1|Page
NUR 242 EXAM 2 – 2026/2027 MEDICAL-
SURGICAL NURSING I: FOUNDATIONAL
CONCEPTS 300 QUESTIONS | ANSWERS &
RATIONALES | A+ GRADE
## Table of Contents
| Section | Topic | Questions |
|---------|------------------------------|-----------|
| 1 | Perioperative Nursing | 1–40 |
| 2 | Pain Management | 41–80 |
| 3 | Fluid, Electrolyte, & Acid-Base Balance | 81–130 |
| 4 | Infection Prevention & Control | 131–165 |
| 5 | Wound Healing & Pressure Injuries | 166–200 |
| 6 | Shock & Hemodynamics | 201–240 |
| 7 | Respiratory Disorders (COPD, Asthma, Pneumonia) | 241–275 |
| 8 | Cardiovascular Disorders (Hypertension, CAD, HF) | 276–300 |
---
,2|Page
## Section 1: Perioperative Nursing
**Questions 1–40**
**1.** A patient is scheduled for surgery and takes warfarin daily.
Which action is most appropriate?
A) Continue warfarin as usual
B) Hold warfarin 5 days before surgery
C) Double the dose day before surgery
D) Switch to enoxaparin 2 days before
**Answer: B** – Warfarin is held 5 days pre-op to allow INR to
normalize.
**2.** Which medication should be continued through the perioperative
period?
A) Metformin
B) Beta-blocker
C) Aspirin
D) Clopidogrel
**Answer: B** – Beta-blockers continue to prevent tachycardia and
myocardial ischemia.
**3.** A patient with diabetes is NPO for surgery. Which intervention is
most appropriate?
,3|Page
A) Hold all insulin
B) Give half of long-acting insulin
C) Start insulin drip
D) Give full dose of long-acting insulin
**Answer: B** – Half dose of long-acting or basal insulin to prevent
ketoacidosis.
**4.** Which lab value requires postponement of elective surgery?
A) K+ 3.5 mEq/L
B) INR 1.2
C) Platelets 50,000/μL
D) Hgb 11 g/dL
**Answer: C** – Platelets <50,000 increase bleeding risk.
**5.** A patient reports a history of malignant hyperthermia. Which
anesthetic agent must be avoided?
A) Propofol
B) Succinylcholine
C) Ketamine
D) Midazolam
**Answer: B** – Succinylcholine and volatile anesthetics (halothane,
sevoflurane) trigger MH.
, 4|Page
**6.** Which preoperative finding requires immediate notification of
the surgical team?
A) BP 150/90
B) HR 100
C) Fever 38.5°C
D) Mild anxiety
**Answer: C** – Fever may indicate infection; elective surgery may be
postponed.
**7.** A patient is NPO but drank water 2 hours before surgery. Which
action is correct?
A) Proceed with surgery
B) Delay surgery 2 more hours
C) Cancel surgery
D) Give antiemetic
**Answer: B** – Clear liquids allowed up to 2 hours pre-op; if <2
hours, delay.
**8.** Which medication is given preoperatively to reduce aspiration
risk?
A) Metoclopramide
B) Famotidine
C) Sodium citrate
NUR 242 EXAM 2 – 2026/2027 MEDICAL-
SURGICAL NURSING I: FOUNDATIONAL
CONCEPTS 300 QUESTIONS | ANSWERS &
RATIONALES | A+ GRADE
## Table of Contents
| Section | Topic | Questions |
|---------|------------------------------|-----------|
| 1 | Perioperative Nursing | 1–40 |
| 2 | Pain Management | 41–80 |
| 3 | Fluid, Electrolyte, & Acid-Base Balance | 81–130 |
| 4 | Infection Prevention & Control | 131–165 |
| 5 | Wound Healing & Pressure Injuries | 166–200 |
| 6 | Shock & Hemodynamics | 201–240 |
| 7 | Respiratory Disorders (COPD, Asthma, Pneumonia) | 241–275 |
| 8 | Cardiovascular Disorders (Hypertension, CAD, HF) | 276–300 |
---
,2|Page
## Section 1: Perioperative Nursing
**Questions 1–40**
**1.** A patient is scheduled for surgery and takes warfarin daily.
Which action is most appropriate?
A) Continue warfarin as usual
B) Hold warfarin 5 days before surgery
C) Double the dose day before surgery
D) Switch to enoxaparin 2 days before
**Answer: B** – Warfarin is held 5 days pre-op to allow INR to
normalize.
**2.** Which medication should be continued through the perioperative
period?
A) Metformin
B) Beta-blocker
C) Aspirin
D) Clopidogrel
**Answer: B** – Beta-blockers continue to prevent tachycardia and
myocardial ischemia.
**3.** A patient with diabetes is NPO for surgery. Which intervention is
most appropriate?
,3|Page
A) Hold all insulin
B) Give half of long-acting insulin
C) Start insulin drip
D) Give full dose of long-acting insulin
**Answer: B** – Half dose of long-acting or basal insulin to prevent
ketoacidosis.
**4.** Which lab value requires postponement of elective surgery?
A) K+ 3.5 mEq/L
B) INR 1.2
C) Platelets 50,000/μL
D) Hgb 11 g/dL
**Answer: C** – Platelets <50,000 increase bleeding risk.
**5.** A patient reports a history of malignant hyperthermia. Which
anesthetic agent must be avoided?
A) Propofol
B) Succinylcholine
C) Ketamine
D) Midazolam
**Answer: B** – Succinylcholine and volatile anesthetics (halothane,
sevoflurane) trigger MH.
, 4|Page
**6.** Which preoperative finding requires immediate notification of
the surgical team?
A) BP 150/90
B) HR 100
C) Fever 38.5°C
D) Mild anxiety
**Answer: C** – Fever may indicate infection; elective surgery may be
postponed.
**7.** A patient is NPO but drank water 2 hours before surgery. Which
action is correct?
A) Proceed with surgery
B) Delay surgery 2 more hours
C) Cancel surgery
D) Give antiemetic
**Answer: B** – Clear liquids allowed up to 2 hours pre-op; if <2
hours, delay.
**8.** Which medication is given preoperatively to reduce aspiration
risk?
A) Metoclopramide
B) Famotidine
C) Sodium citrate
