1|Page
NUR 2804C PCC Exam 2 – Latest Updated
Comprehensive Study Guide and Practice
Examination (PDF Format)
1. A nurse is assessing a 3-month-old infant during a well-child visit. Which developmental characteristic places this
infant at greatest risk for injury?
- A) Flexible bones that bend easily during falls
- B) Straight spine that limits crawling ability
- C) Large head size in proportion to body
- D) Delayed muscle development compared to bone growth
Infants have proportionally large heads compared to their body size, making them top-heavy and at increased risk
for head injuries when they fall or lose balance during early mobility attempts.
2. An older adult patient presents with a noticeable stooped posture and reduced height. The nurse recognizes these
findings as consistent with which age-related change?
- A) Osteoarthritis progression in weight-bearing joints
- B) Kyphosis resulting from vertebral compression
- C) Muscle atrophy due to decreased activity
- D) Loss of intervertebral disc hydration
Age-related bone loss and vertebral compression fractures lead to kyphosis, a forward curvature of the spine that
causes height reduction and a stooped appearance common in older adults.
3. A nurse is teaching a community group about primary prevention strategies for maintaining mobility. Which
intervention should the nurse emphasize as most important?
- A) Scheduling annual bone density screenings
- B) Taking calcium supplements after age 50
- C) Engaging in regular weight-bearing exercise
- D) Using assistive devices for ambulation
Regular physical activity, particularly weight-bearing exercise, is a primary prevention strategy that helps maintain
bone density, muscle strength, and joint flexibility, reducing the risk of mobility impairment across the lifespan.
4. The nurse is caring for a patient with a spinal cord injury. Which individual risk factor for impaired mobility is
most directly related to this patient's condition?
- A) Chronic condition such as diabetes
- B) Neurological condition affecting motor function
- C) Nutritional deficiencies from poor diet
- D) Medication side effects from corticosteroids
Spinal cord injuries represent neurological conditions that directly disrupt motor pathways and sensory function,
leading to significant mobility impairment that often requires comprehensive rehabilitation and long-term care
planning.
,2|Page
5. A patient who has been on bed rest for 5 days develops crackles in the lung bases and reports shortness of breath.
The nurse identifies this as which consequence of immobility?
- A) Pneumonia related to hypoventilation
- B) Pulmonary embolism from venous stasis
- C) Atelectasis from retained secretions
- D) Heart failure from fluid overload
Immobility leads to decreased lung expansion, pooling of secretions, and impaired cough reflex, increasing the risk
of pneumonia. Crackles and dyspnea indicate respiratory compromise from retained secretions and inadequate
ventilation.
6. The nurse is developing a care plan for an immobile patient. Which intervention is most effective for preventing
thrombophlebitis?
- A) Applying sequential compression devices (SCDs)
- B) Massaging the calves to promote circulation
- C) Keeping the legs in a dependent position
- D) Restricting fluid intake to reduce edema
SCDs promote venous return through intermittent compression of the lower extremities, reducing venous stasis and
preventing thrombus formation. Massaging calves can dislodge existing clots and is contraindicated.
7. A patient with a fractured femur reports sudden onset of chest pain, dyspnea, and petechiae on the chest. The
nurse suspects which complication?
- A) Fat embolism syndrome
- B) Pulmonary embolism
- C) Compartment syndrome
- D) Acute respiratory distress syndrome
Fat embolism syndrome presents with the classic triad of hypoxemia, neurological compromise, and petechial rash,
typically occurring 12-72 hours after long bone fractures. The patient's symptoms are consistent with this
complication.
8. A patient in a long leg cast reports severe pain that is unrelieved by pain medication, along with numbness and
tingling in the toes. The nurse should first:
- A) Administer additional pain medication
- B) Assess for signs of compartment syndrome
- C) Elevate the affected extremity higher
- D) Apply ice packs to reduce swelling
Unrelieved pain, paresthesia, and sensory changes in a casted extremity are hallmark signs of compartment
syndrome, a medical emergency requiring immediate intervention to prevent permanent tissue damage.
9. The nurse is teaching a patient with osteoporosis about dietary management. Which food selection indicates the
patient understands the teaching?
,3|Page
- A) Yogurt and spinach with a glass of milk
- B) Black coffee and whole wheat toast
- C) Orange juice with scrambled eggs
- D) Pasta with tomato sauce and cheese
Yogurt, spinach, and milk are all excellent sources of calcium essential for bone health. Patients with osteoporosis
need adequate calcium intake to slow bone loss and maintain bone density.
10. When performing a nursing assessment on an older adult patient, which finding is a normal age-related change
in the musculoskeletal system?
- A) Increased muscle mass and strength
- B) Decreased elasticity and slower movement
- C) Enhanced bone density and hardness
- D) Increased subcutaneous fat layers
Aging causes loss of skin elasticity, muscle weakness, and slower movement due to physiological changes. Bones
become more fragile, and superficial fat layers decrease, leading to reduced protection against injury.
11. A patient is prescribed alendronate (Fosamax) for osteoporosis. Which instruction should the nurse include in
patient teaching?
- A) Take with a full glass of water and remain upright for 30 minutes
- B) Take with milk to enhance absorption
- C) Lie down for 30 minutes after taking
- D) Take with meals to prevent stomach upset
Bisphosphonates like alendronate must be taken with a full glass of water and the patient must remain upright for at
least 30 minutes to prevent esophageal irritation and ensure proper absorption. Food and other medications interfere
with absorption.
12. A school-age child falls and sustains a fracture. The nurse notes that the bone is bent on one side and broken on
the other. This type of fracture is characteristic of children and is called a:
- A) Compound fracture
- B) Greenstick fracture
- C) Complete fracture
- D) Pathological fracture
Children have more porous, flexible bones that bend rather than break completely. A greenstick fracture occurs when
one side of the bone is broken and the other side is bent, which is unique to pediatric patients.
13. A nurse is performing a musculoskeletal assessment on a toddler. Which developmental milestone should the
nurse expect the toddler to have achieved?
- A) Walking independently
- B) Crawling with a curved spine
- C) Running without assistance
- D) Climbing stairs with support
, 4|Page
Toddlers typically develop the ability to crawl, which naturally curves the spine during movement. This milestone
supports spinal development and prepares for walking. The other options occur at later developmental stages.
14. The nurse is teaching a patient with a new fracture about the inflammatory phase of fracture healing. Which
statement indicates the patient understands this process?
- A) "The bone will be completely healed in about 6 weeks"
- B) "Clot formation and inflammation begin the healing process"
- C) "My bone will remodel to its original shape immediately"
- D) "Pain medication cannot help during the healing phase"
Fracture healing begins with the inflammatory phase where hematoma formation and inflammation occur,
establishing the foundation for new bone growth. This process is essential for proper healing and occurs within the
first few days after injury.
15. A patient with a hip fracture is placed in traction. Which nursing intervention is most important to monitor in this
patient?
- A) Neurovascular status of the affected extremity
- B) Urinary output every 4 hours
- C) Skin integrity every shift
- D) Pain level with repositioning
Monitoring neurovascular status is critical in traction patients to detect early signs of compromised circulation or
nerve function. This assessment should be performed every 1-2 hours to prevent permanent damage from traction
complications.
16. The nurse is caring for a patient with a closed reduction and casting of a forearm fracture. Which finding would
indicate a complication requiring immediate attention?
- A) Fingers are pale, cool, and difficult to move
- B) Mild swelling of the fingers
- C) Capillary refill of 2 seconds
- D) Slight discomfort at the fracture site
Pale, cool fingers with decreased movement indicate compromised circulation and nerve function, suggesting
compartment syndrome or vascular compromise. This is an emergency requiring immediate provider notification
and possible cast removal.
17. A postmenopausal woman asks the nurse about her risk for osteoporosis. Which factor should the nurse identify
as a nonmodifiable risk factor?
- A) Current cigarette smoking
- B) Family history of osteoporosis
- C) Sedentary lifestyle
- D) Low dietary calcium intake
Family history is a nonmodifiable risk factor for osteoporosis, along with age, gender, and ethnicity. While lifestyle
factors can be modified, genetic predisposition cannot be changed and requires increased vigilance in prevention
strategies.
NUR 2804C PCC Exam 2 – Latest Updated
Comprehensive Study Guide and Practice
Examination (PDF Format)
1. A nurse is assessing a 3-month-old infant during a well-child visit. Which developmental characteristic places this
infant at greatest risk for injury?
- A) Flexible bones that bend easily during falls
- B) Straight spine that limits crawling ability
- C) Large head size in proportion to body
- D) Delayed muscle development compared to bone growth
Infants have proportionally large heads compared to their body size, making them top-heavy and at increased risk
for head injuries when they fall or lose balance during early mobility attempts.
2. An older adult patient presents with a noticeable stooped posture and reduced height. The nurse recognizes these
findings as consistent with which age-related change?
- A) Osteoarthritis progression in weight-bearing joints
- B) Kyphosis resulting from vertebral compression
- C) Muscle atrophy due to decreased activity
- D) Loss of intervertebral disc hydration
Age-related bone loss and vertebral compression fractures lead to kyphosis, a forward curvature of the spine that
causes height reduction and a stooped appearance common in older adults.
3. A nurse is teaching a community group about primary prevention strategies for maintaining mobility. Which
intervention should the nurse emphasize as most important?
- A) Scheduling annual bone density screenings
- B) Taking calcium supplements after age 50
- C) Engaging in regular weight-bearing exercise
- D) Using assistive devices for ambulation
Regular physical activity, particularly weight-bearing exercise, is a primary prevention strategy that helps maintain
bone density, muscle strength, and joint flexibility, reducing the risk of mobility impairment across the lifespan.
4. The nurse is caring for a patient with a spinal cord injury. Which individual risk factor for impaired mobility is
most directly related to this patient's condition?
- A) Chronic condition such as diabetes
- B) Neurological condition affecting motor function
- C) Nutritional deficiencies from poor diet
- D) Medication side effects from corticosteroids
Spinal cord injuries represent neurological conditions that directly disrupt motor pathways and sensory function,
leading to significant mobility impairment that often requires comprehensive rehabilitation and long-term care
planning.
,2|Page
5. A patient who has been on bed rest for 5 days develops crackles in the lung bases and reports shortness of breath.
The nurse identifies this as which consequence of immobility?
- A) Pneumonia related to hypoventilation
- B) Pulmonary embolism from venous stasis
- C) Atelectasis from retained secretions
- D) Heart failure from fluid overload
Immobility leads to decreased lung expansion, pooling of secretions, and impaired cough reflex, increasing the risk
of pneumonia. Crackles and dyspnea indicate respiratory compromise from retained secretions and inadequate
ventilation.
6. The nurse is developing a care plan for an immobile patient. Which intervention is most effective for preventing
thrombophlebitis?
- A) Applying sequential compression devices (SCDs)
- B) Massaging the calves to promote circulation
- C) Keeping the legs in a dependent position
- D) Restricting fluid intake to reduce edema
SCDs promote venous return through intermittent compression of the lower extremities, reducing venous stasis and
preventing thrombus formation. Massaging calves can dislodge existing clots and is contraindicated.
7. A patient with a fractured femur reports sudden onset of chest pain, dyspnea, and petechiae on the chest. The
nurse suspects which complication?
- A) Fat embolism syndrome
- B) Pulmonary embolism
- C) Compartment syndrome
- D) Acute respiratory distress syndrome
Fat embolism syndrome presents with the classic triad of hypoxemia, neurological compromise, and petechial rash,
typically occurring 12-72 hours after long bone fractures. The patient's symptoms are consistent with this
complication.
8. A patient in a long leg cast reports severe pain that is unrelieved by pain medication, along with numbness and
tingling in the toes. The nurse should first:
- A) Administer additional pain medication
- B) Assess for signs of compartment syndrome
- C) Elevate the affected extremity higher
- D) Apply ice packs to reduce swelling
Unrelieved pain, paresthesia, and sensory changes in a casted extremity are hallmark signs of compartment
syndrome, a medical emergency requiring immediate intervention to prevent permanent tissue damage.
9. The nurse is teaching a patient with osteoporosis about dietary management. Which food selection indicates the
patient understands the teaching?
,3|Page
- A) Yogurt and spinach with a glass of milk
- B) Black coffee and whole wheat toast
- C) Orange juice with scrambled eggs
- D) Pasta with tomato sauce and cheese
Yogurt, spinach, and milk are all excellent sources of calcium essential for bone health. Patients with osteoporosis
need adequate calcium intake to slow bone loss and maintain bone density.
10. When performing a nursing assessment on an older adult patient, which finding is a normal age-related change
in the musculoskeletal system?
- A) Increased muscle mass and strength
- B) Decreased elasticity and slower movement
- C) Enhanced bone density and hardness
- D) Increased subcutaneous fat layers
Aging causes loss of skin elasticity, muscle weakness, and slower movement due to physiological changes. Bones
become more fragile, and superficial fat layers decrease, leading to reduced protection against injury.
11. A patient is prescribed alendronate (Fosamax) for osteoporosis. Which instruction should the nurse include in
patient teaching?
- A) Take with a full glass of water and remain upright for 30 minutes
- B) Take with milk to enhance absorption
- C) Lie down for 30 minutes after taking
- D) Take with meals to prevent stomach upset
Bisphosphonates like alendronate must be taken with a full glass of water and the patient must remain upright for at
least 30 minutes to prevent esophageal irritation and ensure proper absorption. Food and other medications interfere
with absorption.
12. A school-age child falls and sustains a fracture. The nurse notes that the bone is bent on one side and broken on
the other. This type of fracture is characteristic of children and is called a:
- A) Compound fracture
- B) Greenstick fracture
- C) Complete fracture
- D) Pathological fracture
Children have more porous, flexible bones that bend rather than break completely. A greenstick fracture occurs when
one side of the bone is broken and the other side is bent, which is unique to pediatric patients.
13. A nurse is performing a musculoskeletal assessment on a toddler. Which developmental milestone should the
nurse expect the toddler to have achieved?
- A) Walking independently
- B) Crawling with a curved spine
- C) Running without assistance
- D) Climbing stairs with support
, 4|Page
Toddlers typically develop the ability to crawl, which naturally curves the spine during movement. This milestone
supports spinal development and prepares for walking. The other options occur at later developmental stages.
14. The nurse is teaching a patient with a new fracture about the inflammatory phase of fracture healing. Which
statement indicates the patient understands this process?
- A) "The bone will be completely healed in about 6 weeks"
- B) "Clot formation and inflammation begin the healing process"
- C) "My bone will remodel to its original shape immediately"
- D) "Pain medication cannot help during the healing phase"
Fracture healing begins with the inflammatory phase where hematoma formation and inflammation occur,
establishing the foundation for new bone growth. This process is essential for proper healing and occurs within the
first few days after injury.
15. A patient with a hip fracture is placed in traction. Which nursing intervention is most important to monitor in this
patient?
- A) Neurovascular status of the affected extremity
- B) Urinary output every 4 hours
- C) Skin integrity every shift
- D) Pain level with repositioning
Monitoring neurovascular status is critical in traction patients to detect early signs of compromised circulation or
nerve function. This assessment should be performed every 1-2 hours to prevent permanent damage from traction
complications.
16. The nurse is caring for a patient with a closed reduction and casting of a forearm fracture. Which finding would
indicate a complication requiring immediate attention?
- A) Fingers are pale, cool, and difficult to move
- B) Mild swelling of the fingers
- C) Capillary refill of 2 seconds
- D) Slight discomfort at the fracture site
Pale, cool fingers with decreased movement indicate compromised circulation and nerve function, suggesting
compartment syndrome or vascular compromise. This is an emergency requiring immediate provider notification
and possible cast removal.
17. A postmenopausal woman asks the nurse about her risk for osteoporosis. Which factor should the nurse identify
as a nonmodifiable risk factor?
- A) Current cigarette smoking
- B) Family history of osteoporosis
- C) Sedentary lifestyle
- D) Low dietary calcium intake
Family history is a nonmodifiable risk factor for osteoporosis, along with age, gender, and ethnicity. While lifestyle
factors can be modified, genetic predisposition cannot be changed and requires increased vigilance in prevention
strategies.
