NUR 242 Exam 1 – Med-Surg Concepts (2026)
Galen College of Nursing | Actual Questions &
Answers with Rationales
Section 1: Perioperative Nursing (Questions 1-70)
b b b b b
1. A patient is scheduled for surgery. Which finding requires
b b b b b b b b
bpostponement of the procedure? b b b
A. Temperature 101.5°F b
B. Blood pressure 140/90 mmHg
b b b
C. Glucose 120 mg/dL b b
D. Hemoglobin 12 g/dL b b
Answer: A. Temperature 101.5°F
b b b
Rationale: Fever may indicate infection, requiring surgery
b b b b b b
postponement until the cause is identified and treated .
b b b b b b b b b
2. A patient is scheduled for surgery and reports allergies to latex.
b b b b b b b b b b
Which action is most important?
b b b b b
A. Document allergy in the chart b b b b
B. Use latex-free supplies
b b
C. Notify the OR staff b b b
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: Latex allergy requires documentation, use of latex-free
b b b b b b b
supplies, and notification of all healthcare personnel involved in the
b b b b b b b b b b
patient's care .
b b b
3. A patient is scheduled for surgery and is NPO after midnight.
b b b b b b b b b b
Which instruction is most important?
b b b b b
A. "Do not eat or drink after midnight"
b b b b b b
B. "Drink clear liquids only"
b b b
,C. "Eat a light breakfast"
b b b
D. "No restrictions"
b
Answer: A. "Do not eat or drink after midnight"
b b b b b b b b
Rationale: NPO status prevents aspiration during anesthesia. Strict
b b b b b b b
adherence is essential for patient safety .
b b b b b b b
4. A patient takes warfarin (Coumadin) and is scheduled for surgery.
b b b b b b b b b
Which instruction is most important?
b b b b b
A. "Notify your provider to discuss stopping warfarin"
b b b b b b
B. "Continue warfarin as usual" b b b
C. "Double the dose" b b
D. "Stop warfarin immediately"
b b
Answer: A. "Notify your provider to discuss stopping warfarin"
b b b b b b b b
Rationale: Anticoagulants increase bleeding risk; the provider will
b b b b b b b b
determine when to stop the medication based on the procedure and
b b b b b b b b b b b
patient's risk factors .
b b b b
5. A patient in the preoperative holding area is anxious. Which
b b b b b b b b b
intervention is most appropriate?
b b b b
A. Provide information about the procedure
b b b b
B. Offer reassurance b
C. Allow family presence b b
D. All of the above
b b b
Answer: D. All of the above b b b b b
Rationale: Preoperative anxiety is managed with information,
b b b b b b
reassurance, and family support to reduce stress .
b b b b b b b b
6. A patient in the preoperative holding area has signed the consent
b b b b b b b b b b
form. Which statement indicates understanding of informed consent?
b b b b b b b b
A. "I understand the risks and benefits of the procedure"
b b b b b b b b
B. "I didn't read the form"
b b b b
C. "I signed because my family wanted me to"
b b b b b b b
D. "I don't understand but signed anyway"
b b b b b
Answer: A. "I understand the risks and benefits of the procedure"
b b b b b b b b b b
Rationale: Informed consent requires understanding of risks,
b b b b b b b
,benefits, and alternatives. The patient must be competent and
b b b b b b b b
voluntarily agree .
b b b
7. A patient in the preoperative holding area states they are allergic
b b b b b b b b b b
to penicillin. Which action is most important?
b b b b b b b
A. Document allergy b
B. Place allergy band b b
C. Notify anesthesia provider b b
D. All of the above b b b
Answer: D. All of the above b b b b b
Rationale: Allergies must be documented, identified with an allergy
b b b b b b b b
bband, and communicated to all providers to prevent adverse
b b b b b b b b
breactions
.
8. A patient in the preoperative holding area has a missing tooth.
b b b b b b b b b b
Which action is most important?
b b b b b
A. Document
B. Notify anesthesia provider b b
C. Remove dentures b
D. All of the above b b b
Answer: D. All of the above b b b b b
Rationale: Loose teeth or dentures must be documented, and
b b b b b b b b
anesthesia notified to prevent aspiration during intubation .
b b b b b b b b
9. A patient in the preoperative holding area has jewelry. Which action
b b b b b b b b b b
is most appropriate?
b b b
A. Remove jewelry b
B. Tape over jewelry b b
C. Leave jewelry b
D. Cover with gauze b b
Answer: A. Remove jewelry b b b
Rationale: Jewelry should be removed to prevent injury and loss.
b b b b b b b b b
Religious items may be taped if permitted by facility policy .
b b b b b b b b b b b
10. A patient is transferred to the operating room. The nurse should verify:
b b b b b b b b b b b
A. Patient identity b
, B. Procedure
C. Consent
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: The "time out" includes verifying patient identity, procedure, and
b b b b b b b b b
consent before surgery begins .
b b b b b
11. A patient is in the post-anesthesia care unit (PACU). Which assessment
b b b b b b b b b b
bis most important?
b b
A. Airway
B. Breathing
C. Circulation
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: ABCs (airway, breathing, circulation) are the priority in PACU to
b b b b b b b b b b
ensure patient safety .
b b b b
12. A patient in PACU has a pulse oximetry of 88%. Which action is
b b b b b b b b b b b b
bmost appropriate?
b
A. Administer oxygen b
B. Notify provider b
C. Assess airway b
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: Hypoxia requires immediate oxygen therapy, airway assessment,
b b b b b b b
and notification of the provider .
b b b b b b
13. A patient in PACU has a blood pressure of 80/50 mmHg. Which action
b b b b b b b b b b b b
bis most appropriate?
b b
A. Administer IV fluids b b
B. Notify provider b
C. Assess for bleeding b b
D. All of the above
b b b
Galen College of Nursing | Actual Questions &
Answers with Rationales
Section 1: Perioperative Nursing (Questions 1-70)
b b b b b
1. A patient is scheduled for surgery. Which finding requires
b b b b b b b b
bpostponement of the procedure? b b b
A. Temperature 101.5°F b
B. Blood pressure 140/90 mmHg
b b b
C. Glucose 120 mg/dL b b
D. Hemoglobin 12 g/dL b b
Answer: A. Temperature 101.5°F
b b b
Rationale: Fever may indicate infection, requiring surgery
b b b b b b
postponement until the cause is identified and treated .
b b b b b b b b b
2. A patient is scheduled for surgery and reports allergies to latex.
b b b b b b b b b b
Which action is most important?
b b b b b
A. Document allergy in the chart b b b b
B. Use latex-free supplies
b b
C. Notify the OR staff b b b
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: Latex allergy requires documentation, use of latex-free
b b b b b b b
supplies, and notification of all healthcare personnel involved in the
b b b b b b b b b b
patient's care .
b b b
3. A patient is scheduled for surgery and is NPO after midnight.
b b b b b b b b b b
Which instruction is most important?
b b b b b
A. "Do not eat or drink after midnight"
b b b b b b
B. "Drink clear liquids only"
b b b
,C. "Eat a light breakfast"
b b b
D. "No restrictions"
b
Answer: A. "Do not eat or drink after midnight"
b b b b b b b b
Rationale: NPO status prevents aspiration during anesthesia. Strict
b b b b b b b
adherence is essential for patient safety .
b b b b b b b
4. A patient takes warfarin (Coumadin) and is scheduled for surgery.
b b b b b b b b b
Which instruction is most important?
b b b b b
A. "Notify your provider to discuss stopping warfarin"
b b b b b b
B. "Continue warfarin as usual" b b b
C. "Double the dose" b b
D. "Stop warfarin immediately"
b b
Answer: A. "Notify your provider to discuss stopping warfarin"
b b b b b b b b
Rationale: Anticoagulants increase bleeding risk; the provider will
b b b b b b b b
determine when to stop the medication based on the procedure and
b b b b b b b b b b b
patient's risk factors .
b b b b
5. A patient in the preoperative holding area is anxious. Which
b b b b b b b b b
intervention is most appropriate?
b b b b
A. Provide information about the procedure
b b b b
B. Offer reassurance b
C. Allow family presence b b
D. All of the above
b b b
Answer: D. All of the above b b b b b
Rationale: Preoperative anxiety is managed with information,
b b b b b b
reassurance, and family support to reduce stress .
b b b b b b b b
6. A patient in the preoperative holding area has signed the consent
b b b b b b b b b b
form. Which statement indicates understanding of informed consent?
b b b b b b b b
A. "I understand the risks and benefits of the procedure"
b b b b b b b b
B. "I didn't read the form"
b b b b
C. "I signed because my family wanted me to"
b b b b b b b
D. "I don't understand but signed anyway"
b b b b b
Answer: A. "I understand the risks and benefits of the procedure"
b b b b b b b b b b
Rationale: Informed consent requires understanding of risks,
b b b b b b b
,benefits, and alternatives. The patient must be competent and
b b b b b b b b
voluntarily agree .
b b b
7. A patient in the preoperative holding area states they are allergic
b b b b b b b b b b
to penicillin. Which action is most important?
b b b b b b b
A. Document allergy b
B. Place allergy band b b
C. Notify anesthesia provider b b
D. All of the above b b b
Answer: D. All of the above b b b b b
Rationale: Allergies must be documented, identified with an allergy
b b b b b b b b
bband, and communicated to all providers to prevent adverse
b b b b b b b b
breactions
.
8. A patient in the preoperative holding area has a missing tooth.
b b b b b b b b b b
Which action is most important?
b b b b b
A. Document
B. Notify anesthesia provider b b
C. Remove dentures b
D. All of the above b b b
Answer: D. All of the above b b b b b
Rationale: Loose teeth or dentures must be documented, and
b b b b b b b b
anesthesia notified to prevent aspiration during intubation .
b b b b b b b b
9. A patient in the preoperative holding area has jewelry. Which action
b b b b b b b b b b
is most appropriate?
b b b
A. Remove jewelry b
B. Tape over jewelry b b
C. Leave jewelry b
D. Cover with gauze b b
Answer: A. Remove jewelry b b b
Rationale: Jewelry should be removed to prevent injury and loss.
b b b b b b b b b
Religious items may be taped if permitted by facility policy .
b b b b b b b b b b b
10. A patient is transferred to the operating room. The nurse should verify:
b b b b b b b b b b b
A. Patient identity b
, B. Procedure
C. Consent
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: The "time out" includes verifying patient identity, procedure, and
b b b b b b b b b
consent before surgery begins .
b b b b b
11. A patient is in the post-anesthesia care unit (PACU). Which assessment
b b b b b b b b b b
bis most important?
b b
A. Airway
B. Breathing
C. Circulation
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: ABCs (airway, breathing, circulation) are the priority in PACU to
b b b b b b b b b b
ensure patient safety .
b b b b
12. A patient in PACU has a pulse oximetry of 88%. Which action is
b b b b b b b b b b b b
bmost appropriate?
b
A. Administer oxygen b
B. Notify provider b
C. Assess airway b
D. All of the above
b b b
Answer: D. All of the above
b b b b b
Rationale: Hypoxia requires immediate oxygen therapy, airway assessment,
b b b b b b b
and notification of the provider .
b b b b b b
13. A patient in PACU has a blood pressure of 80/50 mmHg. Which action
b b b b b b b b b b b b
bis most appropriate?
b b
A. Administer IV fluids b b
B. Notify provider b
C. Assess for bleeding b b
D. All of the above
b b b
