NURS 201 | Medical-Surgical Nursing – Promoting Wellness | Week 8
Comprehensive Quiz 2026 |WCU
1. A patient’s arterial blood gas (ABG) results show pH 7.32, PaCO2 52 mmHg,
and HCO3 24 mEq/L. Which condition does the nurse suspect?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above 45 mmHg
(respiratory origin), while the bicarbonate is within the normal range, indicating an
uncompensated respiratory acidosis.
2. A client with Chronic Kidney Disease (CKD) presents with a potassium level of
6.7 mEq/L. Which order should the nurse implement first to protect the patient
from cardiac arrest?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Initiate a low-potassium diet immediately
C. Administer IV Furosemide (Lasix)
D. Administer IV Calcium Gluconate
Answer: D
Rationale: While Kayexalate and diuretics help remove potassium, IV Calcium Gluconate is
the priority to stabilize the cardiac membrane and prevent life-threatening arrhythmias.
,3. Which assessment finding in a patient with acute pancreatitis requires
immediate notification of the healthcare provider?
A. Nausea and vomiting for 24 hours
B. Serum amylase level three times the normal limit
C. Epigastric pain radiating to the back
D. Grey Turner’s sign (bluish flank discoloration)
Answer: D
Rationale: Grey Turner’s sign or Cullen’s sign indicates retroperitoneal hemorrhage, a
severe and life-threatening complication of hemorrhagic pancreatitis.
4. A nurse is caring for a patient with liver cirrhosis who has developed hepatic
encephalopathy. Which medication is most critical for reducing the patient’s
ammonia levels?
A. Spironolactone
B. Propranolol
C. Vitamin K
D. Lactulose
Answer: D
Rationale: Lactulose promotes the excretion of ammonia through the stool, which is the
primary treatment for hepatic encephalopathy caused by high serum ammonia levels.
5. The nurse is calculating the fluid resuscitation for a 70kg patient with 40%
Total Body Surface Area (TBSA) burns using the Parkland Formula
(4mL/kg/%TBSA). How much fluid should be given in the first 8 hours?
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 4,200 mL
Answer: A
, Rationale: Total fluid = 4mL x 70kg x 40 = 11,200 mL. Half of the total (5,600 mL) is
administered in the first 8 hours.
6. Which physiological change is responsible for the ‘Kussmaul breathing’
observed in patients with Diabetic Ketoacidosis (DKA)?
A. Compensation for respiratory alkalosis
B. Attempt to blow off excess CO2 to correct metabolic acidosis
C. A response to severe hypoxemia
D. Failure of the renal buffer system
Answer: B
Rationale: Kussmaul breathing is a deep, rapid respiratory pattern that serves as a
compensatory mechanism to eliminate CO2 and raise blood pH in response to metabolic
acidosis.
7. A patient with a history of heart failure is admitted with Syndrome of
Inappropriate Antidiuretic Hormone (SIADH). Which order should the nurse
question?
A. Fluid restriction of 800 mL/day
B. Administration of 3% Hypertonic Saline
C. Encourage oral intake of 2 liters of water daily
D. Daily weights
Answer: C
Rationale: SIADH involves excessive water retention and dilutional hyponatremia.
Increasing oral fluid intake would worsen the condition; fluid restriction is the standard
treatment.
Comprehensive Quiz 2026 |WCU
1. A patient’s arterial blood gas (ABG) results show pH 7.32, PaCO2 52 mmHg,
and HCO3 24 mEq/L. Which condition does the nurse suspect?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above 45 mmHg
(respiratory origin), while the bicarbonate is within the normal range, indicating an
uncompensated respiratory acidosis.
2. A client with Chronic Kidney Disease (CKD) presents with a potassium level of
6.7 mEq/L. Which order should the nurse implement first to protect the patient
from cardiac arrest?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Initiate a low-potassium diet immediately
C. Administer IV Furosemide (Lasix)
D. Administer IV Calcium Gluconate
Answer: D
Rationale: While Kayexalate and diuretics help remove potassium, IV Calcium Gluconate is
the priority to stabilize the cardiac membrane and prevent life-threatening arrhythmias.
,3. Which assessment finding in a patient with acute pancreatitis requires
immediate notification of the healthcare provider?
A. Nausea and vomiting for 24 hours
B. Serum amylase level three times the normal limit
C. Epigastric pain radiating to the back
D. Grey Turner’s sign (bluish flank discoloration)
Answer: D
Rationale: Grey Turner’s sign or Cullen’s sign indicates retroperitoneal hemorrhage, a
severe and life-threatening complication of hemorrhagic pancreatitis.
4. A nurse is caring for a patient with liver cirrhosis who has developed hepatic
encephalopathy. Which medication is most critical for reducing the patient’s
ammonia levels?
A. Spironolactone
B. Propranolol
C. Vitamin K
D. Lactulose
Answer: D
Rationale: Lactulose promotes the excretion of ammonia through the stool, which is the
primary treatment for hepatic encephalopathy caused by high serum ammonia levels.
5. The nurse is calculating the fluid resuscitation for a 70kg patient with 40%
Total Body Surface Area (TBSA) burns using the Parkland Formula
(4mL/kg/%TBSA). How much fluid should be given in the first 8 hours?
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 4,200 mL
Answer: A
, Rationale: Total fluid = 4mL x 70kg x 40 = 11,200 mL. Half of the total (5,600 mL) is
administered in the first 8 hours.
6. Which physiological change is responsible for the ‘Kussmaul breathing’
observed in patients with Diabetic Ketoacidosis (DKA)?
A. Compensation for respiratory alkalosis
B. Attempt to blow off excess CO2 to correct metabolic acidosis
C. A response to severe hypoxemia
D. Failure of the renal buffer system
Answer: B
Rationale: Kussmaul breathing is a deep, rapid respiratory pattern that serves as a
compensatory mechanism to eliminate CO2 and raise blood pH in response to metabolic
acidosis.
7. A patient with a history of heart failure is admitted with Syndrome of
Inappropriate Antidiuretic Hormone (SIADH). Which order should the nurse
question?
A. Fluid restriction of 800 mL/day
B. Administration of 3% Hypertonic Saline
C. Encourage oral intake of 2 liters of water daily
D. Daily weights
Answer: C
Rationale: SIADH involves excessive water retention and dilutional hyponatremia.
Increasing oral fluid intake would worsen the condition; fluid restriction is the standard
treatment.
