# NU 185/ NU185 EXAM 2 – MEDICAL-SURGICAL
NURSING II GUIDE | COMPREHENSIVE
QUESTIONS AND ANSWERS | VERIFIED AND
WELL-DETAILED ANSWERS | DETAILED
EXPLANATIONS AND RATIONALES | COMPLETE
EXAM PREPARATION STUDY GUIDE | PRACTICE
QUESTIONS | LATEST EXAM UPDATE
CORE DOMAINS
1. Integumentary disorders and wound management
2. Hematological disorders
3. Immunological disorders
4. HIV/AIDS and opportunistic infections
5. Cancer and oncologic nursing care
6. Gastrointestinal disorders
7. Liver disorders
8. Gallbladder and pancreatic disorders
9. Pharmacological management and adverse effects
10. Patient safety, education, clinical judgment, and interdisciplinary care
INTRODUCTION
This 100-question assessment is designed to strengthen clinical reasoning and exam
readiness for NU 185 Medical-Surgical Nursing II Exam 2. It emphasizes recognition of
abnormal findings, prioritization, nursing interventions, patient education, medication
safety, interpretation of clinical information, and distinctions among related disorders.
Questions intentionally combine foundational knowledge with application and analysis so
that learners practice translating pathophysiology into safe patient-centered nursing care.
The content follows the published NU 185 Exam 2 domain structure while using original
practice questions rather than purported official examination items.
SECTION ONE: QUESTIONS 1–100
,INTEGUMENTARY DISORDERS
Question 1. A nurse is assessing an older adult who has limited mobility and poor nutritional
intake. Which finding requires the greatest concern for development of a pressure injury?
A. Dry skin on both forearms
B. Nonblanchable erythema over the sacrum
C. Mild edema of both ankles
D. Cool hands after bathing
Correct Answer: B. Nonblanchable erythema over the sacrum
Explanation: Nonblanchable erythema over a pressure-bearing area is characteristic of a
stage 1 pressure injury and indicates localized tissue damage. Early recognition and pressure
relief can prevent progression to deeper tissue injury.
Question 2. A patient with a newly diagnosed stage 2 pressure injury asks why repositioning
is necessary. Which explanation by the nurse is most appropriate?
A. “Repositioning eliminates all bacteria from the wound.”
B. “Repositioning increases pressure over the affected area.”
C. “Repositioning reduces prolonged pressure and improves tissue perfusion.”
D. “Repositioning prevents all wound drainage.”
Correct Answer: C. “Repositioning reduces prolonged pressure and improves tissue
perfusion.”
Explanation: Prolonged pressure compresses blood vessels and decreases tissue perfusion.
Regular repositioning redistributes pressure and supports oxygen and nutrient delivery to
vulnerable tissue.
Question 3. A patient with a full-thickness pressure injury has adipose tissue visible in the
wound bed, but no exposed muscle, tendon, cartilage, or bone. How should the nurse
classify the injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Correct Answer: C. Stage 3
,Explanation: A stage 3 pressure injury involves full-thickness skin loss with visible adipose
tissue and granulation tissue or epibole. Deeper structures such as muscle, tendon, cartilage,
and bone are not exposed.
Question 4. A patient has a wound covered by eschar that prevents visualization of the
wound base. Which classification should the nurse recognize?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Stage 3 pressure injury
D. Unstageable pressure injury
Correct Answer: D. Unstageable pressure injury
Explanation: When slough or eschar completely obscures the extent of tissue damage, the
wound cannot be accurately staged until the wound base becomes visible.
Question 5. A patient with a pressure injury has poor oral intake and an albumin level below
the expected range. Which intervention should the nurse prioritize?
A. Restrict protein to decrease wound drainage
B. Encourage adequate protein and calorie intake
C. Keep the patient on prolonged bed rest
D. Avoid nutritional supplements
Correct Answer: B. Encourage adequate protein and calorie intake
Explanation: Adequate calories and protein are essential for collagen synthesis, immune
function, and tissue repair. Nutritional deficits can delay wound healing and increase
infection risk.
Question 6. A patient with a suspected infected wound develops fever, increasing pain,
purulent drainage, and spreading erythema. Which action should the nurse take first?
A. Document the findings and reassess next shift
B. Apply lotion around the wound
C. Notify the healthcare provider promptly
D. Encourage the patient to ambulate
Correct Answer: C. Notify the healthcare provider promptly
, Explanation: Fever, purulent drainage, increasing pain, and spreading erythema suggest
wound infection and possible systemic involvement. Prompt evaluation and treatment are
required.
Question 7. A patient with a thermal burn has circumferential burns around the chest.
Which complication should the nurse monitor for most closely?
A. Impaired chest expansion
B. Hyperactive bowel sounds
C. Increased urinary concentration
D. Decreased gastric motility only
Correct Answer: A. Impaired chest expansion
Explanation: Circumferential burns of the chest can form restrictive eschar that limits chest
expansion and ventilation. Respiratory compromise requires immediate assessment and
intervention.
Question 8. A patient with a major burn injury is receiving fluid resuscitation. Which
assessment finding provides the most useful indication that renal perfusion is being
maintained?
A. Skin temperature
B. Urine output
C. Bowel sounds
D. Appetite
Correct Answer: B. Urine output
Explanation: Urine output is a practical indicator of renal perfusion during burn
resuscitation. Decreasing output may indicate inadequate circulating volume or renal
hypoperfusion.
Question 9. A patient with a burn injury suddenly develops increasing pain, fever, foul-
smelling drainage, and a change in wound appearance. What complication should the nurse
suspect?
A. Wound infection
B. Normal inflammatory healing
C. Hypoglycemia
D. Venous insufficiency
NURSING II GUIDE | COMPREHENSIVE
QUESTIONS AND ANSWERS | VERIFIED AND
WELL-DETAILED ANSWERS | DETAILED
EXPLANATIONS AND RATIONALES | COMPLETE
EXAM PREPARATION STUDY GUIDE | PRACTICE
QUESTIONS | LATEST EXAM UPDATE
CORE DOMAINS
1. Integumentary disorders and wound management
2. Hematological disorders
3. Immunological disorders
4. HIV/AIDS and opportunistic infections
5. Cancer and oncologic nursing care
6. Gastrointestinal disorders
7. Liver disorders
8. Gallbladder and pancreatic disorders
9. Pharmacological management and adverse effects
10. Patient safety, education, clinical judgment, and interdisciplinary care
INTRODUCTION
This 100-question assessment is designed to strengthen clinical reasoning and exam
readiness for NU 185 Medical-Surgical Nursing II Exam 2. It emphasizes recognition of
abnormal findings, prioritization, nursing interventions, patient education, medication
safety, interpretation of clinical information, and distinctions among related disorders.
Questions intentionally combine foundational knowledge with application and analysis so
that learners practice translating pathophysiology into safe patient-centered nursing care.
The content follows the published NU 185 Exam 2 domain structure while using original
practice questions rather than purported official examination items.
SECTION ONE: QUESTIONS 1–100
,INTEGUMENTARY DISORDERS
Question 1. A nurse is assessing an older adult who has limited mobility and poor nutritional
intake. Which finding requires the greatest concern for development of a pressure injury?
A. Dry skin on both forearms
B. Nonblanchable erythema over the sacrum
C. Mild edema of both ankles
D. Cool hands after bathing
Correct Answer: B. Nonblanchable erythema over the sacrum
Explanation: Nonblanchable erythema over a pressure-bearing area is characteristic of a
stage 1 pressure injury and indicates localized tissue damage. Early recognition and pressure
relief can prevent progression to deeper tissue injury.
Question 2. A patient with a newly diagnosed stage 2 pressure injury asks why repositioning
is necessary. Which explanation by the nurse is most appropriate?
A. “Repositioning eliminates all bacteria from the wound.”
B. “Repositioning increases pressure over the affected area.”
C. “Repositioning reduces prolonged pressure and improves tissue perfusion.”
D. “Repositioning prevents all wound drainage.”
Correct Answer: C. “Repositioning reduces prolonged pressure and improves tissue
perfusion.”
Explanation: Prolonged pressure compresses blood vessels and decreases tissue perfusion.
Regular repositioning redistributes pressure and supports oxygen and nutrient delivery to
vulnerable tissue.
Question 3. A patient with a full-thickness pressure injury has adipose tissue visible in the
wound bed, but no exposed muscle, tendon, cartilage, or bone. How should the nurse
classify the injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Correct Answer: C. Stage 3
,Explanation: A stage 3 pressure injury involves full-thickness skin loss with visible adipose
tissue and granulation tissue or epibole. Deeper structures such as muscle, tendon, cartilage,
and bone are not exposed.
Question 4. A patient has a wound covered by eschar that prevents visualization of the
wound base. Which classification should the nurse recognize?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Stage 3 pressure injury
D. Unstageable pressure injury
Correct Answer: D. Unstageable pressure injury
Explanation: When slough or eschar completely obscures the extent of tissue damage, the
wound cannot be accurately staged until the wound base becomes visible.
Question 5. A patient with a pressure injury has poor oral intake and an albumin level below
the expected range. Which intervention should the nurse prioritize?
A. Restrict protein to decrease wound drainage
B. Encourage adequate protein and calorie intake
C. Keep the patient on prolonged bed rest
D. Avoid nutritional supplements
Correct Answer: B. Encourage adequate protein and calorie intake
Explanation: Adequate calories and protein are essential for collagen synthesis, immune
function, and tissue repair. Nutritional deficits can delay wound healing and increase
infection risk.
Question 6. A patient with a suspected infected wound develops fever, increasing pain,
purulent drainage, and spreading erythema. Which action should the nurse take first?
A. Document the findings and reassess next shift
B. Apply lotion around the wound
C. Notify the healthcare provider promptly
D. Encourage the patient to ambulate
Correct Answer: C. Notify the healthcare provider promptly
, Explanation: Fever, purulent drainage, increasing pain, and spreading erythema suggest
wound infection and possible systemic involvement. Prompt evaluation and treatment are
required.
Question 7. A patient with a thermal burn has circumferential burns around the chest.
Which complication should the nurse monitor for most closely?
A. Impaired chest expansion
B. Hyperactive bowel sounds
C. Increased urinary concentration
D. Decreased gastric motility only
Correct Answer: A. Impaired chest expansion
Explanation: Circumferential burns of the chest can form restrictive eschar that limits chest
expansion and ventilation. Respiratory compromise requires immediate assessment and
intervention.
Question 8. A patient with a major burn injury is receiving fluid resuscitation. Which
assessment finding provides the most useful indication that renal perfusion is being
maintained?
A. Skin temperature
B. Urine output
C. Bowel sounds
D. Appetite
Correct Answer: B. Urine output
Explanation: Urine output is a practical indicator of renal perfusion during burn
resuscitation. Decreasing output may indicate inadequate circulating volume or renal
hypoperfusion.
Question 9. A patient with a burn injury suddenly develops increasing pain, fever, foul-
smelling drainage, and a change in wound appearance. What complication should the nurse
suspect?
A. Wound infection
B. Normal inflammatory healing
C. Hypoglycemia
D. Venous insufficiency
