JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM 2026/2027 |
Complete Solutions | Questions & Verified Answers | Pass
Guaranteed - A+ Graded
Section 1: Perioperative Nursing (Pre-op, Intra-op, Post-op Care) (Q1-15)
Question 1
A 68-year-old patient is scheduled for an elective total knee replacement in the morning.
The nurse is completing preoperative teaching. Which instruction is the priority for the
nurse to reinforce regarding NPO status?
A. "You may drink clear liquids up to 2 hours before your scheduled surgery time."
B. "You should eat a light breakfast the morning of surgery to prevent hypoglycemia."
C. "A strict NPO status after midnight is required for all patients regardless of
anesthesia type."
D. "You may take all your morning medications with a full glass of water before leaving
home."
Correct Answer: A. "You may drink clear liquids up to 2 hours before your scheduled
surgery time." [CORRECT]
Rationale: Current ASA guidelines allow clear liquids up to 2 hours before surgery to
reduce dehydration and aspiration risk; solid foods are withheld 6-8 hours. Option B
increases aspiration risk, option C is outdated, and option D is incorrect because some
medications (like anticoagulants or oral hypoglycemics) may be held per provider order.
Question 2
Which nursing action is the RN's legal responsibility regarding informed consent for
surgery?
,A. Witnessing the patient's signature after verifying the patient understands the
procedure, risks, and alternatives explained by the surgeon
B. Explaining the surgical procedure and all potential complications to the patient and
family
C. Obtaining the patient's signature on the consent form when the surgeon is
unavailable
D. Delegating the witnessing of informed consent to the LPN when the unit is busy
Correct Answer: A. Witnessing the patient's signature after verifying the patient
understands the procedure, risks, and alternatives explained by the surgeon [CORRECT]
Rationale: The RN's role is to witness consent and confirm the patient is informed and
signing voluntarily; explaining the procedure is the surgeon's duty. Option B is the
surgeon's responsibility, option C is outside RN scope, and option D violates legal
standards as witnessing consent requires RN judgment.
Question 3
A postoperative patient who had an abdominal hysterectomy 4 hours ago reports pain
of 8/10. Assessment reveals a blood pressure of 88/50 mmHg, heart rate of 128
beats/min, respiratory rate of 24 breaths/min, and a surgical dressing saturated with
bright red blood. Based on prioritization principles, which intervention should the nurse
implement first?
A. Administer the ordered IV morphine for pain control
B. Apply a new sterile dressing and reinforce the existing one
C. Activate the rapid response team and prepare for fluid resuscitation
D. Place the patient in high-Fowler's position to promote oxygenation
Correct Answer: C. Activate the rapid response team and prepare for fluid resuscitation
[CORRECT]
Rationale: Using the ABCs and Maslow's hierarchy, the patient shows signs of
hemorrhagic shock (hypotension, tachycardia, tachypnea, dressing saturation), which is
,a life-threatening physiological priority over pain or positioning. Option A addresses pain
but not hemorrhage; option B does not treat the cause; option D is contraindicated in
shock as it impedes venous return.
Question 4
Which antiseptic skin preparation solution is most commonly used for preoperative skin
cleansing to reduce microbial colonization without being absorbed systemically in
significant amounts?
A. Povidone-iodine (Betadine)
B. Chlorhexidine gluconate (CHG)
C. Hydrogen peroxide
D. Isopropyl alcohol 70%
Correct Answer: B. Chlorhexidine gluconate (CHG) [CORRECT]
Rationale: CHG is the preferred preoperative skin prep due to broad-spectrum
antimicrobial activity, residual effect, and minimal systemic absorption; it is superior to
povidone-iodine for preventing surgical site infections. Option A has less residual
activity and potential absorption, while options C and D are inappropriate for large-area
surgical prep.
Question 5
The provider orders heparin 5,000 units subcutaneous every 12 hours for DVT
prophylaxis. The vial available is labeled heparin 10,000 units/mL. How many mL should
the nurse administer?
A. 0.25 mL
B. 0.5 mL
C. 1.0 mL
D. 2.0 mL
, Correct Answer: B. 0.5 mL [CORRECT]
Rationale: Using the ratio method (5,000 units ÷ 10,000 units/mL = 0.5 mL), the nurse
must administer 0.5 mL. Option A represents a miscalculation using 2,500 units; option
C is the full vial concentration; option D is a tenfold error confusing units with mL.
Question 6
During intraoperative positioning for a prolonged spinal surgery, the nurse places a
patient in prone position. Which intervention is essential to prevent peripheral
neurovascular complications?
A. Placing a pillow under the knees to reduce lower back strain
B. Ensuring the neck is in neutral alignment without excessive rotation or extension
C. Elevating the head of the bed 30 degrees to prevent aspiration
D. Tucking the arms at the sides with tight restraints to prevent falling
Correct Answer: B. Ensuring the neck is in neutral alignment without excessive rotation
or extension [CORRECT]
Rationale: In prone positioning, maintaining neutral neck alignment prevents brachial
plexus injury and cervical spine complications. Option A is used for supine positioning;
option C is inappropriate for prone surgery; option D risks brachial plexus compression
and neurovascular compromise.
Question 7
A patient arrives in the PACU after general anesthesia. Which assessment is the priority
during the immediate postanesthesia phase?
A. Checking the surgical dressing for drainage
B. Assessing the patency of the airway and adequacy of respirations
C. Evaluating the patient's pain level using a 0-10 scale
D. Assessing the IV site for infiltration or phlebitis
Complete Solutions | Questions & Verified Answers | Pass
Guaranteed - A+ Graded
Section 1: Perioperative Nursing (Pre-op, Intra-op, Post-op Care) (Q1-15)
Question 1
A 68-year-old patient is scheduled for an elective total knee replacement in the morning.
The nurse is completing preoperative teaching. Which instruction is the priority for the
nurse to reinforce regarding NPO status?
A. "You may drink clear liquids up to 2 hours before your scheduled surgery time."
B. "You should eat a light breakfast the morning of surgery to prevent hypoglycemia."
C. "A strict NPO status after midnight is required for all patients regardless of
anesthesia type."
D. "You may take all your morning medications with a full glass of water before leaving
home."
Correct Answer: A. "You may drink clear liquids up to 2 hours before your scheduled
surgery time." [CORRECT]
Rationale: Current ASA guidelines allow clear liquids up to 2 hours before surgery to
reduce dehydration and aspiration risk; solid foods are withheld 6-8 hours. Option B
increases aspiration risk, option C is outdated, and option D is incorrect because some
medications (like anticoagulants or oral hypoglycemics) may be held per provider order.
Question 2
Which nursing action is the RN's legal responsibility regarding informed consent for
surgery?
,A. Witnessing the patient's signature after verifying the patient understands the
procedure, risks, and alternatives explained by the surgeon
B. Explaining the surgical procedure and all potential complications to the patient and
family
C. Obtaining the patient's signature on the consent form when the surgeon is
unavailable
D. Delegating the witnessing of informed consent to the LPN when the unit is busy
Correct Answer: A. Witnessing the patient's signature after verifying the patient
understands the procedure, risks, and alternatives explained by the surgeon [CORRECT]
Rationale: The RN's role is to witness consent and confirm the patient is informed and
signing voluntarily; explaining the procedure is the surgeon's duty. Option B is the
surgeon's responsibility, option C is outside RN scope, and option D violates legal
standards as witnessing consent requires RN judgment.
Question 3
A postoperative patient who had an abdominal hysterectomy 4 hours ago reports pain
of 8/10. Assessment reveals a blood pressure of 88/50 mmHg, heart rate of 128
beats/min, respiratory rate of 24 breaths/min, and a surgical dressing saturated with
bright red blood. Based on prioritization principles, which intervention should the nurse
implement first?
A. Administer the ordered IV morphine for pain control
B. Apply a new sterile dressing and reinforce the existing one
C. Activate the rapid response team and prepare for fluid resuscitation
D. Place the patient in high-Fowler's position to promote oxygenation
Correct Answer: C. Activate the rapid response team and prepare for fluid resuscitation
[CORRECT]
Rationale: Using the ABCs and Maslow's hierarchy, the patient shows signs of
hemorrhagic shock (hypotension, tachycardia, tachypnea, dressing saturation), which is
,a life-threatening physiological priority over pain or positioning. Option A addresses pain
but not hemorrhage; option B does not treat the cause; option D is contraindicated in
shock as it impedes venous return.
Question 4
Which antiseptic skin preparation solution is most commonly used for preoperative skin
cleansing to reduce microbial colonization without being absorbed systemically in
significant amounts?
A. Povidone-iodine (Betadine)
B. Chlorhexidine gluconate (CHG)
C. Hydrogen peroxide
D. Isopropyl alcohol 70%
Correct Answer: B. Chlorhexidine gluconate (CHG) [CORRECT]
Rationale: CHG is the preferred preoperative skin prep due to broad-spectrum
antimicrobial activity, residual effect, and minimal systemic absorption; it is superior to
povidone-iodine for preventing surgical site infections. Option A has less residual
activity and potential absorption, while options C and D are inappropriate for large-area
surgical prep.
Question 5
The provider orders heparin 5,000 units subcutaneous every 12 hours for DVT
prophylaxis. The vial available is labeled heparin 10,000 units/mL. How many mL should
the nurse administer?
A. 0.25 mL
B. 0.5 mL
C. 1.0 mL
D. 2.0 mL
, Correct Answer: B. 0.5 mL [CORRECT]
Rationale: Using the ratio method (5,000 units ÷ 10,000 units/mL = 0.5 mL), the nurse
must administer 0.5 mL. Option A represents a miscalculation using 2,500 units; option
C is the full vial concentration; option D is a tenfold error confusing units with mL.
Question 6
During intraoperative positioning for a prolonged spinal surgery, the nurse places a
patient in prone position. Which intervention is essential to prevent peripheral
neurovascular complications?
A. Placing a pillow under the knees to reduce lower back strain
B. Ensuring the neck is in neutral alignment without excessive rotation or extension
C. Elevating the head of the bed 30 degrees to prevent aspiration
D. Tucking the arms at the sides with tight restraints to prevent falling
Correct Answer: B. Ensuring the neck is in neutral alignment without excessive rotation
or extension [CORRECT]
Rationale: In prone positioning, maintaining neutral neck alignment prevents brachial
plexus injury and cervical spine complications. Option A is used for supine positioning;
option C is inappropriate for prone surgery; option D risks brachial plexus compression
and neurovascular compromise.
Question 7
A patient arrives in the PACU after general anesthesia. Which assessment is the priority
during the immediate postanesthesia phase?
A. Checking the surgical dressing for drainage
B. Assessing the patency of the airway and adequacy of respirations
C. Evaluating the patient's pain level using a 0-10 scale
D. Assessing the IV site for infiltration or phlebitis
