Malignant Hyperthermia, Cardiac
Dysrhythmias, & Musculoskeletal
Disorders Nursing Exam 2026/2027 – 90
NCLEX-Style Questions with Answers &
Rationales
Description:
Master malignant hyperthermia, cardiac rhythms, fracture assessment, gout, TB, and
osteoporosis with 90 exam-style questions and evidence-based rationales. Updated for
2026/2027 nursing curriculum standards.
Download the complete study guide now and pass your medical-surgical nursing exam with
confidence.
, Malignant Hyperthermia & Musculoskeletal Nursing Exam
2026/2027
Section 1: Malignant Hyperthermia
Question 1
A nurse is reviewing assessment findings for a patient at risk for malignant hyperthermia.
Which late sign indicates this condition has developed?
A. Muscle rigidity
B. Elevated temperature
C. Tachycardia
D. Myoglobinuria
Answer: B
Explanation: Elevated temperature is considered a late sign of malignant hyperthermia.
Early signs include muscle rigidity, tachycardia, increased end-tidal CO2, skin mottling,
cyanosis, and myoglobinuria. Patients with genetic predisposition are at higher risk for this
life-threatening condition.
Question 2
Which nursing intervention is most appropriate for a patient experiencing malignant
hyperthermia?
A. Administer cold intravenous fluids and monitor for hypoglycemia
B. Monitor for hypocalcemia and administer dantrolene sodium
C. Monitor for hypercalcemia and administer beta-blockers
D. Monitor end-tidal CO2 and administer dantrolene sodium
Answer: D
Explanation: Dantrolene sodium is the specific pharmacological intervention for malignant
hyperthermia. Key monitoring parameters include end-tidal CO2 (which rises early),
temperature, cardiac rhythm, and myoglobinuria. Hypercalcemia is not a primary concern;
instead, hyperkalemia may occur.
,Section 2: Musculoskeletal Assessment and Fractures
Question 3
A nurse is assessing a patient's range of motion. Which sequence correctly follows
assessment best practices?
A. Passive ROM, active ROM, then resistance ROM
B. Active ROM, resistance ROM, then passive ROM
C. Resistance ROM, active ROM, then passive ROM
D. Passive ROM, resistance ROM, then active ROM
Answer: B
Explanation: The correct sequence begins with active (unassisted) ROM to assess voluntary
movement, followed by resistance ROM to evaluate muscle strength against opposition, and
finally passive ROM to identify points of resistance or restriction within the joint itself.
Question 4
A patient is brought to the emergency department following a fall. The nurse notes the
affected leg appears shorter than the other and the toes point outward. These findings are
most consistent with:
A. Hip dislocation
B. Extracapsular femur fracture
C. Tibial plateau fracture
D. Patellar fracture
Answer: B
Explanation: An extracapsular hip fracture (femoral neck fracture) characteristically
presents with external rotation of the affected leg, shortening of the affected extremity, and
outward pointing of the toes. Bruising is often a late finding, and numbness is not
consistently present.
, Section 3: Bleeding Precautions and Anticoagulation
Question 5
A patient is prescribed anticoagulation therapy. Which instruction should the nurse include in
bleeding precaution teaching?
A. Use a straight razor for shaving to prevent nicks
B. Take NSAIDs for minor pain relief
C. Wear tight-fitting shoes to prevent edema
D. Use an electric razor for shaving
Answer: D
Explanation: Electric razors are recommended to reduce the risk of skin cuts that could lead
to bleeding complications. Patients should avoid NSAIDs, straight razors, tight clothing or
shoes, and rectal interventions such as enemas or suppositories.
Question 6
A patient on warfarin therapy reports excessive nosebleeds that will not stop. The nurse
recognizes this as:
A. An expected therapeutic effect
B. A complication requiring provider notification
C. A sign of medication underdosing
D. A normal side effect that resolves independently
Answer: B
Explanation: Uncontrolled or excessive nosebleeds indicate a bleeding complication of
anticoagulation therapy. The provider should be notified immediately. Other complications
include gastrointestinal bleeding, hematuria, and spontaneous bruising.
Section 4: Cardiac Dysrhythmias
Question 7
A patient presents with a heart rate of 150 beats per minute, narrow QRS complexes, and no
visible P waves. The rhythm is regular. Which intervention is indicated?
Dysrhythmias, & Musculoskeletal
Disorders Nursing Exam 2026/2027 – 90
NCLEX-Style Questions with Answers &
Rationales
Description:
Master malignant hyperthermia, cardiac rhythms, fracture assessment, gout, TB, and
osteoporosis with 90 exam-style questions and evidence-based rationales. Updated for
2026/2027 nursing curriculum standards.
Download the complete study guide now and pass your medical-surgical nursing exam with
confidence.
, Malignant Hyperthermia & Musculoskeletal Nursing Exam
2026/2027
Section 1: Malignant Hyperthermia
Question 1
A nurse is reviewing assessment findings for a patient at risk for malignant hyperthermia.
Which late sign indicates this condition has developed?
A. Muscle rigidity
B. Elevated temperature
C. Tachycardia
D. Myoglobinuria
Answer: B
Explanation: Elevated temperature is considered a late sign of malignant hyperthermia.
Early signs include muscle rigidity, tachycardia, increased end-tidal CO2, skin mottling,
cyanosis, and myoglobinuria. Patients with genetic predisposition are at higher risk for this
life-threatening condition.
Question 2
Which nursing intervention is most appropriate for a patient experiencing malignant
hyperthermia?
A. Administer cold intravenous fluids and monitor for hypoglycemia
B. Monitor for hypocalcemia and administer dantrolene sodium
C. Monitor for hypercalcemia and administer beta-blockers
D. Monitor end-tidal CO2 and administer dantrolene sodium
Answer: D
Explanation: Dantrolene sodium is the specific pharmacological intervention for malignant
hyperthermia. Key monitoring parameters include end-tidal CO2 (which rises early),
temperature, cardiac rhythm, and myoglobinuria. Hypercalcemia is not a primary concern;
instead, hyperkalemia may occur.
,Section 2: Musculoskeletal Assessment and Fractures
Question 3
A nurse is assessing a patient's range of motion. Which sequence correctly follows
assessment best practices?
A. Passive ROM, active ROM, then resistance ROM
B. Active ROM, resistance ROM, then passive ROM
C. Resistance ROM, active ROM, then passive ROM
D. Passive ROM, resistance ROM, then active ROM
Answer: B
Explanation: The correct sequence begins with active (unassisted) ROM to assess voluntary
movement, followed by resistance ROM to evaluate muscle strength against opposition, and
finally passive ROM to identify points of resistance or restriction within the joint itself.
Question 4
A patient is brought to the emergency department following a fall. The nurse notes the
affected leg appears shorter than the other and the toes point outward. These findings are
most consistent with:
A. Hip dislocation
B. Extracapsular femur fracture
C. Tibial plateau fracture
D. Patellar fracture
Answer: B
Explanation: An extracapsular hip fracture (femoral neck fracture) characteristically
presents with external rotation of the affected leg, shortening of the affected extremity, and
outward pointing of the toes. Bruising is often a late finding, and numbness is not
consistently present.
, Section 3: Bleeding Precautions and Anticoagulation
Question 5
A patient is prescribed anticoagulation therapy. Which instruction should the nurse include in
bleeding precaution teaching?
A. Use a straight razor for shaving to prevent nicks
B. Take NSAIDs for minor pain relief
C. Wear tight-fitting shoes to prevent edema
D. Use an electric razor for shaving
Answer: D
Explanation: Electric razors are recommended to reduce the risk of skin cuts that could lead
to bleeding complications. Patients should avoid NSAIDs, straight razors, tight clothing or
shoes, and rectal interventions such as enemas or suppositories.
Question 6
A patient on warfarin therapy reports excessive nosebleeds that will not stop. The nurse
recognizes this as:
A. An expected therapeutic effect
B. A complication requiring provider notification
C. A sign of medication underdosing
D. A normal side effect that resolves independently
Answer: B
Explanation: Uncontrolled or excessive nosebleeds indicate a bleeding complication of
anticoagulation therapy. The provider should be notified immediately. Other complications
include gastrointestinal bleeding, hematuria, and spontaneous bruising.
Section 4: Cardiac Dysrhythmias
Question 7
A patient presents with a heart rate of 150 beats per minute, narrow QRS complexes, and no
visible P waves. The rhythm is regular. Which intervention is indicated?
