Galen NUR 265 Exam 1 - 3 Versions Med-
Surg (2026) Actual Questions & Verified
Answers (PDF, Exams of Nursing
VERSION A (Questions 1–83)
Section A1: Preoperative & Intraoperative Care (Q1–20)
1. A patient scheduled for elective surgery reports taking warfarin
(Coumadin) daily for atrial fibrillation. What should the nurse do?
A. Administer the medication as scheduled
B. Notify the surgeon and anesthesiologist immediately
C. Hold the medication for 5 days pre-op
D. Give vitamin K to reverse effects
Answer: B – Notify the surgeon and anesthesiologist immediately
Rationale: Warfarin increases bleeding risk; decision to hold or bridge must
be made by provider.
2. Which medication should be continued through surgery to prevent
rebound hypertension?
A. Metoprolol
B. Lisinopril
C. Furosemide
D. Metformin
Answer: A – Metoprolol
Rationale: Beta-blockers should be continued to prevent tachycardia and
hypertension; abrupt withdrawal can cause rebound.
3. A patient with type 2 diabetes is NPO before surgery. The morning dose of
metformin should be:
A. Given with a sip of water
B. Held on the day of surgery
C. Doubled before NPO
,D. Given IV
Answer: B – Held on the day of surgery
Rationale: Metformin increases risk of lactic acidosis with NPO status and IV
contrast.
4. A patient asks why they need to remove nail polish before surgery. The
nurse explains:
A. “Nail polish can chip and fall into the surgical site.”
B. “Pulse oximetry readings may be inaccurate.”
C. “It’s an infection control measure.”
D. “The operating room is cold and polish cracks.”
Answer: B – “Pulse oximetry readings may be inaccurate.”
Rationale: Nail polish can interfere with pulse oximeter light transmission.
5. Which herbal supplement increases bleeding risk and should be stopped 7
days before surgery?
A. Echinacea
B. Ginkgo biloba
C. St. John’s wort
D. Valerian root
Answer: B – Ginkgo biloba
Rationale: Ginkgo, garlic, ginseng, and fish oil increase bleeding risk.
6. A patient receives glycopyrrolate as a preoperative medication. The nurse
knows this is given to:
A. Decrease anxiety
B. Dry respiratory secretions
C. Induce amnesia
D. Reverse neuromuscular blockade
Answer: B – Dry respiratory secretions
Rationale: Glycopyrrolate is an anticholinergic that reduces secretions
during intubation.
7. Which laboratory finding would most likely cause postponement of
elective surgery?
,A. Hemoglobin 10.5 g/dL
B. Potassium 3.6 mEq/L
C. Platelets 40,000/µL
D. INR 1.3
Answer: C – Platelets 40,000/µL
Rationale: Severe thrombocytopenia increases bleeding risk; elective surgery
may be delayed.
8. A patient with a family history of malignant hyperthermia is scheduled for
surgery. Which anesthetic agent is safe?
A. Succinylcholine
B. Sevoflurane
C. Propofol
D. Desflurane
Answer: C – Propofol
Rationale: Propofol is safe; succinylcholine and volatile agents trigger MH.
9. The nurse is preparing a patient for surgery. Which statement requires
immediate intervention?
A. “I had a bagel and coffee 3 hours ago.”
B. “I took my blood pressure pill this morning.”
C. “I am allergic to sulfa drugs.”
D. “My wedding ring won’t come off.”
Answer: A – “I had a bagel and coffee 3 hours ago.”
*Rationale: NPO guidelines typically require no food 6-8 hours before
surgery.*
10. A patient asks why they need to wear sequential compression devices
(SCDs) during surgery. The nurse explains:
A. “They keep your legs warm.”
B. “They prevent blood clots by improving circulation.”
C. “They monitor your blood pressure.”
D. “They help you wake up faster.”
, Answer: B – “They prevent blood clots by improving circulation.”
Rationale: SCDs provide mechanical prophylaxis against DVT.
11. A patient receives midazolam (Versed) preoperatively. The nurse should
monitor for:
A. Hypertension
B. Respiratory depression
C. Hyperthermia
D. Seizures
Answer: B – Respiratory depression
Rationale: Benzodiazepines cause sedation and respiratory depression,
especially with opioids.
12. Which patient is at highest risk for postoperative nausea and vomiting
(PONV)?
A. 30-year-old male smoker
B. 25-year-old female with history of motion sickness
C. 60-year-old female with hypertension
D. 70-year-old male with diabetes
Answer: B – 25-year-old female with history of motion sickness
Rationale: Female gender, young age, nonsmoker, history of PONV/motion
sickness are risk factors.
13. A patient with a latex allergy is scheduled for surgery. What should the
nurse ensure?
A. Use of latex gloves only
B. Latex-safe cart and non-latex equipment
C. No special precautions needed
D. Oral antihistamines only
Answer: B – Latex-safe cart and non-latex equipment
Rationale: Latex allergy requires complete avoidance of latex products in OR
and perioperative areas.
14. A patient’s advance directive states “no blood transfusions.” The patient is
having elective surgery with expected blood loss. The nurse should:
Surg (2026) Actual Questions & Verified
Answers (PDF, Exams of Nursing
VERSION A (Questions 1–83)
Section A1: Preoperative & Intraoperative Care (Q1–20)
1. A patient scheduled for elective surgery reports taking warfarin
(Coumadin) daily for atrial fibrillation. What should the nurse do?
A. Administer the medication as scheduled
B. Notify the surgeon and anesthesiologist immediately
C. Hold the medication for 5 days pre-op
D. Give vitamin K to reverse effects
Answer: B – Notify the surgeon and anesthesiologist immediately
Rationale: Warfarin increases bleeding risk; decision to hold or bridge must
be made by provider.
2. Which medication should be continued through surgery to prevent
rebound hypertension?
A. Metoprolol
B. Lisinopril
C. Furosemide
D. Metformin
Answer: A – Metoprolol
Rationale: Beta-blockers should be continued to prevent tachycardia and
hypertension; abrupt withdrawal can cause rebound.
3. A patient with type 2 diabetes is NPO before surgery. The morning dose of
metformin should be:
A. Given with a sip of water
B. Held on the day of surgery
C. Doubled before NPO
,D. Given IV
Answer: B – Held on the day of surgery
Rationale: Metformin increases risk of lactic acidosis with NPO status and IV
contrast.
4. A patient asks why they need to remove nail polish before surgery. The
nurse explains:
A. “Nail polish can chip and fall into the surgical site.”
B. “Pulse oximetry readings may be inaccurate.”
C. “It’s an infection control measure.”
D. “The operating room is cold and polish cracks.”
Answer: B – “Pulse oximetry readings may be inaccurate.”
Rationale: Nail polish can interfere with pulse oximeter light transmission.
5. Which herbal supplement increases bleeding risk and should be stopped 7
days before surgery?
A. Echinacea
B. Ginkgo biloba
C. St. John’s wort
D. Valerian root
Answer: B – Ginkgo biloba
Rationale: Ginkgo, garlic, ginseng, and fish oil increase bleeding risk.
6. A patient receives glycopyrrolate as a preoperative medication. The nurse
knows this is given to:
A. Decrease anxiety
B. Dry respiratory secretions
C. Induce amnesia
D. Reverse neuromuscular blockade
Answer: B – Dry respiratory secretions
Rationale: Glycopyrrolate is an anticholinergic that reduces secretions
during intubation.
7. Which laboratory finding would most likely cause postponement of
elective surgery?
,A. Hemoglobin 10.5 g/dL
B. Potassium 3.6 mEq/L
C. Platelets 40,000/µL
D. INR 1.3
Answer: C – Platelets 40,000/µL
Rationale: Severe thrombocytopenia increases bleeding risk; elective surgery
may be delayed.
8. A patient with a family history of malignant hyperthermia is scheduled for
surgery. Which anesthetic agent is safe?
A. Succinylcholine
B. Sevoflurane
C. Propofol
D. Desflurane
Answer: C – Propofol
Rationale: Propofol is safe; succinylcholine and volatile agents trigger MH.
9. The nurse is preparing a patient for surgery. Which statement requires
immediate intervention?
A. “I had a bagel and coffee 3 hours ago.”
B. “I took my blood pressure pill this morning.”
C. “I am allergic to sulfa drugs.”
D. “My wedding ring won’t come off.”
Answer: A – “I had a bagel and coffee 3 hours ago.”
*Rationale: NPO guidelines typically require no food 6-8 hours before
surgery.*
10. A patient asks why they need to wear sequential compression devices
(SCDs) during surgery. The nurse explains:
A. “They keep your legs warm.”
B. “They prevent blood clots by improving circulation.”
C. “They monitor your blood pressure.”
D. “They help you wake up faster.”
, Answer: B – “They prevent blood clots by improving circulation.”
Rationale: SCDs provide mechanical prophylaxis against DVT.
11. A patient receives midazolam (Versed) preoperatively. The nurse should
monitor for:
A. Hypertension
B. Respiratory depression
C. Hyperthermia
D. Seizures
Answer: B – Respiratory depression
Rationale: Benzodiazepines cause sedation and respiratory depression,
especially with opioids.
12. Which patient is at highest risk for postoperative nausea and vomiting
(PONV)?
A. 30-year-old male smoker
B. 25-year-old female with history of motion sickness
C. 60-year-old female with hypertension
D. 70-year-old male with diabetes
Answer: B – 25-year-old female with history of motion sickness
Rationale: Female gender, young age, nonsmoker, history of PONV/motion
sickness are risk factors.
13. A patient with a latex allergy is scheduled for surgery. What should the
nurse ensure?
A. Use of latex gloves only
B. Latex-safe cart and non-latex equipment
C. No special precautions needed
D. Oral antihistamines only
Answer: B – Latex-safe cart and non-latex equipment
Rationale: Latex allergy requires complete avoidance of latex products in OR
and perioperative areas.
14. A patient’s advance directive states “no blood transfusions.” The patient is
having elective surgery with expected blood loss. The nurse should:
