Rasmussen College MDC 4 Exam 1
Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A patient with septic shock has a mean arterial pressure (MAP) of
58 mmHg. Which of the following is the priority action?
A) Administer a beta-blocker
B) Administer IV fluids and vasopressors
C) Administer a diuretic
D) Administer an antipyretic
Answer: B
Rationale: A MAP of less than 60 mmHg compromises perfusion to
vital organs. The priority is to restore intravascular volume with IV
fluids and initiate vasopressors (like norepinephrine) to improve
blood pressure and tissue perfusion.
2. The nurse is caring for a patient with acute respiratory distress
syndrome (ARDS). Which assessment finding indicates a worsening
of the condition?
A) Decreased PaCO2
B) Increased lung compliance
C) Refractory hypoxemia
D) Clear lung sounds
Answer: C
Rationale: Refractory hypoxemia (hypoxemia that does not improve
with oxygen therapy) is a hallmark of worsening ARDS due to severe
intrapulmonary shunting and alveolar collapse.
3. A patient with a traumatic brain injury is experiencing an increase
in intracranial pressure (ICP). Which vital sign change is most
consistent with Cushing’s triad?
A) Tachycardia, hypotension, tachypnea
B) Bradycardia, hypertension, irregular respirations
C) Tachycardia, hypertension, bradypnea
,D) Bradycardia, hypotension, Cheyne-Stokes respirations
Answer: B
Rationale: Cushing’s triad is a late sign of increased ICP and is
characterized by bradycardia, an increased pulse pressure (widening
gap between systolic and diastolic, leading to hypertension), and
irregular respirations.
4. A patient is admitted with a severe upper gastrointestinal (GI)
bleed. Which finding requires the most immediate intervention?
A) Hematocrit of 28%
B) Heart rate of 110 bpm
C) Blood pressure of 80/40 mmHg
D) Melena stools
Answer: C
Rationale: A blood pressure of 80/40 mmHg indicates hypovolemic
shock, which is a life-threatening emergency requiring immediate
fluid resuscitation and blood product administration.
5. A patient in the intensive care unit (ICU) is diagnosed with
disseminated intravascular coagulation (DIC). Which lab value would
the nurse expect to find?
A) Increased platelet count
B) Prolonged PT and aPTT
C) Decreased D-dimer
D) Increased fibrinogen
Answer: B
Rationale: In DIC, massive clotting depletes clotting factors and
platelets, leading to prolonged PT and aPTT. Fibrinogen levels drop,
and D-dimer levels increase significantly.
6. Which of the following interventions is most appropriate for a
patient experiencing acute kidney injury (AKI) with a potassium level
of 6.8 mEq/L?
A) Administer Kayexalate
, B) Administer IV insulin and dextrose
C) Administer IV normal saline bolus
D) Restrict fluid intake
Answer: B
Rationale: A potassium level of 6.8 mEq/L is dangerously high and
can cause fatal cardiac arrhythmias. IV regular insulin combined
with dextrose rapidly shifts potassium back into the cells, providing
immediate stabilization.
7. The nurse is monitoring a patient with syndrome of inappropriate
antidiuretic hormone (SIADH). Which finding indicates the treatment
is effective?
A) Urine specific gravity decreases to 1.005
B) Serum sodium increases to 138 mEq/L
C) Patient gains 2 kg in 24 hours
D) Urine output drops to 10 mL/hr
Answer: B
Rationale: SIADH causes water retention and dilutional
hyponatremia. A serum sodium increasing to a normal range (135-
145 mEq/L) indicates the condition is resolving.
8. A patient with a spinal cord injury at the C5 level is at highest risk
for which complication?
A) Autonomic dysreflexia
B) Neurogenic shock
C) Spinal shock
D) Both A and B
Answer: D
Rationale: Injuries at T6 or above are at risk for autonomic
dysreflexia. Injuries at T6 or above (especially C5) are also at high
risk for neurogenic shock due to loss of sympathetic tone.
9. Which of the following assessment findings is a hallmark sign of
fat embolism syndrome (FES) in a patient with a femur fracture?
Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A patient with septic shock has a mean arterial pressure (MAP) of
58 mmHg. Which of the following is the priority action?
A) Administer a beta-blocker
B) Administer IV fluids and vasopressors
C) Administer a diuretic
D) Administer an antipyretic
Answer: B
Rationale: A MAP of less than 60 mmHg compromises perfusion to
vital organs. The priority is to restore intravascular volume with IV
fluids and initiate vasopressors (like norepinephrine) to improve
blood pressure and tissue perfusion.
2. The nurse is caring for a patient with acute respiratory distress
syndrome (ARDS). Which assessment finding indicates a worsening
of the condition?
A) Decreased PaCO2
B) Increased lung compliance
C) Refractory hypoxemia
D) Clear lung sounds
Answer: C
Rationale: Refractory hypoxemia (hypoxemia that does not improve
with oxygen therapy) is a hallmark of worsening ARDS due to severe
intrapulmonary shunting and alveolar collapse.
3. A patient with a traumatic brain injury is experiencing an increase
in intracranial pressure (ICP). Which vital sign change is most
consistent with Cushing’s triad?
A) Tachycardia, hypotension, tachypnea
B) Bradycardia, hypertension, irregular respirations
C) Tachycardia, hypertension, bradypnea
,D) Bradycardia, hypotension, Cheyne-Stokes respirations
Answer: B
Rationale: Cushing’s triad is a late sign of increased ICP and is
characterized by bradycardia, an increased pulse pressure (widening
gap between systolic and diastolic, leading to hypertension), and
irregular respirations.
4. A patient is admitted with a severe upper gastrointestinal (GI)
bleed. Which finding requires the most immediate intervention?
A) Hematocrit of 28%
B) Heart rate of 110 bpm
C) Blood pressure of 80/40 mmHg
D) Melena stools
Answer: C
Rationale: A blood pressure of 80/40 mmHg indicates hypovolemic
shock, which is a life-threatening emergency requiring immediate
fluid resuscitation and blood product administration.
5. A patient in the intensive care unit (ICU) is diagnosed with
disseminated intravascular coagulation (DIC). Which lab value would
the nurse expect to find?
A) Increased platelet count
B) Prolonged PT and aPTT
C) Decreased D-dimer
D) Increased fibrinogen
Answer: B
Rationale: In DIC, massive clotting depletes clotting factors and
platelets, leading to prolonged PT and aPTT. Fibrinogen levels drop,
and D-dimer levels increase significantly.
6. Which of the following interventions is most appropriate for a
patient experiencing acute kidney injury (AKI) with a potassium level
of 6.8 mEq/L?
A) Administer Kayexalate
, B) Administer IV insulin and dextrose
C) Administer IV normal saline bolus
D) Restrict fluid intake
Answer: B
Rationale: A potassium level of 6.8 mEq/L is dangerously high and
can cause fatal cardiac arrhythmias. IV regular insulin combined
with dextrose rapidly shifts potassium back into the cells, providing
immediate stabilization.
7. The nurse is monitoring a patient with syndrome of inappropriate
antidiuretic hormone (SIADH). Which finding indicates the treatment
is effective?
A) Urine specific gravity decreases to 1.005
B) Serum sodium increases to 138 mEq/L
C) Patient gains 2 kg in 24 hours
D) Urine output drops to 10 mL/hr
Answer: B
Rationale: SIADH causes water retention and dilutional
hyponatremia. A serum sodium increasing to a normal range (135-
145 mEq/L) indicates the condition is resolving.
8. A patient with a spinal cord injury at the C5 level is at highest risk
for which complication?
A) Autonomic dysreflexia
B) Neurogenic shock
C) Spinal shock
D) Both A and B
Answer: D
Rationale: Injuries at T6 or above are at risk for autonomic
dysreflexia. Injuries at T6 or above (especially C5) are also at high
risk for neurogenic shock due to loss of sympathetic tone.
9. Which of the following assessment findings is a hallmark sign of
fat embolism syndrome (FES) in a patient with a femur fracture?
