NURS 120 | Introduction to Medical-Surgical Nursing | Final Exam
2026 |WCU
1. A patient is 24 hours post-abdominal surgery. Which assessment finding is
most suggestive of an evolving paralytic ileus?
A. Hyperactive bowel sounds in all four quadrants
B. Passage of small amounts of flatus
C. Incisional pain rated 6/10 on a numeric scale
D. Abdominal distension and absent bowel sounds
Answer: D
Rationale: Paralytic ileus is characterized by the absence of peristalsis, leading to
abdominal distension, nausea, vomiting, and lack of bowel sounds or flatus passage.
2. When interpreting an Arterial Blood Gas (ABG) result, the nurse notes: pH
7.30, PaCO2 52 mmHg, and HCO3 26 mEq/L. This indicates which condition?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO2 is high (>45 mmHg),
which points to a respiratory cause. The HCO3 is normal, meaning no compensation is
occurring yet.
,3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which EKG
change is most likely associated with this electrolyte imbalance?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged PR interval
Answer: C
Rationale: Hyperkalemia typically causes tall, peaked T waves. Hypokalemia causes U
waves and ST depression.
4. In the immediate post-operative phase, which nursing intervention is the
highest priority for preventing atelectasis?
A. Encouraging the use of an incentive spirometer every hour
B. Administering prophylactic antibiotics
C. Applying sequential compression devices (SCDs)
D. Maintaining a strict NPO status
Answer: A
Rationale: Incentive spirometry promotes alveolar expansion and helps prevent
atelectasis and subsequent pneumonia in the post-operative period.
5. A patient with Type 1 Diabetes Mellitus presents with deep, rapid
respirations and a fruity breath odor. The nurse suspects Diabetic Ketoacidosis
(DKA). What is the primary cause of these respirations?
A. Compensatory mechanism to increase oxygen saturation
B. Result of fluid volume excess in the lungs
C. Response to high blood glucose levels in the medulla
D. Compensatory mechanism to blow off excess carbon dioxide to correct acidosis
Answer: D
, Rationale: Kussmaul respirations are a compensatory mechanism in DKA to eliminate CO2
and mitigate metabolic acidosis.
6. Which clinical manifestation is a hallmark sign of Peripheral Arterial Disease
(PAD)?
A. Painless, weeping ulcers on the ankles
B. Brownish discoloration of the skin (hemosiderin staining)
C. Warm, edematous lower extremities
D. Dependent rubor and intermittent claudication
Answer: D
Rationale: Intermittent claudication (pain with exercise) and dependent rubor (redness
when legs are down) are classic signs of PAD due to decreased arterial blood flow.
7. A patient is receiving a continuous Heparin infusion. Which laboratory value
must the nurse monitor to adjust the dosage?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count
Answer: C
Rationale: aPTT is used to monitor Heparin therapy, while PT/INR is used to monitor
Warfarin therapy.
8. A nurse assesses a patient and finds Trousseau’s sign is positive. This finding
is indicative of which electrolyte imbalance?
A. Hypermagnesemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Answer: C
2026 |WCU
1. A patient is 24 hours post-abdominal surgery. Which assessment finding is
most suggestive of an evolving paralytic ileus?
A. Hyperactive bowel sounds in all four quadrants
B. Passage of small amounts of flatus
C. Incisional pain rated 6/10 on a numeric scale
D. Abdominal distension and absent bowel sounds
Answer: D
Rationale: Paralytic ileus is characterized by the absence of peristalsis, leading to
abdominal distension, nausea, vomiting, and lack of bowel sounds or flatus passage.
2. When interpreting an Arterial Blood Gas (ABG) result, the nurse notes: pH
7.30, PaCO2 52 mmHg, and HCO3 26 mEq/L. This indicates which condition?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO2 is high (>45 mmHg),
which points to a respiratory cause. The HCO3 is normal, meaning no compensation is
occurring yet.
,3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which EKG
change is most likely associated with this electrolyte imbalance?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged PR interval
Answer: C
Rationale: Hyperkalemia typically causes tall, peaked T waves. Hypokalemia causes U
waves and ST depression.
4. In the immediate post-operative phase, which nursing intervention is the
highest priority for preventing atelectasis?
A. Encouraging the use of an incentive spirometer every hour
B. Administering prophylactic antibiotics
C. Applying sequential compression devices (SCDs)
D. Maintaining a strict NPO status
Answer: A
Rationale: Incentive spirometry promotes alveolar expansion and helps prevent
atelectasis and subsequent pneumonia in the post-operative period.
5. A patient with Type 1 Diabetes Mellitus presents with deep, rapid
respirations and a fruity breath odor. The nurse suspects Diabetic Ketoacidosis
(DKA). What is the primary cause of these respirations?
A. Compensatory mechanism to increase oxygen saturation
B. Result of fluid volume excess in the lungs
C. Response to high blood glucose levels in the medulla
D. Compensatory mechanism to blow off excess carbon dioxide to correct acidosis
Answer: D
, Rationale: Kussmaul respirations are a compensatory mechanism in DKA to eliminate CO2
and mitigate metabolic acidosis.
6. Which clinical manifestation is a hallmark sign of Peripheral Arterial Disease
(PAD)?
A. Painless, weeping ulcers on the ankles
B. Brownish discoloration of the skin (hemosiderin staining)
C. Warm, edematous lower extremities
D. Dependent rubor and intermittent claudication
Answer: D
Rationale: Intermittent claudication (pain with exercise) and dependent rubor (redness
when legs are down) are classic signs of PAD due to decreased arterial blood flow.
7. A patient is receiving a continuous Heparin infusion. Which laboratory value
must the nurse monitor to adjust the dosage?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count
Answer: C
Rationale: aPTT is used to monitor Heparin therapy, while PT/INR is used to monitor
Warfarin therapy.
8. A nurse assesses a patient and finds Trousseau’s sign is positive. This finding
is indicative of which electrolyte imbalance?
A. Hypermagnesemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Answer: C
