NURS 121L-A Medical-Surgical Nursing Practicum Week 9
Comprehensive Quiz 2026 |WCU
1. A nurse is caring for a client who is 24 hours postoperative following an
abdominal surgery. The nurse notes the client’s wound has eviscerated. Which
of the following actions should the nurse take first?
A. Cover the protruding organs with sterile towels soaked in normal saline.
B. Place the client in a high-Fowler’s position.
C. Attempt to reinsert the organs into the abdominal cavity.
D. Assess the client’s vital signs and notify the surgeon.
Answer: A
Rationale: Evisceration is a medical emergency. The first priority is to protect the organs
by covering them with sterile, saline-soaked dressings. Reinsertion should never be
attempted by a nurse, and high-Fowler’s position increases intra-abdominal pressure.
2. A client with chronic kidney disease (CKD) has a serum potassium level of 6.8
mEq/L. Which of the following ECG changes should the nurse expect to see?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged QT interval
Answer: C
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on an ECG as tall,
peaked T waves, widened QRS complexes, and potentially a loss of P waves. U waves are
seen in hypokalemia.
,3. Which of the following findings is the most sensitive early indicator of
increased intracranial pressure (ICP) in a client with a head injury?
A. Change in level of consciousness (LOC)
B. Widening pulse pressure
C. Fixed and dilated pupils
D. Cushing’s triad
Answer: A
Rationale: A change in the level of consciousness is the earliest and most sensitive sign of
increasing ICP. Cushing’s triad (bradycardia, hypertension with widening pulse pressure,
and irregular respirations) is a late sign.
4. A client is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which of
the following arterial blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.48, PaCO2 32, HCO3 24
B. pH 7.30, PaCO2 30, HCO3 16
C. pH 7.25, PaCO2 50, HCO3 28
D. pH 7.50, PaCO2 40, HCO3 32
Answer: B
Rationale: DKA causes metabolic acidosis. Option A shows a low pH (acidosis) and low
bicarbonate (metabolic), with a low PaCO2 reflecting respiratory compensation (Kussmaul
respirations).
, 5. A nurse is administering a blood transfusion to a client. Fifteen minutes into
the transfusion, the client reports low back pain and chills. What is the nurse’s
priority action?
A. Stop the transfusion immediately and start normal saline with new tubing.
B. Check the client’s vital signs and document the reaction.
C. Slow the infusion rate and notify the physician.
D. Administer diphenhydramine as prescribed.
Answer: A
Rationale: Low back pain and chills are signs of a hemolytic transfusion reaction. The
infusion must be stopped immediately to prevent further exposure, and saline started to
maintain IV access and blood pressure.
6. A client with right-sided heart failure is likely to exhibit which of the following
clinical manifestations?
A. Pulmonary edema and crackles
B. Jugular venous distention (JVD) and peripheral edema
C. Dyspnea and orthopnea
D. Frothy pink-tinged sputum
Answer: B
Rationale: Right-sided heart failure causes systemic congestion, leading to JVD,
hepatomegaly, and peripheral edema. Pulmonary symptoms (A, C, D) are characteristic of
left-sided heart failure.
Comprehensive Quiz 2026 |WCU
1. A nurse is caring for a client who is 24 hours postoperative following an
abdominal surgery. The nurse notes the client’s wound has eviscerated. Which
of the following actions should the nurse take first?
A. Cover the protruding organs with sterile towels soaked in normal saline.
B. Place the client in a high-Fowler’s position.
C. Attempt to reinsert the organs into the abdominal cavity.
D. Assess the client’s vital signs and notify the surgeon.
Answer: A
Rationale: Evisceration is a medical emergency. The first priority is to protect the organs
by covering them with sterile, saline-soaked dressings. Reinsertion should never be
attempted by a nurse, and high-Fowler’s position increases intra-abdominal pressure.
2. A client with chronic kidney disease (CKD) has a serum potassium level of 6.8
mEq/L. Which of the following ECG changes should the nurse expect to see?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged QT interval
Answer: C
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on an ECG as tall,
peaked T waves, widened QRS complexes, and potentially a loss of P waves. U waves are
seen in hypokalemia.
,3. Which of the following findings is the most sensitive early indicator of
increased intracranial pressure (ICP) in a client with a head injury?
A. Change in level of consciousness (LOC)
B. Widening pulse pressure
C. Fixed and dilated pupils
D. Cushing’s triad
Answer: A
Rationale: A change in the level of consciousness is the earliest and most sensitive sign of
increasing ICP. Cushing’s triad (bradycardia, hypertension with widening pulse pressure,
and irregular respirations) is a late sign.
4. A client is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which of
the following arterial blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.48, PaCO2 32, HCO3 24
B. pH 7.30, PaCO2 30, HCO3 16
C. pH 7.25, PaCO2 50, HCO3 28
D. pH 7.50, PaCO2 40, HCO3 32
Answer: B
Rationale: DKA causes metabolic acidosis. Option A shows a low pH (acidosis) and low
bicarbonate (metabolic), with a low PaCO2 reflecting respiratory compensation (Kussmaul
respirations).
, 5. A nurse is administering a blood transfusion to a client. Fifteen minutes into
the transfusion, the client reports low back pain and chills. What is the nurse’s
priority action?
A. Stop the transfusion immediately and start normal saline with new tubing.
B. Check the client’s vital signs and document the reaction.
C. Slow the infusion rate and notify the physician.
D. Administer diphenhydramine as prescribed.
Answer: A
Rationale: Low back pain and chills are signs of a hemolytic transfusion reaction. The
infusion must be stopped immediately to prevent further exposure, and saline started to
maintain IV access and blood pressure.
6. A client with right-sided heart failure is likely to exhibit which of the following
clinical manifestations?
A. Pulmonary edema and crackles
B. Jugular venous distention (JVD) and peripheral edema
C. Dyspnea and orthopnea
D. Frothy pink-tinged sputum
Answer: B
Rationale: Right-sided heart failure causes systemic congestion, leading to JVD,
hepatomegaly, and peripheral edema. Pulmonary symptoms (A, C, D) are characteristic of
left-sided heart failure.
