NUR 242 Exam 2 Medical-Surgical Nursing Concepts |
Comprehensive Review Questions and Correct Answers &
Rationales | New Update 2026-2027 - Galen
1. Which of the following best describes the primary purpose of the
preoperative assessment?
A) To determine the patient's understanding of the surgery and obtain informed
consent
B) To administer preoperative medications
C) To complete the surgical checklist
D) To transfer the patient to the operating room
Correct Answer: To determine the patient's understanding of the surgery and
obtain informed consent
Rationale: The four goals of the preoperative assessment are to determine the
patient's understanding, confirm informed consent, assess anxiety, and obtain
relevant health information. The perioperative nurse completes this assessment.
Education and anxiety reduction are key components.
2. What is the primary function of the surgical time-out?
A) To administer anesthesia
B) To verify the correct patient, procedure, and site
C) To document the surgical start time
D) To position the patient
Correct Answer: To verify the correct patient, procedure, and site
Rationale: A time-out is a safety checklist performed immediately before surgery
to confirm the correct patient, procedure, site, and other critical details. It
prevents wrong-site, wrong-procedure, and wrong-patient errors. All team
members participate.
3. According to the exam blueprint, which electrolyte imbalance is most likely
in a patient with prolonged vomiting?
,A) Hyperkalemia and metabolic acidosis
B) Hypokalemia and metabolic alkalosis
C) Hypernatremia and respiratory alkalosis
D) Hypocalcemia and respiratory acidosis
Correct Answer: Hypokalemia and metabolic alkalosis
Rationale: Prolonged vomiting causes loss of gastric fluid rich in hydrogen and
potassium ions. This leads to hypokalemia and metabolic alkalosis. Nurses must
monitor electrolyte levels and replace fluids and electrolytes appropriately to
prevent cardiac dysrhythmias.
4. Which finding is most consistent with respiratory acidosis?
A) pH 7.50, PaCO2 30 mmHg, HCO3 24 mEq/L
B) pH 7.28, PaCO2 55 mmHg, HCO3 24 mEq/L
C) pH 7.30, HCO3 18 mEq/L, PaCO2 35 mmHg
D) pH 7.48, HCO3 30 mEq/L, PaCO2 40 mmHg
Correct Answer: pH 7.28, PaCO2 55 mmHg, HCO3 24 mEq/L
Rationale: The pH is below 7.35 (acidosis), PaCO2 is elevated above 45 mmHg
(respiratory component), and HCO3 is normal. This pattern indicates respiratory
acidosis due to hypoventilation and CO2 retention. Identifying the primary acid-
base disturbance guides appropriate interventions.
5. What is the most likely outcome if a nurse fails to assess for the return of
the gag reflex after an esophagogastroduodenoscopy (EGD)?
A) The patient may develop aspiration pneumonia
B) The patient may experience delayed gastric emptying
C) The patient may develop a peptic ulcer
D) The patient may experience rebound hypoglycemia
Correct Answer: The patient may develop aspiration pneumonia
Rationale: After an EGD, topical anesthesia is used to suppress the gag reflex. If
the nurse offers oral intake before the gag reflex returns, the patient is at high risk
for aspiration. Aspiration can lead to pneumonia and respiratory distress. Always
assess the gag reflex before allowing anything by mouth.
, 6. Which medication is considered first-line for status epilepticus?
A) Oral phenytoin
B) Intravenous lorazepam
C) Intramuscular haloperidol
D) Subcutaneous insulin
Correct Answer: Intravenous lorazepam
Rationale: Benzodiazepines such as lorazepam are first-line for status epilepticus
due to their rapid onset. They enhance GABA-mediated inhibition, terminating
seizure activity. Subsequent anticonvulsants are administered to prevent
recurrence.
7. What is the primary mechanism of action of beta-2 adrenergic agonists in
respiratory care?
A) Reducing inflammation in the airways
B) Bronchodilation by relaxing smooth muscle
C) Suppressing the cough reflex
D) Thinning mucus secretions
Correct Answer: Bronchodilation by relaxing smooth muscle
Rationale: Beta-2 agonists such as albuterol stimulate beta-2 receptors on
bronchial smooth muscle, causing relaxation and bronchodilation. They provide
rapid relief of bronchospasm and are used as rescue medications in asthma and
COPD.
8. Which finding is most consistent with a fat embolism?
A) Bradycardia and hypertension
B) Severe abdominal pain and distension
C) Sudden onset of dyspnea, confusion, and petechiae
D) Polyuria and polydipsia
Correct Answer: Sudden onset of dyspnea, confusion, and petechiae
Rationale: Fat embolism syndrome presents with sudden dyspnea, confusion,
petechiae, and tachycardia, typically 24-72 hours after a long bone fracture. It is a
, life-threatening emergency requiring immediate supportive care and oxygen. It is
not associated with bradycardia or abdominal pain.
9. What is the primary purpose of a low-Fowler's position after abdominal
surgery?
A) To increase intra-abdominal pressure
B) To reduce tension on the incision and promote comfort
C) To prevent respiratory complications
D) To facilitate drainage
Correct Answer: To reduce tension on the incision and promote comfort
Rationale: Low Fowler's position with knees flexed reduces tension on abdominal
incisions and promotes comfort. It also facilitates respiratory expansion. This
position is commonly used after abdominal surgery. Prone and Trendelenburg
positions are contraindicated.
10.Which nutrient is most important for wound healing after surgery?
A) Carbohydrates
B) Fat
C) Protein
D) Water
Correct Answer: Protein
Rationale: Protein is essential for collagen synthesis, tissue repair, and immune
function. Adequate protein intake promotes wound healing and reduces the risk
of dehiscence. Vitamin C and zinc are also important for healing. Carbohydrates
provide energy but are not the primary building blocks.
11.Which finding indicates a potential wound infection?
A) Decreased white blood cell count
B) Clear, serous drainage
C) Increased redness, warmth, and purulent drainage
D) Approximated wound edges
Correct Answer: Increased redness, warmth, and purulent drainage
Comprehensive Review Questions and Correct Answers &
Rationales | New Update 2026-2027 - Galen
1. Which of the following best describes the primary purpose of the
preoperative assessment?
A) To determine the patient's understanding of the surgery and obtain informed
consent
B) To administer preoperative medications
C) To complete the surgical checklist
D) To transfer the patient to the operating room
Correct Answer: To determine the patient's understanding of the surgery and
obtain informed consent
Rationale: The four goals of the preoperative assessment are to determine the
patient's understanding, confirm informed consent, assess anxiety, and obtain
relevant health information. The perioperative nurse completes this assessment.
Education and anxiety reduction are key components.
2. What is the primary function of the surgical time-out?
A) To administer anesthesia
B) To verify the correct patient, procedure, and site
C) To document the surgical start time
D) To position the patient
Correct Answer: To verify the correct patient, procedure, and site
Rationale: A time-out is a safety checklist performed immediately before surgery
to confirm the correct patient, procedure, site, and other critical details. It
prevents wrong-site, wrong-procedure, and wrong-patient errors. All team
members participate.
3. According to the exam blueprint, which electrolyte imbalance is most likely
in a patient with prolonged vomiting?
,A) Hyperkalemia and metabolic acidosis
B) Hypokalemia and metabolic alkalosis
C) Hypernatremia and respiratory alkalosis
D) Hypocalcemia and respiratory acidosis
Correct Answer: Hypokalemia and metabolic alkalosis
Rationale: Prolonged vomiting causes loss of gastric fluid rich in hydrogen and
potassium ions. This leads to hypokalemia and metabolic alkalosis. Nurses must
monitor electrolyte levels and replace fluids and electrolytes appropriately to
prevent cardiac dysrhythmias.
4. Which finding is most consistent with respiratory acidosis?
A) pH 7.50, PaCO2 30 mmHg, HCO3 24 mEq/L
B) pH 7.28, PaCO2 55 mmHg, HCO3 24 mEq/L
C) pH 7.30, HCO3 18 mEq/L, PaCO2 35 mmHg
D) pH 7.48, HCO3 30 mEq/L, PaCO2 40 mmHg
Correct Answer: pH 7.28, PaCO2 55 mmHg, HCO3 24 mEq/L
Rationale: The pH is below 7.35 (acidosis), PaCO2 is elevated above 45 mmHg
(respiratory component), and HCO3 is normal. This pattern indicates respiratory
acidosis due to hypoventilation and CO2 retention. Identifying the primary acid-
base disturbance guides appropriate interventions.
5. What is the most likely outcome if a nurse fails to assess for the return of
the gag reflex after an esophagogastroduodenoscopy (EGD)?
A) The patient may develop aspiration pneumonia
B) The patient may experience delayed gastric emptying
C) The patient may develop a peptic ulcer
D) The patient may experience rebound hypoglycemia
Correct Answer: The patient may develop aspiration pneumonia
Rationale: After an EGD, topical anesthesia is used to suppress the gag reflex. If
the nurse offers oral intake before the gag reflex returns, the patient is at high risk
for aspiration. Aspiration can lead to pneumonia and respiratory distress. Always
assess the gag reflex before allowing anything by mouth.
, 6. Which medication is considered first-line for status epilepticus?
A) Oral phenytoin
B) Intravenous lorazepam
C) Intramuscular haloperidol
D) Subcutaneous insulin
Correct Answer: Intravenous lorazepam
Rationale: Benzodiazepines such as lorazepam are first-line for status epilepticus
due to their rapid onset. They enhance GABA-mediated inhibition, terminating
seizure activity. Subsequent anticonvulsants are administered to prevent
recurrence.
7. What is the primary mechanism of action of beta-2 adrenergic agonists in
respiratory care?
A) Reducing inflammation in the airways
B) Bronchodilation by relaxing smooth muscle
C) Suppressing the cough reflex
D) Thinning mucus secretions
Correct Answer: Bronchodilation by relaxing smooth muscle
Rationale: Beta-2 agonists such as albuterol stimulate beta-2 receptors on
bronchial smooth muscle, causing relaxation and bronchodilation. They provide
rapid relief of bronchospasm and are used as rescue medications in asthma and
COPD.
8. Which finding is most consistent with a fat embolism?
A) Bradycardia and hypertension
B) Severe abdominal pain and distension
C) Sudden onset of dyspnea, confusion, and petechiae
D) Polyuria and polydipsia
Correct Answer: Sudden onset of dyspnea, confusion, and petechiae
Rationale: Fat embolism syndrome presents with sudden dyspnea, confusion,
petechiae, and tachycardia, typically 24-72 hours after a long bone fracture. It is a
, life-threatening emergency requiring immediate supportive care and oxygen. It is
not associated with bradycardia or abdominal pain.
9. What is the primary purpose of a low-Fowler's position after abdominal
surgery?
A) To increase intra-abdominal pressure
B) To reduce tension on the incision and promote comfort
C) To prevent respiratory complications
D) To facilitate drainage
Correct Answer: To reduce tension on the incision and promote comfort
Rationale: Low Fowler's position with knees flexed reduces tension on abdominal
incisions and promotes comfort. It also facilitates respiratory expansion. This
position is commonly used after abdominal surgery. Prone and Trendelenburg
positions are contraindicated.
10.Which nutrient is most important for wound healing after surgery?
A) Carbohydrates
B) Fat
C) Protein
D) Water
Correct Answer: Protein
Rationale: Protein is essential for collagen synthesis, tissue repair, and immune
function. Adequate protein intake promotes wound healing and reduces the risk
of dehiscence. Vitamin C and zinc are also important for healing. Carbohydrates
provide energy but are not the primary building blocks.
11.Which finding indicates a potential wound infection?
A) Decreased white blood cell count
B) Clear, serous drainage
C) Increased redness, warmth, and purulent drainage
D) Approximated wound edges
Correct Answer: Increased redness, warmth, and purulent drainage
