NURS 121L-A | Medical-Surgical Nursing Practicum | Week 11
Advanced Assessment Quiz 2026 |WCU
1. A patient with chronic kidney disease (CKD) presents with a potassium level
of 6.8 mEq/L. Which of the following is the priority nursing intervention?
A. Administer sodium polystyrene sulfonate orally
B. Obtain an immediate 12-lead electrocardiogram (ECG)
C. Educate the patient on a low-potassium diet
D. Increase the IV infusion rate of normal saline
Answer: B
Rationale: Hyperkalemia above 6.5 mEq/L is a medical emergency. The priority is to
assess for life-threatening cardiac dysrhythmias (like peaked T waves) via ECG before
other interventions.
2. Which arterial blood gas (ABG) result is most indicative of a patient in early
stage respiratory failure due to an acute asthma exacerbation?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.30, PaCO2 55 mmHg, HCO3 28 mEq/L
C. pH 7.35, PaCO2 40 mmHg, HCO3 22 mEq/L
D. pH 7.25, PaCO2 35 mmHg, HCO3 18 mEq/L
Answer: A
Rationale: Early asthma exacerbations usually result in respiratory alkalosis due to
hyperventilation. pH 7.48 and PaCO2 30 mmHg indicate this state. Respiratory acidosis
indicates late-stage exhaustion.
,3. A patient post-thyroidectomy develops tingling in the fingers and a positive
Chvostek’s sign. Which medication should the nurse prepare to administer?
A. Calcium gluconate
B. Magnesium sulfate
C. Potassium chloride
D. Sodium bicarbonate
Answer: A
Rationale: These are signs of hypocalcemia, which can occur if the parathyroid glands are
damaged or removed during a thyroidectomy. IV calcium gluconate is the treatment.
4. A nurse is caring for a patient with a chest tube. The nurse notices the water
seal chamber is bubbling continuously. What is the nurse’s first action?
A. Document this as a normal finding
B. Clamp the chest tube immediately
C. Check the system for an air leak
D. Increase the suction pressure
Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling with respiration is normal for a pneumothorax, but continuous
bubbling requires investigation.
5. When assessing a patient with right-sided heart failure, which clinical
manifestation is the nurse most likely to find?
A. Crackles in lung bases
B. Orthopnea
C. Jugular venous distention
D. Pink frothy sputum
Answer: C
, Rationale: Right-sided heart failure causes systemic congestion, leading to JVD, peripheral
edema, and hepatomegaly. The other options are symptoms of left-sided heart failure.
6. A patient with Type 1 Diabetes is found unconscious with a blood glucose of
42 mg/dL. If the patient has no IV access, what is the priority action?
A. Administer 15g of oral glucose gel
B. Start a peripheral IV line immediately
C. Administer IM glucagon
D. Administer 10 units of regular insulin
Answer: C
Rationale: For an unconscious hypoglycemic patient without IV access, IM glucagon is the
standard emergency treatment to mobilize glucose from the liver.
7. Which of the following is the hallmark clinical sign of a Pulmonary Embolism
(PE)?
A. Sudden onset of shortness of breath and chest pain
B. Bradycardia and hypertension
C. Productive cough with yellow sputum
D. Gradual development of peripheral edema
Answer: A
Rationale: PE typically presents suddenly with dyspnea (shortness of breath), pleuritic
chest pain, and tachypnea.
8. A patient is receiving a blood transfusion and begins to complain of back pain
and chills. What is the nurse’s first priority?
A. Slow the rate of the transfusion
B. Check the patient’s temperature
C. Administer diphenhydramine
D. Stop the transfusion immediately
Answer: D
Advanced Assessment Quiz 2026 |WCU
1. A patient with chronic kidney disease (CKD) presents with a potassium level
of 6.8 mEq/L. Which of the following is the priority nursing intervention?
A. Administer sodium polystyrene sulfonate orally
B. Obtain an immediate 12-lead electrocardiogram (ECG)
C. Educate the patient on a low-potassium diet
D. Increase the IV infusion rate of normal saline
Answer: B
Rationale: Hyperkalemia above 6.5 mEq/L is a medical emergency. The priority is to
assess for life-threatening cardiac dysrhythmias (like peaked T waves) via ECG before
other interventions.
2. Which arterial blood gas (ABG) result is most indicative of a patient in early
stage respiratory failure due to an acute asthma exacerbation?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.30, PaCO2 55 mmHg, HCO3 28 mEq/L
C. pH 7.35, PaCO2 40 mmHg, HCO3 22 mEq/L
D. pH 7.25, PaCO2 35 mmHg, HCO3 18 mEq/L
Answer: A
Rationale: Early asthma exacerbations usually result in respiratory alkalosis due to
hyperventilation. pH 7.48 and PaCO2 30 mmHg indicate this state. Respiratory acidosis
indicates late-stage exhaustion.
,3. A patient post-thyroidectomy develops tingling in the fingers and a positive
Chvostek’s sign. Which medication should the nurse prepare to administer?
A. Calcium gluconate
B. Magnesium sulfate
C. Potassium chloride
D. Sodium bicarbonate
Answer: A
Rationale: These are signs of hypocalcemia, which can occur if the parathyroid glands are
damaged or removed during a thyroidectomy. IV calcium gluconate is the treatment.
4. A nurse is caring for a patient with a chest tube. The nurse notices the water
seal chamber is bubbling continuously. What is the nurse’s first action?
A. Document this as a normal finding
B. Clamp the chest tube immediately
C. Check the system for an air leak
D. Increase the suction pressure
Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling with respiration is normal for a pneumothorax, but continuous
bubbling requires investigation.
5. When assessing a patient with right-sided heart failure, which clinical
manifestation is the nurse most likely to find?
A. Crackles in lung bases
B. Orthopnea
C. Jugular venous distention
D. Pink frothy sputum
Answer: C
, Rationale: Right-sided heart failure causes systemic congestion, leading to JVD, peripheral
edema, and hepatomegaly. The other options are symptoms of left-sided heart failure.
6. A patient with Type 1 Diabetes is found unconscious with a blood glucose of
42 mg/dL. If the patient has no IV access, what is the priority action?
A. Administer 15g of oral glucose gel
B. Start a peripheral IV line immediately
C. Administer IM glucagon
D. Administer 10 units of regular insulin
Answer: C
Rationale: For an unconscious hypoglycemic patient without IV access, IM glucagon is the
standard emergency treatment to mobilize glucose from the liver.
7. Which of the following is the hallmark clinical sign of a Pulmonary Embolism
(PE)?
A. Sudden onset of shortness of breath and chest pain
B. Bradycardia and hypertension
C. Productive cough with yellow sputum
D. Gradual development of peripheral edema
Answer: A
Rationale: PE typically presents suddenly with dyspnea (shortness of breath), pleuritic
chest pain, and tachypnea.
8. A patient is receiving a blood transfusion and begins to complain of back pain
and chills. What is the nurse’s first priority?
A. Slow the rate of the transfusion
B. Check the patient’s temperature
C. Administer diphenhydramine
D. Stop the transfusion immediately
Answer: D
