NUR 265 Exam 1 Medical-Surgical Nursing Comprehensive
Practice Examination 2026–2027 | 190 Questions & Answers
| Med-Surg Nursing Exam Prep, Complete Study Guide,
Detailed Rationales, Clinical Assessment & Nursing
Interventions, Comprehensive Practice Test & Latest
Updated Exam Preparation
Question 1
A client is scheduled for an elective cholecystectomy in 6 hours. Which assessment
finding should the nurse report to the surgeon immediately?
A. Blood pressure 128/78 mm Hg
B. Temperature 101.8°F (38.8°C)
C. Heart rate 88 beats/min
D. Fasting blood glucose 110 mg/dL
Correct Answer: B
Explanation: An elevated temperature suggests active infection, which may necessitate
postponing elective surgery. Baseline vital signs and glucose are within normal limits
and do not require urgent surgical notification.
Question 2
A client is being prepared for surgery and asks why they must stop eating 8 hours
before the procedure. What is the nurse's best response?
A. "It prevents you from being hungry during surgery."
B. "It reduces the risk of aspiration during anesthesia."
C. "It helps the anesthesia work faster."
D. "It prevents dehydration during the procedure."
Correct Answer: B
,Explanation: Preoperative fasting reduces gastric content volume, lowering the risk of
aspiration pneumonia during induction of anesthesia when protective airway reflexes
are lost.
Question 3
A postoperative client who had general anesthesia is drowsy with a respiratory rate of 9
breaths/min. Which action should the nurse take first?
A. Administer oxygen via nasal cannula
B. Stimulate the client and encourage deep breathing
C. Document the finding and reassess in 15 minutes
D. Position the client flat on their back
Correct Answer: B
Explanation: Airway and breathing take priority. Stimulating the client and encouraging
deep breathing addresses the cause of hypoventilation from residual anesthesia before
supplemental interventions.
Question 4
A client is 24 hours post-abdominal surgery and reports pain of 7/10. The nurse notes
the client is splinting and refusing to ambulate. Which intervention is most appropriate?
A. Inform the client that ambulation is required and assist them
B. Medicate with the prescribed analgesic 30 minutes before ambulation
C. Withhold pain medication to prevent addiction
D. Document refusal and notify the surgeon
Correct Answer: B
Explanation: Preemptive analgesia 30 minutes before activity improves comfort and
mobility, reducing complications like atelectasis and DVT. Undertreated pain impairs
recovery and is a common barrier to early ambulation.
Question 5
,Which client is at highest risk for malignant hyperthermia during surgery?
A. A client with a history of asthma
B. A client with a family history of hyperthermia during anesthesia
C. A client taking beta-blockers
D. A client with type 2 diabetes
Correct Answer: B
Explanation: Malignant hyperthermia is an autosomal dominant genetic disorder
triggered by inhaled anesthetics and succinylcholine. A positive family history is the
strongest predictor of risk.
Question 6
A client returns from surgery with a Jackson-Pratt drain. Which finding requires
immediate intervention?
A. 50 mL of serosanguineous drainage in 8 hours
B. The drain is compressed and secured
C. Sudden cessation of drainage with increased pain and swelling
D. Drainage output documented as 30 mL
Correct Answer: C
Explanation: Sudden cessation of drainage with pain and swelling suggests drain
occlusion or displacement, leading to fluid accumulation. This requires prompt
assessment and intervention.
Question 7
What is the priority nursing action when a postoperative client's surgical dressing is
saturated with bright red blood?
A. Reinforce the dressing and reassess in 1 hour
B. Mark the drainage borders, assess vital signs, and notify the surgeon
, C. Remove the dressing to inspect the wound
D. Apply a pressure dressing and document
Correct Answer: B
Explanation: Bright red saturation may indicate hemorrhage. Marking borders allows
accurate measurement of continued bleeding; vital sign assessment and surgeon
notification address potential hypovolemia.
Question 8
A client is scheduled for surgery and reports taking warfarin. Which laboratory value is
most important for the nurse to review?
A. Hemoglobin
B. INR
C. Platelet count
D. aPTT
Correct Answer: B
Explanation: INR measures warfarin's anticoagulant effect. An elevated INR increases
surgical bleeding risk and may require reversal before the procedure. Hemoglobin and
platelets do not directly reflect warfarin therapy.
Question 9
During the immediate postoperative period, which assessment finding indicates
possible laryngeal edema?
A. Hoarseness and stridor
B. Nausea and vomiting
C. Urinary retention
D. Incisional pain
Correct Answer: A
Practice Examination 2026–2027 | 190 Questions & Answers
| Med-Surg Nursing Exam Prep, Complete Study Guide,
Detailed Rationales, Clinical Assessment & Nursing
Interventions, Comprehensive Practice Test & Latest
Updated Exam Preparation
Question 1
A client is scheduled for an elective cholecystectomy in 6 hours. Which assessment
finding should the nurse report to the surgeon immediately?
A. Blood pressure 128/78 mm Hg
B. Temperature 101.8°F (38.8°C)
C. Heart rate 88 beats/min
D. Fasting blood glucose 110 mg/dL
Correct Answer: B
Explanation: An elevated temperature suggests active infection, which may necessitate
postponing elective surgery. Baseline vital signs and glucose are within normal limits
and do not require urgent surgical notification.
Question 2
A client is being prepared for surgery and asks why they must stop eating 8 hours
before the procedure. What is the nurse's best response?
A. "It prevents you from being hungry during surgery."
B. "It reduces the risk of aspiration during anesthesia."
C. "It helps the anesthesia work faster."
D. "It prevents dehydration during the procedure."
Correct Answer: B
,Explanation: Preoperative fasting reduces gastric content volume, lowering the risk of
aspiration pneumonia during induction of anesthesia when protective airway reflexes
are lost.
Question 3
A postoperative client who had general anesthesia is drowsy with a respiratory rate of 9
breaths/min. Which action should the nurse take first?
A. Administer oxygen via nasal cannula
B. Stimulate the client and encourage deep breathing
C. Document the finding and reassess in 15 minutes
D. Position the client flat on their back
Correct Answer: B
Explanation: Airway and breathing take priority. Stimulating the client and encouraging
deep breathing addresses the cause of hypoventilation from residual anesthesia before
supplemental interventions.
Question 4
A client is 24 hours post-abdominal surgery and reports pain of 7/10. The nurse notes
the client is splinting and refusing to ambulate. Which intervention is most appropriate?
A. Inform the client that ambulation is required and assist them
B. Medicate with the prescribed analgesic 30 minutes before ambulation
C. Withhold pain medication to prevent addiction
D. Document refusal and notify the surgeon
Correct Answer: B
Explanation: Preemptive analgesia 30 minutes before activity improves comfort and
mobility, reducing complications like atelectasis and DVT. Undertreated pain impairs
recovery and is a common barrier to early ambulation.
Question 5
,Which client is at highest risk for malignant hyperthermia during surgery?
A. A client with a history of asthma
B. A client with a family history of hyperthermia during anesthesia
C. A client taking beta-blockers
D. A client with type 2 diabetes
Correct Answer: B
Explanation: Malignant hyperthermia is an autosomal dominant genetic disorder
triggered by inhaled anesthetics and succinylcholine. A positive family history is the
strongest predictor of risk.
Question 6
A client returns from surgery with a Jackson-Pratt drain. Which finding requires
immediate intervention?
A. 50 mL of serosanguineous drainage in 8 hours
B. The drain is compressed and secured
C. Sudden cessation of drainage with increased pain and swelling
D. Drainage output documented as 30 mL
Correct Answer: C
Explanation: Sudden cessation of drainage with pain and swelling suggests drain
occlusion or displacement, leading to fluid accumulation. This requires prompt
assessment and intervention.
Question 7
What is the priority nursing action when a postoperative client's surgical dressing is
saturated with bright red blood?
A. Reinforce the dressing and reassess in 1 hour
B. Mark the drainage borders, assess vital signs, and notify the surgeon
, C. Remove the dressing to inspect the wound
D. Apply a pressure dressing and document
Correct Answer: B
Explanation: Bright red saturation may indicate hemorrhage. Marking borders allows
accurate measurement of continued bleeding; vital sign assessment and surgeon
notification address potential hypovolemia.
Question 8
A client is scheduled for surgery and reports taking warfarin. Which laboratory value is
most important for the nurse to review?
A. Hemoglobin
B. INR
C. Platelet count
D. aPTT
Correct Answer: B
Explanation: INR measures warfarin's anticoagulant effect. An elevated INR increases
surgical bleeding risk and may require reversal before the procedure. Hemoglobin and
platelets do not directly reflect warfarin therapy.
Question 9
During the immediate postoperative period, which assessment finding indicates
possible laryngeal edema?
A. Hoarseness and stridor
B. Nausea and vomiting
C. Urinary retention
D. Incisional pain
Correct Answer: A
