NUR302: EXIT/NCLEX Med-Surg Questions and
Answers 2026 Prep with Detailed Rationales
Course Code: NUR302
Course Name: Medical-Surgical Nursing Exam Prep & Study Guide
Topic: Comprehensive Medical-Surgical and Endocrine Systems
Academic Year: 2026/2027
1. Which statement best defines systemic lupus erythematosus (SLE)?
A. A localized skin disease causing a classic dry, scaly facial rash.
B. A chronic, systemic autoimmune disease occurring when the immune
system attacks its own tissues and organs.
C. A degenerative, non-inflammatory disorder of joints caused by wear and
tear.
D. A rapid loss of renal function secondary to high-dose steroid treatment.
CORRECT ANSWER: B. A chronic, systemic autoimmune disease
occurring when the immune system attacks its own tissues and organs.
RATIONALE: Systemic lupus erythematosus (SLE) is a multi-system
autoimmune disorder characterized by widespread chronic inflammation and tissue
destruction. Distractor A defines discoid lupus erythematosus (DLE), which is
confined to the skin. Distractor C defines osteoarthritis. Distractor D is an
inaccurate explanation of kidney dysfunction.
2. A nurse is reviewing the charts of several clients diagnosed with lupus.
Which manifestation or type is considered the primary cause of death in
clients with systemic lupus erythematosus?
A. Discoid lupus erythematosus lesions
B. Chronic pericarditis
C. Renal involvement and failure
D. Pleural effusion
CORRECT ANSWER: C. Renal involvement and failure
RATIONALE: Renal involvement (lupus nephritis) stands as the number one
cause of death in clients diagnosed with SLE, followed closely by cardiac
involvement. DLE only affects the skin and is not systemic or life-threatening.
,Pericarditis and pleural effusion are signs of SLE but do not rank as the primary
cause of mortality.
3. Which presentation differentiates discoid lupus erythematosus (DLE) from
systemic lupus erythematosus (SLE)?
A. DLE involves the lungs and pleura.
B. DLE causes severe joint pain and decreased mobility.
C. DLE affects the skin only.
D. DLE causes severe hypertension and nephritis.
CORRECT ANSWER: C. DLE affects the skin only.
RATIONALE: Discoid lupus erythematosus (DLE) is clinically confined to
the integumentary system and presents with skin lesions, while systemic lupus
erythematosus (SLE) can lead to total failure of major organs and systems.
Options A, B, and D describe multi-system involvements classic to SLE.
4. The nurse provides discharge education to a client diagnosed with lupus.
Which key management strategy should the nurse emphasize?
A. Increasing daily exposure to natural ultraviolet rays.
B. Avoiding sunlight and ultraviolet light exposure.
C. Restricting all fluid intake to under 1 liter daily.
D. Stopping all prescribed corticosteroids immediately.
CORRECT ANSWER: B. Avoiding sunlight and ultraviolet light exposure.
RATIONALE: Sunlight is a known trigger that exacerbates lupus flare-ups.
Avoiding sunlight and avoiding long-term exposure to ultraviolet light are
primary preventive management strategies. Increasing sun exposure will
exacerbate the condition. Corticosteroids should never be stopped abruptly due to
the risk of adrenal crisis.
5. A nurse assesses a client for potential environmental and physiological
triggers of lupus. Which factor should be identified as a trigger for a disease
flare?
A. Engaging in meditation exercises
B. Taking a regular vitamin D supplement
C. Stress, sun exposure, and pregnancy
D. A low-protein diet
, CORRECT ANSWER: C. Stress, sun exposure, and pregnancy
RATIONALE: Known triggers that precipitate lupus flares include the sun,
stress, pregnancy, and certain medications. Meditation and vitamin supplements
do not trigger flares; in fact, stress reduction helps prevent exacerbations. Diet
variations do not directly cause an acute lupus flare.
6. A client comes to the clinic presenting with a dry, scaly rash on the face
and upper body in a classic butterfly pattern. The nurse recognizes this as a
hallmark sign of which disorder?
A. Discoid lupus erythematosus (DLE)
B. Osteoarthritis (OA)
C. Rheumatoid arthritis (RA)
D. Acute respiratory distress syndrome (ARDS)
CORRECT ANSWER: A. Discoid lupus erythematosus (DLE)
RATIONALE: A dry, scaly rash on the face or upper body, commonly
referred to as a butterfly rash, is the classic dermatological signature of discoid
lupus erythematosus (DLE). OA and RA are joint disorders without this distinct
scaly butterfly facial distribution. ARDS is a severe respiratory condition.
7. The nurse notes that an assigned client has a history of systemic lupus
erythematosus (SLE). Which collection of clinical manifestations is
consistent with this medical diagnosis?
A. Crepitus, asymmetrical joint involvement, and obesity.
B. Dowager's hump, height loss, and compression fractures.
C. Fever, nephritis, pleural effusion, and abdominal pain.
D. Warm, red, bilaterally symmetrical joint inflammation and morning
stiffness.
CORRECT ANSWER: C. Fever, nephritis, pleural effusion, and abdominal
pain.
RATIONALE: SLE is characterized by systemic findings, including fever,
nephritis, pleural effusion, pericarditis, abdominal pain, and hypertension.
Option A represents osteoarthritis. Option B represents osteoporosis. Option D
represents rheumatoid arthritis.
8. When instructing a client with lupus regarding skin care and hygiene, which
instruction is most appropriate?
A. Scrub the facial lesions vigorously with an alcohol-based cleanser.
Answers 2026 Prep with Detailed Rationales
Course Code: NUR302
Course Name: Medical-Surgical Nursing Exam Prep & Study Guide
Topic: Comprehensive Medical-Surgical and Endocrine Systems
Academic Year: 2026/2027
1. Which statement best defines systemic lupus erythematosus (SLE)?
A. A localized skin disease causing a classic dry, scaly facial rash.
B. A chronic, systemic autoimmune disease occurring when the immune
system attacks its own tissues and organs.
C. A degenerative, non-inflammatory disorder of joints caused by wear and
tear.
D. A rapid loss of renal function secondary to high-dose steroid treatment.
CORRECT ANSWER: B. A chronic, systemic autoimmune disease
occurring when the immune system attacks its own tissues and organs.
RATIONALE: Systemic lupus erythematosus (SLE) is a multi-system
autoimmune disorder characterized by widespread chronic inflammation and tissue
destruction. Distractor A defines discoid lupus erythematosus (DLE), which is
confined to the skin. Distractor C defines osteoarthritis. Distractor D is an
inaccurate explanation of kidney dysfunction.
2. A nurse is reviewing the charts of several clients diagnosed with lupus.
Which manifestation or type is considered the primary cause of death in
clients with systemic lupus erythematosus?
A. Discoid lupus erythematosus lesions
B. Chronic pericarditis
C. Renal involvement and failure
D. Pleural effusion
CORRECT ANSWER: C. Renal involvement and failure
RATIONALE: Renal involvement (lupus nephritis) stands as the number one
cause of death in clients diagnosed with SLE, followed closely by cardiac
involvement. DLE only affects the skin and is not systemic or life-threatening.
,Pericarditis and pleural effusion are signs of SLE but do not rank as the primary
cause of mortality.
3. Which presentation differentiates discoid lupus erythematosus (DLE) from
systemic lupus erythematosus (SLE)?
A. DLE involves the lungs and pleura.
B. DLE causes severe joint pain and decreased mobility.
C. DLE affects the skin only.
D. DLE causes severe hypertension and nephritis.
CORRECT ANSWER: C. DLE affects the skin only.
RATIONALE: Discoid lupus erythematosus (DLE) is clinically confined to
the integumentary system and presents with skin lesions, while systemic lupus
erythematosus (SLE) can lead to total failure of major organs and systems.
Options A, B, and D describe multi-system involvements classic to SLE.
4. The nurse provides discharge education to a client diagnosed with lupus.
Which key management strategy should the nurse emphasize?
A. Increasing daily exposure to natural ultraviolet rays.
B. Avoiding sunlight and ultraviolet light exposure.
C. Restricting all fluid intake to under 1 liter daily.
D. Stopping all prescribed corticosteroids immediately.
CORRECT ANSWER: B. Avoiding sunlight and ultraviolet light exposure.
RATIONALE: Sunlight is a known trigger that exacerbates lupus flare-ups.
Avoiding sunlight and avoiding long-term exposure to ultraviolet light are
primary preventive management strategies. Increasing sun exposure will
exacerbate the condition. Corticosteroids should never be stopped abruptly due to
the risk of adrenal crisis.
5. A nurse assesses a client for potential environmental and physiological
triggers of lupus. Which factor should be identified as a trigger for a disease
flare?
A. Engaging in meditation exercises
B. Taking a regular vitamin D supplement
C. Stress, sun exposure, and pregnancy
D. A low-protein diet
, CORRECT ANSWER: C. Stress, sun exposure, and pregnancy
RATIONALE: Known triggers that precipitate lupus flares include the sun,
stress, pregnancy, and certain medications. Meditation and vitamin supplements
do not trigger flares; in fact, stress reduction helps prevent exacerbations. Diet
variations do not directly cause an acute lupus flare.
6. A client comes to the clinic presenting with a dry, scaly rash on the face
and upper body in a classic butterfly pattern. The nurse recognizes this as a
hallmark sign of which disorder?
A. Discoid lupus erythematosus (DLE)
B. Osteoarthritis (OA)
C. Rheumatoid arthritis (RA)
D. Acute respiratory distress syndrome (ARDS)
CORRECT ANSWER: A. Discoid lupus erythematosus (DLE)
RATIONALE: A dry, scaly rash on the face or upper body, commonly
referred to as a butterfly rash, is the classic dermatological signature of discoid
lupus erythematosus (DLE). OA and RA are joint disorders without this distinct
scaly butterfly facial distribution. ARDS is a severe respiratory condition.
7. The nurse notes that an assigned client has a history of systemic lupus
erythematosus (SLE). Which collection of clinical manifestations is
consistent with this medical diagnosis?
A. Crepitus, asymmetrical joint involvement, and obesity.
B. Dowager's hump, height loss, and compression fractures.
C. Fever, nephritis, pleural effusion, and abdominal pain.
D. Warm, red, bilaterally symmetrical joint inflammation and morning
stiffness.
CORRECT ANSWER: C. Fever, nephritis, pleural effusion, and abdominal
pain.
RATIONALE: SLE is characterized by systemic findings, including fever,
nephritis, pleural effusion, pericarditis, abdominal pain, and hypertension.
Option A represents osteoarthritis. Option B represents osteoporosis. Option D
represents rheumatoid arthritis.
8. When instructing a client with lupus regarding skin care and hygiene, which
instruction is most appropriate?
A. Scrub the facial lesions vigorously with an alcohol-based cleanser.
