure complications
e) A history of respiratory disease and diabetes - Answer b) Involvement of vital organs
e) A history of respiratory disease and diabetes
6. A patient has just entered the postanesthesia care unit (PACU) from surgery. For which
priority needs should the nurse immediately assess the postoperative patient?
a) Vital signs, level of consciousness, presence of pain
b) Skin coloring, surgical incision, limb movements
c) Skin temperature, blood pressure, mental status
d) Temperature, emotional status, wound drainage - Answer a) Vital signs, level of
consciousness, presence of pain
7. The nurse in the postanesthesia care unit (PACU) is assessing a postoperative patient. Which
indicators suggest to the nurse an alteration in tissue perfusion? Select all that apply.
a) Pallor or cyanosis
b) Difficulty with mobility
c) Pain in the incision area
d) Fluid loss
e) Decreased urinary output - Answer a) Pallor or cyanosis
d) Fluid loss
e) Decreased urinary output
8. After surgery, the nurse encourages the patient to move from side to side at least every 2
hours. The patient questions this activity. How does the nurse explain the purpose of this
intervention?
a) Assist peristalsis to return more quickly
,b) Lessen muscle weakness
c) Increase patient's ability to sleep
d) Let the lungs alternatively achieve maximum expansion - Answer d) Let the lungs
alternatively achieve maximum expansion
9. The nurse is creating a plan of care for a postoperative patient. The nursing diagnosis in acute
pain. What would be appropriate outcomes for this patient? Select all that apply.
a) Balanced fluid intake and output
b) Seeks help as needed
c) Absence of nonverbal signs of pain
d) Performs leg exercises as instructed
e) Verbally rates pain as 3 on a 1 to 10 scale - Answer c) Absence of nonverbal signs of pain
e) Verbally rates pain as 3 on a 1 to 10 scale
10. The patient has been in the postanesthesia care unit (PACU) for one hour. The patient is now
groggy but able to respond to voice commands. While assessing the patient, for what reason
would the nurse check the bedclothes underneath the patient?
a) Determine drainage from tubes or drains
b) Assess for fluid balance
c) Detect for possible hemorrhage
d) Monitor perspiration - Answer c) Detect for possible hemorrhage
11. A 65-year-old was diagnosed and treated for right lower lobe pneumonia 4 days ago. Today,
the patient came to the ED reporting abrupt onset of chest pain that is worse with inspiration.
The nurse knows that the symptoms are consistent with:
a) Pleurisy
b) Stable angina
c) Bacteremia
d) Meningitis - Answer a) Pleurisy
12. The ED nurse is caring for Ginny, a 45-year-old female with a recent history of sexual assault.
Ginny came to the ED crying and shaking and stated that she had dyspnea, feeling like she was
choking and couldn't breathe, chest pain, and sweating. Ginny reports that the symptoms
started about 15 minutes before she came to the ED. Ginny's symptoms are consistent with:
a) Myocardial Infarction
b) Pneumonia
c) Panic Attack
d) Influenza - Answer c) Panic Attack
, 13. A 86-year-old female has recent changes in her mental status, reports having no appetite,
and is running a low grade fever. The nurse suspects:
a) Delirium
b) Dementia
c) Urinary tract infection
d) Hypokalemia - Answer c) Urinary tract infection
14. Ted is a 76-year-old male who fell at home and sustained a fracture of his right hip. He is
being admitted to your unit and will have surgery in the morning. Ted has a past medical history
of urinary calculi, benign prostatic hypertrophy, and hypertension. When he arrived to the
medical-surgical unit, he has a strong body odor and visible dirt on his body. An indwelling
urinary catheter was placed in the ED. Ted is at greatest risk for a UTI is related to:
a) History of benign prostatic hypertrophy (BPH)
b) Poor hygiene
c) Indwelling urinary catheter
d) History of urinary calculi
e) His age - Answer c) Indwelling urinary catheter
15. A nurse knows that the patient teaching on the pneumococcal vaccine to a 65-year-old
patient has been effective when the patient states:
a) "The injection will protect me from the flu this year"
b) "I am now protected from getting pneumonia during my lifetime"
c) "I will need re-vaccination in five years"
d) "Now I won't need antibiotics when I get pneumonia" - Answer c) "I will need re-
vaccination in five years"
16. A patient is 14 hours postop from a surgical decompression for compartment syndrome at
the site of an ORIF on the left femur. On assessment, the urine output is 100mL in 8 hours, and
has a dark, reddish brown color. Based on this assessment finding, the nurse will:
a) Check to see if the myoglobin levels decreased
b) Administer an ordered prn fluid bolus to reverse fluid volume deficit
c) Nothing; this is an expected finding following surgery
d) Assess the patient for signs of acute kidney injury - Answer d) Assess the patient for signs
of acute kidney injury
17. A nurse has completed cast care teaching following the application of a plaster cast. The
nurse knows that patient teaching has been effective when the patient states:
with Actual Answers 2025/2026
Update.
1. A patient is being admitted to the hospital on the day before a scheduled surgery. What is the
most appropriate initial question for the nurse to ask this preoperative patient?
a) "What did your surgeon say to you about the type of surgery you are having?"
b) "What questions do you have about your surgery?"
c) "What type of surgery are you having and why are you having it done?"
d) "What do you know about what will be done to you?" - Answer c) "What type of surgery
are you having and why are you having it done?"
2. A benzodiazepine has been administered to a patient preoperatively. After the drug has been
administered, the nurse plans to monitor the patient for which side effects? Select all that apply.
a) Anxiety
b) Hypotension
c) Hypocalcemia
d) Level of Consciousness
e) Sedation - Answer a) Anxiety
d) Level of Consciousness
e) Sedation
3. A preoperative patient has an elevated hemoglobin and hematocrit. What would the nurse
suspect regarding the significance of this increased value?
a) Immune deficiency
b) Kidney dysfunction
c) Malignancy
d) Dehydration - Answer d) Dehydration
4. Which activities should the nurse carry out in the preoperative period for a client scheduled
for surgery? Select all that apply.
a) Identify potential or actual health problems.
b) Verify the presence of a signed consent form.
c) Assess patient's response to interventions.
d) Intervene to prevent complications.
,e) Assess effectiveness of teaching related to postoperative recovery. - Answer a) Identify
potential or actual health problems.
b) Verify the presence of a signed consent form.
e) Assess effectiveness of teaching related to postoperative recovery.
5. A patient having surgery has a degree of risk associated with the surgery. The nurse would
evaluate which patient-related factors as contributing to a high degree of risk associated with
surgery? Select all that apply.
a) Type of institution where surgery is performed
b) Involvement of vital organs
c) Average nutritional status
d) Low likelihood of procedure complications
e) A history of respiratory disease and diabetes - Answer b) Involvement of vital organs
e) A history of respiratory disease and diabetes
6. A patient has just entered the postanesthesia care unit (PACU) from surgery. For which
priority needs should the nurse immediately assess the postoperative patient?
a) Vital signs, level of consciousness, presence of pain
b) Skin coloring, surgical incision, limb movements
c) Skin temperature, blood pressure, mental status
d) Temperature, emotional status, wound drainage - Answer a) Vital signs, level of
consciousness, presence of pain
7. The nurse in the postanesthesia care unit (PACU) is assessing a postoperative patient. Which
indicators suggest to the nurse an alteration in tissue perfusion? Select all that apply.
a) Pallor or cyanosis
b) Difficulty with mobility
c) Pain in the incision area
d) Fluid loss
e) Decreased urinary output - Answer a) Pallor or cyanosis
d) Fluid loss
e) Decreased urinary output
8. After surgery, the nurse encourages the patient to move from side to side at least every 2
hours. The patient questions this activity. How does the nurse explain the purpose of this
intervention?
a) Assist peristalsis to return more quickly
,b) Lessen muscle weakness
c) Increase patient's ability to sleep
d) Let the lungs alternatively achieve maximum expansion - Answer d) Let the lungs
alternatively achieve maximum expansion
9. The nurse is creating a plan of care for a postoperative patient. The nursing diagnosis in acute
pain. What would be appropriate outcomes for this patient? Select all that apply.
a) Balanced fluid intake and output
b) Seeks help as needed
c) Absence of nonverbal signs of pain
d) Performs leg exercises as instructed
e) Verbally rates pain as 3 on a 1 to 10 scale - Answer c) Absence of nonverbal signs of pain
e) Verbally rates pain as 3 on a 1 to 10 scale
10. The patient has been in the postanesthesia care unit (PACU) for one hour. The patient is now
groggy but able to respond to voice commands. While assessing the patient, for what reason
would the nurse check the bedclothes underneath the patient?
a) Determine drainage from tubes or drains
b) Assess for fluid balance
c) Detect for possible hemorrhage
d) Monitor perspiration - Answer c) Detect for possible hemorrhage
11. A 65-year-old was diagnosed and treated for right lower lobe pneumonia 4 days ago. Today,
the patient came to the ED reporting abrupt onset of chest pain that is worse with inspiration.
The nurse knows that the symptoms are consistent with:
a) Pleurisy
b) Stable angina
c) Bacteremia
d) Meningitis - Answer a) Pleurisy
12. The ED nurse is caring for Ginny, a 45-year-old female with a recent history of sexual assault.
Ginny came to the ED crying and shaking and stated that she had dyspnea, feeling like she was
choking and couldn't breathe, chest pain, and sweating. Ginny reports that the symptoms
started about 15 minutes before she came to the ED. Ginny's symptoms are consistent with:
a) Myocardial Infarction
b) Pneumonia
c) Panic Attack
d) Influenza - Answer c) Panic Attack
, 13. A 86-year-old female has recent changes in her mental status, reports having no appetite,
and is running a low grade fever. The nurse suspects:
a) Delirium
b) Dementia
c) Urinary tract infection
d) Hypokalemia - Answer c) Urinary tract infection
14. Ted is a 76-year-old male who fell at home and sustained a fracture of his right hip. He is
being admitted to your unit and will have surgery in the morning. Ted has a past medical history
of urinary calculi, benign prostatic hypertrophy, and hypertension. When he arrived to the
medical-surgical unit, he has a strong body odor and visible dirt on his body. An indwelling
urinary catheter was placed in the ED. Ted is at greatest risk for a UTI is related to:
a) History of benign prostatic hypertrophy (BPH)
b) Poor hygiene
c) Indwelling urinary catheter
d) History of urinary calculi
e) His age - Answer c) Indwelling urinary catheter
15. A nurse knows that the patient teaching on the pneumococcal vaccine to a 65-year-old
patient has been effective when the patient states:
a) "The injection will protect me from the flu this year"
b) "I am now protected from getting pneumonia during my lifetime"
c) "I will need re-vaccination in five years"
d) "Now I won't need antibiotics when I get pneumonia" - Answer c) "I will need re-
vaccination in five years"
16. A patient is 14 hours postop from a surgical decompression for compartment syndrome at
the site of an ORIF on the left femur. On assessment, the urine output is 100mL in 8 hours, and
has a dark, reddish brown color. Based on this assessment finding, the nurse will:
a) Check to see if the myoglobin levels decreased
b) Administer an ordered prn fluid bolus to reverse fluid volume deficit
c) Nothing; this is an expected finding following surgery
d) Assess the patient for signs of acute kidney injury - Answer d) Assess the patient for signs
of acute kidney injury
17. A nurse has completed cast care teaching following the application of a plaster cast. The
nurse knows that patient teaching has been effective when the patient states:
