NURS 121L-A | Medical-Surgical Nursing Practicum | Week 13 Quiz
2026 |WCU
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the
prone position. Which physiological outcome does the nurse anticipate?
A. Decreased work of breathing by relaxing the diaphragm
B. Facilitation of secretion clearance from the upper airways
C. Increased cardiac output by reducing thoracic pressure
D. Improved oxygenation by recruiting collapsed posterior alveoli
Answer: D
Rationale: Prone positioning in ARDS helps to improve oxygenation by redistributing
blood flow and recruiting alveoli in the posterior (dorsal) lung segments that are usually
compressed when the patient is supine.
2. A patient is being treated for Superior Vena Cava Syndrome (SVCS) related to
lung cancer. Which clinical manifestation should the nurse prioritize for
immediate intervention?
A. Periorbital edema and facial swelling
B. Distended neck veins while sitting upright
C. Stridor and difficulty breathing
D. Visible collateral veins on the chest wall
Answer: C
Rationale: While all are signs of SVCS, stridor indicates compression of the trachea, which
is an airway emergency and requires immediate intervention.
,3. A nurse is caring for a patient with Acute Kidney Injury (AKI) who has a serum
potassium of 6.8 mEq/L. Which medication order should the nurse implement
first?
A. Sodium polystyrene sulfonate orally
B. IV Calcium Gluconate
C. Furosemide IV bolus
D. IV regular insulin and 50% dextrose
Answer: B
Rationale: In severe hyperkalemia, IV Calcium Gluconate is administered first to stabilize
the myocardial cell membrane and prevent life-threatening arrhythmias, although it does
not lower the potassium itself.
4. A patient who underwent a thyroidectomy 12 hours ago presents with
tingling in the fingertips and a positive Chvostek’s sign. Which action is the
nurse’s priority?
A. Prepare to administer IV Calcium Gluconate
B. Administer oral potassium supplements
C. Notify the provider of suspected hypokalemia
D. Monitor for signs of Thyroid Storm
Answer: A
Rationale: A positive Chvostek’s sign and tingling indicate hypocalcemia, a common
complication of thyroidectomy due to accidental parathyroid damage. IV Calcium Gluconate
is necessary to prevent tetany and laryngospasm.
, 5. Which assessment finding in a patient with a traumatic brain injury (TBI)
indicates an early sign of increased intracranial pressure (ICP)?
A. Decreased level of consciousness and agitation
B. Cushing’s Triad (bradycardia, hypertension, widened pulse pressure)
C. Fixed and dilated pupils
D. Decerebrate posturing
Answer: A
Rationale: The earliest and most sensitive indicator of increased ICP is a change in the
level of consciousness (LOC). Cushing’s Triad and posturing are late signs.
6. A patient is receiving Continuous Renal Replacement Therapy (CRRT). The
nurse notes that the filter pressure is rapidly increasing. What is the most likely
cause?
A. The patient’s blood pressure is dropping
B. The filter is becoming clotted
C. The replacement fluid rate is too low
D. The catheter is kinked in the patient’s groin
Answer: B
Rationale: An increase in filter pressure (transmembrane pressure) usually indicates that
the filter is clotting, which prevents efficient filtration and requires a system flush or circuit
change.
2026 |WCU
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the
prone position. Which physiological outcome does the nurse anticipate?
A. Decreased work of breathing by relaxing the diaphragm
B. Facilitation of secretion clearance from the upper airways
C. Increased cardiac output by reducing thoracic pressure
D. Improved oxygenation by recruiting collapsed posterior alveoli
Answer: D
Rationale: Prone positioning in ARDS helps to improve oxygenation by redistributing
blood flow and recruiting alveoli in the posterior (dorsal) lung segments that are usually
compressed when the patient is supine.
2. A patient is being treated for Superior Vena Cava Syndrome (SVCS) related to
lung cancer. Which clinical manifestation should the nurse prioritize for
immediate intervention?
A. Periorbital edema and facial swelling
B. Distended neck veins while sitting upright
C. Stridor and difficulty breathing
D. Visible collateral veins on the chest wall
Answer: C
Rationale: While all are signs of SVCS, stridor indicates compression of the trachea, which
is an airway emergency and requires immediate intervention.
,3. A nurse is caring for a patient with Acute Kidney Injury (AKI) who has a serum
potassium of 6.8 mEq/L. Which medication order should the nurse implement
first?
A. Sodium polystyrene sulfonate orally
B. IV Calcium Gluconate
C. Furosemide IV bolus
D. IV regular insulin and 50% dextrose
Answer: B
Rationale: In severe hyperkalemia, IV Calcium Gluconate is administered first to stabilize
the myocardial cell membrane and prevent life-threatening arrhythmias, although it does
not lower the potassium itself.
4. A patient who underwent a thyroidectomy 12 hours ago presents with
tingling in the fingertips and a positive Chvostek’s sign. Which action is the
nurse’s priority?
A. Prepare to administer IV Calcium Gluconate
B. Administer oral potassium supplements
C. Notify the provider of suspected hypokalemia
D. Monitor for signs of Thyroid Storm
Answer: A
Rationale: A positive Chvostek’s sign and tingling indicate hypocalcemia, a common
complication of thyroidectomy due to accidental parathyroid damage. IV Calcium Gluconate
is necessary to prevent tetany and laryngospasm.
, 5. Which assessment finding in a patient with a traumatic brain injury (TBI)
indicates an early sign of increased intracranial pressure (ICP)?
A. Decreased level of consciousness and agitation
B. Cushing’s Triad (bradycardia, hypertension, widened pulse pressure)
C. Fixed and dilated pupils
D. Decerebrate posturing
Answer: A
Rationale: The earliest and most sensitive indicator of increased ICP is a change in the
level of consciousness (LOC). Cushing’s Triad and posturing are late signs.
6. A patient is receiving Continuous Renal Replacement Therapy (CRRT). The
nurse notes that the filter pressure is rapidly increasing. What is the most likely
cause?
A. The patient’s blood pressure is dropping
B. The filter is becoming clotted
C. The replacement fluid rate is too low
D. The catheter is kinked in the patient’s groin
Answer: B
Rationale: An increase in filter pressure (transmembrane pressure) usually indicates that
the filter is clotting, which prevents efficient filtration and requires a system flush or circuit
change.
