NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
EXAM 1: NUR209 / NUR 209
(LATEST UPDATE)
MEDICAL SURGICAL NURSING II
REVIEW WITH QUESTIONS AND VERIFIED ANSWERS
100% CORRECT | GRADE A – FORTIS
Course NUR209 Medical Surgical Nursing II
Institution Fortis College
Academic Year Update
Total Questions 150 Multiple-Choice Questions
Cognitive Levels 20% Recall | 55% Application | 25% Analysis & Priority
Question Style 70% Clinical Vignettes | 20% Pharmacology | 10% Priority/Safety
Standards Alignment NCLEX-RN Standards & Fortis Curriculum
Grade Target Grade A Mastery
EXAM STRUCTURE
Section Topic Questions
1 Cardiovascular Disorders 30 (Q1-Q30)
2 Respiratory Disorders 25 (Q31-Q55)
Grade A Mastery Series Page 1 Verified Answers | 100% Correct
,NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
3 Gastrointestinal Disorders 20 (Q56-Q75)
4 Renal & Genitourinary Disorders 15 (Q76-Q90)
5 Endocrine & Metabolic Disorders 25 (Q91-Q115)
6 Neurological Disorders 20 (Q116-Q135)
7 Hematological & Immunological Disorders 15 (Q136-Q150)
TOTAL 150
EXAMINEE INSTRUCTIONS
• Read each clinical vignette carefully before selecting your answer.
• Each question has four options (A, B, C, D) with only ONE correct answer.
• The correct answer is clearly marked with **[CORRECT]** and bold green formatting.
• Rationales provide clinical reasoning, nursing intervention rationale, medication
rationale, and safety considerations.
• Review rationales for all distractors to strengthen critical thinking skills.
• Use this review alongside NCLEX-RN preparation materials and Fortis course textbooks.
• Cognitive level distribution: 20% recall, 55% application, 25% analysis & priority setting.
Grade A Mastery Series Page 2 Verified Answers | 100% Correct
,NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
SECTION 1: CARDIOVASCULAR DISORDERS
Heart Failure | Coronary Artery Disease | Hypertension | Arrhythmias | Peripheral Vascular
Disease | Valvular Disease | Cardiac Diagnostics | Nursing Interventions
Q1: A 68-year-old female with a history of hypertension and type 2 diabetes is admitted
with worsening dyspnea, bilateral crackles in the lung bases, and 3+ pitting edema in
both lower extremities. Her weight has increased by 4 kg in the past week. Which
assessment finding is most indicative of worsening left-sided heart failure?
A. Jugular vein distension of 8 cm above the sternal angle
B. Bilateral basilar crackles that do not clear with coughing **[CORRECT]**
C. 3+ pitting edema in bilateral lower extremities
D. Hepatomegaly with right upper quadrant tenderness
Correct Answer: B
Rationale: Bilateral basilar crackles that do not clear with coughing are a hallmark of left-sided
heart failure resulting from pulmonary venous congestion and alveolar fluid accumulation. JVD,
peripheral edema, and hepatomegaly are classic signs of RIGHT-sided heart failure reflecting
systemic venous congestion. Recognizing the side of failure directs diuretic therapy and fluid
management priorities.
Q2: The nurse is caring for a patient with heart failure who is receiving furosemide 40 mg
IV twice daily. The morning laboratory results show potassium 3.1 mEq/L, sodium 134
mEq/L, and magnesium 1.6 mg/dL. Which provider order should the nurse anticipate?
A. Administer potassium chloride 20 mEq IV push over 5 minutes
B. Administer oral potassium chloride supplement and reassess in 24 hours
C. Administer potassium chloride 10 mEq in 100 mL of normal saline infused over 1 hour
**[CORRECT]**
D. Hold the next furosemide dose and notify the provider of all abnormal values
Correct Answer: C
Rationale: IV potassium should always be diluted and infused slowly (no faster than 10 mEq/hour
via peripheral line) to prevent fatal arrhythmias and phlebitis; IV push is contraindicated. A loop
diuretic like furosemide causes significant potassium wasting, and oral replacement alone may not
adequately correct severe hypokalemia. Holding furosemide without replacement fails to address
the dangerous electrolyte deficit.
Grade A Mastery Series Page 3 Verified Answers | 100% Correct
, NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
Q3: A patient with heart failure is being discharged with a new prescription for lisinopril
10 mg daily. Which statement by the patient indicates the need for further teaching?
A. "I will take my blood pressure at home and keep a log."
B. "I should call my provider if I develop a dry, hacking cough."
C. "I will take this medication with a high-potassium salt substitute." **[CORRECT]**
D. "I will get up slowly from sitting to prevent dizziness."
Correct Answer: C
Rationale: ACE inhibitors like lisinopril inhibit angiotensin II formation, which reduces
aldosterone secretion and can cause potassium retention; using a high-potassium salt substitute
risks life-threatening hyperkalemia. A persistent dry cough affects up to 20% of patients on ACE
inhibitors and warrants provider notification for possible medication switch. Orthostatic
hypotension and home BP monitoring are appropriate self-management behaviors.
Q4: A patient with acute decompensated heart failure has a BNP level of 1,200 pg/mL. The
nurse understands that this finding indicates which of the following?
A. The patient is at low risk for cardiac events
B. The patient has significant ventricular volume and pressure overload **[CORRECT]**
C. The patient has an acute myocardial infarction
D. The patient has primary pulmonary hypertension
Correct Answer: B
Rationale: BNP is released by ventricular myocytes in response to increased wall stretch from
volume and pressure overload; values above 400 pg/mL strongly support a diagnosis of heart
failure, and a level of 1,200 pg/mL indicates significant decompensation. BNP is not a specific
marker for myocardial infarction (troponin is) nor for primary pulmonary hypertension. A level
this high correlates with elevated cardiac filling pressures and worse prognosis.
Q5: The nurse is teaching a patient with heart failure about daily weight monitoring.
Which statement by the patient demonstrates correct understanding?
A. "I should weigh myself once a week at the same time of day."
B. "I should weigh myself every morning after breakfast and before dressing."
C. "I should weigh myself every morning before eating, after urinating, wearing similar
clothing." **[CORRECT]**
D. "I should notify my provider if I gain 5 pounds in one week."
Correct Answer: C
Rationale: Daily weights must be performed at the same time each morning, before eating, after
voiding, and in similar clothing to detect fluid retention accurately. A weight gain of 2-3 pounds in
one day or 5 pounds in one week warrants provider notification, but waiting a full week to weigh
delays detection of decompensation. Consistency in measurement technique is essential for early
identification of fluid overload.
Grade A Mastery Series Page 4 Verified Answers | 100% Correct
EXAM 1: NUR209 / NUR 209
(LATEST UPDATE)
MEDICAL SURGICAL NURSING II
REVIEW WITH QUESTIONS AND VERIFIED ANSWERS
100% CORRECT | GRADE A – FORTIS
Course NUR209 Medical Surgical Nursing II
Institution Fortis College
Academic Year Update
Total Questions 150 Multiple-Choice Questions
Cognitive Levels 20% Recall | 55% Application | 25% Analysis & Priority
Question Style 70% Clinical Vignettes | 20% Pharmacology | 10% Priority/Safety
Standards Alignment NCLEX-RN Standards & Fortis Curriculum
Grade Target Grade A Mastery
EXAM STRUCTURE
Section Topic Questions
1 Cardiovascular Disorders 30 (Q1-Q30)
2 Respiratory Disorders 25 (Q31-Q55)
Grade A Mastery Series Page 1 Verified Answers | 100% Correct
,NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
3 Gastrointestinal Disorders 20 (Q56-Q75)
4 Renal & Genitourinary Disorders 15 (Q76-Q90)
5 Endocrine & Metabolic Disorders 25 (Q91-Q115)
6 Neurological Disorders 20 (Q116-Q135)
7 Hematological & Immunological Disorders 15 (Q136-Q150)
TOTAL 150
EXAMINEE INSTRUCTIONS
• Read each clinical vignette carefully before selecting your answer.
• Each question has four options (A, B, C, D) with only ONE correct answer.
• The correct answer is clearly marked with **[CORRECT]** and bold green formatting.
• Rationales provide clinical reasoning, nursing intervention rationale, medication
rationale, and safety considerations.
• Review rationales for all distractors to strengthen critical thinking skills.
• Use this review alongside NCLEX-RN preparation materials and Fortis course textbooks.
• Cognitive level distribution: 20% recall, 55% application, 25% analysis & priority setting.
Grade A Mastery Series Page 2 Verified Answers | 100% Correct
,NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
SECTION 1: CARDIOVASCULAR DISORDERS
Heart Failure | Coronary Artery Disease | Hypertension | Arrhythmias | Peripheral Vascular
Disease | Valvular Disease | Cardiac Diagnostics | Nursing Interventions
Q1: A 68-year-old female with a history of hypertension and type 2 diabetes is admitted
with worsening dyspnea, bilateral crackles in the lung bases, and 3+ pitting edema in
both lower extremities. Her weight has increased by 4 kg in the past week. Which
assessment finding is most indicative of worsening left-sided heart failure?
A. Jugular vein distension of 8 cm above the sternal angle
B. Bilateral basilar crackles that do not clear with coughing **[CORRECT]**
C. 3+ pitting edema in bilateral lower extremities
D. Hepatomegaly with right upper quadrant tenderness
Correct Answer: B
Rationale: Bilateral basilar crackles that do not clear with coughing are a hallmark of left-sided
heart failure resulting from pulmonary venous congestion and alveolar fluid accumulation. JVD,
peripheral edema, and hepatomegaly are classic signs of RIGHT-sided heart failure reflecting
systemic venous congestion. Recognizing the side of failure directs diuretic therapy and fluid
management priorities.
Q2: The nurse is caring for a patient with heart failure who is receiving furosemide 40 mg
IV twice daily. The morning laboratory results show potassium 3.1 mEq/L, sodium 134
mEq/L, and magnesium 1.6 mg/dL. Which provider order should the nurse anticipate?
A. Administer potassium chloride 20 mEq IV push over 5 minutes
B. Administer oral potassium chloride supplement and reassess in 24 hours
C. Administer potassium chloride 10 mEq in 100 mL of normal saline infused over 1 hour
**[CORRECT]**
D. Hold the next furosemide dose and notify the provider of all abnormal values
Correct Answer: C
Rationale: IV potassium should always be diluted and infused slowly (no faster than 10 mEq/hour
via peripheral line) to prevent fatal arrhythmias and phlebitis; IV push is contraindicated. A loop
diuretic like furosemide causes significant potassium wasting, and oral replacement alone may not
adequately correct severe hypokalemia. Holding furosemide without replacement fails to address
the dangerous electrolyte deficit.
Grade A Mastery Series Page 3 Verified Answers | 100% Correct
, NUR209 Medical Surgical Nursing II - Exam 1 Review 2026/2027 Update | Fortis College
Q3: A patient with heart failure is being discharged with a new prescription for lisinopril
10 mg daily. Which statement by the patient indicates the need for further teaching?
A. "I will take my blood pressure at home and keep a log."
B. "I should call my provider if I develop a dry, hacking cough."
C. "I will take this medication with a high-potassium salt substitute." **[CORRECT]**
D. "I will get up slowly from sitting to prevent dizziness."
Correct Answer: C
Rationale: ACE inhibitors like lisinopril inhibit angiotensin II formation, which reduces
aldosterone secretion and can cause potassium retention; using a high-potassium salt substitute
risks life-threatening hyperkalemia. A persistent dry cough affects up to 20% of patients on ACE
inhibitors and warrants provider notification for possible medication switch. Orthostatic
hypotension and home BP monitoring are appropriate self-management behaviors.
Q4: A patient with acute decompensated heart failure has a BNP level of 1,200 pg/mL. The
nurse understands that this finding indicates which of the following?
A. The patient is at low risk for cardiac events
B. The patient has significant ventricular volume and pressure overload **[CORRECT]**
C. The patient has an acute myocardial infarction
D. The patient has primary pulmonary hypertension
Correct Answer: B
Rationale: BNP is released by ventricular myocytes in response to increased wall stretch from
volume and pressure overload; values above 400 pg/mL strongly support a diagnosis of heart
failure, and a level of 1,200 pg/mL indicates significant decompensation. BNP is not a specific
marker for myocardial infarction (troponin is) nor for primary pulmonary hypertension. A level
this high correlates with elevated cardiac filling pressures and worse prognosis.
Q5: The nurse is teaching a patient with heart failure about daily weight monitoring.
Which statement by the patient demonstrates correct understanding?
A. "I should weigh myself once a week at the same time of day."
B. "I should weigh myself every morning after breakfast and before dressing."
C. "I should weigh myself every morning before eating, after urinating, wearing similar
clothing." **[CORRECT]**
D. "I should notify my provider if I gain 5 pounds in one week."
Correct Answer: C
Rationale: Daily weights must be performed at the same time each morning, before eating, after
voiding, and in similar clothing to detect fluid retention accurately. A weight gain of 2-3 pounds in
one day or 5 pounds in one week warrants provider notification, but waiting a full week to weigh
delays detection of decompensation. Consistency in measurement technique is essential for early
identification of fluid overload.
Grade A Mastery Series Page 4 Verified Answers | 100% Correct
