,NSG 128 Medical-Surgical Nursing I Exam Prep —
Comprehensive Review + Practice MCQs —
Herzing University 2026/2027
1. A patient is scheduled for surgery in the morning. Which finding requires immediate notification of the
surgeon?
A. The patient's hemoglobin is 13.5 g/dL.
B. The patient reports a dry cough.
C. The patient's temperature is 101.8°F (38.8°C).
D. The patient's blood pressure is 128/82 mm Hg.
Correct Answer: C. The patient's temperature is 101.8°F (38.8°C).
Rationale: A fever may indicate an active infection, which can increase surgical risk and may necessitate
postponing surgery. The surgeon must be notified immediately. The other findings are within normal limits or
not immediately concerning.
2. A nurse is providing preoperative teaching to a patient scheduled for abdominal surgery. Which instruction is
most important to include?
A. "You should eat a heavy meal the night before surgery."
B. "You will need to practice deep breathing and coughing exercises after surgery."
C. "You can drink clear liquids up until the time of surgery."
D. "You should avoid moving your legs after surgery to prevent pain."
Correct Answer: B. "You will need to practice deep breathing and coughing exercises after surgery."
,Rationale: Deep breathing and coughing exercises help prevent postoperative pulmonary complications such
as atelectasis and pneumonia. Patients should be taught these techniques preoperatively. Eating a heavy meal
and drinking clear liquids before surgery are typically restricted. Early ambulation and leg exercises are
encouraged to prevent DVT.
3. A patient is in the post-anesthesia care unit (PACU) following general anesthesia. Which assessment is the
priority?
A. Urine output
B. Respiratory status and airway patency
C. Surgical site dressing
D. Pain level
Correct Answer: B. Respiratory status and airway patency
Rationale: Airway, breathing, and circulation are the priorities in the immediate postoperative period. General
anesthesia can depress respiratory function, and the patient may be at risk for airway obstruction,
hypoventilation, and hypoxemia. Respiratory status must be assessed first.
4. A postoperative patient reports sudden onset of chest pain and shortness of breath. The nurse notes
tachycardia and an oxygen saturation of 88%. What is the priority nursing action?
A. Administer prescribed pain medication.
B. Assist the patient to ambulate.
C. Apply supplemental oxygen and notify the provider immediately.
D. Reassure the patient that this is a normal postoperative finding.
, Correct Answer: C. Apply supplemental oxygen and notify the provider immediately.
Rationale: Sudden chest pain, dyspnea, tachycardia, and hypoxemia in a postoperative patient suggest
pulmonary embolism, a life-threatening complication. The nurse should apply oxygen, notify the provider
immediately, and prepare for further interventions (e.g., anticoagulation, diagnostic imaging).
5. A nurse is assessing a patient's surgical incision. Which finding should be reported immediately?
A. The incision is approximated with staples and dry.
B. The incision has a small amount of serous drainage.
C. The incision edges are separating with evisceration of bowel.
D. The patient reports mild incisional pain.
Correct Answer: C. The incision edges are separating with evisceration of bowel.
Rationale: Evisceration (protrusion of internal organs through a surgical wound) is a surgical emergency. The
nurse should cover the wound with sterile saline-soaked gauze, position the patient supine with knees bent,
and notify the surgeon immediately.
6. A patient is admitted with a diagnosis of gastroenteritis and has been vomiting for 2 days. Which acid-base
imbalance is the patient most at risk for?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Comprehensive Review + Practice MCQs —
Herzing University 2026/2027
1. A patient is scheduled for surgery in the morning. Which finding requires immediate notification of the
surgeon?
A. The patient's hemoglobin is 13.5 g/dL.
B. The patient reports a dry cough.
C. The patient's temperature is 101.8°F (38.8°C).
D. The patient's blood pressure is 128/82 mm Hg.
Correct Answer: C. The patient's temperature is 101.8°F (38.8°C).
Rationale: A fever may indicate an active infection, which can increase surgical risk and may necessitate
postponing surgery. The surgeon must be notified immediately. The other findings are within normal limits or
not immediately concerning.
2. A nurse is providing preoperative teaching to a patient scheduled for abdominal surgery. Which instruction is
most important to include?
A. "You should eat a heavy meal the night before surgery."
B. "You will need to practice deep breathing and coughing exercises after surgery."
C. "You can drink clear liquids up until the time of surgery."
D. "You should avoid moving your legs after surgery to prevent pain."
Correct Answer: B. "You will need to practice deep breathing and coughing exercises after surgery."
,Rationale: Deep breathing and coughing exercises help prevent postoperative pulmonary complications such
as atelectasis and pneumonia. Patients should be taught these techniques preoperatively. Eating a heavy meal
and drinking clear liquids before surgery are typically restricted. Early ambulation and leg exercises are
encouraged to prevent DVT.
3. A patient is in the post-anesthesia care unit (PACU) following general anesthesia. Which assessment is the
priority?
A. Urine output
B. Respiratory status and airway patency
C. Surgical site dressing
D. Pain level
Correct Answer: B. Respiratory status and airway patency
Rationale: Airway, breathing, and circulation are the priorities in the immediate postoperative period. General
anesthesia can depress respiratory function, and the patient may be at risk for airway obstruction,
hypoventilation, and hypoxemia. Respiratory status must be assessed first.
4. A postoperative patient reports sudden onset of chest pain and shortness of breath. The nurse notes
tachycardia and an oxygen saturation of 88%. What is the priority nursing action?
A. Administer prescribed pain medication.
B. Assist the patient to ambulate.
C. Apply supplemental oxygen and notify the provider immediately.
D. Reassure the patient that this is a normal postoperative finding.
, Correct Answer: C. Apply supplemental oxygen and notify the provider immediately.
Rationale: Sudden chest pain, dyspnea, tachycardia, and hypoxemia in a postoperative patient suggest
pulmonary embolism, a life-threatening complication. The nurse should apply oxygen, notify the provider
immediately, and prepare for further interventions (e.g., anticoagulation, diagnostic imaging).
5. A nurse is assessing a patient's surgical incision. Which finding should be reported immediately?
A. The incision is approximated with staples and dry.
B. The incision has a small amount of serous drainage.
C. The incision edges are separating with evisceration of bowel.
D. The patient reports mild incisional pain.
Correct Answer: C. The incision edges are separating with evisceration of bowel.
Rationale: Evisceration (protrusion of internal organs through a surgical wound) is a surgical emergency. The
nurse should cover the wound with sterile saline-soaked gauze, position the patient supine with knees bent,
and notify the surgeon immediately.
6. A patient is admitted with a diagnosis of gastroenteritis and has been vomiting for 2 days. Which acid-base
imbalance is the patient most at risk for?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
