NUR 242 Exam 1 – Medical-Surgical Nursing –
(2026/2027) Galen Actual Questions & Answers, 100%
Guarantee Pass
Section A: Perioperative & Safety
1. A patient is scheduled for surgery. Who is primarily responsible for obtaining
informed consent?
• A. The nurse
• B. The surgeon
• C. The anesthesiologist
• D. The patient's family member
• Answer: B
• Rationale: The surgeon is responsible for explaining the procedure, risks,
benefits, and alternatives and for obtaining the patient's consent. The
nurse's role is typically to witness the signature .
2. A patient with diabetes and limited mobility is at high risk for pressure
injuries. Which intervention should the nurse prioritize to prevent skin
breakdown?
• A. Reposition the patient every 1-2 hours.
• B. Massage reddened areas over bony prominences.
• C. Use a donut-shaped ring cushion.
• D. Limit the patient's fluid intake to reduce incontinence.
• Answer: A
• Rationale: Frequent repositioning (every 1-2 hours) is the cornerstone of
pressure injury prevention . Massaging reddened areas can actually damage
underlying capillaries and worsen tissue injury. Donut cushions can impede
circulation. Adequate hydration is important for skin health .
,3. A bedbound patient has a localized area of non-blanchable redness over the
sacrum with intact skin. How should the nurse stage this pressure injury?
• A. Stage 1
• B. Stage 2
• C. Stage 3
• D. Stage 4
• Answer: A
• Rationale: A Stage 1 pressure injury is defined as intact skin with non-
blanchable erythema over a bony prominence .
4. A patient is one day post-operative. Which lab value would be most
concerning and indicate a possible complication?
• A. White Blood Cell (WBC) count of 12,000/mm³
• B. Hemoglobin of 10 g/dL
• C. Blood pressure of 90/60 mmHg
• D. Potassium level of 4.0 mEq/L
• Answer: C
• Rationale: Post-operative hypotension (BP 90/60) can be a sign of
hemorrhage or hypovolemic shock and requires immediate intervention .
5. A patient is using an incentive spirometer post-operatively. Which instruction
is correct for its use?
• A. Inhale quickly and deeply.
• B. Inhale slowly and deeply.
• C. Exhale quickly into the device.
• D. Use the device once per hour.
• Answer: B
, • Rationale: The patient should inhale slowly and deeply to promote lung
expansion and prevent atelectasis .
6. A patient has a Braden Scale score of 12, indicating high risk for pressure
ulcers. Which intervention is most appropriate?
• A. Assess for pain every 2 hours.
• B. Use a pressure-reducing mattress and reposition frequently.
• C. Limit protein intake to prevent fluid overload.
• D. Cleanse the skin with hot water and soap.
• Answer: B
• Rationale: A low Braden score indicates high pressure injury risk, requiring
frequent repositioning and use of support surfaces . Protein intake should
be increased, not limited, and skin should be cleaned gently.
7. Which statement by a new nurse indicates correct understanding of
delegation to a UAP?
• A. "Once I delegate, the UAP is responsible for the outcome."
• B. "I'm accountable for making sure the task is appropriate and done
correctly."
• C. "If a task is in the job description, I don't need to supervise."
• D. "Delegation removes my legal responsibility."
• Answer: B
• Rationale: The RN retains accountability for the overall nursing care,
including tasks delegated to others. The RN must ensure the task is
appropriate, the person is competent, and proper communication and
supervision occur .
Section B: Fluid, Electrolyte, & Acid-Base Balance
8. A patient's serum sodium level is 150 mEq/L (normal: 135-145 mEq/L). Which
sign would you most expect?
, • A. Dry mucous membranes and thirst
• B. Crackles in the lungs and edema
• C. Muscle cramps and tetany
• D. Lethargy and confusion
• Answer: A
• Rationale: A sodium level of 150 mEq/L indicates hypernatremia, which
causes cellular dehydration and triggers thirst and dry mucous membranes .
9. A nurse is caring for a patient who is 24 hours post-op and receiving IV fluids.
Which assessment finding is the most critical to report?
• A. The patient reports thirst.
• B. The patient's blood pressure is 142/88 mmHg.
• C. Crackles are auscultated in the lung bases.
• D. The patient's urine output is 60 mL/hr.
• Answer: C
• Rationale: Crackles in the lungs are a sign of fluid overload, which can lead
to pulmonary edema. This is a critical finding requiring immediate action .
10. Which of the following acid-base imbalances is most commonly associated
with COPD?
• A. Respiratory Alkalosis
• B. Respiratory Acidosis
• C. Metabolic Alkalosis
• D. Metabolic Acidosis
• Answer: B
• Rationale: Patients with COPD have impaired CO2 elimination, leading to
chronic CO2 retention and respiratory acidosis .
(2026/2027) Galen Actual Questions & Answers, 100%
Guarantee Pass
Section A: Perioperative & Safety
1. A patient is scheduled for surgery. Who is primarily responsible for obtaining
informed consent?
• A. The nurse
• B. The surgeon
• C. The anesthesiologist
• D. The patient's family member
• Answer: B
• Rationale: The surgeon is responsible for explaining the procedure, risks,
benefits, and alternatives and for obtaining the patient's consent. The
nurse's role is typically to witness the signature .
2. A patient with diabetes and limited mobility is at high risk for pressure
injuries. Which intervention should the nurse prioritize to prevent skin
breakdown?
• A. Reposition the patient every 1-2 hours.
• B. Massage reddened areas over bony prominences.
• C. Use a donut-shaped ring cushion.
• D. Limit the patient's fluid intake to reduce incontinence.
• Answer: A
• Rationale: Frequent repositioning (every 1-2 hours) is the cornerstone of
pressure injury prevention . Massaging reddened areas can actually damage
underlying capillaries and worsen tissue injury. Donut cushions can impede
circulation. Adequate hydration is important for skin health .
,3. A bedbound patient has a localized area of non-blanchable redness over the
sacrum with intact skin. How should the nurse stage this pressure injury?
• A. Stage 1
• B. Stage 2
• C. Stage 3
• D. Stage 4
• Answer: A
• Rationale: A Stage 1 pressure injury is defined as intact skin with non-
blanchable erythema over a bony prominence .
4. A patient is one day post-operative. Which lab value would be most
concerning and indicate a possible complication?
• A. White Blood Cell (WBC) count of 12,000/mm³
• B. Hemoglobin of 10 g/dL
• C. Blood pressure of 90/60 mmHg
• D. Potassium level of 4.0 mEq/L
• Answer: C
• Rationale: Post-operative hypotension (BP 90/60) can be a sign of
hemorrhage or hypovolemic shock and requires immediate intervention .
5. A patient is using an incentive spirometer post-operatively. Which instruction
is correct for its use?
• A. Inhale quickly and deeply.
• B. Inhale slowly and deeply.
• C. Exhale quickly into the device.
• D. Use the device once per hour.
• Answer: B
, • Rationale: The patient should inhale slowly and deeply to promote lung
expansion and prevent atelectasis .
6. A patient has a Braden Scale score of 12, indicating high risk for pressure
ulcers. Which intervention is most appropriate?
• A. Assess for pain every 2 hours.
• B. Use a pressure-reducing mattress and reposition frequently.
• C. Limit protein intake to prevent fluid overload.
• D. Cleanse the skin with hot water and soap.
• Answer: B
• Rationale: A low Braden score indicates high pressure injury risk, requiring
frequent repositioning and use of support surfaces . Protein intake should
be increased, not limited, and skin should be cleaned gently.
7. Which statement by a new nurse indicates correct understanding of
delegation to a UAP?
• A. "Once I delegate, the UAP is responsible for the outcome."
• B. "I'm accountable for making sure the task is appropriate and done
correctly."
• C. "If a task is in the job description, I don't need to supervise."
• D. "Delegation removes my legal responsibility."
• Answer: B
• Rationale: The RN retains accountability for the overall nursing care,
including tasks delegated to others. The RN must ensure the task is
appropriate, the person is competent, and proper communication and
supervision occur .
Section B: Fluid, Electrolyte, & Acid-Base Balance
8. A patient's serum sodium level is 150 mEq/L (normal: 135-145 mEq/L). Which
sign would you most expect?
, • A. Dry mucous membranes and thirst
• B. Crackles in the lungs and edema
• C. Muscle cramps and tetany
• D. Lethargy and confusion
• Answer: A
• Rationale: A sodium level of 150 mEq/L indicates hypernatremia, which
causes cellular dehydration and triggers thirst and dry mucous membranes .
9. A nurse is caring for a patient who is 24 hours post-op and receiving IV fluids.
Which assessment finding is the most critical to report?
• A. The patient reports thirst.
• B. The patient's blood pressure is 142/88 mmHg.
• C. Crackles are auscultated in the lung bases.
• D. The patient's urine output is 60 mL/hr.
• Answer: C
• Rationale: Crackles in the lungs are a sign of fluid overload, which can lead
to pulmonary edema. This is a critical finding requiring immediate action .
10. Which of the following acid-base imbalances is most commonly associated
with COPD?
• A. Respiratory Alkalosis
• B. Respiratory Acidosis
• C. Metabolic Alkalosis
• D. Metabolic Acidosis
• Answer: B
• Rationale: Patients with COPD have impaired CO2 elimination, leading to
chronic CO2 retention and respiratory acidosis .
