NU 155 Exam 4 | Med-Surg Nursing I
Nursing Practice Exam (2026/2027) - Galen College
(1) A nurse is caring for a client who is post-operative. Which assessment finding is the
priority to report to the provider?
A. Serosanguineous drainage on the dressing.
B. Absence of bowel sounds in all four quadrants.
C. A decrease in oxygen saturation from 98% to 91%.
D. Urine output of 100 mL over the last 3 hours.
CORRECT ANSWER: C
Rationale: Airway and oxygenation are the top priorities in post-op care (ABC). A significant
drop in O2 saturation indicates potential respiratory compromise or atelectasis.
(2) During the preoperative assessment, the client mentions an allergy to bananas and
avocados. Which action should the nurse take?
A. Document the food allergy only.
B. Alert the surgical team of a possible latex allergy.
C. Administer an antihistamine immediately.
D. Cancel the surgery scheduled for the morning.
CORRECT ANSWER: B
Rationale: There is a known cross-sensitivity between certain foods (bananas, avocados, kiwi,
chestnuts) and latex. This requires latex-free precautions during surgery.
(3) A client receiving chemotherapy has a platelet count of 25,000/mm3. Which intervention is
most important for the nurse to implement?
A. Encourage the use of a firm-bristled toothbrush.
B. Limit visitors to immediate family only.
C. Avoid intramuscular (IM) injections.
D. Maintain the client on strict bed rest.
CORRECT ANSWER: C
Rationale: A platelet count below 50,000 indicates thrombocytopenia, placing the client at high
risk for bleeding. IM injections should be avoided to prevent hematomas and excessive
bleeding.
,(4) A nurse is educating a client on the warning signs of cancer using the 'CAUTION'
acronym. What does the 'U' stand for?
A. Ulcerations that are painful.
B. Unusual bleeding or discharge.
C. Underweight status without effort.
D. Urticaria that persists.
CORRECT ANSWER: B
Rationale: In the CAUTION acronym, U stands for Unusual bleeding or discharge. Others:
Change in bowel/bladder, A sore that doesn't heal, Thickening/lump, Indigestion, Obvious
change in wart/mole, Nagging cough.
(5) Which laboratory value is used to monitor the progression of HIV and the effectiveness of
antiretroviral therapy (ART)?
A. Red blood cell count.
B. CD4+ T-cell count.
C. Serum potassium.
D. Platelet count.
CORRECT ANSWER: B
Rationale: The CD4+ T-cell count is a primary indicator of immune function and is used to
monitor HIV progression and the effectiveness of ART.
(6) A client is admitted with a potassium level of 6.2 mEq/L. Which cardiac rhythm change
should the nurse expect to see on the EKG?
A. U-waves.
B. Tall, peaked T-waves.
C. Flattened T-waves.
D. Shortened PR interval.
CORRECT ANSWER: B
Rationale: Hyperkalemia causes peaked T-waves, widened QRS complexes, and potentially
cardiac arrest. U-waves are associated with hypokalemia.
,(7) A nurse is assessing a client with hypocalcemia. Which sign is elicited by tapping on the
client's facial nerve?
A. Trousseau's sign.
B. Chvostek's sign.
C. Homans' sign.
D. Babinski's sign.
CORRECT ANSWER: B
Rationale: Chvostek's sign is facial twitching elicited by tapping the facial nerve; it is a clinical
manifestation of hypocalcemia.
(8) A client's ABG results are: pH 7.30, PaCO2 55 mm Hg, and HCO3 24 mEq/L. How should
the nurse interpret these results?
A. Respiratory alkalosis.
B. Metabolic acidosis.
C. Respiratory acidosis.
D. Metabolic alkalosis.
CORRECT ANSWER: C
Rationale: A pH below 7.35 is acidotic. A PaCO2 above 45 indicates a respiratory cause. Since
the bicarbonate is normal, this is uncompensated respiratory acidosis.
(9) The nurse is preparing to witness a surgical consent. What is the nurse's primary
responsibility?
A. Explaining the risks and benefits of the procedure.
B. Verifying the client is competent and signed voluntarily.
C. Deciding if the surgery is necessary.
D. Answering technical questions about the surgical technique.
CORRECT ANSWER: B
Rationale: The nurse witnesses the signature to confirm the client is signing voluntarily and
appears competent. Explaining risks/benefits is the surgeon's responsibility.
, (10) A client with neutropenia following chemotherapy is being placed on 'Neutropenic
Precautions.' Which food item should be removed from the meal tray?
A. Cooked carrots.
B. Fresh blueberries.
C. Canned peaches.
D. Baked potato.
CORRECT ANSWER: B
Rationale: Fresh fruits and vegetables can harbor bacteria and fungi; neutropenic clients should
only eat cooked or canned produce to prevent infection.
(11) A nurse is caring for a client who is post-operative. Which assessment finding is the
priority to report to the provider?
A. Serosanguineous drainage on the dressing.
B. Absence of bowel sounds in all four quadrants.
C. A decrease in oxygen saturation from 98% to 91%.
D. Urine output of 100 mL over the last 3 hours.
CORRECT ANSWER: C
Rationale: Airway and oxygenation are the top priorities in post-op care (ABC). A significant
drop in O2 saturation indicates potential respiratory compromise or atelectasis.
(12) During the preoperative assessment, the client mentions an allergy to bananas and
avocados. Which action should the nurse take?
A. Document the food allergy only.
B. Alert the surgical team of a possible latex allergy.
C. Administer an antihistamine immediately.
D. Cancel the surgery scheduled for the morning.
CORRECT ANSWER: B
Rationale: There is a known cross-sensitivity between certain foods (bananas, avocados, kiwi,
chestnuts) and latex. This requires latex-free precautions during surgery.
Nursing Practice Exam (2026/2027) - Galen College
(1) A nurse is caring for a client who is post-operative. Which assessment finding is the
priority to report to the provider?
A. Serosanguineous drainage on the dressing.
B. Absence of bowel sounds in all four quadrants.
C. A decrease in oxygen saturation from 98% to 91%.
D. Urine output of 100 mL over the last 3 hours.
CORRECT ANSWER: C
Rationale: Airway and oxygenation are the top priorities in post-op care (ABC). A significant
drop in O2 saturation indicates potential respiratory compromise or atelectasis.
(2) During the preoperative assessment, the client mentions an allergy to bananas and
avocados. Which action should the nurse take?
A. Document the food allergy only.
B. Alert the surgical team of a possible latex allergy.
C. Administer an antihistamine immediately.
D. Cancel the surgery scheduled for the morning.
CORRECT ANSWER: B
Rationale: There is a known cross-sensitivity between certain foods (bananas, avocados, kiwi,
chestnuts) and latex. This requires latex-free precautions during surgery.
(3) A client receiving chemotherapy has a platelet count of 25,000/mm3. Which intervention is
most important for the nurse to implement?
A. Encourage the use of a firm-bristled toothbrush.
B. Limit visitors to immediate family only.
C. Avoid intramuscular (IM) injections.
D. Maintain the client on strict bed rest.
CORRECT ANSWER: C
Rationale: A platelet count below 50,000 indicates thrombocytopenia, placing the client at high
risk for bleeding. IM injections should be avoided to prevent hematomas and excessive
bleeding.
,(4) A nurse is educating a client on the warning signs of cancer using the 'CAUTION'
acronym. What does the 'U' stand for?
A. Ulcerations that are painful.
B. Unusual bleeding or discharge.
C. Underweight status without effort.
D. Urticaria that persists.
CORRECT ANSWER: B
Rationale: In the CAUTION acronym, U stands for Unusual bleeding or discharge. Others:
Change in bowel/bladder, A sore that doesn't heal, Thickening/lump, Indigestion, Obvious
change in wart/mole, Nagging cough.
(5) Which laboratory value is used to monitor the progression of HIV and the effectiveness of
antiretroviral therapy (ART)?
A. Red blood cell count.
B. CD4+ T-cell count.
C. Serum potassium.
D. Platelet count.
CORRECT ANSWER: B
Rationale: The CD4+ T-cell count is a primary indicator of immune function and is used to
monitor HIV progression and the effectiveness of ART.
(6) A client is admitted with a potassium level of 6.2 mEq/L. Which cardiac rhythm change
should the nurse expect to see on the EKG?
A. U-waves.
B. Tall, peaked T-waves.
C. Flattened T-waves.
D. Shortened PR interval.
CORRECT ANSWER: B
Rationale: Hyperkalemia causes peaked T-waves, widened QRS complexes, and potentially
cardiac arrest. U-waves are associated with hypokalemia.
,(7) A nurse is assessing a client with hypocalcemia. Which sign is elicited by tapping on the
client's facial nerve?
A. Trousseau's sign.
B. Chvostek's sign.
C. Homans' sign.
D. Babinski's sign.
CORRECT ANSWER: B
Rationale: Chvostek's sign is facial twitching elicited by tapping the facial nerve; it is a clinical
manifestation of hypocalcemia.
(8) A client's ABG results are: pH 7.30, PaCO2 55 mm Hg, and HCO3 24 mEq/L. How should
the nurse interpret these results?
A. Respiratory alkalosis.
B. Metabolic acidosis.
C. Respiratory acidosis.
D. Metabolic alkalosis.
CORRECT ANSWER: C
Rationale: A pH below 7.35 is acidotic. A PaCO2 above 45 indicates a respiratory cause. Since
the bicarbonate is normal, this is uncompensated respiratory acidosis.
(9) The nurse is preparing to witness a surgical consent. What is the nurse's primary
responsibility?
A. Explaining the risks and benefits of the procedure.
B. Verifying the client is competent and signed voluntarily.
C. Deciding if the surgery is necessary.
D. Answering technical questions about the surgical technique.
CORRECT ANSWER: B
Rationale: The nurse witnesses the signature to confirm the client is signing voluntarily and
appears competent. Explaining risks/benefits is the surgeon's responsibility.
, (10) A client with neutropenia following chemotherapy is being placed on 'Neutropenic
Precautions.' Which food item should be removed from the meal tray?
A. Cooked carrots.
B. Fresh blueberries.
C. Canned peaches.
D. Baked potato.
CORRECT ANSWER: B
Rationale: Fresh fruits and vegetables can harbor bacteria and fungi; neutropenic clients should
only eat cooked or canned produce to prevent infection.
(11) A nurse is caring for a client who is post-operative. Which assessment finding is the
priority to report to the provider?
A. Serosanguineous drainage on the dressing.
B. Absence of bowel sounds in all four quadrants.
C. A decrease in oxygen saturation from 98% to 91%.
D. Urine output of 100 mL over the last 3 hours.
CORRECT ANSWER: C
Rationale: Airway and oxygenation are the top priorities in post-op care (ABC). A significant
drop in O2 saturation indicates potential respiratory compromise or atelectasis.
(12) During the preoperative assessment, the client mentions an allergy to bananas and
avocados. Which action should the nurse take?
A. Document the food allergy only.
B. Alert the surgical team of a possible latex allergy.
C. Administer an antihistamine immediately.
D. Cancel the surgery scheduled for the morning.
CORRECT ANSWER: B
Rationale: There is a known cross-sensitivity between certain foods (bananas, avocados, kiwi,
chestnuts) and latex. This requires latex-free precautions during surgery.
