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CJE Med-Surg 1 Exam Review Study Guide
Comprehensive Medical-Surgical Nursing Exam Prep
EXAM COVERAGE SUMMARY
This comprehensive examination covers essential medical-surgical nursing concepts including
Maslow's Hierarchy of Needs, bacterial and fungal skin infections (Impetigo, Folliculitis,
Furuncles, Carbuncles, Tinea infections), viral infections (Herpes Zoster), preoperative and
postoperative nursing care, informed consent procedures, anesthesia types, postoperative
complications and interventions (pneumonia, hemorrhage, DVT/VTE/PE, shock, infection,
wound dehiscence/evisceration, ileus, hypotension, respiratory depression, aspiration), pressure
ulcer staging and prevention, skin cancer identification and treatment (BCC, SCC, Melanoma),
acne vulgaris management, scabies and pediculosis treatment, psoriasis care, and wound healing
requirements. The exam emphasizes critical thinking, nursing vigilance, failure to rescue
concepts, and prioritization of patient care across the surgical continuum.
1. A patient scheduled for surgery reports consuming alcohol on the morning of the procedure.
What is the most appropriate nursing action regarding this situation?
A. Proceed with surgery as scheduled since alcohol does not affect surgical outcomes
B. Cancel the surgery immediately without consulting the surgeon
C. Notify the surgeon and anesthesia provider about the alcohol consumption
D. Administer a reversal agent to counteract the effects of the alcohol
C. Notify the surgeon and anesthesia provider about the alcohol consumption
Alcohol consumption on the day of surgery can significantly impact how the body responds to
anesthetic agents and surgical medications, potentially leading to adverse reactions or
complications during the procedure.
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2. A postoperative patient reports a sudden gush of creamy white and red fluid from their
abdominal wound, stating "something gave way." Which complication should the nurse suspect
based on these assessment findings?
A. Normal wound healing with serous drainage
B. Wound infection with purulent discharge
C. Wound dehiscence or evisceration
D. Hematoma formation at the surgical site
C. Wound dehiscence or evisceration
A sudden gush of serosanguineous fluid from an abdominal wound accompanied by the
patient reporting that "something gave way" or "something popped" are classic early signs of
wound dehiscence or evisceration requiring immediate intervention.
3. When assessing a patient's skin for potential melanoma, which type of lesion would be of most
concern as potential melanoma?
A. A small papule with a dry, rough scale
B. A firm, nodular lesion topped with crust
C. A pearly papule with a central crater and a waxy border
D. An irregularly shaped lesion with variable coloration
D. An irregularly shaped lesion with variable coloration
Melanoma typically manifests as an irregularly shaped lesion with dark, red, blue, or mixed
coloration that may show changes in a nevus or appear as a new growth on the skin with
irregular borders and asymmetry.
4. A patient with a Stage III pressure ulcer has extensive tissue damage with sloughing and
tunneling present. Which nursing intervention is most appropriate for this stage of pressure
ulcer?
A. Apply a hydrocolloid dressing to maintain a moist healing environment
B. Debride necrotic tissue and provide prescribed analgesia for pain management
C. Use only sterile saline cleansing without any debridement procedures
D. Apply a semipermeable occlusive dressing and avoid disturbing the wound
B. Debride necrotic tissue and provide prescribed analgesia for pain management
Stage III pressure ulcers are characterized by extensive tissue damage with sloughing,
tunneling, and undermining that requires debridement to remove necrotic tissue along with
appropriate pain management through prescribed analgesia.
5. The preoperative informed consent document must be signed by which individuals before
surgery can proceed?
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A. Only the patient and the primary care provider
B. The patient, a witness, and the physician performing the procedure
C. The patient and the nurse who will be caring for them postoperatively
D. The surgeon, anesthesiologist, and hospital administrator on duty
B. The patient, a witness, and the physician performing the procedure
Informed consent requires signatures from the patient, a witness, and the physician
performing the procedure, and it must be completed before surgery begins to meet legal
requirements and protect against liability if complications arise.
6. A diabetic patient is scheduled for surgery tomorrow morning. The nurse understands that
surgical stress can cause which physiological response in this patient?
A. Decreased blood sugar levels requiring glucose supplementation
B. Skyrocketing blood sugar levels requiring close monitoring
C. No significant change in blood sugar levels during surgery
D. Increased insulin production leading to hypoglycemic episodes
B. Skyrocketing blood sugar levels requiring close monitoring
Stress from surgery can cause diabetic patients' blood sugar levels to skyrocket, requiring
careful monitoring and management throughout the perioperative period to prevent
hyperglycemic complications.
7. Which nutrient is responsible for collagen synthesis and is essential for proper wound healing?
A. Vitamin A
B. Vitamin C
C. Water
D. Zinc
B. Vitamin C
Vitamin C is essential for collagen synthesis, which is crucial for wound healing, while
Vitamin A stimulates epithelial cells, Zinc serves as a cofactor for collagen formation, and
adequate hydration supports overall tissue health.
8. A patient diagnosed with Tinea Capitis is concerned about hair loss. What information should
the nurse provide regarding this condition?
A. Hair loss associated with Tinea Capitis is permanent and irreversible
B. Hair loss is temporary and hair typically grows back after treatment
C. Hair loss only occurs in severe cases requiring surgical intervention
D. Hair loss is not a symptom of Tinea Capitis infections
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B. Hair loss is temporary and hair typically grows back after treatment
Hair loss associated with Tinea Capitis is temporary, and patients can be reassured that their
hair will typically grow back after successful treatment of the fungal infection affecting the
scalp.
9. The nurse is preparing a patient for surgery and notes that the patient takes blood thinners
daily. What action should the nurse take regarding this medication?
A. Administer the blood thinner as scheduled to prevent clotting
B. Double the dose to ensure adequate anticoagulation during surgery
C. Hold the blood thinner as ordered because it could cause dangerous bleeding
D. Switch to a different anticoagulant that has fewer side effects
C. Hold the blood thinner as ordered because it could cause dangerous bleeding
Blood thinners should not be given prior to surgery because even the smallest bleed could
become detrimental to the patient's life during the procedure, so they are typically held per
provider orders.
10. A patient with Impetigo presents with honey-crusted lesions around the nose and mouth.
Which nursing intervention is most appropriate to prevent the spread of this infection?
A. Apply warm compresses to the lesions three times daily
B. Instruct the patient to avoid sharing towels and to bathe daily with antibacterial soap
C. Keep the lesions covered with petroleum jelly to prevent cracking
D. Apply topical corticosteroids to reduce inflammation and itching
B. Instruct the patient to avoid sharing towels and to bathe daily with antibacterial soap
Impetigo is highly contagious and spreads easily, so patients should be taught not to share
personal items like towels and combs, and to bathe daily with antibacterial soap to prevent
transmission to others and spread across the body.
11. The preoperative time out takes place at which point in the surgical process?
A. When the patient arrives at the hospital on the day of surgery
B. After the patient has received preoperative medications
C. Right before the surgery begins with all team members focused on the speaker
D. During the preoperative assessment in the holding area
C. Right before the surgery begins with all team members focused on the speaker
The preoperative time out occurs immediately before surgery begins and requires all eyes on
the speaker, including the physician, to verify that everything is in order and the patient is
ready for the procedure to begin safely.
CJE Med-Surg 1 Exam Review Study Guide
Comprehensive Medical-Surgical Nursing Exam Prep
EXAM COVERAGE SUMMARY
This comprehensive examination covers essential medical-surgical nursing concepts including
Maslow's Hierarchy of Needs, bacterial and fungal skin infections (Impetigo, Folliculitis,
Furuncles, Carbuncles, Tinea infections), viral infections (Herpes Zoster), preoperative and
postoperative nursing care, informed consent procedures, anesthesia types, postoperative
complications and interventions (pneumonia, hemorrhage, DVT/VTE/PE, shock, infection,
wound dehiscence/evisceration, ileus, hypotension, respiratory depression, aspiration), pressure
ulcer staging and prevention, skin cancer identification and treatment (BCC, SCC, Melanoma),
acne vulgaris management, scabies and pediculosis treatment, psoriasis care, and wound healing
requirements. The exam emphasizes critical thinking, nursing vigilance, failure to rescue
concepts, and prioritization of patient care across the surgical continuum.
1. A patient scheduled for surgery reports consuming alcohol on the morning of the procedure.
What is the most appropriate nursing action regarding this situation?
A. Proceed with surgery as scheduled since alcohol does not affect surgical outcomes
B. Cancel the surgery immediately without consulting the surgeon
C. Notify the surgeon and anesthesia provider about the alcohol consumption
D. Administer a reversal agent to counteract the effects of the alcohol
C. Notify the surgeon and anesthesia provider about the alcohol consumption
Alcohol consumption on the day of surgery can significantly impact how the body responds to
anesthetic agents and surgical medications, potentially leading to adverse reactions or
complications during the procedure.
,2|Page
2. A postoperative patient reports a sudden gush of creamy white and red fluid from their
abdominal wound, stating "something gave way." Which complication should the nurse suspect
based on these assessment findings?
A. Normal wound healing with serous drainage
B. Wound infection with purulent discharge
C. Wound dehiscence or evisceration
D. Hematoma formation at the surgical site
C. Wound dehiscence or evisceration
A sudden gush of serosanguineous fluid from an abdominal wound accompanied by the
patient reporting that "something gave way" or "something popped" are classic early signs of
wound dehiscence or evisceration requiring immediate intervention.
3. When assessing a patient's skin for potential melanoma, which type of lesion would be of most
concern as potential melanoma?
A. A small papule with a dry, rough scale
B. A firm, nodular lesion topped with crust
C. A pearly papule with a central crater and a waxy border
D. An irregularly shaped lesion with variable coloration
D. An irregularly shaped lesion with variable coloration
Melanoma typically manifests as an irregularly shaped lesion with dark, red, blue, or mixed
coloration that may show changes in a nevus or appear as a new growth on the skin with
irregular borders and asymmetry.
4. A patient with a Stage III pressure ulcer has extensive tissue damage with sloughing and
tunneling present. Which nursing intervention is most appropriate for this stage of pressure
ulcer?
A. Apply a hydrocolloid dressing to maintain a moist healing environment
B. Debride necrotic tissue and provide prescribed analgesia for pain management
C. Use only sterile saline cleansing without any debridement procedures
D. Apply a semipermeable occlusive dressing and avoid disturbing the wound
B. Debride necrotic tissue and provide prescribed analgesia for pain management
Stage III pressure ulcers are characterized by extensive tissue damage with sloughing,
tunneling, and undermining that requires debridement to remove necrotic tissue along with
appropriate pain management through prescribed analgesia.
5. The preoperative informed consent document must be signed by which individuals before
surgery can proceed?
,3|Page
A. Only the patient and the primary care provider
B. The patient, a witness, and the physician performing the procedure
C. The patient and the nurse who will be caring for them postoperatively
D. The surgeon, anesthesiologist, and hospital administrator on duty
B. The patient, a witness, and the physician performing the procedure
Informed consent requires signatures from the patient, a witness, and the physician
performing the procedure, and it must be completed before surgery begins to meet legal
requirements and protect against liability if complications arise.
6. A diabetic patient is scheduled for surgery tomorrow morning. The nurse understands that
surgical stress can cause which physiological response in this patient?
A. Decreased blood sugar levels requiring glucose supplementation
B. Skyrocketing blood sugar levels requiring close monitoring
C. No significant change in blood sugar levels during surgery
D. Increased insulin production leading to hypoglycemic episodes
B. Skyrocketing blood sugar levels requiring close monitoring
Stress from surgery can cause diabetic patients' blood sugar levels to skyrocket, requiring
careful monitoring and management throughout the perioperative period to prevent
hyperglycemic complications.
7. Which nutrient is responsible for collagen synthesis and is essential for proper wound healing?
A. Vitamin A
B. Vitamin C
C. Water
D. Zinc
B. Vitamin C
Vitamin C is essential for collagen synthesis, which is crucial for wound healing, while
Vitamin A stimulates epithelial cells, Zinc serves as a cofactor for collagen formation, and
adequate hydration supports overall tissue health.
8. A patient diagnosed with Tinea Capitis is concerned about hair loss. What information should
the nurse provide regarding this condition?
A. Hair loss associated with Tinea Capitis is permanent and irreversible
B. Hair loss is temporary and hair typically grows back after treatment
C. Hair loss only occurs in severe cases requiring surgical intervention
D. Hair loss is not a symptom of Tinea Capitis infections
, 4|Page
B. Hair loss is temporary and hair typically grows back after treatment
Hair loss associated with Tinea Capitis is temporary, and patients can be reassured that their
hair will typically grow back after successful treatment of the fungal infection affecting the
scalp.
9. The nurse is preparing a patient for surgery and notes that the patient takes blood thinners
daily. What action should the nurse take regarding this medication?
A. Administer the blood thinner as scheduled to prevent clotting
B. Double the dose to ensure adequate anticoagulation during surgery
C. Hold the blood thinner as ordered because it could cause dangerous bleeding
D. Switch to a different anticoagulant that has fewer side effects
C. Hold the blood thinner as ordered because it could cause dangerous bleeding
Blood thinners should not be given prior to surgery because even the smallest bleed could
become detrimental to the patient's life during the procedure, so they are typically held per
provider orders.
10. A patient with Impetigo presents with honey-crusted lesions around the nose and mouth.
Which nursing intervention is most appropriate to prevent the spread of this infection?
A. Apply warm compresses to the lesions three times daily
B. Instruct the patient to avoid sharing towels and to bathe daily with antibacterial soap
C. Keep the lesions covered with petroleum jelly to prevent cracking
D. Apply topical corticosteroids to reduce inflammation and itching
B. Instruct the patient to avoid sharing towels and to bathe daily with antibacterial soap
Impetigo is highly contagious and spreads easily, so patients should be taught not to share
personal items like towels and combs, and to bathe daily with antibacterial soap to prevent
transmission to others and spread across the body.
11. The preoperative time out takes place at which point in the surgical process?
A. When the patient arrives at the hospital on the day of surgery
B. After the patient has received preoperative medications
C. Right before the surgery begins with all team members focused on the speaker
D. During the preoperative assessment in the holding area
C. Right before the surgery begins with all team members focused on the speaker
The preoperative time out occurs immediately before surgery begins and requires all eyes on
the speaker, including the physician, to verify that everything is in order and the patient is
ready for the procedure to begin safely.
