NURS 121L-A Medical-Surgical Nursing Practicum - Week 5 Advanced
Review 2026 |WCU
1. A patient is admitted with a potassium level of 6.2 mEq/L. Which EKG change
is the nurse most likely to observe?
A. Prominent U waves
B. Prolonged ST segment
C. Tall, peaked T waves
D. Flattened T waves
Answer: C
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves. Prominent U
waves are associated with hypokalemia.
2. Following a thyroidectomy, a patient develops numbness and tingling around
the mouth. What is the priority nursing action?
A. Assess for Trousseau’s or Chvostek’s signs
B. Administer an oral potassium supplement
C. Check the patient’s blood glucose level
D. Encourage the patient to cough and deep breathe
Answer: A
Rationale: Numbness and tingling around the mouth (circumoral paresthesia) are early
signs of hypocalcemia, which can occur if the parathyroid glands are accidentally damaged
or removed during a thyroidectomy.
,3. A patient’s ABG results are: pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these findings?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range, it is uncompensated
respiratory acidosis.
4. Which medication is the primary treatment for a patient experiencing
Malignant Hyperthermia during surgery?
A. Atropine sulfate
B. Naloxone
C. Succinylcholine
D. Dantrolene sodium
Answer: D
Rationale: Dantrolene is a skeletal muscle relaxant that is the specific antidote for
malignant hyperthermia, a life-threatening complication of general anesthesia.
5. A patient with Type 1 Diabetes presents with deep, rapid respirations and a
fruity breath odor. Which condition does the nurse suspect?
A. Hyperglycemic Hyperosmolar State (HHS)
B. Hypoglycemic reaction
C. Respiratory alkalosis
D. Diabetic Ketoacidosis (DKA)
Answer: D
, Rationale: Kussmaul respirations (deep, rapid) and acetone (fruity) breath are hallmark
signs of DKA due to the body attempting to blow off excess CO2 to compensate for
metabolic acidosis.
6. The nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory value is most expected?
A. Hematocrit 55%
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 128 mEq/L
Answer: D
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia.
Therefore, a low serum sodium level (below 135 mEq/L) is expected.
7. A post-operative patient reports sudden chest pain and shortness of breath.
Which action should the nurse take first?
A. Administer the prescribed PRN morphine
B. Apply supplemental oxygen and raise the head of the bed
C. Obtain an EKG
D. Auscultate for bowel sounds
Answer: B
Rationale: Sudden chest pain and dyspnea suggest a pulmonary embolism. The nurse’s
priority is to stabilize oxygenation and respiratory effort.
Review 2026 |WCU
1. A patient is admitted with a potassium level of 6.2 mEq/L. Which EKG change
is the nurse most likely to observe?
A. Prominent U waves
B. Prolonged ST segment
C. Tall, peaked T waves
D. Flattened T waves
Answer: C
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves. Prominent U
waves are associated with hypokalemia.
2. Following a thyroidectomy, a patient develops numbness and tingling around
the mouth. What is the priority nursing action?
A. Assess for Trousseau’s or Chvostek’s signs
B. Administer an oral potassium supplement
C. Check the patient’s blood glucose level
D. Encourage the patient to cough and deep breathe
Answer: A
Rationale: Numbness and tingling around the mouth (circumoral paresthesia) are early
signs of hypocalcemia, which can occur if the parathyroid glands are accidentally damaged
or removed during a thyroidectomy.
,3. A patient’s ABG results are: pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these findings?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range, it is uncompensated
respiratory acidosis.
4. Which medication is the primary treatment for a patient experiencing
Malignant Hyperthermia during surgery?
A. Atropine sulfate
B. Naloxone
C. Succinylcholine
D. Dantrolene sodium
Answer: D
Rationale: Dantrolene is a skeletal muscle relaxant that is the specific antidote for
malignant hyperthermia, a life-threatening complication of general anesthesia.
5. A patient with Type 1 Diabetes presents with deep, rapid respirations and a
fruity breath odor. Which condition does the nurse suspect?
A. Hyperglycemic Hyperosmolar State (HHS)
B. Hypoglycemic reaction
C. Respiratory alkalosis
D. Diabetic Ketoacidosis (DKA)
Answer: D
, Rationale: Kussmaul respirations (deep, rapid) and acetone (fruity) breath are hallmark
signs of DKA due to the body attempting to blow off excess CO2 to compensate for
metabolic acidosis.
6. The nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory value is most expected?
A. Hematocrit 55%
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 128 mEq/L
Answer: D
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia.
Therefore, a low serum sodium level (below 135 mEq/L) is expected.
7. A post-operative patient reports sudden chest pain and shortness of breath.
Which action should the nurse take first?
A. Administer the prescribed PRN morphine
B. Apply supplemental oxygen and raise the head of the bed
C. Obtain an EKG
D. Auscultate for bowel sounds
Answer: B
Rationale: Sudden chest pain and dyspnea suggest a pulmonary embolism. The nurse’s
priority is to stabilize oxygenation and respiratory effort.
