NUR 242 Exam 1 Medical-Surgical Nursing
Concepts (2026/2027) PDF | Nursing | Galen
College
1. A patient is scheduled for surgery under general
anesthesia. Which assessment finding requires immediate
notification of the anesthesia provider?
A. Serum potassium 3.8 mEq/L
B. Loose tooth noted during assessment
C. Patient reports mild anxiety
D. Blood pressure 128/76 mm Hg
Answer: B
Rationale: A loose tooth poses an aspiration risk during
intubation/extubation. The anesthesia provider must be
notified to plan for careful airway management.
2. A diabetic patient receiving NPH insulin is NPO for
surgery in the morning. What is the priority action?
1
,A. Hold all insulin until after surgery
B. Administer half the usual NPH dose with a small sip of
juice
C. Clarify insulin dosing orders with the provider
D. Give full NPH dose subcutaneously as usual
Answer: C
Rationale: The provider must specify insulin management
for NPO patients to avoid hypoglycemia or
hyperglycemia.
3. Which patient statement indicates understanding of
preoperative deep breathing and coughing exercises?
A. “I will practice these only if I feel short of breath.”
B. “I will take shallow breaths to avoid pain.”
C. “I will splint my incision with a pillow while coughing.”
D. “Coughing is discouraged after surgery.”
Answer: C
Rationale: Splinting reduces incisional pain and improves
2
,cough effectiveness, helping prevent
atelectasis/pneumonia.
4. Immediately after surgery, a patient’s oxygen
saturation drops to 88% on room air. First action?
A. Call a code blue
B. Increase oxygen to 4 L/min via nasal cannula
C. Assess airway patency and breath sounds
D. Suction the trachea
Answer: C
Rationale: ABCs begin with airway. Assess for obstruction,
hypoventilation, or bronchospasm before intervening.
5. Which finding in the PACU suggests malignant
hyperthermia?
A. Hypothermia and bradycardia
B. Muscle rigidity and hypercapnia
C. Hypertension and polyuria
D. Hypoglycemia and shivering
3
, Answer: B
Rationale: Malignant hyperthermia presents with muscle
rigidity, tachypnea, hypercapnia, tachycardia, and
hyperthermia.
6. A postoperative patient has a urinary output of 20 mL
over 2 hours. Priority action?
A. Increase IV fluid rate
B. Assess for bladder distention
C. Administer furosemide
D. Document as expected finding
Answer: B
Rationale: Low output may indicate bladder distention
(urinary retention post-anesthesia) or hypovolemia. Assess
first.
7. Which patient is at highest risk for venous
thromboembolism postoperatively?
A. 22-year-old having knee arthroscopy
B. 45-year-old undergoing cholecystectomy, on oral
4
Concepts (2026/2027) PDF | Nursing | Galen
College
1. A patient is scheduled for surgery under general
anesthesia. Which assessment finding requires immediate
notification of the anesthesia provider?
A. Serum potassium 3.8 mEq/L
B. Loose tooth noted during assessment
C. Patient reports mild anxiety
D. Blood pressure 128/76 mm Hg
Answer: B
Rationale: A loose tooth poses an aspiration risk during
intubation/extubation. The anesthesia provider must be
notified to plan for careful airway management.
2. A diabetic patient receiving NPH insulin is NPO for
surgery in the morning. What is the priority action?
1
,A. Hold all insulin until after surgery
B. Administer half the usual NPH dose with a small sip of
juice
C. Clarify insulin dosing orders with the provider
D. Give full NPH dose subcutaneously as usual
Answer: C
Rationale: The provider must specify insulin management
for NPO patients to avoid hypoglycemia or
hyperglycemia.
3. Which patient statement indicates understanding of
preoperative deep breathing and coughing exercises?
A. “I will practice these only if I feel short of breath.”
B. “I will take shallow breaths to avoid pain.”
C. “I will splint my incision with a pillow while coughing.”
D. “Coughing is discouraged after surgery.”
Answer: C
Rationale: Splinting reduces incisional pain and improves
2
,cough effectiveness, helping prevent
atelectasis/pneumonia.
4. Immediately after surgery, a patient’s oxygen
saturation drops to 88% on room air. First action?
A. Call a code blue
B. Increase oxygen to 4 L/min via nasal cannula
C. Assess airway patency and breath sounds
D. Suction the trachea
Answer: C
Rationale: ABCs begin with airway. Assess for obstruction,
hypoventilation, or bronchospasm before intervening.
5. Which finding in the PACU suggests malignant
hyperthermia?
A. Hypothermia and bradycardia
B. Muscle rigidity and hypercapnia
C. Hypertension and polyuria
D. Hypoglycemia and shivering
3
, Answer: B
Rationale: Malignant hyperthermia presents with muscle
rigidity, tachypnea, hypercapnia, tachycardia, and
hyperthermia.
6. A postoperative patient has a urinary output of 20 mL
over 2 hours. Priority action?
A. Increase IV fluid rate
B. Assess for bladder distention
C. Administer furosemide
D. Document as expected finding
Answer: B
Rationale: Low output may indicate bladder distention
(urinary retention post-anesthesia) or hypovolemia. Assess
first.
7. Which patient is at highest risk for venous
thromboembolism postoperatively?
A. 22-year-old having knee arthroscopy
B. 45-year-old undergoing cholecystectomy, on oral
4
