RASMUSSEN UNIVERSITY
College of Nursing
2026-2027 Academic Year
NUR 2392 / NUR 2392
Multidimensional Care II
Final Examination
200 Questions with Comprehensive Rationales
Latest Curriculum Standards
Rasmussen University - College of Nursing
Exam Details
Total Questions: 200
Format: Multiple Choice (A-D)
Cognitive Levels: 25% Recall, 55% Application, 20% Analysis
Question Style: 70% Scenario-based, 20% Direct Recall, 10%
Clinical Judgment
200 Questions | Comprehensive Rationales | Multidimensional Care II
Confidential Examination Material
, NUR 2392 Multidimensional Care II Final Examination | Rasmussen University 2026/2027
Table of Contents
Table of Contents 2
Section 1: Endocrine Disorders 3
Section 2: Cancer Care and Oncology Nursing 9
Section 3: Fluid, Electrolyte, and Acid-Base Imbalances 16
Section 4: Cardiovascular and Respiratory Emergencies 21
Section 5: Renal, Gastrointestinal, and Hepatic Disorders 28
Section 6: Perioperative and Postoperative Care 35
Section 7: Multisystem Management and Prioritization 40
Section 8: Integrated Clinical Scenarios (NGN Style) 44
Page 2
, NUR 2392 Multidimensional Care II Final Examination | Rasmussen University 2026/2027
Section 1: Endocrine Disorders
Pituitary, Thyroid, Pancreas, Adrenals, Parathyroid (Q1-Q30)
1. The nurse is caring for a client with anterior hypopituitarism. Which hormone deficiencies are considered the most
life-threatening and require priority monitoring?
A. Growth hormone (GH) and follicle-stimulating hormone (FSH)
B. Adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) [CORRECT]
C. Prolactin and luteinizing hormone (LH)
D. Melanocyte-stimulating hormone (MSH) and oxytocin
Correct Answer: B
Rationale: ACTH deficiency leads to adrenal insufficiency with risk of adrenal crisis (hypotension, shock), and TSH
deficiency causes secondary hypothyroidism (bradycardia, hypothermia, myxedema coma). Both can be fatal if untreated. GH
and FSH deficiencies affect growth and reproduction but are not immediately life-threatening. Prolactin and LH deficiencies
impact lactation and reproduction. MSH and oxytocin deficiencies are not life-threatening.
2. A client with diabetes insipidus (DI) is admitted with polyuria and polydipsia. Which urinalysis finding is most
consistent with this condition?
A. Specific gravity of 1.030
B. Specific gravity less than 1.005 [CORRECT]
C. Ketones present in the urine
D. Proteinuria with elevated WBCs
Correct Answer: B
Rationale: Diabetes insipidus is caused by ADH deficiency (central) or renal resistance to ADH (nephrogenic), leading to
inability to concentrate urine. The hallmark finding is very dilute urine with specific gravity below 1.005. A specific gravity of
1.030 indicates concentrated urine, normal or seen in dehydration. Ketones suggest DKA. Proteinuria and WBCs suggest kidney
infection or glomerular damage.
3. The nurse is reviewing the medication profile of a client with diabetes insipidus. Which medication should the
nurse expect to administer?
A. Regular insulin
B. Desmopressin (DDAVP) [CORRECT]
C. Furosemide (Lasix)
D. Methimazole (Tapazole)
Correct Answer: B
Rationale: Desmopressin (DDAVP) is a synthetic analog of antidiuretic hormone (ADH) and is the primary treatment for
central diabetes insipidus. It acts on the renal collecting ducts to promote water reabsorption, reducing polyuria and polydipsia.
Regular insulin treats diabetes mellitus. Furosemide would worsen DI symptoms. Methimazole treats hyperthyroidism.
4. A client with SIADH has a serum sodium level of 118 mEq/L. Which intervention is the priority?
A. Administer 3% hypertonic saline intravenously as prescribed [CORRECT]
B. Encourage oral fluid intake of at least 3 liters per day
C. Administer desmopressin (DDAVP) subcutaneously
D. Restrict fluid intake to 800-1000 mL per day
Correct Answer: A
Rationale: SIADH causes excessive water retention leading to severe hyponatremia. A sodium level of 118 mEq/L is critically
low and constitutes a medical emergency with risk of seizures, coma, and brain herniation. Hypertonic saline (3% NaCl) is the
priority for severe symptomatic hyponatremia to rapidly raise serum sodium. Fluid restriction is first-line for mild cases only.
Desmopressin would worsen SIADH. Encouraging fluids would further dilute sodium.
Page 3
, NUR 2392 Multidimensional Care II Final Examination | Rasmussen University 2026/2027
5. The nurse is developing a teaching plan for a client with SIADH. Which statement indicates understanding of fluid
management?
A. "I should drink at least 3 liters of water daily."
B. "I need to limit my fluid intake to about 1 liter per day." [CORRECT]
C. "I should increase my sodium intake by eating salty foods."
D. "I will drink sports drinks to replace electrolytes."
Correct Answer: B
Rationale: SIADH involves excess ADH secretion causing water retention and dilutional hyponatremia. The cornerstone of
management is fluid restriction (typically 800-1000 mL/day) to prevent further water retention and sodium dilution. Drinking 3
liters would worsen hyponatremia. Increasing sodium alone does not correct excess free water. Sports drinks contain free water
and would worsen fluid excess.
6. A client presents with exophthalmos, tachycardia, heat intolerance, and a diffuse goiter. The nurse recognizes these
findings as consistent with which condition?
A. Hashimoto's thyroiditis
B. Graves' disease [CORRECT]
C. Pituitary adenoma
D. Addison's disease
Correct Answer: B
Rationale: Graves' disease is an autoimmune disorder causing hyperthyroidism. The classic triad includes diffuse goiter,
exophthalmos (proptosis from autoimmune infiltration of orbital tissues), and tachycardia with heat intolerance from excess
thyroid hormone increasing metabolic rate. Hashimoto's causes hypothyroidism. Pituitary adenomas cause hormonal imbalances
but not this presentation. Addison's involves adrenal insufficiency with fatigue, hypotension, and hyperpigmentation.
7. The nurse is caring for a client with Graves' disease experiencing agitation, diaphoresis, and temperature of 102.0
F. Which nursing intervention is the priority?
A. Provide a warm blanket and reassure the client
B. Administer prescribed methimazole and monitor cardiac rhythm [CORRECT]
C. Encourage the client to exercise to reduce anxiety
D. Place the client in a supine position to promote rest
Correct Answer: B
Rationale: This client shows signs of thyroid storm, a life-threatening complication of Graves' disease characterized by fever,
tachycardia, agitation, and altered mental status. Priority is administering antithyroid medication (methimazole) to block thyroid
hormone synthesis and monitoring cardiac rhythm due to arrhythmia risk. A cool (not warm) environment is appropriate.
Exercise increases metabolic rate and worsens symptoms. Supine position may worsen respiratory effort.
8. Which nursing intervention is most appropriate for a client hospitalized with Graves' disease?
A. Maintain a warm room temperature and provide extra blankets
B. Encourage frequent visitors to reduce social isolation [CORRECT]
C. Provide a calm, cool environment and monitor daily weights
D. Restrict protein intake to reduce metabolic demands
Correct Answer: B
Rationale: Clients with Graves' disease have elevated metabolic rate causing heat intolerance. A calm, cool environment
reduces metabolic demands and provides comfort. Daily weight monitoring assesses fluid balance. Warm environments worsen
heat intolerance. Too many visitors increase stimulation and agitation. Protein intake should be increased, not restricted, to meet
elevated metabolic demands.
9. A client with hyperthyroidism is prescribed methimazole. The nurse should teach the client to monitor for which
adverse effect?
A. Weight gain and cold intolerance
Page 4
College of Nursing
2026-2027 Academic Year
NUR 2392 / NUR 2392
Multidimensional Care II
Final Examination
200 Questions with Comprehensive Rationales
Latest Curriculum Standards
Rasmussen University - College of Nursing
Exam Details
Total Questions: 200
Format: Multiple Choice (A-D)
Cognitive Levels: 25% Recall, 55% Application, 20% Analysis
Question Style: 70% Scenario-based, 20% Direct Recall, 10%
Clinical Judgment
200 Questions | Comprehensive Rationales | Multidimensional Care II
Confidential Examination Material
, NUR 2392 Multidimensional Care II Final Examination | Rasmussen University 2026/2027
Table of Contents
Table of Contents 2
Section 1: Endocrine Disorders 3
Section 2: Cancer Care and Oncology Nursing 9
Section 3: Fluid, Electrolyte, and Acid-Base Imbalances 16
Section 4: Cardiovascular and Respiratory Emergencies 21
Section 5: Renal, Gastrointestinal, and Hepatic Disorders 28
Section 6: Perioperative and Postoperative Care 35
Section 7: Multisystem Management and Prioritization 40
Section 8: Integrated Clinical Scenarios (NGN Style) 44
Page 2
, NUR 2392 Multidimensional Care II Final Examination | Rasmussen University 2026/2027
Section 1: Endocrine Disorders
Pituitary, Thyroid, Pancreas, Adrenals, Parathyroid (Q1-Q30)
1. The nurse is caring for a client with anterior hypopituitarism. Which hormone deficiencies are considered the most
life-threatening and require priority monitoring?
A. Growth hormone (GH) and follicle-stimulating hormone (FSH)
B. Adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) [CORRECT]
C. Prolactin and luteinizing hormone (LH)
D. Melanocyte-stimulating hormone (MSH) and oxytocin
Correct Answer: B
Rationale: ACTH deficiency leads to adrenal insufficiency with risk of adrenal crisis (hypotension, shock), and TSH
deficiency causes secondary hypothyroidism (bradycardia, hypothermia, myxedema coma). Both can be fatal if untreated. GH
and FSH deficiencies affect growth and reproduction but are not immediately life-threatening. Prolactin and LH deficiencies
impact lactation and reproduction. MSH and oxytocin deficiencies are not life-threatening.
2. A client with diabetes insipidus (DI) is admitted with polyuria and polydipsia. Which urinalysis finding is most
consistent with this condition?
A. Specific gravity of 1.030
B. Specific gravity less than 1.005 [CORRECT]
C. Ketones present in the urine
D. Proteinuria with elevated WBCs
Correct Answer: B
Rationale: Diabetes insipidus is caused by ADH deficiency (central) or renal resistance to ADH (nephrogenic), leading to
inability to concentrate urine. The hallmark finding is very dilute urine with specific gravity below 1.005. A specific gravity of
1.030 indicates concentrated urine, normal or seen in dehydration. Ketones suggest DKA. Proteinuria and WBCs suggest kidney
infection or glomerular damage.
3. The nurse is reviewing the medication profile of a client with diabetes insipidus. Which medication should the
nurse expect to administer?
A. Regular insulin
B. Desmopressin (DDAVP) [CORRECT]
C. Furosemide (Lasix)
D. Methimazole (Tapazole)
Correct Answer: B
Rationale: Desmopressin (DDAVP) is a synthetic analog of antidiuretic hormone (ADH) and is the primary treatment for
central diabetes insipidus. It acts on the renal collecting ducts to promote water reabsorption, reducing polyuria and polydipsia.
Regular insulin treats diabetes mellitus. Furosemide would worsen DI symptoms. Methimazole treats hyperthyroidism.
4. A client with SIADH has a serum sodium level of 118 mEq/L. Which intervention is the priority?
A. Administer 3% hypertonic saline intravenously as prescribed [CORRECT]
B. Encourage oral fluid intake of at least 3 liters per day
C. Administer desmopressin (DDAVP) subcutaneously
D. Restrict fluid intake to 800-1000 mL per day
Correct Answer: A
Rationale: SIADH causes excessive water retention leading to severe hyponatremia. A sodium level of 118 mEq/L is critically
low and constitutes a medical emergency with risk of seizures, coma, and brain herniation. Hypertonic saline (3% NaCl) is the
priority for severe symptomatic hyponatremia to rapidly raise serum sodium. Fluid restriction is first-line for mild cases only.
Desmopressin would worsen SIADH. Encouraging fluids would further dilute sodium.
Page 3
, NUR 2392 Multidimensional Care II Final Examination | Rasmussen University 2026/2027
5. The nurse is developing a teaching plan for a client with SIADH. Which statement indicates understanding of fluid
management?
A. "I should drink at least 3 liters of water daily."
B. "I need to limit my fluid intake to about 1 liter per day." [CORRECT]
C. "I should increase my sodium intake by eating salty foods."
D. "I will drink sports drinks to replace electrolytes."
Correct Answer: B
Rationale: SIADH involves excess ADH secretion causing water retention and dilutional hyponatremia. The cornerstone of
management is fluid restriction (typically 800-1000 mL/day) to prevent further water retention and sodium dilution. Drinking 3
liters would worsen hyponatremia. Increasing sodium alone does not correct excess free water. Sports drinks contain free water
and would worsen fluid excess.
6. A client presents with exophthalmos, tachycardia, heat intolerance, and a diffuse goiter. The nurse recognizes these
findings as consistent with which condition?
A. Hashimoto's thyroiditis
B. Graves' disease [CORRECT]
C. Pituitary adenoma
D. Addison's disease
Correct Answer: B
Rationale: Graves' disease is an autoimmune disorder causing hyperthyroidism. The classic triad includes diffuse goiter,
exophthalmos (proptosis from autoimmune infiltration of orbital tissues), and tachycardia with heat intolerance from excess
thyroid hormone increasing metabolic rate. Hashimoto's causes hypothyroidism. Pituitary adenomas cause hormonal imbalances
but not this presentation. Addison's involves adrenal insufficiency with fatigue, hypotension, and hyperpigmentation.
7. The nurse is caring for a client with Graves' disease experiencing agitation, diaphoresis, and temperature of 102.0
F. Which nursing intervention is the priority?
A. Provide a warm blanket and reassure the client
B. Administer prescribed methimazole and monitor cardiac rhythm [CORRECT]
C. Encourage the client to exercise to reduce anxiety
D. Place the client in a supine position to promote rest
Correct Answer: B
Rationale: This client shows signs of thyroid storm, a life-threatening complication of Graves' disease characterized by fever,
tachycardia, agitation, and altered mental status. Priority is administering antithyroid medication (methimazole) to block thyroid
hormone synthesis and monitoring cardiac rhythm due to arrhythmia risk. A cool (not warm) environment is appropriate.
Exercise increases metabolic rate and worsens symptoms. Supine position may worsen respiratory effort.
8. Which nursing intervention is most appropriate for a client hospitalized with Graves' disease?
A. Maintain a warm room temperature and provide extra blankets
B. Encourage frequent visitors to reduce social isolation [CORRECT]
C. Provide a calm, cool environment and monitor daily weights
D. Restrict protein intake to reduce metabolic demands
Correct Answer: B
Rationale: Clients with Graves' disease have elevated metabolic rate causing heat intolerance. A calm, cool environment
reduces metabolic demands and provides comfort. Daily weight monitoring assesses fluid balance. Warm environments worsen
heat intolerance. Too many visitors increase stimulation and agitation. Protein intake should be increased, not restricted, to meet
elevated metabolic demands.
9. A client with hyperthyroidism is prescribed methimazole. The nurse should teach the client to monitor for which
adverse effect?
A. Weight gain and cold intolerance
Page 4
