NUR 242 Med-Surg Nursing Exam Preparation
Evaluation Galen College of Nursing |
2026/2027 Academic Year Comprehensive
Examination: Exams 1–4
1. A client scheduled for surgery cannot read or write. The surgeon
wants the client's spouse to sign the consent instead. What is the best
action?
• A) Have the spouse sign since the client cannot read
• B) Inform the surgeon the client may sign with an "X" in front of
two witnesses
• C) Notify administration to seek a court-appointed guardian
• D) Proceed without a signed consent
Answer: B
Rationale: Inability to read or write does not indicate incapacity to provide legal
consent. The client can sign with an "X" witnessed by two people, provided they
understand the procedure. The nurse should advocate for the patient's right to
give informed consent.
2. What is the correct timeframe for "Emergent" surgery?
• A) Without delay
• B) Within 24–30 hours
• C) Personal preference
• D) Within 6 weeks
Answer: A
Rationale: Emergent surgery must be performed immediately to preserve life or
prevent permanent disability. Think "EMERGENT" = EMERGENCY. Examples
include severe trauma, ruptured aneurysm, or life-threatening hemorrhage.
,3. What is the correct definition for "Elective" surgery?
• A) Without delay
• B) Within 24–30 hours
• C) Personal preference
• D) Failure to have surgery is not catastrophic
Answer: D
Rationale: Elective surgery is scheduled at the patient's convenience and does
not pose an immediate threat to life if delayed. Examples include cosmetic
surgery, joint replacement, and hernia repair.
4. Which technique is best when rinsing hands and forearms after a
surgical scrub?
• A) Starting at the hand with water running up the forearm
• B) Starting with the hand positioned so water runs off the
extremity
• C) Starting at the elbow with water running down to the hand
• D) Rinsing is not performed
Answer: B
Rationale: Rinsing should allow water to run off the hand rather than up or
down the extremity to prevent contaminants from moving onto scrubbed
surfaces. Hands should be held higher than elbows to allow water to flow from
clean to dirty areas.
5. Which client is at greatest risk for respiratory complications after
general anesthesia?
• A) 55-year-old with chronic allergic rhinitis
• B) 65-year-old on calcium channel blockers
, • C) 45-year-old with type 1 diabetes
• D) 68-year-old with COPD who smokes
Answer: D
Rationale: Advanced age, smoking history, and pre-existing respiratory disease
(COPD) significantly increase the risk of postoperative pulmonary complications.
These factors impair gas exchange and airway clearance.
6. A patient is scheduled for surgery and reports taking an anticoagulant
daily. What is the priority action?
• A) Proceed with the surgery as scheduled
• B) Notify the surgeon and anesthesiologist of the anticoagulant use
• C) Administer the anticoagulant as scheduled
• D) Hold the anticoagulant without notifying anyone
Answer: B
Rationale: Anticoagulants increase the risk of bleeding during and after surgery.
The surgeon and anesthesiologist must be notified to determine if the
medication should be held and when. This may also require a coagulation
profile.
7. A patient is NPO for surgery. The patient asks for a glass of water 2
hours before the scheduled procedure. The nurse should:
• A) Give the patient a small sip of water
• B) Explain the reason for NPO status and provide oral care
• C) Notify the surgeon immediately
• D) Allow ice chips only
Answer: B
Rationale: The nurse should explain the reason for NPO status (risk of aspiration
during anesthesia) and provide oral care to keep the patient comfortable. NPO
, guidelines typically include nothing by mouth 6-8 hours before surgery for solids
and 2 hours for clear liquids.
8. The nurse is preparing a patient for surgery. Which action should be
taken regarding the patient's jewelry?
• A) Allow the patient to keep wedding ring on with tape
• B) Remove all jewelry and secure in a labeled container
• C) Allow all jewelry to remain
• D) Cover jewelry with a bandage
Answer: B
Rationale: All jewelry should be removed and secured in a labeled container to
prevent loss, injury (burn from cautery), and infection. Wedding rings may be
taped in place if permitted by facility policy.
9. A patient is exhibiting signs of malignant hyperthermia after receiving
general anesthesia. What is the priority action?
• A) Administer acetaminophen for fever
• B) Administer dantrolene sodium as prescribed
• C) Apply cooling blankets
• D) Increase the rate of IV fluids
Answer: B
Rationale: Dantrolene sodium is the specific antidote for malignant
hyperthermia. It reduces skeletal muscle metabolism and is the priority
treatment. Other interventions include cooling measures, but dantrolene is life-
saving.
10. The nurse is performing a preoperative assessment. Which finding is
most concerning and should be reported immediately?
Evaluation Galen College of Nursing |
2026/2027 Academic Year Comprehensive
Examination: Exams 1–4
1. A client scheduled for surgery cannot read or write. The surgeon
wants the client's spouse to sign the consent instead. What is the best
action?
• A) Have the spouse sign since the client cannot read
• B) Inform the surgeon the client may sign with an "X" in front of
two witnesses
• C) Notify administration to seek a court-appointed guardian
• D) Proceed without a signed consent
Answer: B
Rationale: Inability to read or write does not indicate incapacity to provide legal
consent. The client can sign with an "X" witnessed by two people, provided they
understand the procedure. The nurse should advocate for the patient's right to
give informed consent.
2. What is the correct timeframe for "Emergent" surgery?
• A) Without delay
• B) Within 24–30 hours
• C) Personal preference
• D) Within 6 weeks
Answer: A
Rationale: Emergent surgery must be performed immediately to preserve life or
prevent permanent disability. Think "EMERGENT" = EMERGENCY. Examples
include severe trauma, ruptured aneurysm, or life-threatening hemorrhage.
,3. What is the correct definition for "Elective" surgery?
• A) Without delay
• B) Within 24–30 hours
• C) Personal preference
• D) Failure to have surgery is not catastrophic
Answer: D
Rationale: Elective surgery is scheduled at the patient's convenience and does
not pose an immediate threat to life if delayed. Examples include cosmetic
surgery, joint replacement, and hernia repair.
4. Which technique is best when rinsing hands and forearms after a
surgical scrub?
• A) Starting at the hand with water running up the forearm
• B) Starting with the hand positioned so water runs off the
extremity
• C) Starting at the elbow with water running down to the hand
• D) Rinsing is not performed
Answer: B
Rationale: Rinsing should allow water to run off the hand rather than up or
down the extremity to prevent contaminants from moving onto scrubbed
surfaces. Hands should be held higher than elbows to allow water to flow from
clean to dirty areas.
5. Which client is at greatest risk for respiratory complications after
general anesthesia?
• A) 55-year-old with chronic allergic rhinitis
• B) 65-year-old on calcium channel blockers
, • C) 45-year-old with type 1 diabetes
• D) 68-year-old with COPD who smokes
Answer: D
Rationale: Advanced age, smoking history, and pre-existing respiratory disease
(COPD) significantly increase the risk of postoperative pulmonary complications.
These factors impair gas exchange and airway clearance.
6. A patient is scheduled for surgery and reports taking an anticoagulant
daily. What is the priority action?
• A) Proceed with the surgery as scheduled
• B) Notify the surgeon and anesthesiologist of the anticoagulant use
• C) Administer the anticoagulant as scheduled
• D) Hold the anticoagulant without notifying anyone
Answer: B
Rationale: Anticoagulants increase the risk of bleeding during and after surgery.
The surgeon and anesthesiologist must be notified to determine if the
medication should be held and when. This may also require a coagulation
profile.
7. A patient is NPO for surgery. The patient asks for a glass of water 2
hours before the scheduled procedure. The nurse should:
• A) Give the patient a small sip of water
• B) Explain the reason for NPO status and provide oral care
• C) Notify the surgeon immediately
• D) Allow ice chips only
Answer: B
Rationale: The nurse should explain the reason for NPO status (risk of aspiration
during anesthesia) and provide oral care to keep the patient comfortable. NPO
, guidelines typically include nothing by mouth 6-8 hours before surgery for solids
and 2 hours for clear liquids.
8. The nurse is preparing a patient for surgery. Which action should be
taken regarding the patient's jewelry?
• A) Allow the patient to keep wedding ring on with tape
• B) Remove all jewelry and secure in a labeled container
• C) Allow all jewelry to remain
• D) Cover jewelry with a bandage
Answer: B
Rationale: All jewelry should be removed and secured in a labeled container to
prevent loss, injury (burn from cautery), and infection. Wedding rings may be
taped in place if permitted by facility policy.
9. A patient is exhibiting signs of malignant hyperthermia after receiving
general anesthesia. What is the priority action?
• A) Administer acetaminophen for fever
• B) Administer dantrolene sodium as prescribed
• C) Apply cooling blankets
• D) Increase the rate of IV fluids
Answer: B
Rationale: Dantrolene sodium is the specific antidote for malignant
hyperthermia. It reduces skeletal muscle metabolism and is the priority
treatment. Other interventions include cooling measures, but dantrolene is life-
saving.
10. The nurse is performing a preoperative assessment. Which finding is
most concerning and should be reported immediately?
