Medical-Surgical Nursing Exam 1 Practice
Test 150 Questions with Complete
Rationales
SECTION A: PERIOPERATIVE NURSING (Questions 1-15)
1. A patient is scheduled for elective surgery. The nurse
discovers that the informed consent form has not been
signed. The patient has already received preoperative
sedation. What is the nurse's priority action?
A. Have the patient sign the consent quickly before the
medication takes full effect
B. Notify the healthcare provider and delay the surgery until the
patient is competent to sign
C. Ask the patient's spouse to sign the consent form
D. Proceed with the surgery as the consent is implied by the
patient's presence
Correct Answer: B
,Rationale: Informed consent must be obtained voluntarily from
a competent patient before any sedation or anesthesia is
administered. If the patient has received sedation, they are not
considered competent to sign. The nurse should notify the
healthcare provider and delay the surgery. The spouse cannot
sign unless the patient has a durable power of attorney for
healthcare. Implied consent does not apply to surgical
procedures.
2. A patient is one hour postoperative following abdominal
surgery. Which assessment finding requires the nurse's
immediate attention?
A. Heart rate of 88 beats/min
B. Blood pressure of 100/60 mmHg
C. Urine output of 20 mL over the past hour
D. Temperature of 37.2°C (99°F)
Correct Answer: C
Rationale: Urine output of less than 30 mL/hour indicates
oliguria and may signal hypovolemia, acute kidney injury, or
,urinary obstruction. This requires immediate reporting to the
healthcare provider. The other findings are within acceptable
ranges for a postoperative patient, though blood pressure
should be monitored.
3. The nurse is providing preoperative teaching to a patient
scheduled for surgery. Which statement by the patient
indicates a need for further teaching?
A. "I will stop smoking at least 24 hours before surgery."
B. "I should tell the anesthesiologist about all the medications I
take."
C. "I can eat a light breakfast the morning of surgery."
D. "I need to remove my jewelry and dentures before surgery."
Correct Answer: C
Rationale: Patients are typically NPO (nothing by mouth) for 8
hours before surgery to prevent aspiration during anesthesia.
Eating a light breakfast on the morning of surgery would violate
NPO guidelines. The other statements reflect correct
understanding of preoperative instructions.
, 4. A patient is in the PACU (Post-Anesthesia Care Unit)
following general anesthesia. Which finding indicates the
patient is emerging from anesthesia?
A. Pupils are dilated and nonreactive
B. The patient is able to state their name and location
C. Respiratory rate is 8 breaths/min
D. The patient is unresponsive to painful stimuli
Correct Answer: B
Rationale: Emergence from anesthesia is indicated by return of
consciousness, orientation to person, place, and time, and
purposeful movement. Dilated, nonreactive pupils, bradycardia,
and unresponsiveness indicate continued anesthesia or
complications.
5. A postoperative patient reports severe nausea. Which
action should the nurse take first?
Test 150 Questions with Complete
Rationales
SECTION A: PERIOPERATIVE NURSING (Questions 1-15)
1. A patient is scheduled for elective surgery. The nurse
discovers that the informed consent form has not been
signed. The patient has already received preoperative
sedation. What is the nurse's priority action?
A. Have the patient sign the consent quickly before the
medication takes full effect
B. Notify the healthcare provider and delay the surgery until the
patient is competent to sign
C. Ask the patient's spouse to sign the consent form
D. Proceed with the surgery as the consent is implied by the
patient's presence
Correct Answer: B
,Rationale: Informed consent must be obtained voluntarily from
a competent patient before any sedation or anesthesia is
administered. If the patient has received sedation, they are not
considered competent to sign. The nurse should notify the
healthcare provider and delay the surgery. The spouse cannot
sign unless the patient has a durable power of attorney for
healthcare. Implied consent does not apply to surgical
procedures.
2. A patient is one hour postoperative following abdominal
surgery. Which assessment finding requires the nurse's
immediate attention?
A. Heart rate of 88 beats/min
B. Blood pressure of 100/60 mmHg
C. Urine output of 20 mL over the past hour
D. Temperature of 37.2°C (99°F)
Correct Answer: C
Rationale: Urine output of less than 30 mL/hour indicates
oliguria and may signal hypovolemia, acute kidney injury, or
,urinary obstruction. This requires immediate reporting to the
healthcare provider. The other findings are within acceptable
ranges for a postoperative patient, though blood pressure
should be monitored.
3. The nurse is providing preoperative teaching to a patient
scheduled for surgery. Which statement by the patient
indicates a need for further teaching?
A. "I will stop smoking at least 24 hours before surgery."
B. "I should tell the anesthesiologist about all the medications I
take."
C. "I can eat a light breakfast the morning of surgery."
D. "I need to remove my jewelry and dentures before surgery."
Correct Answer: C
Rationale: Patients are typically NPO (nothing by mouth) for 8
hours before surgery to prevent aspiration during anesthesia.
Eating a light breakfast on the morning of surgery would violate
NPO guidelines. The other statements reflect correct
understanding of preoperative instructions.
, 4. A patient is in the PACU (Post-Anesthesia Care Unit)
following general anesthesia. Which finding indicates the
patient is emerging from anesthesia?
A. Pupils are dilated and nonreactive
B. The patient is able to state their name and location
C. Respiratory rate is 8 breaths/min
D. The patient is unresponsive to painful stimuli
Correct Answer: B
Rationale: Emergence from anesthesia is indicated by return of
consciousness, orientation to person, place, and time, and
purposeful movement. Dilated, nonreactive pupils, bradycardia,
and unresponsiveness indicate continued anesthesia or
complications.
5. A postoperative patient reports severe nausea. Which
action should the nurse take first?
