NURS 121L-B | Medical-Surgical Nursing Practicum | Week 12 Quiz
2026 |WCU
1. A patient who is 6 hours postoperative after abdominal surgery has a heart
rate of 120 bpm, blood pressure of 90/50 mmHg, and urine output of 15 mL
over the last hour. Which action should the nurse take first?
A. Continue to monitor the patient for the next hour
B. Increase the rate of the maintenance intravenous fluids
C. Notify the surgeon immediately of the findings
D. Administer the prescribed PRN pain medication
Answer: C
Rationale: Tachycardia, hypotension, and oliguria in a postoperative patient are classic
signs of hemorrhage or hypovolemic shock, requiring immediate surgical intervention or
medical evaluation.
2. Which arterial blood gas (ABG) result is most indicative of a patient
experiencing uncompensated respiratory acidosis?
A. pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
C. pH 7.32, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.45, PaCO2 40 mmHg, HCO3 26 mEq/L
Answer: B
Rationale: Respiratory acidosis is characterized by a low pH (below 7.35) and a high
PaCO2 (above 45 mmHg). In the uncompensated state, the HCO3 remains within the
normal range (22-26 mEq/L).
,3. The nurse is assessing a patient with chronic heart failure who is taking
Digoxin. Which finding would suggest digoxin toxicity?
A. Hyperkalemia and increased appetite
B. Visual disturbances and nausea
C. Tachycardia and hypertension
D. Peripheral edema and weight gain
Answer: B
Rationale: Classic signs of digoxin toxicity include gastrointestinal distress (nausea,
vomiting) and visual changes, such as seeing yellow-green halos or blurred vision.
4. A patient with a chest tube has continuous bubbling in the water-seal
chamber. What does this indicate?
A. There is an air leak in the system or the pleural space
B. The system is functioning normally for a pneumothorax
C. The suction is turned up too high
D. The patient is ready for the chest tube to be removed
Answer: A
Rationale: Intermittent bubbling is expected in a patient with a pneumothorax, but
continuous bubbling in the water-seal chamber indicates an air leak in the drainage system
or the patient’s pleural space.
5. Which medication is considered the priority for a patient presenting with a
serum potassium level of 6.8 mEq/L and tall, peaked T-waves on the ECG?
A. Calcium gluconate
B. Furosemide (Lasix)
C. Sodium polystyrene sulfonate (Kayexalate)
D. Spironolactone
Answer: A
, Rationale: Calcium gluconate is administered to stabilize the myocardial cell membrane
and prevent life-threatening arrhythmias in the setting of severe hyperkalemia.
6. A patient with Type 1 Diabetes Mellitus is admitted with Diabetic
Ketoacidosis (DKA). Which IV fluid should the nurse expect to administer first?
A. 5% Dextrose in 0.45% Normal Saline
B. Lactated Ringer’s solution
C. 3% Hypertonic Saline
D. 0.9% Normal Saline
Answer: D
Rationale: The initial goal in DKA treatment is to restore extracellular fluid volume and
stabilize blood pressure using an isotonic crystalloid, typically 0.9% Normal Saline.
7. During an assessment of a patient with a suspected peptic ulcer perforation,
which finding is most characteristic?
A. Hyperactive bowel sounds and diarrhea
B. Mid-epigastric gnawing pain relieved by food
C. A rigid, board-like abdomen and sudden, severe pain
D. Left lower quadrant pain and fever
Answer: C
Rationale: Perforation of a peptic ulcer causes peritonitis, which is clinically manifested by
a rigid, board-like abdomen and sudden, intense abdominal pain.
8. Which diet education is correct for a patient during an acute flare-up of
diverticulitis?
A. Clear liquid diet to rest the bowel
B. High-fiber diet with whole grains
C. Low-protein, high-fat diet
D. High-fiber diet with added seeds and nuts
Answer: A
2026 |WCU
1. A patient who is 6 hours postoperative after abdominal surgery has a heart
rate of 120 bpm, blood pressure of 90/50 mmHg, and urine output of 15 mL
over the last hour. Which action should the nurse take first?
A. Continue to monitor the patient for the next hour
B. Increase the rate of the maintenance intravenous fluids
C. Notify the surgeon immediately of the findings
D. Administer the prescribed PRN pain medication
Answer: C
Rationale: Tachycardia, hypotension, and oliguria in a postoperative patient are classic
signs of hemorrhage or hypovolemic shock, requiring immediate surgical intervention or
medical evaluation.
2. Which arterial blood gas (ABG) result is most indicative of a patient
experiencing uncompensated respiratory acidosis?
A. pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
C. pH 7.32, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.45, PaCO2 40 mmHg, HCO3 26 mEq/L
Answer: B
Rationale: Respiratory acidosis is characterized by a low pH (below 7.35) and a high
PaCO2 (above 45 mmHg). In the uncompensated state, the HCO3 remains within the
normal range (22-26 mEq/L).
,3. The nurse is assessing a patient with chronic heart failure who is taking
Digoxin. Which finding would suggest digoxin toxicity?
A. Hyperkalemia and increased appetite
B. Visual disturbances and nausea
C. Tachycardia and hypertension
D. Peripheral edema and weight gain
Answer: B
Rationale: Classic signs of digoxin toxicity include gastrointestinal distress (nausea,
vomiting) and visual changes, such as seeing yellow-green halos or blurred vision.
4. A patient with a chest tube has continuous bubbling in the water-seal
chamber. What does this indicate?
A. There is an air leak in the system or the pleural space
B. The system is functioning normally for a pneumothorax
C. The suction is turned up too high
D. The patient is ready for the chest tube to be removed
Answer: A
Rationale: Intermittent bubbling is expected in a patient with a pneumothorax, but
continuous bubbling in the water-seal chamber indicates an air leak in the drainage system
or the patient’s pleural space.
5. Which medication is considered the priority for a patient presenting with a
serum potassium level of 6.8 mEq/L and tall, peaked T-waves on the ECG?
A. Calcium gluconate
B. Furosemide (Lasix)
C. Sodium polystyrene sulfonate (Kayexalate)
D. Spironolactone
Answer: A
, Rationale: Calcium gluconate is administered to stabilize the myocardial cell membrane
and prevent life-threatening arrhythmias in the setting of severe hyperkalemia.
6. A patient with Type 1 Diabetes Mellitus is admitted with Diabetic
Ketoacidosis (DKA). Which IV fluid should the nurse expect to administer first?
A. 5% Dextrose in 0.45% Normal Saline
B. Lactated Ringer’s solution
C. 3% Hypertonic Saline
D. 0.9% Normal Saline
Answer: D
Rationale: The initial goal in DKA treatment is to restore extracellular fluid volume and
stabilize blood pressure using an isotonic crystalloid, typically 0.9% Normal Saline.
7. During an assessment of a patient with a suspected peptic ulcer perforation,
which finding is most characteristic?
A. Hyperactive bowel sounds and diarrhea
B. Mid-epigastric gnawing pain relieved by food
C. A rigid, board-like abdomen and sudden, severe pain
D. Left lower quadrant pain and fever
Answer: C
Rationale: Perforation of a peptic ulcer causes peritonitis, which is clinically manifested by
a rigid, board-like abdomen and sudden, intense abdominal pain.
8. Which diet education is correct for a patient during an acute flare-up of
diverticulitis?
A. Clear liquid diet to rest the bowel
B. High-fiber diet with whole grains
C. Low-protein, high-fat diet
D. High-fiber diet with added seeds and nuts
Answer: A
