NUR 242 Exam 1 Questions With 100% Correct Answers
| Latest Updated 2026- 2027 | Graded A+
1|Page
,NUR 242 EXAM 1 — MEDICAL-SURGICAL NURSING CONCEPTS
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: PERIOPERATIVE NURSING — PREOPERATIVE ASSESSMENT AND PREPARATION
Questions 1–25
Q1. A patient scheduled for elective surgery reports taking ginkgo biloba daily. Which action
should the nurse take first?
A. Document the supplement as a home medication
B. Notify the surgeon and anesthesia provider
C. Instruct the patient to stop taking it the morning of surgery
D. Reassure the patient that herbal supplements are safe
Correct Answer: B. Notify the surgeon and anesthesia provider
Rationale: Ginkgo biloba increases bleeding risk by inhibiting platelet aggregation. The surgical
team must be informed so they can determine whether to discontinue the supplement and adjust
perioperative planning. Simply documenting or reassuring the patient without notifying the team
fails to address the potential for excessive bleeding.
Q2. A patient with a history of chronic obstructive pulmonary disease is scheduled for abdominal
surgery. Which preoperative teaching is most important for reducing postoperative respiratory
complications?
A. "Perform incentive spirometry every hour while awake."
B. "Limit fluid intake to prevent pulmonary congestion."
C. "Remain in a supine position for the first 24 hours."
D. "Avoid coughing until the incision has healed."
Correct Answer: A. "Perform incentive spirometry every hour while awake."
Rationale: Incentive spirometry promotes alveolar expansion and prevents atelectasis, a
common postoperative complication in patients with pre-existing pulmonary disease. Fluid
restriction is not routinely indicated, supine positioning impairs lung expansion, and avoiding
coughing increases the risk of retained secretions and pneumonia.
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, Q3. A 78-year-old patient is being prepared for surgery. Which age-related physiologic change
most increases this patient's risk for perioperative complications?
A. Increased hepatic blood flow
B. Decreased glomerular filtration rate
C. Enhanced immune response
D. Increased gastric motility
Correct Answer: B. Decreased glomerular filtration rate
Rationale: Reduced renal clearance in older adults prolongs the elimination of anesthetic agents
and medications, increasing the risk of toxicity and adverse drug effects. Hepatic blood flow
decreases with age, immune response diminishes, and gastric motility slows—all of which make
choices A, C, and D incorrect.
Q4. A patient scheduled for surgery tells the nurse, "I had a bad reaction to anesthesia when I
had my gallbladder removed ten years ago." Which action should the nurse take?
A. Document the statement in the chart and proceed with preparation
B. Reassure the patient that anesthesia techniques have improved
C. Obtain details about the reaction and notify the anesthesia provider
D. Ask the patient to sign the consent form before further discussion
Correct Answer: C. Obtain details about the reaction and notify the anesthesia provider
Rationale: A prior adverse reaction to anesthesia may indicate malignant hyperthermia
susceptibility or other serious risks. The nurse must gather specific information and communicate it
to the anesthesia provider for safe planning. Documentation alone is insufficient, and reassuring the
patient does not address the safety concern.
Q5. Which laboratory value should the nurse report to the surgeon before a scheduled
procedure?
A. Hemoglobin 13.2 g/dL
B. Platelet count 45,000/mm³
C. Serum sodium 140 mEq/L
D. White blood cell count 7,500/mm³
Correct Answer: B. Platelet count 45,000/mm³
Rationale: A platelet count below 50,000/mm³ significantly increases bleeding risk during
surgery. Normal values for hemoglobin, sodium, and white blood cells do not require surgical delay
or intervention.
Q6. A patient who takes warfarin for atrial fibrillation is scheduled for an elective hernia repair.
Which action should the nurse anticipate?
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, A. Administering vitamin K preoperatively
B. Continuing warfarin at the usual dose
C. Holding warfarin and monitoring INR
D. Switching to aspirin until surgery
Correct Answer: C. Holding warfarin and monitoring INR
Rationale: Warfarin must be discontinued before elective surgery to reduce bleeding risk, and
the INR is monitored to ensure coagulation has returned to a safe range. Vitamin K may be used for
urgent reversal but is not routine for elective procedures. Continuing warfarin increases hemorrhage
risk, and aspirin also impairs clotting.
Q7. During a preoperative interview, a patient states, "I smoke about a pack a day." Which
information is most important for the nurse to provide?
A. "Smoking increases your risk of blood clots after surgery."
B. "You should stop smoking at least 24 hours before surgery."
C. "Smoking will not affect your surgery as long as you quit afterward."
D. "You can continue smoking until the morning of surgery."
Correct Answer: B. "You should stop smoking at least 24 hours before surgery."
Rationale: Smoking cessation for at least 24 hours before surgery reduces carboxyhemoglobin
levels and improves oxygen delivery. While smoking does increase clot risk, the most immediate and
actionable teaching is to stop smoking preoperatively. Continuing until surgery is harmful.
Q8. A patient is scheduled for same-day surgery. Which instruction should the nurse include in
preoperative teaching?
A. "Eat a light breakfast on the morning of surgery."
B. "Take all your usual medications with a small sip of water."
C. "Arrange for a responsible adult to drive you home."
D. "You may drive yourself if you feel alert afterward."
Correct Answer: C. "Arrange for a responsible adult to drive you home."
Rationale: Anesthesia and sedatives impair judgment and reflexes, making it unsafe for patients
to drive after surgery. Patients are typically NPO after midnight, and medication instructions vary
based on the provider's orders—not all medications should be taken.
Q9. A patient with diabetes is scheduled for surgery in the morning and is NPO after midnight.
Which finding requires immediate intervention?
A. Blood glucose 110 mg/dL
B. Blood glucose 58 mg/dL
C. Blood glucose 145 mg/dL
D. Blood glucose 180 mg/dL
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| Latest Updated 2026- 2027 | Graded A+
1|Page
,NUR 242 EXAM 1 — MEDICAL-SURGICAL NURSING CONCEPTS
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: PERIOPERATIVE NURSING — PREOPERATIVE ASSESSMENT AND PREPARATION
Questions 1–25
Q1. A patient scheduled for elective surgery reports taking ginkgo biloba daily. Which action
should the nurse take first?
A. Document the supplement as a home medication
B. Notify the surgeon and anesthesia provider
C. Instruct the patient to stop taking it the morning of surgery
D. Reassure the patient that herbal supplements are safe
Correct Answer: B. Notify the surgeon and anesthesia provider
Rationale: Ginkgo biloba increases bleeding risk by inhibiting platelet aggregation. The surgical
team must be informed so they can determine whether to discontinue the supplement and adjust
perioperative planning. Simply documenting or reassuring the patient without notifying the team
fails to address the potential for excessive bleeding.
Q2. A patient with a history of chronic obstructive pulmonary disease is scheduled for abdominal
surgery. Which preoperative teaching is most important for reducing postoperative respiratory
complications?
A. "Perform incentive spirometry every hour while awake."
B. "Limit fluid intake to prevent pulmonary congestion."
C. "Remain in a supine position for the first 24 hours."
D. "Avoid coughing until the incision has healed."
Correct Answer: A. "Perform incentive spirometry every hour while awake."
Rationale: Incentive spirometry promotes alveolar expansion and prevents atelectasis, a
common postoperative complication in patients with pre-existing pulmonary disease. Fluid
restriction is not routinely indicated, supine positioning impairs lung expansion, and avoiding
coughing increases the risk of retained secretions and pneumonia.
2|Page
, Q3. A 78-year-old patient is being prepared for surgery. Which age-related physiologic change
most increases this patient's risk for perioperative complications?
A. Increased hepatic blood flow
B. Decreased glomerular filtration rate
C. Enhanced immune response
D. Increased gastric motility
Correct Answer: B. Decreased glomerular filtration rate
Rationale: Reduced renal clearance in older adults prolongs the elimination of anesthetic agents
and medications, increasing the risk of toxicity and adverse drug effects. Hepatic blood flow
decreases with age, immune response diminishes, and gastric motility slows—all of which make
choices A, C, and D incorrect.
Q4. A patient scheduled for surgery tells the nurse, "I had a bad reaction to anesthesia when I
had my gallbladder removed ten years ago." Which action should the nurse take?
A. Document the statement in the chart and proceed with preparation
B. Reassure the patient that anesthesia techniques have improved
C. Obtain details about the reaction and notify the anesthesia provider
D. Ask the patient to sign the consent form before further discussion
Correct Answer: C. Obtain details about the reaction and notify the anesthesia provider
Rationale: A prior adverse reaction to anesthesia may indicate malignant hyperthermia
susceptibility or other serious risks. The nurse must gather specific information and communicate it
to the anesthesia provider for safe planning. Documentation alone is insufficient, and reassuring the
patient does not address the safety concern.
Q5. Which laboratory value should the nurse report to the surgeon before a scheduled
procedure?
A. Hemoglobin 13.2 g/dL
B. Platelet count 45,000/mm³
C. Serum sodium 140 mEq/L
D. White blood cell count 7,500/mm³
Correct Answer: B. Platelet count 45,000/mm³
Rationale: A platelet count below 50,000/mm³ significantly increases bleeding risk during
surgery. Normal values for hemoglobin, sodium, and white blood cells do not require surgical delay
or intervention.
Q6. A patient who takes warfarin for atrial fibrillation is scheduled for an elective hernia repair.
Which action should the nurse anticipate?
3|Page
, A. Administering vitamin K preoperatively
B. Continuing warfarin at the usual dose
C. Holding warfarin and monitoring INR
D. Switching to aspirin until surgery
Correct Answer: C. Holding warfarin and monitoring INR
Rationale: Warfarin must be discontinued before elective surgery to reduce bleeding risk, and
the INR is monitored to ensure coagulation has returned to a safe range. Vitamin K may be used for
urgent reversal but is not routine for elective procedures. Continuing warfarin increases hemorrhage
risk, and aspirin also impairs clotting.
Q7. During a preoperative interview, a patient states, "I smoke about a pack a day." Which
information is most important for the nurse to provide?
A. "Smoking increases your risk of blood clots after surgery."
B. "You should stop smoking at least 24 hours before surgery."
C. "Smoking will not affect your surgery as long as you quit afterward."
D. "You can continue smoking until the morning of surgery."
Correct Answer: B. "You should stop smoking at least 24 hours before surgery."
Rationale: Smoking cessation for at least 24 hours before surgery reduces carboxyhemoglobin
levels and improves oxygen delivery. While smoking does increase clot risk, the most immediate and
actionable teaching is to stop smoking preoperatively. Continuing until surgery is harmful.
Q8. A patient is scheduled for same-day surgery. Which instruction should the nurse include in
preoperative teaching?
A. "Eat a light breakfast on the morning of surgery."
B. "Take all your usual medications with a small sip of water."
C. "Arrange for a responsible adult to drive you home."
D. "You may drive yourself if you feel alert afterward."
Correct Answer: C. "Arrange for a responsible adult to drive you home."
Rationale: Anesthesia and sedatives impair judgment and reflexes, making it unsafe for patients
to drive after surgery. Patients are typically NPO after midnight, and medication instructions vary
based on the provider's orders—not all medications should be taken.
Q9. A patient with diabetes is scheduled for surgery in the morning and is NPO after midnight.
Which finding requires immediate intervention?
A. Blood glucose 110 mg/dL
B. Blood glucose 58 mg/dL
C. Blood glucose 145 mg/dL
D. Blood glucose 180 mg/dL
4|Page
