Medical-Surgical Nursing Practicum Week 7 Comprehensive Quiz 2026
|WCU
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8
mEq/L and the ECG shows peaked T waves. Which medication should the nurse
expect to administer first to stabilize the myocardium?
A. Sodium polystyrene sulfonate
B. Regular insulin and 50% dextrose
C. Calcium gluconate
D. Furosemide
Answer: C
Rationale: Calcium gluconate does not lower potassium but is administered first in
emergency settings to stabilize the cardiac cell membrane and prevent life-threatening
arrhythmias.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the
early stages of a massive pulmonary embolism?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 45, HCO3 28
D. pH 7.50, PaCO2 40, HCO3 32
Answer: B
Rationale: Early pulmonary embolism typically causes tachypnea and hyperventilation,
leading to respiratory alkalosis (high pH, low PaCO2).
,3. A nurse is caring for a patient post-abdominal surgery who reports a
‘popping’ sensation. Upon inspection, the nurse notes wound dehiscence with
bowel protrusion. What is the immediate priority?
A. Cover the protruding organs with sterile gauze soaked in normal saline
B. Call the surgeon and prepare for immediate transport to the OR
C. Apply a tight abdominal binder to hold the organs in place
D. Place the patient in High-Fowler’s position to reduce pressure
Answer: A
Rationale: In the event of evisceration, the priority is to protect the exposed organs by
covering them with sterile, saline-soaked dressings while a colleague notifies the surgical
team.
4. During the diuretic phase of Acute Kidney Injury, the nurse should monitor
the patient most closely for which complication?
A. Hypokalemia and dehydration
B. Hypervolemia and pulmonary edema
C. Metabolic acidosis and hyperkalemia
D. Hypertension and bradycardia
Answer: A
Rationale: The diuretic phase is characterized by high urine output where the kidneys can
excrete waste but cannot concentrate urine, leading to significant loss of fluids and
electrolytes like potassium.
, 5. A patient with Type 1 Diabetes presents with a blood glucose of 600 mg/dL,
Kussmaul respirations, and a fruity breath odor. What is the primary
pathophysiological mechanism?
A. Extreme insulin resistance with minimal ketosis
B. Breakdown of fat into ketones due to absolute insulin deficiency
C. Severe dehydration leading to hyperosmolar state
D. Excessive glucagon secretion causing glycogenolysis
Answer: B
Rationale: These are classic signs of Diabetic Ketoacidosis (DKA), caused by absolute
insulin deficiency leading to lipolysis and ketone production.
6. A patient is receiving a continuous intravenous heparin infusion for a Deep
Vein Thrombosis. The aPTT is 110 seconds (Control: 30 seconds). Which action
should the nurse take first?
A. Decrease the infusion rate by 50%
B. Stop the infusion and notify the provider
C. Administer Vitamin K intramuscularly
D. Recheck the aPTT in 1 hour
Answer: B
Rationale: An aPTT of 110 is significantly above the therapeutic range (usually 1.5-2.5
times the control). The infusion should be stopped to prevent hemorrhage while awaiting
further orders.
|WCU
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8
mEq/L and the ECG shows peaked T waves. Which medication should the nurse
expect to administer first to stabilize the myocardium?
A. Sodium polystyrene sulfonate
B. Regular insulin and 50% dextrose
C. Calcium gluconate
D. Furosemide
Answer: C
Rationale: Calcium gluconate does not lower potassium but is administered first in
emergency settings to stabilize the cardiac cell membrane and prevent life-threatening
arrhythmias.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the
early stages of a massive pulmonary embolism?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 45, HCO3 28
D. pH 7.50, PaCO2 40, HCO3 32
Answer: B
Rationale: Early pulmonary embolism typically causes tachypnea and hyperventilation,
leading to respiratory alkalosis (high pH, low PaCO2).
,3. A nurse is caring for a patient post-abdominal surgery who reports a
‘popping’ sensation. Upon inspection, the nurse notes wound dehiscence with
bowel protrusion. What is the immediate priority?
A. Cover the protruding organs with sterile gauze soaked in normal saline
B. Call the surgeon and prepare for immediate transport to the OR
C. Apply a tight abdominal binder to hold the organs in place
D. Place the patient in High-Fowler’s position to reduce pressure
Answer: A
Rationale: In the event of evisceration, the priority is to protect the exposed organs by
covering them with sterile, saline-soaked dressings while a colleague notifies the surgical
team.
4. During the diuretic phase of Acute Kidney Injury, the nurse should monitor
the patient most closely for which complication?
A. Hypokalemia and dehydration
B. Hypervolemia and pulmonary edema
C. Metabolic acidosis and hyperkalemia
D. Hypertension and bradycardia
Answer: A
Rationale: The diuretic phase is characterized by high urine output where the kidneys can
excrete waste but cannot concentrate urine, leading to significant loss of fluids and
electrolytes like potassium.
, 5. A patient with Type 1 Diabetes presents with a blood glucose of 600 mg/dL,
Kussmaul respirations, and a fruity breath odor. What is the primary
pathophysiological mechanism?
A. Extreme insulin resistance with minimal ketosis
B. Breakdown of fat into ketones due to absolute insulin deficiency
C. Severe dehydration leading to hyperosmolar state
D. Excessive glucagon secretion causing glycogenolysis
Answer: B
Rationale: These are classic signs of Diabetic Ketoacidosis (DKA), caused by absolute
insulin deficiency leading to lipolysis and ketone production.
6. A patient is receiving a continuous intravenous heparin infusion for a Deep
Vein Thrombosis. The aPTT is 110 seconds (Control: 30 seconds). Which action
should the nurse take first?
A. Decrease the infusion rate by 50%
B. Stop the infusion and notify the provider
C. Administer Vitamin K intramuscularly
D. Recheck the aPTT in 1 hour
Answer: B
Rationale: An aPTT of 110 is significantly above the therapeutic range (usually 1.5-2.5
times the control). The infusion should be stopped to prevent hemorrhage while awaiting
further orders.
