NURS 121L-A Medical-Surgical Nursing Practicum - Week 12
Comprehensive Quiz 2026 |WCU
1. A patient is 12 hours post-thyroidectomy. The nurse identifies a positive
Chvostek’s sign and muscle twitching. Which laboratory value should the nurse
check immediately?
A. Serum Potassium
B. Serum Sodium
C. Serum Calcium
D. Serum Magnesium
Answer: C
Rationale: A positive Chvostek’s sign and muscle twitching are classic signs of
hypocalcemia, which can occur after thyroid surgery if the parathyroid glands are
accidentally damaged or removed.
2. A patient presents with a pH of 7.32, PaCO2 of 55 mmHg, and HCO3 of 28
mEq/L. How should the nurse interpret these arterial blood gas (ABG) results?
A. Uncompensated Respiratory Acidosis
B. Fully Compensated Respiratory Acidosis
C. Partially Compensated Respiratory Acidosis
D. Partially Compensated Metabolic Acidosis
Answer: C
Rationale: The pH is acidic (below 7.35), the PaCO2 is high (above 45), and the HCO3 is
elevated (above 26) attempting to compensate, indicating partially compensated
respiratory acidosis.
,3. The nurse is caring for a patient with a chest tube. While assessing the water
seal chamber, the nurse notes continuous bubbling. What is the nurse’s priority
action?
A. Document this as a normal finding
B. Clamp the tube immediately
C. Increase the suction pressure
D. Check the system for an air leak
Answer: D
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the
system; intermittent bubbling is expected with expiration in a patient with a
pneumothorax.
4. A patient with Type 1 Diabetes is admitted with a blood glucose of 650
mg/dL, Kussmaul respirations, and fruity breath. What is the initial nursing
priority?
A. Administering subcutaneous glargine insulin
B. Administering IV Sodium Bicarbonate
C. Initiating IV fluid resuscitation with Normal Saline
D. Checking the patient’s urine for ketones
Answer: C
Rationale: Fluid resuscitation is the first priority in Diabetic Ketoacidosis (DKA) to restore
circulatory volume and perfusion before or concurrent with insulin therapy.
, 5. An elderly patient with Heart Failure is prescribed Digoxin. Which symptom
reported by the patient would most concern the nurse regarding toxicity?
A. Increased urine output
B. Occasional palpitations
C. Seeing yellow-green halos around lights
D. Dry, hacking cough
Answer: C
Rationale: Visual disturbances, such as yellow-green halos or blurred vision, are classic
signs of digoxin toxicity, alongside nausea and bradycardia.
6. A patient has been admitted with Acute Pancreatitis. Which laboratory result
is most specific in confirming this diagnosis?
A. Elevated Serum Amylase
B. Decreased Serum Calcium
C. Elevated White Blood Cell count
D. Elevated Serum Lipase
Answer: D
Rationale: While both amylase and lipase rise in pancreatitis, lipase stays elevated longer
and is more specific to pancreatic tissue damage.
7. Which assessment finding should the nurse prioritize in a patient who just
returned from a total hip arthroplasty?
A. Pain level of 6/10
B. Patient’s inability to void 2 hours post-op
C. Serosanguinous drainage on the dressing
D. Diminished pedal pulse in the affected extremity
Answer: D
Comprehensive Quiz 2026 |WCU
1. A patient is 12 hours post-thyroidectomy. The nurse identifies a positive
Chvostek’s sign and muscle twitching. Which laboratory value should the nurse
check immediately?
A. Serum Potassium
B. Serum Sodium
C. Serum Calcium
D. Serum Magnesium
Answer: C
Rationale: A positive Chvostek’s sign and muscle twitching are classic signs of
hypocalcemia, which can occur after thyroid surgery if the parathyroid glands are
accidentally damaged or removed.
2. A patient presents with a pH of 7.32, PaCO2 of 55 mmHg, and HCO3 of 28
mEq/L. How should the nurse interpret these arterial blood gas (ABG) results?
A. Uncompensated Respiratory Acidosis
B. Fully Compensated Respiratory Acidosis
C. Partially Compensated Respiratory Acidosis
D. Partially Compensated Metabolic Acidosis
Answer: C
Rationale: The pH is acidic (below 7.35), the PaCO2 is high (above 45), and the HCO3 is
elevated (above 26) attempting to compensate, indicating partially compensated
respiratory acidosis.
,3. The nurse is caring for a patient with a chest tube. While assessing the water
seal chamber, the nurse notes continuous bubbling. What is the nurse’s priority
action?
A. Document this as a normal finding
B. Clamp the tube immediately
C. Increase the suction pressure
D. Check the system for an air leak
Answer: D
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the
system; intermittent bubbling is expected with expiration in a patient with a
pneumothorax.
4. A patient with Type 1 Diabetes is admitted with a blood glucose of 650
mg/dL, Kussmaul respirations, and fruity breath. What is the initial nursing
priority?
A. Administering subcutaneous glargine insulin
B. Administering IV Sodium Bicarbonate
C. Initiating IV fluid resuscitation with Normal Saline
D. Checking the patient’s urine for ketones
Answer: C
Rationale: Fluid resuscitation is the first priority in Diabetic Ketoacidosis (DKA) to restore
circulatory volume and perfusion before or concurrent with insulin therapy.
, 5. An elderly patient with Heart Failure is prescribed Digoxin. Which symptom
reported by the patient would most concern the nurse regarding toxicity?
A. Increased urine output
B. Occasional palpitations
C. Seeing yellow-green halos around lights
D. Dry, hacking cough
Answer: C
Rationale: Visual disturbances, such as yellow-green halos or blurred vision, are classic
signs of digoxin toxicity, alongside nausea and bradycardia.
6. A patient has been admitted with Acute Pancreatitis. Which laboratory result
is most specific in confirming this diagnosis?
A. Elevated Serum Amylase
B. Decreased Serum Calcium
C. Elevated White Blood Cell count
D. Elevated Serum Lipase
Answer: D
Rationale: While both amylase and lipase rise in pancreatitis, lipase stays elevated longer
and is more specific to pancreatic tissue damage.
7. Which assessment finding should the nurse prioritize in a patient who just
returned from a total hip arthroplasty?
A. Pain level of 6/10
B. Patient’s inability to void 2 hours post-op
C. Serosanguinous drainage on the dressing
D. Diminished pedal pulse in the affected extremity
Answer: D
