NUR209 / NUR 209 (Latest 2026/2027 Update)
Medical Surgical Nursing II
Comprehensive Review Examination with Verified Answers
100% Correct | Grade A | Fortis College
Aligned with 2026-2027 NCLEX-RN Test Plan and Fortis College Program Outcomes
100 Questions | 9 Sections | Multiple Choice (A-D)
Section 1: Cardiovascular Disorders - Assessment and Management (Questions 1-15)
Q1: A nurse is assessing a client who is 2 hours post-myocardial infarction (MI). The client reports chest
pain rated 7/10. Which of the following actions should the nurse take first?
A. Administer prescribed morphine sulfate IV **[CORRECT]**
B. Obtain a 12-lead electrocardiogram (ECG)
C. Check the client's most recent troponin level
D. Apply oxygen via nasal cannula at 2 L/min
Correct Answer: A
Rationale: The priority action is to relieve pain and reduce myocardial oxygen demand. Morphine sulfate is the first-line
analgesic for acute MI chest pain because it decreases sympathetic nervous system activity, preload, and afterload. While
obtaining an ECG and checking troponin are important, pain relief takes priority because untreated pain increases cardiac
workload and infarct size. Oxygen should only be applied if SpO2 is below 94%.
Q2: A nurse is caring for a client with heart failure who is receiving furosemide (Lasix) 40 mg IV twice
daily. Which of the following findings should the nurse report to the provider immediately?
A. Weight gain of 1 kg over 2 days
B. Potassium level of 3.0 mEq/L **[CORRECT]**
C. Bilateral ankle edema rated 2+
D. Apical pulse of 88 beats/min
Correct Answer: B
Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia, a dangerous side effect of furosemide requiring immediate
intervention. Hypokalemia increases the risk of fatal cardiac dysrhythmias. Weight gain and edema are expected findings in
heart failure. An apical pulse of 88 is within normal range.
Q3: A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should teach the client
to avoid which of the following foods?
A. Bananas and oranges
B. Dark green leafy vegetables **[CORRECT]**
C. Dairy products such as milk and cheese
D. Lean meats and poultry
NUR209 Comprehensive Review Examination | Page 1
,Correct Answer: B
Rationale: Dark green leafy vegetables (spinach, kale, broccoli) are high in vitamin K, which antagonizes the anticoagulant
effects of warfarin. Consistent intake is important, but large amounts can reduce the INR and increase clot risk. Bananas, dairy,
and lean meats do not significantly interact with warfarin therapy.
Q4: A nurse is reviewing the laboratory results of a client diagnosed with coronary artery disease (CAD).
Which of the following lipid panel results indicates the client is at highest risk for a cardiac event?
A. Total cholesterol 190 mg/dL, LDL 100 mg/dL, HDL 55 mg/dL
B. Total cholesterol 220 mg/dL, LDL 150 mg/dL, HDL 35 mg/dL **[CORRECT]**
C. Total cholesterol 180 mg/dL, LDL 110 mg/dL, HDL 60 mg/dL
D. Total cholesterol 200 mg/dL, LDL 120 mg/dL, HDL 50 mg/dL
Correct Answer: B
Rationale: An LDL of 150 mg/dL is significantly elevated (optimal is less than 100 mg/dL), and an HDL of 35 mg/dL is low
(men should be above 40 mg/dL, women above 50 mg/dL). This combination of high LDL and low HDL represents the highest
cardiac risk. The other options show more favorable lipid profiles.
Q5: A nurse is providing discharge teaching to a client who has undergone a percutaneous coronary
intervention (PCI) with stent placement. Which of the following statements by the client indicates an
understanding of the teaching?
A. I should stop taking clopidogrel after 2 weeks to prevent bleeding.
B. I will take aspirin and clopidogrel exactly as prescribed for at least 12 months. **[CORRECT]**
C. I can resume strenuous exercise within 1 week after the procedure.
D. I should avoid all magnetic resonance imaging (MRI) scans in the future.
Correct Answer: B
Rationale: Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is essential for at least 12 months after stent placement
to prevent stent thrombosis. Stopping clopidogrel early is the most common cause of stent thrombosis. Strenuous exercise should be
avoided for 2-4 weeks post-PCI, and most modern stents are MRI-safe.
Q6: A nurse is caring for a client with left-sided heart failure. Which of the following findings should the
nurse expect?
A. Jugular venous distention and dependent edema
B. Crackles in the lungs and frothy pink sputum **[CORRECT]**
C. Hepatomegaly and ascites
D. Bounding peripheral pulses and bradycardia
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion due to backup of blood into the pulmonary circulation, leading
to crackles (rales) in the lungs and frothy pink sputum (pulmonary edema). Jugular venous distention, dependent edema,
hepatomegaly, and ascites are signs of right-sided heart failure.
Q7: A client is admitted with suspected aortic dissection. Which of the following actions is the priority for
the nurse?
A. Administer prescribed IV antihypertensive medication **[CORRECT]**
B. Obtain a detailed medical history from the client
C. Prepare the client for a computed tomography (CT) scan
D. Assess peripheral pulses in all four extremities
Correct Answer: A
NUR209 Comprehensive Review Examination | Page 2
, Rationale: The priority in aortic dissection is to reduce blood pressure and shear stress on the aortic wall to prevent rupture. IV
antihypertensives (such as nitroprusside with a beta-blocker) are the first priority. While assessing pulses and obtaining imaging
are important, controlling blood pressure is the most urgent intervention to prevent fatal rupture.
Q8: A nurse is monitoring a client who is receiving heparin drip therapy for deep vein thrombosis (DVT).
The client's activated partial thromboplastin time (aPTT) is 45 seconds. Which of the following actions
should the nurse take?
A. Stop the heparin infusion immediately
B. Increase the heparin infusion rate as prescribed **[CORRECT]**
C. Continue the current infusion rate and recheck aPTT in 6 hours
D. Administer protamine sulfate
Correct Answer: B
Rationale: The therapeutic range for aPTT during heparin therapy is typically 1.5 to 2.5 times the control value (approximately
60-80 seconds). An aPTT of 45 seconds is below the therapeutic range, indicating the dose needs to be increased. Stopping
heparin and administering protamine are for overdose situations.
Q9: A nurse is teaching a client about the mechanism of action of metoprolol (Lopressor) for heart
failure. Which of the following statements by the nurse is appropriate?
A. Metoprolol increases the force of your heart's contractions.
B. Metoprolol blocks beta-1 receptors to reduce your heart rate and decrease the workload on your heart.
**[CORRECT]**
C. Metoprolol helps your body get rid of excess fluid.
D. Metoprolol increases blood flow to your kidneys.
Correct Answer: B
Rationale: Metoprolol is a beta-1 selective adrenergic antagonist (beta-blocker) that reduces heart rate, myocardial contractility,
and blood pressure, thereby decreasing the heart's oxygen demand and workload. It does not increase contractility, promote
diuresis, or directly increase renal blood flow.
Q10: A nurse is assessing a client with infective endocarditis. Which of the following findings is most
characteristic of this condition?
A. Pericardial friction rub
B. Janeway lesions and Osler nodes **[CORRECT]**
C. Pulsus paradoxus greater than 10 mmHg
D. Wide pulse pressure
Correct Answer: B
Rationale: Janeway lesions (painless, macular lesions on palms and soles) and Osler nodes (tender, raised nodules on fingers and
toes) are classic findings of infective endocarditis caused by immune complex deposition and microembolization. Pericardial
friction rub suggests pericarditis, pulsus paradoxus suggests cardiac tamponade, and wide pulse pressure suggests aortic
regurgitation.
Q11: A client with chronic heart failure is prescribed spironolactone (Aldactone). The nurse should
monitor for which of the following potential adverse effects?
A. Hypokalemia and dehydration
B. Hyperkalemia and gynecomastia **[CORRECT]**
C. Hyponatremia and hypoglycemia
D. Hypocalcemia and tinnitus
Correct Answer: B
NUR209 Comprehensive Review Examination | Page 3
Medical Surgical Nursing II
Comprehensive Review Examination with Verified Answers
100% Correct | Grade A | Fortis College
Aligned with 2026-2027 NCLEX-RN Test Plan and Fortis College Program Outcomes
100 Questions | 9 Sections | Multiple Choice (A-D)
Section 1: Cardiovascular Disorders - Assessment and Management (Questions 1-15)
Q1: A nurse is assessing a client who is 2 hours post-myocardial infarction (MI). The client reports chest
pain rated 7/10. Which of the following actions should the nurse take first?
A. Administer prescribed morphine sulfate IV **[CORRECT]**
B. Obtain a 12-lead electrocardiogram (ECG)
C. Check the client's most recent troponin level
D. Apply oxygen via nasal cannula at 2 L/min
Correct Answer: A
Rationale: The priority action is to relieve pain and reduce myocardial oxygen demand. Morphine sulfate is the first-line
analgesic for acute MI chest pain because it decreases sympathetic nervous system activity, preload, and afterload. While
obtaining an ECG and checking troponin are important, pain relief takes priority because untreated pain increases cardiac
workload and infarct size. Oxygen should only be applied if SpO2 is below 94%.
Q2: A nurse is caring for a client with heart failure who is receiving furosemide (Lasix) 40 mg IV twice
daily. Which of the following findings should the nurse report to the provider immediately?
A. Weight gain of 1 kg over 2 days
B. Potassium level of 3.0 mEq/L **[CORRECT]**
C. Bilateral ankle edema rated 2+
D. Apical pulse of 88 beats/min
Correct Answer: B
Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia, a dangerous side effect of furosemide requiring immediate
intervention. Hypokalemia increases the risk of fatal cardiac dysrhythmias. Weight gain and edema are expected findings in
heart failure. An apical pulse of 88 is within normal range.
Q3: A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should teach the client
to avoid which of the following foods?
A. Bananas and oranges
B. Dark green leafy vegetables **[CORRECT]**
C. Dairy products such as milk and cheese
D. Lean meats and poultry
NUR209 Comprehensive Review Examination | Page 1
,Correct Answer: B
Rationale: Dark green leafy vegetables (spinach, kale, broccoli) are high in vitamin K, which antagonizes the anticoagulant
effects of warfarin. Consistent intake is important, but large amounts can reduce the INR and increase clot risk. Bananas, dairy,
and lean meats do not significantly interact with warfarin therapy.
Q4: A nurse is reviewing the laboratory results of a client diagnosed with coronary artery disease (CAD).
Which of the following lipid panel results indicates the client is at highest risk for a cardiac event?
A. Total cholesterol 190 mg/dL, LDL 100 mg/dL, HDL 55 mg/dL
B. Total cholesterol 220 mg/dL, LDL 150 mg/dL, HDL 35 mg/dL **[CORRECT]**
C. Total cholesterol 180 mg/dL, LDL 110 mg/dL, HDL 60 mg/dL
D. Total cholesterol 200 mg/dL, LDL 120 mg/dL, HDL 50 mg/dL
Correct Answer: B
Rationale: An LDL of 150 mg/dL is significantly elevated (optimal is less than 100 mg/dL), and an HDL of 35 mg/dL is low
(men should be above 40 mg/dL, women above 50 mg/dL). This combination of high LDL and low HDL represents the highest
cardiac risk. The other options show more favorable lipid profiles.
Q5: A nurse is providing discharge teaching to a client who has undergone a percutaneous coronary
intervention (PCI) with stent placement. Which of the following statements by the client indicates an
understanding of the teaching?
A. I should stop taking clopidogrel after 2 weeks to prevent bleeding.
B. I will take aspirin and clopidogrel exactly as prescribed for at least 12 months. **[CORRECT]**
C. I can resume strenuous exercise within 1 week after the procedure.
D. I should avoid all magnetic resonance imaging (MRI) scans in the future.
Correct Answer: B
Rationale: Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is essential for at least 12 months after stent placement
to prevent stent thrombosis. Stopping clopidogrel early is the most common cause of stent thrombosis. Strenuous exercise should be
avoided for 2-4 weeks post-PCI, and most modern stents are MRI-safe.
Q6: A nurse is caring for a client with left-sided heart failure. Which of the following findings should the
nurse expect?
A. Jugular venous distention and dependent edema
B. Crackles in the lungs and frothy pink sputum **[CORRECT]**
C. Hepatomegaly and ascites
D. Bounding peripheral pulses and bradycardia
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion due to backup of blood into the pulmonary circulation, leading
to crackles (rales) in the lungs and frothy pink sputum (pulmonary edema). Jugular venous distention, dependent edema,
hepatomegaly, and ascites are signs of right-sided heart failure.
Q7: A client is admitted with suspected aortic dissection. Which of the following actions is the priority for
the nurse?
A. Administer prescribed IV antihypertensive medication **[CORRECT]**
B. Obtain a detailed medical history from the client
C. Prepare the client for a computed tomography (CT) scan
D. Assess peripheral pulses in all four extremities
Correct Answer: A
NUR209 Comprehensive Review Examination | Page 2
, Rationale: The priority in aortic dissection is to reduce blood pressure and shear stress on the aortic wall to prevent rupture. IV
antihypertensives (such as nitroprusside with a beta-blocker) are the first priority. While assessing pulses and obtaining imaging
are important, controlling blood pressure is the most urgent intervention to prevent fatal rupture.
Q8: A nurse is monitoring a client who is receiving heparin drip therapy for deep vein thrombosis (DVT).
The client's activated partial thromboplastin time (aPTT) is 45 seconds. Which of the following actions
should the nurse take?
A. Stop the heparin infusion immediately
B. Increase the heparin infusion rate as prescribed **[CORRECT]**
C. Continue the current infusion rate and recheck aPTT in 6 hours
D. Administer protamine sulfate
Correct Answer: B
Rationale: The therapeutic range for aPTT during heparin therapy is typically 1.5 to 2.5 times the control value (approximately
60-80 seconds). An aPTT of 45 seconds is below the therapeutic range, indicating the dose needs to be increased. Stopping
heparin and administering protamine are for overdose situations.
Q9: A nurse is teaching a client about the mechanism of action of metoprolol (Lopressor) for heart
failure. Which of the following statements by the nurse is appropriate?
A. Metoprolol increases the force of your heart's contractions.
B. Metoprolol blocks beta-1 receptors to reduce your heart rate and decrease the workload on your heart.
**[CORRECT]**
C. Metoprolol helps your body get rid of excess fluid.
D. Metoprolol increases blood flow to your kidneys.
Correct Answer: B
Rationale: Metoprolol is a beta-1 selective adrenergic antagonist (beta-blocker) that reduces heart rate, myocardial contractility,
and blood pressure, thereby decreasing the heart's oxygen demand and workload. It does not increase contractility, promote
diuresis, or directly increase renal blood flow.
Q10: A nurse is assessing a client with infective endocarditis. Which of the following findings is most
characteristic of this condition?
A. Pericardial friction rub
B. Janeway lesions and Osler nodes **[CORRECT]**
C. Pulsus paradoxus greater than 10 mmHg
D. Wide pulse pressure
Correct Answer: B
Rationale: Janeway lesions (painless, macular lesions on palms and soles) and Osler nodes (tender, raised nodules on fingers and
toes) are classic findings of infective endocarditis caused by immune complex deposition and microembolization. Pericardial
friction rub suggests pericarditis, pulsus paradoxus suggests cardiac tamponade, and wide pulse pressure suggests aortic
regurgitation.
Q11: A client with chronic heart failure is prescribed spironolactone (Aldactone). The nurse should
monitor for which of the following potential adverse effects?
A. Hypokalemia and dehydration
B. Hyperkalemia and gynecomastia **[CORRECT]**
C. Hyponatremia and hypoglycemia
D. Hypocalcemia and tinnitus
Correct Answer: B
NUR209 Comprehensive Review Examination | Page 3
