NUR209 / NUR 209 Exam 2: Medical-Surgical Nursing II
(Fortis) Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | 100% Verified —
Pass Guaranteed – A+ Graded
Core Medical-Surgical Concepts and Assessment
Q1: A patient is admitted to the medical-surgical unit with a new diagnosis of heart failure.
During the initial assessment, the nurse notes a regular heart rate of 72 beats per minute
with a visible P wave preceding every QRS complex. How should the nurse document this
rhythm?
A. Atrial fibrillation
B. Sinus bradycardia
C. Normal sinus rhythm [CORRECT]
D. First-degree atrioventricular block
Correct Answer: C
Rationale: The best answer is normal sinus rhythm because a regular rate between 60 and
100 beats per minute with a P wave preceding every QRS complex is the hallmark of this
rhythm. This matches the principle that normal sinus rhythm indicates proper electrical
conduction originating from the sinoatrial node, whereas other rhythms would present with
irregular rates, missing P waves, or abnormal intervals.
Q2: The nurse is reviewing arterial blood gas (ABG) results for a patient with chronic
obstructive pulmonary disease. Which of the following values represents a normal,
uncompensated ABG profile?
A. pH 7.32, PaCO2 50 mm Hg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mm Hg, HCO3 22 mEq/L
C. pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L [CORRECT]
D. pH 7.30, PaCO2 40 mm Hg, HCO3 18 mEq/L
Correct Answer: C
Rationale: This choice is correct because a pH of 7.40, PaCO2 of 40 mm Hg, and HCO3 of 24
mEq/L fall perfectly within the standard normal reference ranges. This aligns with the
foundational principle that normal ABG values reflect a balanced acid-base state without the
respiratory or metabolic compensation seen in other abnormal profiles.
Q3: A patient is brought to the emergency department following a motor vehicle collision.
The nurse assesses the patient's neurological status using the Glasgow Coma Scale (GCS).
The patient opens their eyes to pain, speaks in confused sentences, and localizes to painful
stimuli. What is the patient's total GCS score?
A. 9
B. 11
C. 12 [CORRECT]
, D. 14
Correct Answer: C
Rationale: The best answer is 12 because opening eyes to pain is 2 points, speaking in
confused sentences is 4 points, and localizing to pain is 6 points, which totals 12. This
matches the standard GCS scoring system used to objectively quantify a patient's level of
consciousness, distinguishing it from lower scores that indicate deeper impairment.
Q4: A patient is 24 hours postoperative from a tibial fracture repair with a cast in place. The
patient reports severe, unrelenting pain in the affected leg that is not relieved by prescribed
opioid medication. Which assessment finding should the nurse recognize as an early
indicator of compartment syndrome?
A. Warm, pink skin distal to the cast
B. Bounding pedal pulses
C. Pain with passive stretch of the toes [CORRECT]
D. Mild, intermittent tingling that resolves with elevation
Correct Answer: C
Rationale: This choice is correct because pain with passive stretch is one of the earliest and
most reliable clinical indicators of compartment syndrome, occurring before pulselessness
or pallor. This aligns with the principle that increased pressure within a fascial compartment
compromises microcirculation and nerve function first, making it a critical early warning
sign.
Q5: The nurse is evaluating the effectiveness of preoperative teaching for a patient
scheduled for a total knee replacement. Which statement by the patient indicates a need
for further instruction?
A. "I will use my incentive spirometer 10 times every hour while awake."
B. "I should expect some swelling and bruising around the incision site."
C. "I will cross my legs at the knees to get comfortable in bed." [CORRECT]
D. "I need to report any sudden chest pain or shortness of breath immediately."
Correct Answer: C
Rationale: The best answer is the statement about crossing legs at the knees because this
action increases the risk of deep vein thrombosis and can disrupt proper alignment after
joint surgery. This matches the principle that postoperative orthopedic patients must avoid
positions that impede venous return or stress the surgical site.
Q6: A patient with a history of chronic liver disease is admitted with bleeding esophageal
varices. The nurse understands that the primary physiological role of platelets in this
scenario is to:
A. Transport oxygen to the hypoxic tissues.
B. Form a temporary plug at the site of vascular injury. [CORRECT]
C. Produce fibrinogen to dissolve existing blood clots.
D. Phagocytize bacteria to prevent systemic infection.
Correct Answer: C
Rationale: This choice is correct because platelets are essential for primary hemostasis,
adhering to damaged endothelium to form a temporary platelet plug. This aligns with the
foundational concept that platelet dysfunction or depletion directly contributes to the
bleeding risks seen in liver disease, unlike red blood cells or white blood cells.
(Fortis) Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | 100% Verified —
Pass Guaranteed – A+ Graded
Core Medical-Surgical Concepts and Assessment
Q1: A patient is admitted to the medical-surgical unit with a new diagnosis of heart failure.
During the initial assessment, the nurse notes a regular heart rate of 72 beats per minute
with a visible P wave preceding every QRS complex. How should the nurse document this
rhythm?
A. Atrial fibrillation
B. Sinus bradycardia
C. Normal sinus rhythm [CORRECT]
D. First-degree atrioventricular block
Correct Answer: C
Rationale: The best answer is normal sinus rhythm because a regular rate between 60 and
100 beats per minute with a P wave preceding every QRS complex is the hallmark of this
rhythm. This matches the principle that normal sinus rhythm indicates proper electrical
conduction originating from the sinoatrial node, whereas other rhythms would present with
irregular rates, missing P waves, or abnormal intervals.
Q2: The nurse is reviewing arterial blood gas (ABG) results for a patient with chronic
obstructive pulmonary disease. Which of the following values represents a normal,
uncompensated ABG profile?
A. pH 7.32, PaCO2 50 mm Hg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mm Hg, HCO3 22 mEq/L
C. pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L [CORRECT]
D. pH 7.30, PaCO2 40 mm Hg, HCO3 18 mEq/L
Correct Answer: C
Rationale: This choice is correct because a pH of 7.40, PaCO2 of 40 mm Hg, and HCO3 of 24
mEq/L fall perfectly within the standard normal reference ranges. This aligns with the
foundational principle that normal ABG values reflect a balanced acid-base state without the
respiratory or metabolic compensation seen in other abnormal profiles.
Q3: A patient is brought to the emergency department following a motor vehicle collision.
The nurse assesses the patient's neurological status using the Glasgow Coma Scale (GCS).
The patient opens their eyes to pain, speaks in confused sentences, and localizes to painful
stimuli. What is the patient's total GCS score?
A. 9
B. 11
C. 12 [CORRECT]
, D. 14
Correct Answer: C
Rationale: The best answer is 12 because opening eyes to pain is 2 points, speaking in
confused sentences is 4 points, and localizing to pain is 6 points, which totals 12. This
matches the standard GCS scoring system used to objectively quantify a patient's level of
consciousness, distinguishing it from lower scores that indicate deeper impairment.
Q4: A patient is 24 hours postoperative from a tibial fracture repair with a cast in place. The
patient reports severe, unrelenting pain in the affected leg that is not relieved by prescribed
opioid medication. Which assessment finding should the nurse recognize as an early
indicator of compartment syndrome?
A. Warm, pink skin distal to the cast
B. Bounding pedal pulses
C. Pain with passive stretch of the toes [CORRECT]
D. Mild, intermittent tingling that resolves with elevation
Correct Answer: C
Rationale: This choice is correct because pain with passive stretch is one of the earliest and
most reliable clinical indicators of compartment syndrome, occurring before pulselessness
or pallor. This aligns with the principle that increased pressure within a fascial compartment
compromises microcirculation and nerve function first, making it a critical early warning
sign.
Q5: The nurse is evaluating the effectiveness of preoperative teaching for a patient
scheduled for a total knee replacement. Which statement by the patient indicates a need
for further instruction?
A. "I will use my incentive spirometer 10 times every hour while awake."
B. "I should expect some swelling and bruising around the incision site."
C. "I will cross my legs at the knees to get comfortable in bed." [CORRECT]
D. "I need to report any sudden chest pain or shortness of breath immediately."
Correct Answer: C
Rationale: The best answer is the statement about crossing legs at the knees because this
action increases the risk of deep vein thrombosis and can disrupt proper alignment after
joint surgery. This matches the principle that postoperative orthopedic patients must avoid
positions that impede venous return or stress the surgical site.
Q6: A patient with a history of chronic liver disease is admitted with bleeding esophageal
varices. The nurse understands that the primary physiological role of platelets in this
scenario is to:
A. Transport oxygen to the hypoxic tissues.
B. Form a temporary plug at the site of vascular injury. [CORRECT]
C. Produce fibrinogen to dissolve existing blood clots.
D. Phagocytize bacteria to prevent systemic infection.
Correct Answer: C
Rationale: This choice is correct because platelets are essential for primary hemostasis,
adhering to damaged endothelium to form a temporary platelet plug. This aligns with the
foundational concept that platelet dysfunction or depletion directly contributes to the
bleeding risks seen in liver disease, unlike red blood cells or white blood cells.
