NURS 121L-B Medical-Surgical Nursing Practicum - Week 8
Comprehensive Quiz 2026 |WCU
1. A patient presents with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 26
mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: B
Rationale: The pH is low (acidosis) and the PaCO2 is high, indicating a respiratory cause.
The HCO3 is within normal range, suggesting no compensation yet.
2. A client is admitted with suspected Pulmonary Embolism (PE). Which is the
priority nursing action?
A. Administer prescribed analgesic for chest pain
B. Start an intravenous line for heparin infusion
C. Obtain a stat arterial blood gas (ABG) sample
D. Apply oxygen via nasal cannula
Answer: D
Rationale: In a suspected PE, the immediate priority is to improve oxygenation and
stabilize the patient’s respiratory status.
,3. A patient with heart failure is receiving digoxin. Which laboratory result
requires the nurse to hold the medication?
A. Serum Potassium 3.1 mEq/L
B. Serum Sodium 140 mEq/L
C. Serum Digoxin 1.2 ng/mL
D. Serum Calcium 9.5 mg/dL
Answer: A
Rationale: Hypokalemia increases the risk of digoxin toxicity. Digoxin should be held and
the provider notified if potassium is low.
4. A client is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect?
A. Mottled skin and lethargy
B. Anuria and hypotension
C. Tachycardia and cool, clammy skin
D. Bradycardia and bounding pulses
Answer: C
Rationale: In the compensatory stage, the sympathetic nervous system triggers
tachycardia and peripheral vasoconstriction to maintain cardiac output.
5. The nurse is caring for a patient with a chest tube. What should be done if the
chest tube becomes disconnected from the drainage system?
A. Clamp the tube immediately with two hemostats
B. Submerge the end of the tube in 1 inch of sterile water
C. Cover the site with an occlusive petroleum gauze
D. Instruct the patient to perform a Valsalva maneuver
Answer: B
Rationale: Submerging the tube in sterile water creates an immediate water seal and
prevents air from entering the pleural space.
, 6. Which assessment finding in a patient with a leg fracture and a cast indicates
potential compartment syndrome?
A. Warmth in the toes
B. Capillary refill of 2 seconds
C. Pain unrelieved by opioid analgesics
D. Mild swelling of the distal extremity
Answer: C
Rationale: Pain that is out of proportion to the injury and not relieved by standard
analgesics is a hallmark sign of compartment syndrome.
7. A patient with Diabetic Ketoacidosis (DKA) is receiving an insulin drip. The
nurse should switch the IV fluid to include 5% dextrose when the blood glucose
reaches what level?
A. 150 mg/dL
B. 250 mg/dL
C. 350 mg/dL
D. 100 mg/dL
Answer: B
Rationale: To prevent hypoglycemia and cerebral edema during DKA treatment, dextrose
is added when blood glucose drops to 250 mg/dL.
8. The nurse notes frequent premature ventricular contractions (PVCs) on a
patient’s ECG. Which electrolyte imbalance is most likely associated with this?
A. Hypomagnesemia
B. Hypernatremia
C. Hypercalcemia
D. Hypochloremia
Answer: A
Comprehensive Quiz 2026 |WCU
1. A patient presents with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 26
mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: B
Rationale: The pH is low (acidosis) and the PaCO2 is high, indicating a respiratory cause.
The HCO3 is within normal range, suggesting no compensation yet.
2. A client is admitted with suspected Pulmonary Embolism (PE). Which is the
priority nursing action?
A. Administer prescribed analgesic for chest pain
B. Start an intravenous line for heparin infusion
C. Obtain a stat arterial blood gas (ABG) sample
D. Apply oxygen via nasal cannula
Answer: D
Rationale: In a suspected PE, the immediate priority is to improve oxygenation and
stabilize the patient’s respiratory status.
,3. A patient with heart failure is receiving digoxin. Which laboratory result
requires the nurse to hold the medication?
A. Serum Potassium 3.1 mEq/L
B. Serum Sodium 140 mEq/L
C. Serum Digoxin 1.2 ng/mL
D. Serum Calcium 9.5 mg/dL
Answer: A
Rationale: Hypokalemia increases the risk of digoxin toxicity. Digoxin should be held and
the provider notified if potassium is low.
4. A client is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect?
A. Mottled skin and lethargy
B. Anuria and hypotension
C. Tachycardia and cool, clammy skin
D. Bradycardia and bounding pulses
Answer: C
Rationale: In the compensatory stage, the sympathetic nervous system triggers
tachycardia and peripheral vasoconstriction to maintain cardiac output.
5. The nurse is caring for a patient with a chest tube. What should be done if the
chest tube becomes disconnected from the drainage system?
A. Clamp the tube immediately with two hemostats
B. Submerge the end of the tube in 1 inch of sterile water
C. Cover the site with an occlusive petroleum gauze
D. Instruct the patient to perform a Valsalva maneuver
Answer: B
Rationale: Submerging the tube in sterile water creates an immediate water seal and
prevents air from entering the pleural space.
, 6. Which assessment finding in a patient with a leg fracture and a cast indicates
potential compartment syndrome?
A. Warmth in the toes
B. Capillary refill of 2 seconds
C. Pain unrelieved by opioid analgesics
D. Mild swelling of the distal extremity
Answer: C
Rationale: Pain that is out of proportion to the injury and not relieved by standard
analgesics is a hallmark sign of compartment syndrome.
7. A patient with Diabetic Ketoacidosis (DKA) is receiving an insulin drip. The
nurse should switch the IV fluid to include 5% dextrose when the blood glucose
reaches what level?
A. 150 mg/dL
B. 250 mg/dL
C. 350 mg/dL
D. 100 mg/dL
Answer: B
Rationale: To prevent hypoglycemia and cerebral edema during DKA treatment, dextrose
is added when blood glucose drops to 250 mg/dL.
8. The nurse notes frequent premature ventricular contractions (PVCs) on a
patient’s ECG. Which electrolyte imbalance is most likely associated with this?
A. Hypomagnesemia
B. Hypernatremia
C. Hypercalcemia
D. Hypochloremia
Answer: A
