NUR 265 Exam 1 V1, V2 and V3|
Questions and Answers | 2026
Update | 100% Correct - Galen
College of Nursing.
Course
NU 265
1. Preoperative assessment
Question:
A client scheduled for surgery reports taking warfarin daily. Which action should the nurse take?
A. Tell the client to take the medication as prescribed
B. Notify the surgical team about the medication
C. Administer vitamin K immediately
D. Tell the client to double the dose after surgery
Answer: B. Notify the surgical team about the medication
Rationale:
Warfarin increases bleeding risk. The surgical team must determine whether it should be held
or otherwise managed before surgery. The nurse should not independently discontinue or
reverse anticoagulation.
2. Informed consent
Question:
Which statement about informed consent is correct?
A. The nurse is responsible for explaining the surgical procedure
B. The nurse may obtain consent when the provider is unavailable
C. The provider performing the procedure is responsible for explaining it
D. A family member must always sign the consent form
Answer: C. The provider performing the procedure is responsible for explaining it
Rationale:
The provider is responsible for explaining the procedure, risks, benefits, alternatives, and
expected outcomes. The nurse may witness the signature and verify that the client appears to
understand and is voluntarily consenting.
3. Preoperative teaching
,Question:
Which instruction should the nurse provide to a client before abdominal surgery to reduce
postoperative pulmonary complications?
A. Avoid coughing after surgery
B. Practice incentive spirometry and deep breathing
C. Remain on bed rest for 24 hours
D. Limit fluid intake
Answer: B. Practice incentive spirometry and deep breathing
Rationale:
Deep breathing, coughing, incentive spirometry, and early mobilization help prevent atelectasis
and pneumonia after surgery.
4. Surgical time-out
Question:
The nurse participates in the surgical time-out immediately before an invasive procedure. Which
information should be verified?
A. Client identity, procedure, and surgical site
B. Client's preferred meal
C. Family's transportation arrangements
D. Client's discharge prescription
Answer: A. Client identity, procedure, and surgical site
Rationale:
The time-out is a critical patient-safety procedure used to verify the correct patient, procedure,
and site before surgery.
5. Sterile technique
Question:
Which action contaminates a sterile field?
A. Keeping sterile objects above waist level
B. Opening a sterile package away from the body
C. Reaching across the sterile field
D. Maintaining the field in constant view
Answer: C. Reaching across the sterile field
,Rationale:
Reaching over a sterile field risks contamination. Sterile technique requires careful control of
movement and avoidance of contact with contaminated areas.
6. Malignant hyperthermia
Question:
During surgery, a client develops muscle rigidity, tachycardia, rapidly increasing temperature,
and increased carbon dioxide production. Which medication should the nurse anticipate?
A. Naloxone
B. Dantrolene
C. Protamine sulfate
D. Flumazenil
Answer: B. Dantrolene
Rationale:
Malignant hyperthermia is a life-threatening anesthetic reaction. Dantrolene is the specific
treatment because it reduces abnormal calcium release from skeletal muscle.
7. Postoperative respiratory complication
Question:
A postoperative client has shallow respirations and diminished breath sounds at the bases.
Which intervention is most appropriate?
A. Encourage incentive spirometry
B. Maintain strict bed rest
C. Restrict oxygen
D. Encourage rapid shallow breathing
Answer: A. Encourage incentive spirometry
Rationale:
Incentive spirometry promotes lung expansion and helps prevent or treat atelectasis.
8. Pulmonary embolism
Question:
A postoperative client suddenly develops dyspnea, tachycardia, chest pain, and oxygen
desaturation. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
, C. Constipation
D. Urinary retention
Answer: B. Pulmonary embolism
Rationale:
Sudden dyspnea, chest pain, tachycardia, and hypoxemia are concerning for pulmonary
embolism, particularly in a postoperative client.
9. Priority postoperative assessment
Question:
Which postoperative finding requires the most immediate intervention?
A. Pain rated 5/10
B. Temperature of 37.4°C
C. Respiratory rate of 8/min with difficult arousal
D. Mild nausea
Answer: C. Respiratory rate of 8/min with difficult arousal
Rationale:
Airway and breathing take priority. Bradypnea and decreased consciousness may indicate
respiratory depression, potentially related to anesthesia or opioids.
10. Fluid volume deficit
Question:
Which finding is most consistent with fluid volume deficit?
A. Jugular venous distention
B. Peripheral edema
C. Decreased urine output
D. Bounding pulse
Answer: C. Decreased urine output
Rationale:
Fluid volume deficit decreases renal perfusion, resulting in decreased urine output. Other
possible findings include tachycardia, hypotension, dry mucous membranes, and poor skin
turgor.
11. Fluid volume excess
Question:
Which finding is most consistent with fluid volume excess?
Questions and Answers | 2026
Update | 100% Correct - Galen
College of Nursing.
Course
NU 265
1. Preoperative assessment
Question:
A client scheduled for surgery reports taking warfarin daily. Which action should the nurse take?
A. Tell the client to take the medication as prescribed
B. Notify the surgical team about the medication
C. Administer vitamin K immediately
D. Tell the client to double the dose after surgery
Answer: B. Notify the surgical team about the medication
Rationale:
Warfarin increases bleeding risk. The surgical team must determine whether it should be held
or otherwise managed before surgery. The nurse should not independently discontinue or
reverse anticoagulation.
2. Informed consent
Question:
Which statement about informed consent is correct?
A. The nurse is responsible for explaining the surgical procedure
B. The nurse may obtain consent when the provider is unavailable
C. The provider performing the procedure is responsible for explaining it
D. A family member must always sign the consent form
Answer: C. The provider performing the procedure is responsible for explaining it
Rationale:
The provider is responsible for explaining the procedure, risks, benefits, alternatives, and
expected outcomes. The nurse may witness the signature and verify that the client appears to
understand and is voluntarily consenting.
3. Preoperative teaching
,Question:
Which instruction should the nurse provide to a client before abdominal surgery to reduce
postoperative pulmonary complications?
A. Avoid coughing after surgery
B. Practice incentive spirometry and deep breathing
C. Remain on bed rest for 24 hours
D. Limit fluid intake
Answer: B. Practice incentive spirometry and deep breathing
Rationale:
Deep breathing, coughing, incentive spirometry, and early mobilization help prevent atelectasis
and pneumonia after surgery.
4. Surgical time-out
Question:
The nurse participates in the surgical time-out immediately before an invasive procedure. Which
information should be verified?
A. Client identity, procedure, and surgical site
B. Client's preferred meal
C. Family's transportation arrangements
D. Client's discharge prescription
Answer: A. Client identity, procedure, and surgical site
Rationale:
The time-out is a critical patient-safety procedure used to verify the correct patient, procedure,
and site before surgery.
5. Sterile technique
Question:
Which action contaminates a sterile field?
A. Keeping sterile objects above waist level
B. Opening a sterile package away from the body
C. Reaching across the sterile field
D. Maintaining the field in constant view
Answer: C. Reaching across the sterile field
,Rationale:
Reaching over a sterile field risks contamination. Sterile technique requires careful control of
movement and avoidance of contact with contaminated areas.
6. Malignant hyperthermia
Question:
During surgery, a client develops muscle rigidity, tachycardia, rapidly increasing temperature,
and increased carbon dioxide production. Which medication should the nurse anticipate?
A. Naloxone
B. Dantrolene
C. Protamine sulfate
D. Flumazenil
Answer: B. Dantrolene
Rationale:
Malignant hyperthermia is a life-threatening anesthetic reaction. Dantrolene is the specific
treatment because it reduces abnormal calcium release from skeletal muscle.
7. Postoperative respiratory complication
Question:
A postoperative client has shallow respirations and diminished breath sounds at the bases.
Which intervention is most appropriate?
A. Encourage incentive spirometry
B. Maintain strict bed rest
C. Restrict oxygen
D. Encourage rapid shallow breathing
Answer: A. Encourage incentive spirometry
Rationale:
Incentive spirometry promotes lung expansion and helps prevent or treat atelectasis.
8. Pulmonary embolism
Question:
A postoperative client suddenly develops dyspnea, tachycardia, chest pain, and oxygen
desaturation. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
, C. Constipation
D. Urinary retention
Answer: B. Pulmonary embolism
Rationale:
Sudden dyspnea, chest pain, tachycardia, and hypoxemia are concerning for pulmonary
embolism, particularly in a postoperative client.
9. Priority postoperative assessment
Question:
Which postoperative finding requires the most immediate intervention?
A. Pain rated 5/10
B. Temperature of 37.4°C
C. Respiratory rate of 8/min with difficult arousal
D. Mild nausea
Answer: C. Respiratory rate of 8/min with difficult arousal
Rationale:
Airway and breathing take priority. Bradypnea and decreased consciousness may indicate
respiratory depression, potentially related to anesthesia or opioids.
10. Fluid volume deficit
Question:
Which finding is most consistent with fluid volume deficit?
A. Jugular venous distention
B. Peripheral edema
C. Decreased urine output
D. Bounding pulse
Answer: C. Decreased urine output
Rationale:
Fluid volume deficit decreases renal perfusion, resulting in decreased urine output. Other
possible findings include tachycardia, hypotension, dry mucous membranes, and poor skin
turgor.
11. Fluid volume excess
Question:
Which finding is most consistent with fluid volume excess?
