NUR 209
MEDICAL-SURGICAL NURSING II
EXAM 1 | PRACTICE REVIEW
75 ORIGINAL QUESTIONS
Answers and Nursing Rationales
Oncology and Cancer Care
Fluid and Electrolyte Balance
Acid-Base / Arterial Blood Gases
Integumentary Conditions and Burns
Diabetes and Endocrine Disorders
FORTIS COLLEGE | CURRICULUM-INFORMED
Review Edition
Independent educational resource - not an official examination or affiliated product
,NUR 209 | MEDICAL-SURGICAL NURSING II EXAM 1 - ORIGINAL PRACTICE REVIEW
HOW TO USE THIS RESOURCE
Purpose. This independent 75-question collection supports nursing reasoning in the early NUR 209 topics
identified in public Fortis course materials. The questions and rationales are newly authored; they are not copied
from, verified against, or presented as a live Fortis examination.
Evidence basis. The official course catalog verifies the overall NUR 209 curriculum. A publicly shared 2024 Norfolk
syllabus and an October 2025 student concept-map preview support the topical emphasis used here. A current October
2026 campus-specific Exam 1 blueprint has not been authenticated; topic weighting and test dates may differ by campus
or instructor.
Format. 75 single-best-answer questions, organized by domain. Each question includes four options, the supported
answer, and a concise clinical rationale. A rapid answer index and reference list are provided at the end.
TOPIC COVERAGE
Domain Questions Purpose
Oncology and Cancer Nursing 1-15 (15) Staging, cancer warning signs, treatment effects, prioritization
Fluid and Electrolytes 16-33 (18) Volume changes, sodium, potassium, calcium, magnesium,
tonicity
Acid-Base and ABGs 34-46 (13) Interpret primary disturbance and physiologic compensation
Integumentary and Burns 47-60 (14) Burn depth, circulation, inhalation risk, skin lesions
Diabetes and Endocrine 61-75 (15) DKA/HHS, glucose changes, thyroid, adrenal and ADH
disorders
SCOPE AND PROFESSIONAL USE
These are classroom case questions for conceptual learning. They do not replace a current syllabus, clinical protocols,
licensed supervision, institutional policies, or professional medical judgment. Lab reference ranges vary by facility. If a
buyer supplies a current campus blueprint, compare it before advertising exam-specific alignment.
Independent 2026/2027 educational edition | Fortis course-informed Page 2
,NUR 209 | MEDICAL-SURGICAL NURSING II EXAM 1 - ORIGINAL PRACTICE REVIEW
QUICK REFERENCE | CORE CONCEPTS
Values below are typical adult reference intervals; verify the local laboratory reference range when interpreting a real patient result.
Measure Typical adult reference Core interpretation
Arterial pH 7.35-7.45 Below: acidemia; above: alkalemia
PaCO2 35-45 mm Hg Respiratory component
HCO3 22-26 mEq/L Metabolic component
Serum sodium 135-145 mEq/L Water balance and neurologic impact
Serum potassium 3.5-5.0 mEq/L Neuromuscular and cardiac activity
Total calcium ~8.5-10.5 mg/dL Interpret with albumin and clinical context
FOUR PRIMARY ACID-BASE PATTERNS
Pattern pH Primary change
Respiratory acidosis Low PaCO2 increases
Respiratory alkalosis High PaCO2 decreases
Metabolic acidosis Low HCO3 decreases
Metabolic alkalosis High HCO3 increases
PRIORITY FRAMEWORK
Airway and breathing: interpret smoke exposure, hoarseness, respiratory changes, and significant ABG abnormalities
promptly. Circulation: recognize fluid volume changes, potassium-related dysrhythmia risk, and poor distal perfusion.
Neurologic changes: confusion or seizures with low sodium or glucose require urgent assessment. Infection: fever during
severe immune suppression is a serious warning sign.
Topic scope aligns primarily with the publicly accessible Fortis 2024 Week 1-2 themes and the 2025 student concept-map preview.
Renal topics appear in Week 3 in the 2024 syllabus; consequently they are not claimed as a confirmed Exam 1 domain here.
Independent 2026/2027 educational edition | Fortis course-informed Page 3
, NUR 209 | MEDICAL-SURGICAL NURSING II EXAM 1 - ORIGINAL PRACTICE REVIEW
ONCOLOGY & CANCER NURSING
High-yield concepts: TNM staging versus histologic grade; ABCDE melanoma warning features; neutropenia and infection;
thrombocytopenia; symptom assessment; urgent oncologic neurologic signs.
QUESTION 01 | A pathology report states T2N1M0. What does the N category describe?
A. Histologic tumor grade
B. Regional lymph-node involvement
C. Distant organ metastasis
D. Cancer treatment response
ANSWER B - Regional lymph-node involvement
Rationale. In TNM staging, T characterizes the primary tumor, N regional lymph nodes, and M distant metastasis. N1 denotes
regional node involvement defined for that cancer type.
QUESTION 02 | A patient reports that a longstanding mole has become asymmetrical and developed multiple
colors. Which interpretation is best?
A. Changes warrant professional assessment for possible melanoma
B. Any mole with several colors is definitely benign
C. Melanoma only develops in moles larger than 10 mm
D. Normal aging explains all changes in a mole
ANSWER A - Changes warrant professional assessment for possible melanoma
Rationale. Evolution, asymmetry, irregular borders, and varied color are ABCDE warning features. They require clinical
assessment; appearance alone does not confirm a diagnosis.
QUESTION 03 | Which statement accurately distinguishes cancer staging from grading?
A. Grade describes distant spread; stage describes cell appearance
B. Both terms describe only tumor diameter
C. Stage describes extent of spread; grade describes cellular differentiation
D. A high grade always means distant metastasis
ANSWER C - Stage describes extent of spread; grade describes cellular differentiation
Rationale. Stage assesses extent of disease, including spread. Grade describes how abnormal tumor cells appear and how they
differ from normal tissue; the concepts are related but distinct.
Independent 2026/2027 educational edition | Fortis course-informed Page 4
MEDICAL-SURGICAL NURSING II
EXAM 1 | PRACTICE REVIEW
75 ORIGINAL QUESTIONS
Answers and Nursing Rationales
Oncology and Cancer Care
Fluid and Electrolyte Balance
Acid-Base / Arterial Blood Gases
Integumentary Conditions and Burns
Diabetes and Endocrine Disorders
FORTIS COLLEGE | CURRICULUM-INFORMED
Review Edition
Independent educational resource - not an official examination or affiliated product
,NUR 209 | MEDICAL-SURGICAL NURSING II EXAM 1 - ORIGINAL PRACTICE REVIEW
HOW TO USE THIS RESOURCE
Purpose. This independent 75-question collection supports nursing reasoning in the early NUR 209 topics
identified in public Fortis course materials. The questions and rationales are newly authored; they are not copied
from, verified against, or presented as a live Fortis examination.
Evidence basis. The official course catalog verifies the overall NUR 209 curriculum. A publicly shared 2024 Norfolk
syllabus and an October 2025 student concept-map preview support the topical emphasis used here. A current October
2026 campus-specific Exam 1 blueprint has not been authenticated; topic weighting and test dates may differ by campus
or instructor.
Format. 75 single-best-answer questions, organized by domain. Each question includes four options, the supported
answer, and a concise clinical rationale. A rapid answer index and reference list are provided at the end.
TOPIC COVERAGE
Domain Questions Purpose
Oncology and Cancer Nursing 1-15 (15) Staging, cancer warning signs, treatment effects, prioritization
Fluid and Electrolytes 16-33 (18) Volume changes, sodium, potassium, calcium, magnesium,
tonicity
Acid-Base and ABGs 34-46 (13) Interpret primary disturbance and physiologic compensation
Integumentary and Burns 47-60 (14) Burn depth, circulation, inhalation risk, skin lesions
Diabetes and Endocrine 61-75 (15) DKA/HHS, glucose changes, thyroid, adrenal and ADH
disorders
SCOPE AND PROFESSIONAL USE
These are classroom case questions for conceptual learning. They do not replace a current syllabus, clinical protocols,
licensed supervision, institutional policies, or professional medical judgment. Lab reference ranges vary by facility. If a
buyer supplies a current campus blueprint, compare it before advertising exam-specific alignment.
Independent 2026/2027 educational edition | Fortis course-informed Page 2
,NUR 209 | MEDICAL-SURGICAL NURSING II EXAM 1 - ORIGINAL PRACTICE REVIEW
QUICK REFERENCE | CORE CONCEPTS
Values below are typical adult reference intervals; verify the local laboratory reference range when interpreting a real patient result.
Measure Typical adult reference Core interpretation
Arterial pH 7.35-7.45 Below: acidemia; above: alkalemia
PaCO2 35-45 mm Hg Respiratory component
HCO3 22-26 mEq/L Metabolic component
Serum sodium 135-145 mEq/L Water balance and neurologic impact
Serum potassium 3.5-5.0 mEq/L Neuromuscular and cardiac activity
Total calcium ~8.5-10.5 mg/dL Interpret with albumin and clinical context
FOUR PRIMARY ACID-BASE PATTERNS
Pattern pH Primary change
Respiratory acidosis Low PaCO2 increases
Respiratory alkalosis High PaCO2 decreases
Metabolic acidosis Low HCO3 decreases
Metabolic alkalosis High HCO3 increases
PRIORITY FRAMEWORK
Airway and breathing: interpret smoke exposure, hoarseness, respiratory changes, and significant ABG abnormalities
promptly. Circulation: recognize fluid volume changes, potassium-related dysrhythmia risk, and poor distal perfusion.
Neurologic changes: confusion or seizures with low sodium or glucose require urgent assessment. Infection: fever during
severe immune suppression is a serious warning sign.
Topic scope aligns primarily with the publicly accessible Fortis 2024 Week 1-2 themes and the 2025 student concept-map preview.
Renal topics appear in Week 3 in the 2024 syllabus; consequently they are not claimed as a confirmed Exam 1 domain here.
Independent 2026/2027 educational edition | Fortis course-informed Page 3
, NUR 209 | MEDICAL-SURGICAL NURSING II EXAM 1 - ORIGINAL PRACTICE REVIEW
ONCOLOGY & CANCER NURSING
High-yield concepts: TNM staging versus histologic grade; ABCDE melanoma warning features; neutropenia and infection;
thrombocytopenia; symptom assessment; urgent oncologic neurologic signs.
QUESTION 01 | A pathology report states T2N1M0. What does the N category describe?
A. Histologic tumor grade
B. Regional lymph-node involvement
C. Distant organ metastasis
D. Cancer treatment response
ANSWER B - Regional lymph-node involvement
Rationale. In TNM staging, T characterizes the primary tumor, N regional lymph nodes, and M distant metastasis. N1 denotes
regional node involvement defined for that cancer type.
QUESTION 02 | A patient reports that a longstanding mole has become asymmetrical and developed multiple
colors. Which interpretation is best?
A. Changes warrant professional assessment for possible melanoma
B. Any mole with several colors is definitely benign
C. Melanoma only develops in moles larger than 10 mm
D. Normal aging explains all changes in a mole
ANSWER A - Changes warrant professional assessment for possible melanoma
Rationale. Evolution, asymmetry, irregular borders, and varied color are ABCDE warning features. They require clinical
assessment; appearance alone does not confirm a diagnosis.
QUESTION 03 | Which statement accurately distinguishes cancer staging from grading?
A. Grade describes distant spread; stage describes cell appearance
B. Both terms describe only tumor diameter
C. Stage describes extent of spread; grade describes cellular differentiation
D. A high grade always means distant metastasis
ANSWER C - Stage describes extent of spread; grade describes cellular differentiation
Rationale. Stage assesses extent of disease, including spread. Grade describes how abnormal tumor cells appear and how they
differ from normal tissue; the concepts are related but distinct.
Independent 2026/2027 educational edition | Fortis course-informed Page 4
