NSG 123 Exam One Blueprint: (Latest 2026/2027 Update) Perioperative Care,
Pneumonia & TB | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: NSG 123 – Medical-Surgical Nursing / Perioperative & Respiratory
Source: NSG 123 Exam One Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the role of the surgeon in obtaining informed consent for surgery?
Correct Answer: The surgeon must inform the patient of the benefits, alternatives, possible risks,
complications, disfigurement, disability, and removal of body parts as well as what to expect in the
early and late postoperative periods.
1. The surgeon is legally responsible for obtaining informed consent (explaining procedure, risks,
benefits, alternatives).
2. The nurse witnesses the signature and clarifies information but cannot provide the primary
explanation.
3. Consent must be voluntary and obtained without coercion.
2. Who is at risk for wound dehiscence?
Correct Answer: Wound dehiscence (disruption of surgical incision) may occur because of increasing
age, anemia, poor nutritional status, obesity, malignancy, diabetes, the use of steroids, and other factors
in patients undergoing abdominal surgery.
1. Dehiscence risk factors: poor wound healing, increased intra-abdominal pressure (coughing,
vomiting, straining), infection, obesity, malnutrition.
2. Abdominal binder and preventive measures reduce risk.
3. Teach patient splinting incision with pillow during cough.
3. What medication is given for prevention of TB for those exposed to a positive patient?
Correct Answer: Isoniazid (INH) for latent TB infection (LTBI) prevention after exposure.
1. INH prophylaxis for 6-9 months reduces risk of active TB.
2. Monitor LFTs; risk of hepatotoxicity increased with age, alcohol use.
3. Pyridoxine (vitamin B6) given to prevent peripheral neuropathy.
4. What are the phases of perioperative care?
Correct Answer: Preoperative: decision to proceed with surgery to transfer to OR bed. Intraoperative:
transfer to OR bed to admission to PACU. Postoperative: admission to PACU to follow-up evaluation in
clinical setting or home.
1. Preoperative: patient preparation, consent, NPO, skin antisepsis.
2. Intraoperative: circulating nurse, scrub nurse, anesthesiologist, surgeon.
3. Postoperative: PACU phase I (immediate recovery), phase II (pre-discharge).
, 5. What patients need special consideration during surgery?
Correct Answer: 1. Older adults, 2. Obese patients, 3. Patients with disabilities, 4. Patients undergoing
emergency surgery, 5. Patients undergoing ambulatory surgery.
1. Older adults: higher risk of complications, altered drug metabolism, comorbidities.
2. Obese: increased risk of wound infection, DVT, difficult intubation, positioning issues.
3. Emergency surgery: full stomach, higher aspiration risk, limited preoperative optimization.
6. What is the proper sequence for using a metered-dose inhaler (MDI)?
Correct Answer: 1. Shake well. 2. Remove cap. 3. Exhale to end of normal breath. 4. Place mouthpiece
in mouth (tight seal) or two finger widths from open mouth. 5. Press down inhaler while taking slow,
deep breath (3-5 sec), hold breath 10 sec, exhale slowly. 6. Wait 3-5 min before second inhalation. 7.
Rinse mouth with water after use. 8. Rinse mouthpiece, store away from heat. 9. Use spacer if difficulty
coordinating.
1. Shaking ensures proper drug suspension. Spacer improves drug delivery to lungs.
2. Rinse mouth after corticosteroid MDI to prevent thrush.
3. Breath holding allows deposition in airways.
7. What is the nurse's role in informed consent?
Correct Answer: Nurse witnesses consent being signed. The nurse clarifies information provided, and
if the patient requests additional information, the nurse notifies the physician. The nurse ascertains that
the consent form has been signed before administering psychoactive premedication.
1. Nurse ensures patient is competent, consent is voluntary, and patient understands information
(teach-back).
2. Nurse cannot provide primary information; must contact surgeon if patient has unanswered
questions.
3. Consent obtained before premedication (avoid impaired decision-making).
8. What is found during percussion of the lungs in a patient with pneumonia?
Correct Answer: Dullness (replaces resonance when fluid or solid tissue replaces air-containing lung
tissues) — such as occurs with pneumonia, pleural effusions, or tumors.
1. Percussion sounds: resonance (normal lung), dullness (consolidation/fluid), hyperresonance
(air trapping), flatness (solid mass).
2. Dullness over affected area suggests lobar pneumonia or pleural effusion.
3. Tactile fremitus increased with consolidation.
9. When is a patient ready for discharge with community-acquired pneumonia (CAP)?
Correct Answer: Clinical stability defined as temperature ≤100°F (37.8°C), heart rate ≤100 bpm,
respiratory rate ≤24 breaths/min, systolic BP ≥90 mm Hg, oxygen saturation ≥90%, ability to maintain
oral intake, and normal mental status.
1. Inpatients switched from IV to oral antibiotics when hemodynamically stable, improving
clinically, able to take oral medications/fluids, and GI function normal.
2. Discharge criteria include stable vital signs for 24 hours, ability to ambulate, and safe home
environment.
3. Follow-up within 72 hours after discharge.
Pneumonia & TB | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: NSG 123 – Medical-Surgical Nursing / Perioperative & Respiratory
Source: NSG 123 Exam One Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the role of the surgeon in obtaining informed consent for surgery?
Correct Answer: The surgeon must inform the patient of the benefits, alternatives, possible risks,
complications, disfigurement, disability, and removal of body parts as well as what to expect in the
early and late postoperative periods.
1. The surgeon is legally responsible for obtaining informed consent (explaining procedure, risks,
benefits, alternatives).
2. The nurse witnesses the signature and clarifies information but cannot provide the primary
explanation.
3. Consent must be voluntary and obtained without coercion.
2. Who is at risk for wound dehiscence?
Correct Answer: Wound dehiscence (disruption of surgical incision) may occur because of increasing
age, anemia, poor nutritional status, obesity, malignancy, diabetes, the use of steroids, and other factors
in patients undergoing abdominal surgery.
1. Dehiscence risk factors: poor wound healing, increased intra-abdominal pressure (coughing,
vomiting, straining), infection, obesity, malnutrition.
2. Abdominal binder and preventive measures reduce risk.
3. Teach patient splinting incision with pillow during cough.
3. What medication is given for prevention of TB for those exposed to a positive patient?
Correct Answer: Isoniazid (INH) for latent TB infection (LTBI) prevention after exposure.
1. INH prophylaxis for 6-9 months reduces risk of active TB.
2. Monitor LFTs; risk of hepatotoxicity increased with age, alcohol use.
3. Pyridoxine (vitamin B6) given to prevent peripheral neuropathy.
4. What are the phases of perioperative care?
Correct Answer: Preoperative: decision to proceed with surgery to transfer to OR bed. Intraoperative:
transfer to OR bed to admission to PACU. Postoperative: admission to PACU to follow-up evaluation in
clinical setting or home.
1. Preoperative: patient preparation, consent, NPO, skin antisepsis.
2. Intraoperative: circulating nurse, scrub nurse, anesthesiologist, surgeon.
3. Postoperative: PACU phase I (immediate recovery), phase II (pre-discharge).
, 5. What patients need special consideration during surgery?
Correct Answer: 1. Older adults, 2. Obese patients, 3. Patients with disabilities, 4. Patients undergoing
emergency surgery, 5. Patients undergoing ambulatory surgery.
1. Older adults: higher risk of complications, altered drug metabolism, comorbidities.
2. Obese: increased risk of wound infection, DVT, difficult intubation, positioning issues.
3. Emergency surgery: full stomach, higher aspiration risk, limited preoperative optimization.
6. What is the proper sequence for using a metered-dose inhaler (MDI)?
Correct Answer: 1. Shake well. 2. Remove cap. 3. Exhale to end of normal breath. 4. Place mouthpiece
in mouth (tight seal) or two finger widths from open mouth. 5. Press down inhaler while taking slow,
deep breath (3-5 sec), hold breath 10 sec, exhale slowly. 6. Wait 3-5 min before second inhalation. 7.
Rinse mouth with water after use. 8. Rinse mouthpiece, store away from heat. 9. Use spacer if difficulty
coordinating.
1. Shaking ensures proper drug suspension. Spacer improves drug delivery to lungs.
2. Rinse mouth after corticosteroid MDI to prevent thrush.
3. Breath holding allows deposition in airways.
7. What is the nurse's role in informed consent?
Correct Answer: Nurse witnesses consent being signed. The nurse clarifies information provided, and
if the patient requests additional information, the nurse notifies the physician. The nurse ascertains that
the consent form has been signed before administering psychoactive premedication.
1. Nurse ensures patient is competent, consent is voluntary, and patient understands information
(teach-back).
2. Nurse cannot provide primary information; must contact surgeon if patient has unanswered
questions.
3. Consent obtained before premedication (avoid impaired decision-making).
8. What is found during percussion of the lungs in a patient with pneumonia?
Correct Answer: Dullness (replaces resonance when fluid or solid tissue replaces air-containing lung
tissues) — such as occurs with pneumonia, pleural effusions, or tumors.
1. Percussion sounds: resonance (normal lung), dullness (consolidation/fluid), hyperresonance
(air trapping), flatness (solid mass).
2. Dullness over affected area suggests lobar pneumonia or pleural effusion.
3. Tactile fremitus increased with consolidation.
9. When is a patient ready for discharge with community-acquired pneumonia (CAP)?
Correct Answer: Clinical stability defined as temperature ≤100°F (37.8°C), heart rate ≤100 bpm,
respiratory rate ≤24 breaths/min, systolic BP ≥90 mm Hg, oxygen saturation ≥90%, ability to maintain
oral intake, and normal mental status.
1. Inpatients switched from IV to oral antibiotics when hemodynamically stable, improving
clinically, able to take oral medications/fluids, and GI function normal.
2. Discharge criteria include stable vital signs for 24 hours, ability to ambulate, and safe home
environment.
3. Follow-up within 72 hours after discharge.
