NURS 120 | INTRODUCTION TO
MEDICAL-SURGICAL NURSING | EXAM
3 2026 | WCU
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. How should the nurse interpret these findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. Which clinical manifestation should the nurse prioritize when assessing a patient with
suspected right-sided heart failure?
A. Peripheral edema
B. Dyspnea on exertion
,C. Pulmonary crackles
D. Orthopnea
Answer: A
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
causing peripheral edema, JVD, and hepatomegaly. Options A, B, and D are associated with
left-sided heart failure.
3. A patient taking Digoxin reports seeing yellow-green halos around lights. Which action
should the nurse take first?
A. Document the finding as a normal side effect
B. Assess the apical pulse and notify the provider
C. Administer the next scheduled dose
D. Increase the patient’s potassium intake
Answer: B
Conceptual Explanation: Visual disturbances such as yellow-green halos are a classic sign
of Digoxin toxicity. The nurse must hold the med, check the pulse, and notify the physician
for a serum digoxin level.
4. The nurse is reviewing the ECG of a patient with a potassium level of 2.8 mEq/L. Which
finding is most expected?
A. Presence of U-waves
, B. Widened QRS complex
C. Tall, peaked T-waves
D. Shortened QT interval
Answer: A
Conceptual Explanation: Hypokalemia (K < 3.5) causes ST depression, flat or inverted T-
waves, and the appearance of U-waves. Tall peaked T-waves are associated with
hyperkalemia.
5. A nurse is teaching a patient with COPD about pursed-lip breathing. What is the primary
purpose of this technique?
A. To prevent airway collapse during exhalation
B. To increase the respiratory rate
C. To strengthen the diaphragm
D. To promote oxygen saturation during inhalation
Answer: A
Conceptual Explanation: Pursed-lip breathing creates positive pressure in the airways,
keeping the bronchioles open longer to allow more CO2 to be exhaled and reducing air
trapping.
MEDICAL-SURGICAL NURSING | EXAM
3 2026 | WCU
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. How should the nurse interpret these findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. Which clinical manifestation should the nurse prioritize when assessing a patient with
suspected right-sided heart failure?
A. Peripheral edema
B. Dyspnea on exertion
,C. Pulmonary crackles
D. Orthopnea
Answer: A
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
causing peripheral edema, JVD, and hepatomegaly. Options A, B, and D are associated with
left-sided heart failure.
3. A patient taking Digoxin reports seeing yellow-green halos around lights. Which action
should the nurse take first?
A. Document the finding as a normal side effect
B. Assess the apical pulse and notify the provider
C. Administer the next scheduled dose
D. Increase the patient’s potassium intake
Answer: B
Conceptual Explanation: Visual disturbances such as yellow-green halos are a classic sign
of Digoxin toxicity. The nurse must hold the med, check the pulse, and notify the physician
for a serum digoxin level.
4. The nurse is reviewing the ECG of a patient with a potassium level of 2.8 mEq/L. Which
finding is most expected?
A. Presence of U-waves
, B. Widened QRS complex
C. Tall, peaked T-waves
D. Shortened QT interval
Answer: A
Conceptual Explanation: Hypokalemia (K < 3.5) causes ST depression, flat or inverted T-
waves, and the appearance of U-waves. Tall peaked T-waves are associated with
hyperkalemia.
5. A nurse is teaching a patient with COPD about pursed-lip breathing. What is the primary
purpose of this technique?
A. To prevent airway collapse during exhalation
B. To increase the respiratory rate
C. To strengthen the diaphragm
D. To promote oxygen saturation during inhalation
Answer: A
Conceptual Explanation: Pursed-lip breathing creates positive pressure in the airways,
keeping the bronchioles open longer to allow more CO2 to be exhaled and reducing air
trapping.
