NURS 120 Medical-Surgical Nursing Week 6 Comprehensive Quiz 2026
|WCU
1. A patient with a history of chronic renal failure presents with a potassium
level of 6.8 mEq/L. Which ECG change should the nurse prioritize for immediate
intervention?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. ST segment depression
Answer: B
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) causes peaked T waves, widened QRS
complexes, and potentially cardiac arrest. U waves are seen in hypokalemia.
2. Which arterial blood gas (ABG) result is most indicative of partially
compensated metabolic acidosis?
A. pH 7.25, PaCO2 50 mmHg, HCO3 26 mEq/L
B. pH 7.36, PaCO2 45 mmHg, HCO3 24 mEq/L
C. pH 7.48, PaCO2 48 mmHg, HCO3 30 mEq/L
D. pH 7.32, PaCO2 30 mmHg, HCO3 18 mEq/L
Answer: D
Rationale: In metabolic acidosis, pH is low (< 7.35) and HCO3 is low (< 22). Partial
compensation is evident when PaCO2 decreases (< 35) to increase pH, but pH remains
abnormal.
,3. During the intraoperative phase, a patient develops tachycardia, muscle
rigidity, and a rapidly rising temperature. What is the priority nursing action?
A. Administer Dantrolene sodium as ordered
B. Apply cooling blankets immediately
C. Increase the flow of anesthetic gases
D. Obtain an arterial blood gas sample
Answer: A
Rationale: These are classic signs of Malignant Hyperthermia. Dantrolene sodium is the
specific skeletal muscle relaxant required to treat this life-threatening condition.
4. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory value should the nurse expect?
A. Hematocrit 55%
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 128 mEq/L
Answer: D
Rationale: SIADH involves excessive ADH, causing water retention and dilutional
hyponatremia. Serum sodium would be low, and urine would be highly concentrated.
5. When assessing a patient for Trousseau’s sign, the nurse observes carpal
spasm after inflating a blood pressure cuff. This indicates which electrolyte
imbalance?
A. Hypermagnesemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: D
, Rationale: Trousseau’s sign and Chvostek’s sign are clinical indicators of neuromuscular
irritability associated with hypocalcemia.
6. A postoperative patient has a sudden onset of shortness of breath and chest
pain. The nurse suspects a pulmonary embolism. What is the first nursing
action?
A. Notify the rapid response team
B. Administer oxygen via nasal cannula
C. Auscultate lung sounds
D. Prepare for a V/Q scan
Answer: B
Rationale: Airway and breathing are priorities. Providing oxygen addresses the immediate
threat of hypoxia while secondary actions like notification and diagnostics follow.
7. A patient with prolonged vomiting is at risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: D
Rationale: Vomiting leads to the loss of gastric hydrochloric acid, resulting in an excess of
bicarbonate in the blood (metabolic alkalosis).
8. Which IV solution is considered hypertonic and requires cautious
administration to avoid fluid volume overload?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. 0.9% Sodium Chloride
D. Lactated Ringer’s
Answer: B
|WCU
1. A patient with a history of chronic renal failure presents with a potassium
level of 6.8 mEq/L. Which ECG change should the nurse prioritize for immediate
intervention?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. ST segment depression
Answer: B
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) causes peaked T waves, widened QRS
complexes, and potentially cardiac arrest. U waves are seen in hypokalemia.
2. Which arterial blood gas (ABG) result is most indicative of partially
compensated metabolic acidosis?
A. pH 7.25, PaCO2 50 mmHg, HCO3 26 mEq/L
B. pH 7.36, PaCO2 45 mmHg, HCO3 24 mEq/L
C. pH 7.48, PaCO2 48 mmHg, HCO3 30 mEq/L
D. pH 7.32, PaCO2 30 mmHg, HCO3 18 mEq/L
Answer: D
Rationale: In metabolic acidosis, pH is low (< 7.35) and HCO3 is low (< 22). Partial
compensation is evident when PaCO2 decreases (< 35) to increase pH, but pH remains
abnormal.
,3. During the intraoperative phase, a patient develops tachycardia, muscle
rigidity, and a rapidly rising temperature. What is the priority nursing action?
A. Administer Dantrolene sodium as ordered
B. Apply cooling blankets immediately
C. Increase the flow of anesthetic gases
D. Obtain an arterial blood gas sample
Answer: A
Rationale: These are classic signs of Malignant Hyperthermia. Dantrolene sodium is the
specific skeletal muscle relaxant required to treat this life-threatening condition.
4. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory value should the nurse expect?
A. Hematocrit 55%
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 128 mEq/L
Answer: D
Rationale: SIADH involves excessive ADH, causing water retention and dilutional
hyponatremia. Serum sodium would be low, and urine would be highly concentrated.
5. When assessing a patient for Trousseau’s sign, the nurse observes carpal
spasm after inflating a blood pressure cuff. This indicates which electrolyte
imbalance?
A. Hypermagnesemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: D
, Rationale: Trousseau’s sign and Chvostek’s sign are clinical indicators of neuromuscular
irritability associated with hypocalcemia.
6. A postoperative patient has a sudden onset of shortness of breath and chest
pain. The nurse suspects a pulmonary embolism. What is the first nursing
action?
A. Notify the rapid response team
B. Administer oxygen via nasal cannula
C. Auscultate lung sounds
D. Prepare for a V/Q scan
Answer: B
Rationale: Airway and breathing are priorities. Providing oxygen addresses the immediate
threat of hypoxia while secondary actions like notification and diagnostics follow.
7. A patient with prolonged vomiting is at risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: D
Rationale: Vomiting leads to the loss of gastric hydrochloric acid, resulting in an excess of
bicarbonate in the blood (metabolic alkalosis).
8. Which IV solution is considered hypertonic and requires cautious
administration to avoid fluid volume overload?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. 0.9% Sodium Chloride
D. Lactated Ringer’s
Answer: B
