NURS 121L-A: Introduction to Medical-Surgical Nursing Practicum -
Week 14 Comprehensive Final Quiz 2026 |WCU
1. A patient is admitted with a pH of 7.30, a PaCO2 of 52 mmHg, and a HCO3 of
26 mEq/L. Which acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause, and since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. Which electrolyte imbalance should the nurse monitor for in a patient
receiving high-dose furosemide (Lasix)?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium along with
water and sodium, frequently leading to hypokalemia.
,3. A nurse is caring for a postoperative patient who has developed a wound
evisceration. What is the priority nursing action?
A. Gently push the organs back into the abdominal cavity
B. Apply a dry sterile dressing tightly over the wound
C. Place the patient in a high-Fowler’s position
D. Cover the protruding organs with sterile towels moistened with sterile normal saline
Answer: D
Rationale: Evisceration is a medical emergency. The nurse must protect the organs from
drying and infection by using sterile, saline-moistened dressings.
4. When administering Humalog (Insulin Lispro), when should the nurse ensure
the patient eats?
A. 30 to 60 minutes after administration
B. Within 15 minutes of administration
C. 2 hours after administration
D. Only when the blood glucose is above 200 mg/dL
Answer: B
Rationale: Humalog is a rapid-acting insulin with an onset of 15 minutes. Eating within
this timeframe prevents hypoglycemia.
5. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Jugular venous distention (JVD) and peripheral edema
B. Dyspnea and orthopnea
C. Pulmonary edema and crackles
D. Productive cough with pink frothy sputum
Answer: A
Rationale: Right-sided heart failure causes blood to back up into the systemic circulation,
leading to JVD, hepatomegaly, and peripheral edema.
, 6. A patient with COPD is receiving oxygen via nasal cannula. Why is it critical to
avoid high concentrations of oxygen in this patient?
A. High oxygen levels can cause nitrogen narcosis
B. Oxygen toxicity can damage the alveoli
C. It increases the risk of pulmonary embolism
D. It may eliminate the hypoxic drive to breathe
Answer: D
Rationale: In some chronic COPD patients, the stimulus to breathe is low oxygen (hypoxic
drive) rather than high CO2. Providing too much oxygen can suppress their respiratory
effort.
7. What is the primary purpose of using an Incentive Spirometer
postoperatively?
A. To measure the patient’s forced expiratory volume
B. To promote alveolar expansion and prevent atelectasis
C. To strengthen the abdominal muscles used for coughing
D. To decrease the patient’s need for supplemental oxygen
Answer: B
Rationale: Incentive spirometry encourages deep breathing, which helps keep the alveoli
open and prevents lung collapse (atelectasis).
8. A nurse is assessing a patient with a suspected Deep Vein Thrombosis (DVT).
Which finding is most concerning?
A. Unilateral leg swelling and warmth
B. Palpable pedal pulses
C. Pitting edema in both lower extremities
D. Sudden onset of shortness of breath and chest pain
Answer: D
Week 14 Comprehensive Final Quiz 2026 |WCU
1. A patient is admitted with a pH of 7.30, a PaCO2 of 52 mmHg, and a HCO3 of
26 mEq/L. Which acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause, and since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. Which electrolyte imbalance should the nurse monitor for in a patient
receiving high-dose furosemide (Lasix)?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium along with
water and sodium, frequently leading to hypokalemia.
,3. A nurse is caring for a postoperative patient who has developed a wound
evisceration. What is the priority nursing action?
A. Gently push the organs back into the abdominal cavity
B. Apply a dry sterile dressing tightly over the wound
C. Place the patient in a high-Fowler’s position
D. Cover the protruding organs with sterile towels moistened with sterile normal saline
Answer: D
Rationale: Evisceration is a medical emergency. The nurse must protect the organs from
drying and infection by using sterile, saline-moistened dressings.
4. When administering Humalog (Insulin Lispro), when should the nurse ensure
the patient eats?
A. 30 to 60 minutes after administration
B. Within 15 minutes of administration
C. 2 hours after administration
D. Only when the blood glucose is above 200 mg/dL
Answer: B
Rationale: Humalog is a rapid-acting insulin with an onset of 15 minutes. Eating within
this timeframe prevents hypoglycemia.
5. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Jugular venous distention (JVD) and peripheral edema
B. Dyspnea and orthopnea
C. Pulmonary edema and crackles
D. Productive cough with pink frothy sputum
Answer: A
Rationale: Right-sided heart failure causes blood to back up into the systemic circulation,
leading to JVD, hepatomegaly, and peripheral edema.
, 6. A patient with COPD is receiving oxygen via nasal cannula. Why is it critical to
avoid high concentrations of oxygen in this patient?
A. High oxygen levels can cause nitrogen narcosis
B. Oxygen toxicity can damage the alveoli
C. It increases the risk of pulmonary embolism
D. It may eliminate the hypoxic drive to breathe
Answer: D
Rationale: In some chronic COPD patients, the stimulus to breathe is low oxygen (hypoxic
drive) rather than high CO2. Providing too much oxygen can suppress their respiratory
effort.
7. What is the primary purpose of using an Incentive Spirometer
postoperatively?
A. To measure the patient’s forced expiratory volume
B. To promote alveolar expansion and prevent atelectasis
C. To strengthen the abdominal muscles used for coughing
D. To decrease the patient’s need for supplemental oxygen
Answer: B
Rationale: Incentive spirometry encourages deep breathing, which helps keep the alveoli
open and prevents lung collapse (atelectasis).
8. A nurse is assessing a patient with a suspected Deep Vein Thrombosis (DVT).
Which finding is most concerning?
A. Unilateral leg swelling and warmth
B. Palpable pedal pulses
C. Pitting edema in both lower extremities
D. Sudden onset of shortness of breath and chest pain
Answer: D
