NUR 2356 / NUR2356: Multidimensional Care I
MDC 1 Exam 2 (Latest )
Rasmussen University | College of Nursing
75 Multiple-Choice Questions | Comprehensive Examination with Rationales
Format Multiple Choice (A-D), One Correct Answer
Questions 75 Total (8 Sections)
Cognitive Levels 25% Recall | 55% Application | 20% Analysis
Question Types 70% Scenario-Based | 20% Direct Recall | 10% Clinical Judgment
Section 1: Mobility and Immobility
Body Mechanics, Positioning, ROM, Assistive Devices, Complications of Immobility
Q1: A nursing student is preparing to assist a 250-lb postoperative patient from the bed to a wheelchair for
the first time after surgery. Which action by the student demonstrates correct body mechanics?
A. Bend at the waist while keeping the knees straight to maintain a low center of gravity
B. Stand with feet close together to keep the body compact during the transfer
C. Place feet shoulder-width apart, bend the knees, and hold the patient close to the body [CORRECT]
D. Pull the patient toward the nurse using the back muscles for leverage
Correct Answer: C
Rationale: Proper body mechanics require a wide base of support (feet shoulder-width apart), bending at the knees rather than the waist,
and holding the load close to the body to reduce strain on the lumbar spine. Bending at the waist (A), narrowing the stance (B), and
pulling with the back (D) are all common errors that increase the risk of musculoskeletal injury to the nurse. The nurse should also raise
the bed to a comfortable working height and push rather than pull whenever possible.
Q2: Which principle of body mechanics should the nurse apply when moving a heavy object up a hallway?
A. Pull the object toward the body using the back muscles
B. Push the object while keeping the back straight and using leg muscles [CORRECT]
C. Lift the object off the floor and carry it at arm's length
D. Bend forward from the waist to generate momentum
Correct Answer: B
Rationale: Pushing rather than pulling is preferred because it uses the large muscle groups of the legs and maintains the body's center of
gravity, reducing spinal strain. Pulling (A) and carrying at arm's length (C) increase the lever arm on the lumbar spine and significantly
raise injury risk. Bending at the waist (D) is a body mechanics error that places the load directly on the lower back.
Q3: A patient with chronic obstructive pulmonary disease (COPD) reports increased dyspnea while resting
flat in bed. The nurse elevates the head of the bed to 30 degrees. Which position has been implemented,
and what is its primary physiologic benefit?
A. High Fowler's; increases cardiac workload
B. Semi-Fowler's; lowers the diaphragm to promote respiratory function [CORRECT]
C. Orthopneic; decreases chest expansion
D. Trendelenburg; increases venous return to the heart
,Correct Answer: B
Rationale: Semi-Fowler's position (15–45 degrees, commonly 30) lowers the diaphragm, allowing greater chest expansion and improved
ventilation—making it ideal for patients with respiratory difficulty. High Fowler's (45–90 degrees) is more upright and is used for
cardiac dysfunction or eating (A). Orthopneic position involves leaning forward over a bedside table (C), and Trendelenburg positions
the head lower than the body (D), neither of which matches this scenario.
Q4: A patient experiencing an acute asthma exacerbation is severely short of breath and cannot tolerate
lying back in bed. Which positioning intervention best addresses this patient's needs?
A. Place the patient in a flat supine position with legs elevated
B. Position the patient in the orthopneic position, leaning forward over the bedside table [CORRECT]
C. Place the patient in a right lateral recumbent position
D. Position the patient in Trendelenburg at 20 degrees
Correct Answer: B
Rationale: The orthopneic position—sitting upright and leaning forward over a bedside table with arms supported—maximizes chest
expansion and accessory muscle use, making it the position of choice for patients with severe dyspnea or orthopnea. Supine with legs
elevated (A) worsens breathing by compressing the diaphragm. Right lateral (C) and Trendelenburg (D) do not facilitate the
forward-leaning posture that relieves respiratory distress.
Q5: A postoperative patient suddenly becomes hypotensive after receiving IV morphine. The nurse
prepares to place the patient in a modified Trendelenburg position, but a colleague suggests left lateral
recumbent instead. Which rationale supports the left lateral position in this situation?
A. Left lateral position compresses the inferior vena cava to slow bleeding
B. Left lateral position increases blood flow return to the heart, supporting blood pressure [CORRECT]
C. Left lateral position prevents aspiration if vomiting occurs
D. Left lateral position reduces intracranial pressure
Correct Answer: B
Rationale: Left lateral recumbent position enhances venous return to the heart by allowing the uterus (in pregnancy) and abdominal
contents to shift away from the inferior vena cada, and it is used to support blood pressure when hypotension occurs. While
Trendelenburg also raises BP by promoting venous return, the left lateral position is preferred in certain patient populations. Aspiration
prevention (C) is a benefit of lateral positioning in unconscious patients, but it is not the rationale in this hemodynamic scenario.
Q6: The nurse is planning care for a patient who is immobile following spinal surgery. Which position is
contraindicated for this patient?
A. Supine with a pillow under the knees
B. Side-lying with pillows between the knees
C. Prone positioning for chest expansion [CORRECT]
D. Semi-Fowler's with the head of bed at 30 degrees
Correct Answer: C
Rationale: Prone positioning is contraindicated for any patient who has had back surgery or spinal injury because it places direct pressure
on the surgical site and may disrupt fixation hardware or healing tissues. Although prone positioning can improve chest expansion in
some patients (A, B, D are safe alternatives), the post-spinal-surgery patient must never be placed prone. Side-lying with pillow support
and Semi-Fowler's are appropriate for this patient.
Q7: A patient is receiving an enema and is placed in the Sims position. Which description best defines this
position?
A. Lying on the back with the head elevated 45 degrees
B. Side-lying with the upper leg acutely flexed and the lower leg extended [CORRECT]
C. Lying on the abdomen with the head turned to one side
D. Sitting upright leaning forward over a bedside table
, Correct Answer: B
Rationale: Sims position (semi-prone) is a side-lying position in which the patient's upper leg is acutely flexed at the hip and knee while the
lower leg remains extended, allowing access for rectal procedures such as enemas and rectal examinations. Option A describes Fowler's,
C describes prone, and D describes the orthopneic position—none of which match Sims.
Q8: A patient in the emergency department has experienced significant blood loss from a traumatic injury
and remains hypotensive despite fluid resuscitation. The provider orders Trendelenburg positioning. The
nurse understands that this position involves:
A. Lowering the head of the bed 15–30 degrees so the head is lower than the body [CORRECT]
B. Elevating the head of the bed to 90 degrees
C. Turning the patient onto the left side with the right knee drawn up
D. Placing the patient supine with the legs elevated 90 degrees
Correct Answer: A
Rationale: Trendelenburg position inclines the body 15–30 degrees with the head lower than the feet, promoting venous return from the
lower extremities to the heart and brain—useful in hypotension or shock. Fowler's at 90 degrees (B) is the opposite, lateral position (C) is
Sims-like, and supine with legs elevated (D) is modified Trendelenburg but not the classic definition. Trendelenburg should be used
cautiously and is not appropriate for patients with increased intracranial pressure or severe respiratory compromise.
Q9: A patient with a stroke has left-sided hemiplegia and is unable to move the affected arm voluntarily.
The nurse performs passive range of motion (PROM) exercises on the affected extremity. Which
statement best describes the purpose of PROM?
A. PROM is performed by the patient to improve cardiovascular and respiratory function
B. PROM is performed by another person to move the patient's joints through their full range [CORRECT]
C. PROM requires the patient to actively resist the nurse's movements
D. PROM is performed using weighted resistance to build muscle strength
Correct Answer: B
Rationale: Passive range of motion (PROM) is performed entirely by another person (the nurse, therapist, or caregiver) moving the
patient's joints through their full available range without active patient effort; its purpose is to maintain joint mobility and prevent
contractures in patients who cannot move independently. Active ROM (A) is performed by the patient. PROM does not involve resistance
(C) and does not build muscle strength (D)—those goals require active or resistive exercise.
Q10: The nurse is teaching a stable postoperative patient about the importance of performing active range
of motion (AROM) exercises every shift. Which statement by the patient indicates correct understanding
of the primary benefit of AROM?
A. AROM is performed by my nurse and will prevent blood clots
B. AROM is performed by me and improves my respiratory and cardiac function [CORRECT]
C. AROM requires weights and will rebuild my muscle mass quickly
D. AROM is only necessary if I cannot move my arms or legs on my own
Correct Answer: B
Rationale: Active range of motion (AROM) is performed by the patient independently and provides systemic benefits beyond joint
mobility: it stimulates circulation, improves respiratory function through deeper breathing with movement, and supports cardiac return.
Option A confuses AROM with PROM. Weights (C) describe resistive exercise, and AROM is needed for all immobile patients—even
those who can move—to prevent complications (D).
Q11: An older adult patient with right-sided weakness from a recent stroke is being discharged with a
standard cane. Which instruction by the nurse is correct regarding cane use?
A. Hold the cane in the left hand on the weaker side, and move the cane forward with the right leg
MDC 1 Exam 2 (Latest )
Rasmussen University | College of Nursing
75 Multiple-Choice Questions | Comprehensive Examination with Rationales
Format Multiple Choice (A-D), One Correct Answer
Questions 75 Total (8 Sections)
Cognitive Levels 25% Recall | 55% Application | 20% Analysis
Question Types 70% Scenario-Based | 20% Direct Recall | 10% Clinical Judgment
Section 1: Mobility and Immobility
Body Mechanics, Positioning, ROM, Assistive Devices, Complications of Immobility
Q1: A nursing student is preparing to assist a 250-lb postoperative patient from the bed to a wheelchair for
the first time after surgery. Which action by the student demonstrates correct body mechanics?
A. Bend at the waist while keeping the knees straight to maintain a low center of gravity
B. Stand with feet close together to keep the body compact during the transfer
C. Place feet shoulder-width apart, bend the knees, and hold the patient close to the body [CORRECT]
D. Pull the patient toward the nurse using the back muscles for leverage
Correct Answer: C
Rationale: Proper body mechanics require a wide base of support (feet shoulder-width apart), bending at the knees rather than the waist,
and holding the load close to the body to reduce strain on the lumbar spine. Bending at the waist (A), narrowing the stance (B), and
pulling with the back (D) are all common errors that increase the risk of musculoskeletal injury to the nurse. The nurse should also raise
the bed to a comfortable working height and push rather than pull whenever possible.
Q2: Which principle of body mechanics should the nurse apply when moving a heavy object up a hallway?
A. Pull the object toward the body using the back muscles
B. Push the object while keeping the back straight and using leg muscles [CORRECT]
C. Lift the object off the floor and carry it at arm's length
D. Bend forward from the waist to generate momentum
Correct Answer: B
Rationale: Pushing rather than pulling is preferred because it uses the large muscle groups of the legs and maintains the body's center of
gravity, reducing spinal strain. Pulling (A) and carrying at arm's length (C) increase the lever arm on the lumbar spine and significantly
raise injury risk. Bending at the waist (D) is a body mechanics error that places the load directly on the lower back.
Q3: A patient with chronic obstructive pulmonary disease (COPD) reports increased dyspnea while resting
flat in bed. The nurse elevates the head of the bed to 30 degrees. Which position has been implemented,
and what is its primary physiologic benefit?
A. High Fowler's; increases cardiac workload
B. Semi-Fowler's; lowers the diaphragm to promote respiratory function [CORRECT]
C. Orthopneic; decreases chest expansion
D. Trendelenburg; increases venous return to the heart
,Correct Answer: B
Rationale: Semi-Fowler's position (15–45 degrees, commonly 30) lowers the diaphragm, allowing greater chest expansion and improved
ventilation—making it ideal for patients with respiratory difficulty. High Fowler's (45–90 degrees) is more upright and is used for
cardiac dysfunction or eating (A). Orthopneic position involves leaning forward over a bedside table (C), and Trendelenburg positions
the head lower than the body (D), neither of which matches this scenario.
Q4: A patient experiencing an acute asthma exacerbation is severely short of breath and cannot tolerate
lying back in bed. Which positioning intervention best addresses this patient's needs?
A. Place the patient in a flat supine position with legs elevated
B. Position the patient in the orthopneic position, leaning forward over the bedside table [CORRECT]
C. Place the patient in a right lateral recumbent position
D. Position the patient in Trendelenburg at 20 degrees
Correct Answer: B
Rationale: The orthopneic position—sitting upright and leaning forward over a bedside table with arms supported—maximizes chest
expansion and accessory muscle use, making it the position of choice for patients with severe dyspnea or orthopnea. Supine with legs
elevated (A) worsens breathing by compressing the diaphragm. Right lateral (C) and Trendelenburg (D) do not facilitate the
forward-leaning posture that relieves respiratory distress.
Q5: A postoperative patient suddenly becomes hypotensive after receiving IV morphine. The nurse
prepares to place the patient in a modified Trendelenburg position, but a colleague suggests left lateral
recumbent instead. Which rationale supports the left lateral position in this situation?
A. Left lateral position compresses the inferior vena cava to slow bleeding
B. Left lateral position increases blood flow return to the heart, supporting blood pressure [CORRECT]
C. Left lateral position prevents aspiration if vomiting occurs
D. Left lateral position reduces intracranial pressure
Correct Answer: B
Rationale: Left lateral recumbent position enhances venous return to the heart by allowing the uterus (in pregnancy) and abdominal
contents to shift away from the inferior vena cada, and it is used to support blood pressure when hypotension occurs. While
Trendelenburg also raises BP by promoting venous return, the left lateral position is preferred in certain patient populations. Aspiration
prevention (C) is a benefit of lateral positioning in unconscious patients, but it is not the rationale in this hemodynamic scenario.
Q6: The nurse is planning care for a patient who is immobile following spinal surgery. Which position is
contraindicated for this patient?
A. Supine with a pillow under the knees
B. Side-lying with pillows between the knees
C. Prone positioning for chest expansion [CORRECT]
D. Semi-Fowler's with the head of bed at 30 degrees
Correct Answer: C
Rationale: Prone positioning is contraindicated for any patient who has had back surgery or spinal injury because it places direct pressure
on the surgical site and may disrupt fixation hardware or healing tissues. Although prone positioning can improve chest expansion in
some patients (A, B, D are safe alternatives), the post-spinal-surgery patient must never be placed prone. Side-lying with pillow support
and Semi-Fowler's are appropriate for this patient.
Q7: A patient is receiving an enema and is placed in the Sims position. Which description best defines this
position?
A. Lying on the back with the head elevated 45 degrees
B. Side-lying with the upper leg acutely flexed and the lower leg extended [CORRECT]
C. Lying on the abdomen with the head turned to one side
D. Sitting upright leaning forward over a bedside table
, Correct Answer: B
Rationale: Sims position (semi-prone) is a side-lying position in which the patient's upper leg is acutely flexed at the hip and knee while the
lower leg remains extended, allowing access for rectal procedures such as enemas and rectal examinations. Option A describes Fowler's,
C describes prone, and D describes the orthopneic position—none of which match Sims.
Q8: A patient in the emergency department has experienced significant blood loss from a traumatic injury
and remains hypotensive despite fluid resuscitation. The provider orders Trendelenburg positioning. The
nurse understands that this position involves:
A. Lowering the head of the bed 15–30 degrees so the head is lower than the body [CORRECT]
B. Elevating the head of the bed to 90 degrees
C. Turning the patient onto the left side with the right knee drawn up
D. Placing the patient supine with the legs elevated 90 degrees
Correct Answer: A
Rationale: Trendelenburg position inclines the body 15–30 degrees with the head lower than the feet, promoting venous return from the
lower extremities to the heart and brain—useful in hypotension or shock. Fowler's at 90 degrees (B) is the opposite, lateral position (C) is
Sims-like, and supine with legs elevated (D) is modified Trendelenburg but not the classic definition. Trendelenburg should be used
cautiously and is not appropriate for patients with increased intracranial pressure or severe respiratory compromise.
Q9: A patient with a stroke has left-sided hemiplegia and is unable to move the affected arm voluntarily.
The nurse performs passive range of motion (PROM) exercises on the affected extremity. Which
statement best describes the purpose of PROM?
A. PROM is performed by the patient to improve cardiovascular and respiratory function
B. PROM is performed by another person to move the patient's joints through their full range [CORRECT]
C. PROM requires the patient to actively resist the nurse's movements
D. PROM is performed using weighted resistance to build muscle strength
Correct Answer: B
Rationale: Passive range of motion (PROM) is performed entirely by another person (the nurse, therapist, or caregiver) moving the
patient's joints through their full available range without active patient effort; its purpose is to maintain joint mobility and prevent
contractures in patients who cannot move independently. Active ROM (A) is performed by the patient. PROM does not involve resistance
(C) and does not build muscle strength (D)—those goals require active or resistive exercise.
Q10: The nurse is teaching a stable postoperative patient about the importance of performing active range
of motion (AROM) exercises every shift. Which statement by the patient indicates correct understanding
of the primary benefit of AROM?
A. AROM is performed by my nurse and will prevent blood clots
B. AROM is performed by me and improves my respiratory and cardiac function [CORRECT]
C. AROM requires weights and will rebuild my muscle mass quickly
D. AROM is only necessary if I cannot move my arms or legs on my own
Correct Answer: B
Rationale: Active range of motion (AROM) is performed by the patient independently and provides systemic benefits beyond joint
mobility: it stimulates circulation, improves respiratory function through deeper breathing with movement, and supports cardiac return.
Option A confuses AROM with PROM. Weights (C) describe resistive exercise, and AROM is needed for all immobile patients—even
those who can move—to prevent complications (D).
Q11: An older adult patient with right-sided weakness from a recent stroke is being discharged with a
standard cane. Which instruction by the nurse is correct regarding cane use?
A. Hold the cane in the left hand on the weaker side, and move the cane forward with the right leg
