,NSG 123 Medical-Surgical Nursing I
Exam Prep — Comprehensive Review +
Practice MCQs — Herzing University
2026/2027
SECTION 1: PERIOPERATIVE NURSING CARE (Questions 1–40)
1. A nurse is caring for a client scheduled for an elective cholecystectomy. Which action should the nurse take
first during the preoperative phase?
A. Administer the prescribed preoperative antibiotic
B. Verify that the informed consent form is signed and witnessed
C. Teach the client how to use the incentive spirometer
D. Obtain a baseline set of vital signs
Correct Answer: B — Verify that the informed consent form is signed and witnessed
Rationale: The preoperative phase begins when the decision for surgery is made. Ensuring legal and ethical
requirements, including a properly signed and witnessed informed consent, is a priority before other
preparations. Vital signs and teaching are important but consent verification comes first.
2. A client scheduled for surgery tells the nurse, "I don't understand what the surgeon meant by 'exploratory
laparotomy.'" What is the nurse's best response?
A. "It's a procedure where the surgeon opens your abdomen to look for the cause of your symptoms."
B. "The surgeon will explain it to you again before you go to sleep."
,C. "Don't worry; it's a very common surgery."
D. "I will call the surgeon to come and explain it to you."
Correct Answer: D — "I will call the surgeon to come and explain it to you."
Rationale: The surgeon is legally responsible for obtaining informed consent and explaining the procedure,
risks, and benefits. If the client does not understand, the nurse should notify the surgeon to re-educate. The
nurse can clarify information but cannot provide the initial surgical explanation.
3. During the intraoperative phase, which role is responsible for maintaining the sterile field and passing
instruments to the surgeon?
A. Circulating nurse
B. Scrub nurse
C. Registered nurse first assistant (RNFA)
D. Anesthesia provider
Correct Answer: B — Scrub nurse
Rationale: The scrub nurse works directly with the surgeon within the sterile field, passing instruments and
supplies. The circulating nurse works outside the sterile field, managing the environment and documentation.
4. A postoperative client is drowsy and has a respiratory rate of 8 breaths/min. Which action should the nurse
take first?
A. Administer the prescribed opioid analgesic
B. Stimulate the client and encourage deep breathing
, C. Document the finding and reassess in 15 minutes
D. Place the client in a supine position
Correct Answer: B — Stimulate the client and encourage deep breathing
Rationale: A respiratory rate of 8 breaths/min indicates respiratory depression, likely from anesthesia or
opioids. The priority is to stimulate the client and encourage deep breathing to improve oxygenation.
Administering more opioids would worsen the situation.
5. A client is being prepared for surgery and states, "I took my aspirin this morning like I always do." Which is
the nurse's priority action?
A. Document the medication in the preoperative record
B. Notify the surgeon and anesthesia provider immediately
C. Reassure the client that aspirin is safe before surgery
D. Administer vitamin K as prescribed
Correct Answer: B — Notify the surgeon and anesthesia provider immediately
Rationale: Aspirin increases bleeding risk and may need to be discontinued before surgery. The surgeon and
anesthesia provider must be notified to determine whether the surgery should proceed, be delayed, or require
additional precautions.
6. When does the preoperative phase begin?
A. When the client receives discharge instructions
B. When the decision is made to proceed with surgery
Exam Prep — Comprehensive Review +
Practice MCQs — Herzing University
2026/2027
SECTION 1: PERIOPERATIVE NURSING CARE (Questions 1–40)
1. A nurse is caring for a client scheduled for an elective cholecystectomy. Which action should the nurse take
first during the preoperative phase?
A. Administer the prescribed preoperative antibiotic
B. Verify that the informed consent form is signed and witnessed
C. Teach the client how to use the incentive spirometer
D. Obtain a baseline set of vital signs
Correct Answer: B — Verify that the informed consent form is signed and witnessed
Rationale: The preoperative phase begins when the decision for surgery is made. Ensuring legal and ethical
requirements, including a properly signed and witnessed informed consent, is a priority before other
preparations. Vital signs and teaching are important but consent verification comes first.
2. A client scheduled for surgery tells the nurse, "I don't understand what the surgeon meant by 'exploratory
laparotomy.'" What is the nurse's best response?
A. "It's a procedure where the surgeon opens your abdomen to look for the cause of your symptoms."
B. "The surgeon will explain it to you again before you go to sleep."
,C. "Don't worry; it's a very common surgery."
D. "I will call the surgeon to come and explain it to you."
Correct Answer: D — "I will call the surgeon to come and explain it to you."
Rationale: The surgeon is legally responsible for obtaining informed consent and explaining the procedure,
risks, and benefits. If the client does not understand, the nurse should notify the surgeon to re-educate. The
nurse can clarify information but cannot provide the initial surgical explanation.
3. During the intraoperative phase, which role is responsible for maintaining the sterile field and passing
instruments to the surgeon?
A. Circulating nurse
B. Scrub nurse
C. Registered nurse first assistant (RNFA)
D. Anesthesia provider
Correct Answer: B — Scrub nurse
Rationale: The scrub nurse works directly with the surgeon within the sterile field, passing instruments and
supplies. The circulating nurse works outside the sterile field, managing the environment and documentation.
4. A postoperative client is drowsy and has a respiratory rate of 8 breaths/min. Which action should the nurse
take first?
A. Administer the prescribed opioid analgesic
B. Stimulate the client and encourage deep breathing
, C. Document the finding and reassess in 15 minutes
D. Place the client in a supine position
Correct Answer: B — Stimulate the client and encourage deep breathing
Rationale: A respiratory rate of 8 breaths/min indicates respiratory depression, likely from anesthesia or
opioids. The priority is to stimulate the client and encourage deep breathing to improve oxygenation.
Administering more opioids would worsen the situation.
5. A client is being prepared for surgery and states, "I took my aspirin this morning like I always do." Which is
the nurse's priority action?
A. Document the medication in the preoperative record
B. Notify the surgeon and anesthesia provider immediately
C. Reassure the client that aspirin is safe before surgery
D. Administer vitamin K as prescribed
Correct Answer: B — Notify the surgeon and anesthesia provider immediately
Rationale: Aspirin increases bleeding risk and may need to be discontinued before surgery. The surgeon and
anesthesia provider must be notified to determine whether the surgery should proceed, be delayed, or require
additional precautions.
6. When does the preoperative phase begin?
A. When the client receives discharge instructions
B. When the decision is made to proceed with surgery
