MDC 3{NUR 2502} : MULTIDIMENSIONAL CARE III
RASMUSSEN UNIVERSITY | 2026/2027 ACADEMIC YEAR
Medical-Surgical Nursing
50 Verified Questions and Answers with Expert Rationales | Comprehensive
Instructions: Select the best answer for each question. This comprehensive exam covers
all core concepts for MDC 3 (NUR 2502). Each question includes a verified correct
answer and detailed rationale.
UNIT 1: CARDIOVASCULAR DISORDERS (Questions 1-10)
Q1. A 68-year-old patient with a history of heart failure with reduced ejection
fraction (HFrEF) is admitted with worsening dyspnea, orthopnea, and 3+ pitting
edema in the lower extremities. Vital signs: BP 158/92, HR 112, RR 24, O2 saturation
88% on room air. The patient's weight has increased 8 pounds since their last clinic
visit 5 days ago. Which intervention should the nurse implement FIRST?
A. Administer intravenous furosemide 40 mg as prescribed
B. Place the patient in high-Fowler's position with legs dependent
C. Draw blood for BNP, troponin, and basic metabolic panel
D. Apply oxygen via nasal cannula at 2-4 L/min and reassess saturation [CORRECT]
Correct Answer: D
Rationale: Airway and breathing are always the priority in patient care (ABCs). This
patient is hypoxic with an O2 saturation of 88%, which requires immediate intervention
to prevent tissue hypoxia and end-organ damage. While furosemide (A) addresses the
fluid overload causing pulmonary congestion, oxygenation must be established first to
ensure patient safety. Positioning in high-Fowler's (B) is appropriate to facilitate
breathing but is secondary to oxygen administration. Drawing labs (C) is important for
diagnostic purposes but does not address the immediate life threat of hypoxemia. After
,oxygenation is optimized, the nurse should then administer diuretics, maintain upright
positioning, and obtain ordered labs to guide ongoing treatment.
Q2. A patient receiving a heparin infusion for treatment of a pulmonary embolism
has an aPTT of 110 seconds (therapeutic range 60-80 seconds). The patient reports
sudden onset of severe headache and blurred vision. What is the nurse's priority
action?
A. Administer acetaminophen for the headache
B. Stop the heparin infusion immediately [CORRECT]
C. Notify the healthcare provider of the aPTT result
D. Prepare to administer protamine sulfate
Correct Answer: B
Rationale: The priority action is to stop the heparin infusion immediately because the
patient is exhibiting signs of intracranial hemorrhage (severe headache, blurred vision)
with a supratherapeutic aPTT. Anticoagulation therapy must be discontinued first to
prevent further bleeding. While notifying the healthcare provider (C) is essential,
stopping the infusion is the immediate nursing action that can be taken independently.
Acetaminophen (A) would mask symptoms and delay recognition of a life-threatening
event. Protamine sulfate (D) is the antidote for heparin and may be needed, but it
requires a healthcare provider's order and is not the first action; stopping the infusion is
within the nurse's scope of practice and must occur first.
Q3. The nurse is assessing a patient 2 hours after cardiac catheterization via the
right femoral artery. Which finding requires immediate notification of the healthcare
provider?
A. A small amount of serosanguineous drainage at the insertion site
B. The right foot is cool to touch with capillary refill of 6 seconds [CORRECT]
C. The patient reports thirst and requests water
D. A palpable hematoma measuring 1 cm at the insertion site
Correct Answer: B
, Rationale: A cool extremity with delayed capillary refill indicates arterial insufficiency,
suggesting possible thrombus formation, arterial occlusion, or embolism distal to the
catheterization site. This is a vascular emergency requiring immediate intervention to
prevent tissue necrosis and potential limb loss. A small amount of serosanguineous
drainage (A) is normal at the puncture site. Thirst (C) is common due to contrast dye-
induced diuresis and NPO status. A small palpable hematoma (D) is common, though
larger expanding hematomas would be concerning. The nurse should mark and monitor
any hematoma, but a 1cm hematoma without expansion is less urgent than vascular
compromise.
Q4. A patient with heart failure is receiving digoxin 0.125 mg daily. Which
assessment finding would indicate digoxin toxicity and require holding the
medication?
A. Serum potassium level of 4.2 mEq/L
B. Heart rate of 72 and regular
C. Patient reports seeing yellow halos around lights [CORRECT]
D. Blood pressure of 128/76
Correct Answer: C
Rationale: Visual disturbances, including yellow-green halos, blurred vision, or
photophobia, are classic signs of digoxin toxicity. Other symptoms include nausea,
vomiting, anorexia, confusion, and cardiac dysrhythmias. The nurse should hold the
medication and obtain a digoxin level and potassium level, as hypokalemia increases the
risk of toxicity. Normal potassium (A) and normal vital signs (B, D) are reassuring but do
not rule out toxicity. Digoxin toxicity can occur even with therapeutic levels, especially in
patients with renal impairment or electrolyte imbalances.
Q5. The nurse is caring for a patient with acute coronary syndrome who is receiving
nitroglycerin intravenously. Which assessment finding requires the most immediate
action?
A. Patient reports a mild headache rated 3/10
B. Blood pressure decreases from 128/76 to 92/50 [CORRECT]
RASMUSSEN UNIVERSITY | 2026/2027 ACADEMIC YEAR
Medical-Surgical Nursing
50 Verified Questions and Answers with Expert Rationales | Comprehensive
Instructions: Select the best answer for each question. This comprehensive exam covers
all core concepts for MDC 3 (NUR 2502). Each question includes a verified correct
answer and detailed rationale.
UNIT 1: CARDIOVASCULAR DISORDERS (Questions 1-10)
Q1. A 68-year-old patient with a history of heart failure with reduced ejection
fraction (HFrEF) is admitted with worsening dyspnea, orthopnea, and 3+ pitting
edema in the lower extremities. Vital signs: BP 158/92, HR 112, RR 24, O2 saturation
88% on room air. The patient's weight has increased 8 pounds since their last clinic
visit 5 days ago. Which intervention should the nurse implement FIRST?
A. Administer intravenous furosemide 40 mg as prescribed
B. Place the patient in high-Fowler's position with legs dependent
C. Draw blood for BNP, troponin, and basic metabolic panel
D. Apply oxygen via nasal cannula at 2-4 L/min and reassess saturation [CORRECT]
Correct Answer: D
Rationale: Airway and breathing are always the priority in patient care (ABCs). This
patient is hypoxic with an O2 saturation of 88%, which requires immediate intervention
to prevent tissue hypoxia and end-organ damage. While furosemide (A) addresses the
fluid overload causing pulmonary congestion, oxygenation must be established first to
ensure patient safety. Positioning in high-Fowler's (B) is appropriate to facilitate
breathing but is secondary to oxygen administration. Drawing labs (C) is important for
diagnostic purposes but does not address the immediate life threat of hypoxemia. After
,oxygenation is optimized, the nurse should then administer diuretics, maintain upright
positioning, and obtain ordered labs to guide ongoing treatment.
Q2. A patient receiving a heparin infusion for treatment of a pulmonary embolism
has an aPTT of 110 seconds (therapeutic range 60-80 seconds). The patient reports
sudden onset of severe headache and blurred vision. What is the nurse's priority
action?
A. Administer acetaminophen for the headache
B. Stop the heparin infusion immediately [CORRECT]
C. Notify the healthcare provider of the aPTT result
D. Prepare to administer protamine sulfate
Correct Answer: B
Rationale: The priority action is to stop the heparin infusion immediately because the
patient is exhibiting signs of intracranial hemorrhage (severe headache, blurred vision)
with a supratherapeutic aPTT. Anticoagulation therapy must be discontinued first to
prevent further bleeding. While notifying the healthcare provider (C) is essential,
stopping the infusion is the immediate nursing action that can be taken independently.
Acetaminophen (A) would mask symptoms and delay recognition of a life-threatening
event. Protamine sulfate (D) is the antidote for heparin and may be needed, but it
requires a healthcare provider's order and is not the first action; stopping the infusion is
within the nurse's scope of practice and must occur first.
Q3. The nurse is assessing a patient 2 hours after cardiac catheterization via the
right femoral artery. Which finding requires immediate notification of the healthcare
provider?
A. A small amount of serosanguineous drainage at the insertion site
B. The right foot is cool to touch with capillary refill of 6 seconds [CORRECT]
C. The patient reports thirst and requests water
D. A palpable hematoma measuring 1 cm at the insertion site
Correct Answer: B
, Rationale: A cool extremity with delayed capillary refill indicates arterial insufficiency,
suggesting possible thrombus formation, arterial occlusion, or embolism distal to the
catheterization site. This is a vascular emergency requiring immediate intervention to
prevent tissue necrosis and potential limb loss. A small amount of serosanguineous
drainage (A) is normal at the puncture site. Thirst (C) is common due to contrast dye-
induced diuresis and NPO status. A small palpable hematoma (D) is common, though
larger expanding hematomas would be concerning. The nurse should mark and monitor
any hematoma, but a 1cm hematoma without expansion is less urgent than vascular
compromise.
Q4. A patient with heart failure is receiving digoxin 0.125 mg daily. Which
assessment finding would indicate digoxin toxicity and require holding the
medication?
A. Serum potassium level of 4.2 mEq/L
B. Heart rate of 72 and regular
C. Patient reports seeing yellow halos around lights [CORRECT]
D. Blood pressure of 128/76
Correct Answer: C
Rationale: Visual disturbances, including yellow-green halos, blurred vision, or
photophobia, are classic signs of digoxin toxicity. Other symptoms include nausea,
vomiting, anorexia, confusion, and cardiac dysrhythmias. The nurse should hold the
medication and obtain a digoxin level and potassium level, as hypokalemia increases the
risk of toxicity. Normal potassium (A) and normal vital signs (B, D) are reassuring but do
not rule out toxicity. Digoxin toxicity can occur even with therapeutic levels, especially in
patients with renal impairment or electrolyte imbalances.
Q5. The nurse is caring for a patient with acute coronary syndrome who is receiving
nitroglycerin intravenously. Which assessment finding requires the most immediate
action?
A. Patient reports a mild headache rated 3/10
B. Blood pressure decreases from 128/76 to 92/50 [CORRECT]
