COMPREHENSIVE MEDICAL-
SURGICAL NURSING 2 FINAL
EXAMINATION Complete Test Bank:
Questions with Answers & Evidence-
Based Rationales Updated for 2026
NCLEX-RN® Standards & Current
Practice Guidelines
Question 1
The client reports that a previously sensitive area of skin no longer
responds to temperature changes or painful stimuli. This finding indicates a
functional abnormality for which skin layer?
A. Stratum corneum
B. Adipose layer
C. Epidermis
D. Dermis
Correct Answer: D. Dermis
Rationale: The dermis contains the nerve endings responsible for
sensation, including temperature and pain perception. Loss of sensation in
a previously sensitive area indicates damage to the dermal layer where
,these nerve fibers are located. The stratum corneum is the outermost
protective layer, the adipose layer provides insulation and cushioning, and
the epidermis lacks nerve endings .
Question 2
During skin inspection the nurse observes three lesions on the client's right
knee. The lesions are round, have a raised border, and are grouped in a
"smiley face" pattern. Which descriptors does the nurse use to document
these observations?
A. Annular, circinate, clustered
B. Linear, confluent, vesicular
C. Circumscribed, universal, pustular
D. Serpiginous, coalesced, wheal-like
Correct Answer: A. Annular, circinate, clustered
Rationale: "Annular" describes round or ring-shaped lesions, "circinate"
refers to lesions with a raised border, and "clustered" indicates grouping
together. These are the correct dermatological terms for the described
findings. The other options describe different lesion characteristics (linear =
straight line; confluent = merging together; serpiginous = snake-like) .
Question 3
Which technique for obtaining a specimen for bacterial culture is most
correct for the nurse to use with a client who has crusted skin lesions on the
upper back?
,A. Remove several crusts, and swab the underlying exudate.
B. Dampen the culture swab with sterile water, and then roll the swab over
the central crusts.
C. Apply a gauze bandage to the area, remove it after 1 hour, and send the
entire gauze to the laboratory.
D. Clean the area with an antibacterial solution, remove a crust from the
center of the cluster of lesions, and send it to the laboratory.
Correct Answer: A. Remove several crusts, and swab the underlying
exudate.
Rationale: For crusted skin lesions, the most accurate culture technique is
to remove the crusts and swab the exudate underneath, as this is where the
pathogenic organisms are most likely to be found. Moistening the swab is
unnecessary, cleaning the area with antibacterial solution would kill the
organisms being cultured, and the gauze method is not standard practice
for skin lesion cultures .
Question 4
An 88-year-old man is admitted to the ED from home with weakness and
acute confusion. What is the nurse's priority for his care to maintain client
safety?
A. Assess his mental status every 30 minutes
B. Ensure that siderails are raised on his stretcher
C. Check his bowel sounds for intestinal obstruction
D. Teach him to move slowly when walking
Correct Answer: B. Ensure that siderails are raised on his stretcher
Rationale: An elderly patient with acute confusion and weakness is at high
risk for falls and injury. Raising the siderails is the priority safety intervention
to prevent the patient from falling off the stretcher. While assessing mental
, status is important, physical safety measures take priority. Checking bowel
sounds and teaching about slow movement are not immediate safety
priorities .
Question 5
A client is admitted to the ED with multiple stab wounds to his chest,
abdomen and arms. What is the nurse's priority upon admission to the ED?
A. Check for bleeding from the stab wounds
B. Assess and maintain the client's airway
C. Start 2 large-bore IV lines
D. Assess the level of consciousness
Correct Answer: B. Assess and maintain the client's airway
Rationale: The ABCs (Airway, Breathing, Circulation) are the foundation of
emergency care. The airway is always the priority regardless of the
mechanism of injury. A compromised airway is the most immediate threat
to life. After airway is established, breathing and circulation (including
bleeding control and IV access) are addressed. Level of consciousness
assessment is important but follows the ABCs .
Question 6
An older client with heat stroke is being cooled with a cooling blanket and
ice packs under her arms and behind her neck. What assessment indicates
to the nurse that the cooling process is effective?
A. The client is alert and oriented
B. The client states that she feels cooler
SURGICAL NURSING 2 FINAL
EXAMINATION Complete Test Bank:
Questions with Answers & Evidence-
Based Rationales Updated for 2026
NCLEX-RN® Standards & Current
Practice Guidelines
Question 1
The client reports that a previously sensitive area of skin no longer
responds to temperature changes or painful stimuli. This finding indicates a
functional abnormality for which skin layer?
A. Stratum corneum
B. Adipose layer
C. Epidermis
D. Dermis
Correct Answer: D. Dermis
Rationale: The dermis contains the nerve endings responsible for
sensation, including temperature and pain perception. Loss of sensation in
a previously sensitive area indicates damage to the dermal layer where
,these nerve fibers are located. The stratum corneum is the outermost
protective layer, the adipose layer provides insulation and cushioning, and
the epidermis lacks nerve endings .
Question 2
During skin inspection the nurse observes three lesions on the client's right
knee. The lesions are round, have a raised border, and are grouped in a
"smiley face" pattern. Which descriptors does the nurse use to document
these observations?
A. Annular, circinate, clustered
B. Linear, confluent, vesicular
C. Circumscribed, universal, pustular
D. Serpiginous, coalesced, wheal-like
Correct Answer: A. Annular, circinate, clustered
Rationale: "Annular" describes round or ring-shaped lesions, "circinate"
refers to lesions with a raised border, and "clustered" indicates grouping
together. These are the correct dermatological terms for the described
findings. The other options describe different lesion characteristics (linear =
straight line; confluent = merging together; serpiginous = snake-like) .
Question 3
Which technique for obtaining a specimen for bacterial culture is most
correct for the nurse to use with a client who has crusted skin lesions on the
upper back?
,A. Remove several crusts, and swab the underlying exudate.
B. Dampen the culture swab with sterile water, and then roll the swab over
the central crusts.
C. Apply a gauze bandage to the area, remove it after 1 hour, and send the
entire gauze to the laboratory.
D. Clean the area with an antibacterial solution, remove a crust from the
center of the cluster of lesions, and send it to the laboratory.
Correct Answer: A. Remove several crusts, and swab the underlying
exudate.
Rationale: For crusted skin lesions, the most accurate culture technique is
to remove the crusts and swab the exudate underneath, as this is where the
pathogenic organisms are most likely to be found. Moistening the swab is
unnecessary, cleaning the area with antibacterial solution would kill the
organisms being cultured, and the gauze method is not standard practice
for skin lesion cultures .
Question 4
An 88-year-old man is admitted to the ED from home with weakness and
acute confusion. What is the nurse's priority for his care to maintain client
safety?
A. Assess his mental status every 30 minutes
B. Ensure that siderails are raised on his stretcher
C. Check his bowel sounds for intestinal obstruction
D. Teach him to move slowly when walking
Correct Answer: B. Ensure that siderails are raised on his stretcher
Rationale: An elderly patient with acute confusion and weakness is at high
risk for falls and injury. Raising the siderails is the priority safety intervention
to prevent the patient from falling off the stretcher. While assessing mental
, status is important, physical safety measures take priority. Checking bowel
sounds and teaching about slow movement are not immediate safety
priorities .
Question 5
A client is admitted to the ED with multiple stab wounds to his chest,
abdomen and arms. What is the nurse's priority upon admission to the ED?
A. Check for bleeding from the stab wounds
B. Assess and maintain the client's airway
C. Start 2 large-bore IV lines
D. Assess the level of consciousness
Correct Answer: B. Assess and maintain the client's airway
Rationale: The ABCs (Airway, Breathing, Circulation) are the foundation of
emergency care. The airway is always the priority regardless of the
mechanism of injury. A compromised airway is the most immediate threat
to life. After airway is established, breathing and circulation (including
bleeding control and IV access) are addressed. Level of consciousness
assessment is important but follows the ABCs .
Question 6
An older client with heat stroke is being cooled with a cooling blanket and
ice packs under her arms and behind her neck. What assessment indicates
to the nurse that the cooling process is effective?
A. The client is alert and oriented
B. The client states that she feels cooler
