Galen NUR 265 – Med-Surg Exam 2 (Two Versions) 2026 Version A – Questions 1–75 | Version B – Questions 76–150 Answers & Rationales Included

Galen NUR 265 – Med-Surg Exam 2 (Two
Versions) 2026 Version A – Questions 1–75 |
Version B – Questions 76–150 Answers &
Rationales Included

VERSION A (Questions 1–75)
Section A1: Perioperative & Postoperative Complications (Q1–15)
1. A patient is 4 hours post-op from open abdominal surgery.
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kWhich finding suggests early hypovolemic shock?
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A. Urine output 35 mL/hr k k k



B. Heart rate 118 bpm, BP 90/60
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C. Pain score 6/10 k k



D. Temperature 99.2°F (37.3°C) k k



Answer: B – Heart rate 118 bpm, BP 90/60
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Rationale: Tachycardia with hypotension indicates hypovolemia
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kuntil proven otherwise.
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2. A patient post-op from hip replacement suddenly reports
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“something popped” in the incision, and the nurse sees bowel
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loops. What is the priority action?
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A. Push the bowel back ink k k k



B. Cover with sterile saline-moistened dressing
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C. Apply an abdominal binder tightly
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D. Place patient in Trendelenburg
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Answer: B – Cover with sterile saline-moistened dressing
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Rationale: Evisceration requires moist sterile dressing; never
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reinsert organs.
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,3. Which patient is at highest risk for malignant hyperthermia?
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A. 22-year-old with family history of MH, receiving sevoflurane
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B. 65-year-old with hypertension on beta-blockers k k k k



C. 40-year-old with diabetes receiving propofol k k k k



D. 30-year-old with asthma receiving ketamine k k k k



Answer: A – 22-year-old with family history of MH, receiving
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sevoflurane
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Rationale: MH is autosomal dominant triggered by volatile
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anesthetics/succinylcholine.
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4. A patient post-op from thyroidectomy reports tingling around
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the mouth and finger twitching. Which lab value should the nurse
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expect?
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A. Calcium 6.8 mg/dL k k



B. Potassium 5.5 mEq/L k k



C. Sodium 155 mEq/L k k



D. Magnesium 2.5 mg/dL k k



Answer: A – Calcium 6.8 mg/dL
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Rationale: Tetany indicates hypocalcemia from parathyroid injury.
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5. A patient has a Jackson-Pratt drain with 200 mL bright red blood
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in 2 hours. The nurse should:
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A. Empty and reapply suction
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B. Notify the surgeon immediately
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C. Document as normal k k



D. Irrigate the drain k k



Answer: B – Notify the surgeon immediately
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*Rationale: >100 mL/hr suggests hemorrhage.*
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,6. Which finding in the first 24 hours post-op is most indicative of
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atelectasis?
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A. Purulent sputum k



B. Low-grade fever and crackles that clear with coughing
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C. Chest pain with inspiration
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D. Oxygen saturation 85% k k



Answer: B – Low-grade fever and crackles that clear with coughing
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Rationale: Atelectasis causes fever and crackles that often clear
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after deep breathing.
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7. A patient received spinal anesthesia. Which finding requires
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immediate action?
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A. Blood pressure 100/70
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B. Patient reports headache when sitting up
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C. Respiratory rate 8 breaths/min k k k



D. Urinary retention k



Answer: C – Respiratory rate 8 breaths/min
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Rationale: High spinal can cause respiratory depression;
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emergency.
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8. A patient post-op has not voided for 10 hours and has suprapubic
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discomfort. What should the nurse do first?
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A. Insert a Foley catheter
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B. Perform a bladder scan k k k



C. Increase IV fluids k k



D. Palpate the bladder k k



Answer: B – Perform a bladder scan
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Rationale: Bladder scan determines retention non-invasively.
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, 9. Which medication is used to reverse the effects of vecuronium
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(neuromuscular blocker)?
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A. Naloxone
B. Neostigmine
C. Flumazenil
D. Protamine
Answer: B – Neostigmine
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Rationale: Neostigmine with glycopyrrolate reverses
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non-depolarizing NMBs.
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10. A patient post-op from bowel resection has a new colostomy.
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kThe stoma is pale and bluish. What should the nurse do?
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A. Apply warm compress
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B. Notify surgeon immediately
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C. Document as normal k k



D. Massage the stoma k k



Answer: B – Notify surgeon immediately
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Rationale: Pale/blue stoma indicates ischemia or necrosis.
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11. A patient is 1 day post-op and has a fever of 101.5°F (38.6°C),
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kcrackles in lung bases, and a productive cough. The nurse suspects:
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A. Wound infection k



B. Atelectasis progressing to pneumonia k k k



C. Urinary tract infection k k



D. Deep vein thrombosis
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Answer: B – Atelectasis progressing to pneumonia
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Rationale: Post-op day 1 fever often atelectasis; productive cough
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ksuggests infection.
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