MDC III EXAM 1 (RASMUSSEN)
NEWEST 2026: 100 REAL QUESTIONS
& CORRECT ANSWERS WITH
RATIONALES - ALREADY GRADED A+
**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. 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**
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 5**
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?
NEWEST 2026: 100 REAL QUESTIONS
& CORRECT ANSWERS WITH
RATIONALES - ALREADY GRADED A+
**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. 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**
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 5**
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?
