NUR 2755 Multidimensional Care IV MDC
Final Exam: 2026/2027 Questions and
Verified Answers - Rasmussen
OVERVIEW:
NUR 2755 Multidimensional Care IV MDC Final Exam covers emergency,
neurological, burn, respiratory, perioperative and critical care concepts. Includes
near-drowning, heatstroke, shock, stroke, ICP, seizures, spinal cord injury,
autonomic dysreflexia, flail chest, PE, Parkinson's, GBS, MS, frostbite, burn
resuscitation Parkland, Rule of Nines, triage, disaster, DMAT, surgical asepsis,
latex allergy, ventilator management, GCS, medication safety, prioritization and
delegation for comprehensive adult health nursing practice and clinical judgment
preparation for success.
Correct answer highlighted in bold Green + rationales.
1. A client who experienced a near drowning accident in a local pool, but now is awake and
breathing spontaneously, is admitted for observation. Which assessment will be most
important for the nurse to take during the observation period?
A) Auscultate heart sounds
B) palpate peripheral pulses
C) Auscultate breath sounds (NOTE: drowning → risk for pulmonary infection, ARDS, CNS
impairment)
D) check pupil reaction to light
Rationale: Near drowning causes aspiration, alveolar damage, pulmonary edema and ARDS risk. Close
respiratory monitoring including breath sounds, SpO2, work of breathing is priority for 24h.
2. A client who has undergone preadmission laboratory studies, including a complete blood
count, coagulation studies, and electrolytes and creatinine levels. Which of the following
laboratory results should be reported to the surgeon's office by the nurse, knowing that it
could cause surgery to be postponed?
, A) Sodium, 141 mEq/L (normal range 135-145)
B) Hemoglobin, 8.0 g/dL Need HGB >9
C) Platelets, 210,000/mm3 Platelets need >50,000
D) Serum creatinine, 0.8 mg/dl (normal range is 0.6-1.2) Select if Creatinine level 2.0mg/dl
Rationale: Hgb 8.0 indicates anemia impairing oxygen carrying capacity and healing; surgery postponed
until corrected to >9-10 g/dL. Creatinine 2.0 indicates renal dysfunction affecting anesthesia clearance
and drug dosing.
3. The nurse is caring for a patient suspected of having heatstroke. Which findings are
consistent with this diagnosis? (Select all that apply.)
A) Bradycardia
B) Tachycardia (also Tachypnea)
C) Irregular pulse patterns (dysrhythmias)
D) Visual disturbances (hallucinations)
E) Decreased urinary output
F) Mental status changes
G) Loss of coordination
H) Hypertension (should be Hypotension)
Rationale: Heatstroke is hyperthermia >104F with CNS dysfunction, tachycardia, tachypnea,
hypotension, dysrhythmias from electrolyte loss, oliguria, confusion, ataxia, hallucinations due to
cerebral edema.
4. At which time of the day should the nurse encourage the client with Parkinson's disease to
schedule the most demanding physical activities to minimize the effects of hypokinesia?
A) Early in the morning when the client's energy level is high
B) To coincide with the peak action of drug therapy
C) Immediately after a rest period
D) When family members will be available
,Rationale: Levodopa peak action gives best mobility and least bradykinesia/rigidity. Activities
scheduled at peak drug effect improve safety and performance.
5. Which of the following would be classified as an external disaster?
A) A fire started in the emergency department
B) A city-wide power outage
C) Massive flooding
D) A bomb threat to administration
Rationale: External disasters originate outside hospital and bring influx of victims - flooding,
earthquake, mass casualty, chemical plant explosion. Internal disasters originate inside facility.
6. On a hot, humid day, a client arrives in the emergency department presenting with
confusion, lethargy, and the following vital signs: temperature 104.1 degrees F, pulse 132
beats/min, respiration 26 breaths/min, and blood pressure 106/66 mm Hg. What is the most
appropriate intervention for this client? (Heat Stroke)
A) Encourage the client to drink cool water or sports drinks
B) Start an intravenous line and infuse 0.9% saline solution
C) Administer acetaminophen 650 milligram orally
D) Encourage rest and reassess in 15 minutes
Rationale: Heat stroke with confusion and hypotension is a medical emergency with volume depletion.
Immediate isotonic IV fluids restore perfusion and aid cooling; antipyretics ineffective for non-
pyrogenic hyperthermia.
7. The nurse is orienting a new nurse to the pediatric intensive care unit and discussing the
care of a client recovering from drowning. Which statement by the new nurse accurately
demonstrates an understanding of this condition?
A) Drowning results in the collapse of alveoli and pulmonary edema.
B) Drowning causes an increased amount of surfactant in the lungs, which decreases airway
pressure
C) Since the client has recovered, we should not need to monitor for any complications
, D) It is OK to leave children unattended in a bathtub as long as it's only for a minute or two
Rationale: Aspiration washes out surfactant, causes atelectasis, alveolar collapse, pulmonary edema,
V/Q mismatch and ARDS. Continuous monitoring for respiratory deterioration, infection and cerebral
edema is essential.
8. A nurse in an emergency department is caring for a client with a penetrating trauma from a
gunshot and a sucking chest wound. The client has a blood pressure of 101/61 mm Hg, a weak
pulse, rate of 117/min, a respiratory rate of 39/min, and a pulse oximeter reading of 90% on
room air. Which action should the nurse take first in the primary survey?
A) Place the client in Trendelenburg position
B) Remove the dressing to inspect the wound
C) Prepare to insert a central line
D) Administer oxygen via nonrebreather mask per order (Or provide bag valve ventilation)
Rationale: Sucking chest wound = open pneumothorax. Primary survey is Airway-Breathing. Hypoxia is
life-threatening; high-flow O2 via nonrebreather immediately, then occlusive dressing taped on 3 sides.
9. A triage officer is discussing mass casualty triage during a tabletop disaster drill. Which
statement should indicate the staff member requires further teaching?
A) Clients in the emergent category should be treated first
B) Clients in the Expected category should receive comfort measures only (EXPECTED =
EXPECTED TO DIE)
C) Clients in the non-urgent category would include closed fracture injuries
D) Clients in the urgent category would include shock and airway obstruction
Rationale: Urgent (yellow) is stable but needs care within 1-2h e.g., closed fractures, minor burns. Shock
and airway obstruction are Emergent/Immediate (red). Expected (black) receive palliative care.
10. What is a priority nursing assessment in the first 24 hours after admission of client with a
thrombotic stroke?
A) Cholesterol level
B) Pupil size and papillary response (PUPIL SIZE INDICATES ICP)
Final Exam: 2026/2027 Questions and
Verified Answers - Rasmussen
OVERVIEW:
NUR 2755 Multidimensional Care IV MDC Final Exam covers emergency,
neurological, burn, respiratory, perioperative and critical care concepts. Includes
near-drowning, heatstroke, shock, stroke, ICP, seizures, spinal cord injury,
autonomic dysreflexia, flail chest, PE, Parkinson's, GBS, MS, frostbite, burn
resuscitation Parkland, Rule of Nines, triage, disaster, DMAT, surgical asepsis,
latex allergy, ventilator management, GCS, medication safety, prioritization and
delegation for comprehensive adult health nursing practice and clinical judgment
preparation for success.
Correct answer highlighted in bold Green + rationales.
1. A client who experienced a near drowning accident in a local pool, but now is awake and
breathing spontaneously, is admitted for observation. Which assessment will be most
important for the nurse to take during the observation period?
A) Auscultate heart sounds
B) palpate peripheral pulses
C) Auscultate breath sounds (NOTE: drowning → risk for pulmonary infection, ARDS, CNS
impairment)
D) check pupil reaction to light
Rationale: Near drowning causes aspiration, alveolar damage, pulmonary edema and ARDS risk. Close
respiratory monitoring including breath sounds, SpO2, work of breathing is priority for 24h.
2. A client who has undergone preadmission laboratory studies, including a complete blood
count, coagulation studies, and electrolytes and creatinine levels. Which of the following
laboratory results should be reported to the surgeon's office by the nurse, knowing that it
could cause surgery to be postponed?
, A) Sodium, 141 mEq/L (normal range 135-145)
B) Hemoglobin, 8.0 g/dL Need HGB >9
C) Platelets, 210,000/mm3 Platelets need >50,000
D) Serum creatinine, 0.8 mg/dl (normal range is 0.6-1.2) Select if Creatinine level 2.0mg/dl
Rationale: Hgb 8.0 indicates anemia impairing oxygen carrying capacity and healing; surgery postponed
until corrected to >9-10 g/dL. Creatinine 2.0 indicates renal dysfunction affecting anesthesia clearance
and drug dosing.
3. The nurse is caring for a patient suspected of having heatstroke. Which findings are
consistent with this diagnosis? (Select all that apply.)
A) Bradycardia
B) Tachycardia (also Tachypnea)
C) Irregular pulse patterns (dysrhythmias)
D) Visual disturbances (hallucinations)
E) Decreased urinary output
F) Mental status changes
G) Loss of coordination
H) Hypertension (should be Hypotension)
Rationale: Heatstroke is hyperthermia >104F with CNS dysfunction, tachycardia, tachypnea,
hypotension, dysrhythmias from electrolyte loss, oliguria, confusion, ataxia, hallucinations due to
cerebral edema.
4. At which time of the day should the nurse encourage the client with Parkinson's disease to
schedule the most demanding physical activities to minimize the effects of hypokinesia?
A) Early in the morning when the client's energy level is high
B) To coincide with the peak action of drug therapy
C) Immediately after a rest period
D) When family members will be available
,Rationale: Levodopa peak action gives best mobility and least bradykinesia/rigidity. Activities
scheduled at peak drug effect improve safety and performance.
5. Which of the following would be classified as an external disaster?
A) A fire started in the emergency department
B) A city-wide power outage
C) Massive flooding
D) A bomb threat to administration
Rationale: External disasters originate outside hospital and bring influx of victims - flooding,
earthquake, mass casualty, chemical plant explosion. Internal disasters originate inside facility.
6. On a hot, humid day, a client arrives in the emergency department presenting with
confusion, lethargy, and the following vital signs: temperature 104.1 degrees F, pulse 132
beats/min, respiration 26 breaths/min, and blood pressure 106/66 mm Hg. What is the most
appropriate intervention for this client? (Heat Stroke)
A) Encourage the client to drink cool water or sports drinks
B) Start an intravenous line and infuse 0.9% saline solution
C) Administer acetaminophen 650 milligram orally
D) Encourage rest and reassess in 15 minutes
Rationale: Heat stroke with confusion and hypotension is a medical emergency with volume depletion.
Immediate isotonic IV fluids restore perfusion and aid cooling; antipyretics ineffective for non-
pyrogenic hyperthermia.
7. The nurse is orienting a new nurse to the pediatric intensive care unit and discussing the
care of a client recovering from drowning. Which statement by the new nurse accurately
demonstrates an understanding of this condition?
A) Drowning results in the collapse of alveoli and pulmonary edema.
B) Drowning causes an increased amount of surfactant in the lungs, which decreases airway
pressure
C) Since the client has recovered, we should not need to monitor for any complications
, D) It is OK to leave children unattended in a bathtub as long as it's only for a minute or two
Rationale: Aspiration washes out surfactant, causes atelectasis, alveolar collapse, pulmonary edema,
V/Q mismatch and ARDS. Continuous monitoring for respiratory deterioration, infection and cerebral
edema is essential.
8. A nurse in an emergency department is caring for a client with a penetrating trauma from a
gunshot and a sucking chest wound. The client has a blood pressure of 101/61 mm Hg, a weak
pulse, rate of 117/min, a respiratory rate of 39/min, and a pulse oximeter reading of 90% on
room air. Which action should the nurse take first in the primary survey?
A) Place the client in Trendelenburg position
B) Remove the dressing to inspect the wound
C) Prepare to insert a central line
D) Administer oxygen via nonrebreather mask per order (Or provide bag valve ventilation)
Rationale: Sucking chest wound = open pneumothorax. Primary survey is Airway-Breathing. Hypoxia is
life-threatening; high-flow O2 via nonrebreather immediately, then occlusive dressing taped on 3 sides.
9. A triage officer is discussing mass casualty triage during a tabletop disaster drill. Which
statement should indicate the staff member requires further teaching?
A) Clients in the emergent category should be treated first
B) Clients in the Expected category should receive comfort measures only (EXPECTED =
EXPECTED TO DIE)
C) Clients in the non-urgent category would include closed fracture injuries
D) Clients in the urgent category would include shock and airway obstruction
Rationale: Urgent (yellow) is stable but needs care within 1-2h e.g., closed fractures, minor burns. Shock
and airway obstruction are Emergent/Immediate (red). Expected (black) receive palliative care.
10. What is a priority nursing assessment in the first 24 hours after admission of client with a
thrombotic stroke?
A) Cholesterol level
B) Pupil size and papillary response (PUPIL SIZE INDICATES ICP)
