NURS 121L-A Medical-Surgical Nursing Practicum | Actual Exam 1
Questions and Answers 2026 |WCU
1. A patient is undergoing general anesthesia for an emergency laparotomy.
Which clinical manifestation would most likely indicate the onset of Malignant
Hyperthermia (MH)?
A. Significant drop in core body temperature
B. Muscle rigidity and unexplained tachycardia
C. Generalized seizure activity
D. Sudden decrease in end-tidal carbon dioxide
Answer: B
Rationale: Muscle rigidity (specifically masseter muscle rigidity) and tachycardia are the
earliest signs of Malignant Hyperthermia, caused by a hypermetabolic state. Fever is a late
sign.
2. The nurse is caring for a patient with a serum potassium level of 6.2 mEq/L.
Which electrocardiogram (ECG) change is most characteristic of this electrolyte
imbalance?
A. Tall, peaked T-waves
B. ST-segment depression
C. Presence of U-waves
D. Prolonged QT interval
Answer: A
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) causes peaked T-waves, widened QRS
complexes, and eventually cardiac arrest.
,3. A postoperative patient has developed a wound evisceration. What is the
priority nursing action?
A. Call the surgeon to report the incident
B. Apply a dry sterile dressing to the wound
C. Instruct the patient to perform a Valsalva maneuver
D. Cover the protruding organ with sterile saline-soaked gauze
Answer: D
Rationale: Evisceration is an emergency. The priority is to protect the protruding organs
from drying and infection using sterile, moist dressings before notifying the surgical team.
4. Which arterial blood gas (ABG) result would a nurse expect in a patient who
has been vomiting for the past 24 hours?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.50, PaCO2 25, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 40, HCO3 30
Answer: D
Rationale: Vomiting leads to loss of gastric acid (HCl), causing metabolic alkalosis
(increased pH and increased bicarbonate).
5. A patient with AIDS is admitted with a CD4+ T-cell count of 150 cells/mm3.
The nurse should categorize this as which stage of HIV infection according to the
CDC?
A. Stage 1 (Acute Infection)
B. Stage 2 (Chronic Infection)
C. Stage 3 (AIDS)
D. Stage 4 (Unknown)
Answer: C
, Rationale: A CD4+ count of less than 200 cells/mm3 is the clinical definition for Stage 3
HIV, also known as AIDS.
6. What is the primary goal of palliative care for a patient with stage IV lung
cancer?
A. Achieve complete remission of the tumor
B. Limit medical interventions to only those that are life-sustaining
C. Provide symptomatic relief and improve quality of life
D. Assist the patient in transitioning to hospice within 6 months
Answer: C
Rationale: Palliative care focuses on symptom management and quality of life at any stage
of a serious illness, unlike curative care.
7. A nurse is assessing a patient for hypocalcemia. Which technique should the
nurse use to elicit Trousseau’s sign?
A. Tap the facial nerve in front of the ear
B. Inflate a blood pressure cuff above the systolic pressure for 3 minutes
C. Percuss the abdomen for dullness
D. Apply pressure to the calf to check for pain
Answer: B
Rationale: Trousseau’s sign is elicited by inflating a BP cuff on the upper arm; a positive
result is carpal spasm. Tapping the facial nerve is Chvostek’s sign.
8. A preoperative patient reports an allergy to bananas and avocados. Which
action is most important for the nurse to take?
A. Document the food allergy and continue normal prep
B. Ask the patient if they are allergic to shellfish
C. Administer an antihistamine before surgery
D. Alert the surgical team of a possible latex allergy
Answer: D
Questions and Answers 2026 |WCU
1. A patient is undergoing general anesthesia for an emergency laparotomy.
Which clinical manifestation would most likely indicate the onset of Malignant
Hyperthermia (MH)?
A. Significant drop in core body temperature
B. Muscle rigidity and unexplained tachycardia
C. Generalized seizure activity
D. Sudden decrease in end-tidal carbon dioxide
Answer: B
Rationale: Muscle rigidity (specifically masseter muscle rigidity) and tachycardia are the
earliest signs of Malignant Hyperthermia, caused by a hypermetabolic state. Fever is a late
sign.
2. The nurse is caring for a patient with a serum potassium level of 6.2 mEq/L.
Which electrocardiogram (ECG) change is most characteristic of this electrolyte
imbalance?
A. Tall, peaked T-waves
B. ST-segment depression
C. Presence of U-waves
D. Prolonged QT interval
Answer: A
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) causes peaked T-waves, widened QRS
complexes, and eventually cardiac arrest.
,3. A postoperative patient has developed a wound evisceration. What is the
priority nursing action?
A. Call the surgeon to report the incident
B. Apply a dry sterile dressing to the wound
C. Instruct the patient to perform a Valsalva maneuver
D. Cover the protruding organ with sterile saline-soaked gauze
Answer: D
Rationale: Evisceration is an emergency. The priority is to protect the protruding organs
from drying and infection using sterile, moist dressings before notifying the surgical team.
4. Which arterial blood gas (ABG) result would a nurse expect in a patient who
has been vomiting for the past 24 hours?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.50, PaCO2 25, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 40, HCO3 30
Answer: D
Rationale: Vomiting leads to loss of gastric acid (HCl), causing metabolic alkalosis
(increased pH and increased bicarbonate).
5. A patient with AIDS is admitted with a CD4+ T-cell count of 150 cells/mm3.
The nurse should categorize this as which stage of HIV infection according to the
CDC?
A. Stage 1 (Acute Infection)
B. Stage 2 (Chronic Infection)
C. Stage 3 (AIDS)
D. Stage 4 (Unknown)
Answer: C
, Rationale: A CD4+ count of less than 200 cells/mm3 is the clinical definition for Stage 3
HIV, also known as AIDS.
6. What is the primary goal of palliative care for a patient with stage IV lung
cancer?
A. Achieve complete remission of the tumor
B. Limit medical interventions to only those that are life-sustaining
C. Provide symptomatic relief and improve quality of life
D. Assist the patient in transitioning to hospice within 6 months
Answer: C
Rationale: Palliative care focuses on symptom management and quality of life at any stage
of a serious illness, unlike curative care.
7. A nurse is assessing a patient for hypocalcemia. Which technique should the
nurse use to elicit Trousseau’s sign?
A. Tap the facial nerve in front of the ear
B. Inflate a blood pressure cuff above the systolic pressure for 3 minutes
C. Percuss the abdomen for dullness
D. Apply pressure to the calf to check for pain
Answer: B
Rationale: Trousseau’s sign is elicited by inflating a BP cuff on the upper arm; a positive
result is carpal spasm. Tapping the facial nerve is Chvostek’s sign.
8. A preoperative patient reports an allergy to bananas and avocados. Which
action is most important for the nurse to take?
A. Document the food allergy and continue normal prep
B. Ask the patient if they are allergic to shellfish
C. Administer an antihistamine before surgery
D. Alert the surgical team of a possible latex allergy
Answer: D
