NURS 120: Introduction to Medical-Surgical Nursing - Comprehensive
Assessment 2026 |WCU
1. A patient has been smoking for 20 years, leading to the replacement of
normal ciliated columnar epithelial cells in the bronchi with stratified squamous
epithelial cells. This cellular adaptation is known as:
A. Hyperplasia
B. Dysplasia
C. Metaplasia
D. Atrophy
Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type, often due to chronic irritation.
2. Which clinical manifestation should the nurse prioritize when assessing a
patient with a potassium level of 6.2 mEq/L?
A. Tall, peaked T waves on the ECG
B. Increased bowel sounds and diarrhea
C. Hyperactive deep tendon reflexes
D. Muscle weakness in the lower extremities
Answer: A
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) can cause life-threatening cardiac
dysrhythmias, characterized by tall peaked T waves and widened QRS complexes.
,3. An elderly patient is admitted with dehydration. Which physiological change
associated with aging contributes to this risk?
A. Decreased glomerular filtration rate
B. Increased total body water percentage
C. Increased thirst sensation
D. Decreased production of antidiuretic hormone
Answer: A
Rationale: Aging reduces the kidney’s ability to concentrate urine and decreases GFR,
making the elderly more susceptible to fluid imbalances.
4. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 55 mmHg, and
HCO3- 24 mEq/L. What is the correct interpretation?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a high PaCO2 indicates the cause is
respiratory.
5. Which type of hypersensitivity reaction is characterized by an IgE-mediated
response to an allergen, such as in anaphylaxis?
A. Type II
B. Type I
C. Type III
D. Type IV
Answer: B
Rationale: Type I hypersensitivity is immediate and IgE-mediated, leading to mast cell
degranulation.
, 6. During the vascular phase of inflammation, what is the primary purpose of
increased capillary permeability?
A. To reduce the movement of leukocytes to the injury site
B. To allow protein-rich fluid (exudate) to move into the interstitial space
C. To cause vasoconstriction and limit blood loss
D. To decrease the oncotic pressure within the tissues
Answer: B
Rationale: Increased permeability allows leukocytes and plasma proteins to reach the site
of injury to begin the healing process.
7. A patient presents with positive Chvostek’s and Trousseau’s signs. Which
electrolyte imbalance does the nurse suspect?
A. Hypermagnesemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to tetany,
Trousseau’s sign, and Chvostek’s sign.
8. Which of the following is an example of naturally acquired passive immunity?
A. Injection of a tetanus toxoid vaccine
B. Recovery from a case of the measles
C. Antibodies passed from mother to fetus via the placenta
D. Administration of intravenous immunoglobulin (IVIG)
Answer: C
Rationale: Naturally acquired passive immunity occurs when antibodies are transferred
from one person to another naturally, such as through the placenta or breast milk.
Assessment 2026 |WCU
1. A patient has been smoking for 20 years, leading to the replacement of
normal ciliated columnar epithelial cells in the bronchi with stratified squamous
epithelial cells. This cellular adaptation is known as:
A. Hyperplasia
B. Dysplasia
C. Metaplasia
D. Atrophy
Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type, often due to chronic irritation.
2. Which clinical manifestation should the nurse prioritize when assessing a
patient with a potassium level of 6.2 mEq/L?
A. Tall, peaked T waves on the ECG
B. Increased bowel sounds and diarrhea
C. Hyperactive deep tendon reflexes
D. Muscle weakness in the lower extremities
Answer: A
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) can cause life-threatening cardiac
dysrhythmias, characterized by tall peaked T waves and widened QRS complexes.
,3. An elderly patient is admitted with dehydration. Which physiological change
associated with aging contributes to this risk?
A. Decreased glomerular filtration rate
B. Increased total body water percentage
C. Increased thirst sensation
D. Decreased production of antidiuretic hormone
Answer: A
Rationale: Aging reduces the kidney’s ability to concentrate urine and decreases GFR,
making the elderly more susceptible to fluid imbalances.
4. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 55 mmHg, and
HCO3- 24 mEq/L. What is the correct interpretation?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a high PaCO2 indicates the cause is
respiratory.
5. Which type of hypersensitivity reaction is characterized by an IgE-mediated
response to an allergen, such as in anaphylaxis?
A. Type II
B. Type I
C. Type III
D. Type IV
Answer: B
Rationale: Type I hypersensitivity is immediate and IgE-mediated, leading to mast cell
degranulation.
, 6. During the vascular phase of inflammation, what is the primary purpose of
increased capillary permeability?
A. To reduce the movement of leukocytes to the injury site
B. To allow protein-rich fluid (exudate) to move into the interstitial space
C. To cause vasoconstriction and limit blood loss
D. To decrease the oncotic pressure within the tissues
Answer: B
Rationale: Increased permeability allows leukocytes and plasma proteins to reach the site
of injury to begin the healing process.
7. A patient presents with positive Chvostek’s and Trousseau’s signs. Which
electrolyte imbalance does the nurse suspect?
A. Hypermagnesemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to tetany,
Trousseau’s sign, and Chvostek’s sign.
8. Which of the following is an example of naturally acquired passive immunity?
A. Injection of a tetanus toxoid vaccine
B. Recovery from a case of the measles
C. Antibodies passed from mother to fetus via the placenta
D. Administration of intravenous immunoglobulin (IVIG)
Answer: C
Rationale: Naturally acquired passive immunity occurs when antibodies are transferred
from one person to another naturally, such as through the placenta or breast milk.
