NURS 121L-A Medical-Surgical Nursing Week 5 Comprehensive Quiz
2026 |WCU
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mmHg, and
HCO3 24 mEq/L. Which of the following conditions does this most likely
represent?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal
HCO3 confirms that the imbalance is respiratory in origin, representing respiratory
acidosis.
2. Which assessment finding in a post-operative patient should the nurse
prioritize as the most immediate risk for airway compromise?
A. Presence of inspiratory stridor
B. Oxygen saturation of 94% on room air
C. Fine crackles heard in the lung bases
D. Sanguineous drainage on the surgical dressing
Answer: A
Rationale: Stridor is a high-pitched sound indicating laryngeal edema or upper airway
obstruction, which is an emergency. Other findings are less urgent or within expected post-
op ranges.
,3. A patient is receiving a continuous intravenous infusion of 3% sodium
chloride. The nurse must monitor for which complication most closely?
A. Fluid volume deficit
B. Hypotension and bradycardia
C. Muscle tetany and positive Chvostek’s sign
D. Signs of cerebral edema or fluid overload
Answer: D
Rationale: 3% NaCl is a hypertonic solution used to treat severe hyponatremia. It can
cause rapid fluid shifts leading to intravascular fluid overload and pulmonary edema or
osmotic demyelination syndrome.
4. When assessing a patient with suspected hypokalemia, which
electrocardiogram (ECG) change is most characteristic?
A. Peaked T waves
B. Presence of U waves
C. Shortened QT interval
D. Widened QRS complex
Answer: B
Rationale: Hypokalemia typically causes flattened T waves and the appearance of U waves.
Peaked T waves are associated with hyperkalemia.
5. A nurse is caring for a patient who is 4 hours post-abdominal surgery. The
patient reports a ‘popping’ sensation at the incision site, and the nurse observes
internal organs protruding. What is the priority action?
A. Place the patient in a High-Fowler’s position
B. Immediately call the surgeon and push the organs back in
C. Apply a sterile, saline-soaked dressing
D. Administer prescribed PRN pain medication
Answer: C
, Rationale: This is an evisceration. The priority is to cover the site with sterile saline-
soaked gauze to prevent desiccation and infection. Organs should never be pushed back in
by the nurse.
6. Which of the following is an early sign of malignant hyperthermia during
general anesthesia?
A. High fever of 104°F (40°C)
B. Bradycardia
C. Hypotension
D. Muscle rigidity and tachycardia
Answer: D
Rationale: While high fever is a hallmark, it is often a late sign. Tachycardia and
generalized muscle rigidity (especially masseter muscle rigidity) are earlier clinical
indicators.
7. A patient with a history of chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula. Why must the nurse be cautious about high-
flow oxygen administration?
A. It can cause oxygen toxicity in the skin
B. It will lead to metabolic alkalosis
C. It may suppress the patient’s hypoxic drive to breathe
D. It causes an increase in surfactant production
Answer: C
Rationale: In some patients with chronic CO2 retention, the drive to breathe is triggered
by low oxygen levels (hypoxic drive) rather than high CO2. High-flow oxygen can negate
this stimulus, leading to hypoventilation.
2026 |WCU
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mmHg, and
HCO3 24 mEq/L. Which of the following conditions does this most likely
represent?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal
HCO3 confirms that the imbalance is respiratory in origin, representing respiratory
acidosis.
2. Which assessment finding in a post-operative patient should the nurse
prioritize as the most immediate risk for airway compromise?
A. Presence of inspiratory stridor
B. Oxygen saturation of 94% on room air
C. Fine crackles heard in the lung bases
D. Sanguineous drainage on the surgical dressing
Answer: A
Rationale: Stridor is a high-pitched sound indicating laryngeal edema or upper airway
obstruction, which is an emergency. Other findings are less urgent or within expected post-
op ranges.
,3. A patient is receiving a continuous intravenous infusion of 3% sodium
chloride. The nurse must monitor for which complication most closely?
A. Fluid volume deficit
B. Hypotension and bradycardia
C. Muscle tetany and positive Chvostek’s sign
D. Signs of cerebral edema or fluid overload
Answer: D
Rationale: 3% NaCl is a hypertonic solution used to treat severe hyponatremia. It can
cause rapid fluid shifts leading to intravascular fluid overload and pulmonary edema or
osmotic demyelination syndrome.
4. When assessing a patient with suspected hypokalemia, which
electrocardiogram (ECG) change is most characteristic?
A. Peaked T waves
B. Presence of U waves
C. Shortened QT interval
D. Widened QRS complex
Answer: B
Rationale: Hypokalemia typically causes flattened T waves and the appearance of U waves.
Peaked T waves are associated with hyperkalemia.
5. A nurse is caring for a patient who is 4 hours post-abdominal surgery. The
patient reports a ‘popping’ sensation at the incision site, and the nurse observes
internal organs protruding. What is the priority action?
A. Place the patient in a High-Fowler’s position
B. Immediately call the surgeon and push the organs back in
C. Apply a sterile, saline-soaked dressing
D. Administer prescribed PRN pain medication
Answer: C
, Rationale: This is an evisceration. The priority is to cover the site with sterile saline-
soaked gauze to prevent desiccation and infection. Organs should never be pushed back in
by the nurse.
6. Which of the following is an early sign of malignant hyperthermia during
general anesthesia?
A. High fever of 104°F (40°C)
B. Bradycardia
C. Hypotension
D. Muscle rigidity and tachycardia
Answer: D
Rationale: While high fever is a hallmark, it is often a late sign. Tachycardia and
generalized muscle rigidity (especially masseter muscle rigidity) are earlier clinical
indicators.
7. A patient with a history of chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula. Why must the nurse be cautious about high-
flow oxygen administration?
A. It can cause oxygen toxicity in the skin
B. It will lead to metabolic alkalosis
C. It may suppress the patient’s hypoxic drive to breathe
D. It causes an increase in surfactant production
Answer: C
Rationale: In some patients with chronic CO2 retention, the drive to breathe is triggered
by low oxygen levels (hypoxic drive) rather than high CO2. High-flow oxygen can negate
this stimulus, leading to hypoventilation.
