2026 NUR 2755 MDC IV Exam 1 –
Comprehensive Practice Question Bank
RASMUSSEN UNIVERSITY | MEDICAL-SURGICAL
NURSING IV
COMPLETE PRACTICE EXAM | QUESTIONS | STUVIA-
READY FORMAT
Overall Exam Overview: This comprehensive document contains 200 high-quality, exam-style multiple-
choice questions specifically designed to align with the NUR 2755 MDC IV (Medical-Surgical Nursing IV)
Exam 1 content at Rasmussen University. The questions cover all major domains including critical care
concepts, complex multisystem disorders, advanced cardiac and respiratory conditions, neurological
emergencies, endocrine crises, shock states, and nursing management of critically ill patients. Each
question includes a detailed rationale and a situational overview to reinforce learning and ensure you
understand the foundational concepts required to pass the exam. This question bank mirrors the depth,
breadth, and application-level thinking of the actual NUR 2755 Exam 1.
QUESTION 1
Overview: A nurse is caring for a client with cardiogenic shock who has a pulmonary
artery catheter in place. The nurse notes that the cardiac index is 1.6 L/min/m² (normal
2.5-4.0) and the pulmonary artery wedge pressure (PAWP) is 22 mmHg (normal 4-12
mmHg).
Question: Which intervention should the nurse anticipate?
A) Administer IV fluids rapidly
B) Administer dobutamine as ordered
C) Administer furosemide
D) Administer nitroglycerin
Answer: *B) Administer dobutamine as ordered *
,Rationale: The low cardiac index indicates decreased cardiac output, and the elevated
PAWP indicates fluid overload. Dobutamine is a positive inotrope that increases cardiac
contractility and cardiac output. Rapid IV fluids (A) would worsen fluid overload.
Furosemide (C) and nitroglycerin (D) reduce preload but do not increase contractility.
QUESTION 2
Overview: A client with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation with a tidal volume of 8 mL/kg ideal body weight and PEEP of 12 cm H2O.
The nurse notes a plateau pressure of 32 cm H2O.
Question: What is the nurse's priority action?
A) Suction the endotracheal tube
B) Decrease the tidal volume
C) Increase the PEEP
D) Notify the provider
Answer: *B) Decrease the tidal volume *
Rationale: In ARDS, lung-protective ventilation aims to keep plateau pressure < 30 cm
H2O to prevent volutrauma and barotrauma. The priority is to decrease tidal volume.
Suctioning (A) would not address plateau pressure. Increasing PEEP (C) could worsen the
problem. Notifying the provider (D) is appropriate but decreasing tidal volume is a nursing
intervention that can be implemented immediately.
QUESTION 3
Overview: A client is admitted with a suspected pulmonary embolism. The client's SpO2
is 88% on room air. The nurse applies a nasal cannula at 2 L/min and reassesses. After 10
minutes, the SpO2 is 90%.
Question: What is the next action by the nurse?
A) Increase the oxygen to 4 L/min
B) Prepare for intubation
,C) Apply a non-rebreather mask
D) Continue monitoring
Answer: *A) Increase the oxygen to 4 L/min *
Rationale: The target SpO2 is > 90%. Since the client improved to 90% with 2 L/min,
increasing to 4 L/min is appropriate to achieve a higher SpO2. Preparing for intubation (B)
is premature. A non-rebreather mask (C) is not needed at this time. Continuing monitoring
(D) would delay appropriate intervention.
QUESTION 4
Overview: A client with severe sepsis is receiving IV fluids and antibiotics. The client's
blood pressure is 85/50 mmHg despite fluid resuscitation. The provider orders a
vasopressor.
Question: Which vasopressor should the nurse anticipate as the first-line agent?
A) Dopamine
B) Norepinephrine
C) Phenylephrine
D) Epinephrine
Answer: *B) Norepinephrine *
Rationale: Norepinephrine is the first-line vasopressor for septic shock per the Surviving
Sepsis Campaign guidelines. Dopamine (A) is second-line due to increased risk of
arrhythmias. Phenylephrine (C) is a pure alpha-agonist and is not first-line. Epinephrine
(D) is used in anaphylactic shock or refractory septic shock.
QUESTION 5
Overview: A client with acute heart failure is receiving IV furosemide. The nurse assesses
the client and notes a dry cough and wheezing. The client's SpO2 is 94%.
Question: What is the nurse's priority action?
, A) Continue the furosemide infusion
B) Administer albuterol nebulizer
C) Slow the furosemide infusion
D) Notify the provider
Answer: *D) Notify the provider *
Rationale: A dry cough and wheezing in a client receiving furosemide may indicate an
allergic reaction or pulmonary edema worsening. The nurse should notify the provider
immediately. Continuing the infusion (A) without notification is unsafe. Administering
albuterol (B) may be appropriate but only after provider notification. Slowing the infusion
(C) is not sufficient without provider notification.
QUESTION 6
Overview: A nurse is caring for a client with a traumatic brain injury. The client's
intracranial pressure (ICP) is 24 mmHg and cerebral perfusion pressure (CPP) is 58
mmHg. The nurse elevates the head of the bed to 30 degrees.
Question: What is the expected outcome of this intervention?
A) Decreased ICP and increased CPP
B) Increased ICP and decreased CPP
C) Decreased ICP and decreased CPP
D) Increased ICP and increased CPP
Answer: *A) Decreased ICP and increased CPP *
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage,
reducing ICP. This improves CPP (CPP = MAP - ICP). Option B is incorrect as it describes
worsening. Option C would indicate decreased CPP, which is not the goal. Option D is
incorrect as increased ICP is not desired.
QUESTION 7
Comprehensive Practice Question Bank
RASMUSSEN UNIVERSITY | MEDICAL-SURGICAL
NURSING IV
COMPLETE PRACTICE EXAM | QUESTIONS | STUVIA-
READY FORMAT
Overall Exam Overview: This comprehensive document contains 200 high-quality, exam-style multiple-
choice questions specifically designed to align with the NUR 2755 MDC IV (Medical-Surgical Nursing IV)
Exam 1 content at Rasmussen University. The questions cover all major domains including critical care
concepts, complex multisystem disorders, advanced cardiac and respiratory conditions, neurological
emergencies, endocrine crises, shock states, and nursing management of critically ill patients. Each
question includes a detailed rationale and a situational overview to reinforce learning and ensure you
understand the foundational concepts required to pass the exam. This question bank mirrors the depth,
breadth, and application-level thinking of the actual NUR 2755 Exam 1.
QUESTION 1
Overview: A nurse is caring for a client with cardiogenic shock who has a pulmonary
artery catheter in place. The nurse notes that the cardiac index is 1.6 L/min/m² (normal
2.5-4.0) and the pulmonary artery wedge pressure (PAWP) is 22 mmHg (normal 4-12
mmHg).
Question: Which intervention should the nurse anticipate?
A) Administer IV fluids rapidly
B) Administer dobutamine as ordered
C) Administer furosemide
D) Administer nitroglycerin
Answer: *B) Administer dobutamine as ordered *
,Rationale: The low cardiac index indicates decreased cardiac output, and the elevated
PAWP indicates fluid overload. Dobutamine is a positive inotrope that increases cardiac
contractility and cardiac output. Rapid IV fluids (A) would worsen fluid overload.
Furosemide (C) and nitroglycerin (D) reduce preload but do not increase contractility.
QUESTION 2
Overview: A client with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation with a tidal volume of 8 mL/kg ideal body weight and PEEP of 12 cm H2O.
The nurse notes a plateau pressure of 32 cm H2O.
Question: What is the nurse's priority action?
A) Suction the endotracheal tube
B) Decrease the tidal volume
C) Increase the PEEP
D) Notify the provider
Answer: *B) Decrease the tidal volume *
Rationale: In ARDS, lung-protective ventilation aims to keep plateau pressure < 30 cm
H2O to prevent volutrauma and barotrauma. The priority is to decrease tidal volume.
Suctioning (A) would not address plateau pressure. Increasing PEEP (C) could worsen the
problem. Notifying the provider (D) is appropriate but decreasing tidal volume is a nursing
intervention that can be implemented immediately.
QUESTION 3
Overview: A client is admitted with a suspected pulmonary embolism. The client's SpO2
is 88% on room air. The nurse applies a nasal cannula at 2 L/min and reassesses. After 10
minutes, the SpO2 is 90%.
Question: What is the next action by the nurse?
A) Increase the oxygen to 4 L/min
B) Prepare for intubation
,C) Apply a non-rebreather mask
D) Continue monitoring
Answer: *A) Increase the oxygen to 4 L/min *
Rationale: The target SpO2 is > 90%. Since the client improved to 90% with 2 L/min,
increasing to 4 L/min is appropriate to achieve a higher SpO2. Preparing for intubation (B)
is premature. A non-rebreather mask (C) is not needed at this time. Continuing monitoring
(D) would delay appropriate intervention.
QUESTION 4
Overview: A client with severe sepsis is receiving IV fluids and antibiotics. The client's
blood pressure is 85/50 mmHg despite fluid resuscitation. The provider orders a
vasopressor.
Question: Which vasopressor should the nurse anticipate as the first-line agent?
A) Dopamine
B) Norepinephrine
C) Phenylephrine
D) Epinephrine
Answer: *B) Norepinephrine *
Rationale: Norepinephrine is the first-line vasopressor for septic shock per the Surviving
Sepsis Campaign guidelines. Dopamine (A) is second-line due to increased risk of
arrhythmias. Phenylephrine (C) is a pure alpha-agonist and is not first-line. Epinephrine
(D) is used in anaphylactic shock or refractory septic shock.
QUESTION 5
Overview: A client with acute heart failure is receiving IV furosemide. The nurse assesses
the client and notes a dry cough and wheezing. The client's SpO2 is 94%.
Question: What is the nurse's priority action?
, A) Continue the furosemide infusion
B) Administer albuterol nebulizer
C) Slow the furosemide infusion
D) Notify the provider
Answer: *D) Notify the provider *
Rationale: A dry cough and wheezing in a client receiving furosemide may indicate an
allergic reaction or pulmonary edema worsening. The nurse should notify the provider
immediately. Continuing the infusion (A) without notification is unsafe. Administering
albuterol (B) may be appropriate but only after provider notification. Slowing the infusion
(C) is not sufficient without provider notification.
QUESTION 6
Overview: A nurse is caring for a client with a traumatic brain injury. The client's
intracranial pressure (ICP) is 24 mmHg and cerebral perfusion pressure (CPP) is 58
mmHg. The nurse elevates the head of the bed to 30 degrees.
Question: What is the expected outcome of this intervention?
A) Decreased ICP and increased CPP
B) Increased ICP and decreased CPP
C) Decreased ICP and decreased CPP
D) Increased ICP and increased CPP
Answer: *A) Decreased ICP and increased CPP *
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage,
reducing ICP. This improves CPP (CPP = MAP - ICP). Option B is incorrect as it describes
worsening. Option C would indicate decreased CPP, which is not the goal. Option D is
incorrect as increased ICP is not desired.
QUESTION 7
