NURS 121L-A | Medical-Surgical Nursing Practicum | Week 14
Comprehensive Quiz 2026 |WCU
1. A patient is admitted with septic shock. Which of the following clinical
findings indicates the transition from the compensatory stage to the progressive
stage of shock?
A. Narrow pulse pressure and increased heart rate
B. Cool, clammy skin and metabolic acidosis
C. Respiratory alkalosis with rapid breathing
D. Mean Arterial Pressure (MAP) less than 65 mmHg
Answer: D
Rationale: In the progressive stage of shock, compensatory mechanisms fail, and the MAP
drops below 65 mmHg, leading to organ dysfunction due to poor perfusion.
2. A client with acute respiratory distress syndrome (ARDS) is on a ventilator.
The nurse notices the Peak Inspiratory Pressure (PIP) is increasing. What is the
most likely cause?
A. Decreased lung compliance
B. A leak in the ventilator tubing
C. Spontaneous breathing by the patient
D. Endotracheal tube cuff deflation
Answer: A
Rationale: Increased PIP in ARDS usually indicates worsening lung compliance (stiff lungs)
or increased airway resistance, which is characteristic of the fibrotic phase of ARDS.
,3. A patient presents to the ED with a 40% Total Body Surface Area (TBSA) burn.
Using the Parkland Formula (4mL/kg/%TBSA), if the patient weighs 70kg, how
much fluid should be administered in the first 8 hours?
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 7,400 mL
Answer: A
Rationale: Total fluid = 4mL * 70kg * 40 = 11,200 mL. Half is given in the first 8 hours:
11, = 5,600 mL.
4. Which assessment finding is a hallmark sign of Neurogenic Shock following a
spinal cord injury at T4?
A. Tachycardia and hypertension
B. Bradycardia and hypotension
C. Hypotension and cool, pale extremities
D. Hyperreflexia and diaphoresis
Answer: B
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to massive
vasodilation (hypotension) and a loss of the compensatory tachycardic response
(bradycardia).
, 5. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L and ECG changes. Which medication should the nurse expect to
administer first to stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Regular Insulin and Dextrose 50%
C. Sodium Bicarbonate
D. Calcium Gluconate
Answer: D
Rationale: Calcium Gluconate does not lower potassium but it stabilizes the myocardial
cell membrane to prevent lethal arrhythmias in severe hyperkalemia.
6. A patient with increased intracranial pressure (ICP) is being treated with
Mannitol. Which monitoring parameter is most critical for this patient?
A. Bowel sounds
B. Daily weights
C. Serum osmolarity
D. Peripheral pulses
Answer: C
Rationale: Mannitol is an osmotic diuretic. Monitoring serum osmolarity (typically kept
<320 mOsm/L) is essential to prevent severe dehydration and electrolyte imbalances.
7. During a Mass Casualty Incident (MCI), a victim is found with a respiratory
rate of 34, a radial pulse of 120, and follows simple commands. Which color tag
should the triage nurse assign?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
Comprehensive Quiz 2026 |WCU
1. A patient is admitted with septic shock. Which of the following clinical
findings indicates the transition from the compensatory stage to the progressive
stage of shock?
A. Narrow pulse pressure and increased heart rate
B. Cool, clammy skin and metabolic acidosis
C. Respiratory alkalosis with rapid breathing
D. Mean Arterial Pressure (MAP) less than 65 mmHg
Answer: D
Rationale: In the progressive stage of shock, compensatory mechanisms fail, and the MAP
drops below 65 mmHg, leading to organ dysfunction due to poor perfusion.
2. A client with acute respiratory distress syndrome (ARDS) is on a ventilator.
The nurse notices the Peak Inspiratory Pressure (PIP) is increasing. What is the
most likely cause?
A. Decreased lung compliance
B. A leak in the ventilator tubing
C. Spontaneous breathing by the patient
D. Endotracheal tube cuff deflation
Answer: A
Rationale: Increased PIP in ARDS usually indicates worsening lung compliance (stiff lungs)
or increased airway resistance, which is characteristic of the fibrotic phase of ARDS.
,3. A patient presents to the ED with a 40% Total Body Surface Area (TBSA) burn.
Using the Parkland Formula (4mL/kg/%TBSA), if the patient weighs 70kg, how
much fluid should be administered in the first 8 hours?
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 7,400 mL
Answer: A
Rationale: Total fluid = 4mL * 70kg * 40 = 11,200 mL. Half is given in the first 8 hours:
11, = 5,600 mL.
4. Which assessment finding is a hallmark sign of Neurogenic Shock following a
spinal cord injury at T4?
A. Tachycardia and hypertension
B. Bradycardia and hypotension
C. Hypotension and cool, pale extremities
D. Hyperreflexia and diaphoresis
Answer: B
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to massive
vasodilation (hypotension) and a loss of the compensatory tachycardic response
(bradycardia).
, 5. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L and ECG changes. Which medication should the nurse expect to
administer first to stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Regular Insulin and Dextrose 50%
C. Sodium Bicarbonate
D. Calcium Gluconate
Answer: D
Rationale: Calcium Gluconate does not lower potassium but it stabilizes the myocardial
cell membrane to prevent lethal arrhythmias in severe hyperkalemia.
6. A patient with increased intracranial pressure (ICP) is being treated with
Mannitol. Which monitoring parameter is most critical for this patient?
A. Bowel sounds
B. Daily weights
C. Serum osmolarity
D. Peripheral pulses
Answer: C
Rationale: Mannitol is an osmotic diuretic. Monitoring serum osmolarity (typically kept
<320 mOsm/L) is essential to prevent severe dehydration and electrolyte imbalances.
7. During a Mass Casualty Incident (MCI), a victim is found with a respiratory
rate of 34, a radial pulse of 120, and follows simple commands. Which color tag
should the triage nurse assign?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
