Rasmussen University | NUR2502 Multidimensional Care III | 2026/2027
NUR 2502 / NUR2502 Final Exam
Multidimensional Care III / MDC 3
Rasmussen University | 2026/2027 Curriculum Standards
Passing Score: 70% | 100 Questions | Multiple Choice (A-D)
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Section 1: Cardiovascular Disorders (Heart Failure, Valvular Disorders, Cardiac
Diagnostics, and Anticoagulation)
Q1: A nurse is caring for a patient with suspected heart failure. Which diagnostic test is considered the
gold standard for confirming the diagnosis of heart failure?
A. A. B-type natriuretic peptide (BNP) level
B. B. Chest X-ray
C. C. Echocardiogram (ECHO) **[CORRECT]**
D. D. Electrocardiogram (ECG)
Correct Answer: C
Rationale: The echocardiogram is the gold standard diagnostic test for heart failure because it provides direct visualization of
cardiac structures, ejection fraction, and valve function. BNP is a useful screening biomarker but does not provide structural
information. Chest X-ray and ECG are supportive but not definitive for HF diagnosis per 2026/2027 Rasmussen NUR2502
standards.
Q2: A patient with heart failure reports a new onset of a nocturnal cough that worsens when lying flat.
The nurse recognizes this finding as:
A. A. A late sign of right-sided heart failure
B. B. An early sign of left-sided heart failure **[CORRECT]**
C. C. A sign of pulmonary embolism
D. D. An expected finding in right-sided heart failure
Correct Answer: B
Rationale: Nocturnal cough is an early sign of left-sided heart failure resulting from pulmonary congestion that worsens in
the supine position. This occurs because fluid redistributes into the pulmonary vasculature when the patient lies flat.
Right-sided heart failure presents with peripheral edema, JVD, and weight gain, not pulmonary symptoms.
Q3: Which laboratory value would the nurse expect to be elevated in a patient with heart failure?
A. A. Troponin I
B. B. B-type natriuretic peptide (BNP) **[CORRECT]**
C. C. D-dimer
D. D. Creatine kinase-MB (CK-MB)
Correct Answer: B
Rationale: BNP is released by the ventricles in response to increased pressure and volume overload, making it a key biomarker
for detecting and monitoring heart failure. Troponin I and CK-MB are cardiac injury markers used for acute coronary
syndrome. D-dimer is used to rule out pulmonary embolism, not heart failure.
NUR 2502 MDC 3 Final Exam | Page 1
,Rasmussen University | NUR2502 Multidimensional Care III | 2026/2027
Q4: The nurse is providing discharge teaching to a patient with heart failure. Which instruction is most
important for the patient to understand regarding daily weight monitoring?
A. A. Weigh yourself once a week at different times of the day
B. B. Weigh yourself daily on the same scale at the same time each morning **[CORRECT]**
C. C. Weigh yourself only when you notice swelling in your legs
D. D. Weigh yourself before and after each meal to track fluid intake
Correct Answer: B
Rationale: Daily weight monitoring on the same scale at the same time each morning (after voiding, before eating) is the most
reliable method for detecting fluid retention early in heart failure patients. Consistent conditions ensure accurate comparison.
A weight gain of 2-3 pounds in a day or 5 pounds in a week warrants notification of the healthcare provider per
evidence-based HF management guidelines.
Q5: A patient with left-sided heart failure is likely to exhibit which cluster of symptoms?
A. A. Peripheral edema, hepatomegaly, and ascites
B. B. Dyspnea on exertion, orthopnea, and crackles on auscultation **[CORRECT]**
C. C. Weight gain, JVD, and dependent edema
D. D. Bruising, fatigue, and prolonged bleeding
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, leading to dyspnea on exertion, orthopnea, paroxysmal
nocturnal dyspnea (PND), crackles, and an S3 gallop. Peripheral edema, hepatomegaly, ascites, JVD, and weight gain are
manifestations of right-sided heart failure due to systemic venous congestion.
Q6: Which clinical finding would the nurse identify as a manifestation of right-sided heart failure?
A. A. Crackles on lung auscultation
B. B. Paroxysmal nocturnal dyspnea
C. C. Jugular venous distension (JVD) and hepatomegaly **[CORRECT]**
D. D. Pink frothy sputum
Correct Answer: C
Rationale: Right-sided heart failure results in systemic venous congestion, producing JVD, hepatomegaly, ascites, peripheral
edema, and weight gain. Crackles, PND, and pink frothy sputum are classic left-sided heart failure findings related to
pulmonary fluid overload.
Q7: A nurse is reviewing the medical record of a patient admitted with heart failure. Which risk factor
identified in the history is most directly associated with the development of heart failure?
A. A. Allergic rhinitis
B. B. Hypertension **[CORRECT]**
C. C. Osteoarthritis
D. D. Migraine headaches
Correct Answer: B
Rationale: Hypertension is a major risk factor for heart failure because chronic elevated blood pressure increases afterload,
causing the left ventricle to work harder, leading to hypertrophy and eventual pump failure. Additional HF risk factors
include lifestyle factors, smoking, and diabetes. Allergic rhinitis, osteoarthritis, and migraines are not directly linked to heart
failure development.
Q8: A nurse is developing a care plan for a patient with heart failure. Which intervention is most
appropriate for managing fluid overload?
A. A. Encourage liberal fluid intake of 3 liters daily
B. B. Implement daily weights, intake and output monitoring, and a low-sodium diet **[CORRECT]**
C. C. Restrict all physical activity to bed rest only
NUR 2502 MDC 3 Final Exam | Page 2
, Rasmussen University | NUR2502 Multidimensional Care III | 2026/2027
D. D. Administer prescribed potassium-sparing diuretics without monitoring
Correct Answer: B
Rationale: Daily weights, strict intake and output monitoring, and a low-sodium diet (typically less than 2-3 g/day) are
cornerstone interventions for managing fluid overload in heart failure. Liberal fluid intake would worsen congestion. While
activity may need modification, complete bed rest is not routinely indicated. All medications require monitoring for therapeutic
effect and side effects.
Q9: A patient with heart failure asks why they must limit sodium in their diet. What is the best response
by the nurse?
A. A. Sodium decreases blood pressure and can cause dizziness
B. B. Sodium promotes fluid retention, which worsens heart failure symptoms **[CORRECT]**
C. C. Sodium increases heart rate and causes palpitations
D. D. Sodium directly weakens the heart muscle over time
Correct Answer: B
Rationale: Sodium promotes water retention through osmotic mechanisms, increasing intravascular volume and worsening
fluid overload in heart failure patients. This exacerbates dyspnea, edema, and other HF symptoms. A low-sodium diet is a
fundamental component of HF self-management education per 2026/2027 multidimensional care standards.
Q10: The nurse is caring for a patient with heart failure who has an S3 gallop on auscultation. What does
this finding indicate?
A. A. The patient has developed aortic stenosis
B. B. The patient has increased ventricular filling pressure and volume overload **[CORRECT]**
C. C. The patient has pericardial inflammation
D. D. The patient has a normal heart sound variant
Correct Answer: B
Rationale: An S3 gallop is an extra heart sound heard during early diastole that indicates increased ventricular filling pressure
and volume overload, which are hallmark pathophysiological findings in heart failure. It is not associated with aortic stenosis,
pericarditis (which produces a friction rub), and is never considered a normal variant in adults.
Q11: A nurse is evaluating the effectiveness of heart failure treatment. Which assessment finding
suggests the treatment is effective?
A. A. The patient gained 4 pounds over the past week
B. B. The patient reports decreased dyspnea and has stable daily weights **[CORRECT]**
C. C. The patient has new-onset JVD
D. D. The patient requires 3 pillows to sleep
Correct Answer: B
Rationale: Decreased dyspnea and stable daily weights indicate that fluid overload is being managed effectively and cardiac
output is improving. Weight gain, new JVD, and increased orthopnea (needing more pillows) all suggest worsening heart
failure and treatment failure.
Q12: A nurse is reviewing the health history of a patient diagnosed with mitral stenosis. Which condition
is the most common cause of this valvular disorder?
A. A. Bacterial endocarditis
B. B. Rheumatic fever **[CORRECT]**
C. C. Myocardial infarction
D. D. Congenital defect
Correct Answer: B
Rationale: Rheumatic fever is the most common cause of mitral stenosis, as the inflammatory process damages the mitral
valve leaflets, causing them to become thickened, fused, and narrowed over time. While bacterial endocarditis can affect
NUR 2502 MDC 3 Final Exam | Page 3
NUR 2502 / NUR2502 Final Exam
Multidimensional Care III / MDC 3
Rasmussen University | 2026/2027 Curriculum Standards
Passing Score: 70% | 100 Questions | Multiple Choice (A-D)
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Section 1: Cardiovascular Disorders (Heart Failure, Valvular Disorders, Cardiac
Diagnostics, and Anticoagulation)
Q1: A nurse is caring for a patient with suspected heart failure. Which diagnostic test is considered the
gold standard for confirming the diagnosis of heart failure?
A. A. B-type natriuretic peptide (BNP) level
B. B. Chest X-ray
C. C. Echocardiogram (ECHO) **[CORRECT]**
D. D. Electrocardiogram (ECG)
Correct Answer: C
Rationale: The echocardiogram is the gold standard diagnostic test for heart failure because it provides direct visualization of
cardiac structures, ejection fraction, and valve function. BNP is a useful screening biomarker but does not provide structural
information. Chest X-ray and ECG are supportive but not definitive for HF diagnosis per 2026/2027 Rasmussen NUR2502
standards.
Q2: A patient with heart failure reports a new onset of a nocturnal cough that worsens when lying flat.
The nurse recognizes this finding as:
A. A. A late sign of right-sided heart failure
B. B. An early sign of left-sided heart failure **[CORRECT]**
C. C. A sign of pulmonary embolism
D. D. An expected finding in right-sided heart failure
Correct Answer: B
Rationale: Nocturnal cough is an early sign of left-sided heart failure resulting from pulmonary congestion that worsens in
the supine position. This occurs because fluid redistributes into the pulmonary vasculature when the patient lies flat.
Right-sided heart failure presents with peripheral edema, JVD, and weight gain, not pulmonary symptoms.
Q3: Which laboratory value would the nurse expect to be elevated in a patient with heart failure?
A. A. Troponin I
B. B. B-type natriuretic peptide (BNP) **[CORRECT]**
C. C. D-dimer
D. D. Creatine kinase-MB (CK-MB)
Correct Answer: B
Rationale: BNP is released by the ventricles in response to increased pressure and volume overload, making it a key biomarker
for detecting and monitoring heart failure. Troponin I and CK-MB are cardiac injury markers used for acute coronary
syndrome. D-dimer is used to rule out pulmonary embolism, not heart failure.
NUR 2502 MDC 3 Final Exam | Page 1
,Rasmussen University | NUR2502 Multidimensional Care III | 2026/2027
Q4: The nurse is providing discharge teaching to a patient with heart failure. Which instruction is most
important for the patient to understand regarding daily weight monitoring?
A. A. Weigh yourself once a week at different times of the day
B. B. Weigh yourself daily on the same scale at the same time each morning **[CORRECT]**
C. C. Weigh yourself only when you notice swelling in your legs
D. D. Weigh yourself before and after each meal to track fluid intake
Correct Answer: B
Rationale: Daily weight monitoring on the same scale at the same time each morning (after voiding, before eating) is the most
reliable method for detecting fluid retention early in heart failure patients. Consistent conditions ensure accurate comparison.
A weight gain of 2-3 pounds in a day or 5 pounds in a week warrants notification of the healthcare provider per
evidence-based HF management guidelines.
Q5: A patient with left-sided heart failure is likely to exhibit which cluster of symptoms?
A. A. Peripheral edema, hepatomegaly, and ascites
B. B. Dyspnea on exertion, orthopnea, and crackles on auscultation **[CORRECT]**
C. C. Weight gain, JVD, and dependent edema
D. D. Bruising, fatigue, and prolonged bleeding
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, leading to dyspnea on exertion, orthopnea, paroxysmal
nocturnal dyspnea (PND), crackles, and an S3 gallop. Peripheral edema, hepatomegaly, ascites, JVD, and weight gain are
manifestations of right-sided heart failure due to systemic venous congestion.
Q6: Which clinical finding would the nurse identify as a manifestation of right-sided heart failure?
A. A. Crackles on lung auscultation
B. B. Paroxysmal nocturnal dyspnea
C. C. Jugular venous distension (JVD) and hepatomegaly **[CORRECT]**
D. D. Pink frothy sputum
Correct Answer: C
Rationale: Right-sided heart failure results in systemic venous congestion, producing JVD, hepatomegaly, ascites, peripheral
edema, and weight gain. Crackles, PND, and pink frothy sputum are classic left-sided heart failure findings related to
pulmonary fluid overload.
Q7: A nurse is reviewing the medical record of a patient admitted with heart failure. Which risk factor
identified in the history is most directly associated with the development of heart failure?
A. A. Allergic rhinitis
B. B. Hypertension **[CORRECT]**
C. C. Osteoarthritis
D. D. Migraine headaches
Correct Answer: B
Rationale: Hypertension is a major risk factor for heart failure because chronic elevated blood pressure increases afterload,
causing the left ventricle to work harder, leading to hypertrophy and eventual pump failure. Additional HF risk factors
include lifestyle factors, smoking, and diabetes. Allergic rhinitis, osteoarthritis, and migraines are not directly linked to heart
failure development.
Q8: A nurse is developing a care plan for a patient with heart failure. Which intervention is most
appropriate for managing fluid overload?
A. A. Encourage liberal fluid intake of 3 liters daily
B. B. Implement daily weights, intake and output monitoring, and a low-sodium diet **[CORRECT]**
C. C. Restrict all physical activity to bed rest only
NUR 2502 MDC 3 Final Exam | Page 2
, Rasmussen University | NUR2502 Multidimensional Care III | 2026/2027
D. D. Administer prescribed potassium-sparing diuretics without monitoring
Correct Answer: B
Rationale: Daily weights, strict intake and output monitoring, and a low-sodium diet (typically less than 2-3 g/day) are
cornerstone interventions for managing fluid overload in heart failure. Liberal fluid intake would worsen congestion. While
activity may need modification, complete bed rest is not routinely indicated. All medications require monitoring for therapeutic
effect and side effects.
Q9: A patient with heart failure asks why they must limit sodium in their diet. What is the best response
by the nurse?
A. A. Sodium decreases blood pressure and can cause dizziness
B. B. Sodium promotes fluid retention, which worsens heart failure symptoms **[CORRECT]**
C. C. Sodium increases heart rate and causes palpitations
D. D. Sodium directly weakens the heart muscle over time
Correct Answer: B
Rationale: Sodium promotes water retention through osmotic mechanisms, increasing intravascular volume and worsening
fluid overload in heart failure patients. This exacerbates dyspnea, edema, and other HF symptoms. A low-sodium diet is a
fundamental component of HF self-management education per 2026/2027 multidimensional care standards.
Q10: The nurse is caring for a patient with heart failure who has an S3 gallop on auscultation. What does
this finding indicate?
A. A. The patient has developed aortic stenosis
B. B. The patient has increased ventricular filling pressure and volume overload **[CORRECT]**
C. C. The patient has pericardial inflammation
D. D. The patient has a normal heart sound variant
Correct Answer: B
Rationale: An S3 gallop is an extra heart sound heard during early diastole that indicates increased ventricular filling pressure
and volume overload, which are hallmark pathophysiological findings in heart failure. It is not associated with aortic stenosis,
pericarditis (which produces a friction rub), and is never considered a normal variant in adults.
Q11: A nurse is evaluating the effectiveness of heart failure treatment. Which assessment finding
suggests the treatment is effective?
A. A. The patient gained 4 pounds over the past week
B. B. The patient reports decreased dyspnea and has stable daily weights **[CORRECT]**
C. C. The patient has new-onset JVD
D. D. The patient requires 3 pillows to sleep
Correct Answer: B
Rationale: Decreased dyspnea and stable daily weights indicate that fluid overload is being managed effectively and cardiac
output is improving. Weight gain, new JVD, and increased orthopnea (needing more pillows) all suggest worsening heart
failure and treatment failure.
Q12: A nurse is reviewing the health history of a patient diagnosed with mitral stenosis. Which condition
is the most common cause of this valvular disorder?
A. A. Bacterial endocarditis
B. B. Rheumatic fever **[CORRECT]**
C. C. Myocardial infarction
D. D. Congenital defect
Correct Answer: B
Rationale: Rheumatic fever is the most common cause of mitral stenosis, as the inflammatory process damages the mitral
valve leaflets, causing them to become thickened, fused, and narrowed over time. While bacterial endocarditis can affect
NUR 2502 MDC 3 Final Exam | Page 3
