NUR 209 Exam 2 Medical-
Surgical Nursing II Review
2026/2027 – Questions,
Answers & Detailed Rationales
Guaranteed Pas (GRADED A+)
1. A client with heart failure reports increasing shortness of
breath and difficulty sleeping flat. Which finding should the
nurse recognize as most concerning?
A. Mild ankle edema at the end of the day
B. Orthopnea requiring three pillows
C. Occasional dry cough
D. Heart rate of 78 beats/min
Answer: _B. Orthopnea requiring three pillows_
Rationale: Orthopnea is a common manifestation of worsening
left-sided heart failure caused by pulmonary congestion.
Increasing difficulty breathing while lying flat should prompt
further assessment and intervention.
2. A client receiving furosemide for heart failure should be
monitored closely for which electrolyte imbalance?
,A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: _C. Hypokalemia_
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion. The nurse should monitor potassium levels
and assess for manifestations such as weakness, muscle cramps,
and dysrhythmias.
3. Which assessment finding is most characteristic of left-
sided heart failure?
A. Ascites
B. Jugular venous distention
C. Pulmonary crackles
D. Dependent peripheral edema
Answer: _C. Pulmonary crackles_
Rationale: Left-sided heart failure causes blood to back up into
the pulmonary circulation, resulting in pulmonary congestion,
crackles, dyspnea, and possibly pulmonary edema.
4. A client with chronic obstructive pulmonary disease
(COPD) is receiving oxygen therapy. Which nursing action
is appropriate?
,A. Administer oxygen at the highest possible flow rate
B. Maintain prescribed oxygen therapy and monitor respiratory
status
C. Discontinue oxygen if the client becomes drowsy
D. Encourage prolonged breath-holding exercises
Answer: _B. Maintain prescribed oxygen therapy and monitor
respiratory status_
Rationale: Clients with COPD may require carefully titrated
oxygen therapy. The nurse should administer oxygen as
prescribed and continuously assess oxygenation, respiratory
effort, and level of consciousness.
5. Which instruction should the nurse provide to a client
with COPD who is experiencing dyspnea?
A. Use pursed-lip breathing
B. Hold the breath for 10 seconds
C. Lie flat in bed
D. Breathe rapidly through the mouth
Answer: _A. Use pursed-lip breathing_
Rationale: Pursed-lip breathing helps keep small airways open
during exhalation, promotes more complete emptying of trapped
air, and can decrease the sensation of dyspnea.
, 6. A client with pneumonia has a temperature of 39°C
(102.2°F), respiratory rate of 30/min, and oxygen saturation
of 88%. Which action should the nurse take first?
A. Encourage oral fluids
B. Apply prescribed supplemental oxygen
C. Obtain a sputum specimen
D. Administer an antipyretic
Answer: _B. Apply prescribed supplemental oxygen_
Rationale: An oxygen saturation of 88% indicates impaired
oxygenation. Airway and breathing take priority, so oxygen
should be administered as prescribed while further interventions
are initiated.
7. Which finding in a client with pneumonia requires
immediate nursing intervention?
A. Productive cough
B. Temperature of 38.1°C (100.6°F)
C. Oxygen saturation of 84%
D. Fatigue after ambulation
Answer: _C. Oxygen saturation of 84%_
Rationale: Severe hypoxemia can compromise tissue
oxygenation and requires prompt intervention. The nurse should
address oxygenation before less urgent manifestations.
Surgical Nursing II Review
2026/2027 – Questions,
Answers & Detailed Rationales
Guaranteed Pas (GRADED A+)
1. A client with heart failure reports increasing shortness of
breath and difficulty sleeping flat. Which finding should the
nurse recognize as most concerning?
A. Mild ankle edema at the end of the day
B. Orthopnea requiring three pillows
C. Occasional dry cough
D. Heart rate of 78 beats/min
Answer: _B. Orthopnea requiring three pillows_
Rationale: Orthopnea is a common manifestation of worsening
left-sided heart failure caused by pulmonary congestion.
Increasing difficulty breathing while lying flat should prompt
further assessment and intervention.
2. A client receiving furosemide for heart failure should be
monitored closely for which electrolyte imbalance?
,A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: _C. Hypokalemia_
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion. The nurse should monitor potassium levels
and assess for manifestations such as weakness, muscle cramps,
and dysrhythmias.
3. Which assessment finding is most characteristic of left-
sided heart failure?
A. Ascites
B. Jugular venous distention
C. Pulmonary crackles
D. Dependent peripheral edema
Answer: _C. Pulmonary crackles_
Rationale: Left-sided heart failure causes blood to back up into
the pulmonary circulation, resulting in pulmonary congestion,
crackles, dyspnea, and possibly pulmonary edema.
4. A client with chronic obstructive pulmonary disease
(COPD) is receiving oxygen therapy. Which nursing action
is appropriate?
,A. Administer oxygen at the highest possible flow rate
B. Maintain prescribed oxygen therapy and monitor respiratory
status
C. Discontinue oxygen if the client becomes drowsy
D. Encourage prolonged breath-holding exercises
Answer: _B. Maintain prescribed oxygen therapy and monitor
respiratory status_
Rationale: Clients with COPD may require carefully titrated
oxygen therapy. The nurse should administer oxygen as
prescribed and continuously assess oxygenation, respiratory
effort, and level of consciousness.
5. Which instruction should the nurse provide to a client
with COPD who is experiencing dyspnea?
A. Use pursed-lip breathing
B. Hold the breath for 10 seconds
C. Lie flat in bed
D. Breathe rapidly through the mouth
Answer: _A. Use pursed-lip breathing_
Rationale: Pursed-lip breathing helps keep small airways open
during exhalation, promotes more complete emptying of trapped
air, and can decrease the sensation of dyspnea.
, 6. A client with pneumonia has a temperature of 39°C
(102.2°F), respiratory rate of 30/min, and oxygen saturation
of 88%. Which action should the nurse take first?
A. Encourage oral fluids
B. Apply prescribed supplemental oxygen
C. Obtain a sputum specimen
D. Administer an antipyretic
Answer: _B. Apply prescribed supplemental oxygen_
Rationale: An oxygen saturation of 88% indicates impaired
oxygenation. Airway and breathing take priority, so oxygen
should be administered as prescribed while further interventions
are initiated.
7. Which finding in a client with pneumonia requires
immediate nursing intervention?
A. Productive cough
B. Temperature of 38.1°C (100.6°F)
C. Oxygen saturation of 84%
D. Fatigue after ambulation
Answer: _C. Oxygen saturation of 84%_
Rationale: Severe hypoxemia can compromise tissue
oxygenation and requires prompt intervention. The nurse should
address oxygenation before less urgent manifestations.
