NUR 2755
Multidimensional Care IV
MDC IV Exam 2
Rasmussen College
passing score of 90% or higher
What You’ll Receive (Digital Download)
Exam-Style Qs that mirror the actual Exam
Most Comprehensive to Pass the Exam
Printable + tablet-friendly PDF
,1. A 68-year-old client is admitted with severe community-acquired pneumonia.
Which clinical findings require immediate intervention?
Select all that apply.
A. SpO₂ 86% on 2L nasal cannula
B. Productive cough with green sputum
C. New onset confusion
D. Respiratory rate 22 breaths/min
E. Temperature 100.8°F (38.2°C)
A, C
Expert Rationale:
• A. SpO₂ below 90% indicates significant hypoxemia and requires escalation of
oxygen therapy.
• C. Confusion is a possible sign of hypoxia or sepsis in older adults and requires
prompt action.
• B, D, E. These are expected in pneumonia and not priority findings.
2. The nurse is caring for a patient on mechanical ventilation due to ARDS.
Which interventions are most appropriate to prevent ventilator-associated
pneumonia (VAP)?
Select all that apply.
A. Elevate HOB to at least 30 degrees
B. Administer sedatives continuously to keep the patient immobile
C. Provide oral care every 2 to 4 hours
D. Suction oral secretions regularly
E. Turn the patient every 8 hours
A, C, D
Expert Rationale:
• A, C, D. These are evidence-based interventions to reduce VAP risk.
, • B. Continuous sedation increases the risk of VAP and delays weaning.
• E. Patients should be turned at least every 2 hours, not 8.
3. A patient develops ARDS following severe pancreatitis. Which of the following
interventions should the nurse expect to implement?
Select all that apply.
A. Administer corticosteroids to reduce lung inflammation
B. Initiate prone positioning for severe hypoxemia
C. Use low tidal volume settings on ventilator
D. Infuse fluids liberally to increase perfusion
E. Monitor for barotrauma and oxygen toxicity
B, C, E
Expert Rationale:
• B. Prone positioning improves oxygenation in ARDS.
• C. Low tidal volume ventilation helps minimize lung injury.
• E. Monitor for complications like barotrauma and O₂ toxicity.
• A. Corticosteroids may be used in some cases, but are not first-line.
• D. Fluid overload can worsen pulmonary edema.
4. A client with a suspected pulmonary embolism suddenly becomes restless
and tachypneic. What is the nurse's priority action?
A. Obtain a stat chest X-ray
B. Administer prescribed heparin
C. Raise the head of the bed and apply oxygen
D. Call the Rapid Response Team
C
Expert Rationale:
• C. Always follow ABCs—airway and oxygenation come first.
• B. Heparin is important but not before stabilizing breathing.
Multidimensional Care IV
MDC IV Exam 2
Rasmussen College
passing score of 90% or higher
What You’ll Receive (Digital Download)
Exam-Style Qs that mirror the actual Exam
Most Comprehensive to Pass the Exam
Printable + tablet-friendly PDF
,1. A 68-year-old client is admitted with severe community-acquired pneumonia.
Which clinical findings require immediate intervention?
Select all that apply.
A. SpO₂ 86% on 2L nasal cannula
B. Productive cough with green sputum
C. New onset confusion
D. Respiratory rate 22 breaths/min
E. Temperature 100.8°F (38.2°C)
A, C
Expert Rationale:
• A. SpO₂ below 90% indicates significant hypoxemia and requires escalation of
oxygen therapy.
• C. Confusion is a possible sign of hypoxia or sepsis in older adults and requires
prompt action.
• B, D, E. These are expected in pneumonia and not priority findings.
2. The nurse is caring for a patient on mechanical ventilation due to ARDS.
Which interventions are most appropriate to prevent ventilator-associated
pneumonia (VAP)?
Select all that apply.
A. Elevate HOB to at least 30 degrees
B. Administer sedatives continuously to keep the patient immobile
C. Provide oral care every 2 to 4 hours
D. Suction oral secretions regularly
E. Turn the patient every 8 hours
A, C, D
Expert Rationale:
• A, C, D. These are evidence-based interventions to reduce VAP risk.
, • B. Continuous sedation increases the risk of VAP and delays weaning.
• E. Patients should be turned at least every 2 hours, not 8.
3. A patient develops ARDS following severe pancreatitis. Which of the following
interventions should the nurse expect to implement?
Select all that apply.
A. Administer corticosteroids to reduce lung inflammation
B. Initiate prone positioning for severe hypoxemia
C. Use low tidal volume settings on ventilator
D. Infuse fluids liberally to increase perfusion
E. Monitor for barotrauma and oxygen toxicity
B, C, E
Expert Rationale:
• B. Prone positioning improves oxygenation in ARDS.
• C. Low tidal volume ventilation helps minimize lung injury.
• E. Monitor for complications like barotrauma and O₂ toxicity.
• A. Corticosteroids may be used in some cases, but are not first-line.
• D. Fluid overload can worsen pulmonary edema.
4. A client with a suspected pulmonary embolism suddenly becomes restless
and tachypneic. What is the nurse's priority action?
A. Obtain a stat chest X-ray
B. Administer prescribed heparin
C. Raise the head of the bed and apply oxygen
D. Call the Rapid Response Team
C
Expert Rationale:
• C. Always follow ABCs—airway and oxygenation come first.
• B. Heparin is important but not before stabilizing breathing.
