NUR 201: ADULT HEALTH
NURSING I – COMPREHENSIVE
EXAM (2026 EDITION)
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section 1: Perioperative Nursing
1. A patient undergoing a total knee replacement asks the nurse, "Why do I
need to stop my ibuprofen before surgery?" What is the best response?
• A. "Ibuprofen can increase your blood pressure during surgery."
• B. "Ibuprofen interferes with platelet aggregation, increasing bleeding
risk."
• C. "Ibuprofen causes excessive sedation with anesthesia."
• D. "Ibuprofen may lead to kidney failure post-operatively."
Rationale: NSAIDs like ibuprofen inhibit cyclooxygenase (COX), reducing
thromboxane A2 and impairing platelet aggregation, which increases bleeding risk
during and after surgery.
2. During the preoperative assessment, the patient reports taking ginkgo biloba
daily. Which priority action should the nurse take?
• A. Advise the patient to take the next dose with a sip of water.
• B. Notify the surgeon immediately because of bleeding risk.
• C. Document the finding as "no significant risk."
• D. Instruct the patient to double the dose for better effect.
,Rationale: Ginkgo biloba has antiplatelet effects and can potentiate bleeding. It is
typically discontinued 36 hours before surgery. The surgeon must be informed.
3. A patient is NPO for 8 hours before surgery but drank 200 mL of water 2
hours ago. What should the nurse do?
• A. Clarify with the anesthesia provider as clear fluids may be allowed up
to 2 hours prior.
• B. Cancel the surgery immediately.
• C. Give the patient antacids and proceed.
• D. Reschedule surgery for the next day.
Rationale: Current 2026 ASA guidelines allow clear liquids up to 2 hours before
anesthesia. The anesthesiologist should make the final decision.
4. Postoperatively, which finding in a patient who had spinal anesthesia
requires immediate nursing intervention?
• A. Blood pressure 110/70 mm Hg
• B. Mild nausea
• C. Complaint of "pins and needles" in feet
• D. Sudden severe headache worse when sitting up
Rationale: This describes a post-dural puncture headache (PDPH) from CSF leakage.
Treatment may include an epidural blood patch.
5. The nurse is performing a time-out before surgery. Which element is
essential?
• A. Reviewing the patient's insurance coverage
• B. Confirming correct patient, procedure, site, and consent
• C. Checking the sterilizer's temperature log
• D. Verifying the surgeon’s credentials
Rationale: The Universal Protocol requires a time-out to verify patient identity,
procedure, site, and consent to prevent wrong-site surgery.
6. A patient in the PACU has an oxygen saturation of 88% on room air. What is
the priority action?
• A. Apply supplemental oxygen and assess breath sounds.
• B. Place the patient in Trendelenburg position.
• C. Suction the oropharynx immediately.
• D. Call a rapid response team.
, Rationale: Hypoxemia is common post-op due to atelectasis or opioid respiratory
depression. Oxygen is first-line, followed by further assessment.
7. Which patient is at highest risk for malignant hyperthermia?
• A. Elderly man with hypertension
• B. Young adult with history of muscle rigidity after previous anesthesia
• C. Middle-aged woman with diabetes
• D. Adolescent with asthma
Rationale: Malignant hyperthermia is an autosomal dominant disorder triggered by
volatile anesthetics or succinylcholine. Previous reaction is key.
8. The nurse notes a postoperative patient's temperature is 39.5°C (103.1°F)
within 1 hour of surgery. Which action is most appropriate?
• A. Apply cooling blankets and administer acetaminophen.
• B. Assess for other signs of malignant hyperthermia and notify
anesthesia.
• C. Increase room temperature and cover patient.
• D. Obtain a urine culture.
Rationale: Early post-op hyperthermia (especially if rapidly rising) suggests
malignant hyperthermia, not infection. Immediate treatment with dantrolene is
critical.
9. A patient after abdominal surgery has a nurse remove the indwelling urinary
catheter on postoperative day 1. The patient has not voided for 8 hours. What
is the priority intervention?
• A. Straight catheterize immediately.
• B. Perform a bladder scan.
• C. Increase IV fluids.
• D. Encourage ambulation.
Rationale: Bladder scan is noninvasive to assess urinary retention before considering
catheterization.
10. Which statement by a patient demonstrates understanding of postoperative
deep breathing and coughing exercises?
• A. "I should hold my breath as long as possible before coughing."
• B. "I will take a deep breath, hold it, then cough from my chest."
• C. "I should only cough if I feel mucus in my throat."
• D. "I will avoid deep breathing if I have abdominal pain."
NURSING I – COMPREHENSIVE
EXAM (2026 EDITION)
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section 1: Perioperative Nursing
1. A patient undergoing a total knee replacement asks the nurse, "Why do I
need to stop my ibuprofen before surgery?" What is the best response?
• A. "Ibuprofen can increase your blood pressure during surgery."
• B. "Ibuprofen interferes with platelet aggregation, increasing bleeding
risk."
• C. "Ibuprofen causes excessive sedation with anesthesia."
• D. "Ibuprofen may lead to kidney failure post-operatively."
Rationale: NSAIDs like ibuprofen inhibit cyclooxygenase (COX), reducing
thromboxane A2 and impairing platelet aggregation, which increases bleeding risk
during and after surgery.
2. During the preoperative assessment, the patient reports taking ginkgo biloba
daily. Which priority action should the nurse take?
• A. Advise the patient to take the next dose with a sip of water.
• B. Notify the surgeon immediately because of bleeding risk.
• C. Document the finding as "no significant risk."
• D. Instruct the patient to double the dose for better effect.
,Rationale: Ginkgo biloba has antiplatelet effects and can potentiate bleeding. It is
typically discontinued 36 hours before surgery. The surgeon must be informed.
3. A patient is NPO for 8 hours before surgery but drank 200 mL of water 2
hours ago. What should the nurse do?
• A. Clarify with the anesthesia provider as clear fluids may be allowed up
to 2 hours prior.
• B. Cancel the surgery immediately.
• C. Give the patient antacids and proceed.
• D. Reschedule surgery for the next day.
Rationale: Current 2026 ASA guidelines allow clear liquids up to 2 hours before
anesthesia. The anesthesiologist should make the final decision.
4. Postoperatively, which finding in a patient who had spinal anesthesia
requires immediate nursing intervention?
• A. Blood pressure 110/70 mm Hg
• B. Mild nausea
• C. Complaint of "pins and needles" in feet
• D. Sudden severe headache worse when sitting up
Rationale: This describes a post-dural puncture headache (PDPH) from CSF leakage.
Treatment may include an epidural blood patch.
5. The nurse is performing a time-out before surgery. Which element is
essential?
• A. Reviewing the patient's insurance coverage
• B. Confirming correct patient, procedure, site, and consent
• C. Checking the sterilizer's temperature log
• D. Verifying the surgeon’s credentials
Rationale: The Universal Protocol requires a time-out to verify patient identity,
procedure, site, and consent to prevent wrong-site surgery.
6. A patient in the PACU has an oxygen saturation of 88% on room air. What is
the priority action?
• A. Apply supplemental oxygen and assess breath sounds.
• B. Place the patient in Trendelenburg position.
• C. Suction the oropharynx immediately.
• D. Call a rapid response team.
, Rationale: Hypoxemia is common post-op due to atelectasis or opioid respiratory
depression. Oxygen is first-line, followed by further assessment.
7. Which patient is at highest risk for malignant hyperthermia?
• A. Elderly man with hypertension
• B. Young adult with history of muscle rigidity after previous anesthesia
• C. Middle-aged woman with diabetes
• D. Adolescent with asthma
Rationale: Malignant hyperthermia is an autosomal dominant disorder triggered by
volatile anesthetics or succinylcholine. Previous reaction is key.
8. The nurse notes a postoperative patient's temperature is 39.5°C (103.1°F)
within 1 hour of surgery. Which action is most appropriate?
• A. Apply cooling blankets and administer acetaminophen.
• B. Assess for other signs of malignant hyperthermia and notify
anesthesia.
• C. Increase room temperature and cover patient.
• D. Obtain a urine culture.
Rationale: Early post-op hyperthermia (especially if rapidly rising) suggests
malignant hyperthermia, not infection. Immediate treatment with dantrolene is
critical.
9. A patient after abdominal surgery has a nurse remove the indwelling urinary
catheter on postoperative day 1. The patient has not voided for 8 hours. What
is the priority intervention?
• A. Straight catheterize immediately.
• B. Perform a bladder scan.
• C. Increase IV fluids.
• D. Encourage ambulation.
Rationale: Bladder scan is noninvasive to assess urinary retention before considering
catheterization.
10. Which statement by a patient demonstrates understanding of postoperative
deep breathing and coughing exercises?
• A. "I should hold my breath as long as possible before coughing."
• B. "I will take a deep breath, hold it, then cough from my chest."
• C. "I should only cough if I feel mucus in my throat."
• D. "I will avoid deep breathing if I have abdominal pain."
