NURS 121L-A | Medical-Surgical Nursing Practicum | Week 3
Comprehensive Quiz 2026 |WCU
1. A patient is admitted with severe vomiting and diarrhea. Which acid-base
imbalance should the nurse prioritize for assessment?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: While vomiting leads to loss of gastric acid (alkalosis), lower GI losses via
diarrhea typically lead to a loss of bicarbonate, resulting in metabolic acidosis. In complex
cases, the nurse must monitor for both, but diarrhea specifically triggers metabolic
acidosis.
2. The nurse is caring for a patient post-cholecystectomy who reports sudden
chest pain and dyspnea. Which is the immediate priority?
A. Administer prescribed PRN analgesic
B. Encourage the use of the incentive spirometer
C. Perform a focused respiratory assessment and check O2 saturation
D. Notify the surgeon of possible wound dehiscence
Answer: C
Rationale: Sudden chest pain and dyspnea post-surgery suggest a pulmonary embolism.
Immediate assessment of airway and oxygenation is the first priority in the nursing
process.
,3. Which electrolyte abnormality is most likely to cause a flattened T-wave and
the presence of a U-wave on an ECG?
A. Hypokalemia
B. Hypocalcemia
C. Hypercalcemia
D. Hyperkalemia
Answer: A
Rationale: Hypokalemia typically presents with flattened or inverted T-waves and the
development of U-waves. Hyperkalemia would show peaked T-waves.
4. During a pre-operative assessment, the patient reveals a strong family history
of high fever during surgery. The nurse should alert the surgical team to risk for:
A. Hypovolemic Shock
B. Malignant Hyperthermia
C. Anaphylactic Reaction
D. Autonomic Dysreflexia
Answer: B
Rationale: Malignant Hyperthermia is a life-threatening, inherited muscular disorder
triggered by volatile inhalational anesthetic agents and succinylcholine.
5. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, HCO3 26 mEq/L. How
does the nurse interpret these findings?
A. Uncompensated Respiratory Acidosis
B. Fully Compensated Metabolic Acidosis
C. Partially Compensated Respiratory Alkalosis
D. Uncompensated Metabolic Alkalosis
Answer: A
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
within normal range (uncompensated).
, 6. The nurse is monitoring a patient receiving a rapid infusion of 0.9% Normal
Saline. Which finding indicates Fluid Volume Excess?
A. Decreased skin turgor
B. Crackles auscultated in lung bases
C. Flat neck veins when supine
D. Increased urine specific gravity
Answer: B
Rationale: Adventitious breath sounds like crackles are a key sign of pulmonary
congestion due to fluid volume excess.
7. In the ‘Time Out’ phase of the Universal Protocol, who is responsible for
verifying the patient’s identity and surgical site?
A. Only the surgeon
B. The entire surgical team
C. Only the anesthesiologist
D. Only the circulating nurse
Answer: B
Rationale: The ‘Time Out’ is a collaborative process where all members of the surgical
team must agree on the patient identity, site, and procedure.
8. A patient with a serum calcium level of 7.0 mg/dL is at risk for which clinical
manifestation?
A. Constipation and kidney stones
B. Shortened QT interval
C. Positive Trousseau’s sign
D. Hypoactive bowel sounds
Answer: C
Rationale: Normal calcium is 9.0-10.5 mg/dL. Hypocalcemia increases neuromuscular
excitability, leading to Trousseau’s and Chvostek’s signs.
Comprehensive Quiz 2026 |WCU
1. A patient is admitted with severe vomiting and diarrhea. Which acid-base
imbalance should the nurse prioritize for assessment?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: While vomiting leads to loss of gastric acid (alkalosis), lower GI losses via
diarrhea typically lead to a loss of bicarbonate, resulting in metabolic acidosis. In complex
cases, the nurse must monitor for both, but diarrhea specifically triggers metabolic
acidosis.
2. The nurse is caring for a patient post-cholecystectomy who reports sudden
chest pain and dyspnea. Which is the immediate priority?
A. Administer prescribed PRN analgesic
B. Encourage the use of the incentive spirometer
C. Perform a focused respiratory assessment and check O2 saturation
D. Notify the surgeon of possible wound dehiscence
Answer: C
Rationale: Sudden chest pain and dyspnea post-surgery suggest a pulmonary embolism.
Immediate assessment of airway and oxygenation is the first priority in the nursing
process.
,3. Which electrolyte abnormality is most likely to cause a flattened T-wave and
the presence of a U-wave on an ECG?
A. Hypokalemia
B. Hypocalcemia
C. Hypercalcemia
D. Hyperkalemia
Answer: A
Rationale: Hypokalemia typically presents with flattened or inverted T-waves and the
development of U-waves. Hyperkalemia would show peaked T-waves.
4. During a pre-operative assessment, the patient reveals a strong family history
of high fever during surgery. The nurse should alert the surgical team to risk for:
A. Hypovolemic Shock
B. Malignant Hyperthermia
C. Anaphylactic Reaction
D. Autonomic Dysreflexia
Answer: B
Rationale: Malignant Hyperthermia is a life-threatening, inherited muscular disorder
triggered by volatile inhalational anesthetic agents and succinylcholine.
5. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, HCO3 26 mEq/L. How
does the nurse interpret these findings?
A. Uncompensated Respiratory Acidosis
B. Fully Compensated Metabolic Acidosis
C. Partially Compensated Respiratory Alkalosis
D. Uncompensated Metabolic Alkalosis
Answer: A
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
within normal range (uncompensated).
, 6. The nurse is monitoring a patient receiving a rapid infusion of 0.9% Normal
Saline. Which finding indicates Fluid Volume Excess?
A. Decreased skin turgor
B. Crackles auscultated in lung bases
C. Flat neck veins when supine
D. Increased urine specific gravity
Answer: B
Rationale: Adventitious breath sounds like crackles are a key sign of pulmonary
congestion due to fluid volume excess.
7. In the ‘Time Out’ phase of the Universal Protocol, who is responsible for
verifying the patient’s identity and surgical site?
A. Only the surgeon
B. The entire surgical team
C. Only the anesthesiologist
D. Only the circulating nurse
Answer: B
Rationale: The ‘Time Out’ is a collaborative process where all members of the surgical
team must agree on the patient identity, site, and procedure.
8. A patient with a serum calcium level of 7.0 mg/dL is at risk for which clinical
manifestation?
A. Constipation and kidney stones
B. Shortened QT interval
C. Positive Trousseau’s sign
D. Hypoactive bowel sounds
Answer: C
Rationale: Normal calcium is 9.0-10.5 mg/dL. Hypocalcemia increases neuromuscular
excitability, leading to Trousseau’s and Chvostek’s signs.
