NURS 120 | INTRODUCTION TO
MEDICAL-SURGICAL NURSING | STUDY
GUIDE EXAM 3 2026 | WCU
1. A patient’s arterial blood gas (ABG) results show pH 7.28, PaCO2 50 mmHg, and HCO3 24
mEq/L. Which physiological process is most likely occurring?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
cause). Since the HCO3 is within the normal range, it indicates an uncompensated
respiratory acidosis, often caused by hypoventilation.
2. When caring for a patient with a potassium level of 2.8 mEq/L, which electrocardiogram
(ECG) change should the nurse monitor for most closely?
A. Tall, peaked T waves
B. Widened QRS complexes
,C. Presence of U waves
D. Shortened QT interval
Answer: C
Conceptual Explanation: Hypokalemia (K < 3.5) typically causes the presence of U waves,
ST-segment depression, and flat or inverted T waves. Tall peaked T waves are indicative of
hyperkalemia.
3. A patient is scheduled for a radical neck dissection. The nurse notes the patient’s signature
on the informed consent but realizes the patient does not understand the potential risks.
What is the nurse’s priority action?
A. Explain the risks of the surgery to the patient.
B. Document that the consent was signed and continue pre-op care.
C. Notify the surgeon that the patient needs further clarification.
D. Witness the signature as it is a legal requirement.
Answer: C
Conceptual Explanation: The surgeon is responsible for explaining the procedure and its
risks. The nurse’s role is to witness the signature and ensure the patient is informed; if the
patient is confused, the nurse must contact the surgeon.
, 4. During the intraoperative period, a patient develops a heart rate of 120 bpm, muscle
rigidity, and a rapidly rising temperature. Which medication should the nurse prepare to
administer?
A. Atropine sulfate
B. Dantrolene sodium
C. Naloxone
D. Succinylcholine
Answer: B
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening reaction to general anesthesia. Dantrolene is the specific skeletal muscle
relaxant used to treat it.
5. A patient with Stage IV lung cancer is being admitted. According to the TNM staging
system, what does ‘N2’ signify?
A. The tumor is 2 centimeters in diameter.
B. Involvement of regional lymph nodes.
C. There are two separate primary tumors found.
D. Metastasis to two distant organs.
Answer: B
MEDICAL-SURGICAL NURSING | STUDY
GUIDE EXAM 3 2026 | WCU
1. A patient’s arterial blood gas (ABG) results show pH 7.28, PaCO2 50 mmHg, and HCO3 24
mEq/L. Which physiological process is most likely occurring?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
cause). Since the HCO3 is within the normal range, it indicates an uncompensated
respiratory acidosis, often caused by hypoventilation.
2. When caring for a patient with a potassium level of 2.8 mEq/L, which electrocardiogram
(ECG) change should the nurse monitor for most closely?
A. Tall, peaked T waves
B. Widened QRS complexes
,C. Presence of U waves
D. Shortened QT interval
Answer: C
Conceptual Explanation: Hypokalemia (K < 3.5) typically causes the presence of U waves,
ST-segment depression, and flat or inverted T waves. Tall peaked T waves are indicative of
hyperkalemia.
3. A patient is scheduled for a radical neck dissection. The nurse notes the patient’s signature
on the informed consent but realizes the patient does not understand the potential risks.
What is the nurse’s priority action?
A. Explain the risks of the surgery to the patient.
B. Document that the consent was signed and continue pre-op care.
C. Notify the surgeon that the patient needs further clarification.
D. Witness the signature as it is a legal requirement.
Answer: C
Conceptual Explanation: The surgeon is responsible for explaining the procedure and its
risks. The nurse’s role is to witness the signature and ensure the patient is informed; if the
patient is confused, the nurse must contact the surgeon.
, 4. During the intraoperative period, a patient develops a heart rate of 120 bpm, muscle
rigidity, and a rapidly rising temperature. Which medication should the nurse prepare to
administer?
A. Atropine sulfate
B. Dantrolene sodium
C. Naloxone
D. Succinylcholine
Answer: B
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening reaction to general anesthesia. Dantrolene is the specific skeletal muscle
relaxant used to treat it.
5. A patient with Stage IV lung cancer is being admitted. According to the TNM staging
system, what does ‘N2’ signify?
A. The tumor is 2 centimeters in diameter.
B. Involvement of regional lymph nodes.
C. There are two separate primary tumors found.
D. Metastasis to two distant organs.
Answer: B
