NURS 121L-A Medical-Surgical Nursing Practicum Week 1
Comprehensive Quiz 2026 WCU
1. A patient with chronic kidney disease presents with a potassium level of 6.4
mEq/L. Which ECG change is the nurse most likely to observe?
A. Tall, peaked T waves
B. Prolonged PR interval
C. Prominent U waves
D. ST-segment depression
Answer: A
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) typically causes tall, peaked T waves, widened
QRS complexes, and eventually ventricular fibrillation if untreated.
2. Which assessment finding in a patient who underwent a thyroidectomy 12
hours ago would indicate a positive Trousseau’s sign?
A. Facial twitching when the cheek is tapped
B. Generalized seizure activity
C. Hyperextension of the neck with muscle rigidity
D. Carpal spasm after inflating a blood pressure cuff
Answer: D
Rationale: Trousseau’s sign is carpal spasm induced by inflating a BP cuff above systolic
pressure for a few minutes, indicating hypocalcemia, a risk after thyroid surgery due to
potential parathyroid damage.
,3. A patient has been vomiting for 48 hours and has an ABG result of: pH 7.50,
PaCO2 44 mmHg, HCO3 32 mEq/L. How should the nurse interpret this result?
A. Metabolic Alkalosis, Uncompensated
B. Metabolic Acidosis, Fully Compensated
C. Respiratory Alkalosis, Uncompensated
D. Respiratory Acidosis, Partially Compensated
Answer: A
Rationale: The pH is high (>7.45) indicating alkalosis. The HCO3 is high (>26) indicating a
metabolic cause. The PaCO2 is normal, showing no compensation yet.
4. A preoperative patient is scheduled for surgery in 2 hours but has not signed
the informed consent. The surgeon is busy in another procedure. What is the
nurse’s priority action?
A. Sign the consent for the patient as a witness
B. Notify the surgical team and ensure the surgeon speaks with the patient before surgery
C. Explain the risks and benefits of the surgery to the patient
D. Cancel the surgery and reschedule for the following day
Answer: B
Rationale: The nurse’s role is to witness the signature and ensure the patient understands,
but the legal responsibility to explain risks, benefits, and alternatives lies solely with the
surgeon.
, 5. During surgery, a patient develops tachycardia, muscle rigidity, and a rapidly
rising temperature. Which medication should the nurse prepare to administer
immediately?
A. Naloxone
B. Epinephrine
C. Atropine sulfate
D. Dantrolene sodium
Answer: D
Rationale: These are classic signs of malignant hyperthermia, a life-threatening anesthesia
complication. Dantrolene is the specific skeletal muscle relaxant used to treat it.
6. A post-operative patient reports sudden shortness of breath and chest pain
that worsens with deep breathing. The nurse notes a respiratory rate of 28 and
oxygen saturation of 88%. Which complication is suspected?
A. Atelectasis
B. Hypovolemic shock
C. Pneumonia
D. Pulmonary embolism
Answer: D
Rationale: Sudden onset of dyspnea, pleuritic chest pain, and hypoxia are hallmark signs of
a pulmonary embolism, a common post-op complication often originating from a DVT.
7. A patient with a nasogastric (NG) tube set to continuous low suction is at
highest risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: B
Comprehensive Quiz 2026 WCU
1. A patient with chronic kidney disease presents with a potassium level of 6.4
mEq/L. Which ECG change is the nurse most likely to observe?
A. Tall, peaked T waves
B. Prolonged PR interval
C. Prominent U waves
D. ST-segment depression
Answer: A
Rationale: Hyperkalemia (K+ > 5.0 mEq/L) typically causes tall, peaked T waves, widened
QRS complexes, and eventually ventricular fibrillation if untreated.
2. Which assessment finding in a patient who underwent a thyroidectomy 12
hours ago would indicate a positive Trousseau’s sign?
A. Facial twitching when the cheek is tapped
B. Generalized seizure activity
C. Hyperextension of the neck with muscle rigidity
D. Carpal spasm after inflating a blood pressure cuff
Answer: D
Rationale: Trousseau’s sign is carpal spasm induced by inflating a BP cuff above systolic
pressure for a few minutes, indicating hypocalcemia, a risk after thyroid surgery due to
potential parathyroid damage.
,3. A patient has been vomiting for 48 hours and has an ABG result of: pH 7.50,
PaCO2 44 mmHg, HCO3 32 mEq/L. How should the nurse interpret this result?
A. Metabolic Alkalosis, Uncompensated
B. Metabolic Acidosis, Fully Compensated
C. Respiratory Alkalosis, Uncompensated
D. Respiratory Acidosis, Partially Compensated
Answer: A
Rationale: The pH is high (>7.45) indicating alkalosis. The HCO3 is high (>26) indicating a
metabolic cause. The PaCO2 is normal, showing no compensation yet.
4. A preoperative patient is scheduled for surgery in 2 hours but has not signed
the informed consent. The surgeon is busy in another procedure. What is the
nurse’s priority action?
A. Sign the consent for the patient as a witness
B. Notify the surgical team and ensure the surgeon speaks with the patient before surgery
C. Explain the risks and benefits of the surgery to the patient
D. Cancel the surgery and reschedule for the following day
Answer: B
Rationale: The nurse’s role is to witness the signature and ensure the patient understands,
but the legal responsibility to explain risks, benefits, and alternatives lies solely with the
surgeon.
, 5. During surgery, a patient develops tachycardia, muscle rigidity, and a rapidly
rising temperature. Which medication should the nurse prepare to administer
immediately?
A. Naloxone
B. Epinephrine
C. Atropine sulfate
D. Dantrolene sodium
Answer: D
Rationale: These are classic signs of malignant hyperthermia, a life-threatening anesthesia
complication. Dantrolene is the specific skeletal muscle relaxant used to treat it.
6. A post-operative patient reports sudden shortness of breath and chest pain
that worsens with deep breathing. The nurse notes a respiratory rate of 28 and
oxygen saturation of 88%. Which complication is suspected?
A. Atelectasis
B. Hypovolemic shock
C. Pneumonia
D. Pulmonary embolism
Answer: D
Rationale: Sudden onset of dyspnea, pleuritic chest pain, and hypoxia are hallmark signs of
a pulmonary embolism, a common post-op complication often originating from a DVT.
7. A patient with a nasogastric (NG) tube set to continuous low suction is at
highest risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: B
