NURS 121L-A Medical-Surgical Nursing Practicum Week 6 Final
Comprehensive Quiz 2026 |WCU
1. A patient is scheduled for an emergency appendectomy. The nurse notes the
patient received a heavy meal 2 hours ago. What is the priority nursing risk?
A. Aspiration during induction of anesthesia
B. Postoperative paralytic ileus
C. Incisional dehiscence due to abdominal pressure
D. Delayed wound healing
Answer: A
Rationale: NPO status is critical for surgery to prevent the aspiration of gastric contents
into the lungs during anesthesia induction when protective airway reflexes are lost.
2. During the immediate postoperative period, a patient’s oxygen saturation
drops to 88% and crackles are heard in the lung bases. Which intervention
should the nurse perform first?
A. Encourage deep breathing and coughing
B. Administer a prescribed bronchodilator
C. Notify the rapid response team
D. Prepare for chest X-ray
Answer: A
Rationale: Hypoxemia and crackles in the immediate post-op period often indicate
atelectasis. Encouraging deep breathing and coughing helps expand the alveoli and
improve gas exchange.
,3. Which clinical manifestation is the earliest sign of malignant hyperthermia in
a patient receiving general anesthesia?
A. Sinus tachycardia and increased end-tidal CO2
B. Muscle rigidity and jaw clenching
C. Hyperthermia (temperature of 104°F)
D. Hypokalemia
Answer: A
Rationale: Tachycardia and an unexplained rise in end-tidal carbon dioxide are usually the
first signs of malignant hyperthermia. High fever is a late sign.
4. A nurse is caring for a patient who is 2 days postoperative following
abdominal surgery. The patient reports a ‘popping’ sensation and the nurse
observes a loop of bowel protruding through the incision. What is the priority
action?
A. Apply a dry sterile dressing and call the surgeon
B. Cover the protruding organ with sterile saline-soaked dressings
C. Push the bowel back into the abdominal cavity gently
D. Place the patient in High-Fowler’s position
Answer: B
Rationale: This is a wound evisceration. The nurse must cover the exposed organs with
sterile, moist saline dressings to prevent drying and necrosis while keeping the patient in a
low-Fowler’s position with knees flexed.
, 5. Which laboratory value would be of most concern for a patient scheduled for
surgery in 4 hours?
A. Hemoglobin 11.5 g/dL
B. Sodium 136 mEq/L
C. WBC 10,500/mm3
D. Potassium 2.8 mEq/L
Answer: D
Rationale: Hypokalemia (K+ 2.8) increases the risk of cardiac arrhythmias and digitalis
toxicity during anesthesia. It must be addressed before the procedure.
6. A nurse is monitoring a patient on a Patient-Controlled Analgesia (PCA) pump
for morphine. The nurse finds the patient lethargic with a respiratory rate of 8
breaths/min. Which medication should be available?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Naloxone is the reversal agent for opioid-induced respiratory depression.
Flumazenil is for benzodiazepines.
7. To prevent deep vein thrombosis (DVT) in a postoperative patient, which
nursing intervention is most effective?
A. Placing pillows under the patient’s knees
B. Massaging the calves twice daily
C. Early and frequent ambulation
D. Limiting fluid intake
Answer: C
Comprehensive Quiz 2026 |WCU
1. A patient is scheduled for an emergency appendectomy. The nurse notes the
patient received a heavy meal 2 hours ago. What is the priority nursing risk?
A. Aspiration during induction of anesthesia
B. Postoperative paralytic ileus
C. Incisional dehiscence due to abdominal pressure
D. Delayed wound healing
Answer: A
Rationale: NPO status is critical for surgery to prevent the aspiration of gastric contents
into the lungs during anesthesia induction when protective airway reflexes are lost.
2. During the immediate postoperative period, a patient’s oxygen saturation
drops to 88% and crackles are heard in the lung bases. Which intervention
should the nurse perform first?
A. Encourage deep breathing and coughing
B. Administer a prescribed bronchodilator
C. Notify the rapid response team
D. Prepare for chest X-ray
Answer: A
Rationale: Hypoxemia and crackles in the immediate post-op period often indicate
atelectasis. Encouraging deep breathing and coughing helps expand the alveoli and
improve gas exchange.
,3. Which clinical manifestation is the earliest sign of malignant hyperthermia in
a patient receiving general anesthesia?
A. Sinus tachycardia and increased end-tidal CO2
B. Muscle rigidity and jaw clenching
C. Hyperthermia (temperature of 104°F)
D. Hypokalemia
Answer: A
Rationale: Tachycardia and an unexplained rise in end-tidal carbon dioxide are usually the
first signs of malignant hyperthermia. High fever is a late sign.
4. A nurse is caring for a patient who is 2 days postoperative following
abdominal surgery. The patient reports a ‘popping’ sensation and the nurse
observes a loop of bowel protruding through the incision. What is the priority
action?
A. Apply a dry sterile dressing and call the surgeon
B. Cover the protruding organ with sterile saline-soaked dressings
C. Push the bowel back into the abdominal cavity gently
D. Place the patient in High-Fowler’s position
Answer: B
Rationale: This is a wound evisceration. The nurse must cover the exposed organs with
sterile, moist saline dressings to prevent drying and necrosis while keeping the patient in a
low-Fowler’s position with knees flexed.
, 5. Which laboratory value would be of most concern for a patient scheduled for
surgery in 4 hours?
A. Hemoglobin 11.5 g/dL
B. Sodium 136 mEq/L
C. WBC 10,500/mm3
D. Potassium 2.8 mEq/L
Answer: D
Rationale: Hypokalemia (K+ 2.8) increases the risk of cardiac arrhythmias and digitalis
toxicity during anesthesia. It must be addressed before the procedure.
6. A nurse is monitoring a patient on a Patient-Controlled Analgesia (PCA) pump
for morphine. The nurse finds the patient lethargic with a respiratory rate of 8
breaths/min. Which medication should be available?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Naloxone is the reversal agent for opioid-induced respiratory depression.
Flumazenil is for benzodiazepines.
7. To prevent deep vein thrombosis (DVT) in a postoperative patient, which
nursing intervention is most effective?
A. Placing pillows under the patient’s knees
B. Massaging the calves twice daily
C. Early and frequent ambulation
D. Limiting fluid intake
Answer: C
