NUR 2502 Multidimensional Care III (MDC3) Exam 1 –
Comprehensive NCLEX-Style Questions with Rationales
(Reproductive & Renal Focus, Priority, Delegation, SATA,
Clinical Judgment) 2026/2027
1. A client with a urinary tract infection has just been diagnosed with acute
kidney injury. The provider ordered lab work. Which of the following abnormal
labs would the nurse expect in this client?
A. Potassium = 3.0 mEq/L
B. Potassium = 5.8 mEq/L
C. Sodium = 140 mEq/L
D. Hemoglobin = 14 g/dL
Answer: B. Potassium = 5.8 mEq/L
Rationale: Acute kidney injury (AKI) often leads to hyperkalemia due to impaired renal
excretion of potassium. A level of 3.0 is hypokalemia and not expected in AKI. Sodium and
hemoglobin may be normal initially.
2. The nurse includes which of the following in self-management teaching for a
client diagnosed with vulvovaginitis?
A. Cleanse the inner labial mucosa with water, not soap
B. Use scented feminine sprays
C. Avoid wearing cotton underwear
D. Apply heat packs to the vagina daily
Answer: A. Cleanse the inner labial mucosa with water, not soap
Rationale: Soap can disrupt the vaginal pH, increasing irritation and infection risk. Cotton
underwear is recommended, and scented products should be avoided.
3. The nurse educates a teenage client on the benefits of receiving the HPV
vaccine as protection against which type of cancer?
,A. Ovarian cancer
B. Cervical cancer
C. Breast cancer
D. Prostate cancer
Answer: B. Cervical cancer
Rationale: The HPV vaccine primarily prevents infections with high-risk HPV strains that can
lead to cervical cancer.
4. A 40-year-old woman has heavy vaginal bleeding. Which of the following
questions is the priority when evaluating the client’s chief complaint?
A. “When did your last menstrual period start?”
B. “Are you feeling weak, dizzy, or lightheaded?”
C. “Do you exercise regularly?”
D. “Have you tried any home remedies?”
Answer: B. “Are you feeling weak, dizzy, or lightheaded?”
Rationale: Assessing for hemodynamic instability (signs of shock or anemia) is the priority
over other history questions.
5. A nurse is providing education to a client diagnosed with urinary incontinence.
Which of the following should be included in the client’s teaching?
A. Maintain an ideal body weight
B. Drink caffeine to stimulate bladder
C. Avoid Kegel exercises
D. Drink large amounts of fluids at bedtime
Answer: A. Maintain an ideal body weight
Rationale: Weight management reduces pressure on the bladder, helping prevent incontinence.
Excess caffeine and fluids at night worsen symptoms.
6. A client experiencing secondary syphilis may experience which of the following
signs and symptoms? (SATA)
,A. Generalized rash
B. Headache
C. Low-grade fever
D. Painful chancre
Answer: A, B, C
Rationale: Secondary syphilis is systemic, often presenting with generalized rash, malaise,
headache, and low-grade fever. Painful chancre is characteristic of primary syphilis, not
secondary.
7. A nurse is teaching an older adult client with diabetes about preventing long-
term complications of nephropathy. Which instruction should the nurse include?
A. “Maintain stable blood glucose levels.”
B. “Avoid protein intake entirely.”
C. “Stop all physical activity.”
D. “Restrict water intake to 1 L/day.”
Answer: A. “Maintain stable blood glucose levels.”
Rationale: Tight glycemic control prevents progression of diabetic nephropathy. Protein
restriction may be individualized; hydration and activity are encouraged.
8. When educating a client, the nurse shares that which of the following is the
most common cause of chronic pyelonephritis?
A. Repeated or continued upper urinary tract infections
B. Acute glomerulonephritis
C. Dehydration
D. Hypertension
Answer: A. Repeated or continued upper urinary tract infections
Rationale: Chronic pyelonephritis is usually caused by recurrent infections or urinary tract
abnormalities that allow bacteria to ascend.
9. Which of the following is considered a modifiable risk factor for the
development of prostate cancer?
, A. Diet
B. Age
C. Genetics
D. Family history
Answer: A. Diet
Rationale: Diet, obesity, and lifestyle factors are modifiable risks. Age, genetics, and family
history are non-modifiable.
10. Which of the following are common assessment findings for a client with
acute pyelonephritis? (SATA)
A. Burning and frequency of urination
B. Flank pain
C. Fever
D. Bradycardia
Answer: A, B, C
Rationale: Clients with pyelonephritis present with urinary symptoms, flank pain, and fever.
Bradycardia is not a typical finding.
11. A nurse is caring for a client diagnosed with polycystic kidney disease. The
nurse anticipates the following interventions or treatment options except which
one?
A. Administer medications as prescribed
B. Implement low sodium diet
C. Monitor strict intake and output
D. Blood transfusion
Answer: D. Blood transfusion
Rationale: Blood transfusion is not a standard intervention for polycystic kidney disease
unless there is severe anemia. The focus is on controlling hypertension, monitoring fluid balance,
and managing pain.
Comprehensive NCLEX-Style Questions with Rationales
(Reproductive & Renal Focus, Priority, Delegation, SATA,
Clinical Judgment) 2026/2027
1. A client with a urinary tract infection has just been diagnosed with acute
kidney injury. The provider ordered lab work. Which of the following abnormal
labs would the nurse expect in this client?
A. Potassium = 3.0 mEq/L
B. Potassium = 5.8 mEq/L
C. Sodium = 140 mEq/L
D. Hemoglobin = 14 g/dL
Answer: B. Potassium = 5.8 mEq/L
Rationale: Acute kidney injury (AKI) often leads to hyperkalemia due to impaired renal
excretion of potassium. A level of 3.0 is hypokalemia and not expected in AKI. Sodium and
hemoglobin may be normal initially.
2. The nurse includes which of the following in self-management teaching for a
client diagnosed with vulvovaginitis?
A. Cleanse the inner labial mucosa with water, not soap
B. Use scented feminine sprays
C. Avoid wearing cotton underwear
D. Apply heat packs to the vagina daily
Answer: A. Cleanse the inner labial mucosa with water, not soap
Rationale: Soap can disrupt the vaginal pH, increasing irritation and infection risk. Cotton
underwear is recommended, and scented products should be avoided.
3. The nurse educates a teenage client on the benefits of receiving the HPV
vaccine as protection against which type of cancer?
,A. Ovarian cancer
B. Cervical cancer
C. Breast cancer
D. Prostate cancer
Answer: B. Cervical cancer
Rationale: The HPV vaccine primarily prevents infections with high-risk HPV strains that can
lead to cervical cancer.
4. A 40-year-old woman has heavy vaginal bleeding. Which of the following
questions is the priority when evaluating the client’s chief complaint?
A. “When did your last menstrual period start?”
B. “Are you feeling weak, dizzy, or lightheaded?”
C. “Do you exercise regularly?”
D. “Have you tried any home remedies?”
Answer: B. “Are you feeling weak, dizzy, or lightheaded?”
Rationale: Assessing for hemodynamic instability (signs of shock or anemia) is the priority
over other history questions.
5. A nurse is providing education to a client diagnosed with urinary incontinence.
Which of the following should be included in the client’s teaching?
A. Maintain an ideal body weight
B. Drink caffeine to stimulate bladder
C. Avoid Kegel exercises
D. Drink large amounts of fluids at bedtime
Answer: A. Maintain an ideal body weight
Rationale: Weight management reduces pressure on the bladder, helping prevent incontinence.
Excess caffeine and fluids at night worsen symptoms.
6. A client experiencing secondary syphilis may experience which of the following
signs and symptoms? (SATA)
,A. Generalized rash
B. Headache
C. Low-grade fever
D. Painful chancre
Answer: A, B, C
Rationale: Secondary syphilis is systemic, often presenting with generalized rash, malaise,
headache, and low-grade fever. Painful chancre is characteristic of primary syphilis, not
secondary.
7. A nurse is teaching an older adult client with diabetes about preventing long-
term complications of nephropathy. Which instruction should the nurse include?
A. “Maintain stable blood glucose levels.”
B. “Avoid protein intake entirely.”
C. “Stop all physical activity.”
D. “Restrict water intake to 1 L/day.”
Answer: A. “Maintain stable blood glucose levels.”
Rationale: Tight glycemic control prevents progression of diabetic nephropathy. Protein
restriction may be individualized; hydration and activity are encouraged.
8. When educating a client, the nurse shares that which of the following is the
most common cause of chronic pyelonephritis?
A. Repeated or continued upper urinary tract infections
B. Acute glomerulonephritis
C. Dehydration
D. Hypertension
Answer: A. Repeated or continued upper urinary tract infections
Rationale: Chronic pyelonephritis is usually caused by recurrent infections or urinary tract
abnormalities that allow bacteria to ascend.
9. Which of the following is considered a modifiable risk factor for the
development of prostate cancer?
, A. Diet
B. Age
C. Genetics
D. Family history
Answer: A. Diet
Rationale: Diet, obesity, and lifestyle factors are modifiable risks. Age, genetics, and family
history are non-modifiable.
10. Which of the following are common assessment findings for a client with
acute pyelonephritis? (SATA)
A. Burning and frequency of urination
B. Flank pain
C. Fever
D. Bradycardia
Answer: A, B, C
Rationale: Clients with pyelonephritis present with urinary symptoms, flank pain, and fever.
Bradycardia is not a typical finding.
11. A nurse is caring for a client diagnosed with polycystic kidney disease. The
nurse anticipates the following interventions or treatment options except which
one?
A. Administer medications as prescribed
B. Implement low sodium diet
C. Monitor strict intake and output
D. Blood transfusion
Answer: D. Blood transfusion
Rationale: Blood transfusion is not a standard intervention for polycystic kidney disease
unless there is severe anemia. The focus is on controlling hypertension, monitoring fluid balance,
and managing pain.
