NURS 120: Introduction to Medical-Surgical Nursing - Module Exam 1
(Week 3) 2026 |WCU
1. A patient is admitted with a serum sodium level of 118 mEq/L. Which nursing
intervention is the highest priority?
A. Encourage increased oral fluid intake
B. Implement seizure precautions
C. Administer hypotonic intravenous fluids
D. Monitor for signs of hyperkalemia
Answer: B
Rationale: Severe hyponatremia (below 120 mEq/L) places the patient at high risk for
cerebral edema, seizures, and coma. Seizure precautions are a safety priority.
2. Which clinical manifestation is most characteristic of hypocalcemia?
A. Positive Chvostek’s sign
B. Diminished deep tendon reflexes
C. Shortened QT interval on EKG
D. Constipation and muscle weakness
Answer: A
Rationale: A positive Chvostek’s sign (facial twitching when the facial nerve is tapped)
indicates neuromuscular excitability caused by low calcium levels.
,3. A patient’s ABG results are: pH 7.28, PaCO2 52 mmHg, HCO3 24 mEq/L. How
should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high (>45)
indicating a respiratory cause. The HCO3 is normal, meaning there is no compensation yet.
4. During the intraoperative period, a patient develops muscle rigidity,
tachycardia, and a rapidly rising body temperature. Which medication should
the nurse anticipate administering?
A. Dantrolene sodium
B. Naloxone
C. Atropine sulfate
D. Succinylcholine
Answer: A
Rationale: These are signs of Malignant Hyperthermia, a surgical emergency. Dantrolene is
the specific muscle relaxant used to treat this condition.
5. A patient with a potassium level of 6.2 mEq/L is admitted. What EKG change
is most likely to be observed?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged QT interval
Answer: A
, Rationale: Hyperkalemia classically causes tall, peaked T waves. If left untreated, it can
lead to widened QRS complexes and cardiac arrest.
6. Which IV fluid is considered isotonic and commonly used for fluid
resuscitation in hypovolemic shock?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. 3% Normal Saline
D. 10% Dextrose in Water
Answer: A
Rationale: 0.9% Normal Saline (NS) is an isotonic crystalloid that stays in the intravascular
space, making it ideal for volume expansion.
7. A nurse is providing discharge teaching for a patient with a Patient-Controlled
Analgesia (PCA) pump. Which statement by the patient indicates a need for
further teaching?
A. I should push the button when I feel pain starting.
B. My family can push the button for me if I am too tired.
C. I cannot overdose because the machine has a limit.
D. I will still be monitored frequently for my breathing.
Answer: B
Rationale: Only the patient should push the PCA button (PCA by proxy is dangerous).
Family members pushing the button can lead to over-sedation and respiratory depression.
8. Which patient is at the highest risk for developing respiratory acidosis?
A. A patient with excessive vomiting
B. A patient with Chronic Obstructive Pulmonary Disease (COPD)
C. A patient having a severe panic attack
D. A patient with uncontrolled Type 1 Diabetes
Answer: B
(Week 3) 2026 |WCU
1. A patient is admitted with a serum sodium level of 118 mEq/L. Which nursing
intervention is the highest priority?
A. Encourage increased oral fluid intake
B. Implement seizure precautions
C. Administer hypotonic intravenous fluids
D. Monitor for signs of hyperkalemia
Answer: B
Rationale: Severe hyponatremia (below 120 mEq/L) places the patient at high risk for
cerebral edema, seizures, and coma. Seizure precautions are a safety priority.
2. Which clinical manifestation is most characteristic of hypocalcemia?
A. Positive Chvostek’s sign
B. Diminished deep tendon reflexes
C. Shortened QT interval on EKG
D. Constipation and muscle weakness
Answer: A
Rationale: A positive Chvostek’s sign (facial twitching when the facial nerve is tapped)
indicates neuromuscular excitability caused by low calcium levels.
,3. A patient’s ABG results are: pH 7.28, PaCO2 52 mmHg, HCO3 24 mEq/L. How
should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high (>45)
indicating a respiratory cause. The HCO3 is normal, meaning there is no compensation yet.
4. During the intraoperative period, a patient develops muscle rigidity,
tachycardia, and a rapidly rising body temperature. Which medication should
the nurse anticipate administering?
A. Dantrolene sodium
B. Naloxone
C. Atropine sulfate
D. Succinylcholine
Answer: A
Rationale: These are signs of Malignant Hyperthermia, a surgical emergency. Dantrolene is
the specific muscle relaxant used to treat this condition.
5. A patient with a potassium level of 6.2 mEq/L is admitted. What EKG change
is most likely to be observed?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged QT interval
Answer: A
, Rationale: Hyperkalemia classically causes tall, peaked T waves. If left untreated, it can
lead to widened QRS complexes and cardiac arrest.
6. Which IV fluid is considered isotonic and commonly used for fluid
resuscitation in hypovolemic shock?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. 3% Normal Saline
D. 10% Dextrose in Water
Answer: A
Rationale: 0.9% Normal Saline (NS) is an isotonic crystalloid that stays in the intravascular
space, making it ideal for volume expansion.
7. A nurse is providing discharge teaching for a patient with a Patient-Controlled
Analgesia (PCA) pump. Which statement by the patient indicates a need for
further teaching?
A. I should push the button when I feel pain starting.
B. My family can push the button for me if I am too tired.
C. I cannot overdose because the machine has a limit.
D. I will still be monitored frequently for my breathing.
Answer: B
Rationale: Only the patient should push the PCA button (PCA by proxy is dangerous).
Family members pushing the button can lead to over-sedation and respiratory depression.
8. Which patient is at the highest risk for developing respiratory acidosis?
A. A patient with excessive vomiting
B. A patient with Chronic Obstructive Pulmonary Disease (COPD)
C. A patient having a severe panic attack
D. A patient with uncontrolled Type 1 Diabetes
Answer: B
