NURS 121L-B Medical-Surgical Nursing Practicum - Week 3
Comprehensive Assessment 2026 |WCU
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which ECG
change is most characteristic of this electrolyte imbalance?
A. Peaked T waves
B. Shortened QT interval
C. Widened QRS complex
D. Presence of U waves
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) typically manifests as flat or inverted T
waves and the emergence of U waves. Peaked T waves and widened QRS are signs of
hyperkalemia.
2. An arterial blood gas (ABG) result shows pH 7.30, PaCO2 52 mmHg, and HCO3
24 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal
bicarbonate (22-26) indicates that the acidosis is respiratory in origin.
,3. During the preoperative assessment, a patient reports an allergy to bananas
and avocados. Which action is the priority for the nurse?
A. Notify the dietary department
B. Document the allergy as a food sensitivity
C. Alert the surgical team to a potential latex allergy
D. Cancel the surgery immediately
Answer: C
Rationale: There is a known cross-reactivity between certain fruits (bananas, avocados,
kiwis) and latex. This requires latex-safe precautions in the operating room.
4. A patient is 2 hours post-abdominal surgery and has a blood pressure of
88/56 mmHg and a heart rate of 115 bpm. What is the nurse’s first priority?
A. Administer pain medication
B. Increase the IV fluid rate as ordered
C. Check the surgical dressing for hemorrhage
D. Document the findings as normal post-op
Answer: C
Rationale: Tachycardia and hypotension in a post-operative patient are early signs of
hypovolemic shock or hemorrhage. The nurse must first assess the source of potential
bleeding.
5. Which of the following patients is at the highest risk for developing metabolic
alkalosis?
A. A patient with chronic obstructive pulmonary disease (COPD)
B. A patient receiving prolonged nasogastric suctioning
C. A patient with severe diarrhea
D. A patient in diabetic ketoacidosis
Answer: B
, Rationale: Nasogastric suctioning removes gastric acid (HCl), leading to an excess of
bicarbonate in the blood, resulting in metabolic alkalosis.
6. A nurse is caring for a patient with a serum sodium level of 128 mEq/L. Which
nursing intervention is most appropriate?
A. Encourage increased water intake
B. Initiate seizure precautions
C. Administer 0.45% normal saline
D. Administer a loop diuretic
Answer: B
Rationale: Hyponatremia (sodium < 135 mEq/L) can cause cerebral edema and increase
the risk for seizures. Safety precautions are a priority.
7. The nurse is monitoring a patient receiving magnesium sulfate IV for
preeclampsia. The patient’s deep tendon reflexes (DTRs) are 0+. What is the
next action?
A. Continue the infusion at the current rate
B. Administer calcium gluconate
C. Increase the patient’s fluid intake
D. Encourage the patient to ambulate
Answer: B
Rationale: Absence of deep tendon reflexes is a sign of magnesium toxicity. Calcium
gluconate is the pharmacological antagonist for magnesium.
Comprehensive Assessment 2026 |WCU
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which ECG
change is most characteristic of this electrolyte imbalance?
A. Peaked T waves
B. Shortened QT interval
C. Widened QRS complex
D. Presence of U waves
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) typically manifests as flat or inverted T
waves and the emergence of U waves. Peaked T waves and widened QRS are signs of
hyperkalemia.
2. An arterial blood gas (ABG) result shows pH 7.30, PaCO2 52 mmHg, and HCO3
24 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal
bicarbonate (22-26) indicates that the acidosis is respiratory in origin.
,3. During the preoperative assessment, a patient reports an allergy to bananas
and avocados. Which action is the priority for the nurse?
A. Notify the dietary department
B. Document the allergy as a food sensitivity
C. Alert the surgical team to a potential latex allergy
D. Cancel the surgery immediately
Answer: C
Rationale: There is a known cross-reactivity between certain fruits (bananas, avocados,
kiwis) and latex. This requires latex-safe precautions in the operating room.
4. A patient is 2 hours post-abdominal surgery and has a blood pressure of
88/56 mmHg and a heart rate of 115 bpm. What is the nurse’s first priority?
A. Administer pain medication
B. Increase the IV fluid rate as ordered
C. Check the surgical dressing for hemorrhage
D. Document the findings as normal post-op
Answer: C
Rationale: Tachycardia and hypotension in a post-operative patient are early signs of
hypovolemic shock or hemorrhage. The nurse must first assess the source of potential
bleeding.
5. Which of the following patients is at the highest risk for developing metabolic
alkalosis?
A. A patient with chronic obstructive pulmonary disease (COPD)
B. A patient receiving prolonged nasogastric suctioning
C. A patient with severe diarrhea
D. A patient in diabetic ketoacidosis
Answer: B
, Rationale: Nasogastric suctioning removes gastric acid (HCl), leading to an excess of
bicarbonate in the blood, resulting in metabolic alkalosis.
6. A nurse is caring for a patient with a serum sodium level of 128 mEq/L. Which
nursing intervention is most appropriate?
A. Encourage increased water intake
B. Initiate seizure precautions
C. Administer 0.45% normal saline
D. Administer a loop diuretic
Answer: B
Rationale: Hyponatremia (sodium < 135 mEq/L) can cause cerebral edema and increase
the risk for seizures. Safety precautions are a priority.
7. The nurse is monitoring a patient receiving magnesium sulfate IV for
preeclampsia. The patient’s deep tendon reflexes (DTRs) are 0+. What is the
next action?
A. Continue the infusion at the current rate
B. Administer calcium gluconate
C. Increase the patient’s fluid intake
D. Encourage the patient to ambulate
Answer: B
Rationale: Absence of deep tendon reflexes is a sign of magnesium toxicity. Calcium
gluconate is the pharmacological antagonist for magnesium.
