NURS 120 Medical-Surgical Nursing Exam 1 Study Guide 2026 |WCU
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical
manifestation should the nurse prioritize?
A. Increased thirst and dry mucous membranes
B. Hyperreflexia and muscle twitching
C. Confusion and seizures
D. Cardiac dysrhythmias and peaked T waves
Answer: C
Rationale: Hyponatremia (normal 135-145) causes water to shift into brain cells, leading
to cerebral edema, confusion, and seizures. Thirst is common in hypernatremia.
2. Which ABG result indicates partially compensated respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 30
B. pH 7.42, PaCO2 48, HCO3 31
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 30, HCO3 22
Answer: A
Rationale: In respiratory acidosis, pH is low and PaCO2 is high. Partial compensation
occurs when the HCO3 rises above normal to buffer the acid, but the pH is not yet in the
normal range.
,3. A patient is scheduled for surgery and has been taking Aspirin 81 mg daily.
What is the nurse’s priority action?
A. Notify the surgeon regarding the risk of bleeding
B. Ensure the patient stays NPO
C. Check the patient’s potassium level
D. Administer the aspirin with a sip of water
Answer: A
Rationale: Aspirin is an antiplatelet agent that increases the risk of perioperative bleeding
and is typically held 7-10 days before surgery.
4. During the intraoperative phase, the scrub nurse is responsible for:
A. Coordinating the movement of the patient
B. Documenting the nursing care plan
C. Obtaining informed consent
D. Handing sterile instruments to the surgeon
Answer: D
Rationale: The scrub nurse maintains the sterile field and assists the surgeon by passing
instruments. The circulating nurse manages the environment and documentation.
5. A patient post-abdominal surgery complains of a ‘popping’ sensation and the
nurse notes bowel loops protruding through the incision. What is the immediate
priority?
A. Push the organs back into the abdomen
B. Call the surgeon after 30 minutes
C. Cover the area with sterile saline-soaked dressings
D. Ask the patient to cough and deep breathe
Answer: C
Rationale: This is evisceration. The nurse must cover the protruding organs with sterile,
saline-moistened gauze to prevent drying and infection, and call the surgeon immediately.
, 6. Which assessment finding is most characteristic of hypocalcemia?
A. Decreased deep tendon reflexes
B. Bony pain and kidney stones
C. Positive Trousseau’s sign
D. Extreme thirst and polyuria
Answer: C
Rationale: Hypocalcemia causes neuromuscular excitability, manifested by Trousseau’s
sign (carpal spasm with BP cuff inflation) and Chvostek’s sign.
7. A patient has a potassium level of 6.2 mEq/L. Which medication would the
nurse expect to administer for immediate stabilization of the cardiac
membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Furosemide (Lasix)
D. Regular Insulin with D50
Answer: B
Rationale: While insulin and Kayexalate lower potassium, Calcium Gluconate is used first
to stabilize the cardiac membrane and prevent lethal dysrhythmias in severe hyperkalemia.
8. The nurse is teaching a patient about PCA (Patient-Controlled Analgesia).
Which statement by the patient indicates a need for further teaching?
A. I will push the button when I start to feel pain.
B. My wife can push the button for me while I am sleeping.
C. I should not wait until the pain is severe to push the button.
D. The machine has a lockout limit to prevent overdose.
Answer: B
Rationale: Only the patient should push the PCA button (PCA by proxy is contraindicated)
to prevent oversedation and respiratory depression.
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical
manifestation should the nurse prioritize?
A. Increased thirst and dry mucous membranes
B. Hyperreflexia and muscle twitching
C. Confusion and seizures
D. Cardiac dysrhythmias and peaked T waves
Answer: C
Rationale: Hyponatremia (normal 135-145) causes water to shift into brain cells, leading
to cerebral edema, confusion, and seizures. Thirst is common in hypernatremia.
2. Which ABG result indicates partially compensated respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 30
B. pH 7.42, PaCO2 48, HCO3 31
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 30, HCO3 22
Answer: A
Rationale: In respiratory acidosis, pH is low and PaCO2 is high. Partial compensation
occurs when the HCO3 rises above normal to buffer the acid, but the pH is not yet in the
normal range.
,3. A patient is scheduled for surgery and has been taking Aspirin 81 mg daily.
What is the nurse’s priority action?
A. Notify the surgeon regarding the risk of bleeding
B. Ensure the patient stays NPO
C. Check the patient’s potassium level
D. Administer the aspirin with a sip of water
Answer: A
Rationale: Aspirin is an antiplatelet agent that increases the risk of perioperative bleeding
and is typically held 7-10 days before surgery.
4. During the intraoperative phase, the scrub nurse is responsible for:
A. Coordinating the movement of the patient
B. Documenting the nursing care plan
C. Obtaining informed consent
D. Handing sterile instruments to the surgeon
Answer: D
Rationale: The scrub nurse maintains the sterile field and assists the surgeon by passing
instruments. The circulating nurse manages the environment and documentation.
5. A patient post-abdominal surgery complains of a ‘popping’ sensation and the
nurse notes bowel loops protruding through the incision. What is the immediate
priority?
A. Push the organs back into the abdomen
B. Call the surgeon after 30 minutes
C. Cover the area with sterile saline-soaked dressings
D. Ask the patient to cough and deep breathe
Answer: C
Rationale: This is evisceration. The nurse must cover the protruding organs with sterile,
saline-moistened gauze to prevent drying and infection, and call the surgeon immediately.
, 6. Which assessment finding is most characteristic of hypocalcemia?
A. Decreased deep tendon reflexes
B. Bony pain and kidney stones
C. Positive Trousseau’s sign
D. Extreme thirst and polyuria
Answer: C
Rationale: Hypocalcemia causes neuromuscular excitability, manifested by Trousseau’s
sign (carpal spasm with BP cuff inflation) and Chvostek’s sign.
7. A patient has a potassium level of 6.2 mEq/L. Which medication would the
nurse expect to administer for immediate stabilization of the cardiac
membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Furosemide (Lasix)
D. Regular Insulin with D50
Answer: B
Rationale: While insulin and Kayexalate lower potassium, Calcium Gluconate is used first
to stabilize the cardiac membrane and prevent lethal dysrhythmias in severe hyperkalemia.
8. The nurse is teaching a patient about PCA (Patient-Controlled Analgesia).
Which statement by the patient indicates a need for further teaching?
A. I will push the button when I start to feel pain.
B. My wife can push the button for me while I am sleeping.
C. I should not wait until the pain is severe to push the button.
D. The machine has a lockout limit to prevent overdose.
Answer: B
Rationale: Only the patient should push the PCA button (PCA by proxy is contraindicated)
to prevent oversedation and respiratory depression.
