NUR242 EXAM 1 ACTUAL 2026/2027 | Medical-Surgical
Nursing Exam | Questions & Verified Answers 100% Correct |
Grade A | Galen | Pass Guaranteed - A+ Graded
Section 1: Perioperative Nursing
Q1: A 58-year-old patient is scheduled for elective colon surgery in the morning. The
nurse is reviewing preoperative instructions. Which statement by the patient indicates
understanding of NPO status?
A. "I can have clear liquids up until 2 hours before surgery"
B. "I should not eat or drink anything after midnight unless my surgeon says otherwise"
[CORRECT]
C. "I can take my medications with a full glass of water in the morning"
D. "I should eat a light breakfast to keep my strength up"
Correct Answer: B
Rationale: For Exam 1 in NUR242, remember that standard NPO status is typically
"nothing by mouth after midnight" for morning surgeries, though some protocols allow
clear liquids up to 2-4 hours before. The patient should clarify with their surgeon rather
than making assumptions. Eating before surgery risks aspiration during anesthesia.
Q2: During the preoperative assessment, the nurse notes the patient takes warfarin
daily. Which action is most appropriate?
A. Tell the patient to take the usual dose the morning of surgery
B. Notify the surgeon and anticipate holding warfarin 5 days before surgery [CORRECT]
C. Have the patient stop the medication immediately without consulting the surgeon
D. Administer vitamin K prophylactically
Correct Answer: B
Rationale: That's correct because in Med-Surg nursing, anticoagulants like warfarin
increase bleeding risk during surgery. The nurse must notify the surgeon to determine
the appropriate hold time (usually 5 days) and whether bridging therapy with heparin is
needed. Never have patients stop anticoagulants without provider orders.
,Q3: A patient in the PACU is drowsy but arousable, with stable vital signs. The priority
nursing assessment is:
A. Checking the surgical dressing for drainage
B. Assessing airway patency and respiratory status [CORRECT]
C. Evaluating pain level on a 0-10 scale
D. Checking IV fluid rate
Correct Answer: B
Rationale: The priority nursing action is always airway first in the PACU. Even with stable
vitals, residual anesthesia can depress respiratory drive and airway reflexes. Once
airway and breathing are confirmed adequate, then assess circulation, surgical site, and
pain.
Q4: A postoperative patient on day 2 has sudden onset of dyspnea, tachycardia, and
chest pain. Which complication is most likely?
A. Wound infection
B. Pulmonary embolism from DVT [CORRECT]
C. Paralytic ileus
D. Urinary retention
Correct Answer: B
Rationale: That's the classic presentation for pulmonary embolism—a postoperative
complication from venous stasis and hypercoagulability. The triad of dyspnea,
tachycardia, and chest pain requires immediate intervention. Postoperative patients are
at high risk for DVT/PE due to immobility and surgical trauma.
Q5: Which positioning technique prevents nerve injury during lengthy surgical
procedures?
A. Placing a pillow under the knees for comfort
B. Padding bony prominences and maintaining neutral alignment [CORRECT]
C. Allowing arms to hang dependently off the table
D. Keeping the head elevated 45 degrees throughout
Correct Answer: B
Rationale: For Exam 1, remember that intraoperative positioning requires protecting
pressure points and maintaining neutral joint alignment to prevent nerve compression
injuries (ulnar, peroneal, brachial plexus). Dependent arms can cause brachial plexus
stretch; knee pillows can cause popliteal nerve compression if not positioned carefully.
, Q6: A patient post-abdominal surgery has absent bowel sounds and no flatus for 48
hours. Which complication is suspected?
A. Normal postoperative recovery
B. Paralytic ileus [CORRECT]
C. Wound dehiscence
D. Hemorrhage
Correct Answer: B
Rationale: That's correct because absent bowel sounds with no flatus 48 hours after
abdominal surgery suggests paralytic ileus—temporary paralysis of intestinal motility
from surgical manipulation and anesthesia. Normal recovery should show return of
peristalsis and flatus by 24-48 hours.
Q7: A postoperative patient has a temperature of 38.8°C (101.8°F) on postoperative day
2. Which assessment finding would indicate a serious complication?
A. Clear lungs with normal breath sounds
B. Foul-smelling wound drainage with erythema [CORRECT]
C. Pain controlled at 3/10 with PCA
D. Urine output 50 mL/hour
Correct Answer: B
Rationale: That's the concerning finding because postoperative fever with foul-smelling,
erythematous wound drainage suggests surgical site infection or wound dehiscence
with possible necrotizing infection. While atelectasis causes early post-op fever, wound
complications require immediate surgical evaluation.
Q8: Which intervention is most effective for preventing postoperative atelectasis?
A. Administering prophylactic antibiotics
B. Incentive spirometry and early ambulation [CORRECT]
C. Maintaining strict bed rest
D. Inserting a nasogastric tube
Correct Answer: B
Rationale: For Exam 1 in NUR242, remember that atelectasis prevention relies on lung
expansion— incentive spirometry promotes deep breathing and alveolar recruitment,
while early ambulation increases ventilation and perfusion matching. Antibiotics treat
infection, not prevent atelectasis; bed rest worsens it.
Nursing Exam | Questions & Verified Answers 100% Correct |
Grade A | Galen | Pass Guaranteed - A+ Graded
Section 1: Perioperative Nursing
Q1: A 58-year-old patient is scheduled for elective colon surgery in the morning. The
nurse is reviewing preoperative instructions. Which statement by the patient indicates
understanding of NPO status?
A. "I can have clear liquids up until 2 hours before surgery"
B. "I should not eat or drink anything after midnight unless my surgeon says otherwise"
[CORRECT]
C. "I can take my medications with a full glass of water in the morning"
D. "I should eat a light breakfast to keep my strength up"
Correct Answer: B
Rationale: For Exam 1 in NUR242, remember that standard NPO status is typically
"nothing by mouth after midnight" for morning surgeries, though some protocols allow
clear liquids up to 2-4 hours before. The patient should clarify with their surgeon rather
than making assumptions. Eating before surgery risks aspiration during anesthesia.
Q2: During the preoperative assessment, the nurse notes the patient takes warfarin
daily. Which action is most appropriate?
A. Tell the patient to take the usual dose the morning of surgery
B. Notify the surgeon and anticipate holding warfarin 5 days before surgery [CORRECT]
C. Have the patient stop the medication immediately without consulting the surgeon
D. Administer vitamin K prophylactically
Correct Answer: B
Rationale: That's correct because in Med-Surg nursing, anticoagulants like warfarin
increase bleeding risk during surgery. The nurse must notify the surgeon to determine
the appropriate hold time (usually 5 days) and whether bridging therapy with heparin is
needed. Never have patients stop anticoagulants without provider orders.
,Q3: A patient in the PACU is drowsy but arousable, with stable vital signs. The priority
nursing assessment is:
A. Checking the surgical dressing for drainage
B. Assessing airway patency and respiratory status [CORRECT]
C. Evaluating pain level on a 0-10 scale
D. Checking IV fluid rate
Correct Answer: B
Rationale: The priority nursing action is always airway first in the PACU. Even with stable
vitals, residual anesthesia can depress respiratory drive and airway reflexes. Once
airway and breathing are confirmed adequate, then assess circulation, surgical site, and
pain.
Q4: A postoperative patient on day 2 has sudden onset of dyspnea, tachycardia, and
chest pain. Which complication is most likely?
A. Wound infection
B. Pulmonary embolism from DVT [CORRECT]
C. Paralytic ileus
D. Urinary retention
Correct Answer: B
Rationale: That's the classic presentation for pulmonary embolism—a postoperative
complication from venous stasis and hypercoagulability. The triad of dyspnea,
tachycardia, and chest pain requires immediate intervention. Postoperative patients are
at high risk for DVT/PE due to immobility and surgical trauma.
Q5: Which positioning technique prevents nerve injury during lengthy surgical
procedures?
A. Placing a pillow under the knees for comfort
B. Padding bony prominences and maintaining neutral alignment [CORRECT]
C. Allowing arms to hang dependently off the table
D. Keeping the head elevated 45 degrees throughout
Correct Answer: B
Rationale: For Exam 1, remember that intraoperative positioning requires protecting
pressure points and maintaining neutral joint alignment to prevent nerve compression
injuries (ulnar, peroneal, brachial plexus). Dependent arms can cause brachial plexus
stretch; knee pillows can cause popliteal nerve compression if not positioned carefully.
, Q6: A patient post-abdominal surgery has absent bowel sounds and no flatus for 48
hours. Which complication is suspected?
A. Normal postoperative recovery
B. Paralytic ileus [CORRECT]
C. Wound dehiscence
D. Hemorrhage
Correct Answer: B
Rationale: That's correct because absent bowel sounds with no flatus 48 hours after
abdominal surgery suggests paralytic ileus—temporary paralysis of intestinal motility
from surgical manipulation and anesthesia. Normal recovery should show return of
peristalsis and flatus by 24-48 hours.
Q7: A postoperative patient has a temperature of 38.8°C (101.8°F) on postoperative day
2. Which assessment finding would indicate a serious complication?
A. Clear lungs with normal breath sounds
B. Foul-smelling wound drainage with erythema [CORRECT]
C. Pain controlled at 3/10 with PCA
D. Urine output 50 mL/hour
Correct Answer: B
Rationale: That's the concerning finding because postoperative fever with foul-smelling,
erythematous wound drainage suggests surgical site infection or wound dehiscence
with possible necrotizing infection. While atelectasis causes early post-op fever, wound
complications require immediate surgical evaluation.
Q8: Which intervention is most effective for preventing postoperative atelectasis?
A. Administering prophylactic antibiotics
B. Incentive spirometry and early ambulation [CORRECT]
C. Maintaining strict bed rest
D. Inserting a nasogastric tube
Correct Answer: B
Rationale: For Exam 1 in NUR242, remember that atelectasis prevention relies on lung
expansion— incentive spirometry promotes deep breathing and alveolar recruitment,
while early ambulation increases ventilation and perfusion matching. Antibiotics treat
infection, not prevent atelectasis; bed rest worsens it.
