RASMUSSEN UNIVERSITY
NUR 2755 / Multidimensional Care IV (MDC 4)
NUR 2755 — MDC 4 Exam 2
Complete Review • 100 Questions
Latest Update
Course: NUR 2755 Multidimensional Care IV (MDC 4)
Exam: Exam 2 - Comprehensive Review
Total Questions: 100 Multiple-Choice Questions
Format: 4 options (A-D) with single best answer
Cognitive Distribution: 25% Recall | 55% Application | 20% Analysis
Question Style: 75% Scenario-based | 15% Direct Recall | 10% Clinical
Reasoning/Calculation
Content Coverage: Shock, Burns, Respiratory Disorders, Perioperative Care, Integrated Clinical
Scenarios
Key Calculations: Rule of Nines, Parkland Formula, MAP Calculation, ABG Interpretation
Verification: 100% Verified Correct Answers with Comprehensive Rationales
Grade Standard: Grade A+ Aligned with Rasmussen Curriculum Standards
Academic Year: 2026 - 2027
This examination review is designed for educational use by nursing students preparing for the NUR 2755 MDC 4 Exam 2 at Rasmussen
University. All answers have been verified against current evidence-based multidimensional care references and 2026-2027 curriculum
standards. The content integrates the Next-Generation NCLEX clinical judgment framework for nursing competency in critical care.
Rasmussen University • Multidimensional Care IV • 2026-2027
Page 1 | Rasmussen University | NUR 2755 MDC 4 Exam 2
,NUR 2755 MDC 4 Exam 2 - Multidimensional Care IV | Rasmussen University Latest Update
NUR 2755 MDC 4 Exam 2 Review
This comprehensive examination review contains 100 multiple-choice questions organized into five sections aligned
with the Rasmussen University NUR 2755 Multidimensional Care IV (MDC 4) curriculum. The questions assess
mastery of shock states and hemodynamic management, burn injuries and wound care, respiratory disorders and
ventilation, perioperative and postoperative care, and integrated clinical scenarios requiring prioritization and clinical
judgment. Each question is presented in a four-option format with the verified correct answer and a comprehensive
rationale that explains the underlying multidimensional care reasoning, including pathophysiology, clinical
manifestations, nursing interventions, and Rasmussen course-specific competencies with 2026/2027 references.
Sectio
Questions Content Focus
n
1 Q1-Q25 Shock States and Hemodynamic Management
2 Q26-Q45 Burn Injuries and Wound Care
3 Q46-Q65 Respiratory Disorders and Ventilation
4 Q66-Q85 Perioperative and Postoperative Care
5 Q86-Q100 Integrated Clinical Scenarios and Prioritization
Section 1: Shock States and Hemodynamic Management
Distributive, hypovolemic, cardiogenic, and obstructive shock; MAP calculation; SNS compensation; stages of shock;
complications (MODS, ARDS, DIC); pharmacology; collaborative care.
Q1. A 68-year-old male is admitted to the ICU with sepsis. The nurse understands that shock progresses
through four distinct stages. Which stage of shock is characterized by early cellular changes that are not yet
clinically apparent, with vital signs often remaining within normal limits due to compensatory mechanisms?
A. The progressive stage, where compensatory mechanisms have failed.
B. The initial stage, where cellular hypoxia begins but vital signs remain normal because less than 25%
of effective blood volume is lost. [CORRECT]
C. The compensatory stage, where sympathetic nervous system activation produces tachycardia and
vasoconstriction.
D. The refractory stage, where irreversible cellular damage has occurred.
Correct Answer: B
Rationale: The initial stage of shock begins at the cellular level with inadequate oxygen delivery and anaerobic
metabolism, but vital signs often remain within normal limits because compensatory mechanisms have not yet been
activated and less than 25% of effective blood volume has been lost. The compensatory stage follows, with
sympathetic nervous system activation producing tachycardia, tachypnea, and vasoconstriction. The progressive
stage involves failing compensation with falling blood pressure and organ dysfunction. The refractory (irreversible)
stage involves widespread cellular death and organ failure that cannot be reversed.
Page 2 | Rasmussen University | NUR 2755 MDC 4 Exam 2
,NUR 2755 MDC 4 Exam 2 - Multidimensional Care IV | Rasmussen University Latest Update
Q2. A patient in the ICU has a blood pressure of 90/50 mmHg. Using the formula MAP = (SBP + 2DBP) / 3,
what is the patient's mean arterial pressure (MAP), and how should the nurse interpret this value?
A. MAP 60 mmHg - adequate for tissue perfusion.
B. MAP 63 mmHg - below the minimum of 65 mmHg required for adequate tissue perfusion of vital
organs; requires intervention. [CORRECT]
C. MAP 70 mmHg - within the normal range of 70 to 100 mmHg.
D. MAP 90 mmHg - elevated and requires antihypertensive therapy.
Correct Answer: B
Rationale: MAP calculation: (90 + 2x50) / 3 = (90 + 100) / 3 = = 63.3 mmHg. The normal MAP range is 70
to 100 mmHg, and a minimum MAP of 65 mmHg is required to maintain adequate perfusion of vital organs including
the brain, heart, and kidneys. A MAP below 65 mmHg indicates inadequate tissue perfusion and requires immediate
intervention such as fluid resuscitation, vasopressor therapy, or both. Sustained low MAP leads to cellular hypoxia,
anaerobic metabolism, and progression through the stages of shock toward multi-organ dysfunction syndrome
(MODS).
Q3. A patient in early hypovolemic shock demonstrates tachycardia, tachypnea, and narrowed pulse pressure.
The nurse understands these findings represent sympathetic nervous system (SNS) compensation. Which
physiologic mechanism best explains the narrowed pulse pressure observed in this compensatory stage?
A. Decreased stroke volume with compensatory vasoconstriction lowering diastolic pressure more than
systolic.
B. Decreased stroke volume with compensatory vasoconstriction raising diastolic pressure more than
systolic, narrowing the difference between the two. [CORRECT]
C. Increased stroke volume with vasodilation.
D. Increased heart rate with vasodilation.
Correct Answer: B
Rationale: In the compensatory stage of shock, decreased blood volume reduces stroke volume and systolic pressure.
The SNS compensates by releasing norepinephrine, causing vasoconstriction that raises diastolic pressure more than
systolic, narrowing the pulse pressure (the difference between systolic and diastolic). Tachycardia and tachypnea
also occur to improve oxygen delivery. Narrowed pulse pressure (less than 25% of systolic) is an early, sensitive
indicator of shock - often preceding a fall in systolic blood pressure. Recognizing this sign allows early intervention
before progression to the irreversible stage.
Q4. A 72-year-old woman is admitted with septic shock. Vital signs: T 38.9 C, HR 122, BP 84/46, RR 28, SpO2
92%. Lactate 4.8 mmol/L. The nurse recognizes this as distributive shock. Which hemodynamic profile is
most characteristic of septic shock?
A. Cold, clammy skin with decreased cardiac output and increased SVR.
B. Warm, flushed skin early in the course with decreased SVR, increased cardiac output, and mixed
venous oxygen saturation often elevated. [CORRECT]
C. Bradycardia with widened pulse pressure.
D. Hypertension with bradycardia and warm extremities.
Correct Answer: B
Rationale: Septic shock is a form of distributive shock characterized by profound vasodilation (decreased systemic
vascular resistance), increased cardiac output (early), and maldistribution of blood flow with shunting. The classic
early presentation includes warm, flushed skin due to vasodilation, tachycardia, fever or hypothermia, tachypnea,
and altered mental status. The decreased SVR distinguishes it from cardiogenic and hypovolemic shock (which
present with increased SVR and cold, clammy skin). Lactate greater than 2 mmol/L with persistent hypotension
requiring vasopressors after adequate fluid resuscitation defines septic shock per Sepsis-3 criteria.
Page 3 | Rasmussen University | NUR 2755 MDC 4 Exam 2
, NUR 2755 MDC 4 Exam 2 - Multidimensional Care IV | Rasmussen University Latest Update
Q5. A 24-year-old male presents to the ED after a diving accident with a C5 spinal cord injury. He is
hypotensive (BP 80/48), bradycardic (HR 48), and his skin is warm and dry below the level of injury. The
nurse recognizes this presentation as neurogenic shock. Which mechanism best explains this hemodynamic
profile?
A. Loss of sympathetic tone below the level of injury producing vasodilation, decreased SVR, and
unopposed parasympathetic (vagal) activity causing bradycardia. [CORRECT]
B. Massive sympathetic discharge causing vasoconstriction and tachycardia.
C. Cardiac tamponade preventing ventricular filling.
D. Hypovolemia from blood loss at the injury site.
Correct Answer: A
Rationale: Neurogenic shock occurs after spinal cord injury above T6 and is characterized by loss of sympathetic
tone below the level of injury. This produces massive vasodilation with decreased systemic vascular resistance,
hypotension, and warm/dry skin. Unopposed parasympathetic (vagal) activity causes bradycardia - a key feature
distinguishing neurogenic shock from other forms of shock which typically present with tachycardia. Treatment
includes fluid resuscitation, vasopressors (norepinephrine for both alpha and beta effects to support BP and heart
rate), and atropine for symptomatic bradycardia. Neurogenic shock differs from spinal shock, which is a temporary
loss of spinal reflexes.
Q6. A patient receives IV penicillin and within minutes develops urticaria, wheezing, stridor, hypotension (BP
76/40), and tachycardia (HR 132). The nurse recognizes anaphylactic shock. Which immediate intervention is
the priority?
A. Administer diphenhydramine (Benadryl) IV.
B. Administer epinephrine 0.3 to 0.5 mg IM (lateral thigh) immediately, then call the rapid response
team. [CORRECT]
C. Administer IV fluids wide open.
D. Administer methylprednisolone IV.
Correct Answer: B
Rationale: Anaphylactic shock is a Type I hypersensitivity reaction causing massive mast cell degranulation,
histamine release, vasodilation, increased capillary permeability, bronchospasm, and upper airway edema. The
first-line treatment is IM epinephrine 0.3 to 0.5 mg (adult dose of 1:1000 concentration) administered into the
anterolateral thigh (vastus lateralis), which provides rapid alpha-1 vasoconstriction (raises BP, reduces edema),
beta-1 cardiac stimulation (raises HR and contractility), and beta-2 bronchodilation (relieves bronchospasm).
Antihistamines (diphenhydramine), corticosteroids (methylprednisolone), and IV fluids are adjunctive treatments that
follow epinephrine. Delaying epinephrine increases mortality.
Page 4 | Rasmussen University | NUR 2755 MDC 4 Exam 2
NUR 2755 / Multidimensional Care IV (MDC 4)
NUR 2755 — MDC 4 Exam 2
Complete Review • 100 Questions
Latest Update
Course: NUR 2755 Multidimensional Care IV (MDC 4)
Exam: Exam 2 - Comprehensive Review
Total Questions: 100 Multiple-Choice Questions
Format: 4 options (A-D) with single best answer
Cognitive Distribution: 25% Recall | 55% Application | 20% Analysis
Question Style: 75% Scenario-based | 15% Direct Recall | 10% Clinical
Reasoning/Calculation
Content Coverage: Shock, Burns, Respiratory Disorders, Perioperative Care, Integrated Clinical
Scenarios
Key Calculations: Rule of Nines, Parkland Formula, MAP Calculation, ABG Interpretation
Verification: 100% Verified Correct Answers with Comprehensive Rationales
Grade Standard: Grade A+ Aligned with Rasmussen Curriculum Standards
Academic Year: 2026 - 2027
This examination review is designed for educational use by nursing students preparing for the NUR 2755 MDC 4 Exam 2 at Rasmussen
University. All answers have been verified against current evidence-based multidimensional care references and 2026-2027 curriculum
standards. The content integrates the Next-Generation NCLEX clinical judgment framework for nursing competency in critical care.
Rasmussen University • Multidimensional Care IV • 2026-2027
Page 1 | Rasmussen University | NUR 2755 MDC 4 Exam 2
,NUR 2755 MDC 4 Exam 2 - Multidimensional Care IV | Rasmussen University Latest Update
NUR 2755 MDC 4 Exam 2 Review
This comprehensive examination review contains 100 multiple-choice questions organized into five sections aligned
with the Rasmussen University NUR 2755 Multidimensional Care IV (MDC 4) curriculum. The questions assess
mastery of shock states and hemodynamic management, burn injuries and wound care, respiratory disorders and
ventilation, perioperative and postoperative care, and integrated clinical scenarios requiring prioritization and clinical
judgment. Each question is presented in a four-option format with the verified correct answer and a comprehensive
rationale that explains the underlying multidimensional care reasoning, including pathophysiology, clinical
manifestations, nursing interventions, and Rasmussen course-specific competencies with 2026/2027 references.
Sectio
Questions Content Focus
n
1 Q1-Q25 Shock States and Hemodynamic Management
2 Q26-Q45 Burn Injuries and Wound Care
3 Q46-Q65 Respiratory Disorders and Ventilation
4 Q66-Q85 Perioperative and Postoperative Care
5 Q86-Q100 Integrated Clinical Scenarios and Prioritization
Section 1: Shock States and Hemodynamic Management
Distributive, hypovolemic, cardiogenic, and obstructive shock; MAP calculation; SNS compensation; stages of shock;
complications (MODS, ARDS, DIC); pharmacology; collaborative care.
Q1. A 68-year-old male is admitted to the ICU with sepsis. The nurse understands that shock progresses
through four distinct stages. Which stage of shock is characterized by early cellular changes that are not yet
clinically apparent, with vital signs often remaining within normal limits due to compensatory mechanisms?
A. The progressive stage, where compensatory mechanisms have failed.
B. The initial stage, where cellular hypoxia begins but vital signs remain normal because less than 25%
of effective blood volume is lost. [CORRECT]
C. The compensatory stage, where sympathetic nervous system activation produces tachycardia and
vasoconstriction.
D. The refractory stage, where irreversible cellular damage has occurred.
Correct Answer: B
Rationale: The initial stage of shock begins at the cellular level with inadequate oxygen delivery and anaerobic
metabolism, but vital signs often remain within normal limits because compensatory mechanisms have not yet been
activated and less than 25% of effective blood volume has been lost. The compensatory stage follows, with
sympathetic nervous system activation producing tachycardia, tachypnea, and vasoconstriction. The progressive
stage involves failing compensation with falling blood pressure and organ dysfunction. The refractory (irreversible)
stage involves widespread cellular death and organ failure that cannot be reversed.
Page 2 | Rasmussen University | NUR 2755 MDC 4 Exam 2
,NUR 2755 MDC 4 Exam 2 - Multidimensional Care IV | Rasmussen University Latest Update
Q2. A patient in the ICU has a blood pressure of 90/50 mmHg. Using the formula MAP = (SBP + 2DBP) / 3,
what is the patient's mean arterial pressure (MAP), and how should the nurse interpret this value?
A. MAP 60 mmHg - adequate for tissue perfusion.
B. MAP 63 mmHg - below the minimum of 65 mmHg required for adequate tissue perfusion of vital
organs; requires intervention. [CORRECT]
C. MAP 70 mmHg - within the normal range of 70 to 100 mmHg.
D. MAP 90 mmHg - elevated and requires antihypertensive therapy.
Correct Answer: B
Rationale: MAP calculation: (90 + 2x50) / 3 = (90 + 100) / 3 = = 63.3 mmHg. The normal MAP range is 70
to 100 mmHg, and a minimum MAP of 65 mmHg is required to maintain adequate perfusion of vital organs including
the brain, heart, and kidneys. A MAP below 65 mmHg indicates inadequate tissue perfusion and requires immediate
intervention such as fluid resuscitation, vasopressor therapy, or both. Sustained low MAP leads to cellular hypoxia,
anaerobic metabolism, and progression through the stages of shock toward multi-organ dysfunction syndrome
(MODS).
Q3. A patient in early hypovolemic shock demonstrates tachycardia, tachypnea, and narrowed pulse pressure.
The nurse understands these findings represent sympathetic nervous system (SNS) compensation. Which
physiologic mechanism best explains the narrowed pulse pressure observed in this compensatory stage?
A. Decreased stroke volume with compensatory vasoconstriction lowering diastolic pressure more than
systolic.
B. Decreased stroke volume with compensatory vasoconstriction raising diastolic pressure more than
systolic, narrowing the difference between the two. [CORRECT]
C. Increased stroke volume with vasodilation.
D. Increased heart rate with vasodilation.
Correct Answer: B
Rationale: In the compensatory stage of shock, decreased blood volume reduces stroke volume and systolic pressure.
The SNS compensates by releasing norepinephrine, causing vasoconstriction that raises diastolic pressure more than
systolic, narrowing the pulse pressure (the difference between systolic and diastolic). Tachycardia and tachypnea
also occur to improve oxygen delivery. Narrowed pulse pressure (less than 25% of systolic) is an early, sensitive
indicator of shock - often preceding a fall in systolic blood pressure. Recognizing this sign allows early intervention
before progression to the irreversible stage.
Q4. A 72-year-old woman is admitted with septic shock. Vital signs: T 38.9 C, HR 122, BP 84/46, RR 28, SpO2
92%. Lactate 4.8 mmol/L. The nurse recognizes this as distributive shock. Which hemodynamic profile is
most characteristic of septic shock?
A. Cold, clammy skin with decreased cardiac output and increased SVR.
B. Warm, flushed skin early in the course with decreased SVR, increased cardiac output, and mixed
venous oxygen saturation often elevated. [CORRECT]
C. Bradycardia with widened pulse pressure.
D. Hypertension with bradycardia and warm extremities.
Correct Answer: B
Rationale: Septic shock is a form of distributive shock characterized by profound vasodilation (decreased systemic
vascular resistance), increased cardiac output (early), and maldistribution of blood flow with shunting. The classic
early presentation includes warm, flushed skin due to vasodilation, tachycardia, fever or hypothermia, tachypnea,
and altered mental status. The decreased SVR distinguishes it from cardiogenic and hypovolemic shock (which
present with increased SVR and cold, clammy skin). Lactate greater than 2 mmol/L with persistent hypotension
requiring vasopressors after adequate fluid resuscitation defines septic shock per Sepsis-3 criteria.
Page 3 | Rasmussen University | NUR 2755 MDC 4 Exam 2
, NUR 2755 MDC 4 Exam 2 - Multidimensional Care IV | Rasmussen University Latest Update
Q5. A 24-year-old male presents to the ED after a diving accident with a C5 spinal cord injury. He is
hypotensive (BP 80/48), bradycardic (HR 48), and his skin is warm and dry below the level of injury. The
nurse recognizes this presentation as neurogenic shock. Which mechanism best explains this hemodynamic
profile?
A. Loss of sympathetic tone below the level of injury producing vasodilation, decreased SVR, and
unopposed parasympathetic (vagal) activity causing bradycardia. [CORRECT]
B. Massive sympathetic discharge causing vasoconstriction and tachycardia.
C. Cardiac tamponade preventing ventricular filling.
D. Hypovolemia from blood loss at the injury site.
Correct Answer: A
Rationale: Neurogenic shock occurs after spinal cord injury above T6 and is characterized by loss of sympathetic
tone below the level of injury. This produces massive vasodilation with decreased systemic vascular resistance,
hypotension, and warm/dry skin. Unopposed parasympathetic (vagal) activity causes bradycardia - a key feature
distinguishing neurogenic shock from other forms of shock which typically present with tachycardia. Treatment
includes fluid resuscitation, vasopressors (norepinephrine for both alpha and beta effects to support BP and heart
rate), and atropine for symptomatic bradycardia. Neurogenic shock differs from spinal shock, which is a temporary
loss of spinal reflexes.
Q6. A patient receives IV penicillin and within minutes develops urticaria, wheezing, stridor, hypotension (BP
76/40), and tachycardia (HR 132). The nurse recognizes anaphylactic shock. Which immediate intervention is
the priority?
A. Administer diphenhydramine (Benadryl) IV.
B. Administer epinephrine 0.3 to 0.5 mg IM (lateral thigh) immediately, then call the rapid response
team. [CORRECT]
C. Administer IV fluids wide open.
D. Administer methylprednisolone IV.
Correct Answer: B
Rationale: Anaphylactic shock is a Type I hypersensitivity reaction causing massive mast cell degranulation,
histamine release, vasodilation, increased capillary permeability, bronchospasm, and upper airway edema. The
first-line treatment is IM epinephrine 0.3 to 0.5 mg (adult dose of 1:1000 concentration) administered into the
anterolateral thigh (vastus lateralis), which provides rapid alpha-1 vasoconstriction (raises BP, reduces edema),
beta-1 cardiac stimulation (raises HR and contractility), and beta-2 bronchodilation (relieves bronchospasm).
Antihistamines (diphenhydramine), corticosteroids (methylprednisolone), and IV fluids are adjunctive treatments that
follow epinephrine. Delaying epinephrine increases mortality.
Page 4 | Rasmussen University | NUR 2755 MDC 4 Exam 2
