NU 155 Exam 3 Medical-Surgical Nursing I (2026) PDF |
Galen College of Nursing
INTRODUCTION
This premium study resource features high-yield, board-style multiple-
choice questions designed specifically for the Galen College of Nursing NU
155 Medical-Surgical Nursing I Exam 3. Every question is paired with a
verified, updated answer and a comprehensive clinical rationale to help
you master complex nursing concepts. Use this targeted practice guide to
boost your confidence, refine your clinical judgment, and ace your
upcoming exam.
Question 1
A nurse is caring for a client who is 48 hours postoperative following
abdominal surgery. The client reports a sudden "giving way" sensation in
the abdominal wound after a severe coughing fit. Upon assessment, the
nurse notes the surgical incision has separated, and a loop of the small
intestine is visible. Which of the following is the priority nursing action?
A. Apply a dry, sterile pressure dressing to the wound.
B. Gently push the protruding loop of bowel back into the abdominal cavity.
C. Place the client in a low Fowler's position with knees flexed and cover
the wound with sterile saline-moistened dressings.
D. Document the findings and contact the surgeon within the hour.
,Answer: C. Place the client in a low Fowler's position with knees
flexed and cover the wound with sterile saline-moistened dressings.
Explanation: This client is experiencing wound evisceration, a
medical emergency. The priority action is to minimize tension on the
abdominal wall by placing the client in a low Fowler's position with
knees flexed. The exposed organs must be covered immediately with
sterile dressings soaked in sterile normal saline to prevent tissue
drying and necrosis. The nurse must not attempt to reinsert organs,
apply a dry dressing, or delay emergency notification of the surgical
team.
Question 2
During a surgical procedure under general anesthesia, the circulating
nurse notes that the client’s end-tidal carbon dioxide (ETCO₂) level is
rapidly escalating, the heart rate has risen to 142 beats/minute, and the
client's jaw muscles are rigidly clenched. Which medication should the
nurse anticipate administering immediately?
A. IV Meperidine
B. IV Dantrolene sodium
C. IV Succinylcholine
D. IV Atropine sulfate
Answer: B. IV Dantrolene sodium
,Explanation: The client is exhibiting hallmark signs of malignant
hyperthermia (MH), a rare, life-threatening genetic hypermetabolic
reaction to volatile inhalational anesthetics or succinylcholine. Rigid
jaw muscles (masseter spasm), unexplained tachycardia, and rising
ETCO₂ are early indicators. Dantrolene sodium is a skeletal muscle
relaxant that acts as the primary antidote by halting calcium release
from the sarcoplasmic reticulum. Succinylcholine is a triggering
agent and must be avoided.
Question 3
A nurse is reinforcing discharge teaching regarding deep vein thrombosis
(DVT) prevention for a postoperative client. Which statement made by the
client indicates a correct understanding of the instructions?
A. "I will massage my legs firmly twice a day if they feel sore or stiff."
B. "I should avoid crossing my legs at the knees or ankles when sitting."
C. "I need to limit my fluid intake to prevent swelling in my lower
extremities."
D. "I will perform ankle pump exercises only when sitting up in a chair."
Answer: B. "I should avoid crossing my legs at the knees or ankles
when sitting."
Explanation: Crossing the legs at the knees or ankles compresses
the popliteal vessels and impairs venous return, increasing the risk
of venous stasis and DVT formation. Massaging the legs is strictly
, contraindicated because it can dislodge an undetected thrombus,
causing a pulmonary embolism. Postoperative clients require
adequate hydration to prevent hemoconcentration, and ankle pumps
should be performed frequently while in bed or a chair.
Question 4
A postoperative client is receiving patient-controlled analgesia (PCA) with
morphine sulfate. The nurse assesses the client and finds the following:
respiratory rate 9 breaths/minute, oxygen saturation 89% on room air,
and the client is difficult to arouse with verbal commands. What is the
nurse's immediate priority action?
A. Administer a dose of naloxone as prescribed and stop the PCA infusion.
B. Increase the oxygen flow rate via nasal cannula to 4 L/min.
C. Encourage the client to take deep, controlled breaths every 30
seconds.
D. Document the findings and re-evaluate the respiratory status in 15
minutes.
Answer: A. Administer a dose of naloxone as prescribed and stop the
PCA infusion.
Explanation: The client is showing signs of opioid-induced central
nervous system and respiratory depression (respiratory rate <10
breaths/min, somnolence, hypoxia). The immediate priority is to
stop the opioid infusion and reverse the respiratory depression by
Galen College of Nursing
INTRODUCTION
This premium study resource features high-yield, board-style multiple-
choice questions designed specifically for the Galen College of Nursing NU
155 Medical-Surgical Nursing I Exam 3. Every question is paired with a
verified, updated answer and a comprehensive clinical rationale to help
you master complex nursing concepts. Use this targeted practice guide to
boost your confidence, refine your clinical judgment, and ace your
upcoming exam.
Question 1
A nurse is caring for a client who is 48 hours postoperative following
abdominal surgery. The client reports a sudden "giving way" sensation in
the abdominal wound after a severe coughing fit. Upon assessment, the
nurse notes the surgical incision has separated, and a loop of the small
intestine is visible. Which of the following is the priority nursing action?
A. Apply a dry, sterile pressure dressing to the wound.
B. Gently push the protruding loop of bowel back into the abdominal cavity.
C. Place the client in a low Fowler's position with knees flexed and cover
the wound with sterile saline-moistened dressings.
D. Document the findings and contact the surgeon within the hour.
,Answer: C. Place the client in a low Fowler's position with knees
flexed and cover the wound with sterile saline-moistened dressings.
Explanation: This client is experiencing wound evisceration, a
medical emergency. The priority action is to minimize tension on the
abdominal wall by placing the client in a low Fowler's position with
knees flexed. The exposed organs must be covered immediately with
sterile dressings soaked in sterile normal saline to prevent tissue
drying and necrosis. The nurse must not attempt to reinsert organs,
apply a dry dressing, or delay emergency notification of the surgical
team.
Question 2
During a surgical procedure under general anesthesia, the circulating
nurse notes that the client’s end-tidal carbon dioxide (ETCO₂) level is
rapidly escalating, the heart rate has risen to 142 beats/minute, and the
client's jaw muscles are rigidly clenched. Which medication should the
nurse anticipate administering immediately?
A. IV Meperidine
B. IV Dantrolene sodium
C. IV Succinylcholine
D. IV Atropine sulfate
Answer: B. IV Dantrolene sodium
,Explanation: The client is exhibiting hallmark signs of malignant
hyperthermia (MH), a rare, life-threatening genetic hypermetabolic
reaction to volatile inhalational anesthetics or succinylcholine. Rigid
jaw muscles (masseter spasm), unexplained tachycardia, and rising
ETCO₂ are early indicators. Dantrolene sodium is a skeletal muscle
relaxant that acts as the primary antidote by halting calcium release
from the sarcoplasmic reticulum. Succinylcholine is a triggering
agent and must be avoided.
Question 3
A nurse is reinforcing discharge teaching regarding deep vein thrombosis
(DVT) prevention for a postoperative client. Which statement made by the
client indicates a correct understanding of the instructions?
A. "I will massage my legs firmly twice a day if they feel sore or stiff."
B. "I should avoid crossing my legs at the knees or ankles when sitting."
C. "I need to limit my fluid intake to prevent swelling in my lower
extremities."
D. "I will perform ankle pump exercises only when sitting up in a chair."
Answer: B. "I should avoid crossing my legs at the knees or ankles
when sitting."
Explanation: Crossing the legs at the knees or ankles compresses
the popliteal vessels and impairs venous return, increasing the risk
of venous stasis and DVT formation. Massaging the legs is strictly
, contraindicated because it can dislodge an undetected thrombus,
causing a pulmonary embolism. Postoperative clients require
adequate hydration to prevent hemoconcentration, and ankle pumps
should be performed frequently while in bed or a chair.
Question 4
A postoperative client is receiving patient-controlled analgesia (PCA) with
morphine sulfate. The nurse assesses the client and finds the following:
respiratory rate 9 breaths/minute, oxygen saturation 89% on room air,
and the client is difficult to arouse with verbal commands. What is the
nurse's immediate priority action?
A. Administer a dose of naloxone as prescribed and stop the PCA infusion.
B. Increase the oxygen flow rate via nasal cannula to 4 L/min.
C. Encourage the client to take deep, controlled breaths every 30
seconds.
D. Document the findings and re-evaluate the respiratory status in 15
minutes.
Answer: A. Administer a dose of naloxone as prescribed and stop the
PCA infusion.
Explanation: The client is showing signs of opioid-induced central
nervous system and respiratory depression (respiratory rate <10
breaths/min, somnolence, hypoxia). The immediate priority is to
stop the opioid infusion and reverse the respiratory depression by
