AND ANSWERS () (VERIFIED ANSWERS)
Rasmussen College MDC 2 (Multidimensional Care II) Exam 1
Academic Year 2026/2027 | High-Yield Verified Questions, Answers & Rationales
Table of Contents
1. Section I: Endocrine System Disorders (Questions 1–15)
2. Section II: Renal & Urinary Systems (Questions 16–30)
3. Section III: Fluid, Electrolyte & Acid-Base Balance (Questions 31–40)
4. Section IV: Applied Clinical Prioritization & Scenarios (Questions 41–50)
Section I: Endocrine System Disorders
Question 1
A nurse is caring for a client admitted with acute Hypothyroidism (Myxedema Coma).
Which assessment finding requires immediate intervention by the nurse?
• A. Dry skin and brittle hair
• B. Respiratory rate of $8 \text{ breaths/min}$ and decreased level of consciousness
• C. Generalized non-pitting edema
• D. Client report of cold intolerance
Correct Answer: B. Respiratory rate of $8 \text{ breaths/min}$ and decreased level of
consciousness
Rationale: Myxedema Coma is a severe, life-threatening complication of unmanaged
hypothyroidism. The most critical signs are severe hypoventilation, respiratory failure,
hypotension, hyponatremia, hypothermia, and coma. Airway maintenance and ventilatory
support are the top priorities. Options A, C, and D are expected clinical manifestations of
hypothyroidism that do not pose an immediate threat to life.
Question 2
A client who underwent a total thyroidectomy 12 hours ago reports numbness and tingling
around their mouth and fingers. Which nursing action should be performed first?
• A. Check the operative dressing for hemorrhage.
, • B. Assess for Chvostek's and Trousseau's signs and prepare Calcium Gluconate.
• C. Reassure the client that paresthesia is a normal side effect of anesthesia.
• D. Elevate the head of the bed to $45^\circ$.
Correct Answer: B. Assess for Chvostek's and Trousseau's signs and prepare Calcium
Gluconate.
Rationale: Accidental removal or damage to the parathyroid glands during thyroidectomy causes
acute hypocalcemia. Perioral numbness, tingling in fingertips/toes, and muscle twitching are
early signs of hypocalcemia, which can progress to tetany, laryngospasm, and cardiac arrest.
Assessing for Chvostek’s (facial twitching) and Trousseau’s (carpopedal spasm) signs confirms
hypocalcemia, and IV Calcium Gluconate must be readily available.
Question 3
The nurse is teaching a client newly diagnosed with Type 1 Diabetes Mellitus about insulin
management. Which statement indicates the client understands the peak action time of
Lispro (Humalog) insulin?
• A. "I will eat my meal within 15 minutes of taking this insulin because it works very
fast."
• B. "This insulin will peak in 6 to 10 hours after injection."
• C. "I should take this insulin at bedtime because it has no peak."
• D. "I will need to wait 1 hour after injection before eating."
Correct Answer: A. "I will eat my meal within 15 minutes of taking this insulin because it
works very fast."
Rationale: Lispro (Humalog) is a rapid-acting insulin with an onset of 15 minutes, a peak of 30
minutes to 1.5 hours, and a duration of 3 to 5 hours. Because of its rapid onset, the client must
eat immediately (within 5–15 minutes) after administration to prevent severe hypoglycemia.
Question 4
A client with Cushing’s Disease is admitted to the medical-surgical unit. Which laboratory
finding should the nurse anticipate?
• A. Blood glucose $72 \text{ mg/dL}$, Serum Sodium $128 \text{ mEq/L}$
• B. Blood glucose $210 \text{ mg/dL}$, Serum Sodium $149 \text{ mEq/L}$, Serum
Potassium $3.1 \text{ mEq/L}$
• C. Blood glucose $90 \text{ mg/dL}$, Serum Sodium $138 \text{ mEq/L}$, Serum
Potassium $5.2 \text{ mEq/L}$
, • D. Blood glucose $110 \text{ mg/dL}$, Serum Calcium $11.5 \text{ mg/dL}$
Correct Answer: B. Blood glucose $210 \text{ mg/dL}$, Serum Sodium $149 \text{ mEq/L}$,
Serum Potassium $3.1 \text{ mEq/L}$
Rationale: Cushing’s Disease involves hypercortisolism. Excess glucocorticoids cause
gluconeogenesis leading to hyperglycemia. Excess mineralocorticoids (aldosterone effects) lead
to sodium and water retention (hypernatremia) and potassium excretion (hypokalemia).
Question 5
A nurse is assessing a client presenting with Addisonian Crisis (Acute Adrenal
Insufficiency). Which baseline vital sign and lab set is classic for this condition?
• A. BP 82/50 mmHg, $K^+: 6.2 \text{ mEq/L}$, $Na^+: 126 \text{ mEq/L}$, Blood
Glucose: $54 \text{ mg/dL}$
• B. BP 170/100 mmHg, $K^+: 3.2 \text{ mEq/L}$, $Na^+: 150 \text{ mEq/L}$, Blood
Glucose: $180 \text{ mg/dL}$
• C. BP 120/80 mmHg, $K^+: 4.0 \text{ mEq/L}$, $Na^+: 140 \text{ mEq/L}$, Blood
Glucose: $95 \text{ mg/dL}$
• D. BP 140/90 mmHg, $K^+: 4.5 \text{ mEq/L}$, $Na^+: 135 \text{ mEq/L}$, Blood
Glucose: $110 \text{ mg/dL}$
Correct Answer: A. BP 82/50 mmHg, $K^+: 6.2 \text{ mEq/L}$, $Na^+: 126 \text{ mEq/L}$,
Blood Glucose: $54 \text{ mg/dL}$
Rationale: Addison’s disease is a deficiency of glucocorticoids and mineralocorticoids
(aldosterone). Lack of aldosterone causes massive sodium loss, fluid loss, severe
hypotension/shock, and potassium retention (hyperkalemia). Lack of cortisol causes severe
hypoglycemia. Treatment requires IV Hydrocortisone, fluid resuscitation ($0.9\% \text{ NS}$),
and glucose monitoring.
Question 6
Which diagnostic result best confirms a diagnosis of Diabetes Insipidus (DI)?
• A. Urine specific gravity of $1.035$ and urine output of $50 \text{ mL/hr}$
• B. High serum osmolality ($>295 \text{ mOsm/kg}$) combined with low urine specific
gravity ($<1.005$)
• C. Serum sodium of $125 \text{ mEq/L}$ and concentrated urine
• D. Fasting blood glucose level of $300 \text{ mg/dL}$