NURS 121L-B Medical-Surgical Nursing Practicum - Week 10
Comprehensive Quiz 2026 |WCU
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation. Which finding most indicates that the Positive End-Expiratory
Pressure (PEEP) is effective?
A. An increase in PaO2 with a lower FiO2
B. A decrease in the patient’s heart rate
C. Clear breath sounds bilaterally
D. A reduction in peak inspiratory pressure
Answer: A
Rationale: The primary goal of PEEP is to keep alveoli open and improve oxygenation.
Effectiveness is demonstrated by improved arterial oxygen (PaO2) while being able to
decrease the fraction of inspired oxygen (FiO2).
2. A nurse is caring for a patient who is 2 hours post-thyroidectomy. The patient
reports numbness and tingling in the fingers and toes. What is the nurse’s
priority action?
A. Check the patient’s potassium levels
B. Administer an analgesic for post-operative pain
C. Notify the provider of potential airway obstruction
D. Assess the patient’s Chvostek and Trousseau signs
Answer: D
Rationale: Numbness and tingling (paresthesia) after thyroid surgery suggest
hypocalcemia due to accidental parathyroid gland trauma or removal. Assessing for
Chvostek and Trousseau signs confirms tetany risk.
,3. Which arterial blood gas (ABG) result is most consistent with a patient
experiencing Diabetic Ketoacidosis (DKA)?
A. pH 7.48, PaCO2 35, HCO3 30
B. pH 7.30, PaCO2 30, HCO3 16
C. pH 7.32, PaCO2 48, HCO3 26
D. pH 7.50, PaCO2 25, HCO3 22
Answer: B
Rationale: DKA results in metabolic acidosis with respiratory compensation. A low pH
(acidosis), low HCO3 (metabolic origin), and low PaCO2 (respiratory
compensation/Kussmaul respirations) match this state.
4. A patient with cirrhosis and hepatic encephalopathy is prescribed lactulose.
What is the primary therapeutic goal of this medication?
A. To reduce bilirubin levels
B. To treat chronic constipation
C. To prevent gastrointestinal bleeding
D. To decrease serum ammonia levels
Answer: D
Rationale: Lactulose acidifies the colon, converting ammonia to ammonium, which is then
excreted in the stool, thereby reducing serum ammonia and improving encephalopathy
symptoms.
5. While assessing a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What does this finding indicate?
A. The chest tube is functioning correctly
B. The lung has fully re-expanded
C. There is an air leak in the system
D. The suction pressure is set too high
Answer: C
, Rationale: Intermittent bubbling in the water-seal chamber is normal during expiration or
coughing; however, continuous bubbling indicates an air leak in the drainage system or at
the insertion site.
6. A patient in the ICU is being monitored for increased intracranial pressure
(ICP). Which of the following clinical manifestations represents Cushing’s Triad?
A. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Hypotension, bradycardia, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and shallow breathing
Answer: A
Rationale: Cushing’s Triad (systolic hypertension with widening pulse pressure,
bradycardia, and irregular/slow respirations) is a late sign of increased ICP and brainstem
herniation.
7. Which medication should the nurse have readily available as an antidote for a
patient receiving a Heparin infusion?
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Naloxone
Answer: B
Rationale: Protamine sulfate is the specific antidote used to reverse the effects of heparin
in cases of overdose or severe bleeding.
Comprehensive Quiz 2026 |WCU
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation. Which finding most indicates that the Positive End-Expiratory
Pressure (PEEP) is effective?
A. An increase in PaO2 with a lower FiO2
B. A decrease in the patient’s heart rate
C. Clear breath sounds bilaterally
D. A reduction in peak inspiratory pressure
Answer: A
Rationale: The primary goal of PEEP is to keep alveoli open and improve oxygenation.
Effectiveness is demonstrated by improved arterial oxygen (PaO2) while being able to
decrease the fraction of inspired oxygen (FiO2).
2. A nurse is caring for a patient who is 2 hours post-thyroidectomy. The patient
reports numbness and tingling in the fingers and toes. What is the nurse’s
priority action?
A. Check the patient’s potassium levels
B. Administer an analgesic for post-operative pain
C. Notify the provider of potential airway obstruction
D. Assess the patient’s Chvostek and Trousseau signs
Answer: D
Rationale: Numbness and tingling (paresthesia) after thyroid surgery suggest
hypocalcemia due to accidental parathyroid gland trauma or removal. Assessing for
Chvostek and Trousseau signs confirms tetany risk.
,3. Which arterial blood gas (ABG) result is most consistent with a patient
experiencing Diabetic Ketoacidosis (DKA)?
A. pH 7.48, PaCO2 35, HCO3 30
B. pH 7.30, PaCO2 30, HCO3 16
C. pH 7.32, PaCO2 48, HCO3 26
D. pH 7.50, PaCO2 25, HCO3 22
Answer: B
Rationale: DKA results in metabolic acidosis with respiratory compensation. A low pH
(acidosis), low HCO3 (metabolic origin), and low PaCO2 (respiratory
compensation/Kussmaul respirations) match this state.
4. A patient with cirrhosis and hepatic encephalopathy is prescribed lactulose.
What is the primary therapeutic goal of this medication?
A. To reduce bilirubin levels
B. To treat chronic constipation
C. To prevent gastrointestinal bleeding
D. To decrease serum ammonia levels
Answer: D
Rationale: Lactulose acidifies the colon, converting ammonia to ammonium, which is then
excreted in the stool, thereby reducing serum ammonia and improving encephalopathy
symptoms.
5. While assessing a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What does this finding indicate?
A. The chest tube is functioning correctly
B. The lung has fully re-expanded
C. There is an air leak in the system
D. The suction pressure is set too high
Answer: C
, Rationale: Intermittent bubbling in the water-seal chamber is normal during expiration or
coughing; however, continuous bubbling indicates an air leak in the drainage system or at
the insertion site.
6. A patient in the ICU is being monitored for increased intracranial pressure
(ICP). Which of the following clinical manifestations represents Cushing’s Triad?
A. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Hypotension, bradycardia, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and shallow breathing
Answer: A
Rationale: Cushing’s Triad (systolic hypertension with widening pulse pressure,
bradycardia, and irregular/slow respirations) is a late sign of increased ICP and brainstem
herniation.
7. Which medication should the nurse have readily available as an antidote for a
patient receiving a Heparin infusion?
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Naloxone
Answer: B
Rationale: Protamine sulfate is the specific antidote used to reverse the effects of heparin
in cases of overdose or severe bleeding.
