NURS 121L-A Introduction to Medical-Surgical Nursing Practicum
Week 11 Comprehensive Quiz 2026 |WCU
1. A patient with chronic kidney disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Calcium gluconate
B. Sodium polystyrene sulfonate
C. Regular insulin and D50
D. Furosemide
Answer: A
Rationale: Calcium gluconate does not lower potassium but is administered first in severe
hyperkalemia to protect the myocardium from arrhythmias by stabilizing the cardiac
membrane.
2. Which clinical manifestation is an early sign of malignant hyperthermia during
general anesthesia?
A. Tachycardia
B. Muscle rigidity
C. Hyperthermia (105°F)
D. Myoglobinuria
Answer: A
Rationale: Tachycardia is often the earliest sign of malignant hyperthermia. Rigidity and
extreme temperature spikes are later signs.
,3. A patient is 12 hours postoperative following a total thyroidectomy. The
nurse notes the patient is experiencing muscle spasms and a positive Chvostek’s
sign. Which electrolyte imbalance is likely?
A. Hypercalcemia
B. Hypocalcemia
C. Hyponatremia
D. Hypokalemia
Answer: B
Rationale: The parathyroid glands may be damaged or removed during a thyroidectomy,
leading to hypocalcemia, which presents with neuromuscular irritability (tetany).
4. The nurse is caring for a patient with a chest tube. What should the nurse do
if the chest tube becomes disconnected from the drainage system?
A. Clamp the tube immediately
B. Cover the opening with a sterile occlusive dressing
C. Submerge the end of the tube in sterile water
D. Reconnect the tube using clean technique
Answer: C
Rationale: Submerging the tube in 2 cm of sterile water creates a temporary water seal
and prevents air from entering the pleural space while a new system is prepared.
5. A patient with COPD is receiving oxygen via nasal cannula at 2L/min. Which
finding would most concern the nurse?
A. SPO2 of 89%
B. Respiratory rate of 10 breaths/min
C. Clubbing of the fingers
D. Productive cough with clear sputum
Answer: B
, Rationale: In COPD patients, a high oxygen flow or sensitivity can suppress the hypoxic
drive to breathe, leading to respiratory depression (hypoventilation).
6. Which assessment finding is most characteristic of right-sided heart failure?
A. Jugular venous distention
B. Pulmonary crackles
C. Orthopnea
D. Frothy pink sputum
Answer: A
Rationale: Right-sided heart failure leads to systemic venous congestion, causing JVD,
peripheral edema, and hepatomegaly. Crackles and orthopnea are left-sided signs.
7. A patient with Type 1 Diabetes Mellitus is found unconscious with a blood
glucose of 42 mg/dL. What is the priority nursing action?
A. Administer 15g of simple carbohydrates orally
B. Check the urine for ketones
C. Wait for the patient to wake up to assess swallow reflex
D. Administer 1mg of Glucagon IM or SQ
Answer: D
Rationale: For an unconscious hypoglycemic patient without IV access, Glucagon IM/SQ is
the priority. Oral carbs are for conscious patients.
8. A patient is diagnosed with Autonomic Dysreflexia. What is the immediate
priority nursing intervention?
A. Administer antihypertensives
B. Place the patient in a high-Fowler’s position
C. Assess for bladder distention
D. Check for fecal impaction
Answer: B
Week 11 Comprehensive Quiz 2026 |WCU
1. A patient with chronic kidney disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Calcium gluconate
B. Sodium polystyrene sulfonate
C. Regular insulin and D50
D. Furosemide
Answer: A
Rationale: Calcium gluconate does not lower potassium but is administered first in severe
hyperkalemia to protect the myocardium from arrhythmias by stabilizing the cardiac
membrane.
2. Which clinical manifestation is an early sign of malignant hyperthermia during
general anesthesia?
A. Tachycardia
B. Muscle rigidity
C. Hyperthermia (105°F)
D. Myoglobinuria
Answer: A
Rationale: Tachycardia is often the earliest sign of malignant hyperthermia. Rigidity and
extreme temperature spikes are later signs.
,3. A patient is 12 hours postoperative following a total thyroidectomy. The
nurse notes the patient is experiencing muscle spasms and a positive Chvostek’s
sign. Which electrolyte imbalance is likely?
A. Hypercalcemia
B. Hypocalcemia
C. Hyponatremia
D. Hypokalemia
Answer: B
Rationale: The parathyroid glands may be damaged or removed during a thyroidectomy,
leading to hypocalcemia, which presents with neuromuscular irritability (tetany).
4. The nurse is caring for a patient with a chest tube. What should the nurse do
if the chest tube becomes disconnected from the drainage system?
A. Clamp the tube immediately
B. Cover the opening with a sterile occlusive dressing
C. Submerge the end of the tube in sterile water
D. Reconnect the tube using clean technique
Answer: C
Rationale: Submerging the tube in 2 cm of sterile water creates a temporary water seal
and prevents air from entering the pleural space while a new system is prepared.
5. A patient with COPD is receiving oxygen via nasal cannula at 2L/min. Which
finding would most concern the nurse?
A. SPO2 of 89%
B. Respiratory rate of 10 breaths/min
C. Clubbing of the fingers
D. Productive cough with clear sputum
Answer: B
, Rationale: In COPD patients, a high oxygen flow or sensitivity can suppress the hypoxic
drive to breathe, leading to respiratory depression (hypoventilation).
6. Which assessment finding is most characteristic of right-sided heart failure?
A. Jugular venous distention
B. Pulmonary crackles
C. Orthopnea
D. Frothy pink sputum
Answer: A
Rationale: Right-sided heart failure leads to systemic venous congestion, causing JVD,
peripheral edema, and hepatomegaly. Crackles and orthopnea are left-sided signs.
7. A patient with Type 1 Diabetes Mellitus is found unconscious with a blood
glucose of 42 mg/dL. What is the priority nursing action?
A. Administer 15g of simple carbohydrates orally
B. Check the urine for ketones
C. Wait for the patient to wake up to assess swallow reflex
D. Administer 1mg of Glucagon IM or SQ
Answer: D
Rationale: For an unconscious hypoglycemic patient without IV access, Glucagon IM/SQ is
the priority. Oral carbs are for conscious patients.
8. A patient is diagnosed with Autonomic Dysreflexia. What is the immediate
priority nursing intervention?
A. Administer antihypertensives
B. Place the patient in a high-Fowler’s position
C. Assess for bladder distention
D. Check for fecal impaction
Answer: B
