NUR 209 Medical-Surgical Nursing II 2025 – Review with Verified Questions and Correct Answers

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NUR 209 Medical-Surgical Nursing II
2025 – Review with Verified Questions
and Correct Answers


1. A patient with chronic renal failure is prescribed a low-potassium diet. Which food
should the nurse instruct the patient to avoid?
A. Apples
B. Bananas
C. Carrots
D. Green beans
Correct Answer: B
Rationale: Bananas are high in potassium, which can exacerbate hyperkalemia in chronic
renal failure patients. Apples, carrots, and green beans are lower in potassium and
generally safe.
2. A nurse is assessing a patient with suspected hypervolemia. Which symptom is most
indicative of this condition?
A. Dry mucous membranes
B. Neck vein distension
C. Decreased blood pressure
D. Increased urine output
Correct Answer: B
Rationale: Neck vein distension is a classic sign of hypervolemia due to increased fluid
volume. Dry mucous membranes and decreased blood pressure suggest hypovolemia,
while increased urine output is not typical.
3. A patient with diabetic ketoacidosis (DKA) is receiving IV insulin. Which laboratory
value should the nurse monitor closely?
A. Serum potassium
B. Serum calcium
C. Hemoglobin
D. Platelet count
Correct Answer: A
Rationale: Insulin therapy in DKA can cause a rapid shift of potassium into cells,
leading to hypokalemia. Monitoring serum potassium is critical to prevent cardiac
arrhythmias. Other values are less directly affected.
4. A patient with a history of heart failure is admitted with pulmonary edema. Which
medication should the nurse expect to administer first?
A. Lisinopril
B. Furosemide

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C. Metoprolol
D. Digoxin
Correct Answer: B
Rationale: Furosemide, a loop diuretic, is the first-line treatment for pulmonary edema to
reduce fluid overload and relieve respiratory distress. Lisinopril and Metoprolol are used
long-term, and digoxin is less urgent.
5. A nurse is caring for a patient with a suspected stroke. Which initial assessment tool
should be used to evaluate neurological status?
A. Glasgow Coma Scale
B. NIH Stroke Scale
C. Morse Fall Scale
D. Braden Scale
**Correct Answer: B
Rationale: The NIH Stroke Scale is specifically designed to assess stroke severity and
guide treatment. The Glasgow Coma Scale is used for general consciousness, while
Morse and Braden assess fall and pressure ulcer risks, respectively.
6. A patient with Addison’s disease is experiencing a crisis. Which clinical finding is most
concerning?
A. Hyperglycemia
B. Hypotension
C. Hyperkalemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypotension in Addisonian crisis is life-threatening due to cortisol deficiency
and fluid loss. Hyperkalemia and hyponatremia are expected, but hypotension requires
immediate intervention. Hyperglycemia is not typical.
7. A nurse is teaching a patient with melanoma about skin self-examination. Which criterion
is part of the ABCDE rule?
A. Blanching
B. Color variation
C. Elevation
D. Firmness
Correct Answer: B
Rationale: The ABCDE rule for melanoma includes Asymmetry, Border irregularity,
Color variation, Diameter >6mm, and Evolving. Blanching, elevation, and firmness are
not part of this rule.
8. A patient with a nasogastric tube receiving Lasix has a potassium level of 3.0 mEq/L.
What should the nurse do first?
A. Administer the Lasix as ordered
B. Hold the Lasix and notify the provider
C. Encourage potassium-rich foods
D. Administer a potassium supplement
Correct Answer: B
Rationale: Hypokalemia (K+ <3.5 mEq/L) is exacerbated by Lasix, a potassium-wasting
diuretic. The nurse should hold the dose and notify the provider to prevent arrhythmias.
Supplements or dietary changes require orders.

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9. A patient with chronic kidney disease is prescribed Kayexalate for hyperkalemia. What
should the nurse teach the patient to expect?
A. Increased thirst
B. Diarrhea
C. Constipation
D. Dry skin
Correct Answer: B
Rationale: Kayexalate (sodium polystyrene) removes potassium via the GI tract, often
causing diarrhea. Thirst, constipation, and dry skin are not typical side effects.
10. A nurse is caring for a patient post-craniotomy. Which position should be avoided to
prevent increased intracranial pressure?
A. Head of bed elevated 30 degrees
B. Supine with head neutral
C. Head turned to the side
D. Trendelenburg position
Correct Answer: D
Rationale: Trendelenburg position increases intracranial pressure by promoting cerebral
blood flow. Elevating the head 30 degrees or maintaining a neutral position helps reduce
pressure.
11. A patient with heart failure is prescribed spironolactone. Which electrolyte imbalance
should the nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, increasing the risk of
hyperkalemia. Hypokalemia is more common with loop diuretics, and hyponatremia or
hypercalcemia are less likely.
12. A nurse is assessing a patient with suspected meningitis. Which finding requires
immediate intervention?
A. Fever of 101°F
B. Nuchal rigidity
C. Altered mental status
D. Photophobia
Correct Answer: C
Rationale: Altered mental status indicates worsening neurological involvement in
meningitis, requiring urgent intervention. Fever, nuchal rigidity, and photophobia are
expected but less immediately critical.
13. A patient with type 1 diabetes reports nausea and abdominal pain. Arterial blood gases
show pH 7.30, HCO3 18 mEq/L, and PaCO2 30 mm Hg. What is the nurse’s priority
action?
A. Administer sodium bicarbonate
B. Notify the provider for insulin therapy
C. Encourage oral fluid intake
D. Monitor blood glucose every 4 hours