NURS 121L-A: Introduction to Medical-Surgical Nursing Practicum -
Module Exam 1 Comprehensive Review 2026 |WCU
1. A nurse is caring for a client diagnosed with Clostridioides difficile. Which
infection control measure is the highest priority when exiting the client’s room?
A. Washing hands with antimicrobial soap and water
B. Using an alcohol-based hand rub for 20 seconds
C. Removing the mask before removing the gown
D. Double-bagging all soiled linens before transport
Answer: A
Rationale: C. difficile spores are resistant to alcohol-based sanitizers. Friction and water
are required to physically remove spores from the hands.
2. When assessing a client’s risk for falls using the Morse Fall Scale, the nurse
notes the client has a history of falling, uses a walker, and has an IV line. Which
action should the nurse take first?
A. Request a sitter to stay with the client at all times
B. Apply bilateral wrist restraints to prevent wandering
C. Administer a sedative to keep the client in bed
D. Ensure the call light is within reach and the bed is in the lowest position
Answer: D
Rationale: Environmental safety interventions like low bed and accessible call lights are
the first-line non-pharmacological interventions for fall risk.
,3. A nurse is performing an abdominal assessment. In which order should the
nurse perform the physical examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Palpation, Percussion, Auscultation, Inspection
Answer: C
Rationale: For the abdomen, auscultation is done before palpation or percussion to avoid
altering bowel sounds.
4. A client is scheduled for elective surgery. The nurse notes the client does not
seem to understand the procedure explained by the surgeon. What is the
nurse’s most appropriate action?
A. Notify the surgeon that the client requires further clarification
B. Proceed with the checklist and have the client sign the form
C. Explain the risks and benefits of the surgery to the client
D. Document that the client is anxious but willing to proceed
Answer: A
Rationale: The nurse witnesses the signature but the surgeon is responsible for providing
informed consent. If the client doesn’t understand, the surgeon must return.
5. During the ‘Situation’ portion of the SBAR communication tool, which
information should the nurse provide?
A. A brief statement of the current problem or reason for contact
B. The client’s medical history and allergies
C. Recent laboratory results and vital sign trends
D. Specific interventions the nurse believes are needed
Answer: A
, Rationale: S (Situation) is a concise statement of the immediate problem. Background (B)
includes history, Assessment (A) includes vitals/findings, and Recommendation (R)
includes suggestions.
6. A nurse is preparing to administer an intramuscular injection using the Z-track
method. What is the primary rationale for this technique?
A. To decrease the amount of pain felt by the client
B. To ensure the medication is injected into the subcutaneous fat
C. To prevent the medication from leaking back into the subcutaneous tissue
D. To increase the speed of medication absorption
Answer: C
Rationale: The Z-track method creates a zigzag path that seals the medication in the
muscle and prevents irritation to subcutaneous tissues.
7. Which vital sign change would the nurse expect to see in a client experiencing
early stages of hypovolemic shock?
A. Decreased heart rate and increased blood pressure
B. Increased heart rate and decreased blood pressure
C. Decreased respiratory rate and increased temperature
D. Increased heart rate and increased blood pressure
Answer: B
Rationale: In hypovolemia, the heart rate increases (tachycardia) to compensate for
decreased stroke volume, while the blood pressure eventually drops.
Module Exam 1 Comprehensive Review 2026 |WCU
1. A nurse is caring for a client diagnosed with Clostridioides difficile. Which
infection control measure is the highest priority when exiting the client’s room?
A. Washing hands with antimicrobial soap and water
B. Using an alcohol-based hand rub for 20 seconds
C. Removing the mask before removing the gown
D. Double-bagging all soiled linens before transport
Answer: A
Rationale: C. difficile spores are resistant to alcohol-based sanitizers. Friction and water
are required to physically remove spores from the hands.
2. When assessing a client’s risk for falls using the Morse Fall Scale, the nurse
notes the client has a history of falling, uses a walker, and has an IV line. Which
action should the nurse take first?
A. Request a sitter to stay with the client at all times
B. Apply bilateral wrist restraints to prevent wandering
C. Administer a sedative to keep the client in bed
D. Ensure the call light is within reach and the bed is in the lowest position
Answer: D
Rationale: Environmental safety interventions like low bed and accessible call lights are
the first-line non-pharmacological interventions for fall risk.
,3. A nurse is performing an abdominal assessment. In which order should the
nurse perform the physical examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Palpation, Percussion, Auscultation, Inspection
Answer: C
Rationale: For the abdomen, auscultation is done before palpation or percussion to avoid
altering bowel sounds.
4. A client is scheduled for elective surgery. The nurse notes the client does not
seem to understand the procedure explained by the surgeon. What is the
nurse’s most appropriate action?
A. Notify the surgeon that the client requires further clarification
B. Proceed with the checklist and have the client sign the form
C. Explain the risks and benefits of the surgery to the client
D. Document that the client is anxious but willing to proceed
Answer: A
Rationale: The nurse witnesses the signature but the surgeon is responsible for providing
informed consent. If the client doesn’t understand, the surgeon must return.
5. During the ‘Situation’ portion of the SBAR communication tool, which
information should the nurse provide?
A. A brief statement of the current problem or reason for contact
B. The client’s medical history and allergies
C. Recent laboratory results and vital sign trends
D. Specific interventions the nurse believes are needed
Answer: A
, Rationale: S (Situation) is a concise statement of the immediate problem. Background (B)
includes history, Assessment (A) includes vitals/findings, and Recommendation (R)
includes suggestions.
6. A nurse is preparing to administer an intramuscular injection using the Z-track
method. What is the primary rationale for this technique?
A. To decrease the amount of pain felt by the client
B. To ensure the medication is injected into the subcutaneous fat
C. To prevent the medication from leaking back into the subcutaneous tissue
D. To increase the speed of medication absorption
Answer: C
Rationale: The Z-track method creates a zigzag path that seals the medication in the
muscle and prevents irritation to subcutaneous tissues.
7. Which vital sign change would the nurse expect to see in a client experiencing
early stages of hypovolemic shock?
A. Decreased heart rate and increased blood pressure
B. Increased heart rate and decreased blood pressure
C. Decreased respiratory rate and increased temperature
D. Increased heart rate and increased blood pressure
Answer: B
Rationale: In hypovolemia, the heart rate increases (tachycardia) to compensate for
decreased stroke volume, while the blood pressure eventually drops.
