NURS 121L-B Medical-Surgical Nursing Practicum Week 11 Quiz 2026
|WCU
1. A patient returns to the unit following a thyroidectomy. Which assessment
finding requires immediate intervention by the nurse?
A. Positive Chvostek’s sign
B. Slight hoarseness when speaking
C. Pain level of 4/10 at the incision site
D. Calcium level of 9.2 mg/dL
Answer: A
Rationale: A positive Chvostek’s sign indicates hypocalcemia, which is a potential
complication of thyroidectomy if the parathyroid glands are accidentally damaged or
removed. Hypocalcemia can lead to tetany and laryngospasm.
2. When caring for a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What is the priority action?
A. Check the system for an air leak
B. Increase the suction pressure
C. Document this as a normal finding
D. Clamp the chest tube near the patient’s chest
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or from the patient’s lung. Intermittent bubbling during expiration is normal in
some cases, but continuous bubbling is not.
,3. A patient with Type 1 Diabetes Mellitus presents with a blood glucose of 600
mg/dL and fruity-scented breath. Which acid-base imbalance does the nurse
expect?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale: The patient is showing signs of Diabetic Ketoacidosis (DKA). In DKA, ketones
(acids) build up in the blood, leading to metabolic acidosis. Fruity breath is caused by
acetone.
4. Which medication is the gold standard for treating an acute asthma attack?
A. Salmeterol
B. Montelukast
C. Fluticasone
D. Albuterol
Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used as a rescue inhaler for
acute bronchospasm. Salmeterol is long-acting; Fluticasone is a steroid for maintenance.
5. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving
oxygen. Why must the nurse be cautious about high-flow oxygen
administration?
A. It may suppress the patient’s drive to breathe
B. It increases the risk of oxygen toxicity
C. It causes immediate pulmonary edema
D. It results in metabolic alkalosis
Answer: A
, Rationale: In patients with chronic hypercapnia (COPD), the stimulus to breathe may shift
from high CO2 levels to low O2 levels (hypoxic drive). High-flow O2 can abolish this drive,
leading to respiratory arrest.
6. What is the primary purpose of the ‘Time Out’ procedure in the operating
room?
A. To allow the surgeon to rest before the procedure
B. To check if the anesthesia equipment is functional
C. To ensure all insurance paperwork is signed
D. To verify the correct patient, site, and procedure
Answer: D
Rationale: The ‘Time Out’ is a safety protocol performed immediately before starting
surgery to prevent wrong-site, wrong-procedure, and wrong-person surgery.
7. A patient on heparin therapy has an Activated Partial Thromboplastin Time
(aPTT) of 120 seconds (Control: 30s). What is the priority nursing action?
A. Stop the heparin infusion and notify the provider
B. Administer Vitamin K
C. Increase the heparin infusion rate
D. Continue the infusion as this is a therapeutic level
Answer: A
Rationale: A therapeutic aPTT is typically 1.5 to 2.5 times the control. 120 seconds is
excessively high (4x control), placing the patient at high risk for bleeding. The infusion
must be stopped.
|WCU
1. A patient returns to the unit following a thyroidectomy. Which assessment
finding requires immediate intervention by the nurse?
A. Positive Chvostek’s sign
B. Slight hoarseness when speaking
C. Pain level of 4/10 at the incision site
D. Calcium level of 9.2 mg/dL
Answer: A
Rationale: A positive Chvostek’s sign indicates hypocalcemia, which is a potential
complication of thyroidectomy if the parathyroid glands are accidentally damaged or
removed. Hypocalcemia can lead to tetany and laryngospasm.
2. When caring for a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What is the priority action?
A. Check the system for an air leak
B. Increase the suction pressure
C. Document this as a normal finding
D. Clamp the chest tube near the patient’s chest
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or from the patient’s lung. Intermittent bubbling during expiration is normal in
some cases, but continuous bubbling is not.
,3. A patient with Type 1 Diabetes Mellitus presents with a blood glucose of 600
mg/dL and fruity-scented breath. Which acid-base imbalance does the nurse
expect?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale: The patient is showing signs of Diabetic Ketoacidosis (DKA). In DKA, ketones
(acids) build up in the blood, leading to metabolic acidosis. Fruity breath is caused by
acetone.
4. Which medication is the gold standard for treating an acute asthma attack?
A. Salmeterol
B. Montelukast
C. Fluticasone
D. Albuterol
Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used as a rescue inhaler for
acute bronchospasm. Salmeterol is long-acting; Fluticasone is a steroid for maintenance.
5. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving
oxygen. Why must the nurse be cautious about high-flow oxygen
administration?
A. It may suppress the patient’s drive to breathe
B. It increases the risk of oxygen toxicity
C. It causes immediate pulmonary edema
D. It results in metabolic alkalosis
Answer: A
, Rationale: In patients with chronic hypercapnia (COPD), the stimulus to breathe may shift
from high CO2 levels to low O2 levels (hypoxic drive). High-flow O2 can abolish this drive,
leading to respiratory arrest.
6. What is the primary purpose of the ‘Time Out’ procedure in the operating
room?
A. To allow the surgeon to rest before the procedure
B. To check if the anesthesia equipment is functional
C. To ensure all insurance paperwork is signed
D. To verify the correct patient, site, and procedure
Answer: D
Rationale: The ‘Time Out’ is a safety protocol performed immediately before starting
surgery to prevent wrong-site, wrong-procedure, and wrong-person surgery.
7. A patient on heparin therapy has an Activated Partial Thromboplastin Time
(aPTT) of 120 seconds (Control: 30s). What is the priority nursing action?
A. Stop the heparin infusion and notify the provider
B. Administer Vitamin K
C. Increase the heparin infusion rate
D. Continue the infusion as this is a therapeutic level
Answer: A
Rationale: A therapeutic aPTT is typically 1.5 to 2.5 times the control. 120 seconds is
excessively high (4x control), placing the patient at high risk for bleeding. The infusion
must be stopped.
