NURS 121L-B Introduction to Medical-Surgical Nursing Module 3 Exam
2026 |WCU
1. A nurse is caring for a postoperative patient who suddenly develops chest
pain and dyspnea. Which action should the nurse take first?
A. Administer prescribed morphine
B. Obtain an electrocardiogram (ECG)
C. Elevate the head of the bed and apply oxygen
D. Notify the rapid response team
Answer: C
Rationale: Elevating the head of the bed and applying oxygen addresses immediate gas
exchange needs in a suspected pulmonary embolism or cardiac event before secondary
interventions.
2. The nurse is reviewing the arterial blood gas (ABG) results of a patient: pH
7.28, PaCO2 50 mmHg, HCO3 24 mEq/L. Which acid-base imbalance does this
represent?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory), while the
bicarbonate is normal, indicating uncompensated respiratory acidosis.
,3. When assessing a patient with hypokalemia, which EKG change is most
characteristic?
A. Peaked T waves
B. Widened QRS complex
C. Presence of U waves
D. Shortened PR interval
Answer: C
Rationale: Hypokalemia typically causes ST segment depression, flattened T waves, and
the appearance of U waves.
4. A nurse observes a patient’s surgical wound and notes the bowel is
protruding through the incision. What is the priority nursing action?
A. Push the bowel back into the abdominal cavity
B. Apply a tight pressure dressing to the site
C. Cover the protruding organ with sterile gauze soaked in normal saline
D. Check the patient’s vital signs immediately
Answer: C
Rationale: Wound evisceration is a medical emergency. The nurse must cover the organ
with sterile, saline-soaked dressings to keep it moist while preparing for surgery.
5. Which clinical manifestation is an early sign of malignant hyperthermia during
surgery?
A. Muscle rigidity and tachycardia
B. Temperature of 105 degrees F
C. Hypotension
D. Bradycardia
Answer: A
Rationale: Muscle rigidity (especially of the jaw) and tachycardia are early signs of
malignant hyperthermia; high temperature is often a late sign.
, 6. A patient with a history of heart failure reports a weight gain of 3 lbs in 24
hours. What is the nurse’s priority assessment?
A. Blood pressure
B. Urine output
C. Skin turgor
D. Auscultation of lung sounds
Answer: D
Rationale: Rapid weight gain suggests fluid volume excess. The priority is assessing for
pulmonary edema (crackles) in heart failure patients.
7. The nurse is teaching a patient about using an incentive spirometer. Which
instruction is correct?
A. Exhale forcefully into the device
B. Blow out quickly to raise the ball as high as possible
C. Use the device once every 4 hours while awake
D. Inhale slowly and deeply through the mouthpiece
Answer: D
Rationale: Incentive spirometry requires slow, deep inhalation to expand the alveoli and
prevent atelectasis.
8. A patient has a serum calcium level of 7.2 mg/dL. The nurse should assess for
which physical finding?
A. Decreased deep tendon reflexes
B. Positive Trousseau’s sign
C. Constipation
D. Polyuria
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to signs like
Trousseau’s (carpal spasm with BP cuff) and Chvostek’s.
2026 |WCU
1. A nurse is caring for a postoperative patient who suddenly develops chest
pain and dyspnea. Which action should the nurse take first?
A. Administer prescribed morphine
B. Obtain an electrocardiogram (ECG)
C. Elevate the head of the bed and apply oxygen
D. Notify the rapid response team
Answer: C
Rationale: Elevating the head of the bed and applying oxygen addresses immediate gas
exchange needs in a suspected pulmonary embolism or cardiac event before secondary
interventions.
2. The nurse is reviewing the arterial blood gas (ABG) results of a patient: pH
7.28, PaCO2 50 mmHg, HCO3 24 mEq/L. Which acid-base imbalance does this
represent?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory), while the
bicarbonate is normal, indicating uncompensated respiratory acidosis.
,3. When assessing a patient with hypokalemia, which EKG change is most
characteristic?
A. Peaked T waves
B. Widened QRS complex
C. Presence of U waves
D. Shortened PR interval
Answer: C
Rationale: Hypokalemia typically causes ST segment depression, flattened T waves, and
the appearance of U waves.
4. A nurse observes a patient’s surgical wound and notes the bowel is
protruding through the incision. What is the priority nursing action?
A. Push the bowel back into the abdominal cavity
B. Apply a tight pressure dressing to the site
C. Cover the protruding organ with sterile gauze soaked in normal saline
D. Check the patient’s vital signs immediately
Answer: C
Rationale: Wound evisceration is a medical emergency. The nurse must cover the organ
with sterile, saline-soaked dressings to keep it moist while preparing for surgery.
5. Which clinical manifestation is an early sign of malignant hyperthermia during
surgery?
A. Muscle rigidity and tachycardia
B. Temperature of 105 degrees F
C. Hypotension
D. Bradycardia
Answer: A
Rationale: Muscle rigidity (especially of the jaw) and tachycardia are early signs of
malignant hyperthermia; high temperature is often a late sign.
, 6. A patient with a history of heart failure reports a weight gain of 3 lbs in 24
hours. What is the nurse’s priority assessment?
A. Blood pressure
B. Urine output
C. Skin turgor
D. Auscultation of lung sounds
Answer: D
Rationale: Rapid weight gain suggests fluid volume excess. The priority is assessing for
pulmonary edema (crackles) in heart failure patients.
7. The nurse is teaching a patient about using an incentive spirometer. Which
instruction is correct?
A. Exhale forcefully into the device
B. Blow out quickly to raise the ball as high as possible
C. Use the device once every 4 hours while awake
D. Inhale slowly and deeply through the mouthpiece
Answer: D
Rationale: Incentive spirometry requires slow, deep inhalation to expand the alveoli and
prevent atelectasis.
8. A patient has a serum calcium level of 7.2 mg/dL. The nurse should assess for
which physical finding?
A. Decreased deep tendon reflexes
B. Positive Trousseau’s sign
C. Constipation
D. Polyuria
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to signs like
Trousseau’s (carpal spasm with BP cuff) and Chvostek’s.
