NURS 121L-B | Introduction to Medical-Surgical Nursing Practicum -
Week 10 Final Quiz 2026 |WCU
1. A nurse is caring for a patient who is 24 hours post-abdominal surgery. The
patient suddenly reports a ‘popping’ sensation and the nurse observes a loop of
bowel protruding from the incision. What is the immediate priority action?
A. Administer an immediate dose of prescribed PRN opioid analgesic.
B. Attempt to push the protruding organ back into the abdominal cavity gently.
C. Place the patient in a High-Fowler’s position to reduce abdominal pressure.
D. Apply a sterile dressing moistened with warm sterile normal saline.
Answer: D
Rationale: Evisceration is a medical emergency. The nurse must cover the protruding
organs with sterile dressings soaked in sterile normal saline to prevent tissue drying and
necrosis. The patient should be kept in low-Fowler’s with knees flexed, and the surgeon
must be notified immediately.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a
patient who has been experiencing prolonged, severe vomiting?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.48, PaCO2 40, HCO3 30
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.50, PaCO2 28, HCO3 22
Answer: B
Rationale: Prolonged vomiting leads to metabolic alkalosis due to the loss of gastric
hydrochloric acid. This is characterized by an elevated pH (>7.45) and an elevated
bicarbonate (HCO3) level (>26 mEq/L).
,3. A patient with a history of heart failure is admitted with reports of shortness
of breath and a 5-pound weight gain in 48 hours. Which breath sound is most
characteristic of this condition?
A. Wheezes
B. Stridor
C. Crackles
D. Pleural friction rub
Answer: C
Rationale: Crackles (rales) are typical of fluid overload and pulmonary edema associated
with heart failure. They represent the opening of small airways and alveoli that have been
collapsed by fluid.
4. A nurse is monitoring a patient receiving a blood transfusion. Five minutes
into the transfusion, the patient reports back pain, chills, and becomes febrile.
What is the first action the nurse should take?
A. Slow the infusion rate and notify the physician.
B. Check the patient’s identification band against the blood bag label.
C. Administer diphenhydramine as ordered for an allergic reaction.
D. Stop the transfusion immediately and disconnect the tubing at the hub.
Answer: D
Rationale: The symptoms suggest a hemolytic transfusion reaction. The nurse must stop
the infusion immediately to prevent further exposure to the incompatible blood and
maintain the IV line with normal saline using new tubing.
, 5. A patient has a serum potassium level of 2.8 mEq/L. Which cardiac monitor
finding is most closely associated with this laboratory result?
A. Peaked T waves
B. Presence of U waves
C. Shortened QT interval
D. Widened QRS complex
Answer: B
Rationale: Hypokalemia (K+ < 3.5 mEq/L) is associated with the presence of U waves, ST-
segment depression, and flattened T waves. Peaked T waves and widened QRS are signs of
hyperkalemia.
6. The nurse is preparing to administer NPH insulin and Regular insulin in the
same syringe. Which action by the nurse is correct?
A. Draw up the NPH insulin first, followed by the Regular insulin.
B. Draw up the Regular insulin first, followed by the NPH insulin.
C. Inject air into the Regular vial, then air into the NPH vial.
D. Shake the NPH vial vigorously to ensure the suspension is mixed.
Answer: B
Rationale: To prevent contaminating the short-acting Regular insulin with the longer-
acting NPH insulin, the nurse should draw the Regular (clear) first, then the NPH (cloudy).
Air is injected into NPH first, then Regular.
7. When assessing a patient for deep vein thrombosis (DVT), which clinical
manifestation should the nurse prioritize?
A. Bilateral dependent edema
B. Diminished pedal pulses in the affected limb
C. Coolness and pallor of the affected extremity
D. Unilateral calf swelling and tenderness
Answer: D
Week 10 Final Quiz 2026 |WCU
1. A nurse is caring for a patient who is 24 hours post-abdominal surgery. The
patient suddenly reports a ‘popping’ sensation and the nurse observes a loop of
bowel protruding from the incision. What is the immediate priority action?
A. Administer an immediate dose of prescribed PRN opioid analgesic.
B. Attempt to push the protruding organ back into the abdominal cavity gently.
C. Place the patient in a High-Fowler’s position to reduce abdominal pressure.
D. Apply a sterile dressing moistened with warm sterile normal saline.
Answer: D
Rationale: Evisceration is a medical emergency. The nurse must cover the protruding
organs with sterile dressings soaked in sterile normal saline to prevent tissue drying and
necrosis. The patient should be kept in low-Fowler’s with knees flexed, and the surgeon
must be notified immediately.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a
patient who has been experiencing prolonged, severe vomiting?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.48, PaCO2 40, HCO3 30
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.50, PaCO2 28, HCO3 22
Answer: B
Rationale: Prolonged vomiting leads to metabolic alkalosis due to the loss of gastric
hydrochloric acid. This is characterized by an elevated pH (>7.45) and an elevated
bicarbonate (HCO3) level (>26 mEq/L).
,3. A patient with a history of heart failure is admitted with reports of shortness
of breath and a 5-pound weight gain in 48 hours. Which breath sound is most
characteristic of this condition?
A. Wheezes
B. Stridor
C. Crackles
D. Pleural friction rub
Answer: C
Rationale: Crackles (rales) are typical of fluid overload and pulmonary edema associated
with heart failure. They represent the opening of small airways and alveoli that have been
collapsed by fluid.
4. A nurse is monitoring a patient receiving a blood transfusion. Five minutes
into the transfusion, the patient reports back pain, chills, and becomes febrile.
What is the first action the nurse should take?
A. Slow the infusion rate and notify the physician.
B. Check the patient’s identification band against the blood bag label.
C. Administer diphenhydramine as ordered for an allergic reaction.
D. Stop the transfusion immediately and disconnect the tubing at the hub.
Answer: D
Rationale: The symptoms suggest a hemolytic transfusion reaction. The nurse must stop
the infusion immediately to prevent further exposure to the incompatible blood and
maintain the IV line with normal saline using new tubing.
, 5. A patient has a serum potassium level of 2.8 mEq/L. Which cardiac monitor
finding is most closely associated with this laboratory result?
A. Peaked T waves
B. Presence of U waves
C. Shortened QT interval
D. Widened QRS complex
Answer: B
Rationale: Hypokalemia (K+ < 3.5 mEq/L) is associated with the presence of U waves, ST-
segment depression, and flattened T waves. Peaked T waves and widened QRS are signs of
hyperkalemia.
6. The nurse is preparing to administer NPH insulin and Regular insulin in the
same syringe. Which action by the nurse is correct?
A. Draw up the NPH insulin first, followed by the Regular insulin.
B. Draw up the Regular insulin first, followed by the NPH insulin.
C. Inject air into the Regular vial, then air into the NPH vial.
D. Shake the NPH vial vigorously to ensure the suspension is mixed.
Answer: B
Rationale: To prevent contaminating the short-acting Regular insulin with the longer-
acting NPH insulin, the nurse should draw the Regular (clear) first, then the NPH (cloudy).
Air is injected into NPH first, then Regular.
7. When assessing a patient for deep vein thrombosis (DVT), which clinical
manifestation should the nurse prioritize?
A. Bilateral dependent edema
B. Diminished pedal pulses in the affected limb
C. Coolness and pallor of the affected extremity
D. Unilateral calf swelling and tenderness
Answer: D
