NURS 120 Medical-Surgical Nursing Module Exam 2 2026 |WCU
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which
electrocardiogram (ECG) change should the nurse expect to observe first?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Inverted P waves
Answer: C
Rationale: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves as an early sign.
Prominent U waves are associated with hypokalemia.
2. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 50 mmHg, and HCO3
24 mEq/L. How should the nurse interpret these results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
,3. During the preoperative assessment, a patient reports an allergy to avocados
and bananas. Which intraoperative complication is this patient at highest risk
for?
A. Latex sensitivity
B. Malignant hyperthermia
C. Anaphylaxis to propofol
D. Lidocaine toxicity
Answer: A
Rationale: Patients with allergies to avocados, bananas, strawberries, or kiwi are at a
significantly higher risk for latex allergy due to cross-reactivity.
4. Which electrolyte imbalance is most likely to cause a positive Chvostek’s
sign?
A. Hypermagnesemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when tapping the facial nerve) and
Trousseau’s sign (carpal spasm with BP cuff) are classic indicators of hypocalcemia.
5. A post-operative patient is receiving morphine via a PCA pump. The nurse
finds the patient lethargic with a respiratory rate of 8 breaths/min. Which
medication should the nurse prepare to administer?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
, Rationale: Naloxone is the opioid antagonist used to reverse respiratory depression
caused by opioids like morphine.
6. A patient with a history of chronic obstructive pulmonary disease (COPD) is
most likely to present with which acid-base imbalance?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: COPD causes CO2 retention due to impaired gas exchange, leading to chronic
respiratory acidosis.
7. Which assessment finding is a hallmark early sign of Malignant Hyperthermia
during surgery?
A. Hypothermia
B. Muscle rigidity
C. Bradypnea
D. Hypotension
Answer: B
Rationale: Muscle rigidity (specifically of the jaw) and an unexplained rise in end-tidal CO2
are the earliest signs of Malignant Hyperthermia; high fever is a late sign.
8. The nurse is caring for a patient with a serum sodium level of 128 mEq/L.
Which clinical manifestation should the nurse prioritize?
A. Dry mucous membranes
B. Thirst
C. Hyperreflexia
D. Confusion and seizures
Answer: D
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which
electrocardiogram (ECG) change should the nurse expect to observe first?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Inverted P waves
Answer: C
Rationale: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves as an early sign.
Prominent U waves are associated with hypokalemia.
2. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 50 mmHg, and HCO3
24 mEq/L. How should the nurse interpret these results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
,3. During the preoperative assessment, a patient reports an allergy to avocados
and bananas. Which intraoperative complication is this patient at highest risk
for?
A. Latex sensitivity
B. Malignant hyperthermia
C. Anaphylaxis to propofol
D. Lidocaine toxicity
Answer: A
Rationale: Patients with allergies to avocados, bananas, strawberries, or kiwi are at a
significantly higher risk for latex allergy due to cross-reactivity.
4. Which electrolyte imbalance is most likely to cause a positive Chvostek’s
sign?
A. Hypermagnesemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when tapping the facial nerve) and
Trousseau’s sign (carpal spasm with BP cuff) are classic indicators of hypocalcemia.
5. A post-operative patient is receiving morphine via a PCA pump. The nurse
finds the patient lethargic with a respiratory rate of 8 breaths/min. Which
medication should the nurse prepare to administer?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
, Rationale: Naloxone is the opioid antagonist used to reverse respiratory depression
caused by opioids like morphine.
6. A patient with a history of chronic obstructive pulmonary disease (COPD) is
most likely to present with which acid-base imbalance?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: COPD causes CO2 retention due to impaired gas exchange, leading to chronic
respiratory acidosis.
7. Which assessment finding is a hallmark early sign of Malignant Hyperthermia
during surgery?
A. Hypothermia
B. Muscle rigidity
C. Bradypnea
D. Hypotension
Answer: B
Rationale: Muscle rigidity (specifically of the jaw) and an unexplained rise in end-tidal CO2
are the earliest signs of Malignant Hyperthermia; high fever is a late sign.
8. The nurse is caring for a patient with a serum sodium level of 128 mEq/L.
Which clinical manifestation should the nurse prioritize?
A. Dry mucous membranes
B. Thirst
C. Hyperreflexia
D. Confusion and seizures
Answer: D
