NUR 2502 / NUR2502 Final Exam: Multidimensional
Care III / MDC 3 – Rasmussen Actual Exam –
Complete Questions and Answers with Detailed
Rationales – Pass Guaranteed – A+ Graded
Foundations: Multidimensional Care Concepts & Complex Patient Management
Q1: A patient in the ICU has a serum sodium of 128 mEq/L. Which clinical manifestation
would the nurse expect to assess?
A. Hyperactive reflexes and tetany
B. Muscle weakness, headache, and possible seizures [CORRECT]
C. Widened QRS complex and peaked T waves
D. Positive Chvostek's sign and carpopedal spasms
Correct Answer: B
Rationale: Hyponatremia causes water to shift into cells, leading to cerebral edema that
presents with headache, confusion, muscle weakness, and potential seizures. The best
answer is B because these are classic signs of low sodium that you need to recognize
quickly in complex care.
Q2: A patient with acute kidney injury has a serum potassium of 6.2 mEq/L. Which
intervention is the priority?
A. Administer oral kayexalate immediately
B. Prepare the patient for emergent dialysis
C. Obtain a 12-lead ECG and administer calcium gluconate per protocol [CORRECT]
D. Encourage the patient to drink plenty of fluids
Correct Answer: C
Rationale: Hyperkalemia at this level can cause fatal dysrhythmias, so the priority is
protecting the heart first with calcium gluconate while getting an ECG to assess for
peaked T waves or QRS widening. This aligns with the evidence-based protocol for
,managing life-threatening potassium levels before shifting potassium out of the
vascular space.
Q3: A patient with diabetic ketoacidosis has the following arterial blood gas: pH 7.25,
PaCO2 28 mmHg, HCO3 14 mEq/L. How would the nurse interpret these results?
A. Respiratory acidosis with partial compensation
B. Metabolic acidosis with respiratory compensation [CORRECT]
C. Metabolic alkalosis with full compensation
D. Respiratory alkalosis with metabolic compensation
Correct Answer: B
Rationale: The low pH tells us it's acidosis, the low bicarbonate confirms it's metabolic
in origin, and the low PaCO2 shows the lungs are trying to compensate by blowing off
carbon dioxide. Given this patient's presentation with DKA, this interpretation guides
your priority interventions.
Q4: A patient with hypocalcemia is receiving IV calcium gluconate. Which assessment
finding indicates the medication is effective?
A. Resolution of tingling around the mouth and fingers
B. Decreased blood pressure and slower heart rate
C. Absence of muscle cramps and improved Chvostek's sign [CORRECT]
D. Increased urine output and decreased respiratory rate
Correct Answer: C
Rationale: The best answer is C because hypocalcemia causes neuromuscular
irritability seen as muscle cramps, tetany, and a positive Chvostek's sign, so
improvement in these clinical indicators tells you the calcium replacement is working.
You would also continue monitoring for ECG changes since prolonged QT intervals can
occur with low calcium levels.
Q5: Which acid-base disorder is commonly associated with severe vomiting and
nasogastric suctioning?
A. Metabolic acidosis from bicarbonate loss
B. Metabolic alkalosis from hydrogen ion loss [CORRECT]
C. Respiratory acidosis from hypoventilation
D. Respiratory alkalosis from hyperventilation
Correct Answer: B
, Rationale: When stomach acid is lost through vomiting or NG suction, hydrogen ions are
depleted and bicarbonate increases relative to acid, creating a metabolic alkalosis. This
is correct because in multidimensional care we see this frequently with postoperative
patients who have prolonged NG decompression.
Q6: A nurse is caring for four patients on a step-down unit. Which patient should the
nurse assess first?
A. A patient 2 hours post-op who is requesting pain medication
B. A patient with heart failure whose oxygen saturation dropped from 94% to 88%
[CORRECT]
C. A patient with CKD who needs discharge teaching completed
D. A patient with diabetes who is due for a routine blood glucose check
Correct Answer: B
Rationale: The best answer is B because in complex patient management we always
prioritize using the ABC framework, and a dropping oxygen saturation indicates a
potential respiratory compromise that could rapidly deteriorate. The other patients have
needs that are important but not immediately life-threatening.
Q7: A patient with respiratory alkalosis has an ABG showing pH 7.50, PaCO2 30 mmHg,
and HCO3 24 mEq/L. What is the most likely cause?
A. Opioid overdose causing hypoventilation
B. Anxiety-induced hyperventilation or pain [CORRECT]
C. Severe diarrhea with bicarbonate loss
D. Diabetic ketoacidosis with compensatory breathing
Correct Answer: B
Rationale: Respiratory alkalosis is driven by a low PaCO2 from blowing off too much
carbon dioxide, which commonly happens with anxiety, pain, or early hypoxemia where
the patient is breathing fast. This aligns with what we see in clinical practice when
patients are anxious or in significant discomfort.
Q8: A patient with Cushing's syndrome develops severe hypokalemia. Which cardiac
rhythm change is the nurse most concerned about?
A. Flattened T waves and the appearance of U waves [CORRECT]
B. Peaked T waves and widened QRS complexes
C. Shortened QT interval and bradycardia
Care III / MDC 3 – Rasmussen Actual Exam –
Complete Questions and Answers with Detailed
Rationales – Pass Guaranteed – A+ Graded
Foundations: Multidimensional Care Concepts & Complex Patient Management
Q1: A patient in the ICU has a serum sodium of 128 mEq/L. Which clinical manifestation
would the nurse expect to assess?
A. Hyperactive reflexes and tetany
B. Muscle weakness, headache, and possible seizures [CORRECT]
C. Widened QRS complex and peaked T waves
D. Positive Chvostek's sign and carpopedal spasms
Correct Answer: B
Rationale: Hyponatremia causes water to shift into cells, leading to cerebral edema that
presents with headache, confusion, muscle weakness, and potential seizures. The best
answer is B because these are classic signs of low sodium that you need to recognize
quickly in complex care.
Q2: A patient with acute kidney injury has a serum potassium of 6.2 mEq/L. Which
intervention is the priority?
A. Administer oral kayexalate immediately
B. Prepare the patient for emergent dialysis
C. Obtain a 12-lead ECG and administer calcium gluconate per protocol [CORRECT]
D. Encourage the patient to drink plenty of fluids
Correct Answer: C
Rationale: Hyperkalemia at this level can cause fatal dysrhythmias, so the priority is
protecting the heart first with calcium gluconate while getting an ECG to assess for
peaked T waves or QRS widening. This aligns with the evidence-based protocol for
,managing life-threatening potassium levels before shifting potassium out of the
vascular space.
Q3: A patient with diabetic ketoacidosis has the following arterial blood gas: pH 7.25,
PaCO2 28 mmHg, HCO3 14 mEq/L. How would the nurse interpret these results?
A. Respiratory acidosis with partial compensation
B. Metabolic acidosis with respiratory compensation [CORRECT]
C. Metabolic alkalosis with full compensation
D. Respiratory alkalosis with metabolic compensation
Correct Answer: B
Rationale: The low pH tells us it's acidosis, the low bicarbonate confirms it's metabolic
in origin, and the low PaCO2 shows the lungs are trying to compensate by blowing off
carbon dioxide. Given this patient's presentation with DKA, this interpretation guides
your priority interventions.
Q4: A patient with hypocalcemia is receiving IV calcium gluconate. Which assessment
finding indicates the medication is effective?
A. Resolution of tingling around the mouth and fingers
B. Decreased blood pressure and slower heart rate
C. Absence of muscle cramps and improved Chvostek's sign [CORRECT]
D. Increased urine output and decreased respiratory rate
Correct Answer: C
Rationale: The best answer is C because hypocalcemia causes neuromuscular
irritability seen as muscle cramps, tetany, and a positive Chvostek's sign, so
improvement in these clinical indicators tells you the calcium replacement is working.
You would also continue monitoring for ECG changes since prolonged QT intervals can
occur with low calcium levels.
Q5: Which acid-base disorder is commonly associated with severe vomiting and
nasogastric suctioning?
A. Metabolic acidosis from bicarbonate loss
B. Metabolic alkalosis from hydrogen ion loss [CORRECT]
C. Respiratory acidosis from hypoventilation
D. Respiratory alkalosis from hyperventilation
Correct Answer: B
, Rationale: When stomach acid is lost through vomiting or NG suction, hydrogen ions are
depleted and bicarbonate increases relative to acid, creating a metabolic alkalosis. This
is correct because in multidimensional care we see this frequently with postoperative
patients who have prolonged NG decompression.
Q6: A nurse is caring for four patients on a step-down unit. Which patient should the
nurse assess first?
A. A patient 2 hours post-op who is requesting pain medication
B. A patient with heart failure whose oxygen saturation dropped from 94% to 88%
[CORRECT]
C. A patient with CKD who needs discharge teaching completed
D. A patient with diabetes who is due for a routine blood glucose check
Correct Answer: B
Rationale: The best answer is B because in complex patient management we always
prioritize using the ABC framework, and a dropping oxygen saturation indicates a
potential respiratory compromise that could rapidly deteriorate. The other patients have
needs that are important but not immediately life-threatening.
Q7: A patient with respiratory alkalosis has an ABG showing pH 7.50, PaCO2 30 mmHg,
and HCO3 24 mEq/L. What is the most likely cause?
A. Opioid overdose causing hypoventilation
B. Anxiety-induced hyperventilation or pain [CORRECT]
C. Severe diarrhea with bicarbonate loss
D. Diabetic ketoacidosis with compensatory breathing
Correct Answer: B
Rationale: Respiratory alkalosis is driven by a low PaCO2 from blowing off too much
carbon dioxide, which commonly happens with anxiety, pain, or early hypoxemia where
the patient is breathing fast. This aligns with what we see in clinical practice when
patients are anxious or in significant discomfort.
Q8: A patient with Cushing's syndrome develops severe hypokalemia. Which cardiac
rhythm change is the nurse most concerned about?
A. Flattened T waves and the appearance of U waves [CORRECT]
B. Peaked T waves and widened QRS complexes
C. Shortened QT interval and bradycardia
