NUR 242 Exam 1 Galen Med-Surg
Concepts Questions and Ansẉers with
Expert-Verified Explanation 2026\2027
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Questions and Ansẉers
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Expert-Verified Explanation
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─
1. A nurse is providing preoperative teaching to a client scheduled for surgery.
Which statement by the client indicates a correct understanding of why they
must remain NPO before surgery?
A. "I need to keep my stomach empty to prevent nausea after surgery."
B. "Having an empty stomach reduces the risk of aspiration during anesthesia."
C. "NPO status prevents me from gaining weight from the IV fluids."
D. "I cannot eat because the surgeon needs an empty bowel for the procedure."
Correct Answer: B
Expert Explanation: The primary reason for NPO (nothing by mouth) status
before surgery is to reduce the risk of aspiration of gastric contents into the
lungs during induction of anesthesia and extubation. Aspiration can cause
severe pneumonitis (Mendelson's syndrome), airway obstruction, and death.
While preventing nausea is a secondary benefit, the main purpose is safety.
Weight gain from IV fluids is not a concern. Empty bowel is only required for
certain GI surgeries, not all procedures. The nurse should reinforce that the
client must follow NPO instructions exactly (typically no food for 6–8 hours,
clear liquids up to 2 hours before surgery) and report any violation.
2. A client is receiving moderate sedation (conscious sedation) for a
colonoscopy. Which assessment finding is most important for the nurse to
monitor?
A. Level of consciousness
B. Capillary refill
C. Bowel sounds
D. Urine output
Correct Answer: A
Expert Explanation: During moderate sedation, the client should remain
responsive to verbal and tactile stimulation and maintain a patent airway
independently. The most important monitoring parameters are level of
consciousness, respiratory rate, oxygen saturation, and blood pressure.
,Capillary refill, bowel sounds, and urine output are not priorities during this
short procedure. The nurse should assess sedation level using a standardized
scale (e.g., Ramsay Sedation Scale), ensure supplemental oxygen is
administered, and have reversal agents (flumazenil for benzodiazepines,
naloxone for opioids) available. Over-sedation can lead to airway obstruction,
hypoventilation, and aspiration.
3. A client is transferred to the post-anesthesia care unit (PACU) after surgery.
Which assessment should the nurse perform first?
A. Pain level
B. Surgical incision site
C. Airway and breathing
D. Fluid intake and output
Correct Answer: C
Expert Explanation: The priority assessment in the PACU is airway,
breathing, and circulation (ABC). Anesthesia and opioids can cause airway
obstruction (from tongue relaxation, laryngospasm), hypoventilation, and
hypotension. The nurse should ensure the airway is patent, assess respiratory
rate and depth, auscultate breath sounds, and monitor oxygen saturation. Pain
assessment, incision check, and I/O are important but secondary to airway and
breathing. The nurse should also assess level of consciousness, vital signs, and
surgical site for bleeding. If the client is not fully awake, position them on their
side (recovery position) to prevent aspiration.
4. A client who had abdominal surgery 6 hours ago reports pain of 8/10. The
nurse administers IV morphine as ordered. What is the priority reassessment
after administration?
A. Respiratory rate and depth
B. Pain level
C. Sedation level
D. Blood pressure
Correct Answer: A
Expert Explanation: IV morphine (opioid) can cause respiratory depression as
a serious adverse effect. The nurse must reassess respiratory rate, depth, and
pattern within 5–15 minutes after IV administration. A respiratory rate <10
breaths/min or shallow breathing requires intervention (stimulation, naloxone).
Pain level and sedation level are also important but not the priority. Blood
, pressure may decrease (hypotension) but is less immediately life-threatening
than respiratory depression. The nurse should also monitor for nausea,
vomiting, and pruritus. Opioid-naïve clients, older adults, and those with sleep
apnea are at higher risk for respiratory depression.
5. A client is 2 days post-operative from a bowel resection. The nurse notes that
the surgical incision is red, warm to the touch, and has purulent drainage. What
is the nurse's priority action?
A. Apply a sterile dressing and document findings
B. Notify the healthcare provider immediately
C. Obtain a wound culture
D. Irrigate the wound with normal saline
Correct Answer: B
Expert Explanation: Redness, warmth, and purulent drainage indicate a
surgical site infection (SSI). The nurse must notify the healthcare provider
immediately for evaluation and antibiotic orders. The provider will order a
wound culture before starting antibiotics. Applying a sterile dressing is
appropriate after notifying the provider. Irrigation may be ordered but is not
the priority. The nurse should also assess for systemic signs of infection (fever,
chills, elevated WBC count) and implement wound precautions (contact isolation
if MRSA suspected). SSIs increase hospital stay, morbidity, and mortality.
6. A client with HIV has a CD4+ T-cell count of 180 cells/mm³. Which
complication is the client at highest risk for?
A. Kaposi's sarcoma
B. Opportunistic infections
C. Non-Hodgkin lymphoma
D. Wasting syndrome
Correct Answer: B
Expert Explanation: A CD4+ count <200 cells/mm³ defines AIDS (acquired
immunodeficiency syndrome) and indicates severe immunosuppression. The
client is at highest risk for opportunistic infections (OIs) such as Pneumocystis
jirovecii pneumonia (PJP), toxoplasmosis, cryptococcal meningitis, disseminated
Mycobacterium avium complex (MAC), and cytomegalovirus (CMV). Kaposi's
sarcoma, non-Hodgkin lymphoma, and wasting syndrome are also AIDS-
defining conditions but are less common than OIs. The nurse should administer
prophylactic medications (e.g., trimethoprim-sulfamethoxazole for PJP), monitor
Concepts Questions and Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified Explanation
, Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
1. A nurse is providing preoperative teaching to a client scheduled for surgery.
Which statement by the client indicates a correct understanding of why they
must remain NPO before surgery?
A. "I need to keep my stomach empty to prevent nausea after surgery."
B. "Having an empty stomach reduces the risk of aspiration during anesthesia."
C. "NPO status prevents me from gaining weight from the IV fluids."
D. "I cannot eat because the surgeon needs an empty bowel for the procedure."
Correct Answer: B
Expert Explanation: The primary reason for NPO (nothing by mouth) status
before surgery is to reduce the risk of aspiration of gastric contents into the
lungs during induction of anesthesia and extubation. Aspiration can cause
severe pneumonitis (Mendelson's syndrome), airway obstruction, and death.
While preventing nausea is a secondary benefit, the main purpose is safety.
Weight gain from IV fluids is not a concern. Empty bowel is only required for
certain GI surgeries, not all procedures. The nurse should reinforce that the
client must follow NPO instructions exactly (typically no food for 6–8 hours,
clear liquids up to 2 hours before surgery) and report any violation.
2. A client is receiving moderate sedation (conscious sedation) for a
colonoscopy. Which assessment finding is most important for the nurse to
monitor?
A. Level of consciousness
B. Capillary refill
C. Bowel sounds
D. Urine output
Correct Answer: A
Expert Explanation: During moderate sedation, the client should remain
responsive to verbal and tactile stimulation and maintain a patent airway
independently. The most important monitoring parameters are level of
consciousness, respiratory rate, oxygen saturation, and blood pressure.
,Capillary refill, bowel sounds, and urine output are not priorities during this
short procedure. The nurse should assess sedation level using a standardized
scale (e.g., Ramsay Sedation Scale), ensure supplemental oxygen is
administered, and have reversal agents (flumazenil for benzodiazepines,
naloxone for opioids) available. Over-sedation can lead to airway obstruction,
hypoventilation, and aspiration.
3. A client is transferred to the post-anesthesia care unit (PACU) after surgery.
Which assessment should the nurse perform first?
A. Pain level
B. Surgical incision site
C. Airway and breathing
D. Fluid intake and output
Correct Answer: C
Expert Explanation: The priority assessment in the PACU is airway,
breathing, and circulation (ABC). Anesthesia and opioids can cause airway
obstruction (from tongue relaxation, laryngospasm), hypoventilation, and
hypotension. The nurse should ensure the airway is patent, assess respiratory
rate and depth, auscultate breath sounds, and monitor oxygen saturation. Pain
assessment, incision check, and I/O are important but secondary to airway and
breathing. The nurse should also assess level of consciousness, vital signs, and
surgical site for bleeding. If the client is not fully awake, position them on their
side (recovery position) to prevent aspiration.
4. A client who had abdominal surgery 6 hours ago reports pain of 8/10. The
nurse administers IV morphine as ordered. What is the priority reassessment
after administration?
A. Respiratory rate and depth
B. Pain level
C. Sedation level
D. Blood pressure
Correct Answer: A
Expert Explanation: IV morphine (opioid) can cause respiratory depression as
a serious adverse effect. The nurse must reassess respiratory rate, depth, and
pattern within 5–15 minutes after IV administration. A respiratory rate <10
breaths/min or shallow breathing requires intervention (stimulation, naloxone).
Pain level and sedation level are also important but not the priority. Blood
, pressure may decrease (hypotension) but is less immediately life-threatening
than respiratory depression. The nurse should also monitor for nausea,
vomiting, and pruritus. Opioid-naïve clients, older adults, and those with sleep
apnea are at higher risk for respiratory depression.
5. A client is 2 days post-operative from a bowel resection. The nurse notes that
the surgical incision is red, warm to the touch, and has purulent drainage. What
is the nurse's priority action?
A. Apply a sterile dressing and document findings
B. Notify the healthcare provider immediately
C. Obtain a wound culture
D. Irrigate the wound with normal saline
Correct Answer: B
Expert Explanation: Redness, warmth, and purulent drainage indicate a
surgical site infection (SSI). The nurse must notify the healthcare provider
immediately for evaluation and antibiotic orders. The provider will order a
wound culture before starting antibiotics. Applying a sterile dressing is
appropriate after notifying the provider. Irrigation may be ordered but is not
the priority. The nurse should also assess for systemic signs of infection (fever,
chills, elevated WBC count) and implement wound precautions (contact isolation
if MRSA suspected). SSIs increase hospital stay, morbidity, and mortality.
6. A client with HIV has a CD4+ T-cell count of 180 cells/mm³. Which
complication is the client at highest risk for?
A. Kaposi's sarcoma
B. Opportunistic infections
C. Non-Hodgkin lymphoma
D. Wasting syndrome
Correct Answer: B
Expert Explanation: A CD4+ count <200 cells/mm³ defines AIDS (acquired
immunodeficiency syndrome) and indicates severe immunosuppression. The
client is at highest risk for opportunistic infections (OIs) such as Pneumocystis
jirovecii pneumonia (PJP), toxoplasmosis, cryptococcal meningitis, disseminated
Mycobacterium avium complex (MAC), and cytomegalovirus (CMV). Kaposi's
sarcoma, non-Hodgkin lymphoma, and wasting syndrome are also AIDS-
defining conditions but are less common than OIs. The nurse should administer
prophylactic medications (e.g., trimethoprim-sulfamethoxazole for PJP), monitor
