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NUR 242 – MEDICAL-SURGICAL NURSING (GALEN COLLEGE)
QUESTIONS LATEST EDITION 2026 – 2027 VERSION SOLVED QUESTIONS
& ANSWERS
NUR 242 – Medical-Surgical Nursing (Galen College) — Questions
10-Point Summarized Exam Coverage
Perioperative Nursing Care (Q1–30): Preoperative assessment and preparation,
informed consent, intraoperative safety, postoperative complications (hemorrhage,
infection, dehiscence, malignant hyperthermia), and discharge planning.
Fluid, Electrolyte & Acid-Base Imbalances (Q31–60): Sodium, potassium, calcium,
and magnesium imbalances; IV therapy; acid-base interpretation (respiratory vs.
metabolic acidosis/alkalosis); and nursing interventions.
Respiratory Disorders (Q61–100): Pneumonia, COPD, asthma, pulmonary embolism,
chest tubes, oxygen therapy, and respiratory failure.
Cardiovascular Disorders (Q101–140): Heart failure, acute coronary syndromes,
dysrhythmias, valvular disease, peripheral vascular disease, and cardiac monitoring.
Gastrointestinal & Hepatobiliary Disorders (Q141–180): Peptic ulcer disease,
inflammatory bowel disease, cirrhosis, pancreatitis, bowel obstruction, and GI
bleeding.
Endocrine Disorders (Q181–215): Diabetes mellitus, DKA, HHS, thyroid disorders
(thyroid storm, myxedema coma), adrenal disorders (Addison's, Cushing's), and SIADH.
Renal & Urinary Disorders (Q216–245): Acute kidney injury, chronic kidney disease,
dialysis, hyperkalemia management, nephrotic syndrome, and urinary tract infections.
Neurological Disorders (Q246–275): Stroke, seizures, increased intracranial pressure,
traumatic brain injury, spinal cord injury, and meningitis.
Musculoskeletal & Integumentary Disorders (Q276–290): Osteoarthritis, rheumatoid
arthritis, osteoporosis, fractures, compartment syndrome, and pressure injuries.
Emergency, Critical Care & Safety (Q291–300): Shock, sepsis, anaphylaxis,
prioritization, delegation, and evidence-based practice.
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SECTION 1: PERIOPERATIVE NURSING CARE (Questions 1–30)
Question 1
A nurse is conducting a preoperative assessment for a client scheduled for abdominal
surgery. Which finding places the client at the highest risk for surgical complications?
A) Blood pressure of 138/86 mm Hg
B) Serum potassium of 2.8 mEq/L
C) Hemoglobin of 13.5 g/dL
D) Fasting blood glucose of 95 mg/dL
Answer: B
Rationale: Hypokalemia (serum potassium <3.5 mEq/L) increases the risk of cardiac
dysrhythmias during surgery and anesthesia. The other values are within acceptable
preoperative ranges.
Question 2
A client is scheduled for surgery in the morning. Which instruction should the nurse
include in the preoperative teaching?
A) "You may have clear liquids up to 2 hours before surgery."
B) "Remove all jewelry and nail polish before coming to the hospital."
C) "Take your anticoagulant medication as usual on the morning of surgery."
D) "Shave the surgical site at home the night before."
Answer: B
Rationale: Jewelry and nail polish should be removed to prevent burns from
electrocautery and to allow accurate pulse oximetry monitoring. Anticoagulants are
typically held before surgery. Shaving is performed by surgical staff.
Question 3
A nurse is assessing a postoperative client who had abdominal surgery. Which finding
requires immediate intervention?
A) Temperature of 37.8°C (100°F)
B) Heart rate of 92 beats per minute
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C) Dehiscence of the surgical wound
D) Mild incisional pain at the surgical site
Answer: C
Rationale: Dehiscence (wound separation) is a surgical emergency that requires
immediate intervention to prevent evisceration and infection.
Question 4
A client is undergoing general anesthesia. Which assessment finding should the nurse
report immediately as a sign of malignant hyperthermia?
A) Decreased heart rate
B) Muscle rigidity and elevated temperature
C) Hypotension and bradycardia
D) Decreased oxygen saturation
Answer: B
Rationale: Malignant hyperthermia is a life-threatening reaction to anesthesia
characterized by muscle rigidity, hyperthermia, tachycardia, and hypercarbia.
Question 5
A nurse is caring for a postoperative client who is drowsy and has a respiratory rate of 8
breaths per minute. Which action should the nurse take first?
A) Administer naloxone
B) Stimulate the client and encourage deep breathing
C) Document the finding and continue monitoring
D) Increase the oxygen flow rate
Answer: B
Rationale: The priority is to stimulate the client and encourage deep breathing to
prevent respiratory depression from anesthesia or opioids.
Question 6
A client is scheduled for an elective surgery. Which preoperative laboratory test is
essential before the procedure?
A) Serum electrolytes
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B) Thyroid function tests
C) Urinalysis
D) All of the above
Answer: D
Rationale: Preoperative laboratory tests typically include serum electrolytes, urinalysis,
complete blood count, and coagulation studies.
Question 7
A nurse is teaching a client about postoperative leg exercises. What is the primary
purpose of these exercises?
A) To prevent deep vein thrombosis
B) To increase muscle mass
C) To reduce incisional pain
D) To improve appetite
Answer: A
Rationale: Leg exercises promote venous return and prevent stasis, reducing the risk of
deep vein thrombosis (DVT) after surgery.
Question 8
A client develops a fever of 38.9°C (102°F) on the second postoperative day. Which
complication should the nurse suspect?
A) Atelectasis
B) Hemorrhage
C) Wound infection
D) Pulmonary embolism
Answer: A
Rationale: Atelectasis is the most common cause of fever in the first 48 hours after
surgery due to alveolar collapse and impaired gas exchange.
Question 9
A nurse is assessing a postoperative client for signs of hemorrhage. Which finding is an
early indicator?
NUR 242 – MEDICAL-SURGICAL NURSING (GALEN COLLEGE)
QUESTIONS LATEST EDITION 2026 – 2027 VERSION SOLVED QUESTIONS
& ANSWERS
NUR 242 – Medical-Surgical Nursing (Galen College) — Questions
10-Point Summarized Exam Coverage
Perioperative Nursing Care (Q1–30): Preoperative assessment and preparation,
informed consent, intraoperative safety, postoperative complications (hemorrhage,
infection, dehiscence, malignant hyperthermia), and discharge planning.
Fluid, Electrolyte & Acid-Base Imbalances (Q31–60): Sodium, potassium, calcium,
and magnesium imbalances; IV therapy; acid-base interpretation (respiratory vs.
metabolic acidosis/alkalosis); and nursing interventions.
Respiratory Disorders (Q61–100): Pneumonia, COPD, asthma, pulmonary embolism,
chest tubes, oxygen therapy, and respiratory failure.
Cardiovascular Disorders (Q101–140): Heart failure, acute coronary syndromes,
dysrhythmias, valvular disease, peripheral vascular disease, and cardiac monitoring.
Gastrointestinal & Hepatobiliary Disorders (Q141–180): Peptic ulcer disease,
inflammatory bowel disease, cirrhosis, pancreatitis, bowel obstruction, and GI
bleeding.
Endocrine Disorders (Q181–215): Diabetes mellitus, DKA, HHS, thyroid disorders
(thyroid storm, myxedema coma), adrenal disorders (Addison's, Cushing's), and SIADH.
Renal & Urinary Disorders (Q216–245): Acute kidney injury, chronic kidney disease,
dialysis, hyperkalemia management, nephrotic syndrome, and urinary tract infections.
Neurological Disorders (Q246–275): Stroke, seizures, increased intracranial pressure,
traumatic brain injury, spinal cord injury, and meningitis.
Musculoskeletal & Integumentary Disorders (Q276–290): Osteoarthritis, rheumatoid
arthritis, osteoporosis, fractures, compartment syndrome, and pressure injuries.
Emergency, Critical Care & Safety (Q291–300): Shock, sepsis, anaphylaxis,
prioritization, delegation, and evidence-based practice.
, Page 2 of 103
SECTION 1: PERIOPERATIVE NURSING CARE (Questions 1–30)
Question 1
A nurse is conducting a preoperative assessment for a client scheduled for abdominal
surgery. Which finding places the client at the highest risk for surgical complications?
A) Blood pressure of 138/86 mm Hg
B) Serum potassium of 2.8 mEq/L
C) Hemoglobin of 13.5 g/dL
D) Fasting blood glucose of 95 mg/dL
Answer: B
Rationale: Hypokalemia (serum potassium <3.5 mEq/L) increases the risk of cardiac
dysrhythmias during surgery and anesthesia. The other values are within acceptable
preoperative ranges.
Question 2
A client is scheduled for surgery in the morning. Which instruction should the nurse
include in the preoperative teaching?
A) "You may have clear liquids up to 2 hours before surgery."
B) "Remove all jewelry and nail polish before coming to the hospital."
C) "Take your anticoagulant medication as usual on the morning of surgery."
D) "Shave the surgical site at home the night before."
Answer: B
Rationale: Jewelry and nail polish should be removed to prevent burns from
electrocautery and to allow accurate pulse oximetry monitoring. Anticoagulants are
typically held before surgery. Shaving is performed by surgical staff.
Question 3
A nurse is assessing a postoperative client who had abdominal surgery. Which finding
requires immediate intervention?
A) Temperature of 37.8°C (100°F)
B) Heart rate of 92 beats per minute
, Page 3 of 103
C) Dehiscence of the surgical wound
D) Mild incisional pain at the surgical site
Answer: C
Rationale: Dehiscence (wound separation) is a surgical emergency that requires
immediate intervention to prevent evisceration and infection.
Question 4
A client is undergoing general anesthesia. Which assessment finding should the nurse
report immediately as a sign of malignant hyperthermia?
A) Decreased heart rate
B) Muscle rigidity and elevated temperature
C) Hypotension and bradycardia
D) Decreased oxygen saturation
Answer: B
Rationale: Malignant hyperthermia is a life-threatening reaction to anesthesia
characterized by muscle rigidity, hyperthermia, tachycardia, and hypercarbia.
Question 5
A nurse is caring for a postoperative client who is drowsy and has a respiratory rate of 8
breaths per minute. Which action should the nurse take first?
A) Administer naloxone
B) Stimulate the client and encourage deep breathing
C) Document the finding and continue monitoring
D) Increase the oxygen flow rate
Answer: B
Rationale: The priority is to stimulate the client and encourage deep breathing to
prevent respiratory depression from anesthesia or opioids.
Question 6
A client is scheduled for an elective surgery. Which preoperative laboratory test is
essential before the procedure?
A) Serum electrolytes
, Page 4 of 103
B) Thyroid function tests
C) Urinalysis
D) All of the above
Answer: D
Rationale: Preoperative laboratory tests typically include serum electrolytes, urinalysis,
complete blood count, and coagulation studies.
Question 7
A nurse is teaching a client about postoperative leg exercises. What is the primary
purpose of these exercises?
A) To prevent deep vein thrombosis
B) To increase muscle mass
C) To reduce incisional pain
D) To improve appetite
Answer: A
Rationale: Leg exercises promote venous return and prevent stasis, reducing the risk of
deep vein thrombosis (DVT) after surgery.
Question 8
A client develops a fever of 38.9°C (102°F) on the second postoperative day. Which
complication should the nurse suspect?
A) Atelectasis
B) Hemorrhage
C) Wound infection
D) Pulmonary embolism
Answer: A
Rationale: Atelectasis is the most common cause of fever in the first 48 hours after
surgery due to alveolar collapse and impaired gas exchange.
Question 9
A nurse is assessing a postoperative client for signs of hemorrhage. Which finding is an
early indicator?
