NURl 209/l NUR209l HESIl –l Medical-
Surgicall Nursingl IIl |l Fortisl (Latestl 2026/l
2027l Update)l 100%l Verifiedl Questionsl &l
Answersl |l Gradel A
Q:l Al clientl withl al 16-yearl historyl ofl diabetesl mellitusl isl havingl renall functionl testsl
becausel ofl recentl fatigue,l weakness,l elevatedl bloodl ureal nitrogen,l andl seruml creatininel
levels.l Whichl findingl shouldl thel nursel concludel asl anl earlyl symptoml ofl renall
insufficiency?
A)l Dyspnea.l
B)l Nocturia.l
C)l Confusion.l
D)l Stomatitis.
Answer:
B)l Nocturia.
Rationale:l Asl thel glomerularl filtrationl ratel decreasesl inl earlyl renall insufficiency,l
metabolicl wastel products,l includingl urea,l creatinine,l andl otherl substances,l suchl phenols,l
hormones,l electrolytes,l accumulatel inl thel blood.l Inl thel earlyl stagel ofl renall
insufficiency,l polyurial resultsl froml thel inabilityl ofl thel kidneysl tol concentratel urinel andl
contributel tol nocturial (B).l (A,l C,l andl D)l arel morel commonl inl thel laterl stagesl ofl renall
failure.
Q:l Al clientl withl heartl diseasel isl onl al continuousl telemetryl monitorl andl hasl
developedl sinusl bradycardia.l Inl determiningl thel possiblel causel ofl thel bradycardia,l thel
nursel assessesl thel client'sl medicationl record.l Whichl medicationl isl mostl likelyl thel causel
ofl thel bradycardia?
A)l Propanololl (Inderal).l
B)l Captoprill (Capoten).l
C)l Furosemidel (Lasix).l
D)l Dobutaminel (Dobutrex).
,Answer:
A)l Propanololl (Inderal).
Rationale:l Inderall (A)l isl al betal adrenergicl blockingl agent,l whichl causesl decreasedl heartl
ratel andl decreasedl contractility.l Neitherl (B),l anl ACEl inhibitor,l norl (C),l al loopl diuretic,l
causesl bradycardia.l (D)l isl al sympathomimetic,l directl actingl cardiacl stimulant,l whichl
wouldl increasel thel heartl rate.
Q:l Al clientl hasl beenl takingl orall corticosteroidsl forl thel pastl fivel daysl becausel ofl
seasonall allergies.l Whichl assessmentl findingl isl ofl mostl concernl tol thel nurse?
A)l Whitel bloodl countl ofl 10,000l mm3.l
B)l Seruml glucosel ofl 115l mg/dl.l
C)l Purulentl sputum.l
D)l Excessivel hunger.
Answer:
C)l Purulentl sputum.l
Rationale:l Steroidsl causel immunosuppression,l andl al purulentl sputuml (C)l isl anl
indicationl ofl infection,l sol thisl symptoml isl ofl greatestl concern.l Orall steroidsl mayl
increasel (A)l andl oftenl causel (D).l (B)l mayl remainl normal,l borderline,l orl increasel whilel
takingl orall steroids.
Q:l Al femalel clientl receivingl IVl vasopressinl (Pitressin)l forl esophageall varicel rupturel
reportsl tol thel nursel thatl shel feelsl substernall tightnessl andl pressurel acrossl herl chest.l
Whichl PRNl protocoll shouldl thel nursel initiate?
A)l Startl anl IVl nitroglycerinl infusion.
B)l Nasogastricl lavagel withl cooll saline.l
C)l Increasel thel vasopressinl infusion.l
D)l Preparel forl endotracheall intubation.
Answer:
A)l Startl anl IVl nitroglycerinl infusion.l
Rationale:l Vasopressinl isl usedl tol promotel vasoconstriction,l therebyl reducingl bleeding.l
Vasoconstrictionl ofl thel coronaryl arteriesl canl leadl tol anginal andl myocardiall infarction,l
,andl shouldl bel counteractedl byl IVl nitroglycerinl perl prescribedl protocoll (A).l (B)l willl
notl resolvel thel cardiacl problem.l (C)l willl worsenl thel problem.l Endotracheall intubationl
mayl bel neededl ifl respiratoryl distressl occursl (D).
Q:l Al clientl withl gastroesophageall refluxl diseasel (GERD)l hasl beenl experiencingl
severel refluxl duringl sleep.l Whichl recommendationl byl thel nursel isl mostl effectivel tol
assistl thel client?
A)l Losingl weight.l
B)l Decreasingl caffeinel intake.l
C)l Avoidingl largel meals.l
D)l Raisingl thel headl ofl thel bedl onl blocks.
Answer:
D)l Raisingl thel headl ofl thel bedl onl blocks.l
Rationale:l Raisingl thel headl ofl thel bedl onl blocksl (D)l (reversel Trendelenburgl position)l
tol reducel refluxl andl subsequentl aspirationl isl thel mostl effectivel recommendationl forl al
clientl experiencingl severel gastroesophageall refluxl duringl sleep.l (A,l Bl andl C)l mayl bel
effectivel recommendationsl butl raisingl thel headl ofl thel bedl isl morel effectivel forl reliefl
duringl sleep.
Q:l Thel nursel isl caringl forl al clientl withl syndromel ofl inappropriatel antidiureticl
hormonel (SIADH),l whichl isl manifestedl byl whichl symptoms?
A)l Lossl ofl thirst,l weightl gain.l
B)l Dependentl edema,l fever.l
C)l Polydipsia,l polyuria.l
D)l Hypernatremia,l tachypnea.
Answer:
A)l Lossl ofl thirst,l weightl gain.
l
Rationale:l SIADHl occursl whenl thel posteriorl pituitaryl glandl releasesl tool muchl ADH,l
causingl waterl retention,l al urinel outputl ofl lessl thanl 20l ml/hour,l andl dilutionall
hyponatremia.l Otherl indicationsl ofl SIADHl arel lossl ofl thirst,l weightl gainl (A),l
irritability,l musclel weakness,l andl decreasedl levell ofl consciousness.l (B)l isl notl associatedl
withl SIADH.l (C)l isl al findingl associatedl withl diabetesl insipidusl (al waterl metabolisml
probleml causedl byl anl ADHl deficiency),l notl SIADH.l Thel increasel inl plasmal volumel
, causesl anl increasel inl thel glomerularl filtrationl ratel thatl inhibitsl thel releasel ofl renninl
andl aldosterone,l whichl resultsl inl anl increasedl sodiuml lossl inl urine,l leadingl tol greaterl
hyponatremia,l notl (D).
Q:l Thel nursel isl planningl carel forl al clientl withl newlyl diagnosedl diabetesl mellitusl
thatl requiresl insulin.l Whichl assessmentl shouldl thel nursel identifyl beforel beginningl thel
teachingl session?
A)l Presentl knowledgel relatedl tol thel skilll ofl injection.l
B)l Intelligencel andl developmentall levell
ofl thel client.l
C)l Willingnessl ofl thel clientl tol learnl thel injectionl sites.l
D)l Financiall resourcesl availablel forl thel equipment.
Answer:
C)l Willingnessl ofl thel clientl tol learnl thel injectionl sites.l
Rationale:l Ifl al clientl isl incapablel orl doesl notl wantl tol learn,l itl isl unlikelyl thatl learningl
willl occur,l sol motivationl isl thel firstl factorl thel nursel shouldl assessl beforel teachingl (C).l
Tol determinel learningl needs,l thel nursel shouldl assessl (A),l butl thisl isl notl thel mostl
importantl factorl forl thel nursel tol assess.l (Bl andl D)l arel factorsl tol consider,l butl notl asl
vitall asl (C).
Q:l Thel nursel isl caringl forl al clientl whol hasl takenl al largel quantityl ofl furosemidel
(Lasix)l tol promotel weightl loss.l Thel nursel anticipatesl thel findingl ofl whichl acid-basel
imbalance?
A)l PO2l ofl 78l mml Hg
B)l HCO3l ofl 34l mEq/L
C)l PCO2l ofl 56l mml Hg
D)l pHl ofl 7.31
Answer:
B)l HCO3l ofl 34l mEq/L
Rationale:l Diureticsl (non-potassiuml sparing)l causel metabolicl alkalosis.l A)l PO2l ofl 78l
mml Hg:l Thisl Po2l demonstratesl mildl hypoxemia,l consistentl withl respiratoryl disorders,l
notl withl diureticl use.l C)l PCO2l ofl 56l mml Hg:l CO2l retentionl resultsl froml
Surgicall Nursingl IIl |l Fortisl (Latestl 2026/l
2027l Update)l 100%l Verifiedl Questionsl &l
Answersl |l Gradel A
Q:l Al clientl withl al 16-yearl historyl ofl diabetesl mellitusl isl havingl renall functionl testsl
becausel ofl recentl fatigue,l weakness,l elevatedl bloodl ureal nitrogen,l andl seruml creatininel
levels.l Whichl findingl shouldl thel nursel concludel asl anl earlyl symptoml ofl renall
insufficiency?
A)l Dyspnea.l
B)l Nocturia.l
C)l Confusion.l
D)l Stomatitis.
Answer:
B)l Nocturia.
Rationale:l Asl thel glomerularl filtrationl ratel decreasesl inl earlyl renall insufficiency,l
metabolicl wastel products,l includingl urea,l creatinine,l andl otherl substances,l suchl phenols,l
hormones,l electrolytes,l accumulatel inl thel blood.l Inl thel earlyl stagel ofl renall
insufficiency,l polyurial resultsl froml thel inabilityl ofl thel kidneysl tol concentratel urinel andl
contributel tol nocturial (B).l (A,l C,l andl D)l arel morel commonl inl thel laterl stagesl ofl renall
failure.
Q:l Al clientl withl heartl diseasel isl onl al continuousl telemetryl monitorl andl hasl
developedl sinusl bradycardia.l Inl determiningl thel possiblel causel ofl thel bradycardia,l thel
nursel assessesl thel client'sl medicationl record.l Whichl medicationl isl mostl likelyl thel causel
ofl thel bradycardia?
A)l Propanololl (Inderal).l
B)l Captoprill (Capoten).l
C)l Furosemidel (Lasix).l
D)l Dobutaminel (Dobutrex).
,Answer:
A)l Propanololl (Inderal).
Rationale:l Inderall (A)l isl al betal adrenergicl blockingl agent,l whichl causesl decreasedl heartl
ratel andl decreasedl contractility.l Neitherl (B),l anl ACEl inhibitor,l norl (C),l al loopl diuretic,l
causesl bradycardia.l (D)l isl al sympathomimetic,l directl actingl cardiacl stimulant,l whichl
wouldl increasel thel heartl rate.
Q:l Al clientl hasl beenl takingl orall corticosteroidsl forl thel pastl fivel daysl becausel ofl
seasonall allergies.l Whichl assessmentl findingl isl ofl mostl concernl tol thel nurse?
A)l Whitel bloodl countl ofl 10,000l mm3.l
B)l Seruml glucosel ofl 115l mg/dl.l
C)l Purulentl sputum.l
D)l Excessivel hunger.
Answer:
C)l Purulentl sputum.l
Rationale:l Steroidsl causel immunosuppression,l andl al purulentl sputuml (C)l isl anl
indicationl ofl infection,l sol thisl symptoml isl ofl greatestl concern.l Orall steroidsl mayl
increasel (A)l andl oftenl causel (D).l (B)l mayl remainl normal,l borderline,l orl increasel whilel
takingl orall steroids.
Q:l Al femalel clientl receivingl IVl vasopressinl (Pitressin)l forl esophageall varicel rupturel
reportsl tol thel nursel thatl shel feelsl substernall tightnessl andl pressurel acrossl herl chest.l
Whichl PRNl protocoll shouldl thel nursel initiate?
A)l Startl anl IVl nitroglycerinl infusion.
B)l Nasogastricl lavagel withl cooll saline.l
C)l Increasel thel vasopressinl infusion.l
D)l Preparel forl endotracheall intubation.
Answer:
A)l Startl anl IVl nitroglycerinl infusion.l
Rationale:l Vasopressinl isl usedl tol promotel vasoconstriction,l therebyl reducingl bleeding.l
Vasoconstrictionl ofl thel coronaryl arteriesl canl leadl tol anginal andl myocardiall infarction,l
,andl shouldl bel counteractedl byl IVl nitroglycerinl perl prescribedl protocoll (A).l (B)l willl
notl resolvel thel cardiacl problem.l (C)l willl worsenl thel problem.l Endotracheall intubationl
mayl bel neededl ifl respiratoryl distressl occursl (D).
Q:l Al clientl withl gastroesophageall refluxl diseasel (GERD)l hasl beenl experiencingl
severel refluxl duringl sleep.l Whichl recommendationl byl thel nursel isl mostl effectivel tol
assistl thel client?
A)l Losingl weight.l
B)l Decreasingl caffeinel intake.l
C)l Avoidingl largel meals.l
D)l Raisingl thel headl ofl thel bedl onl blocks.
Answer:
D)l Raisingl thel headl ofl thel bedl onl blocks.l
Rationale:l Raisingl thel headl ofl thel bedl onl blocksl (D)l (reversel Trendelenburgl position)l
tol reducel refluxl andl subsequentl aspirationl isl thel mostl effectivel recommendationl forl al
clientl experiencingl severel gastroesophageall refluxl duringl sleep.l (A,l Bl andl C)l mayl bel
effectivel recommendationsl butl raisingl thel headl ofl thel bedl isl morel effectivel forl reliefl
duringl sleep.
Q:l Thel nursel isl caringl forl al clientl withl syndromel ofl inappropriatel antidiureticl
hormonel (SIADH),l whichl isl manifestedl byl whichl symptoms?
A)l Lossl ofl thirst,l weightl gain.l
B)l Dependentl edema,l fever.l
C)l Polydipsia,l polyuria.l
D)l Hypernatremia,l tachypnea.
Answer:
A)l Lossl ofl thirst,l weightl gain.
l
Rationale:l SIADHl occursl whenl thel posteriorl pituitaryl glandl releasesl tool muchl ADH,l
causingl waterl retention,l al urinel outputl ofl lessl thanl 20l ml/hour,l andl dilutionall
hyponatremia.l Otherl indicationsl ofl SIADHl arel lossl ofl thirst,l weightl gainl (A),l
irritability,l musclel weakness,l andl decreasedl levell ofl consciousness.l (B)l isl notl associatedl
withl SIADH.l (C)l isl al findingl associatedl withl diabetesl insipidusl (al waterl metabolisml
probleml causedl byl anl ADHl deficiency),l notl SIADH.l Thel increasel inl plasmal volumel
, causesl anl increasel inl thel glomerularl filtrationl ratel thatl inhibitsl thel releasel ofl renninl
andl aldosterone,l whichl resultsl inl anl increasedl sodiuml lossl inl urine,l leadingl tol greaterl
hyponatremia,l notl (D).
Q:l Thel nursel isl planningl carel forl al clientl withl newlyl diagnosedl diabetesl mellitusl
thatl requiresl insulin.l Whichl assessmentl shouldl thel nursel identifyl beforel beginningl thel
teachingl session?
A)l Presentl knowledgel relatedl tol thel skilll ofl injection.l
B)l Intelligencel andl developmentall levell
ofl thel client.l
C)l Willingnessl ofl thel clientl tol learnl thel injectionl sites.l
D)l Financiall resourcesl availablel forl thel equipment.
Answer:
C)l Willingnessl ofl thel clientl tol learnl thel injectionl sites.l
Rationale:l Ifl al clientl isl incapablel orl doesl notl wantl tol learn,l itl isl unlikelyl thatl learningl
willl occur,l sol motivationl isl thel firstl factorl thel nursel shouldl assessl beforel teachingl (C).l
Tol determinel learningl needs,l thel nursel shouldl assessl (A),l butl thisl isl notl thel mostl
importantl factorl forl thel nursel tol assess.l (Bl andl D)l arel factorsl tol consider,l butl notl asl
vitall asl (C).
Q:l Thel nursel isl caringl forl al clientl whol hasl takenl al largel quantityl ofl furosemidel
(Lasix)l tol promotel weightl loss.l Thel nursel anticipatesl thel findingl ofl whichl acid-basel
imbalance?
A)l PO2l ofl 78l mml Hg
B)l HCO3l ofl 34l mEq/L
C)l PCO2l ofl 56l mml Hg
D)l pHl ofl 7.31
Answer:
B)l HCO3l ofl 34l mEq/L
Rationale:l Diureticsl (non-potassiuml sparing)l causel metabolicl alkalosis.l A)l PO2l ofl 78l
mml Hg:l Thisl Po2l demonstratesl mildl hypoxemia,l consistentl withl respiratoryl disorders,l
notl withl diureticl use.l C)l PCO2l ofl 56l mml Hg:l CO2l retentionl resultsl froml
