NURS 120 Introduction to Medical-Surgical Nursing Comprehensive
Final Exam 2026 |WCU
1. A patient has a pH of 7.31, a PaCO2 of 50 mmHg, and an HCO3 of 24 mEq/L.
Which acid-base imbalance is present?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 indicates a respiratory
cause. The HCO3 is normal, confirming uncompensated respiratory acidosis.
2. Which assessment finding is most indicative of hypocalcemia?
A. Negative Chvostek’s sign
B. A positive Trousseau’s sign
C. Depressed deep tendon reflexes
D. Constipation
Answer: B
Rationale: Positive Trousseau’s and Chvostek’s signs are classic indicators of
neuromuscular irritability caused by hypocalcemia.
,3. The nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which
intervention is the priority?
A. Check the patient’s blood pressure
B. Administer a dose of oral potassium
C. Initiate cardiac monitoring
D. Assess for bowel sounds
Answer: C
Rationale: Hyperkalemia (K+ > 5.0) can cause life-threatening cardiac arrhythmias;
therefore, EKG monitoring is the immediate priority.
4. During the preoperative assessment, a patient reports an allergy to bananas
and avocados. Which action should the nurse take?
A. Document the allergy and continue with standard care
B. Alert the surgical team of a potential latex allergy
C. Inform the kitchen to remove these items from the patient’s diet
D. Assess for a history of penicillin allergy
Answer: B
Rationale: Cross-reactivity exists between latex and certain foods like bananas, avocados,
and kiwi.
5. A postoperative patient has a sudden onset of shortness of breath and chest
pain. Which complication does the nurse suspect?
A. Pneumonia
B. Pulmonary Embolism
C. Atelectasis
D. Heart Failure
Answer: B
Rationale: Sudden respiratory distress and chest pain in a post-op patient are classic signs
of a pulmonary embolism, a medical emergency.
, 6. Which vital sign change is the earliest indicator of hypovolemic shock?
A. Decreased blood pressure
B. Decreased respiratory rate
C. Increased heart rate
D. Increased temperature
Answer: C
Rationale: Tachycardia is a compensatory mechanism to maintain cardiac output when
fluid volume is low; hypotension is a later sign.
7. A patient with COPD is receiving oxygen. Which SpO2 range is generally
targeted for this patient population?
A. 95-100%
B. 92-96%
C. 80-85%
D. 88-92%
Answer: D
Rationale: In COPD patients, a high oxygen concentration can suppress the hypoxic drive
to breathe; therefore, a lower target of 88-92% is common.
8. When teaching a patient about using an incentive spirometer, which
instruction is correct?
A. Exhale forcefully into the device
B. Lie flat while using the device
C. Use the device once every 8 hours
D. Inhale slowly and deeply through the mouthpiece
Answer: D
Rationale: Incentive spirometry requires slow, deep inhalations to expand the alveoli and
prevent atelectasis.
Final Exam 2026 |WCU
1. A patient has a pH of 7.31, a PaCO2 of 50 mmHg, and an HCO3 of 24 mEq/L.
Which acid-base imbalance is present?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 indicates a respiratory
cause. The HCO3 is normal, confirming uncompensated respiratory acidosis.
2. Which assessment finding is most indicative of hypocalcemia?
A. Negative Chvostek’s sign
B. A positive Trousseau’s sign
C. Depressed deep tendon reflexes
D. Constipation
Answer: B
Rationale: Positive Trousseau’s and Chvostek’s signs are classic indicators of
neuromuscular irritability caused by hypocalcemia.
,3. The nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which
intervention is the priority?
A. Check the patient’s blood pressure
B. Administer a dose of oral potassium
C. Initiate cardiac monitoring
D. Assess for bowel sounds
Answer: C
Rationale: Hyperkalemia (K+ > 5.0) can cause life-threatening cardiac arrhythmias;
therefore, EKG monitoring is the immediate priority.
4. During the preoperative assessment, a patient reports an allergy to bananas
and avocados. Which action should the nurse take?
A. Document the allergy and continue with standard care
B. Alert the surgical team of a potential latex allergy
C. Inform the kitchen to remove these items from the patient’s diet
D. Assess for a history of penicillin allergy
Answer: B
Rationale: Cross-reactivity exists between latex and certain foods like bananas, avocados,
and kiwi.
5. A postoperative patient has a sudden onset of shortness of breath and chest
pain. Which complication does the nurse suspect?
A. Pneumonia
B. Pulmonary Embolism
C. Atelectasis
D. Heart Failure
Answer: B
Rationale: Sudden respiratory distress and chest pain in a post-op patient are classic signs
of a pulmonary embolism, a medical emergency.
, 6. Which vital sign change is the earliest indicator of hypovolemic shock?
A. Decreased blood pressure
B. Decreased respiratory rate
C. Increased heart rate
D. Increased temperature
Answer: C
Rationale: Tachycardia is a compensatory mechanism to maintain cardiac output when
fluid volume is low; hypotension is a later sign.
7. A patient with COPD is receiving oxygen. Which SpO2 range is generally
targeted for this patient population?
A. 95-100%
B. 92-96%
C. 80-85%
D. 88-92%
Answer: D
Rationale: In COPD patients, a high oxygen concentration can suppress the hypoxic drive
to breathe; therefore, a lower target of 88-92% is common.
8. When teaching a patient about using an incentive spirometer, which
instruction is correct?
A. Exhale forcefully into the device
B. Lie flat while using the device
C. Use the device once every 8 hours
D. Inhale slowly and deeply through the mouthpiece
Answer: D
Rationale: Incentive spirometry requires slow, deep inhalations to expand the alveoli and
prevent atelectasis.
