NURS 121L-B Medical-Surgical Nursing Practicum Exam 2 Study Guide
2026 |WCU
1. A post-operative patient exhibits tachycardia, muscle rigidity, and a rapidly
rising body temperature. Which medication should the nurse prepare to
administer immediately?
A. Dantrolene sodium
B. Naloxone
C. Calcium gluconate
D. Furosemide
Answer: A
Rationale: The symptoms describe Malignant Hyperthermia, a life-threatening anesthesia
complication. Dantrolene is the specific skeletal muscle relaxant used for treatment.
2. When interpreting Arterial Blood Gas (ABG) results, the nurse notes: pH 7.28,
PaCO2 55 mm Hg, and HCO3 26 mEq/L. Which acid-base imbalance is present?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: A
Rationale: The pH is low (acidosis), and the PaCO2 is high (respiratory origin), while the
HCO3 is normal, indicating uncompensated respiratory acidosis.
,3. A patient with a potassium level of 6.2 mEq/L is admitted. Which EKG change
should the nurse expect to see?
A. Tall, peaked T waves
B. Prolonged ST segment
C. Prominent U waves
D. Flattened T waves
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves and widened QRS
complexes, which can lead to cardiac arrest.
4. The nurse is assessing a patient for Chvostek’s sign. Which technique is
correct?
A. Tapping the facial nerve in front of the ear
B. Inflating a blood pressure cuff on the upper arm
C. Percussing the abdomen for shifting dullness
D. Applying pressure to the calf muscle
Answer: A
Rationale: Chvostek’s sign is a twitching of the facial muscles in response to tapping over
the facial nerve, indicating hypocalcemia or hypomagnesemia.
5. A patient’s ABG results are pH 7.52, PaCO2 30 mm Hg, and HCO3 24 mEq/L.
The nurse identifies this as:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: D
Rationale: High pH (>7.45) indicates alkalosis; low PaCO2 (<35) indicates the cause is
respiratory.
, 6. During the ‘Time-Out’ procedure in the operating room, which action is
mandatory?
A. Confirming the correct patient, site, and procedure
B. Checking the patient’s insurance status
C. Starting the primary IV infusion
D. Shaving the surgical site
Answer: A
Rationale: The ‘Time-Out’ is a safety protocol to verify the correct patient, correct site, and
correct procedure before an incision is made.
7. A patient is receiving Patient-Controlled Analgesia (PCA). Which assessment
finding requires immediate intervention?
A. Patient reporting pain level 3/10
B. Urinary output of 40 mL per hour
C. Sleepiness but easily aroused by name
D. Respiratory rate of 8 breaths per minute
Answer: D
Rationale: Respiratory depression (RR < 12) is the most dangerous side effect of opioid
analgesics delivered via PCA.
8. Which electrolyte imbalance is most likely to cause Trousseau’s sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: Trousseau’s sign (carpal spasm when BP cuff is inflated) is a classic sign of
hypocalcemia.
2026 |WCU
1. A post-operative patient exhibits tachycardia, muscle rigidity, and a rapidly
rising body temperature. Which medication should the nurse prepare to
administer immediately?
A. Dantrolene sodium
B. Naloxone
C. Calcium gluconate
D. Furosemide
Answer: A
Rationale: The symptoms describe Malignant Hyperthermia, a life-threatening anesthesia
complication. Dantrolene is the specific skeletal muscle relaxant used for treatment.
2. When interpreting Arterial Blood Gas (ABG) results, the nurse notes: pH 7.28,
PaCO2 55 mm Hg, and HCO3 26 mEq/L. Which acid-base imbalance is present?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: A
Rationale: The pH is low (acidosis), and the PaCO2 is high (respiratory origin), while the
HCO3 is normal, indicating uncompensated respiratory acidosis.
,3. A patient with a potassium level of 6.2 mEq/L is admitted. Which EKG change
should the nurse expect to see?
A. Tall, peaked T waves
B. Prolonged ST segment
C. Prominent U waves
D. Flattened T waves
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves and widened QRS
complexes, which can lead to cardiac arrest.
4. The nurse is assessing a patient for Chvostek’s sign. Which technique is
correct?
A. Tapping the facial nerve in front of the ear
B. Inflating a blood pressure cuff on the upper arm
C. Percussing the abdomen for shifting dullness
D. Applying pressure to the calf muscle
Answer: A
Rationale: Chvostek’s sign is a twitching of the facial muscles in response to tapping over
the facial nerve, indicating hypocalcemia or hypomagnesemia.
5. A patient’s ABG results are pH 7.52, PaCO2 30 mm Hg, and HCO3 24 mEq/L.
The nurse identifies this as:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: D
Rationale: High pH (>7.45) indicates alkalosis; low PaCO2 (<35) indicates the cause is
respiratory.
, 6. During the ‘Time-Out’ procedure in the operating room, which action is
mandatory?
A. Confirming the correct patient, site, and procedure
B. Checking the patient’s insurance status
C. Starting the primary IV infusion
D. Shaving the surgical site
Answer: A
Rationale: The ‘Time-Out’ is a safety protocol to verify the correct patient, correct site, and
correct procedure before an incision is made.
7. A patient is receiving Patient-Controlled Analgesia (PCA). Which assessment
finding requires immediate intervention?
A. Patient reporting pain level 3/10
B. Urinary output of 40 mL per hour
C. Sleepiness but easily aroused by name
D. Respiratory rate of 8 breaths per minute
Answer: D
Rationale: Respiratory depression (RR < 12) is the most dangerous side effect of opioid
analgesics delivered via PCA.
8. Which electrolyte imbalance is most likely to cause Trousseau’s sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: Trousseau’s sign (carpal spasm when BP cuff is inflated) is a classic sign of
hypocalcemia.
