Medical-Surgical Nursing 2 Comprehensive Master Practice
Exam Bank 2026 | Questions, Answers, Rationales & Exam
Prep Study Guide
Section 1: Orthopedics, Mobility, & Tissue Trauma
Question 1
The nurse is developing a plan of care for a 65-year-old patient, focusing on
preventive health care. While planning this care, the nurse understands that the
aging process is most affected by which factor?
• A. Hobbies and interests
• B. Financial issues
• C. Age at retirement
• D. Immobility
CORRECT ANSWER: D
RATIONALE: Immobility drives muscle atrophy and bone loss, cardiac and
respiratory decline, and skin breakdown, making it the most significant
physiological driver of physical aging decline. Hobbies and interests affect
psychosocial well-being, not the physical aging process. Financial issues affect
access to resources and care, not immediate cellular physiology. Age at retirement
is a life-stage marker with no direct physiological impact.
Question 2
What disorder is considered a primary cause of prolonged immobility and motor
deficits in the older adult population?
• A. Stroke
• B. Carpal tunnel syndrome
• C. Minor localized burns
• D. Dissociative identity disorder
, CORRECT ANSWER: A
RATIONALE: A stroke can cause hemiparesis, hemiplegia, or significant
motor and balance deficits, directly leading to prolonged immobility in older
adults. Carpal tunnel syndrome affects wrist and hand function but does not impair
overall systemic mobility. Minor burns are localized and typically resolve without
limiting ambulation. Dissociative identity disorder is a psychiatric condition with
no direct physical mobility impact.
Question 3
A female patient with systemic lupus erythematosus (SLE) complains of severe
photosensitivity. The nurse should instruct the patient on which self-care measure?
• A. Include foods high in beta-carotene in her daily diet.
• B. Use a commercial tanning bed once per week to help with skin rashes.
• C. Wear high-SPF sunblock whenever she is outdoors.
• D. Manage baseline joint pain exclusively with prescribed medications.
CORRECT ANSWER: C
RATIONALE: Photosensitivity in SLE means ultraviolet (UV) exposure can
directly damage skin cells, triggering local skin rashes and systemic disease flares.
Therefore, applying broad-spectrum sunblock and implementing sun-protective
clothing measures are critical self-care interventions. Beta-carotene does not treat
photosensitivity. Tanning beds emit intense UV radiation and are strictly
contraindicated. Pain medications manage arthralgia but do not address UV skin
protection.
Question 4
A patient presents to the clinic after falling from her bike and is diagnosed with a
Grade II ankle sprain. The nurse should make which statements to the patient
regarding the treatment of her sprained ankle? (Select all that apply.)
• A. Rest your ankle as much as possible and avoid weight-bearing.
• B. Place an ice pack on your ankle for 30 minutes every 4 hours.
, • C. Begin walking on your injured ankle after 24 hours, and increase your
ambulation as tolerated.
• D. You should wrap your ankle snugly with an elastic compression bandage.
• E. Prop your ankle on pillows above the heart level while resting.
• F. Take stimulant laxatives concurrently with your narcotic pain medication.
CORRECT ANSWER: A, B, D, E, F
RATIONALE: Management of a sprain follows the standard RICE (Rest,
Ice, Compression, Elevation) protocol. Applying ice controls inflammation,
compression bandages reduce interstitial fluid shifts, and elevation minimizes
edema. Opioid analgesics cause constipation by slowing bowel motility, making
education regarding stimulant laxatives (F) highly appropriate. Walking within 24
hours (C) is contraindicated for a Grade II sprain because the ligaments are
partially torn and unstable, meaning early weight-bearing can cause severe re-
injury.
Question 5
A patient presents to the clinic with a compound fracture of the right leg. The nurse
anticipates the administration of which classes of medications? (Select all that
apply.)
• A. Hepatitis B vaccine
• B. High-dose oral aspirin
• C. Systemic corticosteroids
• D. Tetanus toxoid booster
• E. Intravenous (IV) broad-spectrum antibiotics
CORRECT ANSWER: D, E
RATIONALE: A compound (open) fracture breaks the skin barrier, creating a
direct portal for environmental bacterial contamination into the deep tissues and
bone. Administering a tetanus booster (D) and intravenous antibiotics (E) is
standard protocol to prevent tetanus and serious bone infections like osteomyelitis.
Hepatitis B vaccines are not indicated for orthopedic trauma. Aspirin increases
, bleeding risks at the injury site, and corticosteroids are avoided because they
suppress immune function and delay both wound and bone healing.
Question 6
A nurse is preparing to care for a patient who requires skeletal traction for a
fractured femur. The nurse knows which statement is true regarding skeletal
traction?
• A. It uses a series of removable pins, ropes, and weights to realign bones.
• B. It requires nurses to frequently assess and modify the amount of weight
applied based on pain.
• C. It is used exclusively for fractures of the lower extremity bones.
• D. It carries a significantly high risk for the development of bone infection.
CORRECT ANSWER: D
RATIONALE: Skeletal traction requires pins, wires, or tongs to be surgically
inserted directly into the bone matrix. This breaks the skin barrier and creates a
direct path for pathogens, placing the patient at a high risk for pin-site infections
and osteomyelitis. Pins are surgically anchored, not easily removable (A). The
nurse must never adjust traction weights independently (B) without a specific
provider order. Skeletal traction can also be utilized for upper extremity or cervical
spine fractures (C).
Question 7
Which nursing action is most appropriate for monitoring an inpatient with a newly
casted lower extremity for the development of an infection underneath the cast?
• A. Assess the patient's vital signs every hour while the patient is awake.
• B. Remove the cast weekly to directly inspect the wound bed for signs of
infection.
• C. Evaluate internal body temperature trends and sniff around the cast edges
for foul odors.
• D. Remove the cast bi-weekly to check the wound for signs of infection.
Exam Bank 2026 | Questions, Answers, Rationales & Exam
Prep Study Guide
Section 1: Orthopedics, Mobility, & Tissue Trauma
Question 1
The nurse is developing a plan of care for a 65-year-old patient, focusing on
preventive health care. While planning this care, the nurse understands that the
aging process is most affected by which factor?
• A. Hobbies and interests
• B. Financial issues
• C. Age at retirement
• D. Immobility
CORRECT ANSWER: D
RATIONALE: Immobility drives muscle atrophy and bone loss, cardiac and
respiratory decline, and skin breakdown, making it the most significant
physiological driver of physical aging decline. Hobbies and interests affect
psychosocial well-being, not the physical aging process. Financial issues affect
access to resources and care, not immediate cellular physiology. Age at retirement
is a life-stage marker with no direct physiological impact.
Question 2
What disorder is considered a primary cause of prolonged immobility and motor
deficits in the older adult population?
• A. Stroke
• B. Carpal tunnel syndrome
• C. Minor localized burns
• D. Dissociative identity disorder
, CORRECT ANSWER: A
RATIONALE: A stroke can cause hemiparesis, hemiplegia, or significant
motor and balance deficits, directly leading to prolonged immobility in older
adults. Carpal tunnel syndrome affects wrist and hand function but does not impair
overall systemic mobility. Minor burns are localized and typically resolve without
limiting ambulation. Dissociative identity disorder is a psychiatric condition with
no direct physical mobility impact.
Question 3
A female patient with systemic lupus erythematosus (SLE) complains of severe
photosensitivity. The nurse should instruct the patient on which self-care measure?
• A. Include foods high in beta-carotene in her daily diet.
• B. Use a commercial tanning bed once per week to help with skin rashes.
• C. Wear high-SPF sunblock whenever she is outdoors.
• D. Manage baseline joint pain exclusively with prescribed medications.
CORRECT ANSWER: C
RATIONALE: Photosensitivity in SLE means ultraviolet (UV) exposure can
directly damage skin cells, triggering local skin rashes and systemic disease flares.
Therefore, applying broad-spectrum sunblock and implementing sun-protective
clothing measures are critical self-care interventions. Beta-carotene does not treat
photosensitivity. Tanning beds emit intense UV radiation and are strictly
contraindicated. Pain medications manage arthralgia but do not address UV skin
protection.
Question 4
A patient presents to the clinic after falling from her bike and is diagnosed with a
Grade II ankle sprain. The nurse should make which statements to the patient
regarding the treatment of her sprained ankle? (Select all that apply.)
• A. Rest your ankle as much as possible and avoid weight-bearing.
• B. Place an ice pack on your ankle for 30 minutes every 4 hours.
, • C. Begin walking on your injured ankle after 24 hours, and increase your
ambulation as tolerated.
• D. You should wrap your ankle snugly with an elastic compression bandage.
• E. Prop your ankle on pillows above the heart level while resting.
• F. Take stimulant laxatives concurrently with your narcotic pain medication.
CORRECT ANSWER: A, B, D, E, F
RATIONALE: Management of a sprain follows the standard RICE (Rest,
Ice, Compression, Elevation) protocol. Applying ice controls inflammation,
compression bandages reduce interstitial fluid shifts, and elevation minimizes
edema. Opioid analgesics cause constipation by slowing bowel motility, making
education regarding stimulant laxatives (F) highly appropriate. Walking within 24
hours (C) is contraindicated for a Grade II sprain because the ligaments are
partially torn and unstable, meaning early weight-bearing can cause severe re-
injury.
Question 5
A patient presents to the clinic with a compound fracture of the right leg. The nurse
anticipates the administration of which classes of medications? (Select all that
apply.)
• A. Hepatitis B vaccine
• B. High-dose oral aspirin
• C. Systemic corticosteroids
• D. Tetanus toxoid booster
• E. Intravenous (IV) broad-spectrum antibiotics
CORRECT ANSWER: D, E
RATIONALE: A compound (open) fracture breaks the skin barrier, creating a
direct portal for environmental bacterial contamination into the deep tissues and
bone. Administering a tetanus booster (D) and intravenous antibiotics (E) is
standard protocol to prevent tetanus and serious bone infections like osteomyelitis.
Hepatitis B vaccines are not indicated for orthopedic trauma. Aspirin increases
, bleeding risks at the injury site, and corticosteroids are avoided because they
suppress immune function and delay both wound and bone healing.
Question 6
A nurse is preparing to care for a patient who requires skeletal traction for a
fractured femur. The nurse knows which statement is true regarding skeletal
traction?
• A. It uses a series of removable pins, ropes, and weights to realign bones.
• B. It requires nurses to frequently assess and modify the amount of weight
applied based on pain.
• C. It is used exclusively for fractures of the lower extremity bones.
• D. It carries a significantly high risk for the development of bone infection.
CORRECT ANSWER: D
RATIONALE: Skeletal traction requires pins, wires, or tongs to be surgically
inserted directly into the bone matrix. This breaks the skin barrier and creates a
direct path for pathogens, placing the patient at a high risk for pin-site infections
and osteomyelitis. Pins are surgically anchored, not easily removable (A). The
nurse must never adjust traction weights independently (B) without a specific
provider order. Skeletal traction can also be utilized for upper extremity or cervical
spine fractures (C).
Question 7
Which nursing action is most appropriate for monitoring an inpatient with a newly
casted lower extremity for the development of an infection underneath the cast?
• A. Assess the patient's vital signs every hour while the patient is awake.
• B. Remove the cast weekly to directly inspect the wound bed for signs of
infection.
• C. Evaluate internal body temperature trends and sniff around the cast edges
for foul odors.
• D. Remove the cast bi-weekly to check the wound for signs of infection.
