NURS 121L-B Medical-Surgical Nursing Practicum Week 7
Comprehensive Quiz 2026 |WCU
1. A patient with a history of COPD presents with a pH of 7.28, PaCO2 of 58
mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Uncompensated Respiratory Acidosis
B. Partially Compensated Respiratory Acidosis
C. Fully Compensated Metabolic Alkalosis
D. Uncompensated Metabolic Acidosis
Answer: B
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
elevated, indicating the kidneys are attempting to compensate but have not yet returned
the pH to normal.
2. Which clinical manifestation should a nurse prioritize when assessing a
patient with a serum potassium level of 6.2 mEq/L?
A. Tall, peaked T waves on the ECG
B. Hyperactive bowel sounds
C. Muscle weakness in lower extremities
D. Increased urinary output
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) can lead to life-threatening cardiac dysrhythmias; tall,
peaked T waves are an early sign of potassium’s effect on cardiac conduction.
,3. A patient is 24 hours post-thyroidectomy. The nurse notes the patient is
experiencing numbness and tingling around the mouth and fingertips. What is
the priority nursing action?
A. Encourage the patient to use the incentive spirometer
B. Check the surgical dressing for bleeding
C. Assess for Chvostek’s sign
D. Administer an oral potassium supplement
Answer: C
Rationale: Hypocalcemia is a risk after thyroidectomy due to potential accidental
parathyroid removal. Numbness/tingling (paresthesia) is an early sign; assessing
Chvostek’s sign helps confirm tetany risk.
4. The nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory result is most consistent with this
diagnosis?
A. Serum sodium 128 mEq/L
B. Serum osmolarity 310 mOsm/kg
C. Urine specific gravity 1.002
D. Hematocrit 55%
Answer: A
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia.
Low serum sodium and low serum osmolarity are characteristic.
, 5. During the administration of a blood transfusion, the patient complains of
low back pain and chills. What is the nurse’s immediate priority?
A. Slow the infusion rate and call the provider
B. Stop the transfusion and disconnect the tubing
C. Administer diphenhydramine as ordered
D. Recheck the patient’s ID band and blood bag labels
Answer: B
Rationale: Low back pain and chills suggest an acute hemolytic reaction. The first action is
to stop the transfusion immediately to prevent further damage.
6. A patient is diagnosed with Diabetes Insipidus (DI). Which medication does
the nurse expect the provider to prescribe?
A. Furosemide
B. Spironolactone
C. Desmopressin (DDAVP)
D. Regular Insulin
Answer: C
Rationale: DI is characterized by a deficiency of ADH. Desmopressin is a synthetic analog
of ADH used to replace the hormone and reduce urine output.
7. When assessing a patient with Cushing’s Syndrome, which physical finding is
the nurse most likely to observe?
A. Hypotension and weight loss
B. Truncal obesity and moon face
C. Hyperpigmentation of the skin
D. Tachycardia and tremors
Answer: B
Rationale: Cushing’s Syndrome (excess cortisol) typically results in fat redistribution to
the face (moon face), back (buffalo hump), and trunk (truncal obesity).
Comprehensive Quiz 2026 |WCU
1. A patient with a history of COPD presents with a pH of 7.28, PaCO2 of 58
mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Uncompensated Respiratory Acidosis
B. Partially Compensated Respiratory Acidosis
C. Fully Compensated Metabolic Alkalosis
D. Uncompensated Metabolic Acidosis
Answer: B
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
elevated, indicating the kidneys are attempting to compensate but have not yet returned
the pH to normal.
2. Which clinical manifestation should a nurse prioritize when assessing a
patient with a serum potassium level of 6.2 mEq/L?
A. Tall, peaked T waves on the ECG
B. Hyperactive bowel sounds
C. Muscle weakness in lower extremities
D. Increased urinary output
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) can lead to life-threatening cardiac dysrhythmias; tall,
peaked T waves are an early sign of potassium’s effect on cardiac conduction.
,3. A patient is 24 hours post-thyroidectomy. The nurse notes the patient is
experiencing numbness and tingling around the mouth and fingertips. What is
the priority nursing action?
A. Encourage the patient to use the incentive spirometer
B. Check the surgical dressing for bleeding
C. Assess for Chvostek’s sign
D. Administer an oral potassium supplement
Answer: C
Rationale: Hypocalcemia is a risk after thyroidectomy due to potential accidental
parathyroid removal. Numbness/tingling (paresthesia) is an early sign; assessing
Chvostek’s sign helps confirm tetany risk.
4. The nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory result is most consistent with this
diagnosis?
A. Serum sodium 128 mEq/L
B. Serum osmolarity 310 mOsm/kg
C. Urine specific gravity 1.002
D. Hematocrit 55%
Answer: A
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia.
Low serum sodium and low serum osmolarity are characteristic.
, 5. During the administration of a blood transfusion, the patient complains of
low back pain and chills. What is the nurse’s immediate priority?
A. Slow the infusion rate and call the provider
B. Stop the transfusion and disconnect the tubing
C. Administer diphenhydramine as ordered
D. Recheck the patient’s ID band and blood bag labels
Answer: B
Rationale: Low back pain and chills suggest an acute hemolytic reaction. The first action is
to stop the transfusion immediately to prevent further damage.
6. A patient is diagnosed with Diabetes Insipidus (DI). Which medication does
the nurse expect the provider to prescribe?
A. Furosemide
B. Spironolactone
C. Desmopressin (DDAVP)
D. Regular Insulin
Answer: C
Rationale: DI is characterized by a deficiency of ADH. Desmopressin is a synthetic analog
of ADH used to replace the hormone and reduce urine output.
7. When assessing a patient with Cushing’s Syndrome, which physical finding is
the nurse most likely to observe?
A. Hypotension and weight loss
B. Truncal obesity and moon face
C. Hyperpigmentation of the skin
D. Tachycardia and tremors
Answer: B
Rationale: Cushing’s Syndrome (excess cortisol) typically results in fat redistribution to
the face (moon face), back (buffalo hump), and trunk (truncal obesity).
