NURS 120 MEDICAL-SURGICAL
NURSING EXAM 3 (2026 UPDATE) WCU
QUESTIONS AND ANSWERS
1. A patient’s arterial blood gas (ABG) results are: pH 7.25, PaCO2 58 mmHg, and HCO3 26
mEq/L. Which condition does the nurse suspect?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. The PaCO2 is elevated
(above 45 mmHg), while the HCO3 is within the normal range, indicating the cause is
respiratory in nature.
2. A nurse is caring for a patient with Congestive Heart Failure (CHF). Which assessment
finding is most indicative of left-sided heart failure?
A. Jugular venous distention (JVD)
B. Crackles heard in lung bases
,C. Dependent edema in the ankles
D. Hepatosplenomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, resulting
in symptoms like crackles, dyspnea, and orthopnea. JVD and peripheral edema are signs of
right-sided heart failure.
3. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 550
mg/dL and positive ketonuria. What is the priority nursing intervention?
A. Administer 50% Dextrose IV push
B. Initiate intravenous Regular Insulin infusion
C. Administer subcutaneous Glucagon
D. Provide a high-carbohydrate snack
Answer: B
Conceptual Explanation: The patient is experiencing Diabetic Ketoacidosis (DKA). The
priority is IV fluid resuscitation and IV Regular Insulin to lower blood glucose and stop
ketone production.
4. Which medication should the nurse anticipate administering to a patient with a potassium
level of 6.8 mEq/L and EKG changes?
A. Sodium Polystyrene Sulfonate (Kayexalate)
, B. Furosemide (Lasix)
C. Calcium Gluconate
D. Spironolactone
Answer: C
Conceptual Explanation: While Kayexalate removes potassium, Calcium Gluconate is the
priority to stabilize the myocardium and prevent lethal dysrhythmias in the presence of
severe hyperkalemia.
5. A patient is 12 hours post-thyroidectomy. The nurse notes the patient has developed a
‘crowing’ sound on inspiration and is increasingly restless. Which action is most appropriate?
A. Prepare for emergency tracheostomy at the bedside
B. Administer a PRN sedative for anxiety
C. Encourage the patient to use the incentive spirometer
D. Place the patient in a prone position to drain secretions
Answer: A
Conceptual Explanation: Stridor (crowing sound) indicates laryngeal edema and potential
airway obstruction, which is a medical emergency following thyroid surgery.
6. When caring for a patient with Chronic Obstructive Pulmonary Disease (COPD), what is the
recommended oxygen delivery goal?
A. Maintain SpO2 between 95% and 100%
NURSING EXAM 3 (2026 UPDATE) WCU
QUESTIONS AND ANSWERS
1. A patient’s arterial blood gas (ABG) results are: pH 7.25, PaCO2 58 mmHg, and HCO3 26
mEq/L. Which condition does the nurse suspect?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. The PaCO2 is elevated
(above 45 mmHg), while the HCO3 is within the normal range, indicating the cause is
respiratory in nature.
2. A nurse is caring for a patient with Congestive Heart Failure (CHF). Which assessment
finding is most indicative of left-sided heart failure?
A. Jugular venous distention (JVD)
B. Crackles heard in lung bases
,C. Dependent edema in the ankles
D. Hepatosplenomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, resulting
in symptoms like crackles, dyspnea, and orthopnea. JVD and peripheral edema are signs of
right-sided heart failure.
3. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 550
mg/dL and positive ketonuria. What is the priority nursing intervention?
A. Administer 50% Dextrose IV push
B. Initiate intravenous Regular Insulin infusion
C. Administer subcutaneous Glucagon
D. Provide a high-carbohydrate snack
Answer: B
Conceptual Explanation: The patient is experiencing Diabetic Ketoacidosis (DKA). The
priority is IV fluid resuscitation and IV Regular Insulin to lower blood glucose and stop
ketone production.
4. Which medication should the nurse anticipate administering to a patient with a potassium
level of 6.8 mEq/L and EKG changes?
A. Sodium Polystyrene Sulfonate (Kayexalate)
, B. Furosemide (Lasix)
C. Calcium Gluconate
D. Spironolactone
Answer: C
Conceptual Explanation: While Kayexalate removes potassium, Calcium Gluconate is the
priority to stabilize the myocardium and prevent lethal dysrhythmias in the presence of
severe hyperkalemia.
5. A patient is 12 hours post-thyroidectomy. The nurse notes the patient has developed a
‘crowing’ sound on inspiration and is increasingly restless. Which action is most appropriate?
A. Prepare for emergency tracheostomy at the bedside
B. Administer a PRN sedative for anxiety
C. Encourage the patient to use the incentive spirometer
D. Place the patient in a prone position to drain secretions
Answer: A
Conceptual Explanation: Stridor (crowing sound) indicates laryngeal edema and potential
airway obstruction, which is a medical emergency following thyroid surgery.
6. When caring for a patient with Chronic Obstructive Pulmonary Disease (COPD), what is the
recommended oxygen delivery goal?
A. Maintain SpO2 between 95% and 100%
