Galen NUR 242 Exam 2
UPDATED CONTENT
Medical-Surgical Nursing
(A+ Guarantee) | PDF Edition
A comprehensive 110-item examination aligned with 2026-2027 Galen College of Nursing
curriculum standards for Medical-Surgical Nursing. The exam assesses competence across
eight domains: perioperative nursing, fluid and electrolyte/acid-base balance,
cardiovascular nursing, respiratory nursing, neurological nursing, renal/urinary nursing,
gastrointestinal nursing, and musculoskeletal/integumentary nursing. Each item includes an
A+ level rationale doubling as study guide content.
Total Questions 110
Sections 8
Cognitive Levels Recall 30% / Application 50% / Analysis 20%
Question Style Scenario-Based 75% / Direct Recall 25%
Question Format Multiple Choice (4 options, one correct)
Aligned Standard 2026-2027 Galen College of Nursing Curriculum
Special Features A+ Verified Answers & Rationales | Competency Labels
Section Domain Items
Section 1 Perioperative Nursing Q1-Q14
Section 2 Fluid, Electrolyte, and Acid-Base Balance Q15-Q30
Section 3 Cardiovascular Nursing Q31-Q48
,Galen NUR 242 Exam 2 | Medical-Surgical Nursing 2026/2027 Updated | A+ Guarantee
Section 4 Respiratory Nursing Q49-Q64
Section 5 Neurological Nursing Q65-Q78
Section 6 Renal and Urinary Nursing Q79-Q92
Section 7 Gastrointestinal Nursing Q93-Q104
Section 8 Musculoskeletal and Integumentary Nursing Q105-Q110
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated - A+ Guarantee
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,Galen NUR 242 Exam 2 | Medical-Surgical Nursing 2026/2027 Updated | A+ Guarantee
SECTION 1: Perioperative Nursing
Preoperative, Intraoperative, & Postoperative Care | Range: Q1-Q14 | Cognitive Levels: Recall 30% |
Application 50% | Analysis 20% | Style: Scenario-Based 75% | Direct Recall 25%
Competency: Preoperative Informed Consent
Q1: A 67-year-old patient is scheduled for a total knee replacement tomorrow morning. The
patient asks the nurse to explain the risks of the surgery again after the surgeon already
discussed them. Which action by the nurse is MOST appropriate?
A. Tell the patient that the surgeon already explained everything and the consent form is signed
B. Witness the patient's signature on the consent form after the surgeon has explained the
procedure, risks, and alternatives [CORRECT]
C. Explain the surgical risks in detail to the patient and obtain the signature independently
D. Cancel the surgery until the patient can speak with the anesthesiologist again
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the patient's signature after the provider
(surgeon) has explained the procedure, risks, benefits, and alternatives. The nurse does NOT obtain
consent independently because explaining surgical risks is outside the nursing scope of practice. Refusing
to help or canceling surgery is inappropriate. If the patient has unresolved questions, the nurse must notify
the surgeon.
Competency: Preoperative NPO Guidelines
Q2: A patient scheduled for an elective cholecystectomy at 0800 asks the nurse what time they
must stop drinking water. Following the 2026/2027 enhanced recovery (ERAS) guidelines, the
nurse should respond:
A. Nothing by mouth after midnight regardless of the type of intake
B. Stop solid food 6 hours before surgery; clear fluids may continue until 2 hours before the
scheduled surgery [CORRECT]
C. Stop all fluids 8 hours before surgery
D. Stop fluids 4 hours and solid food 12 hours before surgery
Correct Answer: B
Rationale: ERAS and ASA guidelines recommend stopping solid food 6 hours and clear fluids 2 hours
before elective surgery to reduce gastric volume while preventing dehydration and insulin resistance. The
traditional 'NPO after midnight' is outdated and increases catabolism. Clear fluids include water, clear
juice, and black coffee (no milk).
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated Page 3
, Galen NUR 242 Exam 2 | Medical-Surgical Nursing 2026/2027 Updated | A+ Guarantee
Competency: Preoperative Risk Assessment
Q3: During preoperative assessment, the nurse notes a patient has a history of OSA, BMI 42,
and a 30-pack-year smoking history. Which intraoperative concern is HIGHEST priority for
the anesthesia team?
A. Increased risk of deep vein thrombosis due to obesity
B. Difficult airway management and postoperative respiratory depression [CORRECT]
C. Increased risk of surgical site infection
D. Increased risk of urinary retention
Correct Answer: B
Rationale: Obesity, OSA, and smoking significantly increase risk of difficult intubation, intraoperative
airway obstruction, and postoperative respiratory depression requiring prolonged monitoring. While DVT,
SSI, and urinary retention are also concerns, airway and respiratory risks are immediate life threats that
take priority for anesthesia planning.
Competency: Intraoperative Patient Safety
Q4: The surgical team is preparing a patient in the lithotomy position for a transurethral
procedure. Which intraoperative safety intervention is MOST important to prevent injury?
A. Pad the stirrups and avoid hip flexion greater than 90 degrees to prevent nerve injury and
compartment syndrome [CORRECT]
B. Place the patient in Trendelenburg position to improve venous return
C. Apply sequential compression devices only after the procedure
D. Restrict IV fluids to less than 500 mL intraoperatively
Correct Answer: A
Rationale: Lithotomy positioning risks common peroneal, obturator, and femoral nerve injury, plus
compartment syndrome of the lower extremities. Padding stirrups, avoiding hip flexion >90 degrees,
limiting time in lithotomy, and assessing lower extremities postoperatively are essential. Trendelenburg
increases intracocular and intracranial pressure and is not used here. SCDs should be applied
preoperatively.
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated Page 4
UPDATED CONTENT
Medical-Surgical Nursing
(A+ Guarantee) | PDF Edition
A comprehensive 110-item examination aligned with 2026-2027 Galen College of Nursing
curriculum standards for Medical-Surgical Nursing. The exam assesses competence across
eight domains: perioperative nursing, fluid and electrolyte/acid-base balance,
cardiovascular nursing, respiratory nursing, neurological nursing, renal/urinary nursing,
gastrointestinal nursing, and musculoskeletal/integumentary nursing. Each item includes an
A+ level rationale doubling as study guide content.
Total Questions 110
Sections 8
Cognitive Levels Recall 30% / Application 50% / Analysis 20%
Question Style Scenario-Based 75% / Direct Recall 25%
Question Format Multiple Choice (4 options, one correct)
Aligned Standard 2026-2027 Galen College of Nursing Curriculum
Special Features A+ Verified Answers & Rationales | Competency Labels
Section Domain Items
Section 1 Perioperative Nursing Q1-Q14
Section 2 Fluid, Electrolyte, and Acid-Base Balance Q15-Q30
Section 3 Cardiovascular Nursing Q31-Q48
,Galen NUR 242 Exam 2 | Medical-Surgical Nursing 2026/2027 Updated | A+ Guarantee
Section 4 Respiratory Nursing Q49-Q64
Section 5 Neurological Nursing Q65-Q78
Section 6 Renal and Urinary Nursing Q79-Q92
Section 7 Gastrointestinal Nursing Q93-Q104
Section 8 Musculoskeletal and Integumentary Nursing Q105-Q110
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated - A+ Guarantee
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated Page 2
,Galen NUR 242 Exam 2 | Medical-Surgical Nursing 2026/2027 Updated | A+ Guarantee
SECTION 1: Perioperative Nursing
Preoperative, Intraoperative, & Postoperative Care | Range: Q1-Q14 | Cognitive Levels: Recall 30% |
Application 50% | Analysis 20% | Style: Scenario-Based 75% | Direct Recall 25%
Competency: Preoperative Informed Consent
Q1: A 67-year-old patient is scheduled for a total knee replacement tomorrow morning. The
patient asks the nurse to explain the risks of the surgery again after the surgeon already
discussed them. Which action by the nurse is MOST appropriate?
A. Tell the patient that the surgeon already explained everything and the consent form is signed
B. Witness the patient's signature on the consent form after the surgeon has explained the
procedure, risks, and alternatives [CORRECT]
C. Explain the surgical risks in detail to the patient and obtain the signature independently
D. Cancel the surgery until the patient can speak with the anesthesiologist again
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the patient's signature after the provider
(surgeon) has explained the procedure, risks, benefits, and alternatives. The nurse does NOT obtain
consent independently because explaining surgical risks is outside the nursing scope of practice. Refusing
to help or canceling surgery is inappropriate. If the patient has unresolved questions, the nurse must notify
the surgeon.
Competency: Preoperative NPO Guidelines
Q2: A patient scheduled for an elective cholecystectomy at 0800 asks the nurse what time they
must stop drinking water. Following the 2026/2027 enhanced recovery (ERAS) guidelines, the
nurse should respond:
A. Nothing by mouth after midnight regardless of the type of intake
B. Stop solid food 6 hours before surgery; clear fluids may continue until 2 hours before the
scheduled surgery [CORRECT]
C. Stop all fluids 8 hours before surgery
D. Stop fluids 4 hours and solid food 12 hours before surgery
Correct Answer: B
Rationale: ERAS and ASA guidelines recommend stopping solid food 6 hours and clear fluids 2 hours
before elective surgery to reduce gastric volume while preventing dehydration and insulin resistance. The
traditional 'NPO after midnight' is outdated and increases catabolism. Clear fluids include water, clear
juice, and black coffee (no milk).
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated Page 3
, Galen NUR 242 Exam 2 | Medical-Surgical Nursing 2026/2027 Updated | A+ Guarantee
Competency: Preoperative Risk Assessment
Q3: During preoperative assessment, the nurse notes a patient has a history of OSA, BMI 42,
and a 30-pack-year smoking history. Which intraoperative concern is HIGHEST priority for
the anesthesia team?
A. Increased risk of deep vein thrombosis due to obesity
B. Difficult airway management and postoperative respiratory depression [CORRECT]
C. Increased risk of surgical site infection
D. Increased risk of urinary retention
Correct Answer: B
Rationale: Obesity, OSA, and smoking significantly increase risk of difficult intubation, intraoperative
airway obstruction, and postoperative respiratory depression requiring prolonged monitoring. While DVT,
SSI, and urinary retention are also concerns, airway and respiratory risks are immediate life threats that
take priority for anesthesia planning.
Competency: Intraoperative Patient Safety
Q4: The surgical team is preparing a patient in the lithotomy position for a transurethral
procedure. Which intraoperative safety intervention is MOST important to prevent injury?
A. Pad the stirrups and avoid hip flexion greater than 90 degrees to prevent nerve injury and
compartment syndrome [CORRECT]
B. Place the patient in Trendelenburg position to improve venous return
C. Apply sequential compression devices only after the procedure
D. Restrict IV fluids to less than 500 mL intraoperatively
Correct Answer: A
Rationale: Lithotomy positioning risks common peroneal, obturator, and femoral nerve injury, plus
compartment syndrome of the lower extremities. Padding stirrups, avoiding hip flexion >90 degrees,
limiting time in lithotomy, and assessing lower extremities postoperatively are essential. Trendelenburg
increases intracocular and intracranial pressure and is not used here. SCDs should be applied
preoperatively.
Galen NUR 242 - Medical-Surgical Nursing - Exam 2 - 2026/2027 Updated Page 4
