Galen NUR 265 – Med-Surg Exam 2, Set 1
(Practice Exam) 150 Questions with Answers
& Rationales
Section 1: Perioperative & Postoperative Care (Q1–20)
1. A patient is 2 hours post-op from abdominal surgery. Which
finding requires immediate notification of the surgeon?
A. Pain rated 5/10
B. Heart rate 110 bpm, BP 88/50
C. Urine output 40 mL/hr
D. Temperature 99.8°F (37.7°C)
Answer: B – Heart rate 110 bpm, BP 88/50
Rationale: Tachycardia with hypotension suggests hypovolemia or
hemorrhage.
2. A patient received general anesthesia. The nurse’s priority in the
immediate post-op period is:
A. Pain management
B. Airway patency
C. Wound assessment
D. Fluid replacement
Answer: B – Airway patency
Rationale: Airway is always first; anesthesia can cause airway
obstruction.
,3. Which assessment finding indicates malignant hyperthermia?
A. Hypothermia and bradycardia
B. Muscle rigidity and hyperthermia
C. Hypotension and polyuria
D. Respiratory depression and miosis
Answer: B – Muscle rigidity and hyperthermia
Rationale: Malignant hyperthermia is a life-threatening reaction to
volatile anesthetics/succinylcholine.
4. A patient post-op has a Jackson-Pratt drain with 150 mL of bright
red blood in 1 hour. What should the nurse do first?
A. Document as normal
B. Empty the drain
C. Notify the provider
D. Apply pressure to the site
Answer: C – Notify the provider
*Rationale: >100 mL/hr suggests active bleeding.*
5. Which instruction is correct for a patient after outpatient
surgery with general anesthesia?
A. “You may drive yourself home.”
B. “Do not drink alcohol for 24 hours.”
C. “Return to work tomorrow.”
D. “You can eat a full meal immediately.”
Answer: B – “Do not drink alcohol for 24 hours.”
Rationale: Alcohol interacts with anesthesia and sedatives; impairs
recovery.
6. A patient post-op reports sudden chest pain and dyspnea. The
nurse suspects pulmonary embolism. The priority action is:
,A. Give aspirin
B. Apply oxygen and notify provider
C. Ambulate the patient
D. Administer morphine
Answer: B – Apply oxygen and notify provider
Rationale: Oxygenation and rapid treatment are critical for PE.
7. Which patient is at highest risk for postoperative pneumonia?
A. 30-year-old having knee arthroscopy
B. 65-year-old smoker with abdominal surgery
C. 20-year-old with tonsillectomy
D. 45-year-old with cataract surgery
Answer: B – 65-year-old smoker with abdominal surgery
Rationale: Older age, smoking, and abdominal incision (splinting)
increase pneumonia risk.
8. A patient post-op has not voided for 8 hours and reports
suprapubic discomfort. What should the nurse do first?
A. Insert a Foley catheter
B. Bladder scan
C. Increase IV fluids
D. Encourage ambulation
Answer: B – Bladder scan
Rationale: Bladder scan determines urinary retention
non-invasively.
9. Which finding in the first 24 hours post-op is most concerning
for infection?
A. WBC 12,000/µL
B. Temperature 100.2°F (37.9°C)
, C. Purulent drainage from incision
D. Pain at incision site
Answer: C – Purulent drainage from incision
Rationale: Purulent drainage indicates infection; fever and mild
leukocytosis are expected post-op.
10. A patient is 6 hours post-op and has not ambulated. The nurse’s
best action is:
A. Wait until tomorrow
B. Assist the patient to sit at the bedside
C. Notify physical therapy
D. Apply sequential compression devices only
Answer: B – Assist the patient to sit at the bedside
Rationale: Early mobilization prevents DVT, atelectasis, and ileus.
11. Which medication is given to reverse the effects of
neuromuscular blockers?
A. Naloxone
B. Neostigmine
C. Flumazenil
D. Protamine
Answer: B – Neostigmine
Rationale: Neostigmine (with glycopyrrolate) reverses
non-depolarizing neuromuscular blockers.
12. A patient post-op has a nasogastric tube to low intermittent
suction. Which finding indicates the tube is functioning correctly?
A. Nausea and vomiting
B. Abdominal distention
C. Output of 800 mL green fluid in 8 hours
(Practice Exam) 150 Questions with Answers
& Rationales
Section 1: Perioperative & Postoperative Care (Q1–20)
1. A patient is 2 hours post-op from abdominal surgery. Which
finding requires immediate notification of the surgeon?
A. Pain rated 5/10
B. Heart rate 110 bpm, BP 88/50
C. Urine output 40 mL/hr
D. Temperature 99.8°F (37.7°C)
Answer: B – Heart rate 110 bpm, BP 88/50
Rationale: Tachycardia with hypotension suggests hypovolemia or
hemorrhage.
2. A patient received general anesthesia. The nurse’s priority in the
immediate post-op period is:
A. Pain management
B. Airway patency
C. Wound assessment
D. Fluid replacement
Answer: B – Airway patency
Rationale: Airway is always first; anesthesia can cause airway
obstruction.
,3. Which assessment finding indicates malignant hyperthermia?
A. Hypothermia and bradycardia
B. Muscle rigidity and hyperthermia
C. Hypotension and polyuria
D. Respiratory depression and miosis
Answer: B – Muscle rigidity and hyperthermia
Rationale: Malignant hyperthermia is a life-threatening reaction to
volatile anesthetics/succinylcholine.
4. A patient post-op has a Jackson-Pratt drain with 150 mL of bright
red blood in 1 hour. What should the nurse do first?
A. Document as normal
B. Empty the drain
C. Notify the provider
D. Apply pressure to the site
Answer: C – Notify the provider
*Rationale: >100 mL/hr suggests active bleeding.*
5. Which instruction is correct for a patient after outpatient
surgery with general anesthesia?
A. “You may drive yourself home.”
B. “Do not drink alcohol for 24 hours.”
C. “Return to work tomorrow.”
D. “You can eat a full meal immediately.”
Answer: B – “Do not drink alcohol for 24 hours.”
Rationale: Alcohol interacts with anesthesia and sedatives; impairs
recovery.
6. A patient post-op reports sudden chest pain and dyspnea. The
nurse suspects pulmonary embolism. The priority action is:
,A. Give aspirin
B. Apply oxygen and notify provider
C. Ambulate the patient
D. Administer morphine
Answer: B – Apply oxygen and notify provider
Rationale: Oxygenation and rapid treatment are critical for PE.
7. Which patient is at highest risk for postoperative pneumonia?
A. 30-year-old having knee arthroscopy
B. 65-year-old smoker with abdominal surgery
C. 20-year-old with tonsillectomy
D. 45-year-old with cataract surgery
Answer: B – 65-year-old smoker with abdominal surgery
Rationale: Older age, smoking, and abdominal incision (splinting)
increase pneumonia risk.
8. A patient post-op has not voided for 8 hours and reports
suprapubic discomfort. What should the nurse do first?
A. Insert a Foley catheter
B. Bladder scan
C. Increase IV fluids
D. Encourage ambulation
Answer: B – Bladder scan
Rationale: Bladder scan determines urinary retention
non-invasively.
9. Which finding in the first 24 hours post-op is most concerning
for infection?
A. WBC 12,000/µL
B. Temperature 100.2°F (37.9°C)
, C. Purulent drainage from incision
D. Pain at incision site
Answer: C – Purulent drainage from incision
Rationale: Purulent drainage indicates infection; fever and mild
leukocytosis are expected post-op.
10. A patient is 6 hours post-op and has not ambulated. The nurse’s
best action is:
A. Wait until tomorrow
B. Assist the patient to sit at the bedside
C. Notify physical therapy
D. Apply sequential compression devices only
Answer: B – Assist the patient to sit at the bedside
Rationale: Early mobilization prevents DVT, atelectasis, and ileus.
11. Which medication is given to reverse the effects of
neuromuscular blockers?
A. Naloxone
B. Neostigmine
C. Flumazenil
D. Protamine
Answer: B – Neostigmine
Rationale: Neostigmine (with glycopyrrolate) reverses
non-depolarizing neuromuscular blockers.
12. A patient post-op has a nasogastric tube to low intermittent
suction. Which finding indicates the tube is functioning correctly?
A. Nausea and vomiting
B. Abdominal distention
C. Output of 800 mL green fluid in 8 hours
