NURS 121L-B Medical-Surgical Nursing Practicum - Week 14 Advanced
Quiz 2026 |WCU
1. A patient is admitted with a suspected tension pneumothorax. Which clinical
finding should the nurse anticipate first?
A. Tracheal deviation toward the affected side
B. Decreased cardiac output and hypotension
C. Increased breath sounds on the affected side
D. Flattened neck veins
Answer: B
Rationale: In a tension pneumothorax, the increasing pressure in the pleural space shifts
the mediastinum, compressing the heart and great vessels, leading to decreased venous
return and cardiac output (hypotension). Tracheal deviation occurs away from the affected
side.
2. A patient with Acute Renal Failure has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize administering?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Calcium Gluconate IV
D. Regular Insulin and D50W
Answer: C
Rationale: While Kayexalate and Insulin/D50 move or remove potassium, Calcium
Gluconate is prioritized first in severe hyperkalemia to stabilize the myocardial cell
membrane and prevent life-threatening dysrhythmias.
,3. Which arterial blood gas (ABG) result would the nurse expect in a patient
experiencing early stages of Hypovolemic Shock?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.35, PaCO2 40, HCO3 24
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.25, PaCO2 40, HCO3 18
Answer: C
Rationale: Early shock often causes tachypnea due to hypoxia or anxiety, leading to
respiratory alkalosis (high pH, low CO2). As shock progresses, lactic acidosis leads to
metabolic acidosis.
4. A patient is 24 hours post-thyroidectomy. They report tingling around the
mouth and fingertips. What is the nurse’s priority action?
A. Check the surgical dressing for hemorrhage
B. Assess for Trousseau’s sign
C. Administer a prescribed sedative
D. Encourage the patient to use the incentive spirometer
Answer: B
Rationale: Tingling (paresthesia) is an early sign of hypocalcemia, often caused by
accidental removal or damage to the parathyroid glands during thyroid surgery. Assessing
for Trousseau’s sign helps confirm hypocalcemic tetany.
, 5. A nurse is caring for a patient with a T6 spinal cord injury. The patient reports
a sudden pounding headache and their BP is 190/110. What is the first
intervention?
A. Place the patient in a high-Fowler’s position
B. Palpate the bladder for distention
C. Administer hydralazine IV
D. Check the patient’s skin for pressure sores
Answer: A
Rationale: The first action for Autonomic Dysreflexia is to sit the patient up (high-
Fowler’s) to lower blood pressure via orthostatic effect, followed by identifying and
removing the stimulus (usually a full bladder).
6. Which clinical manifestation is a hallmark sign of Diabetes Insipidus?
A. Serum sodium of 125 mEq/L
B. Urine specific gravity of 1.035
C. Weight gain and edema
D. Urine output of 500 mL/hr
Answer: D
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to massive
polyuria (often >250 mL/hr) and low urine specific gravity (<1.005). Serum sodium is
usually high, not low.
7. A patient with a Glascow Coma Scale (GCS) score of 7 requires what
immediate nursing priority?
A. Preparing for endotracheal intubation
B. Assessing pupillary response
C. Monitoring hourly urine output
D. Performing a neurological check every 15 minutes
Answer: A
Quiz 2026 |WCU
1. A patient is admitted with a suspected tension pneumothorax. Which clinical
finding should the nurse anticipate first?
A. Tracheal deviation toward the affected side
B. Decreased cardiac output and hypotension
C. Increased breath sounds on the affected side
D. Flattened neck veins
Answer: B
Rationale: In a tension pneumothorax, the increasing pressure in the pleural space shifts
the mediastinum, compressing the heart and great vessels, leading to decreased venous
return and cardiac output (hypotension). Tracheal deviation occurs away from the affected
side.
2. A patient with Acute Renal Failure has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize administering?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Calcium Gluconate IV
D. Regular Insulin and D50W
Answer: C
Rationale: While Kayexalate and Insulin/D50 move or remove potassium, Calcium
Gluconate is prioritized first in severe hyperkalemia to stabilize the myocardial cell
membrane and prevent life-threatening dysrhythmias.
,3. Which arterial blood gas (ABG) result would the nurse expect in a patient
experiencing early stages of Hypovolemic Shock?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.35, PaCO2 40, HCO3 24
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.25, PaCO2 40, HCO3 18
Answer: C
Rationale: Early shock often causes tachypnea due to hypoxia or anxiety, leading to
respiratory alkalosis (high pH, low CO2). As shock progresses, lactic acidosis leads to
metabolic acidosis.
4. A patient is 24 hours post-thyroidectomy. They report tingling around the
mouth and fingertips. What is the nurse’s priority action?
A. Check the surgical dressing for hemorrhage
B. Assess for Trousseau’s sign
C. Administer a prescribed sedative
D. Encourage the patient to use the incentive spirometer
Answer: B
Rationale: Tingling (paresthesia) is an early sign of hypocalcemia, often caused by
accidental removal or damage to the parathyroid glands during thyroid surgery. Assessing
for Trousseau’s sign helps confirm hypocalcemic tetany.
, 5. A nurse is caring for a patient with a T6 spinal cord injury. The patient reports
a sudden pounding headache and their BP is 190/110. What is the first
intervention?
A. Place the patient in a high-Fowler’s position
B. Palpate the bladder for distention
C. Administer hydralazine IV
D. Check the patient’s skin for pressure sores
Answer: A
Rationale: The first action for Autonomic Dysreflexia is to sit the patient up (high-
Fowler’s) to lower blood pressure via orthostatic effect, followed by identifying and
removing the stimulus (usually a full bladder).
6. Which clinical manifestation is a hallmark sign of Diabetes Insipidus?
A. Serum sodium of 125 mEq/L
B. Urine specific gravity of 1.035
C. Weight gain and edema
D. Urine output of 500 mL/hr
Answer: D
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to massive
polyuria (often >250 mL/hr) and low urine specific gravity (<1.005). Serum sodium is
usually high, not low.
7. A patient with a Glascow Coma Scale (GCS) score of 7 requires what
immediate nursing priority?
A. Preparing for endotracheal intubation
B. Assessing pupillary response
C. Monitoring hourly urine output
D. Performing a neurological check every 15 minutes
Answer: A
