NURS 201 Medical-Surgical Nursing - Promoting Wellness - Week 14
High-Level Mastery Quiz 2026 |WCU
1. A patient with a T6 spinal cord injury reports a sudden, severe headache and
is found to have a blood pressure of 190/100 mmHg. What is the nurse’s priority
intervention?
A. Administer an antihypertensive medication immediately.
B. Place the patient in a supine position to stabilize blood pressure.
C. Check the patient’s urinary catheter for kinks or obstruction.
D. Notify the healthcare provider to request a CT scan of the head.
Answer: C
Rationale: The symptoms suggest autonomic dysreflexia, a medical emergency in SCI
patients above T6. The priority is to remove the triggering stimulus, often a distended
bladder or bowel, while sitting the patient upright.
2. A client is admitted with Acute Respiratory Distress Syndrome (ARDS). Which
ventilator setting is specifically utilized to prevent alveolar collapse at the end of
expiration?
A. Fraction of inspired oxygen (FiO2)
B. Positive End-Expiratory Pressure (PEEP)
C. Tidal Volume (VT)
D. Inspiratory-to-Expiratory (I:E) ratio
Answer: B
Rationale: PEEP provides pressure at the end of expiration to keep alveoli open, improving
gas exchange and preventing surfactant inactivation in ARDS.
,3. Which laboratory value is most indicative of the effectiveness of treatment
for a patient experiencing a Myocardial Infarction (MI)?
A. Troponin T and I
B. Creatine Kinase (CK-MB)
C. Myoglobin
D. Brain Natriuretic Peptide (BNP)
Answer: A
Rationale: Troponins are highly specific to cardiac muscle and remain elevated longer
than other markers, making them the gold standard for diagnosing and monitoring MI.
4. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L. Which medication should the nurse anticipate administering to
protect the heart from dysrhythmias?
A. Sodium Polystyrene Sulfonate
B. Regular Insulin and Glucose
C. Calcium Gluconate
D. Furosemide
Answer: C
Rationale: While other medications lower potassium, Calcium Gluconate is administered
first to stabilize the myocardial cell membrane and prevent lethal arrhythmias.
5. When caring for a patient with Liver Cirrhosis and Hepatic Encephalopathy,
which assessment finding indicates that lactulose therapy is effective?
A. Increased serum albumin levels
B. Decreased abdominal girth
C. Presence of two soft bowel movements per day
D. Improved Glasgow Coma Scale (GCS) score
Answer: D
, Rationale: Lactulose is given to reduce ammonia levels. Improvement in neurological
status (cognition/alertness) is the primary indicator of effectiveness, though bowel
movements are a side effect.
6. A patient presents with ‘Cushing’s Triad’ following a head injury. Which set of
vital signs does the nurse expect to see?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and Kussmaul respirations
Answer: B
Rationale: Cushing’s Triad is a late sign of increased intracranial pressure (ICP)
characterized by bradycardia, widened pulse pressure (rising systolic), and respiratory
irregularity.
7. During a blood transfusion, a patient develops chills, lower back pain, and
hypotension. After stopping the transfusion, what is the nurse’s next action?
A. Administer diphenhydramine as ordered.
B. Slow the infusion rate and monitor for 15 minutes.
C. Infuse normal saline through new tubing.
D. Obtain a urine specimen to check for hemoglobinuria.
Answer: C
Rationale: This is a suspected acute hemolytic reaction. The nurse must stop the blood and
maintain IV access with fresh saline and new tubing to prevent circulatory collapse.
High-Level Mastery Quiz 2026 |WCU
1. A patient with a T6 spinal cord injury reports a sudden, severe headache and
is found to have a blood pressure of 190/100 mmHg. What is the nurse’s priority
intervention?
A. Administer an antihypertensive medication immediately.
B. Place the patient in a supine position to stabilize blood pressure.
C. Check the patient’s urinary catheter for kinks or obstruction.
D. Notify the healthcare provider to request a CT scan of the head.
Answer: C
Rationale: The symptoms suggest autonomic dysreflexia, a medical emergency in SCI
patients above T6. The priority is to remove the triggering stimulus, often a distended
bladder or bowel, while sitting the patient upright.
2. A client is admitted with Acute Respiratory Distress Syndrome (ARDS). Which
ventilator setting is specifically utilized to prevent alveolar collapse at the end of
expiration?
A. Fraction of inspired oxygen (FiO2)
B. Positive End-Expiratory Pressure (PEEP)
C. Tidal Volume (VT)
D. Inspiratory-to-Expiratory (I:E) ratio
Answer: B
Rationale: PEEP provides pressure at the end of expiration to keep alveoli open, improving
gas exchange and preventing surfactant inactivation in ARDS.
,3. Which laboratory value is most indicative of the effectiveness of treatment
for a patient experiencing a Myocardial Infarction (MI)?
A. Troponin T and I
B. Creatine Kinase (CK-MB)
C. Myoglobin
D. Brain Natriuretic Peptide (BNP)
Answer: A
Rationale: Troponins are highly specific to cardiac muscle and remain elevated longer
than other markers, making them the gold standard for diagnosing and monitoring MI.
4. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L. Which medication should the nurse anticipate administering to
protect the heart from dysrhythmias?
A. Sodium Polystyrene Sulfonate
B. Regular Insulin and Glucose
C. Calcium Gluconate
D. Furosemide
Answer: C
Rationale: While other medications lower potassium, Calcium Gluconate is administered
first to stabilize the myocardial cell membrane and prevent lethal arrhythmias.
5. When caring for a patient with Liver Cirrhosis and Hepatic Encephalopathy,
which assessment finding indicates that lactulose therapy is effective?
A. Increased serum albumin levels
B. Decreased abdominal girth
C. Presence of two soft bowel movements per day
D. Improved Glasgow Coma Scale (GCS) score
Answer: D
, Rationale: Lactulose is given to reduce ammonia levels. Improvement in neurological
status (cognition/alertness) is the primary indicator of effectiveness, though bowel
movements are a side effect.
6. A patient presents with ‘Cushing’s Triad’ following a head injury. Which set of
vital signs does the nurse expect to see?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and Kussmaul respirations
Answer: B
Rationale: Cushing’s Triad is a late sign of increased intracranial pressure (ICP)
characterized by bradycardia, widened pulse pressure (rising systolic), and respiratory
irregularity.
7. During a blood transfusion, a patient develops chills, lower back pain, and
hypotension. After stopping the transfusion, what is the nurse’s next action?
A. Administer diphenhydramine as ordered.
B. Slow the infusion rate and monitor for 15 minutes.
C. Infuse normal saline through new tubing.
D. Obtain a urine specimen to check for hemoglobinuria.
Answer: C
Rationale: This is a suspected acute hemolytic reaction. The nurse must stop the blood and
maintain IV access with fresh saline and new tubing to prevent circulatory collapse.
