NURS 121L-B Module Exam 1 Practicum 2026 |WCU
1. A nurse is caring for a client who is 2 hours postoperative following
abdominal surgery. The client’s heart rate is 110/min, blood pressure is 92/58
mmHg, and urinary output is 15 mL/hr. Which of the following is the nurse’s
priority action?
A. Increase the intravenous fluid rate as prescribed.
B. Apply oxygen via nasal cannula at 2 L/min.
C. Encourage the client to use the incentive spirometer.
D. Administer the prescribed PRN pain medication.
Answer: A
Rationale: The client is exhibiting signs of hypovolemic shock (tachycardia, hypotension,
and oliguria). Increasing IV fluids is the priority to restore circulating volume and maintain
organ perfusion.
2. During the preoperative interview, a client reports an allergy to bananas and
kiwi. Which of the following actions should the nurse take?
A. Place an allergy band on the client and notify the surgical team of a potential latex allergy.
B. Administer an antihistamine as a prophylactic measure before surgery.
C. Document the food allergy and proceed with standard surgical preparations.
D. Ask the client if they have ever had a reaction to avocados as well.
Answer: A
Rationale: Cross-sensitivities exist between certain foods (bananas, kiwi, avocados) and
latex. A potential latex allergy must be communicated to the surgical team to ensure a
latex-free environment.
,3. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.30,
PaCO2 55 mmHg, HCO3 26 mEq/L. Which of the following acid-base imbalances
is the client experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range, this is uncompensated
respiratory acidosis.
4. A nurse is assessing a client with hypocalcemia. Which of the following
findings should the nurse expect?
A. Hyporeflexia and muscle weakness
B. Constipation and abdominal distension
C. Positive Chvostek’s sign
D. Shortened QT interval on ECG
Answer: C
Rationale: Hypocalcemia increases neuromuscular excitability. A positive Chvostek’s sign
(facial twitching when the facial nerve is tapped) is a classic indicator of low calcium.
5. Which of the following is the most reliable indicator of a client’s fluid volume
status in the acute care setting?
A. Skin turgor over the sternum
B. Daily weights at the same time each day
C. Intake and output totals for 24 hours
D. Presence of dependent edema
Answer: B
, Rationale: Daily weights are the most sensitive and accurate objective measurement of
fluid gains or losses in the acute care setting.
6. A client is receiving a continuous intravenous infusion of magnesium sulfate.
Which finding should the nurse report to the provider immediately?
A. Flushing and a feeling of warmth
B. Respiratory rate of 10/min
C. Magnesium level of 3.0 mEq/L
D. Blood pressure of 118/74 mmHg
Answer: B
Rationale: Magnesium toxicity can lead to respiratory depression. A respiratory rate
below 12/min is a critical finding requiring immediate intervention and potential
administration of calcium gluconate.
7. A nurse is preparing a client for surgery. The client has signed the informed
consent but states, ‘I still don’t understand why they have to remove my whole
gallbladder.’ Which action should the nurse take?
A. Explain the risks and benefits of the procedure to the client.
B. Reassure the client that the surgeon is highly skilled.
C. Witness the signature and document that the client was hesitant.
D. Notify the surgeon that the client needs further clarification.
Answer: D
Rationale: While the nurse witnesses the signature, it is the surgeon’s responsibility to
provide the explanation of the procedure. If the client does not understand, the surgeon
must be called back.
1. A nurse is caring for a client who is 2 hours postoperative following
abdominal surgery. The client’s heart rate is 110/min, blood pressure is 92/58
mmHg, and urinary output is 15 mL/hr. Which of the following is the nurse’s
priority action?
A. Increase the intravenous fluid rate as prescribed.
B. Apply oxygen via nasal cannula at 2 L/min.
C. Encourage the client to use the incentive spirometer.
D. Administer the prescribed PRN pain medication.
Answer: A
Rationale: The client is exhibiting signs of hypovolemic shock (tachycardia, hypotension,
and oliguria). Increasing IV fluids is the priority to restore circulating volume and maintain
organ perfusion.
2. During the preoperative interview, a client reports an allergy to bananas and
kiwi. Which of the following actions should the nurse take?
A. Place an allergy band on the client and notify the surgical team of a potential latex allergy.
B. Administer an antihistamine as a prophylactic measure before surgery.
C. Document the food allergy and proceed with standard surgical preparations.
D. Ask the client if they have ever had a reaction to avocados as well.
Answer: A
Rationale: Cross-sensitivities exist between certain foods (bananas, kiwi, avocados) and
latex. A potential latex allergy must be communicated to the surgical team to ensure a
latex-free environment.
,3. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.30,
PaCO2 55 mmHg, HCO3 26 mEq/L. Which of the following acid-base imbalances
is the client experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range, this is uncompensated
respiratory acidosis.
4. A nurse is assessing a client with hypocalcemia. Which of the following
findings should the nurse expect?
A. Hyporeflexia and muscle weakness
B. Constipation and abdominal distension
C. Positive Chvostek’s sign
D. Shortened QT interval on ECG
Answer: C
Rationale: Hypocalcemia increases neuromuscular excitability. A positive Chvostek’s sign
(facial twitching when the facial nerve is tapped) is a classic indicator of low calcium.
5. Which of the following is the most reliable indicator of a client’s fluid volume
status in the acute care setting?
A. Skin turgor over the sternum
B. Daily weights at the same time each day
C. Intake and output totals for 24 hours
D. Presence of dependent edema
Answer: B
, Rationale: Daily weights are the most sensitive and accurate objective measurement of
fluid gains or losses in the acute care setting.
6. A client is receiving a continuous intravenous infusion of magnesium sulfate.
Which finding should the nurse report to the provider immediately?
A. Flushing and a feeling of warmth
B. Respiratory rate of 10/min
C. Magnesium level of 3.0 mEq/L
D. Blood pressure of 118/74 mmHg
Answer: B
Rationale: Magnesium toxicity can lead to respiratory depression. A respiratory rate
below 12/min is a critical finding requiring immediate intervention and potential
administration of calcium gluconate.
7. A nurse is preparing a client for surgery. The client has signed the informed
consent but states, ‘I still don’t understand why they have to remove my whole
gallbladder.’ Which action should the nurse take?
A. Explain the risks and benefits of the procedure to the client.
B. Reassure the client that the surgeon is highly skilled.
C. Witness the signature and document that the client was hesitant.
D. Notify the surgeon that the client needs further clarification.
Answer: D
Rationale: While the nurse witnesses the signature, it is the surgeon’s responsibility to
provide the explanation of the procedure. If the client does not understand, the surgeon
must be called back.
