NURS 121L-B | Medical-Surgical Nursing Practicum Module Exam 4
2026 |WCU
1. A patient is admitted with suspected acute pancreatitis. Which laboratory
finding would the nurse expect to see that most specifically indicates this
condition?
A. Decreased serum bilirubin
B. Elevated serum amylase and lipase
C. Elevated serum calcium
D. Decreased white blood cell count
Answer: B
Rationale: Serum amylase and lipase are the primary enzymes released by the pancreas
when it is inflamed; lipase is more specific to the pancreas and stays elevated longer than
amylase.
2. A nurse is caring for a patient post-thyroidectomy. Which assessment finding
is the most critical to report immediately?
A. Laryngeal stridor
B. Sore throat when swallowing
C. Pain at the incision site
D. Hoarseness of voice
Answer: A
Rationale: Laryngeal stridor is a sign of upper airway obstruction, which can occur due to
edema or nerve damage post-thyroidectomy and is a medical emergency.
,3. Which clinical manifestation should a nurse monitor for in a patient with a
suspected tension pneumothorax?
A. Bradycardia and hypertension
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Tracheal deviation to the affected side
Answer: C
Rationale: In a tension pneumothorax, air accumulates in the pleural space, increasing
pressure and shifting the mediastinum (and trachea) toward the opposite, unaffected side.
4. A patient with Type 1 Diabetes is found unresponsive with a blood glucose of
42 mg/dL. Which action should the nurse take first?
A. Administer 1 mg of Glucagon IM or Subcutaneously
B. Administer 15g of simple carbohydrates orally
C. Re-check the blood glucose in 15 minutes
D. Administer 10 units of Regular insulin
Answer: A
Rationale: For an unresponsive hypoglycemic patient, Glucagon or IV Dextrose is required
because the patient cannot safely swallow oral carbohydrates.
5. A nurse is assessing a patient with Chronic Obstructive Pulmonary Disease
(COPD). Which finding suggests the patient is experiencing ‘cor pulmonale’?
A. Clubbing of the fingers
B. Increased anterior-posterior chest diameter
C. Productive cough with green sputum
D. Peripheral edema and jugular venous distention
Answer: D
Rationale: Cor pulmonale is right-sided heart failure caused by pulmonary disease, leading
to systemic venous congestion manifested as peripheral edema and JVD.
, 6. A patient is receiving a heparin infusion for a deep vein thrombosis (DVT).
Which laboratory value is used to monitor the effectiveness of this therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C
Rationale: aPTT is the standard lab test used to monitor heparin’s anticoagulant effect,
while PT/INR is used for warfarin.
7. During the first 24 hours after a major burn, what is the primary goal of fluid
resuscitation?
A. To prevent infection at the burn site
B. To prevent electrolyte imbalances like hyperkalemia
C. To decrease the risk of metabolic acidosis
D. To maintain cardiac output and tissue perfusion
Answer: D
Rationale: The massive shift of fluids into the interstitial space (third spacing) in the first
24 hours of a burn causes hypovolemia; fluid resuscitation is vital to maintain organ
perfusion.
8. A patient with a history of cirrhosis presents with increased confusion and
asterixis. Which medication should the nurse anticipate administering?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Vitamin K
Answer: C
2026 |WCU
1. A patient is admitted with suspected acute pancreatitis. Which laboratory
finding would the nurse expect to see that most specifically indicates this
condition?
A. Decreased serum bilirubin
B. Elevated serum amylase and lipase
C. Elevated serum calcium
D. Decreased white blood cell count
Answer: B
Rationale: Serum amylase and lipase are the primary enzymes released by the pancreas
when it is inflamed; lipase is more specific to the pancreas and stays elevated longer than
amylase.
2. A nurse is caring for a patient post-thyroidectomy. Which assessment finding
is the most critical to report immediately?
A. Laryngeal stridor
B. Sore throat when swallowing
C. Pain at the incision site
D. Hoarseness of voice
Answer: A
Rationale: Laryngeal stridor is a sign of upper airway obstruction, which can occur due to
edema or nerve damage post-thyroidectomy and is a medical emergency.
,3. Which clinical manifestation should a nurse monitor for in a patient with a
suspected tension pneumothorax?
A. Bradycardia and hypertension
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Tracheal deviation to the affected side
Answer: C
Rationale: In a tension pneumothorax, air accumulates in the pleural space, increasing
pressure and shifting the mediastinum (and trachea) toward the opposite, unaffected side.
4. A patient with Type 1 Diabetes is found unresponsive with a blood glucose of
42 mg/dL. Which action should the nurse take first?
A. Administer 1 mg of Glucagon IM or Subcutaneously
B. Administer 15g of simple carbohydrates orally
C. Re-check the blood glucose in 15 minutes
D. Administer 10 units of Regular insulin
Answer: A
Rationale: For an unresponsive hypoglycemic patient, Glucagon or IV Dextrose is required
because the patient cannot safely swallow oral carbohydrates.
5. A nurse is assessing a patient with Chronic Obstructive Pulmonary Disease
(COPD). Which finding suggests the patient is experiencing ‘cor pulmonale’?
A. Clubbing of the fingers
B. Increased anterior-posterior chest diameter
C. Productive cough with green sputum
D. Peripheral edema and jugular venous distention
Answer: D
Rationale: Cor pulmonale is right-sided heart failure caused by pulmonary disease, leading
to systemic venous congestion manifested as peripheral edema and JVD.
, 6. A patient is receiving a heparin infusion for a deep vein thrombosis (DVT).
Which laboratory value is used to monitor the effectiveness of this therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C
Rationale: aPTT is the standard lab test used to monitor heparin’s anticoagulant effect,
while PT/INR is used for warfarin.
7. During the first 24 hours after a major burn, what is the primary goal of fluid
resuscitation?
A. To prevent infection at the burn site
B. To prevent electrolyte imbalances like hyperkalemia
C. To decrease the risk of metabolic acidosis
D. To maintain cardiac output and tissue perfusion
Answer: D
Rationale: The massive shift of fluids into the interstitial space (third spacing) in the first
24 hours of a burn causes hypovolemia; fluid resuscitation is vital to maintain organ
perfusion.
8. A patient with a history of cirrhosis presents with increased confusion and
asterixis. Which medication should the nurse anticipate administering?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Vitamin K
Answer: C
