NURS 121L-A Medical-Surgical Nursing Module Exam 2 (Week 6) 2026
|WCU
1. A patient in the PACU exhibits tachycardia, muscle rigidity, and a rapidly
rising body temperature of 105°F. Which immediate intervention should the
nurse anticipate?
A. Application of a cooling blanket and iced saline gastric lavage
B. Administration of intravenous dantrolene sodium
C. Administration of intravenous naloxone to reverse opioid sedation
D. Immediate intubation and administration of intravenous succinylcholine
Answer: B
Rationale: The symptoms describe Malignant Hyperthermia, a life-threatening
complication of general anesthesia. Dantrolene sodium is the specific skeletal muscle
relaxant used to treat this metabolic crisis.
2. Which arterial blood gas (ABG) result would the nurse expect for a patient
with chronic obstructive pulmonary disease (COPD) experiencing acute
respiratory failure?
A. pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.28, PaCO2 55 mmHg, HCO3 28 mEq/L
C. pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L
D. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
Answer: B
Rationale: COPD patients typically exhibit respiratory acidosis due to CO2 retention. A pH
below 7.35 and PaCO2 above 45 mmHg with a slightly elevated HCO3 (compensatory) is
characteristic.
,3. A patient presents with a serum potassium level of 6.5 mEq/L. Which
electrocardiogram (ECG) change is the nurse most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Presence of a U wave
D. Prolonged QT interval
Answer: A
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) causes peaked T waves, widened QRS
complexes, and potentially cardiac arrest. U waves are associated with hypokalemia.
4. Before a surgical procedure, the nurse witnesses the patient signing the
informed consent form. What is the nurse’s primary responsibility in this
process?
A. Confirming the patient has been informed and that the signature is authentic
B. Explaining the risks and benefits of the surgical procedure to the patient
C. Choosing the alternative treatment options if the patient refuses surgery
D. Ensuring the surgeon has documented the patient’s medical history accurately
Answer: A
Rationale: The nurse’s role is to witness the signature and verify that the patient is
competent and signed voluntarily. The surgeon is responsible for explaining the procedure
and its risks.
5. On the second postoperative day, a patient’s abdominal wound eviscerates.
What is the nurse’s priority action?
A. Call the surgeon to request an order for an immediate dose of antibiotics
B. Push the protruding organs gently back into the abdominal cavity
C. Place the patient in a High-Fowler’s position to ease breathing
D. Apply a sterile dressing moistened with sterile normal saline
Answer: D
, Rationale: Evisceration is a medical emergency. The nurse must cover the exposed organs
with sterile, saline-soaked dressings to prevent tissue necrosis and infection, then notify
the surgeon immediately.
6. A patient with a history of alcohol abuse presents with hypocalcemia. Which
clinical sign should the nurse assess for?
A. Negative Babinski reflex
B. Positive Chvostek’s sign
C. Hyporeflexia and muscle weakness
D. Bradycardia and hypertension
Answer: B
Rationale: Hypocalcemia causes neuromuscular irritability. Chvostek’s sign (facial
twitching when tapping the facial nerve) and Trousseau’s sign (carpal spasm with BP cuff
inflation) are classic indicators.
7. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory value is most consistent with this diagnosis?
A. Hematocrit of 55%
B. Serum osmolality of 310 mOsm/kg
C. Urine specific gravity of 1.002
D. Serum sodium of 128 mEq/L
Answer: D
Rationale: SIADH leads to excessive water retention, resulting in dilutional hyponatremia
(sodium < 135 mEq/L) and low serum osmolality.
|WCU
1. A patient in the PACU exhibits tachycardia, muscle rigidity, and a rapidly
rising body temperature of 105°F. Which immediate intervention should the
nurse anticipate?
A. Application of a cooling blanket and iced saline gastric lavage
B. Administration of intravenous dantrolene sodium
C. Administration of intravenous naloxone to reverse opioid sedation
D. Immediate intubation and administration of intravenous succinylcholine
Answer: B
Rationale: The symptoms describe Malignant Hyperthermia, a life-threatening
complication of general anesthesia. Dantrolene sodium is the specific skeletal muscle
relaxant used to treat this metabolic crisis.
2. Which arterial blood gas (ABG) result would the nurse expect for a patient
with chronic obstructive pulmonary disease (COPD) experiencing acute
respiratory failure?
A. pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.28, PaCO2 55 mmHg, HCO3 28 mEq/L
C. pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L
D. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
Answer: B
Rationale: COPD patients typically exhibit respiratory acidosis due to CO2 retention. A pH
below 7.35 and PaCO2 above 45 mmHg with a slightly elevated HCO3 (compensatory) is
characteristic.
,3. A patient presents with a serum potassium level of 6.5 mEq/L. Which
electrocardiogram (ECG) change is the nurse most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Presence of a U wave
D. Prolonged QT interval
Answer: A
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) causes peaked T waves, widened QRS
complexes, and potentially cardiac arrest. U waves are associated with hypokalemia.
4. Before a surgical procedure, the nurse witnesses the patient signing the
informed consent form. What is the nurse’s primary responsibility in this
process?
A. Confirming the patient has been informed and that the signature is authentic
B. Explaining the risks and benefits of the surgical procedure to the patient
C. Choosing the alternative treatment options if the patient refuses surgery
D. Ensuring the surgeon has documented the patient’s medical history accurately
Answer: A
Rationale: The nurse’s role is to witness the signature and verify that the patient is
competent and signed voluntarily. The surgeon is responsible for explaining the procedure
and its risks.
5. On the second postoperative day, a patient’s abdominal wound eviscerates.
What is the nurse’s priority action?
A. Call the surgeon to request an order for an immediate dose of antibiotics
B. Push the protruding organs gently back into the abdominal cavity
C. Place the patient in a High-Fowler’s position to ease breathing
D. Apply a sterile dressing moistened with sterile normal saline
Answer: D
, Rationale: Evisceration is a medical emergency. The nurse must cover the exposed organs
with sterile, saline-soaked dressings to prevent tissue necrosis and infection, then notify
the surgeon immediately.
6. A patient with a history of alcohol abuse presents with hypocalcemia. Which
clinical sign should the nurse assess for?
A. Negative Babinski reflex
B. Positive Chvostek’s sign
C. Hyporeflexia and muscle weakness
D. Bradycardia and hypertension
Answer: B
Rationale: Hypocalcemia causes neuromuscular irritability. Chvostek’s sign (facial
twitching when tapping the facial nerve) and Trousseau’s sign (carpal spasm with BP cuff
inflation) are classic indicators.
7. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory value is most consistent with this diagnosis?
A. Hematocrit of 55%
B. Serum osmolality of 310 mOsm/kg
C. Urine specific gravity of 1.002
D. Serum sodium of 128 mEq/L
Answer: D
Rationale: SIADH leads to excessive water retention, resulting in dilutional hyponatremia
(sodium < 135 mEq/L) and low serum osmolality.
