Galen NUR 265 – Med-Surg Exam 2, Set 1 (Practice Exam) 150 Questions with Answers & Rationales

Galen NUR 265 – Med-Surg Exam 2, Set 1
(Practice Exam) 150 Questions with Answers
& Rationales



Section 1: Perioperative & Postoperative Care (Q1–20)
1. A patient is 2 hours post-op from abdominal surgery. Which
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kfinding requires immediate notification of the surgeon?
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A. Pain rated 5/10
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B. Heart rate 110 bpm, BP 88/50
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C. Urine output 40 mL/hr
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D. Temperature 99.8°F (37.7°C) k k



Answer: B – Heart rate 110 bpm, BP 88/50
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Rationale: Tachycardia with hypotension suggests hypovolemia or
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khemorrhage.
2. A patient received general anesthesia. The nurse’s priority in the
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immediate post-op period is:
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A. Pain management
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B. Airway patency k



C. Wound assessment k



D. Fluid replacement
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Answer: B – Airway patency
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Rationale: Airway is always first; anesthesia can cause airway
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obstruction.
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,3. Which assessment finding indicates malignant hyperthermia?
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A. Hypothermia and bradycardia k k



B. Muscle rigidity and hyperthermia
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C. Hypotension and polyuria k k



D. Respiratory depression and miosis k k k



Answer: B – Muscle rigidity and hyperthermia
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Rationale: Malignant hyperthermia is a life-threatening reaction to
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volatile anesthetics/succinylcholine.
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4. A patient post-op has a Jackson-Pratt drain with 150 mL of bright
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red blood in 1 hour. What should the nurse do first?
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A. Document as normal k k



B. Empty the drain k k



C. Notify the provider
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D. Apply pressure to the site
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Answer: C – Notify the provider
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*Rationale: >100 mL/hr suggests active bleeding.*
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5. Which instruction is correct for a patient after outpatient
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surgery with general anesthesia?
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A. “You may drive yourself home.”
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B. “Do not drink alcohol for 24 hours.”
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C. “Return to work tomorrow.”
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D. “You can eat a full meal immediately.”
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Answer: B – “Do not drink alcohol for 24 hours.”
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Rationale: Alcohol interacts with anesthesia and sedatives; impairs
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recovery.
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6. A patient post-op reports sudden chest pain and dyspnea. The
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nurse suspects pulmonary embolism. The priority action is:
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,A. Give aspirin
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B. Apply oxygen and notify provider
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C. Ambulate the patient k k



D. Administer morphine k



Answer: B – Apply oxygen and notify provider
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Rationale: Oxygenation and rapid treatment are critical for PE.
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7. Which patient is at highest risk for postoperative pneumonia?
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A. 30-year-old having knee arthroscopy k k k



B. 65-year-old smoker with abdominal surgery k k k k



C. 20-year-old with tonsillectomy k k



D. 45-year-old with cataract surgery k k k



Answer: B – 65-year-old smoker with abdominal surgery
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Rationale: Older age, smoking, and abdominal incision (splinting)
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increase pneumonia risk.
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8. A patient post-op has not voided for 8 hours and reports
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suprapubic discomfort. What should the nurse do first?
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A. Insert a Foley catheter
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B. Bladder scan k



C. Increase IV fluids k k



D. Encourage ambulation k



Answer: B – Bladder scan
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Rationale: Bladder scan determines urinary retention
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non-invasively.
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9. Which finding in the first 24 hours post-op is most concerning
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for infection?
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A. WBC 12,000/µLk



B. Temperature 100.2°F (37.9°C) k k

, C. Purulent drainage from incision
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D. Pain at incision site
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Answer: C – Purulent drainage from incision
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Rationale: Purulent drainage indicates infection; fever and mild
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leukocytosis are expected post-op.
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10. A patient is 6 hours post-op and has not ambulated. The nurse’s
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kbest action is:
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A. Wait until tomorrow
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B. Assist the patient to sit at the bedside
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C. Notify physical therapy
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D. Apply sequential compression devices only
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kAnswer: B – Assist the patient to sit at the bedside
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Rationale: Early mobilization prevents DVT, atelectasis, and ileus.
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11. Which medication is given to reverse the effects of
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kneuromuscular blockers? k



A. Naloxone
B. Neostigmine
C. Flumazenil
D. Protamine
Answer: B – Neostigmine
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Rationale: Neostigmine (with glycopyrrolate) reverses
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knon-depolarizing neuromuscular blockers. k k




12. A patient post-op has a nasogastric tube to low intermittent
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ksuction. Which finding indicates the tube is functioning correctly?
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A. Nausea and vomiting k k



B. Abdominal distention k



C. Output of 800 mL green fluid in 8 hours
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