West Coast University NURS 120 Week 2 Quiz (pdf) |
2026/2027 | Medical-Surgical Nursing Q&A | Nursing
1. Which of the following best describes the primary composition of intracellular fluid (ICF)?
A) It contains approximately one-third of total body water and is rich in sodium.
B) It contains approximately two-thirds of total body water and is rich in potassium.
C) It contains approximately one-half of total body water and is rich in chloride.
D) It contains approximately one-quarter of total body water and is rich in calcium.
Correct Answer: It contains approximately two-thirds of total body water and is rich in potassium.
Rationale: Intracellular fluid (ICF) accounts for about 66% of total body water in adults and is the
primary reservoir of potassium in the body. Sodium, chloride, and calcium are predominantly
extracellular electrolytes. Therefore, the ICF compartment is characterized by high potassium
concentration and comprises the largest fluid volume in the body.
2. What is the primary determinant of extracellular fluid osmolality?
A) Potassium
B) Glucose
C) Sodium
D) Albumin
Correct Answer: Sodium
Rationale: Sodium is the most abundant cation in the extracellular fluid and serves as the primary
determinant of extracellular fluid osmolality and volume. While glucose and albumin contribute to
serum osmolality, their influence is secondary to that of sodium under normal physiologic conditions.
Potassium is the dominant intracellular cation and does not primarily regulate extracellular
osmolality.
3. A patient is diagnosed with hypovolemia. Which intravenous solution is considered isotonic and
appropriate for initial volume replacement?
A) 0.45% Sodium Chloride
B) 0.9% Sodium Chloride
C) 3% Sodium Chloride
D) 10% Dextrose in Water
Correct Answer: 0.9% Sodium Chloride
,Rationale: 0.9% Sodium Chloride (normal saline) is an isotonic crystalloid solution commonly used to
expand extracellular fluid volume in hypovolemic states. 0.45% Sodium Chloride is hypotonic and
would not effectively expand vascular volume. 3% Sodium Chloride is hypertonic and reserved for
severe hyponatremia, while 10% Dextrose in Water is hypertonic and not indicated for initial volume
resuscitation.
4. A patient's arterial blood gas results show: pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L. How
should the nurse interpret these findings?
A) Respiratory Alkalosis
B) Metabolic Acidosis
C) Respiratory Acidosis
D) Metabolic Alkalosis
Correct Answer: Respiratory Acidosis
Rationale: The pH of 7.30 indicates acidemia, and the elevated PaCO2 of 52 mmHg (normal: 35–45
mmHg) identifies the respiratory system as the primary cause. The HCO3 of 24 mEq/L is within
normal limits, indicating no metabolic compensation has occurred yet. Therefore, the interpretation is
acute respiratory acidosis.
5. Which clinical manifestation is a classic sign of hypocalcemia?
A) Muscle weakness
B) Brisk deep tendon reflexes
C) Positive Chvostek's sign
D) Decreased neuromuscular excitability
Correct Answer: Positive Chvostek's sign
Rationale: Chvostek's sign is a classic indicator of hypocalcemia-related neuromuscular irritability,
elicited by tapping the facial nerve and observing facial muscle twitching. Hypocalcemia increases
neuromuscular excitability, manifesting as tetany, paresthesias, and hyperreflexia rather than muscle
weakness or decreased excitability. Therefore, a positive Chvostek's sign strongly suggests
hypocalcemia.
6. What is the primary goal of the preoperative nursing assessment?
A) To explain the risks of the surgical procedure
B) To obtain legal signature for the consent form
C) To identify risk factors and establish a baseline for care
D) To administer preoperative medications
,Correct Answer: To identify risk factors and establish a baseline for care
Rationale: The preoperative assessment focuses on identifying patient-specific risks, allergies,
baseline physiologic status, and psychosocial factors that influence surgical outcomes. Explaining
risks and obtaining consent are provider responsibilities, while administering preoperative
medications occurs after assessment and provider orders. Establishing a comprehensive baseline
enables the nurse to detect postoperative changes and ensure patient safety.
7. Which member of the surgical team is responsible for maintaining the sterile field during
surgery?
A) Circulating nurse
B) Anesthesiologist
C) Scrub nurse
D) Surgeon's assistant
Correct Answer: Scrub nurse
Rationale: The scrub nurse or surgical technologist works directly within the sterile field, handling
sterile instruments and supplies while ensuring sterility is maintained. The circulating nurse remains
outside the sterile field and manages documentation and supplies. The anesthesiologist manages
anesthesia, while the surgeon's assistant provides surgical assistance but does not bear primary
responsibility for sterile field maintenance.
8. A patient in the PACU is difficult to arouse and has a respiratory rate of 8 breaths per minute.
Which medication should the nurse anticipate administering?
A) Protamine Sulfate
B) Flumazenil
C) Naloxone
D) Vitamin K
Correct Answer: Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse respiratory depression and sedation
caused by opioid analgesics administered during surgery. Flumazenil reverses benzodiazepine effects
but is not indicated for opioid-induced respiratory depression. Protamine Sulfate reverses heparin,
and Vitamin K reverses warfarin, neither of which addresses the clinical presentation described.
9. Which factor is most important in determining a patient's risk for postoperative atelectasis?
A) The patient's age and smoking history
B) The patient's blood pressure reading
C) The patient's fasting blood glucose level
, D) The patient's preoperative hemoglobin level
Correct Answer: The patient's age and smoking history
Rationale: Age and smoking history are significant risk factors for postoperative atelectasis due to
reduced lung compliance, impaired mucociliary clearance, and decreased functional residual
capacity. While other factors contribute to overall surgical risk, they are not as directly linked to
alveolar collapse as age and smoking status. Incentive spirometry and early ambulation are key
preventive interventions for high-risk patients.
10. In the context of fluid balance, which principle explains why isotonic solutions remain in the
extracellular compartment?
A) Osmotic pressure is equal inside and outside the cell.
B) Hydrostatic pressure pulls fluid into the cell.
C) Oncotic pressure drives fluid out of the vessel.
D) Active transport pumps fluid into the intracellular space.
Correct Answer: Osmotic pressure is equal inside and outside the cell.
Rationale: Isotonic solutions have the same osmolality as intracellular fluid, so there is no net osmotic
gradient driving water into or out of cells. Hydrostatic pressure and oncotic pressure influence
capillary-level fluid exchange but do not explain why isotonic solutions distribute primarily in the
extracellular compartment. Active transport maintains ionic gradients but does not primarily regulate
water movement for isotonic solutions.
11. What distinguishes respiratory acidosis from metabolic acidosis when interpreting arterial
blood gases?
A) The pH is elevated in respiratory acidosis.
B) The PaCO2 is elevated in respiratory acidosis.
C) The HCO3 is elevated in respiratory acidosis.
D) The PaO2 is decreased in respiratory acidosis.
Correct Answer: The PaCO2 is elevated in respiratory acidosis.
Rationale: Respiratory acidosis is characterized by an elevated PaCO2 (>45 mmHg) due to alveolar
hypoventilation, causing acid retention. Metabolic acidosis features a low HCO3 (<22 mEq/L) with
compensatory hyperventilation. The pH is decreased in both conditions, and PaO2 changes are not
specific to distinguishing the primary disorder.
12. Which term refers to the movement of fluid from an area of higher pressure to an area of lower
pressure through a semipermeable membrane?
A) Osmosis
2026/2027 | Medical-Surgical Nursing Q&A | Nursing
1. Which of the following best describes the primary composition of intracellular fluid (ICF)?
A) It contains approximately one-third of total body water and is rich in sodium.
B) It contains approximately two-thirds of total body water and is rich in potassium.
C) It contains approximately one-half of total body water and is rich in chloride.
D) It contains approximately one-quarter of total body water and is rich in calcium.
Correct Answer: It contains approximately two-thirds of total body water and is rich in potassium.
Rationale: Intracellular fluid (ICF) accounts for about 66% of total body water in adults and is the
primary reservoir of potassium in the body. Sodium, chloride, and calcium are predominantly
extracellular electrolytes. Therefore, the ICF compartment is characterized by high potassium
concentration and comprises the largest fluid volume in the body.
2. What is the primary determinant of extracellular fluid osmolality?
A) Potassium
B) Glucose
C) Sodium
D) Albumin
Correct Answer: Sodium
Rationale: Sodium is the most abundant cation in the extracellular fluid and serves as the primary
determinant of extracellular fluid osmolality and volume. While glucose and albumin contribute to
serum osmolality, their influence is secondary to that of sodium under normal physiologic conditions.
Potassium is the dominant intracellular cation and does not primarily regulate extracellular
osmolality.
3. A patient is diagnosed with hypovolemia. Which intravenous solution is considered isotonic and
appropriate for initial volume replacement?
A) 0.45% Sodium Chloride
B) 0.9% Sodium Chloride
C) 3% Sodium Chloride
D) 10% Dextrose in Water
Correct Answer: 0.9% Sodium Chloride
,Rationale: 0.9% Sodium Chloride (normal saline) is an isotonic crystalloid solution commonly used to
expand extracellular fluid volume in hypovolemic states. 0.45% Sodium Chloride is hypotonic and
would not effectively expand vascular volume. 3% Sodium Chloride is hypertonic and reserved for
severe hyponatremia, while 10% Dextrose in Water is hypertonic and not indicated for initial volume
resuscitation.
4. A patient's arterial blood gas results show: pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L. How
should the nurse interpret these findings?
A) Respiratory Alkalosis
B) Metabolic Acidosis
C) Respiratory Acidosis
D) Metabolic Alkalosis
Correct Answer: Respiratory Acidosis
Rationale: The pH of 7.30 indicates acidemia, and the elevated PaCO2 of 52 mmHg (normal: 35–45
mmHg) identifies the respiratory system as the primary cause. The HCO3 of 24 mEq/L is within
normal limits, indicating no metabolic compensation has occurred yet. Therefore, the interpretation is
acute respiratory acidosis.
5. Which clinical manifestation is a classic sign of hypocalcemia?
A) Muscle weakness
B) Brisk deep tendon reflexes
C) Positive Chvostek's sign
D) Decreased neuromuscular excitability
Correct Answer: Positive Chvostek's sign
Rationale: Chvostek's sign is a classic indicator of hypocalcemia-related neuromuscular irritability,
elicited by tapping the facial nerve and observing facial muscle twitching. Hypocalcemia increases
neuromuscular excitability, manifesting as tetany, paresthesias, and hyperreflexia rather than muscle
weakness or decreased excitability. Therefore, a positive Chvostek's sign strongly suggests
hypocalcemia.
6. What is the primary goal of the preoperative nursing assessment?
A) To explain the risks of the surgical procedure
B) To obtain legal signature for the consent form
C) To identify risk factors and establish a baseline for care
D) To administer preoperative medications
,Correct Answer: To identify risk factors and establish a baseline for care
Rationale: The preoperative assessment focuses on identifying patient-specific risks, allergies,
baseline physiologic status, and psychosocial factors that influence surgical outcomes. Explaining
risks and obtaining consent are provider responsibilities, while administering preoperative
medications occurs after assessment and provider orders. Establishing a comprehensive baseline
enables the nurse to detect postoperative changes and ensure patient safety.
7. Which member of the surgical team is responsible for maintaining the sterile field during
surgery?
A) Circulating nurse
B) Anesthesiologist
C) Scrub nurse
D) Surgeon's assistant
Correct Answer: Scrub nurse
Rationale: The scrub nurse or surgical technologist works directly within the sterile field, handling
sterile instruments and supplies while ensuring sterility is maintained. The circulating nurse remains
outside the sterile field and manages documentation and supplies. The anesthesiologist manages
anesthesia, while the surgeon's assistant provides surgical assistance but does not bear primary
responsibility for sterile field maintenance.
8. A patient in the PACU is difficult to arouse and has a respiratory rate of 8 breaths per minute.
Which medication should the nurse anticipate administering?
A) Protamine Sulfate
B) Flumazenil
C) Naloxone
D) Vitamin K
Correct Answer: Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse respiratory depression and sedation
caused by opioid analgesics administered during surgery. Flumazenil reverses benzodiazepine effects
but is not indicated for opioid-induced respiratory depression. Protamine Sulfate reverses heparin,
and Vitamin K reverses warfarin, neither of which addresses the clinical presentation described.
9. Which factor is most important in determining a patient's risk for postoperative atelectasis?
A) The patient's age and smoking history
B) The patient's blood pressure reading
C) The patient's fasting blood glucose level
, D) The patient's preoperative hemoglobin level
Correct Answer: The patient's age and smoking history
Rationale: Age and smoking history are significant risk factors for postoperative atelectasis due to
reduced lung compliance, impaired mucociliary clearance, and decreased functional residual
capacity. While other factors contribute to overall surgical risk, they are not as directly linked to
alveolar collapse as age and smoking status. Incentive spirometry and early ambulation are key
preventive interventions for high-risk patients.
10. In the context of fluid balance, which principle explains why isotonic solutions remain in the
extracellular compartment?
A) Osmotic pressure is equal inside and outside the cell.
B) Hydrostatic pressure pulls fluid into the cell.
C) Oncotic pressure drives fluid out of the vessel.
D) Active transport pumps fluid into the intracellular space.
Correct Answer: Osmotic pressure is equal inside and outside the cell.
Rationale: Isotonic solutions have the same osmolality as intracellular fluid, so there is no net osmotic
gradient driving water into or out of cells. Hydrostatic pressure and oncotic pressure influence
capillary-level fluid exchange but do not explain why isotonic solutions distribute primarily in the
extracellular compartment. Active transport maintains ionic gradients but does not primarily regulate
water movement for isotonic solutions.
11. What distinguishes respiratory acidosis from metabolic acidosis when interpreting arterial
blood gases?
A) The pH is elevated in respiratory acidosis.
B) The PaCO2 is elevated in respiratory acidosis.
C) The HCO3 is elevated in respiratory acidosis.
D) The PaO2 is decreased in respiratory acidosis.
Correct Answer: The PaCO2 is elevated in respiratory acidosis.
Rationale: Respiratory acidosis is characterized by an elevated PaCO2 (>45 mmHg) due to alveolar
hypoventilation, causing acid retention. Metabolic acidosis features a low HCO3 (<22 mEq/L) with
compensatory hyperventilation. The pH is decreased in both conditions, and PaO2 changes are not
specific to distinguishing the primary disorder.
12. Which term refers to the movement of fluid from an area of higher pressure to an area of lower
pressure through a semipermeable membrane?
A) Osmosis
