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JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM 2026/2027 |
Complete Solutions | Verified Answers | Pass Guaranteed -
A+ Graded
Section 1: Perioperative Nursing (Pre-op, Intra-op, Post-op Care) (Q1-18)
Q1. A 68-year-old patient is scheduled for elective laparoscopic cholecystectomy in 3
days. During preoperative teaching, the nurse instructs the patient on incentive
spirometry use. Which statement by the patient indicates correct understanding?
A. "I should use the spirometer every 2 hours while I'm awake for the first 2 days after
surgery."
B. "I need to take rapid, shallow breaths into the device to get the highest reading
possible."
C. "I should hold my breath for 5 seconds at maximal inspiration before exhaling
normally."
D. "I only need to use the spirometer when I feel short of breath after surgery."
Correct Answer: C
Rationale: Incentive spirometry requires the patient to inhale slowly and deeply, hold
at maximal inspiration for 3-5 seconds, then exhale normally to promote alveolar
expansion and prevent atelectasis. Option A is incorrect because frequency is
typically every 1-2 hours while awake, but holding breath is the critical technique.
Option B describes incorrect rapid breathing. Option D is incorrect because
prophylactic scheduled use prevents complications, not PRN use.
Q2. A nurse is providing preoperative instructions to a patient scheduled for colon
resection under general anesthesia at 0800. Which instruction is the priority for the
nurse to include regarding NPO status?
A. "You may drink clear liquids up to 2 hours before your scheduled surgery time."
B. "You may have a light breakfast the morning of surgery if you finish by 0600."
C. "You should be NPO after midnight, including no water, gum, or mints."
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D. "You may take your morning medications with a small sip of water unless
otherwise directed."
Correct Answer: C
Rationale: For general anesthesia, the standard and safest instruction is NPO after
midnight (or 8 hours before surgery) to reduce aspiration risk. While ASA guidelines
may allow clear liquids up to 2 hours before in some settings, the priority safety
instruction for a MedSurg 1 exam context is the traditional NPO after midnight rule,
including no gum or mints which increase secretions and aspiration risk. Option D is
a secondary instruction that requires specific provider orders.
Q3. A postoperative patient on the medical-surgical unit reports sudden severe
incisional pain on post-op day 5 after abdominal surgery. The nurse notes
evisceration of abdominal contents through the wound. What is the nurse's first
action?
A. Place the patient in high-Fowler's position to reduce intra-abdominal pressure.
B. Cover the exposed organs with sterile saline-soaked dressings and notify the
surgeon immediately.
C. Apply an abdominal binder tightly around the wound to contain the organs.
D. Remove the existing dressing to assess the full extent of tissue damage.
Correct Answer: B
Rationale: Wound dehiscence with evisceration is a surgical emergency. The nurse
must immediately cover exposed organs with sterile saline-soaked dressings to
prevent tissue desiccation and infection, keep the patient NPO, and notify the
surgeon. High-Fowler's (A) increases intra-abdominal pressure. Tight binders (C) can
compromise blood flow. Removing dressings (D) increases infection risk.
Q4. A postoperative patient is prescribed morphine sulfate 4 mg IV every 4 hours
PRN for pain. The available concentration is morphine 2 mg/mL. How many mL
should the nurse administer per dose? (Record your answer using a whole number.)
,3
A. 0.5 mL
B. 1 mL
C. 2 mL
D. 4 mL
Correct Answer: C
Rationale: Using the dosage calculation formula (Desired/Have × Volume): 4 mg / 2
mg × 1 mL = 2 mL. The nurse should administer 2 mL to deliver the prescribed 4 mg
dose. Options A, B, and D represent calculation errors.
Q5. A nurse is caring for a patient on post-op day 1 after total knee replacement. The
patient is receiving enoxaparin 40 mg subcutaneously daily for DVT prophylaxis.
Which assessment finding requires immediate nursing intervention?
A. Mild ecchymosis at the injection site
B. Blood pressure 138/84 mmHg
C. Sudden onset of dyspnea and chest pain
D. Pain rated 6/10 at the surgical site
Correct Answer: C
Rationale: Sudden dyspnea and chest pain in a postoperative patient receiving
anticoagulation prophylaxis may indicate pulmonary embolism, a life-threatening
complication that typically occurs 48-72 hours post-op or later. This requires
immediate activation of the rapid response team. Ecchymosis (A) is expected. Blood
pressure (B) and pain (D) are not emergent findings.
Q6. A patient returns from the PACU after lumbar spinal fusion. The nurse notes the
patient has not voided in 6 hours and has a distended bladder. Which intervention is
appropriate first?
A. Insert an indwelling urinary catheter immediately.
B. Perform a bladder scan and implement noninvasive measures first.
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C. Administer a diuretic to stimulate urine production.
D. Notify the surgeon that the patient needs emergency surgery.
Correct Answer: B
Rationale: Postoperative urinary retention is common after spinal anesthesia or
opioids. The nurse should first perform a bladder scan to assess residual volume,
then implement noninvasive measures (privacy, running water, positioning).
Catheterization (A) is indicated only if retention persists after conservative measures
or if volume exceeds protocol limits. Diuretics (C) are inappropriate. Surgery (D) is
unnecessary.
Q7. A nurse has four postoperative patients. Which patient should the nurse assess
first?
A. A patient on post-op day 2 after appendectomy with pain rated 3/10 and stable
vital signs
B. A patient on post-op day 1 after hip replacement with a new oxygen saturation of
89% on room air
C. A patient on post-op day 3 after cholecystectomy requesting PRN pain medication
D. A patient on post-op day 1 after mastectomy with a Jackson-Pratt drain output of
50 mL in 8 hours
Correct Answer: B
Rationale: Using the ABCs prioritization framework, the patient with SpO2 89%
represents an unstable respiratory status and potential airway/breathing
compromise, requiring immediate assessment and oxygen intervention. The other
patients are stable (A, D) or have non-urgent needs (C).
Q8. During intraoperative positioning for a 4-hour abdominal surgery, the patient is
placed in supine position. Which complication is the nurse in the OR most likely
monitoring to prevent?
JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM 2026/2027 |
Complete Solutions | Verified Answers | Pass Guaranteed -
A+ Graded
Section 1: Perioperative Nursing (Pre-op, Intra-op, Post-op Care) (Q1-18)
Q1. A 68-year-old patient is scheduled for elective laparoscopic cholecystectomy in 3
days. During preoperative teaching, the nurse instructs the patient on incentive
spirometry use. Which statement by the patient indicates correct understanding?
A. "I should use the spirometer every 2 hours while I'm awake for the first 2 days after
surgery."
B. "I need to take rapid, shallow breaths into the device to get the highest reading
possible."
C. "I should hold my breath for 5 seconds at maximal inspiration before exhaling
normally."
D. "I only need to use the spirometer when I feel short of breath after surgery."
Correct Answer: C
Rationale: Incentive spirometry requires the patient to inhale slowly and deeply, hold
at maximal inspiration for 3-5 seconds, then exhale normally to promote alveolar
expansion and prevent atelectasis. Option A is incorrect because frequency is
typically every 1-2 hours while awake, but holding breath is the critical technique.
Option B describes incorrect rapid breathing. Option D is incorrect because
prophylactic scheduled use prevents complications, not PRN use.
Q2. A nurse is providing preoperative instructions to a patient scheduled for colon
resection under general anesthesia at 0800. Which instruction is the priority for the
nurse to include regarding NPO status?
A. "You may drink clear liquids up to 2 hours before your scheduled surgery time."
B. "You may have a light breakfast the morning of surgery if you finish by 0600."
C. "You should be NPO after midnight, including no water, gum, or mints."
,2
D. "You may take your morning medications with a small sip of water unless
otherwise directed."
Correct Answer: C
Rationale: For general anesthesia, the standard and safest instruction is NPO after
midnight (or 8 hours before surgery) to reduce aspiration risk. While ASA guidelines
may allow clear liquids up to 2 hours before in some settings, the priority safety
instruction for a MedSurg 1 exam context is the traditional NPO after midnight rule,
including no gum or mints which increase secretions and aspiration risk. Option D is
a secondary instruction that requires specific provider orders.
Q3. A postoperative patient on the medical-surgical unit reports sudden severe
incisional pain on post-op day 5 after abdominal surgery. The nurse notes
evisceration of abdominal contents through the wound. What is the nurse's first
action?
A. Place the patient in high-Fowler's position to reduce intra-abdominal pressure.
B. Cover the exposed organs with sterile saline-soaked dressings and notify the
surgeon immediately.
C. Apply an abdominal binder tightly around the wound to contain the organs.
D. Remove the existing dressing to assess the full extent of tissue damage.
Correct Answer: B
Rationale: Wound dehiscence with evisceration is a surgical emergency. The nurse
must immediately cover exposed organs with sterile saline-soaked dressings to
prevent tissue desiccation and infection, keep the patient NPO, and notify the
surgeon. High-Fowler's (A) increases intra-abdominal pressure. Tight binders (C) can
compromise blood flow. Removing dressings (D) increases infection risk.
Q4. A postoperative patient is prescribed morphine sulfate 4 mg IV every 4 hours
PRN for pain. The available concentration is morphine 2 mg/mL. How many mL
should the nurse administer per dose? (Record your answer using a whole number.)
,3
A. 0.5 mL
B. 1 mL
C. 2 mL
D. 4 mL
Correct Answer: C
Rationale: Using the dosage calculation formula (Desired/Have × Volume): 4 mg / 2
mg × 1 mL = 2 mL. The nurse should administer 2 mL to deliver the prescribed 4 mg
dose. Options A, B, and D represent calculation errors.
Q5. A nurse is caring for a patient on post-op day 1 after total knee replacement. The
patient is receiving enoxaparin 40 mg subcutaneously daily for DVT prophylaxis.
Which assessment finding requires immediate nursing intervention?
A. Mild ecchymosis at the injection site
B. Blood pressure 138/84 mmHg
C. Sudden onset of dyspnea and chest pain
D. Pain rated 6/10 at the surgical site
Correct Answer: C
Rationale: Sudden dyspnea and chest pain in a postoperative patient receiving
anticoagulation prophylaxis may indicate pulmonary embolism, a life-threatening
complication that typically occurs 48-72 hours post-op or later. This requires
immediate activation of the rapid response team. Ecchymosis (A) is expected. Blood
pressure (B) and pain (D) are not emergent findings.
Q6. A patient returns from the PACU after lumbar spinal fusion. The nurse notes the
patient has not voided in 6 hours and has a distended bladder. Which intervention is
appropriate first?
A. Insert an indwelling urinary catheter immediately.
B. Perform a bladder scan and implement noninvasive measures first.
, 4
C. Administer a diuretic to stimulate urine production.
D. Notify the surgeon that the patient needs emergency surgery.
Correct Answer: B
Rationale: Postoperative urinary retention is common after spinal anesthesia or
opioids. The nurse should first perform a bladder scan to assess residual volume,
then implement noninvasive measures (privacy, running water, positioning).
Catheterization (A) is indicated only if retention persists after conservative measures
or if volume exceeds protocol limits. Diuretics (C) are inappropriate. Surgery (D) is
unnecessary.
Q7. A nurse has four postoperative patients. Which patient should the nurse assess
first?
A. A patient on post-op day 2 after appendectomy with pain rated 3/10 and stable
vital signs
B. A patient on post-op day 1 after hip replacement with a new oxygen saturation of
89% on room air
C. A patient on post-op day 3 after cholecystectomy requesting PRN pain medication
D. A patient on post-op day 1 after mastectomy with a Jackson-Pratt drain output of
50 mL in 8 hours
Correct Answer: B
Rationale: Using the ABCs prioritization framework, the patient with SpO2 89%
represents an unstable respiratory status and potential airway/breathing
compromise, requiring immediate assessment and oxygen intervention. The other
patients are stable (A, D) or have non-urgent needs (C).
Q8. During intraoperative positioning for a 4-hour abdominal surgery, the patient is
placed in supine position. Which complication is the nurse in the OR most likely
monitoring to prevent?
