NUR 242 MED SURG EXAM 1 GALEN COLLEGE OF NURSING |
LATEST ACTUAL EXAM COMPLETE QUESTIONS
WITH CORRECT ANSWERS AND RATIONALES ALREADY
GRADED A+
SECTION A: PERIOPERATIVE CARE (Questions 1–40)
1. A client is scheduled for an emergent appendectomy. The nurse understands
that this type of surgery is classified as:
A. Elective surgery
B. Urgent surgery
C. Emergent surgery ✔
D. Optional surgery
Rationale: Emergent surgery is performed immediately without delay to preserve
life, limb, or function. Appendectomy for a ruptured appendix is emergent
because delay could be fatal. Elective surgery is planned in advance; urgent
surgery is performed within 24–30 hours; optional surgery is based on personal
preference.
2. A client is being prepared for surgery and asks the nurse, "Why do I need to
sign this consent form?" The nurse's best response is:
A. "It protects the hospital from lawsuits."
B. "It gives the surgeon permission to perform the procedure."
C. "It confirms that you understand the risks, benefits, and alternatives of the
surgery." ✔
D. "It is a hospital policy requirement."
Rationale: Informed consent is a legal and ethical requirement that ensures the
client understands the procedure, including its risks, benefits, and alternatives. It
is based on the principle of autonomy and requires voluntary agreement. The
nurse's role is to witness the signature and confirm understanding, not to provide
detailed medical information.
3. The preoperative period is defined as:
1
,A. From the time the client is transferred to the operating room until admission to
the PACU
B. From the decision for surgery until the client is transferred to the operating
room table ✔
C. From PACU admission until follow-up with the provider
D. From the operating room until discharge home
Rationale: The preoperative period begins when the decision for surgical
intervention is made and ends when the client is transferred to the operating
room table. The intraoperative period is from transfer to the OR table to PACU
admission; the postoperative period begins with PACU admission.
4. A client is scheduled for a cholecystectomy in 2 days. This type of surgery is
classified as:
A. Emergent
B. Urgent
C. Elective ✔
D. Optional
Rationale: Elective surgery is planned in advance and is not an emergency. It is
performed to improve quality of life or treat a condition that is not immediately
life-threatening. Cholecystectomy for chronic cholecystitis is typically elective. The
key phrase "failure to have surgery is not catastrophic" distinguishes elective from
emergent/urgent procedures.
5. A client who cannot read or write is scheduled for surgery. The surgeon asks
the client's spouse to sign the consent form. The nurse's best action is to:
A. Allow the spouse to sign the consent
B. Contact the hospital ethics committee
C. Ask the surgeon to use a witness and ensure the consent is explained to the
client using an interpreter or appropriate method ✔
D. Proceed with the surgery without a signed consent
Rationale: The client must provide informed consent personally unless they are
incapacitated. If the client cannot read, the consent must be read and explained
2
,to them in a language they understand, with a witness present. The spouse
cannot sign on behalf of a competent adult.
6. Which of the following clients would be at highest risk for complications during
the intraoperative period?
A. A 25-year-old with no significant medical history
B. A 45-year-old with controlled hypertension
C. A 70-year-old with diabetes, hypertension, and obesity ✔
D. A 30-year-old with a history of asthma
Rationale: Advanced age, diabetes, hypertension, and obesity are significant risk
factors for intraoperative complications including cardiovascular events, impaired
wound healing, and respiratory issues. Multiple comorbidities increase the
cumulative risk.
7. A client is NPO (nothing by mouth) before surgery. The primary reason for this
is to:
A. Prevent dehydration
B. Reduce the risk of aspiration during anesthesia ✔
C. Decrease the risk of infection
D. Improve surgical site visibility
Rationale: NPO status reduces gastric volume and acidity, minimizing the risk of
aspiration of gastric contents into the lungs during anesthesia induction.
Aspiration pneumonitis (Mendelson's syndrome) is a serious complication.
8. The nurse is preparing a client for surgery. Which statement by the client
indicates a need for further teaching regarding NPO status?
A. "I understand I cannot eat anything after midnight."
B. "I can have clear liquids up to 2 hours before surgery." ✔
C. "I cannot chew gum or suck on hard candy."
D. "I should not drink coffee or milk before surgery."
Rationale: Current guidelines allow clear liquids up to 2 hours before surgery.
However, many institutions still require NPO after midnight, and the nurse should
3
, follow facility policy. The client's statement may indicate understanding of the
updated guideline but could conflict with the specific order.
9. A client asks the nurse about the difference between general and regional
anesthesia. The nurse correctly states:
A. General anesthesia only affects a specific body part
B. Regional anesthesia causes loss of consciousness
C. General anesthesia affects the entire body and causes loss of consciousness ✔
D. Regional anesthesia is always safer than general anesthesia
Rationale: General anesthesia produces a reversible loss of consciousness,
amnesia, and analgesia affecting the entire body. Regional anesthesia blocks
nerve impulses in a specific area (e.g., spinal, epidural, peripheral nerve block)
without loss of consciousness.
10. During the preoperative assessment, the client reports taking herbal
supplements including ginkgo biloba. The nurse's priority action is to:
A. Document the information and proceed with surgery
B. Instruct the client to stop taking the supplement immediately
C. Notify the surgeon and anesthesia provider because ginkgo can increase
bleeding risk ✔
D. Tell the client it is safe to continue the supplement
Rationale: Ginkgo biloba has antiplatelet effects and can increase the risk of
bleeding during and after surgery. The surgeon and anesthesia provider must be
notified. The client should be advised to stop the supplement per provider order,
typically 2–3 weeks before surgery.
11. A client is undergoing surgery under general anesthesia. Which phase of
anesthesia involves the induction and maintenance of unconsciousness?
A. Preoperative phase
B. Induction phase ✔
C. Emergence phase
D. Postoperative phase
4
LATEST ACTUAL EXAM COMPLETE QUESTIONS
WITH CORRECT ANSWERS AND RATIONALES ALREADY
GRADED A+
SECTION A: PERIOPERATIVE CARE (Questions 1–40)
1. A client is scheduled for an emergent appendectomy. The nurse understands
that this type of surgery is classified as:
A. Elective surgery
B. Urgent surgery
C. Emergent surgery ✔
D. Optional surgery
Rationale: Emergent surgery is performed immediately without delay to preserve
life, limb, or function. Appendectomy for a ruptured appendix is emergent
because delay could be fatal. Elective surgery is planned in advance; urgent
surgery is performed within 24–30 hours; optional surgery is based on personal
preference.
2. A client is being prepared for surgery and asks the nurse, "Why do I need to
sign this consent form?" The nurse's best response is:
A. "It protects the hospital from lawsuits."
B. "It gives the surgeon permission to perform the procedure."
C. "It confirms that you understand the risks, benefits, and alternatives of the
surgery." ✔
D. "It is a hospital policy requirement."
Rationale: Informed consent is a legal and ethical requirement that ensures the
client understands the procedure, including its risks, benefits, and alternatives. It
is based on the principle of autonomy and requires voluntary agreement. The
nurse's role is to witness the signature and confirm understanding, not to provide
detailed medical information.
3. The preoperative period is defined as:
1
,A. From the time the client is transferred to the operating room until admission to
the PACU
B. From the decision for surgery until the client is transferred to the operating
room table ✔
C. From PACU admission until follow-up with the provider
D. From the operating room until discharge home
Rationale: The preoperative period begins when the decision for surgical
intervention is made and ends when the client is transferred to the operating
room table. The intraoperative period is from transfer to the OR table to PACU
admission; the postoperative period begins with PACU admission.
4. A client is scheduled for a cholecystectomy in 2 days. This type of surgery is
classified as:
A. Emergent
B. Urgent
C. Elective ✔
D. Optional
Rationale: Elective surgery is planned in advance and is not an emergency. It is
performed to improve quality of life or treat a condition that is not immediately
life-threatening. Cholecystectomy for chronic cholecystitis is typically elective. The
key phrase "failure to have surgery is not catastrophic" distinguishes elective from
emergent/urgent procedures.
5. A client who cannot read or write is scheduled for surgery. The surgeon asks
the client's spouse to sign the consent form. The nurse's best action is to:
A. Allow the spouse to sign the consent
B. Contact the hospital ethics committee
C. Ask the surgeon to use a witness and ensure the consent is explained to the
client using an interpreter or appropriate method ✔
D. Proceed with the surgery without a signed consent
Rationale: The client must provide informed consent personally unless they are
incapacitated. If the client cannot read, the consent must be read and explained
2
,to them in a language they understand, with a witness present. The spouse
cannot sign on behalf of a competent adult.
6. Which of the following clients would be at highest risk for complications during
the intraoperative period?
A. A 25-year-old with no significant medical history
B. A 45-year-old with controlled hypertension
C. A 70-year-old with diabetes, hypertension, and obesity ✔
D. A 30-year-old with a history of asthma
Rationale: Advanced age, diabetes, hypertension, and obesity are significant risk
factors for intraoperative complications including cardiovascular events, impaired
wound healing, and respiratory issues. Multiple comorbidities increase the
cumulative risk.
7. A client is NPO (nothing by mouth) before surgery. The primary reason for this
is to:
A. Prevent dehydration
B. Reduce the risk of aspiration during anesthesia ✔
C. Decrease the risk of infection
D. Improve surgical site visibility
Rationale: NPO status reduces gastric volume and acidity, minimizing the risk of
aspiration of gastric contents into the lungs during anesthesia induction.
Aspiration pneumonitis (Mendelson's syndrome) is a serious complication.
8. The nurse is preparing a client for surgery. Which statement by the client
indicates a need for further teaching regarding NPO status?
A. "I understand I cannot eat anything after midnight."
B. "I can have clear liquids up to 2 hours before surgery." ✔
C. "I cannot chew gum or suck on hard candy."
D. "I should not drink coffee or milk before surgery."
Rationale: Current guidelines allow clear liquids up to 2 hours before surgery.
However, many institutions still require NPO after midnight, and the nurse should
3
, follow facility policy. The client's statement may indicate understanding of the
updated guideline but could conflict with the specific order.
9. A client asks the nurse about the difference between general and regional
anesthesia. The nurse correctly states:
A. General anesthesia only affects a specific body part
B. Regional anesthesia causes loss of consciousness
C. General anesthesia affects the entire body and causes loss of consciousness ✔
D. Regional anesthesia is always safer than general anesthesia
Rationale: General anesthesia produces a reversible loss of consciousness,
amnesia, and analgesia affecting the entire body. Regional anesthesia blocks
nerve impulses in a specific area (e.g., spinal, epidural, peripheral nerve block)
without loss of consciousness.
10. During the preoperative assessment, the client reports taking herbal
supplements including ginkgo biloba. The nurse's priority action is to:
A. Document the information and proceed with surgery
B. Instruct the client to stop taking the supplement immediately
C. Notify the surgeon and anesthesia provider because ginkgo can increase
bleeding risk ✔
D. Tell the client it is safe to continue the supplement
Rationale: Ginkgo biloba has antiplatelet effects and can increase the risk of
bleeding during and after surgery. The surgeon and anesthesia provider must be
notified. The client should be advised to stop the supplement per provider order,
typically 2–3 weeks before surgery.
11. A client is undergoing surgery under general anesthesia. Which phase of
anesthesia involves the induction and maintenance of unconsciousness?
A. Preoperative phase
B. Induction phase ✔
C. Emergence phase
D. Postoperative phase
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