NURS 121L-A Medical-Surgical Nursing Practicum Exam 2 Study Guide
2026 |WCU
1. A patient’s arterial blood gas (ABG) results show: pH 7.31, PaCO2 52 mmHg,
and HCO3 25 mEq/L. Which interpretation is correct?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory), indicating
respiratory acidosis. The HCO3 is within normal range, suggesting no compensation.
2. When assessing a patient with left-sided heart failure, which clinical
manifestation should the nurse expect to find?
A. Jugular venous distention
B. Splenomegaly
C. Peripheral edema
D. Crackles in lung bases
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary system,
leading to pulmonary congestion and crackles. The other options are signs of right-sided
heart failure.
,3. A nurse is caring for a patient who is 12 hours post-operative after a total hip
arthroplasty. Which intervention is a priority to prevent dislocation?
A. Maintain the leg in an adducted position
B. Flex the hip more than 90 degrees when sitting
C. Allow the patient to cross their legs for comfort
D. Keep the affected leg in an abducted position
Answer: D
Rationale: Abduction is necessary to keep the prosthetic ball in the socket and prevent
dislocation. Adduction and flexion beyond 90 degrees increase the risk of dislocation.
4. A patient with Type 1 Diabetes is found unconscious with a blood glucose of
42 mg/dL. The nurse should administer which medication immediately?
A. Subcutaneous Insulin Glargine
B. Intravenous Glucagon or 50% Dextrose
C. Oral orange juice with sugar
D. Intravenous Normal Saline bolus
Answer: B
Rationale: For an unconscious patient with severe hypoglycemia, IV Dextrose or Glucagon
is the standard emergency treatment to rapidly increase blood glucose levels.
5. Which assessment finding in a patient with a long bone fracture would most
likely indicate a fat embolism syndrome?
A. Nausea and vomiting
B. Petechiae on the chest and axilla
C. Hypotension and bradycardia
D. Increased urinary output
Answer: B
, Rationale: Petechiae on the upper body and chest are a classic, late-stage sign of fat
embolism syndrome following long bone fractures, distinguishing it from a pulmonary
embolism.
6. The nurse is monitoring a patient receiving a blood transfusion. Within the
first 15 minutes, the patient reports back pain and dyspnea. What is the priority
action?
A. Slow the infusion rate
B. Notify the physician immediately
C. Administer diphenhydramine
D. Stop the transfusion and disconnect the tubing
Answer: D
Rationale: These symptoms suggest a hemolytic reaction. The nurse must stop the
transfusion immediately to prevent further exposure to the incompatible blood.
7. A patient is diagnosed with Graves’ disease. Which clinical finding should the
nurse anticipate?
A. Bradycardia and weight gain
B. Constipation and dry skin
C. Cold intolerance and lethargy
D. Exophthalmos and tachycardia
Answer: D
Rationale: Graves’ disease is a form of hyperthyroidism characterized by increased
metabolic rate, resulting in tachycardia and heat intolerance, alongside exophthalmos
(bulging eyes).
2026 |WCU
1. A patient’s arterial blood gas (ABG) results show: pH 7.31, PaCO2 52 mmHg,
and HCO3 25 mEq/L. Which interpretation is correct?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory), indicating
respiratory acidosis. The HCO3 is within normal range, suggesting no compensation.
2. When assessing a patient with left-sided heart failure, which clinical
manifestation should the nurse expect to find?
A. Jugular venous distention
B. Splenomegaly
C. Peripheral edema
D. Crackles in lung bases
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary system,
leading to pulmonary congestion and crackles. The other options are signs of right-sided
heart failure.
,3. A nurse is caring for a patient who is 12 hours post-operative after a total hip
arthroplasty. Which intervention is a priority to prevent dislocation?
A. Maintain the leg in an adducted position
B. Flex the hip more than 90 degrees when sitting
C. Allow the patient to cross their legs for comfort
D. Keep the affected leg in an abducted position
Answer: D
Rationale: Abduction is necessary to keep the prosthetic ball in the socket and prevent
dislocation. Adduction and flexion beyond 90 degrees increase the risk of dislocation.
4. A patient with Type 1 Diabetes is found unconscious with a blood glucose of
42 mg/dL. The nurse should administer which medication immediately?
A. Subcutaneous Insulin Glargine
B. Intravenous Glucagon or 50% Dextrose
C. Oral orange juice with sugar
D. Intravenous Normal Saline bolus
Answer: B
Rationale: For an unconscious patient with severe hypoglycemia, IV Dextrose or Glucagon
is the standard emergency treatment to rapidly increase blood glucose levels.
5. Which assessment finding in a patient with a long bone fracture would most
likely indicate a fat embolism syndrome?
A. Nausea and vomiting
B. Petechiae on the chest and axilla
C. Hypotension and bradycardia
D. Increased urinary output
Answer: B
, Rationale: Petechiae on the upper body and chest are a classic, late-stage sign of fat
embolism syndrome following long bone fractures, distinguishing it from a pulmonary
embolism.
6. The nurse is monitoring a patient receiving a blood transfusion. Within the
first 15 minutes, the patient reports back pain and dyspnea. What is the priority
action?
A. Slow the infusion rate
B. Notify the physician immediately
C. Administer diphenhydramine
D. Stop the transfusion and disconnect the tubing
Answer: D
Rationale: These symptoms suggest a hemolytic reaction. The nurse must stop the
transfusion immediately to prevent further exposure to the incompatible blood.
7. A patient is diagnosed with Graves’ disease. Which clinical finding should the
nurse anticipate?
A. Bradycardia and weight gain
B. Constipation and dry skin
C. Cold intolerance and lethargy
D. Exophthalmos and tachycardia
Answer: D
Rationale: Graves’ disease is a form of hyperthyroidism characterized by increased
metabolic rate, resulting in tachycardia and heat intolerance, alongside exophthalmos
(bulging eyes).
