NUR209 COMPREHENSIVE EXAM 2026/2027 | Medical
Surgical Nursing II with Questions and Answers/ Updated
2026 Graded A+/Instant Download PDF
Table of Contents
1. Cardiovascular Disorders
2. Respiratory Disorders
3. Neurological Disorders
4. Renal and Urinary Disorders
5. Gastrointestinal Disorders
6. Hepatobiliary and Pancreatic Disorders
7. Endocrine Disorders
8. Hematologic and Immunologic Disorders
9. Musculoskeletal Disorders
10. Integumentary Disorders
11. Oncology Nursing
12. Critical Care Nursing
13. Shock and Hemodynamic Management
14. Fluid, Electrolyte, and Acid-Base Balance
15. Perioperative Nursing
16. Pain Management
17. Infectious Diseases
18. Emergency Nursing
19. Multisystem Disorders
20. Professional Clinical Judgment and Prioritization
1.
A nurse is caring for a client admitted with an acute ST-segment elevation myocardial
infarction (STEMI). Two hours after successful percutaneous coronary intervention, the client
,suddenly develops hypotension, jugular venous distention, and muffled heart sounds. Which
nursing action is the priority?
A. Administer IV furosemide immediately.
B. Increase the nitroglycerin infusion.
C. Prepare the client for emergency pericardiocentesis.
D. Place the client in Trendelenburg position.
Answer: C Prepare the client for emergency pericardiocentesis
Rationale: Beck's triad indicates cardiac tamponade, a life-threatening complication
requiring immediate pericardiocentesis to relieve cardiac compression. Furosemide may
worsen hypotension, nitroglycerin further reduces preload, and Trendelenburg does not treat
the underlying mechanical obstruction.
2.
A client with acute decompensated heart failure develops worsening dyspnea despite
receiving oxygen via nasal cannula. Which assessment finding requires the nurse's
immediate intervention?
A. Bilateral ankle edema
B. Pink frothy sputum with diffuse crackles
C. Mild hepatomegaly
D. Weight gain of 1 kg over 24 hours
Answer: B Pink frothy sputum with diffuse crackles
Rationale: Pink frothy sputum indicates acute pulmonary edema requiring immediate
intervention to preserve oxygenation. Peripheral edema, hepatomegaly, and modest weight
gain reflect fluid overload but are not as immediately life-threatening.
3.
A nurse reviews arterial blood gas results for a client experiencing a severe COPD
exacerbation: pH 7.28, PaCO₂ 62 mmHg, HCO₃⁻ 29 mEq/L. Which interpretation is most
accurate?
A. Metabolic acidosis with compensation
B. Respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Fully compensated metabolic alkalosis
Answer: C Partially compensated respiratory acidosis
, Rationale: The low pH and elevated PaCO₂ indicate respiratory acidosis. The elevated
bicarbonate reflects partial renal compensation, but normalization of pH has not occurred.
The remaining options do not match the ABG pattern.
4.
A patient with bacterial meningitis suddenly becomes increasingly difficult to arouse. Which
nursing intervention has the highest priority?
A. Encourage oral fluid intake.
B. Administer prescribed stool softeners.
C. Assess for signs of increased intracranial pressure and notify the provider immediately.
D. Reposition every four hours.
Answer: C Assess for signs of increased intracranial pressure and notify the provider
immediately
Rationale: Decreased level of consciousness is a critical indicator of increased intracranial
pressure requiring rapid evaluation. Hydration, bowel care, and routine repositioning are
important but secondary priorities.
5.
A nurse is evaluating a client with acute kidney injury. Which laboratory finding most
strongly suggests worsening renal function?
A. Hemoglobin 13.5 g/dL
B. Sodium 138 mEq/L
C. Serum creatinine increased from 1.0 to 3.4 mg/dL in 48 hours
D. Potassium 4.2 mEq/L
Answer: C Serum creatinine increased from 1.0 to 3.4 mg/dL in 48 hours
Rationale: A rapid increase in serum creatinine reflects significantly reduced glomerular
filtration and progression of acute kidney injury. The remaining values are within normal
limits or less indicative of worsening renal failure.
6.
A postoperative client develops sudden unilateral leg swelling, warmth, and calf tenderness.
Which nursing action is most appropriate?
Surgical Nursing II with Questions and Answers/ Updated
2026 Graded A+/Instant Download PDF
Table of Contents
1. Cardiovascular Disorders
2. Respiratory Disorders
3. Neurological Disorders
4. Renal and Urinary Disorders
5. Gastrointestinal Disorders
6. Hepatobiliary and Pancreatic Disorders
7. Endocrine Disorders
8. Hematologic and Immunologic Disorders
9. Musculoskeletal Disorders
10. Integumentary Disorders
11. Oncology Nursing
12. Critical Care Nursing
13. Shock and Hemodynamic Management
14. Fluid, Electrolyte, and Acid-Base Balance
15. Perioperative Nursing
16. Pain Management
17. Infectious Diseases
18. Emergency Nursing
19. Multisystem Disorders
20. Professional Clinical Judgment and Prioritization
1.
A nurse is caring for a client admitted with an acute ST-segment elevation myocardial
infarction (STEMI). Two hours after successful percutaneous coronary intervention, the client
,suddenly develops hypotension, jugular venous distention, and muffled heart sounds. Which
nursing action is the priority?
A. Administer IV furosemide immediately.
B. Increase the nitroglycerin infusion.
C. Prepare the client for emergency pericardiocentesis.
D. Place the client in Trendelenburg position.
Answer: C Prepare the client for emergency pericardiocentesis
Rationale: Beck's triad indicates cardiac tamponade, a life-threatening complication
requiring immediate pericardiocentesis to relieve cardiac compression. Furosemide may
worsen hypotension, nitroglycerin further reduces preload, and Trendelenburg does not treat
the underlying mechanical obstruction.
2.
A client with acute decompensated heart failure develops worsening dyspnea despite
receiving oxygen via nasal cannula. Which assessment finding requires the nurse's
immediate intervention?
A. Bilateral ankle edema
B. Pink frothy sputum with diffuse crackles
C. Mild hepatomegaly
D. Weight gain of 1 kg over 24 hours
Answer: B Pink frothy sputum with diffuse crackles
Rationale: Pink frothy sputum indicates acute pulmonary edema requiring immediate
intervention to preserve oxygenation. Peripheral edema, hepatomegaly, and modest weight
gain reflect fluid overload but are not as immediately life-threatening.
3.
A nurse reviews arterial blood gas results for a client experiencing a severe COPD
exacerbation: pH 7.28, PaCO₂ 62 mmHg, HCO₃⁻ 29 mEq/L. Which interpretation is most
accurate?
A. Metabolic acidosis with compensation
B. Respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Fully compensated metabolic alkalosis
Answer: C Partially compensated respiratory acidosis
, Rationale: The low pH and elevated PaCO₂ indicate respiratory acidosis. The elevated
bicarbonate reflects partial renal compensation, but normalization of pH has not occurred.
The remaining options do not match the ABG pattern.
4.
A patient with bacterial meningitis suddenly becomes increasingly difficult to arouse. Which
nursing intervention has the highest priority?
A. Encourage oral fluid intake.
B. Administer prescribed stool softeners.
C. Assess for signs of increased intracranial pressure and notify the provider immediately.
D. Reposition every four hours.
Answer: C Assess for signs of increased intracranial pressure and notify the provider
immediately
Rationale: Decreased level of consciousness is a critical indicator of increased intracranial
pressure requiring rapid evaluation. Hydration, bowel care, and routine repositioning are
important but secondary priorities.
5.
A nurse is evaluating a client with acute kidney injury. Which laboratory finding most
strongly suggests worsening renal function?
A. Hemoglobin 13.5 g/dL
B. Sodium 138 mEq/L
C. Serum creatinine increased from 1.0 to 3.4 mg/dL in 48 hours
D. Potassium 4.2 mEq/L
Answer: C Serum creatinine increased from 1.0 to 3.4 mg/dL in 48 hours
Rationale: A rapid increase in serum creatinine reflects significantly reduced glomerular
filtration and progression of acute kidney injury. The remaining values are within normal
limits or less indicative of worsening renal failure.
6.
A postoperative client develops sudden unilateral leg swelling, warmth, and calf tenderness.
Which nursing action is most appropriate?
