NURS 121L-B Medical-Surgical Nursing Practicum Week 4
Comprehensive Quiz 2026 |WCU
1. A patient who is 12 hours post-abdominal surgery has not voided since the
procedure. What is the nurse’s first priority action?
A. Perform a bladder scan at the bedside
B. Insert a straight catheter immediately
C. Encourage increased oral fluid intake
D. Notify the surgeon of possible renal failure
Answer: A
Rationale: The first step is assessment using a non-invasive tool like a bladder scan to
determine if the issue is urinary retention or decreased urine production.
2. Which ABG result most accurately reflects a patient with a history of COPD
experiencing an acute exacerbation?
A. pH 7.48, PaCO2 30, HCO3 22
B. pH 7.30, PaCO2 55, HCO3 28
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.25, PaCO2 35, HCO3 18
Answer: B
Rationale: COPD exacerbations typically lead to respiratory acidosis (low pH, high PaCO2)
with partial compensation (elevated HCO3).
,3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG
change should the nurse expect to see?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Rationale: Hyperkalemia (K > 5.0) causes characteristic tall, peaked T waves and wide QRS
complexes.
4. During a post-operative assessment, the nurse notes the patient’s abdominal
wound has dehisced and a loop of bowel is protruding. What is the immediate
nursing action?
A. Push the bowel back into the abdominal cavity
B. Cover the wound with a dry sterile dressing
C. Cover the wound with sterile towels soaked in normal saline
D. Place the patient in a High-Fowler’s position
Answer: C
Rationale: Evisceration is a medical emergency; the protruding organ must be kept moist
with sterile saline-soaked dressings while awaiting surgery.
5. Which assessment finding is most indicative of hypocalcemia?
A. Negative Chvostek’s sign
B. Polyuria and polydipsia
C. Hyporeflexia and muscle weakness
D. Carpopedal spasm when a BP cuff is inflated
Answer: D
Rationale: Trousseau’s sign (carpopedal spasm) and Chvostek’s sign (facial twitching) are
classic indicators of neuromuscular excitability in hypocalcemia.
, 6. A patient is receiving a continuous IV infusion of 0.45% Normal Saline. This
solution is classified as:
A. Hypotonic
B. Hypertonic
C. Isotonic
D. Colloid
Answer: A
Rationale: 0.45% Normal Saline is hypotonic, meaning it has a lower osmolarity than
plasma and causes water to shift into cells.
7. What is the primary purpose of using an incentive spirometer in the post-
operative period?
A. To reduce post-operative pain
B. To increase the patient’s oxygen saturation to 100%
C. To prevent or treat atelectasis
D. To improve the strength of abdominal muscles
Answer: C
Rationale: Incentive spirometry promotes deep breathing and lung expansion, which
prevents alveolar collapse (atelectasis) post-surgery.
8. A nurse is monitoring a patient with a Patient-Controlled Analgesia (PCA)
pump. Which finding is the most concerning?
A. Respiratory rate of 8 breaths per minute
B. Patient reports a pain level of 3/10
C. Patient is drowsy but easily aroused
D. The patient has not pressed the button in 2 hours
Answer: A
Rationale: Respiratory depression (RR < 10-12) is the most dangerous side effect of opioid
use via PCA.
Comprehensive Quiz 2026 |WCU
1. A patient who is 12 hours post-abdominal surgery has not voided since the
procedure. What is the nurse’s first priority action?
A. Perform a bladder scan at the bedside
B. Insert a straight catheter immediately
C. Encourage increased oral fluid intake
D. Notify the surgeon of possible renal failure
Answer: A
Rationale: The first step is assessment using a non-invasive tool like a bladder scan to
determine if the issue is urinary retention or decreased urine production.
2. Which ABG result most accurately reflects a patient with a history of COPD
experiencing an acute exacerbation?
A. pH 7.48, PaCO2 30, HCO3 22
B. pH 7.30, PaCO2 55, HCO3 28
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.25, PaCO2 35, HCO3 18
Answer: B
Rationale: COPD exacerbations typically lead to respiratory acidosis (low pH, high PaCO2)
with partial compensation (elevated HCO3).
,3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG
change should the nurse expect to see?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Rationale: Hyperkalemia (K > 5.0) causes characteristic tall, peaked T waves and wide QRS
complexes.
4. During a post-operative assessment, the nurse notes the patient’s abdominal
wound has dehisced and a loop of bowel is protruding. What is the immediate
nursing action?
A. Push the bowel back into the abdominal cavity
B. Cover the wound with a dry sterile dressing
C. Cover the wound with sterile towels soaked in normal saline
D. Place the patient in a High-Fowler’s position
Answer: C
Rationale: Evisceration is a medical emergency; the protruding organ must be kept moist
with sterile saline-soaked dressings while awaiting surgery.
5. Which assessment finding is most indicative of hypocalcemia?
A. Negative Chvostek’s sign
B. Polyuria and polydipsia
C. Hyporeflexia and muscle weakness
D. Carpopedal spasm when a BP cuff is inflated
Answer: D
Rationale: Trousseau’s sign (carpopedal spasm) and Chvostek’s sign (facial twitching) are
classic indicators of neuromuscular excitability in hypocalcemia.
, 6. A patient is receiving a continuous IV infusion of 0.45% Normal Saline. This
solution is classified as:
A. Hypotonic
B. Hypertonic
C. Isotonic
D. Colloid
Answer: A
Rationale: 0.45% Normal Saline is hypotonic, meaning it has a lower osmolarity than
plasma and causes water to shift into cells.
7. What is the primary purpose of using an incentive spirometer in the post-
operative period?
A. To reduce post-operative pain
B. To increase the patient’s oxygen saturation to 100%
C. To prevent or treat atelectasis
D. To improve the strength of abdominal muscles
Answer: C
Rationale: Incentive spirometry promotes deep breathing and lung expansion, which
prevents alveolar collapse (atelectasis) post-surgery.
8. A nurse is monitoring a patient with a Patient-Controlled Analgesia (PCA)
pump. Which finding is the most concerning?
A. Respiratory rate of 8 breaths per minute
B. Patient reports a pain level of 3/10
C. Patient is drowsy but easily aroused
D. The patient has not pressed the button in 2 hours
Answer: A
Rationale: Respiratory depression (RR < 10-12) is the most dangerous side effect of opioid
use via PCA.
