MDC III EXAM 1 (RASMUSSEN)
NEWEST 2026 ACTUAL EXAM TEST
BANK| MDC 3 EXAM 1 REVIEW WITH
COMPLETE REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS
GURANTEED PASS
Question 1
A nurse is caring for a client with severe hyperkalemia (potassium level 6.8
mEq/L). Which intervention should the nurse implement FIRST?
A. Administer oral Kayexalate
B. Prepare the client for hemodialysis
C. Administer IV calcium gluconate
D. Administer IV insulin with dextrose
ANSWER: C. Administer IV calcium gluconate
Rationale: In severe hyperkalemia (>6.5 mEq/L), the priority is cardiac
membrane stabilization. IV calcium gluconate directly antagonizes the effects
of potassium on the cardiac cell membrane, reducing the risk of life-
threatening arrhythmias. Kayexalate, insulin with dextrose, and hemodialysis
all take longer to work and address potassium levels indirectly. Remember:
Cardiac protection is ALWAYS the priority in severe hyperkalemia.
,Question 2
A client with heart failure has a serum sodium level of 128 mEq/L. Which IV
fluid should the nurse anticipate administering?
A. 0.45% normal saline
B. 0.9% normal saline
C. 3% normal saline
D. D5W
ANSWER: B. 0.9% normal saline
Rationale: For clients with heart failure who have hyponatremia, 0.9% normal
saline (isotonic) is the safest choice. Hypotonic fluids (0.45% NS, D5W) would
worsen fluid overload in heart failure patients. Hypertonic saline (3%) is
reserved for severe, symptomatic hyponatremia with neurological symptoms,
but carries significant fluid overload risks in heart failure patients.
Question 3
A nurse is reviewing ABG results: pH 7.30, PaCO2 37 mmHg, HCO3 15
mEq/L. Which acid-base imbalance is present?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
ANSWER: C. Metabolic acidosis
Rationale: The pH is low (7.30), indicating acidosis. The PaCO2 is normal (37),
and the HCO3 is low (15). A low HCO3 with a low pH indicates metabolic
acidosis. The kidneys are the primary issue here, not the lungs.
,Question 4
The nurse is assessing a client with hypocalcemia. Which finding should the
nurse expect?
A. Shortened QT interval on EKG
B. Prolonged QT interval on EKG
C. Peaked T waves on EKG
D. Prominent U waves on EKG
ANSWER: B. Prolonged QT interval on EKG
Rationale: Hypocalcemia prolongs the QT interval because calcium is needed
for myocardial repolarization. Shortened QT is seen in hypercalcemia. Peaked
T waves are seen in hyperkalemia. Prominent U waves are seen in
hypokalemia.
Question 5
A client with chronic obstructive pulmonary disease (COPD) has the
following ABGs: pH 7.35, PaCO2 55 mmHg, HCO3 32 mEq/L. What is the
nurse's interpretation?
A. Partially compensated respiratory acidosis
B. Fully compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Mixed acidosis
ANSWER: B. Fully compensated respiratory acidosis
Rationale: The pH is low-normal (7.35 - the low end of normal but still within
range). The PaCO2 is high (55 - respiratory acidosis). The HCO3 is high (32 -
metabolic compensation from the kidneys). Since the pH has returned to
normal range, this is fully compensated respiratory acidosis, which is
commonly seen in chronic COPD patients.
, Question 6
A nurse is caring for a client with SIADH (Syndrome of Inappropriate
Antidiuretic Hormone). Which laboratory finding is the nurse most
concerned about?
A. Serum sodium 118 mEq/L
B. Serum potassium 5.8 mEq/L
C. Serum calcium 11.0 mg/dL
D. Serum magnesium 1.0 mEq/L
ANSWER: A. Serum sodium 118 mEq/L
Rationale: SIADH causes excessive water retention, leading to dilutional
hyponatremia. Severe hyponatremia (<120 mEq/L) can cause cerebral
edema, seizures, and coma. This is the most life-threatening finding in SIADH
patients. Potassium, calcium, and magnesium are not primarily affected by
SIADH.
Question 7
A 55-year-old female client asks the nurse about breast cancer screening
recommendations. What is the current recommendation for when to begin
annual mammography?
A. Age 30
B. Age 40
C. Age 45
D. Age 50
ANSWER: C. Age 45
Rationale: Current guidelines recommend that women at average risk begin
annual mammography at age 45. Women ages 40-44 may begin screening if
NEWEST 2026 ACTUAL EXAM TEST
BANK| MDC 3 EXAM 1 REVIEW WITH
COMPLETE REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS
GURANTEED PASS
Question 1
A nurse is caring for a client with severe hyperkalemia (potassium level 6.8
mEq/L). Which intervention should the nurse implement FIRST?
A. Administer oral Kayexalate
B. Prepare the client for hemodialysis
C. Administer IV calcium gluconate
D. Administer IV insulin with dextrose
ANSWER: C. Administer IV calcium gluconate
Rationale: In severe hyperkalemia (>6.5 mEq/L), the priority is cardiac
membrane stabilization. IV calcium gluconate directly antagonizes the effects
of potassium on the cardiac cell membrane, reducing the risk of life-
threatening arrhythmias. Kayexalate, insulin with dextrose, and hemodialysis
all take longer to work and address potassium levels indirectly. Remember:
Cardiac protection is ALWAYS the priority in severe hyperkalemia.
,Question 2
A client with heart failure has a serum sodium level of 128 mEq/L. Which IV
fluid should the nurse anticipate administering?
A. 0.45% normal saline
B. 0.9% normal saline
C. 3% normal saline
D. D5W
ANSWER: B. 0.9% normal saline
Rationale: For clients with heart failure who have hyponatremia, 0.9% normal
saline (isotonic) is the safest choice. Hypotonic fluids (0.45% NS, D5W) would
worsen fluid overload in heart failure patients. Hypertonic saline (3%) is
reserved for severe, symptomatic hyponatremia with neurological symptoms,
but carries significant fluid overload risks in heart failure patients.
Question 3
A nurse is reviewing ABG results: pH 7.30, PaCO2 37 mmHg, HCO3 15
mEq/L. Which acid-base imbalance is present?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
ANSWER: C. Metabolic acidosis
Rationale: The pH is low (7.30), indicating acidosis. The PaCO2 is normal (37),
and the HCO3 is low (15). A low HCO3 with a low pH indicates metabolic
acidosis. The kidneys are the primary issue here, not the lungs.
,Question 4
The nurse is assessing a client with hypocalcemia. Which finding should the
nurse expect?
A. Shortened QT interval on EKG
B. Prolonged QT interval on EKG
C. Peaked T waves on EKG
D. Prominent U waves on EKG
ANSWER: B. Prolonged QT interval on EKG
Rationale: Hypocalcemia prolongs the QT interval because calcium is needed
for myocardial repolarization. Shortened QT is seen in hypercalcemia. Peaked
T waves are seen in hyperkalemia. Prominent U waves are seen in
hypokalemia.
Question 5
A client with chronic obstructive pulmonary disease (COPD) has the
following ABGs: pH 7.35, PaCO2 55 mmHg, HCO3 32 mEq/L. What is the
nurse's interpretation?
A. Partially compensated respiratory acidosis
B. Fully compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Mixed acidosis
ANSWER: B. Fully compensated respiratory acidosis
Rationale: The pH is low-normal (7.35 - the low end of normal but still within
range). The PaCO2 is high (55 - respiratory acidosis). The HCO3 is high (32 -
metabolic compensation from the kidneys). Since the pH has returned to
normal range, this is fully compensated respiratory acidosis, which is
commonly seen in chronic COPD patients.
, Question 6
A nurse is caring for a client with SIADH (Syndrome of Inappropriate
Antidiuretic Hormone). Which laboratory finding is the nurse most
concerned about?
A. Serum sodium 118 mEq/L
B. Serum potassium 5.8 mEq/L
C. Serum calcium 11.0 mg/dL
D. Serum magnesium 1.0 mEq/L
ANSWER: A. Serum sodium 118 mEq/L
Rationale: SIADH causes excessive water retention, leading to dilutional
hyponatremia. Severe hyponatremia (<120 mEq/L) can cause cerebral
edema, seizures, and coma. This is the most life-threatening finding in SIADH
patients. Potassium, calcium, and magnesium are not primarily affected by
SIADH.
Question 7
A 55-year-old female client asks the nurse about breast cancer screening
recommendations. What is the current recommendation for when to begin
annual mammography?
A. Age 30
B. Age 40
C. Age 45
D. Age 50
ANSWER: C. Age 45
Rationale: Current guidelines recommend that women at average risk begin
annual mammography at age 45. Women ages 40-44 may begin screening if
