Galen NUR 265 – Med-Surg Exam 2, Set 1
(2026 Edition) 150 Original Questions with
Answers & Rationales
Section 1: Preoperative & Intraoperative Care (Q1–15)
1. A patient scheduled for surgery reports taking clopidogrel
(Plavix) daily. The nurse should:
A. Administer the medication as scheduled
B. Notify the surgeon and anesthesiologist
C. Hold the medication for 24 hours pre-op
D. Give vitamin K to reverse effects
Answer: B – Notify the surgeon and anesthesiologist
Rationale: Antiplatelet agents increase bleeding risk; decision to
hold or continue must be made by provider.
2. Which medication should be withheld before surgery due to risk
of adrenal insufficiency?
A. Metoprolol
B. Prednisone
C. Lisinopril
D. Metformin
Answer: B – Prednisone
Rationale: Chronic steroids can cause adrenal suppression; stress
dose steroids may be needed perioperatively.
3. A patient with diabetes is NPO before surgery. The nurse should:
A. Hold all diabetes medications
B. Give half the usual insulin dose
,C. Notify provider for insulin adjustment and monitor glucose
D. Give oral hypoglycemics with a sip of water
Answer: C – Notify provider for insulin adjustment and monitor
glucose
Rationale: NPO patients require insulin adjustments to prevent
hypo/hyperglycemia.
4. A patient is concerned about waking up during surgery. The
nurse explains:
A. “That never happens with modern anesthesia.”
B. “Anesthesia awareness is rare, and monitors help prevent it.”
C. “You will be paralyzed so you can’t move even if awake.”
D. “It happens in 50% of surgeries.”
Answer: B – “Anesthesia awareness is rare, and monitors help
prevent it.”
*Rationale: Anesthesia awareness is rare (0.1-0.2%); BIS monitors
reduce risk.*
5. Which herbal supplement increases bleeding risk and should be
stopped before surgery?
A. Echinacea
B. St. John’s wort
C. Garlic
D. Valerian root
Answer: C – Garlic
Rationale: Garlic, ginkgo, ginseng, and fish oil increase bleeding
risk.
6. A patient receives atropine 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: Atropine is an anticholinergic that reduces secretions
during intubation.
7. Which laboratory finding would most likely cause postponement
of elective surgery?
A. Hemoglobin 11 g/dL
B. Potassium 3.5 mEq/L
C. Platelets 50,000/µL
D. INR 1.2
Answer: C – Platelets 50,000/µL
Rationale: Severe thrombocytopenia increases bleeding risk;
elective surgery may be delayed.
8. A patient with a history of malignant hyperthermia is scheduled
for surgery. Which anesthetic agent should be avoided?
A. Propofol
B. Ketamine
C. Succinylcholine
D. Etomidate
Answer: C – Succinylcholine
Rationale: Succinylcholine and volatile anesthetics (sevoflurane,
desflurane) trigger MH.
9. The nurse is preparing a patient for surgery. Which statement
requires immediate intervention?
, A. “I had a glass of water 2 hours ago.”
B. “I took my blood pressure pill this morning.”
C. “I am allergic to penicillin.”
D. “My wedding ring won’t come off.”
Answer: A – “I had a glass of water 2 hours ago.”
*Rationale: NPO guidelines typically require no fluids 2-6 hours
before surgery depending on procedure.*
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. 25-year-old female nonsmoker with history of motion sickness
(2026 Edition) 150 Original Questions with
Answers & Rationales
Section 1: Preoperative & Intraoperative Care (Q1–15)
1. A patient scheduled for surgery reports taking clopidogrel
(Plavix) daily. The nurse should:
A. Administer the medication as scheduled
B. Notify the surgeon and anesthesiologist
C. Hold the medication for 24 hours pre-op
D. Give vitamin K to reverse effects
Answer: B – Notify the surgeon and anesthesiologist
Rationale: Antiplatelet agents increase bleeding risk; decision to
hold or continue must be made by provider.
2. Which medication should be withheld before surgery due to risk
of adrenal insufficiency?
A. Metoprolol
B. Prednisone
C. Lisinopril
D. Metformin
Answer: B – Prednisone
Rationale: Chronic steroids can cause adrenal suppression; stress
dose steroids may be needed perioperatively.
3. A patient with diabetes is NPO before surgery. The nurse should:
A. Hold all diabetes medications
B. Give half the usual insulin dose
,C. Notify provider for insulin adjustment and monitor glucose
D. Give oral hypoglycemics with a sip of water
Answer: C – Notify provider for insulin adjustment and monitor
glucose
Rationale: NPO patients require insulin adjustments to prevent
hypo/hyperglycemia.
4. A patient is concerned about waking up during surgery. The
nurse explains:
A. “That never happens with modern anesthesia.”
B. “Anesthesia awareness is rare, and monitors help prevent it.”
C. “You will be paralyzed so you can’t move even if awake.”
D. “It happens in 50% of surgeries.”
Answer: B – “Anesthesia awareness is rare, and monitors help
prevent it.”
*Rationale: Anesthesia awareness is rare (0.1-0.2%); BIS monitors
reduce risk.*
5. Which herbal supplement increases bleeding risk and should be
stopped before surgery?
A. Echinacea
B. St. John’s wort
C. Garlic
D. Valerian root
Answer: C – Garlic
Rationale: Garlic, ginkgo, ginseng, and fish oil increase bleeding
risk.
6. A patient receives atropine 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: Atropine is an anticholinergic that reduces secretions
during intubation.
7. Which laboratory finding would most likely cause postponement
of elective surgery?
A. Hemoglobin 11 g/dL
B. Potassium 3.5 mEq/L
C. Platelets 50,000/µL
D. INR 1.2
Answer: C – Platelets 50,000/µL
Rationale: Severe thrombocytopenia increases bleeding risk;
elective surgery may be delayed.
8. A patient with a history of malignant hyperthermia is scheduled
for surgery. Which anesthetic agent should be avoided?
A. Propofol
B. Ketamine
C. Succinylcholine
D. Etomidate
Answer: C – Succinylcholine
Rationale: Succinylcholine and volatile anesthetics (sevoflurane,
desflurane) trigger MH.
9. The nurse is preparing a patient for surgery. Which statement
requires immediate intervention?
, A. “I had a glass of water 2 hours ago.”
B. “I took my blood pressure pill this morning.”
C. “I am allergic to penicillin.”
D. “My wedding ring won’t come off.”
Answer: A – “I had a glass of water 2 hours ago.”
*Rationale: NPO guidelines typically require no fluids 2-6 hours
before surgery depending on procedure.*
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. 25-year-old female nonsmoker with history of motion sickness
