NUR209 Medical-Surgical Nursing II Comprehensive
Exam Review Actual 2026/2027 with Detailed Rationales |
100% Verified | Pass Guaranteed
SECTION I: CARDIOVASCULAR & PERIPHERAL VASCULAR
DISORDERS (Questions 1–18)
Q1: A client with coronary artery disease is prescribed nitroglycerin sublingual tablets
for angina. The nurse should instruct the client to take the medication at the onset of
chest pain and repeat every 5 minutes for up to how many doses before calling
emergency services?
A. 2 doses
B. 3 doses
C. 4 doses
D. 5 doses
Correct Answer: B
Rationale: Correct because the standard protocol for sublingual nitroglycerin allows up
to 3 doses (one every 5 minutes) for persistent chest pain; if pain persists after 3 doses,
emergency services should be contacted immediately. This matches the American
Heart Association guidelines for acute anginal episodes.
Q2: A client with heart failure is receiving furosemide 40 mg IV daily. Which laboratory
value requires immediate nursing intervention?
,A. Potassium 3.8 mEq/L
B. Sodium 138 mEq/L
C. Potassium 2.9 mEq/L
D. BUN 22 mg/dL
Correct Answer: C
Rationale: Correct because a potassium level of 2.9 mEq/L indicates severe
hypokalemia, a life-threatening adverse effect of loop diuretics like furosemide that can
precipitate lethal cardiac dysrhythmias; immediate potassium replacement and cardiac
monitoring are required.
Q3: A client with aortic stenosis reports increasing dyspnea on exertion, orthopnea, and
paroxysmal nocturnal dyspnea. The nurse recognizes these symptoms as indicators of
which complication?
A. Left-sided heart failure
B. Right-sided heart failure
C. Pulmonary embolism
D. Cardiac tamponade
Correct Answer: A
Rationale: Correct because aortic stenosis creates pressure overload on the left
ventricle, leading to left-sided heart failure manifested by pulmonary congestion
symptoms including dyspnea on exertion, orthopnea, and paroxysmal nocturnal
dyspnea.
,Q4: A client with peripheral arterial disease (PAD) complains of severe leg pain at rest
that improves when the legs are dependent. The nurse documents this finding as:
A. Intermittent claudication
B. Rest pain
C. Venous stasis ulceration
D. Deep vein thrombosis
Correct Answer: B
Rationale: Correct because rest pain in PAD occurs when arterial insufficiency is severe
enough to cause ischemic pain even without exertion, and the pain characteristically
improves with dependency due to gravity-assisted blood flow to the extremities.
Q5: A client with hypertension is prescribed lisinopril. The nurse should monitor for
which adverse effect that requires immediate reporting?
A. Dry cough
B. Angioedema
C. Dizziness
D. Fatigue
Correct Answer: B
Rationale: Correct because angioedema is a rare but potentially life-threatening adverse
effect of ACE inhibitors like lisinopril that can cause airway obstruction; immediate
discontinuation of the drug and emergency intervention are required.
, Q6: A client post-cardiac catheterization via the femoral artery has a sandbag placed
over the insertion site. The nurse should assess the client for which complication by
checking the pedal pulse distal to the insertion site?
A. Hematoma formation
B. Arterial thrombosis
C. Retroperitoneal bleeding
D. Pseudoaneurysm
Correct Answer: B
Rationale: Correct because assessment of distal pulses evaluates arterial patency distal
to the catheterization site; diminished or absent pedal pulses indicate arterial
thrombosis, a serious complication requiring immediate intervention to prevent limb
ischemia.
Q7: A client with atrial fibrillation is prescribed warfarin. The nurse knows the
therapeutic INR range for this client is:
A. 1.5–2.0
B. 2.0–3.0
C. 2.5–3.5
D. 3.0–4.0
Correct Answer: B
Exam Review Actual 2026/2027 with Detailed Rationales |
100% Verified | Pass Guaranteed
SECTION I: CARDIOVASCULAR & PERIPHERAL VASCULAR
DISORDERS (Questions 1–18)
Q1: A client with coronary artery disease is prescribed nitroglycerin sublingual tablets
for angina. The nurse should instruct the client to take the medication at the onset of
chest pain and repeat every 5 minutes for up to how many doses before calling
emergency services?
A. 2 doses
B. 3 doses
C. 4 doses
D. 5 doses
Correct Answer: B
Rationale: Correct because the standard protocol for sublingual nitroglycerin allows up
to 3 doses (one every 5 minutes) for persistent chest pain; if pain persists after 3 doses,
emergency services should be contacted immediately. This matches the American
Heart Association guidelines for acute anginal episodes.
Q2: A client with heart failure is receiving furosemide 40 mg IV daily. Which laboratory
value requires immediate nursing intervention?
,A. Potassium 3.8 mEq/L
B. Sodium 138 mEq/L
C. Potassium 2.9 mEq/L
D. BUN 22 mg/dL
Correct Answer: C
Rationale: Correct because a potassium level of 2.9 mEq/L indicates severe
hypokalemia, a life-threatening adverse effect of loop diuretics like furosemide that can
precipitate lethal cardiac dysrhythmias; immediate potassium replacement and cardiac
monitoring are required.
Q3: A client with aortic stenosis reports increasing dyspnea on exertion, orthopnea, and
paroxysmal nocturnal dyspnea. The nurse recognizes these symptoms as indicators of
which complication?
A. Left-sided heart failure
B. Right-sided heart failure
C. Pulmonary embolism
D. Cardiac tamponade
Correct Answer: A
Rationale: Correct because aortic stenosis creates pressure overload on the left
ventricle, leading to left-sided heart failure manifested by pulmonary congestion
symptoms including dyspnea on exertion, orthopnea, and paroxysmal nocturnal
dyspnea.
,Q4: A client with peripheral arterial disease (PAD) complains of severe leg pain at rest
that improves when the legs are dependent. The nurse documents this finding as:
A. Intermittent claudication
B. Rest pain
C. Venous stasis ulceration
D. Deep vein thrombosis
Correct Answer: B
Rationale: Correct because rest pain in PAD occurs when arterial insufficiency is severe
enough to cause ischemic pain even without exertion, and the pain characteristically
improves with dependency due to gravity-assisted blood flow to the extremities.
Q5: A client with hypertension is prescribed lisinopril. The nurse should monitor for
which adverse effect that requires immediate reporting?
A. Dry cough
B. Angioedema
C. Dizziness
D. Fatigue
Correct Answer: B
Rationale: Correct because angioedema is a rare but potentially life-threatening adverse
effect of ACE inhibitors like lisinopril that can cause airway obstruction; immediate
discontinuation of the drug and emergency intervention are required.
, Q6: A client post-cardiac catheterization via the femoral artery has a sandbag placed
over the insertion site. The nurse should assess the client for which complication by
checking the pedal pulse distal to the insertion site?
A. Hematoma formation
B. Arterial thrombosis
C. Retroperitoneal bleeding
D. Pseudoaneurysm
Correct Answer: B
Rationale: Correct because assessment of distal pulses evaluates arterial patency distal
to the catheterization site; diminished or absent pedal pulses indicate arterial
thrombosis, a serious complication requiring immediate intervention to prevent limb
ischemia.
Q7: A client with atrial fibrillation is prescribed warfarin. The nurse knows the
therapeutic INR range for this client is:
A. 1.5–2.0
B. 2.0–3.0
C. 2.5–3.5
D. 3.0–4.0
Correct Answer: B
