NURS 120 | Introduction to Medical-Surgical Nursing | Module Exam 3
2026 |WCU
1. A patient is 12 hours postoperative following an abdominal cholecystectomy.
Which of the following findings should the nurse prioritize for immediate
intervention?
A. Bowel sounds are absent in all four quadrants
B. The patient has sudden onset shortness of breath and tachycardia
C. The patient reports a pain level of 6 on a 1-10 scale
D. Serosanguineous drainage on the surgical dressing
Answer: B
Rationale: Sudden onset of shortness of breath and tachycardia are classic signs of a
pulmonary embolism, a life-threatening postoperative complication that requires
immediate assessment and intervention.
2. A nurse is interpreting arterial blood gas (ABG) results: pH 7.28, PaCO2 55
mmHg, and HCO3 26 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic 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, this is uncompensated
respiratory acidosis.
,3. During the intraoperative phase, the circulating nurse notices a rise in the
patient’s end-tidal CO2 and a rapid increase in body temperature. What should
the nurse suspect?
A. Anaphylactic shock
B. Septicemia
C. Malignant hyperthermia
D. Hypovolemic shock
Answer: C
Rationale: Malignant hyperthermia is a rare, life-threatening reaction to volatile anesthetic
agents. Early signs include increased end-tidal CO2 and muscle rigidity, followed by
hyperpyrexia.
4. A patient with a potassium level of 2.8 mEq/L is admitted. Which of the
following cardiac manifestations should the nurse monitor for?
A. Peaked T waves
B. Presence of U waves
C. Shortened QT interval
D. Widened QRS complex
Answer: B
Rationale: Hypokalemia (low potassium) is associated with the presence of U waves, ST-
segment depression, and flattened T waves on an ECG.
5. A nurse is caring for a postoperative patient who has developed wound
evisceration. Which action should the nurse take first?
A. Cover the protruding organs with sterile gauze soaked in normal saline
B. Place the patient in a high-Fowler’s position
C. Notify the surgeon immediately
D. Apply a pressure dressing to the site
Answer: A
, Rationale: Wound evisceration is a medical emergency. The first priority is to protect the
organs from drying and infection by covering them with sterile, saline-soaked dressings.
6. Which electrolyte imbalance is most commonly associated with a positive
Chvostek’s sign?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) and
Trousseau’s sign are clinical indicators of hypocalcemia or hypomagnesemia.
7. A patient is prescribed 0.45% Sodium Chloride (1/2 NS). How should the nurse
classify this IV solution?
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Answer: B
Rationale: 0.45% Sodium Chloride is a hypotonic solution, meaning its osmolarity is lower
than that of plasma, causing fluid to move into the cells.
8. What is the primary purpose of the ‘Time-Out’ procedure in the operating
room?
A. To ensure the surgical equipment is sterile
B. To allow the surgeon to rest before starting
C. To confirm the correct patient, site, and procedure
D. To count the number of sponges used
Answer: C
2026 |WCU
1. A patient is 12 hours postoperative following an abdominal cholecystectomy.
Which of the following findings should the nurse prioritize for immediate
intervention?
A. Bowel sounds are absent in all four quadrants
B. The patient has sudden onset shortness of breath and tachycardia
C. The patient reports a pain level of 6 on a 1-10 scale
D. Serosanguineous drainage on the surgical dressing
Answer: B
Rationale: Sudden onset of shortness of breath and tachycardia are classic signs of a
pulmonary embolism, a life-threatening postoperative complication that requires
immediate assessment and intervention.
2. A nurse is interpreting arterial blood gas (ABG) results: pH 7.28, PaCO2 55
mmHg, and HCO3 26 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic 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, this is uncompensated
respiratory acidosis.
,3. During the intraoperative phase, the circulating nurse notices a rise in the
patient’s end-tidal CO2 and a rapid increase in body temperature. What should
the nurse suspect?
A. Anaphylactic shock
B. Septicemia
C. Malignant hyperthermia
D. Hypovolemic shock
Answer: C
Rationale: Malignant hyperthermia is a rare, life-threatening reaction to volatile anesthetic
agents. Early signs include increased end-tidal CO2 and muscle rigidity, followed by
hyperpyrexia.
4. A patient with a potassium level of 2.8 mEq/L is admitted. Which of the
following cardiac manifestations should the nurse monitor for?
A. Peaked T waves
B. Presence of U waves
C. Shortened QT interval
D. Widened QRS complex
Answer: B
Rationale: Hypokalemia (low potassium) is associated with the presence of U waves, ST-
segment depression, and flattened T waves on an ECG.
5. A nurse is caring for a postoperative patient who has developed wound
evisceration. Which action should the nurse take first?
A. Cover the protruding organs with sterile gauze soaked in normal saline
B. Place the patient in a high-Fowler’s position
C. Notify the surgeon immediately
D. Apply a pressure dressing to the site
Answer: A
, Rationale: Wound evisceration is a medical emergency. The first priority is to protect the
organs from drying and infection by covering them with sterile, saline-soaked dressings.
6. Which electrolyte imbalance is most commonly associated with a positive
Chvostek’s sign?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) and
Trousseau’s sign are clinical indicators of hypocalcemia or hypomagnesemia.
7. A patient is prescribed 0.45% Sodium Chloride (1/2 NS). How should the nurse
classify this IV solution?
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Answer: B
Rationale: 0.45% Sodium Chloride is a hypotonic solution, meaning its osmolarity is lower
than that of plasma, causing fluid to move into the cells.
8. What is the primary purpose of the ‘Time-Out’ procedure in the operating
room?
A. To ensure the surgical equipment is sterile
B. To allow the surgeon to rest before starting
C. To confirm the correct patient, site, and procedure
D. To count the number of sponges used
Answer: C
