1
Fortis College NUR 209 NUR209 Actual
Exam Questions and Answers with
Rationales 2026/2027 | Medical-Surgical
Nursing II Exam 1 | Pass Guarantee
Q001: A 64-year-old with NYHA Class IV heart failure receiving dobutamine 5
mcg/kg/min develops new-onset rapid atrial fibrillation at 160 bpm with chest
pain. BP drops to 78/50 mm Hg. Which immediate action is priority?
Options:
A. Increase dobutamine to 10 mcg/kg/min
B. Administer IV diltiazem 20 mg push
C. Perform synchronized cardioversion at 200 J - CORRECT
D. Give sublingual nitroglycerin 0.4 mg
ANSWER: C
Q002: A post-MI patient on heparin 18 units/kg/h has an aPTT of 110 seconds
(control 30). Platelet count drops from 220k to 90k/µL after 5 days. Which
intervention is most urgent?
Options:
A. Reduce heparin to 12 units/kg/h
B. Switch to argatroban infusion - CORRECT
C. Add oral warfarin 10 mg
D. Transfuse one unit of platelets
ANSWER: B
Q003: A 58-year-old with advanced COPD (FEV₁ 28 %) arrives in the ER with a
PaCO₂ of 92 mm Hg and pH 7.18. He is obtunded. Which ventilator setting should
the nurse question?
, 2
Options:
A. Tidal volume 480 mL (6 mL/kg)
B. Respiratory rate 8 breaths/min
C. PEEP 0 cm H₂O - CORRECT
D. FiO₂ 0.24
ANSWER: C
Q004: During a adenosine 6 mg IV push for SVT, the monitor shows a 6-second
sinus pause. Patient remains conscious. Which action is appropriate?
Options:
A. Prepare transcutaneous pacing pads
B. Give atropine 0.5 mg IV
C. Continue monitoring; pause is expected - CORRECT
D. Start CPR
ANSWER: C
Q005: A patient with hypertensive crisis (BP 240/140) on nicardipine 15 mg/h
develops acute flashing pulmonary edema. Which additional IV agent is most
appropriate?
Options:
A. Nitroglycerin 50 mg in 250 mL at 50 mcg/min - CORRECT
B. Hydralazine 20 mg IV push
C. Labetalol 20 mg IV push
D. Clevidipine 1 mg/h
ANSWER: A
Q006: A 70-kg patient on CRRT suddenly alarms “air in blood line.” Which
immediate nursing action is indicated?
, 3
Options:
A. Clamp lines and stop blood pump; place patient in left-lateral Trendelenburg -
CORRECT
B. Resume therapy at lower blood-flow rate
C. Increase ultrafiltration to remove air
D. Flush line with 100 mL saline
ANSWER: A
Q007: A patient in DKA has initial glucose 620 mg/dL, K⁺ 3.2 mEq/L, pH 6.9.
After 2 L 0.9 % saline and insulin 0.1 units/kg/h, K⁺ is 2.8 mEq/L and urine output
80 mL/h. Which change is critical?
Options:
A. Decrease insulin to 0.05 units/kg/h
B. Add 40 mEq KCl to each liter of IVF - CORRECT
C. Switch to 0.45 % saline
D. Start sodium bicarbonate drip
ANSWER: B
Q008: A patient with thyroid storm has temp 41 °C, HR 170, agitation. Which
cooling method is most effective and physiologically appropriate?
Options:
A. Ice packs to axilla and groin
B. Cooling blanket plus acetaminophen 650 mg
C. Ice-water immersion bath
D. Cold saline 30 mL/kg IV plus cooling blanket - CORRECT
ANSWER: D
Fortis College NUR 209 NUR209 Actual
Exam Questions and Answers with
Rationales 2026/2027 | Medical-Surgical
Nursing II Exam 1 | Pass Guarantee
Q001: A 64-year-old with NYHA Class IV heart failure receiving dobutamine 5
mcg/kg/min develops new-onset rapid atrial fibrillation at 160 bpm with chest
pain. BP drops to 78/50 mm Hg. Which immediate action is priority?
Options:
A. Increase dobutamine to 10 mcg/kg/min
B. Administer IV diltiazem 20 mg push
C. Perform synchronized cardioversion at 200 J - CORRECT
D. Give sublingual nitroglycerin 0.4 mg
ANSWER: C
Q002: A post-MI patient on heparin 18 units/kg/h has an aPTT of 110 seconds
(control 30). Platelet count drops from 220k to 90k/µL after 5 days. Which
intervention is most urgent?
Options:
A. Reduce heparin to 12 units/kg/h
B. Switch to argatroban infusion - CORRECT
C. Add oral warfarin 10 mg
D. Transfuse one unit of platelets
ANSWER: B
Q003: A 58-year-old with advanced COPD (FEV₁ 28 %) arrives in the ER with a
PaCO₂ of 92 mm Hg and pH 7.18. He is obtunded. Which ventilator setting should
the nurse question?
, 2
Options:
A. Tidal volume 480 mL (6 mL/kg)
B. Respiratory rate 8 breaths/min
C. PEEP 0 cm H₂O - CORRECT
D. FiO₂ 0.24
ANSWER: C
Q004: During a adenosine 6 mg IV push for SVT, the monitor shows a 6-second
sinus pause. Patient remains conscious. Which action is appropriate?
Options:
A. Prepare transcutaneous pacing pads
B. Give atropine 0.5 mg IV
C. Continue monitoring; pause is expected - CORRECT
D. Start CPR
ANSWER: C
Q005: A patient with hypertensive crisis (BP 240/140) on nicardipine 15 mg/h
develops acute flashing pulmonary edema. Which additional IV agent is most
appropriate?
Options:
A. Nitroglycerin 50 mg in 250 mL at 50 mcg/min - CORRECT
B. Hydralazine 20 mg IV push
C. Labetalol 20 mg IV push
D. Clevidipine 1 mg/h
ANSWER: A
Q006: A 70-kg patient on CRRT suddenly alarms “air in blood line.” Which
immediate nursing action is indicated?
, 3
Options:
A. Clamp lines and stop blood pump; place patient in left-lateral Trendelenburg -
CORRECT
B. Resume therapy at lower blood-flow rate
C. Increase ultrafiltration to remove air
D. Flush line with 100 mL saline
ANSWER: A
Q007: A patient in DKA has initial glucose 620 mg/dL, K⁺ 3.2 mEq/L, pH 6.9.
After 2 L 0.9 % saline and insulin 0.1 units/kg/h, K⁺ is 2.8 mEq/L and urine output
80 mL/h. Which change is critical?
Options:
A. Decrease insulin to 0.05 units/kg/h
B. Add 40 mEq KCl to each liter of IVF - CORRECT
C. Switch to 0.45 % saline
D. Start sodium bicarbonate drip
ANSWER: B
Q008: A patient with thyroid storm has temp 41 °C, HR 170, agitation. Which
cooling method is most effective and physiologically appropriate?
Options:
A. Ice packs to axilla and groin
B. Cooling blanket plus acetaminophen 650 mg
C. Ice-water immersion bath
D. Cold saline 30 mL/kg IV plus cooling blanket - CORRECT
ANSWER: D
