NUR 265/ NUR265 Exam – (New 2026/ 2027
Update) Advanced Concepts of Medical-
Surgical Nursing Guide| Questions &
Answers | Grade A| 100% Correct (Verified
Solutions)- Galen
Section 1: Pre-operative & Intraoperative Care
1. A patient scheduled for surgery is taking Clopidogrel. What is the
nurse's priority action?
A. Notify the surgeon because the medication increases bleeding risk.
B. Ensure the patient takes the morning dose on the day of surgery.
C. Check the patient's INR to see if it is within therapeutic range.
D. Administer Vitamin K to reverse the medication's effects.
Correct ,,,answer,,,,: A. Notify the surgeon because the medication
increases bleeding risk.
Rationale: Clopidogrel (Plavix) is an antiplatelet agent that significantly
increases the risk of hemorrhage during and after surgery. The surgeon
typically requires the medication to be stopped for 5–7 days prior to the
procedure and will make the final determination. It is not monitored with
an INR (for warfarin) or reversed with Vitamin K.
2. The nurse is providing preoperative teaching to a patient. Which
client statement indicates an understanding of how to prevent a
common postoperative complication?
A. "I will ask for pain medication as soon as I feel any discomfort."
B. "I will use my incentive spirometer ten times every hour after surgery."
,C. "I will stay in bed as much as possible until my discharge day."
D. "I will avoid moving my legs to prevent pulling on my stitches."
Correct ,,,answer,,,,: B. "I will use my incentive spirometer ten times
every hour after surgery."
Rationale: Atelectasis and pneumonia are common post-op
complications. The incentive spirometer promotes deep breathing and
lung expansion, helping to prevent them. Early ambulation, not bed rest, is
encouraged. Pain management is important, but not the primary
preventive measure for pulmonary issues.
3. A patient is to receive general anesthesia. What is the nurse's priority
assessment immediately after the patient is brought to the post-
anesthesia care unit (PACU)?
A. Assess the surgical incision for bleeding.
B. Check the patient's gag reflex and level of consciousness.
C. Review the intake and output from the operating room.
D. Determine the patient's pain level on a 0–10 scale.
Correct ,,,answer,,,,: B. Check the patient's gag reflex and level of
consciousness.
Rationale: The priority in the immediate post-op period is airway patency.
General anesthesia depresses the gag and cough reflexes, putting the
patient at high risk for aspiration. Therefore, assessing these reflexes and
the level of consciousness is the most critical initial action.
4. The nurse is administering a preoperative medication. Which of the
following is the primary goal for administering an anticholinergic (e.g.,
glycopyrrolate) preoperatively?
A. To reduce anxiety and promote sedation.
B. To decrease oral and respiratory secretions.
,C. To prevent postoperative nausea and vomiting.
D. To provide amnesia of the surgical event.
Correct ,,,answer,,,,: B. To decrease oral and respiratory secretions.
Rationale: Anticholinergics work by drying up secretions, which helps
prevent aspiration and keeps the airway clear during intubation and
surgery. Other medications (e.g., benzodiazepines for anxiety/amnesia;
antiemetics for N/V) have different primary purposes.
5. A patient tells the nurse, "I'm so nervous about my surgery
tomorrow." What is the most therapeutic response from the nurse?
A. "Don't worry; this is a very routine procedure with no real risks."
B. "It is normal to feel anxious. Tell me more about what is concerning
you."
C. "I can give you a sedative right now to help you sleep through the night."
D. "You should focus on the positive outcome and stop thinking about the
surgery."
Correct ,,,answer,,,,: B. "It is normal to normalizing anxious. Tell me
more about what is concerning you."
Rationale: Acknowledging the patient's feelings and encouraging them to
express specific concerns is therapeutic and helps identify areas for
targeted teaching. Dismissing the anxiety or providing false reassurance is
unhelpful and erodes trust.
6. A patient is NPO for surgery. The patient asks for a cup of water to
take their morning blood pressure pill. What is the nurse's best
response?
A. Give the patient a small sip of water to take the pill, as it won't affect the
surgery.
B. Tell the patient they cannot have anything at all, including medication.
C. Explain that NPO means nothing by mouth, but check with the provider
, for instructions on essential medications.
D. Instruct the patient to take the pill by crushing it and placing it under
their tongue.
Correct ,,,answer,,,,: C. Explain that NPO means nothing by mouth, but
check with the provider for instructions on essential medications.
Rationale: NPO status is critical for preventing aspiration. However,
essential medications for chronic conditions (e.g., blood pressure, anti-
seizure, cardiac) may be allowed with a tiny sip of water. The nurse must
verify with the provider or anesthesia team.
7. Which diagnostic test result must the nurse report to the surgeon
immediately before a patient is cleared for surgery?
A. Hemoglobin level of 12 g/dL.
B. Potassium level of 6.2 mEq/L.
C. White blood cell count of 11,000/mm³.
D. Serum creatinine level of 1.0 mg/dL.
Correct ,,,answer,,,,: B. Potassium level of 6.2 mEq/L.
Rationale: A potassium of 6.2 mEq/L indicates severe hyperkalemia,
which can lead to life-threatening cardiac dysrhythmias (e.g., ventricular
fibrillation). Surgery would likely be postponed until the electrolyte
imbalance is corrected.
8. A patient with a latex allergy is scheduled for surgery. What is the
most important action for the operating room nurse?
A. Ensure that all supplies in the room are latex-free and flag the patient's
chart.
B. Administer a routine dose of diphenhydramine (Benadryl)
preoperatively.
C. Request that the surgical team wear cloth gloves instead of latex ones.
D. No special action is needed; latex allergies are very rare.
Update) Advanced Concepts of Medical-
Surgical Nursing Guide| Questions &
Answers | Grade A| 100% Correct (Verified
Solutions)- Galen
Section 1: Pre-operative & Intraoperative Care
1. A patient scheduled for surgery is taking Clopidogrel. What is the
nurse's priority action?
A. Notify the surgeon because the medication increases bleeding risk.
B. Ensure the patient takes the morning dose on the day of surgery.
C. Check the patient's INR to see if it is within therapeutic range.
D. Administer Vitamin K to reverse the medication's effects.
Correct ,,,answer,,,,: A. Notify the surgeon because the medication
increases bleeding risk.
Rationale: Clopidogrel (Plavix) is an antiplatelet agent that significantly
increases the risk of hemorrhage during and after surgery. The surgeon
typically requires the medication to be stopped for 5–7 days prior to the
procedure and will make the final determination. It is not monitored with
an INR (for warfarin) or reversed with Vitamin K.
2. The nurse is providing preoperative teaching to a patient. Which
client statement indicates an understanding of how to prevent a
common postoperative complication?
A. "I will ask for pain medication as soon as I feel any discomfort."
B. "I will use my incentive spirometer ten times every hour after surgery."
,C. "I will stay in bed as much as possible until my discharge day."
D. "I will avoid moving my legs to prevent pulling on my stitches."
Correct ,,,answer,,,,: B. "I will use my incentive spirometer ten times
every hour after surgery."
Rationale: Atelectasis and pneumonia are common post-op
complications. The incentive spirometer promotes deep breathing and
lung expansion, helping to prevent them. Early ambulation, not bed rest, is
encouraged. Pain management is important, but not the primary
preventive measure for pulmonary issues.
3. A patient is to receive general anesthesia. What is the nurse's priority
assessment immediately after the patient is brought to the post-
anesthesia care unit (PACU)?
A. Assess the surgical incision for bleeding.
B. Check the patient's gag reflex and level of consciousness.
C. Review the intake and output from the operating room.
D. Determine the patient's pain level on a 0–10 scale.
Correct ,,,answer,,,,: B. Check the patient's gag reflex and level of
consciousness.
Rationale: The priority in the immediate post-op period is airway patency.
General anesthesia depresses the gag and cough reflexes, putting the
patient at high risk for aspiration. Therefore, assessing these reflexes and
the level of consciousness is the most critical initial action.
4. The nurse is administering a preoperative medication. Which of the
following is the primary goal for administering an anticholinergic (e.g.,
glycopyrrolate) preoperatively?
A. To reduce anxiety and promote sedation.
B. To decrease oral and respiratory secretions.
,C. To prevent postoperative nausea and vomiting.
D. To provide amnesia of the surgical event.
Correct ,,,answer,,,,: B. To decrease oral and respiratory secretions.
Rationale: Anticholinergics work by drying up secretions, which helps
prevent aspiration and keeps the airway clear during intubation and
surgery. Other medications (e.g., benzodiazepines for anxiety/amnesia;
antiemetics for N/V) have different primary purposes.
5. A patient tells the nurse, "I'm so nervous about my surgery
tomorrow." What is the most therapeutic response from the nurse?
A. "Don't worry; this is a very routine procedure with no real risks."
B. "It is normal to feel anxious. Tell me more about what is concerning
you."
C. "I can give you a sedative right now to help you sleep through the night."
D. "You should focus on the positive outcome and stop thinking about the
surgery."
Correct ,,,answer,,,,: B. "It is normal to normalizing anxious. Tell me
more about what is concerning you."
Rationale: Acknowledging the patient's feelings and encouraging them to
express specific concerns is therapeutic and helps identify areas for
targeted teaching. Dismissing the anxiety or providing false reassurance is
unhelpful and erodes trust.
6. A patient is NPO for surgery. The patient asks for a cup of water to
take their morning blood pressure pill. What is the nurse's best
response?
A. Give the patient a small sip of water to take the pill, as it won't affect the
surgery.
B. Tell the patient they cannot have anything at all, including medication.
C. Explain that NPO means nothing by mouth, but check with the provider
, for instructions on essential medications.
D. Instruct the patient to take the pill by crushing it and placing it under
their tongue.
Correct ,,,answer,,,,: C. Explain that NPO means nothing by mouth, but
check with the provider for instructions on essential medications.
Rationale: NPO status is critical for preventing aspiration. However,
essential medications for chronic conditions (e.g., blood pressure, anti-
seizure, cardiac) may be allowed with a tiny sip of water. The nurse must
verify with the provider or anesthesia team.
7. Which diagnostic test result must the nurse report to the surgeon
immediately before a patient is cleared for surgery?
A. Hemoglobin level of 12 g/dL.
B. Potassium level of 6.2 mEq/L.
C. White blood cell count of 11,000/mm³.
D. Serum creatinine level of 1.0 mg/dL.
Correct ,,,answer,,,,: B. Potassium level of 6.2 mEq/L.
Rationale: A potassium of 6.2 mEq/L indicates severe hyperkalemia,
which can lead to life-threatening cardiac dysrhythmias (e.g., ventricular
fibrillation). Surgery would likely be postponed until the electrolyte
imbalance is corrected.
8. A patient with a latex allergy is scheduled for surgery. What is the
most important action for the operating room nurse?
A. Ensure that all supplies in the room are latex-free and flag the patient's
chart.
B. Administer a routine dose of diphenhydramine (Benadryl)
preoperatively.
C. Request that the surgical team wear cloth gloves instead of latex ones.
D. No special action is needed; latex allergies are very rare.
