University of Toronto Medical-Surgical Nursing II Final Written Exam with
questions and answers with rationales Final Exam 2026
Section 1: Fundamentals & Initial Assessment (Questions 1-20)
Question 1: A client reports nausea, vomiting, and diarrhea for 5 days. The nurse
assesses mucous membranes as pale and dry, sunken eyes, pulse 122 and
thready, respirations 23, blood pressure 78/55, temperature 101.8°F. Which is the
priority nursing intervention?
A. Encourage oral rehydration therapy
B. Request an order for IV rehydration therapy
C. Administer an antiemetic
D. Obtain a stool culture
Correct Answer: B. Request an order for IV rehydration therapy
,Rationale: The client is demonstrating hemodynamic instability (tachycardia,
hypotension) that could lead to shock. IV rehydration therapy is indicated
immediately. Oral rehydration can begin once the client becomes
hemodynamically stable .
Question 2: Assessing the "5 P's" is part of the initial nursing neurovascular
assessment. What are the "5 P's"?
A. Pain, Pulse, Pallor, Paralysis, Paresthesia
B. Pain, Pulse, Position, Pressure, Pallor
C. Pulse, Pain, Poikilothermia, Paresthesia, Paralysis
D. Pain, Pressure, Position, Pulse, Paralysis
Correct Answer: A. Pain, Pulse, Pallor, Paralysis, Paresthesia
Rationale: The 5 P's are used to assess neurovascular status: Pain, Pulse
(diminished), Pallor (pale color), Paralysis (loss of movement), and Paresthesia
(numbness/tingling) .
,Question 3: An emergency room nurse is conducting a neurovascular assessment
on a patient with a possible fracture of the elbow. Where should the assessment
be conducted?
A. Above the point of injury
B. Below the point of injury
C. Both above and below the injury
D. Only at the injury site
Correct Answer: B. Below the point of injury
Rationale: The neurovascular assessment should be conducted below the point of
injury to assess for distal perfusion and nerve function .
Question 4: A patient has been admitted with an abnormal "hump back"
curvature of the spine. The nurse knows this is:
, A. Spinal Kyphosis
B. Spinal Lordosis
C. Spinal Scoliosis
D. Normal curvature of the spine
Correct Answer: A. Spinal Kyphosis
Rationale: Kyphosis is an exaggerated posterior curvature of the thoracic spine,
commonly referred to as "hump back" or "dowager's hump" .
Question 5: Which musculoskeletal diagnostic tests require assessment of
allergies to radiopaque dye, including shellfish and iodine? (Select all that apply)
A. Arthrogram
B. Arthroscopy
questions and answers with rationales Final Exam 2026
Section 1: Fundamentals & Initial Assessment (Questions 1-20)
Question 1: A client reports nausea, vomiting, and diarrhea for 5 days. The nurse
assesses mucous membranes as pale and dry, sunken eyes, pulse 122 and
thready, respirations 23, blood pressure 78/55, temperature 101.8°F. Which is the
priority nursing intervention?
A. Encourage oral rehydration therapy
B. Request an order for IV rehydration therapy
C. Administer an antiemetic
D. Obtain a stool culture
Correct Answer: B. Request an order for IV rehydration therapy
,Rationale: The client is demonstrating hemodynamic instability (tachycardia,
hypotension) that could lead to shock. IV rehydration therapy is indicated
immediately. Oral rehydration can begin once the client becomes
hemodynamically stable .
Question 2: Assessing the "5 P's" is part of the initial nursing neurovascular
assessment. What are the "5 P's"?
A. Pain, Pulse, Pallor, Paralysis, Paresthesia
B. Pain, Pulse, Position, Pressure, Pallor
C. Pulse, Pain, Poikilothermia, Paresthesia, Paralysis
D. Pain, Pressure, Position, Pulse, Paralysis
Correct Answer: A. Pain, Pulse, Pallor, Paralysis, Paresthesia
Rationale: The 5 P's are used to assess neurovascular status: Pain, Pulse
(diminished), Pallor (pale color), Paralysis (loss of movement), and Paresthesia
(numbness/tingling) .
,Question 3: An emergency room nurse is conducting a neurovascular assessment
on a patient with a possible fracture of the elbow. Where should the assessment
be conducted?
A. Above the point of injury
B. Below the point of injury
C. Both above and below the injury
D. Only at the injury site
Correct Answer: B. Below the point of injury
Rationale: The neurovascular assessment should be conducted below the point of
injury to assess for distal perfusion and nerve function .
Question 4: A patient has been admitted with an abnormal "hump back"
curvature of the spine. The nurse knows this is:
, A. Spinal Kyphosis
B. Spinal Lordosis
C. Spinal Scoliosis
D. Normal curvature of the spine
Correct Answer: A. Spinal Kyphosis
Rationale: Kyphosis is an exaggerated posterior curvature of the thoracic spine,
commonly referred to as "hump back" or "dowager's hump" .
Question 5: Which musculoskeletal diagnostic tests require assessment of
allergies to radiopaque dye, including shellfish and iodine? (Select all that apply)
A. Arthrogram
B. Arthroscopy
