NURS 201 Medical-Surgical Nursing - Week 6 Comprehensive Quiz
2026 |WCU
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24
mEq/L. Which acid-base imbalance is occurring?
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 within the normal range (22-26), it is uncompensated
respiratory acidosis.
2. When caring for a patient with Chronic Obstructive Pulmonary Disease
(COPD), which oxygen delivery setting is most appropriate to prevent
suppression of the hypoxic drive?
A. 10-15 L/min via Non-rebreather mask
B. Venturi mask at 50% FiO2
C. 6 L/min via Simple Face Mask
D. 1-2 L/min via Nasal Cannula
Answer: D
Rationale: Patients with chronic hypercapnia rely on low oxygen levels (hypoxic drive) to
stimulate breathing. High concentrations of oxygen can suppress this drive, leading to
respiratory arrest.
,3. A patient is 24 hours post-operative after a total hip arthroplasty. Which
clinical manifestation most strongly suggests a pulmonary embolism (PE)?
A. Productive cough with yellow sputum
B. Pain and swelling in the calf of the affected leg
C. Sudden onset of shortness of breath and chest pain
D. Incisional pain rated 8/10 on the numeric scale
Answer: C
Rationale: While calf pain suggests DVT (a precursor to PE), sudden dyspnea and chest
pain are classic signs of an actual pulmonary embolism, which is a medical emergency.
4. In the management of Hyperkalemia (Potassium 6.5 mEq/L), which
medication is administered to stabilize the myocardial cell membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Sodium Bicarbonate
Answer: B
Rationale: Calcium gluconate does not lower potassium levels but protects the heart from
the dysrhythmic effects of high potassium by stabilizing the cardiac membrane.
5. A patient with Type 1 Diabetes Mellitus presents to the ER with Kussmaul
respirations and a fruity breath odor. Which lab result is most expected?
A. Blood Glucose 900 mg/dL, pH 7.40
B. Blood Glucose 450 mg/dL, pH 7.25
C. Serum Bicarbonate 28 mEq/L
D. Negative urine ketones
Answer: B
, Rationale: Diabetic Ketoacidosis (DKA) is characterized by hyperglycemia, metabolic
acidosis (low pH), and the presence of ketones. Kussmaul respirations are a compensatory
mechanism to blow off CO2.
6. A nurse is assessing a patient for Trousseau’s sign. Which electrolyte
abnormality is the nurse screening for?
A. Hypermagnesemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Answer: C
Rationale: Trousseau’s sign (carpal spasm induced by inflating a blood pressure cuff) and
Chvostek’s sign are clinical indicators of hypocalcemia and neuromuscular irritability.
7. Which assessment finding is the most sensitive early indicator of increased
intracranial pressure (ICP)?
A. Cushing’s Triad (Widening pulse pressure, bradycardia)
B. Change in Level of Consciousness (LOC)
C. Fixed and dilated pupils
D. Projectile vomiting
Answer: B
Rationale: Changes in LOC, such as restlessness, agitation, or confusion, are the earliest
signs of rising ICP. Cushing’s triad is a late sign indicating impending brain herniation.
2026 |WCU
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24
mEq/L. Which acid-base imbalance is occurring?
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 within the normal range (22-26), it is uncompensated
respiratory acidosis.
2. When caring for a patient with Chronic Obstructive Pulmonary Disease
(COPD), which oxygen delivery setting is most appropriate to prevent
suppression of the hypoxic drive?
A. 10-15 L/min via Non-rebreather mask
B. Venturi mask at 50% FiO2
C. 6 L/min via Simple Face Mask
D. 1-2 L/min via Nasal Cannula
Answer: D
Rationale: Patients with chronic hypercapnia rely on low oxygen levels (hypoxic drive) to
stimulate breathing. High concentrations of oxygen can suppress this drive, leading to
respiratory arrest.
,3. A patient is 24 hours post-operative after a total hip arthroplasty. Which
clinical manifestation most strongly suggests a pulmonary embolism (PE)?
A. Productive cough with yellow sputum
B. Pain and swelling in the calf of the affected leg
C. Sudden onset of shortness of breath and chest pain
D. Incisional pain rated 8/10 on the numeric scale
Answer: C
Rationale: While calf pain suggests DVT (a precursor to PE), sudden dyspnea and chest
pain are classic signs of an actual pulmonary embolism, which is a medical emergency.
4. In the management of Hyperkalemia (Potassium 6.5 mEq/L), which
medication is administered to stabilize the myocardial cell membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Sodium Bicarbonate
Answer: B
Rationale: Calcium gluconate does not lower potassium levels but protects the heart from
the dysrhythmic effects of high potassium by stabilizing the cardiac membrane.
5. A patient with Type 1 Diabetes Mellitus presents to the ER with Kussmaul
respirations and a fruity breath odor. Which lab result is most expected?
A. Blood Glucose 900 mg/dL, pH 7.40
B. Blood Glucose 450 mg/dL, pH 7.25
C. Serum Bicarbonate 28 mEq/L
D. Negative urine ketones
Answer: B
, Rationale: Diabetic Ketoacidosis (DKA) is characterized by hyperglycemia, metabolic
acidosis (low pH), and the presence of ketones. Kussmaul respirations are a compensatory
mechanism to blow off CO2.
6. A nurse is assessing a patient for Trousseau’s sign. Which electrolyte
abnormality is the nurse screening for?
A. Hypermagnesemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Answer: C
Rationale: Trousseau’s sign (carpal spasm induced by inflating a blood pressure cuff) and
Chvostek’s sign are clinical indicators of hypocalcemia and neuromuscular irritability.
7. Which assessment finding is the most sensitive early indicator of increased
intracranial pressure (ICP)?
A. Cushing’s Triad (Widening pulse pressure, bradycardia)
B. Change in Level of Consciousness (LOC)
C. Fixed and dilated pupils
D. Projectile vomiting
Answer: B
Rationale: Changes in LOC, such as restlessness, agitation, or confusion, are the earliest
signs of rising ICP. Cushing’s triad is a late sign indicating impending brain herniation.
