TIMBY’S INTRODUCTORY MEDICAL-
SURGICAL NURSING 13TH EDITION
STUDY GUIDE 2026 – COMPLETE
CHAPTER REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
Section 1: Fundamentals of Nursing Care (Questions 1-20)
1. A nurse is performing a sterile dressing change. Which action by the nurse violates sterile
technique?
A. Holding sterile items above waist level.
B. Pouring sterile solution into a sterile basin without touching the rim.
C. Using sterile gloves to place a sterile drape from the edge toward the center.
D. Turning one's back to a sterile field to answer a client's question.
Answer: D (Turning away from a sterile field compromises its integrity as it can no longer
be monitored for contamination.)
2. The primary purpose of the "SBAR" (Situation, Background, Assessment, Recommendation)
communication tool is to:
A. Document a client's discharge instructions.
B. Provide a structured framework for hand-off reports and critical communication.
C. Perform a comprehensive head-to-toe assessment.
D. Educate the family about the client's diagnosis.
Answer: B
3. A nurse is assessing a client's wound. Which characteristic of wound drainage, if noted,
should be reported as a potential sign of infection?
A. Serous drainage.
B. Serosanguineous drainage.
C. Purulent, greenish-yellow drainage with an odor.
D. Sanguineous drainage.
Answer: C (Purulent drainage indicates the presence of infection.)
,4. A client has a "Do Not Resuscitate (DNR)" order. The nurse understands this means:
A. No medical interventions can be provided.
B. Only comfort measures should be provided.
C. Cardiopulmonary resuscitation (CPR) will not be initiated in the event of cardiac or respiratory
arrest.
D. The client cannot receive antibiotics or IV fluids.
Answer: C (A DNR order is specific to resuscitation efforts.)
5. Which action is the best example of the nurse's role as a client advocate?
A. Administering pain medication as prescribed.
B. Respecting a client's refusal of a blood transfusion based on their religious beliefs.
C. Completing all charting by the end of the shift.
D. Following the physician's orders exactly.
Answer: B (Advocacy involves protecting and supporting a client's autonomy and rights.)
6. The nurse is preparing to transfer a client with left-sided weakness from bed to chair. To
ensure safety, the nurse should position the:
A. Chair on the client's right side.
B. Chair on the client's left side.
C. Bed in the lowest position.
D. Client's stronger side toward the direction of movement.
Answer: D (Move the client toward their stronger side to maximize stability and effort.)
7. What is the priority nursing intervention for a client demonstrating signs of a pulmonary
embolism (sudden dyspnea, chest pain)?
A. Administer oxygen.
B. Notify the physician/Rapid Response Team immediately.
C. Elevate the head of the bed.
D. Take vital signs.
Answer: B (A pulmonary embolism is a medical emergency requiring immediate
intervention.)
8. A nurse delegates the task of taking vital signs for a stable client to an unlicensed assistive
personnel (UAP). Who retains ultimate accountability for this task?
A. The UAP.
B. The charge nurse.
C. The nurse who delegated the task.
D. The physician.
,Answer: C (The nurse delegating retains accountability for appropriate delegation and
client outcomes.)
9. The nurse is teaching a client about a new medication. Which statement by the client
indicates understanding of the teaching?
A. "I will take this on an empty stomach if I have an upset stomach."
B. "I will call my doctor if I notice any new side effects."
C. "I can stop taking this when I feel better."
D. "I can double the dose if I miss one."
Answer: B
10. A priority goal for a client with impaired physical mobility is to prevent:
A. Boredom.
B. Muscle hypertrophy.
C. Contractures and pressure injuries.
D. Increased independence.
Answer: C
11. When assessing a client's pain, the nurse should use which approach?
A. Use a standardized pain scale appropriate for the client.
B. Rely on observed behaviors only.
C. Assume pain level based on diagnosis.
D. Only medicate when the client requests it.
Answer: A (Pain is subjective and should be measured with a validated tool.)
12. The first step the nurse should take when discovering a medication error is to:
A. Document the error in the chart.
B. Notify the physician.
C. Assess the client's condition.
D. Report the error to the nursing supervisor.
Answer: C (Client safety is the immediate priority.)
13. Which client is at greatest risk for developing a pressure injury?
A. A 25-year-old with a fractured wrist.
B. A 40-year-old ambulatory post-operative client.
C. A 70-year-old incontinent client with limited mobility following a stroke.
D. A 50-year-old with controlled diabetes.
Answer: C (Age, immobility, and incontinence are major risk factors.)
, 14. A nurse is performing nasopharyngeal suctioning. The nurse should limit each suctioning
pass to a maximum of:
A. 5 seconds.
B. 10 seconds.
C. 20 seconds.
D. 30 seconds.
Answer: B (Prolonged suctioning can cause hypoxia and mucosal damage.)
15. The purpose of passive range-of-motion exercises is to:
A. Build muscle strength.
B. Prevent joint contractures and maintain mobility.
C. Provide cardiovascular exercise.
D. Actively engage the client in care.
Answer: B
16. A client on bed rest is prescribed anti-embolism stockings. The nurse should:
A. Apply them while the client is supine in bed.
B. Apply them after the client has been sitting in a chair.
C. Roll them down for client comfort.
D. Keep them on continuously for one week.
Answer: A (They should be applied before venous pooling occurs.)
17. Which sign is an early symptom of hypoxia?
A. Cyanosis.
B. Restlessness and anxiety.
C. Bradycardia.
D. Unresponsiveness.
Answer: B (Restlessness is a common early neurological sign of decreased oxygen.)
18. The nurse is teaching a client about a low-sodium diet. Which food choice by the client
indicates a need for further teaching?
A. Grilled chicken breast.
B. Fresh steamed vegetables.
C. Canned soup and crackers.
D. Baked potato.
Answer: C (Canned soups are typically very high in sodium.)
19. Before administering a blood transfusion, the most critical nursing action is:
A. Checking the blood product with another nurse at the client's bedside.
B. Taking the client's vital signs.
SURGICAL NURSING 13TH EDITION
STUDY GUIDE 2026 – COMPLETE
CHAPTER REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
Section 1: Fundamentals of Nursing Care (Questions 1-20)
1. A nurse is performing a sterile dressing change. Which action by the nurse violates sterile
technique?
A. Holding sterile items above waist level.
B. Pouring sterile solution into a sterile basin without touching the rim.
C. Using sterile gloves to place a sterile drape from the edge toward the center.
D. Turning one's back to a sterile field to answer a client's question.
Answer: D (Turning away from a sterile field compromises its integrity as it can no longer
be monitored for contamination.)
2. The primary purpose of the "SBAR" (Situation, Background, Assessment, Recommendation)
communication tool is to:
A. Document a client's discharge instructions.
B. Provide a structured framework for hand-off reports and critical communication.
C. Perform a comprehensive head-to-toe assessment.
D. Educate the family about the client's diagnosis.
Answer: B
3. A nurse is assessing a client's wound. Which characteristic of wound drainage, if noted,
should be reported as a potential sign of infection?
A. Serous drainage.
B. Serosanguineous drainage.
C. Purulent, greenish-yellow drainage with an odor.
D. Sanguineous drainage.
Answer: C (Purulent drainage indicates the presence of infection.)
,4. A client has a "Do Not Resuscitate (DNR)" order. The nurse understands this means:
A. No medical interventions can be provided.
B. Only comfort measures should be provided.
C. Cardiopulmonary resuscitation (CPR) will not be initiated in the event of cardiac or respiratory
arrest.
D. The client cannot receive antibiotics or IV fluids.
Answer: C (A DNR order is specific to resuscitation efforts.)
5. Which action is the best example of the nurse's role as a client advocate?
A. Administering pain medication as prescribed.
B. Respecting a client's refusal of a blood transfusion based on their religious beliefs.
C. Completing all charting by the end of the shift.
D. Following the physician's orders exactly.
Answer: B (Advocacy involves protecting and supporting a client's autonomy and rights.)
6. The nurse is preparing to transfer a client with left-sided weakness from bed to chair. To
ensure safety, the nurse should position the:
A. Chair on the client's right side.
B. Chair on the client's left side.
C. Bed in the lowest position.
D. Client's stronger side toward the direction of movement.
Answer: D (Move the client toward their stronger side to maximize stability and effort.)
7. What is the priority nursing intervention for a client demonstrating signs of a pulmonary
embolism (sudden dyspnea, chest pain)?
A. Administer oxygen.
B. Notify the physician/Rapid Response Team immediately.
C. Elevate the head of the bed.
D. Take vital signs.
Answer: B (A pulmonary embolism is a medical emergency requiring immediate
intervention.)
8. A nurse delegates the task of taking vital signs for a stable client to an unlicensed assistive
personnel (UAP). Who retains ultimate accountability for this task?
A. The UAP.
B. The charge nurse.
C. The nurse who delegated the task.
D. The physician.
,Answer: C (The nurse delegating retains accountability for appropriate delegation and
client outcomes.)
9. The nurse is teaching a client about a new medication. Which statement by the client
indicates understanding of the teaching?
A. "I will take this on an empty stomach if I have an upset stomach."
B. "I will call my doctor if I notice any new side effects."
C. "I can stop taking this when I feel better."
D. "I can double the dose if I miss one."
Answer: B
10. A priority goal for a client with impaired physical mobility is to prevent:
A. Boredom.
B. Muscle hypertrophy.
C. Contractures and pressure injuries.
D. Increased independence.
Answer: C
11. When assessing a client's pain, the nurse should use which approach?
A. Use a standardized pain scale appropriate for the client.
B. Rely on observed behaviors only.
C. Assume pain level based on diagnosis.
D. Only medicate when the client requests it.
Answer: A (Pain is subjective and should be measured with a validated tool.)
12. The first step the nurse should take when discovering a medication error is to:
A. Document the error in the chart.
B. Notify the physician.
C. Assess the client's condition.
D. Report the error to the nursing supervisor.
Answer: C (Client safety is the immediate priority.)
13. Which client is at greatest risk for developing a pressure injury?
A. A 25-year-old with a fractured wrist.
B. A 40-year-old ambulatory post-operative client.
C. A 70-year-old incontinent client with limited mobility following a stroke.
D. A 50-year-old with controlled diabetes.
Answer: C (Age, immobility, and incontinence are major risk factors.)
, 14. A nurse is performing nasopharyngeal suctioning. The nurse should limit each suctioning
pass to a maximum of:
A. 5 seconds.
B. 10 seconds.
C. 20 seconds.
D. 30 seconds.
Answer: B (Prolonged suctioning can cause hypoxia and mucosal damage.)
15. The purpose of passive range-of-motion exercises is to:
A. Build muscle strength.
B. Prevent joint contractures and maintain mobility.
C. Provide cardiovascular exercise.
D. Actively engage the client in care.
Answer: B
16. A client on bed rest is prescribed anti-embolism stockings. The nurse should:
A. Apply them while the client is supine in bed.
B. Apply them after the client has been sitting in a chair.
C. Roll them down for client comfort.
D. Keep them on continuously for one week.
Answer: A (They should be applied before venous pooling occurs.)
17. Which sign is an early symptom of hypoxia?
A. Cyanosis.
B. Restlessness and anxiety.
C. Bradycardia.
D. Unresponsiveness.
Answer: B (Restlessness is a common early neurological sign of decreased oxygen.)
18. The nurse is teaching a client about a low-sodium diet. Which food choice by the client
indicates a need for further teaching?
A. Grilled chicken breast.
B. Fresh steamed vegetables.
C. Canned soup and crackers.
D. Baked potato.
Answer: C (Canned soups are typically very high in sodium.)
19. Before administering a blood transfusion, the most critical nursing action is:
A. Checking the blood product with another nurse at the client's bedside.
B. Taking the client's vital signs.
