NURS 121L-B Medical-Surgical Nursing Practicum Module 3 Exam 2026
|WCU
1. A patient’s arterial blood gas (ABG) results show: pH 7.28, PaCO2 55 mmHg,
and HCO3 26 mEq/L. Which acid-base imbalance is the patient experiencing?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal or
high HCO3 indicates the cause is respiratory, typical of hypoventilation.
2. Which of the following ECG changes should the nurse prioritize when caring
for a patient with a potassium level of 6.2 mEq/L?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Rationale: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T waves and
widened QRS complexes, which can lead to ventricular fibrillation if untreated.
,3. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula. Which oxygen flow rate should the nurse prioritize to
avoid suppressing the respiratory drive?
A. 8-10 L/min
B. 5-6 L/min
C. 1-2 L/min
D. 15 L/min via non-rebreather
Answer: C
Rationale: Patients with COPD may rely on a hypoxic drive to breathe; excessive oxygen
can decrease their stimulus to breathe. Low-flow oxygen is typically titrated to keep SpO2
between 88-92%.
4. A nurse is assessing a patient 2 hours post-thyroidectomy. The patient reports
numbness and tingling in the fingers and around the mouth. What is the nurse’s
priority action?
A. Check for Trousseau’s sign
B. Administer an analgesic
C. Notify the provider of potential hypocalcemia
D. Encourage the patient to cough and deep breathe
Answer: C
Rationale: Paresthesia is an early sign of hypocalcemia, often due to accidental
parathyroid gland removal during thyroid surgery. This is a medical emergency due to the
risk of laryngospasm.
, 5. When caring for a patient with Acute Respiratory Distress Syndrome (ARDS),
the nurse notes refractory hypoxemia. This is defined as:
A. High carbon dioxide levels despite mechanical ventilation
B. Low arterial oxygen despite increasing supplemental oxygen
C. Improvement of oxygenation when placed in the prone position
D. Oxygen saturation below 90% on room air
Answer: B
Rationale: Refractory hypoxemia is a hallmark of ARDS, where the patient’s PaO2 does not
significantly improve even with 100% inspired oxygen concentrations.
6. A patient is diagnosed with deep vein thrombosis (DVT) in the right calf.
Which nursing intervention is contraindicated?
A. Elevation of the affected extremity
B. Massaging the affected area to reduce pain
C. Application of warm, moist heat
D. Administration of subcutaneous heparin
Answer: B
Rationale: Massaging the leg of a patient with DVT is strictly contraindicated as it can
dislodge the clot, leading to a pulmonary embolism.
7. The nurse is assessing a patient with right-sided heart failure. Which clinical
manifestation is most expected?
A. Jugular venous distention (JVD)
B. Pulmonary crackles
C. Pink frothy sputum
D. Dyspnea on exertion
Answer: A
Rationale: Right-sided heart failure causes systemic congestion, leading to JVD, peripheral
edema, and hepatomegaly. Pulmonary symptoms are typical of left-sided heart failure.
|WCU
1. A patient’s arterial blood gas (ABG) results show: pH 7.28, PaCO2 55 mmHg,
and HCO3 26 mEq/L. Which acid-base imbalance is the patient experiencing?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal or
high HCO3 indicates the cause is respiratory, typical of hypoventilation.
2. Which of the following ECG changes should the nurse prioritize when caring
for a patient with a potassium level of 6.2 mEq/L?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Rationale: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T waves and
widened QRS complexes, which can lead to ventricular fibrillation if untreated.
,3. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula. Which oxygen flow rate should the nurse prioritize to
avoid suppressing the respiratory drive?
A. 8-10 L/min
B. 5-6 L/min
C. 1-2 L/min
D. 15 L/min via non-rebreather
Answer: C
Rationale: Patients with COPD may rely on a hypoxic drive to breathe; excessive oxygen
can decrease their stimulus to breathe. Low-flow oxygen is typically titrated to keep SpO2
between 88-92%.
4. A nurse is assessing a patient 2 hours post-thyroidectomy. The patient reports
numbness and tingling in the fingers and around the mouth. What is the nurse’s
priority action?
A. Check for Trousseau’s sign
B. Administer an analgesic
C. Notify the provider of potential hypocalcemia
D. Encourage the patient to cough and deep breathe
Answer: C
Rationale: Paresthesia is an early sign of hypocalcemia, often due to accidental
parathyroid gland removal during thyroid surgery. This is a medical emergency due to the
risk of laryngospasm.
, 5. When caring for a patient with Acute Respiratory Distress Syndrome (ARDS),
the nurse notes refractory hypoxemia. This is defined as:
A. High carbon dioxide levels despite mechanical ventilation
B. Low arterial oxygen despite increasing supplemental oxygen
C. Improvement of oxygenation when placed in the prone position
D. Oxygen saturation below 90% on room air
Answer: B
Rationale: Refractory hypoxemia is a hallmark of ARDS, where the patient’s PaO2 does not
significantly improve even with 100% inspired oxygen concentrations.
6. A patient is diagnosed with deep vein thrombosis (DVT) in the right calf.
Which nursing intervention is contraindicated?
A. Elevation of the affected extremity
B. Massaging the affected area to reduce pain
C. Application of warm, moist heat
D. Administration of subcutaneous heparin
Answer: B
Rationale: Massaging the leg of a patient with DVT is strictly contraindicated as it can
dislodge the clot, leading to a pulmonary embolism.
7. The nurse is assessing a patient with right-sided heart failure. Which clinical
manifestation is most expected?
A. Jugular venous distention (JVD)
B. Pulmonary crackles
C. Pink frothy sputum
D. Dyspnea on exertion
Answer: A
Rationale: Right-sided heart failure causes systemic congestion, leading to JVD, peripheral
edema, and hepatomegaly. Pulmonary symptoms are typical of left-sided heart failure.
