Exam 2: NUR 209/ NUR 209 (Latest 2026/ 2027 Update) Medical Surgical Nursing II: Med-Surg Review| Questions and Answers| Grade A| 100% Correct (Verified Solutions) – Fortis

INSTANT PDF DOWNLOAD — This official test bank for NUR 209 Exam 2 Medical Surgical Nursing II at Fortis College covers all content for the 2026/2027 academic year second examination. It contains verified questions and answers with detailed rationales in multiple-choice, select-all-that-apply (SATA), ordered response, and clinical scenario formats aligned with nursing program standards. ENDOCRINE DISORDERS (EXAM 2 FOCUS) DIABETES MELLITUS Type 1 Diabetes Mellitus – Autoimmune destruction of pancreatic beta cells → absolute insulin deficiency. Onset typically 30 years, sudden, thin, ketosis prone. Treatment: insulin required (lifelong). Diabetic ketoacidosis (DKA) risk. A1C goal 7% (6.5% for some). Diagnostic criteria: fasting plasma glucose ≥126 mg/dL (8 hours no food), random plasma glucose ≥200 mg/dL with symptoms, OGTT 2-hour ≥200 mg/dL, A1C ≥6.5%. Type 2 Diabetes Mellitus – Insulin resistance with relative insulin deficiency, not absolute. Onset typically 30 years, insidious, overweight/obese, strong genetic component. Ketosis resistant (ketoacidosis less common). Treatment: lifestyle modifications (diet, exercise, weight loss), oral antidiabetic agents (metformin first-line), GLP-1 agonists, SGLT2 inhibitors, insulin if needed. Gestational Diabetes Mellitus (GDM) – Glucose intolerance first diagnosed during pregnancy (usually 24-28 weeks gestation). Risk factors: obesity, advanced maternal age, family history of diabetes, previous GDM, previous macrosomic infant 9 lbs. Screening: 1-hour glucose challenge test (50g glucose – threshold 130-140 mg/dL). Diagnosis: 3-hour OGTT (100g glucose). Treatment: dietary modifications, blood glucose monitoring, insulin if needed (oral agents may be used but insulin is gold standard). Increased risk of developing Type 2 DM later in life. Diabetic Ketoacidosis (DKA) – Life-threatening complication of Type 1 DM (can occur in Type 2 with severe stress). Pathophysiology: absolute insulin deficiency → increased counterregulatory hormones (glucagon, cortisol, epinephrine, growth hormone) → increased hepatic glucose production (hyperglycemia) and lipolysis (ketogenesis) → metabolic acidosis. Precipitating factors: illness/infection (most common), missed insulin doses, new diagnosis, physiological stress (surgery, MI), medications (steroids, SGLT2 inhibitors). Assessment findings: polyuria, polydipsia, weakness, nausea, vomiting, abdominal pain, Kussmaul respirations (deep, rapid breathing), fruity breath odor (acetone), dehydration (poor skin turgor, dry mucous membranes, tachycardia, hypotension), altered mental status (confusion to coma). Diagnostic criteria: blood glucose 250 mg/dL, pH 7.3, HCO3 15 mEq/L, ketonemia (positive serum ketones) or ketonuria, anion gap 12. Treatment: IV fluids (NS 1L first hour, then 0.45% NS, D5NS