NURS 121L-A Medical-Surgical Nursing Practicum - Week 10 Final Quiz
2026 |WCU
1. A patient with chronic obstructive pulmonary disease (COPD) presents with
arterial blood gas (ABG) results: pH 7.31, PaCO2 58 mmHg, and HCO3 30 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Alkalosis, uncompensated
C. Respiratory Acidosis, partially compensated
D. Metabolic Alkalosis, fully compensated
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
high (compensatory response). Because the pH is not within the normal range, it is
partially compensated.
2. An elderly patient is 24 hours post-operative following a total hip
arthroplasty. The nurse notes the patient is suddenly confused, has a
respiratory rate of 28, and petechiae on the chest. Which complication is most
likely?
A. Pulmonary Embolism
B. Fat Embolism Syndrome
C. Deep Vein Thrombosis
D. Hypovolemic Shock
Answer: B
Rationale: Fat Embolism Syndrome is characterized by the triad of respiratory distress,
neurological changes (confusion), and a petechial rash, often following long bone or joint
surgery.
,3. When caring for a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What is the priority nursing action?
A. Document this as a normal finding for a patient with a pneumothorax.
B. Clamp the chest tube immediately and call the provider.
C. Increase the suction pressure on the wall regulator.
D. Check for a leak in the system starting at the insertion site.
Answer: D
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak. The nurse
should assess the system for leaks. Intermittent bubbling is normal during expiration in a
patient with a pneumothorax.
4. A patient is admitted with a diagnosis of Acute Pancreatitis. Which laboratory
value would the nurse expect to be significantly elevated?
A. Serum Creatinine
B. Serum Potassium
C. Hemoglobin
D. Serum Amylase
Answer: D
Rationale: In acute pancreatitis, serum amylase and lipase levels rise rapidly within the
first 24 hours of symptom onset.
5. Which assessment finding should the nurse report immediately for a patient
who underwent a thyroidectomy 6 hours ago?
A. Hoarseness when speaking
B. Positive Trousseau’s sign
C. Complaints of sore throat
D. Pain level 4 out of 10
Answer: B
, Rationale: A positive Trousseau’s sign indicates hypocalcemia, a potential complication of
thyroidectomy if the parathyroid glands are accidentally removed or damaged.
6. A patient with heart failure is prescribed Digoxin 0.125 mg daily. Which
assessment finding would require the nurse to withhold the medication?
A. Blood pressure 140/90 mmHg
B. Serum Potassium of 4.5 mEq/L
C. Respiratory rate of 20 breaths per minute
D. Apical pulse of 52 beats per minute
Answer: D
Rationale: Digoxin is a positive inotrope and negative chronotrope. It should be withheld if
the apical heart rate is below 60 bpm to prevent bradycardia.
7. What is the primary goal of nursing care for a patient in the immediate post-
ictal phase of a generalized tonic-clonic seizure?
A. To maintain a patent airway and monitor vital signs.
B. To restrain the patient to prevent further injury.
C. To administer oral anti-epileptic medications.
D. To encourage the patient to walk to regain muscle tone.
Answer: A
Rationale: Airway management is the priority following a seizure as the patient is often
somnolent and at risk for aspiration or airway occlusion.
2026 |WCU
1. A patient with chronic obstructive pulmonary disease (COPD) presents with
arterial blood gas (ABG) results: pH 7.31, PaCO2 58 mmHg, and HCO3 30 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Alkalosis, uncompensated
C. Respiratory Acidosis, partially compensated
D. Metabolic Alkalosis, fully compensated
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
high (compensatory response). Because the pH is not within the normal range, it is
partially compensated.
2. An elderly patient is 24 hours post-operative following a total hip
arthroplasty. The nurse notes the patient is suddenly confused, has a
respiratory rate of 28, and petechiae on the chest. Which complication is most
likely?
A. Pulmonary Embolism
B. Fat Embolism Syndrome
C. Deep Vein Thrombosis
D. Hypovolemic Shock
Answer: B
Rationale: Fat Embolism Syndrome is characterized by the triad of respiratory distress,
neurological changes (confusion), and a petechial rash, often following long bone or joint
surgery.
,3. When caring for a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What is the priority nursing action?
A. Document this as a normal finding for a patient with a pneumothorax.
B. Clamp the chest tube immediately and call the provider.
C. Increase the suction pressure on the wall regulator.
D. Check for a leak in the system starting at the insertion site.
Answer: D
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak. The nurse
should assess the system for leaks. Intermittent bubbling is normal during expiration in a
patient with a pneumothorax.
4. A patient is admitted with a diagnosis of Acute Pancreatitis. Which laboratory
value would the nurse expect to be significantly elevated?
A. Serum Creatinine
B. Serum Potassium
C. Hemoglobin
D. Serum Amylase
Answer: D
Rationale: In acute pancreatitis, serum amylase and lipase levels rise rapidly within the
first 24 hours of symptom onset.
5. Which assessment finding should the nurse report immediately for a patient
who underwent a thyroidectomy 6 hours ago?
A. Hoarseness when speaking
B. Positive Trousseau’s sign
C. Complaints of sore throat
D. Pain level 4 out of 10
Answer: B
, Rationale: A positive Trousseau’s sign indicates hypocalcemia, a potential complication of
thyroidectomy if the parathyroid glands are accidentally removed or damaged.
6. A patient with heart failure is prescribed Digoxin 0.125 mg daily. Which
assessment finding would require the nurse to withhold the medication?
A. Blood pressure 140/90 mmHg
B. Serum Potassium of 4.5 mEq/L
C. Respiratory rate of 20 breaths per minute
D. Apical pulse of 52 beats per minute
Answer: D
Rationale: Digoxin is a positive inotrope and negative chronotrope. It should be withheld if
the apical heart rate is below 60 bpm to prevent bradycardia.
7. What is the primary goal of nursing care for a patient in the immediate post-
ictal phase of a generalized tonic-clonic seizure?
A. To maintain a patent airway and monitor vital signs.
B. To restrain the patient to prevent further injury.
C. To administer oral anti-epileptic medications.
D. To encourage the patient to walk to regain muscle tone.
Answer: A
Rationale: Airway management is the priority following a seizure as the patient is often
somnolent and at risk for aspiration or airway occlusion.
