Med-Surg 1 Final Exam Review: Must-
KnowConcepts, Practice Ǫuestions, and Study
Tips for Success
[Document subtitle]
, Med-Surg 1 Final Exam Review: Must-Know
Concepts, Practice Ǫuestions, and Study Tips for
Success
1. The caregiver has just reassessed the condition of a postoperative patient who
was admitted 1 hour ago to the surgical unit. The caregiver plans to monitor which
parameter most carefully during the next hour?
Select one:
a. Serous drainage on the surgical dressing
b. Temperature of 37.6°C (99.6°F)
c. Urinary output of 20 mL/hour
d. Blood pressure of 100/70 mm Hg
Rationale:
Urinary output of 20 mL/hour is significantly low and may indicate decreased renal
perfusion or hypovolemia, which is a concern in postoperative patients. The normal urinary
output should be at least 30 mL/hour. Immediate intervention is necessary to prevent
complications such as acute kidney injury.
2. When performing a surgical dressing change on a patient's abdominal dressing, the
caregiver notes an increased amount of drainage and separation of the incision line.
The underlying tissue is visible to the caregiver. The caregiver should take which
action in the
initial care of this wound?
Select one:
a. Apply a sterile dressing soaked in povidone-iodine.
b. Apply a sterile dressing soaked with normal saline.
c. Irrigate the wound and apply a sterile dry dressing.
d. Leave the incision open to the air to dry the area.
Rationale:
A sterile dressing soaked in normal saline helps keep the wound moist and prevents further
tissue damage while awaiting medical intervention. This is the best initial action to protect
the wound and prevent infection.
1
,3. In preparation for ambulation, the caregiver is planning to assist a postoperative
patient to progress from a lying position to a sitting position. Which nursing action
is appropriate to maintain the safety of the patient?
Select one:
a. Assess the patient for signs of dizziness and hypotension.
b. Assist the patient to move quickly from the lying position to the sitting position.
c. Allow the patient to rise from the bed to a standing position unassisted.
d. Elevate the head of the bed quickly to assist the patient to a sitting position.
Rationale:
Postoperative patients are at risk for orthostatic hypotension, which can lead to dizziness
and falls. Assessing for dizziness and hypotension before standing helps ensure the patient's
safety.
4. The caregiver is teaching a patient about coughing and deep-breathing
techniques to prevent postoperative complications. Which statement is most
appropriate for the caregiver to make to the patient at this time as it relates to
these techniques?
Select one:
a. "Administration of intravenous fluids will prevent or treat fluid imbalance."
b. "Close monitoring of your oxygen saturation will detect hypoxemia."
c. "Use of an incentive spirometer will help prevent pneumonia."
d. "Early ambulation and administration of blood thinners will prevent pulmonary
embolism."
Rationale:
Using an incentive spirometer encourages deep breathing, which helps prevent atelectasis
and pneumonia, common postoperative respiratory complications.
5. The caregiver is caring for four patients who will undergo surgery today. Which
patient does the caregiver recognize as at highest risk for surgical
complications?
Select one:
a. 69-year-old who will be discharged after surgery to an extended care facility
b. 58-year-old who has well-controlled Type II diabetes
c. 64-year-old who has just received pre-surgical prophylactic antibiotics
d. 52-year-old who takes aspirin daily
2
, Rationale:
Aspirin is an antiplatelet medication that increases the risk of bleeding during and after
surgery. Patients taking aspirin may require special precautions, such as discontinuation
before surgery to reduce the risk of excessive bleeding.
6. Which assessment data finding for a patient scheduled for total knee
replacement surgery is most important for the caregiver to communicate to the
surgeon and anesthesia provider before the procedure? (Select all that apply.)
Select one or more:
a. The patient took a total of 1300 mg of aspirin yesterday.
b. The patient took a regularly scheduled antihypertensive drug with a sip of water 2
hours ago.
c. After receiving the preoperative medications, the patient tells the caregiver that he lied
on the assessment form and that he really is a current smoker.
d. The serum potassium level is 3.0 mEq/L (3.0 mmol/L).
e. The oxygen saturation is 97%.
Rationale:
Aspirin use (a) increases bleeding risk and should be reported.
Current smoking (c) increases anesthesia and wound healing risks.
Low potassium level (d) may increase the risk of cardiac complications under
anesthesia.
Taking antihypertensive medications (b) with a sip of water is typically allowed
and does not pose a major concern.
Oxygen saturation of G7% (e) is normal and does not need immediate intervention.
7. The caregiver has instructed a preoperative patient using an incentive spirometer to
sustain the inhaled breath for 3 seconds. When the patient asks about the rationale for
this action, the caregiver explains that this action achieves which function?
Select one:
a. Increases surfactant production
b. Maintains inflation of the alveoli
3
KnowConcepts, Practice Ǫuestions, and Study
Tips for Success
[Document subtitle]
, Med-Surg 1 Final Exam Review: Must-Know
Concepts, Practice Ǫuestions, and Study Tips for
Success
1. The caregiver has just reassessed the condition of a postoperative patient who
was admitted 1 hour ago to the surgical unit. The caregiver plans to monitor which
parameter most carefully during the next hour?
Select one:
a. Serous drainage on the surgical dressing
b. Temperature of 37.6°C (99.6°F)
c. Urinary output of 20 mL/hour
d. Blood pressure of 100/70 mm Hg
Rationale:
Urinary output of 20 mL/hour is significantly low and may indicate decreased renal
perfusion or hypovolemia, which is a concern in postoperative patients. The normal urinary
output should be at least 30 mL/hour. Immediate intervention is necessary to prevent
complications such as acute kidney injury.
2. When performing a surgical dressing change on a patient's abdominal dressing, the
caregiver notes an increased amount of drainage and separation of the incision line.
The underlying tissue is visible to the caregiver. The caregiver should take which
action in the
initial care of this wound?
Select one:
a. Apply a sterile dressing soaked in povidone-iodine.
b. Apply a sterile dressing soaked with normal saline.
c. Irrigate the wound and apply a sterile dry dressing.
d. Leave the incision open to the air to dry the area.
Rationale:
A sterile dressing soaked in normal saline helps keep the wound moist and prevents further
tissue damage while awaiting medical intervention. This is the best initial action to protect
the wound and prevent infection.
1
,3. In preparation for ambulation, the caregiver is planning to assist a postoperative
patient to progress from a lying position to a sitting position. Which nursing action
is appropriate to maintain the safety of the patient?
Select one:
a. Assess the patient for signs of dizziness and hypotension.
b. Assist the patient to move quickly from the lying position to the sitting position.
c. Allow the patient to rise from the bed to a standing position unassisted.
d. Elevate the head of the bed quickly to assist the patient to a sitting position.
Rationale:
Postoperative patients are at risk for orthostatic hypotension, which can lead to dizziness
and falls. Assessing for dizziness and hypotension before standing helps ensure the patient's
safety.
4. The caregiver is teaching a patient about coughing and deep-breathing
techniques to prevent postoperative complications. Which statement is most
appropriate for the caregiver to make to the patient at this time as it relates to
these techniques?
Select one:
a. "Administration of intravenous fluids will prevent or treat fluid imbalance."
b. "Close monitoring of your oxygen saturation will detect hypoxemia."
c. "Use of an incentive spirometer will help prevent pneumonia."
d. "Early ambulation and administration of blood thinners will prevent pulmonary
embolism."
Rationale:
Using an incentive spirometer encourages deep breathing, which helps prevent atelectasis
and pneumonia, common postoperative respiratory complications.
5. The caregiver is caring for four patients who will undergo surgery today. Which
patient does the caregiver recognize as at highest risk for surgical
complications?
Select one:
a. 69-year-old who will be discharged after surgery to an extended care facility
b. 58-year-old who has well-controlled Type II diabetes
c. 64-year-old who has just received pre-surgical prophylactic antibiotics
d. 52-year-old who takes aspirin daily
2
, Rationale:
Aspirin is an antiplatelet medication that increases the risk of bleeding during and after
surgery. Patients taking aspirin may require special precautions, such as discontinuation
before surgery to reduce the risk of excessive bleeding.
6. Which assessment data finding for a patient scheduled for total knee
replacement surgery is most important for the caregiver to communicate to the
surgeon and anesthesia provider before the procedure? (Select all that apply.)
Select one or more:
a. The patient took a total of 1300 mg of aspirin yesterday.
b. The patient took a regularly scheduled antihypertensive drug with a sip of water 2
hours ago.
c. After receiving the preoperative medications, the patient tells the caregiver that he lied
on the assessment form and that he really is a current smoker.
d. The serum potassium level is 3.0 mEq/L (3.0 mmol/L).
e. The oxygen saturation is 97%.
Rationale:
Aspirin use (a) increases bleeding risk and should be reported.
Current smoking (c) increases anesthesia and wound healing risks.
Low potassium level (d) may increase the risk of cardiac complications under
anesthesia.
Taking antihypertensive medications (b) with a sip of water is typically allowed
and does not pose a major concern.
Oxygen saturation of G7% (e) is normal and does not need immediate intervention.
7. The caregiver has instructed a preoperative patient using an incentive spirometer to
sustain the inhaled breath for 3 seconds. When the patient asks about the rationale for
this action, the caregiver explains that this action achieves which function?
Select one:
a. Increases surfactant production
b. Maintains inflation of the alveoli
3
