MDC4 EXAM 1 AND STUDY GUIDE (RASMUSSEN)
NEWEST 2026/ 2027 TEST BANK| MDC4 EXAM 1
REVIEW WITH COMPLETE 450 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST RECENT!!)
1. A patient with septic shock has a mean arterial pressure
(MAP) of 55 mm Hg. Which prescribed intervention should the
nurse implement first?
A. Insert a Foley catheter
B. Administer norepinephrine IV
C. Give a 500 mL bolus of lactated Ringer’s
D. Draw serum lactate level
Answer: C
Rationale: In septic shock, the first-line intervention is IV fluid
resuscitation (30 mL/kg crystalloid). MAP <65 indicates
hypoperfusion. Norepinephrine is started after fluids if
1
,hypotension persists. Lactate and Foley are important but not
first.
2. A patient with acute respiratory distress syndrome (ARDS)
is on a ventilator with PEEP of 12 cm H₂O. Which assessment
finding indicates a complication of PEEP?
A. PaO₂ 88 mm Hg
B. Blood pressure 88/50 mm Hg
C. Urine output 40 mL/hr
D. Heart rate 88 bpm
Answer: B
Rationale: High PEEP decreases venous return and cardiac
output, causing hypotension. PaO₂ 88 is expected improvement.
Hypotension requires immediate evaluation (fluid, lower PEEP,
vasopressors).
2
,3. A nurse is caring for a patient post-cardiac arrest now
receiving therapeutic hypothermia. Which assessment is most
critical?
A. Blood glucose every 2 hours
B. Shivering assessment
C. Core temperature monitoring
D. Pupil reactivity
Answer: C
Rationale: Core temperature must be maintained at 32–36°C.
Hypothermia decreases metabolism but risks arrhythmias,
coagulopathy, and infection. Temperature monitoring is priority.
Shivering is important but secondary to maintaining target temp.
4. A patient with chronic kidney disease (CKD) stage 4 has a
potassium level of 6.8 mEq/L. Which ECG change would the
3
, nurse expect?
A. U waves
B. Widened QRS
C. Prolonged PR interval
D. Tall peaked T waves
Answer: D
Rationale: Hyperkalemia (K >5.5) causes tall, peaked T waves
early. As K increases, PR prolongs, QRS widens, then sine wave
→ cardiac arrest. U waves are seen in hypokalemia.
5. A patient with a massive pulmonary embolism suddenly
becomes hypotensive and hypoxic. Which medication does
the nurse prepare to administer?
A. Heparin bolus
B. Alteplase (tPA)
4
NEWEST 2026/ 2027 TEST BANK| MDC4 EXAM 1
REVIEW WITH COMPLETE 450 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST RECENT!!)
1. A patient with septic shock has a mean arterial pressure
(MAP) of 55 mm Hg. Which prescribed intervention should the
nurse implement first?
A. Insert a Foley catheter
B. Administer norepinephrine IV
C. Give a 500 mL bolus of lactated Ringer’s
D. Draw serum lactate level
Answer: C
Rationale: In septic shock, the first-line intervention is IV fluid
resuscitation (30 mL/kg crystalloid). MAP <65 indicates
hypoperfusion. Norepinephrine is started after fluids if
1
,hypotension persists. Lactate and Foley are important but not
first.
2. A patient with acute respiratory distress syndrome (ARDS)
is on a ventilator with PEEP of 12 cm H₂O. Which assessment
finding indicates a complication of PEEP?
A. PaO₂ 88 mm Hg
B. Blood pressure 88/50 mm Hg
C. Urine output 40 mL/hr
D. Heart rate 88 bpm
Answer: B
Rationale: High PEEP decreases venous return and cardiac
output, causing hypotension. PaO₂ 88 is expected improvement.
Hypotension requires immediate evaluation (fluid, lower PEEP,
vasopressors).
2
,3. A nurse is caring for a patient post-cardiac arrest now
receiving therapeutic hypothermia. Which assessment is most
critical?
A. Blood glucose every 2 hours
B. Shivering assessment
C. Core temperature monitoring
D. Pupil reactivity
Answer: C
Rationale: Core temperature must be maintained at 32–36°C.
Hypothermia decreases metabolism but risks arrhythmias,
coagulopathy, and infection. Temperature monitoring is priority.
Shivering is important but secondary to maintaining target temp.
4. A patient with chronic kidney disease (CKD) stage 4 has a
potassium level of 6.8 mEq/L. Which ECG change would the
3
, nurse expect?
A. U waves
B. Widened QRS
C. Prolonged PR interval
D. Tall peaked T waves
Answer: D
Rationale: Hyperkalemia (K >5.5) causes tall, peaked T waves
early. As K increases, PR prolongs, QRS widens, then sine wave
→ cardiac arrest. U waves are seen in hypokalemia.
5. A patient with a massive pulmonary embolism suddenly
becomes hypotensive and hypoxic. Which medication does
the nurse prepare to administer?
A. Heparin bolus
B. Alteplase (tPA)
4
