NURS 120 | Introduction to Medical-Surgical Nursing | Module Exam 4
(Week 12) 2026 |WCU
1. A nurse is caring for a patient who is 24 hours postoperative following a
cholecystectomy. The patient reports sudden shortness of breath and chest
pain. Which of the following should be the nurse’s priority action?
A. Administer the prescribed analgesic for pain
B. Notify the surgeon of the pain level
C. Encourage the use of the incentive spirometer
D. Perform a focused respiratory assessment and check oxygen saturation
Answer: D
Rationale: Sudden shortness of breath and chest pain in a postoperative patient are
clinical indicators of a pulmonary embolism. The nurse’s first action should be to assess the
patient’s respiratory status and oxygenation level before intervening or notifying the
provider.
2. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range (22-26), this represents
uncompensated respiratory acidosis.
,3. A nurse is assessing a patient with a potassium level of 2.8 mEq/L. Which of
the following electrocardiogram (ECG) changes should the nurse expect to
observe?
A. Tall, peaked T waves
B. Widened QRS complex
C. ST-segment depression and prominent U waves
D. Shortened PR interval
Answer: C
Rationale: Hypokalemia (low potassium) is associated with ST-segment depression,
flattened T waves, and the appearance of U waves. Tall, peaked T waves are seen in
hyperkalemia.
4. During a preoperative assessment, a patient reveals they have been taking
ginkgo biloba regularly. Why is this information critical for the surgical team?
A. It can increase the risk of postoperative bleeding
B. It may cause profound sedation when combined with anesthesia
C. It may lead to severe electrolyte imbalances
D. It can cause acute hypertensive crisis during induction
Answer: A
Rationale: Ginkgo biloba has antiplatelet properties and can increase the risk of bleeding
during and after surgery. It should typically be discontinued at least 1-2 weeks before an
elective procedure.
, 5. A nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min via nasal cannula. The patient’s SpO2
is 89%. Which of the following actions is most appropriate?
A. Increase the oxygen flow to 6 L/min immediately
B. Switch the patient to a non-rebreather mask
C. Continue to monitor as this is an expected range for a COPD patient
D. Prepare for emergency intubation
Answer: C
Rationale: Patients with COPD often have a ‘hypoxic drive’ and maintain lower baseline
oxygen saturation levels (typically 88-92%). Over-oxygenating these patients can suppress
their respiratory drive.
6. A patient is undergoing general anesthesia and suddenly develops muscle
rigidity, a rapidly rising temperature, and tachycardia. Which medication should
the nurse expect to be administered?
A. Dantrolene
B. Naloxone
C. Atropine
D. Flumazenil
Answer: A
Rationale: These are classic signs of malignant hyperthermia, a life-threatening
complication of general anesthesia. Dantrolene is the skeletal muscle relaxant used
specifically to treat this condition.
(Week 12) 2026 |WCU
1. A nurse is caring for a patient who is 24 hours postoperative following a
cholecystectomy. The patient reports sudden shortness of breath and chest
pain. Which of the following should be the nurse’s priority action?
A. Administer the prescribed analgesic for pain
B. Notify the surgeon of the pain level
C. Encourage the use of the incentive spirometer
D. Perform a focused respiratory assessment and check oxygen saturation
Answer: D
Rationale: Sudden shortness of breath and chest pain in a postoperative patient are
clinical indicators of a pulmonary embolism. The nurse’s first action should be to assess the
patient’s respiratory status and oxygenation level before intervening or notifying the
provider.
2. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range (22-26), this represents
uncompensated respiratory acidosis.
,3. A nurse is assessing a patient with a potassium level of 2.8 mEq/L. Which of
the following electrocardiogram (ECG) changes should the nurse expect to
observe?
A. Tall, peaked T waves
B. Widened QRS complex
C. ST-segment depression and prominent U waves
D. Shortened PR interval
Answer: C
Rationale: Hypokalemia (low potassium) is associated with ST-segment depression,
flattened T waves, and the appearance of U waves. Tall, peaked T waves are seen in
hyperkalemia.
4. During a preoperative assessment, a patient reveals they have been taking
ginkgo biloba regularly. Why is this information critical for the surgical team?
A. It can increase the risk of postoperative bleeding
B. It may cause profound sedation when combined with anesthesia
C. It may lead to severe electrolyte imbalances
D. It can cause acute hypertensive crisis during induction
Answer: A
Rationale: Ginkgo biloba has antiplatelet properties and can increase the risk of bleeding
during and after surgery. It should typically be discontinued at least 1-2 weeks before an
elective procedure.
, 5. A nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min via nasal cannula. The patient’s SpO2
is 89%. Which of the following actions is most appropriate?
A. Increase the oxygen flow to 6 L/min immediately
B. Switch the patient to a non-rebreather mask
C. Continue to monitor as this is an expected range for a COPD patient
D. Prepare for emergency intubation
Answer: C
Rationale: Patients with COPD often have a ‘hypoxic drive’ and maintain lower baseline
oxygen saturation levels (typically 88-92%). Over-oxygenating these patients can suppress
their respiratory drive.
6. A patient is undergoing general anesthesia and suddenly develops muscle
rigidity, a rapidly rising temperature, and tachycardia. Which medication should
the nurse expect to be administered?
A. Dantrolene
B. Naloxone
C. Atropine
D. Flumazenil
Answer: A
Rationale: These are classic signs of malignant hyperthermia, a life-threatening
complication of general anesthesia. Dantrolene is the skeletal muscle relaxant used
specifically to treat this condition.
