CEN Musculoskeletal & Wound Practice Questions
Musculoskeletal & Wound makes up 4 of every 50 questions on a Tigertest CEN practice test. Here are 10 of the 16 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Based on the BCEN CEN Examination Content Outline effective July 2026. Original questions; 50 per test, weighted like the real exam. Not affiliated with BCEN.
1. Which finding is an early sign of compartment syndrome?
- A.Total paralysis
- B.Pain on passive stretch
- C.Absent distal pulses
- D.Pale, cold fingers
Answer: B. Pain out of proportion and pain with passive stretch come early. Loss of pulses and paralysis are late signs, so their presence cannot rule it out.
2. For suspected compartment syndrome in a casted limb, what should the nurse do with the limb?
- A.Apply ice and wrap it tightly
- B.Hang it below the bed
- C.Raise it high above the heart
- D.Keep it at heart level
Answer: D. Raising the limb high lowers arterial inflow. The cast or dressing is loosened and the provider notified; fasciotomy may be needed.
3. A finger was cleanly amputated in a saw accident. How should the part be stored?
- A.Moist, bagged, on ice
- B.Kept dry at room temperature
- C.Placed straight on ice
- D.Soaked in a cup of saline
Answer: A. The part is wrapped in moist sterile gauze, sealed in a bag and placed in ice water. Direct contact with ice causes frostbite.
4. A patient fell on an outstretched hand and has tenderness in the anatomic snuffbox with a normal x-ray. What should the nurse expect?
- A.Immediate surgery
- B.Heat and massage
- C.Splint it as a fracture
- D.Discharge without a splint
Answer: C. Scaphoid fractures can hide on early films and risk avascular necrosis. A thumb spica splint and follow-up imaging are standard.
5. Under the Ottawa ankle rules, which finding means an ankle x-ray is needed?
- A.Bruising on the top of the foot
- B.Pain on heel walking only
- C.Unable to bear weight 4 steps
- D.Mild swelling only
Answer: C. An x-ray is needed for bone tenderness at the back edge or tip of a malleolus, or inability to bear weight for four steps both right after injury and in the ED.
6. A patient has a hip fracture. How does the injured leg usually look?
- A.Shortened and externally rotated
- B.Normal length and alignment
- C.Shortened and adducted inward
- D.Lengthened and internally rotated
Answer: A. Muscle pull on a displaced femoral neck fracture shortens the leg and rotates it outward. Posterior hip dislocation, by contrast, rotates it inward.
7. A patient has a posterior hip dislocation after a car crash. Why is prompt reduction important?
- A.To ease urinary flow
- B.To prevent wound infection
- C.To prevent tetanus
- D.Risk of femoral head death
Answer: D. Dislocation stretches the vessels to the femoral head. Delayed reduction raises the risk of avascular necrosis and sciatic nerve injury.
8. A patient has a femur fracture and becomes short of breath, confused and develops tiny spots on the chest a day later. What is most likely?
- A.Allergic reaction
- B.Fat embolism syndrome
- C.Pulmonary edema
- D.Simple pneumothorax
Answer: B. Fat embolism usually appears 24 to 72 hours after long bone or pelvic fractures, with respiratory distress, confusion and a petechial rash.
9. A patient with an unstable pelvic fracture is hypotensive. What device can reduce bleeding before surgery?
- A.A thigh tourniquet
- B.A pelvic binder
- C.A traction splint
- D.A rigid cervical collar
Answer: B. A binder over the greater trochanters closes the pelvic ring and reduces venous bleeding. Repeated rocking of the pelvis is avoided.
10. A patient has a hot, swollen knee, fever and severe pain on any movement. What must be ruled out?
- A.Osteoarthritis flare
- B.Bursitis only
- C.Simple sprain
- D.Septic arthritis
Answer: D. A hot, painful joint with fever is septic until proven otherwise. Joint aspiration and urgent antibiotics protect the cartilage.
Practice all 16 musculoskeletal & wound questions, and the rest of the 200-question bank, in the free CEN training sets. Questions you miss come back until you have mastered them.
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