NURS 120 | INTRODUCTION TO
MEDICAL-SURGICAL NURSING | EXAM
2 2026 | WCU
1. A patient is scheduled for surgery in two hours. The nurse notes the patient has not been
NPO as ordered and ate a light snack one hour ago. What is the priority nursing action?
A. Document the intake and proceed with pre-operative medications.
B. Administer an emetic to clear the stomach contents.
C. Notify the surgeon and the anesthesiologist immediately.
D. Insert a nasogastric tube to aspirate the stomach contents.
Answer: C
Conceptual Explanation: Patient safety is paramount. Eating before surgery increases the
risk of aspiration during anesthesia. The surgeon and anesthesiologist must be notified to
determine if the surgery should be delayed or cancelled.
2. Which of the following electrolyte imbalances is most closely associated with the
development of Trousseau’s and Chvostek’s signs?
A. Hypocalcemia
,B. Hyponatremia
C. Hyperkalemia
D. Hypomagnesemia
Answer: A
Conceptual Explanation: Hypocalcemia increases neuromuscular excitability. Trousseau’s
sign (carpal spasm with BP cuff inflation) and Chvostek’s sign (facial twitching when
tapping the facial nerve) are classic indicators.
3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which EKG 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
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) causes characteristic
tall, peaked T waves and widened QRS complexes, which can lead to cardiac arrest.
4. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, HCO3 26 mEq/L. How should the
nurse interpret these results?
A. Metabolic Acidosis
, B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is low (<7.35) indicating acidosis. The PaCO2 is high
(>45 mmHg) and the HCO3 is normal, indicating the lungs are the cause (respiratory).
5. During the intraoperative phase, which member of the surgical team is responsible for
maintaining the sterile field and passing instruments?
A. Circulating Nurse
B. Anesthesiologist
C. Scrub Nurse
D. Surgeon’s Assistant
Answer: C
Conceptual Explanation: The scrub nurse remains within the sterile field, assists with
draping, and handles sterile instruments. The circulating nurse works outside the sterile
field.
MEDICAL-SURGICAL NURSING | EXAM
2 2026 | WCU
1. A patient is scheduled for surgery in two hours. The nurse notes the patient has not been
NPO as ordered and ate a light snack one hour ago. What is the priority nursing action?
A. Document the intake and proceed with pre-operative medications.
B. Administer an emetic to clear the stomach contents.
C. Notify the surgeon and the anesthesiologist immediately.
D. Insert a nasogastric tube to aspirate the stomach contents.
Answer: C
Conceptual Explanation: Patient safety is paramount. Eating before surgery increases the
risk of aspiration during anesthesia. The surgeon and anesthesiologist must be notified to
determine if the surgery should be delayed or cancelled.
2. Which of the following electrolyte imbalances is most closely associated with the
development of Trousseau’s and Chvostek’s signs?
A. Hypocalcemia
,B. Hyponatremia
C. Hyperkalemia
D. Hypomagnesemia
Answer: A
Conceptual Explanation: Hypocalcemia increases neuromuscular excitability. Trousseau’s
sign (carpal spasm with BP cuff inflation) and Chvostek’s sign (facial twitching when
tapping the facial nerve) are classic indicators.
3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which EKG 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
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) causes characteristic
tall, peaked T waves and widened QRS complexes, which can lead to cardiac arrest.
4. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, HCO3 26 mEq/L. How should the
nurse interpret these results?
A. Metabolic Acidosis
, B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is low (<7.35) indicating acidosis. The PaCO2 is high
(>45 mmHg) and the HCO3 is normal, indicating the lungs are the cause (respiratory).
5. During the intraoperative phase, which member of the surgical team is responsible for
maintaining the sterile field and passing instruments?
A. Circulating Nurse
B. Anesthesiologist
C. Scrub Nurse
D. Surgeon’s Assistant
Answer: C
Conceptual Explanation: The scrub nurse remains within the sterile field, assists with
draping, and handles sterile instruments. The circulating nurse works outside the sterile
field.
