NUR 2502 / NUR2502: Multidimensional Care III / MDC 3
Comprehensive Final Exam (Latest 2026/2027)
Test Guide Questions and Verified Answers | 100% Correct | Rasmussen University
100 Questions | Aligned with 2026-2027 Curriculum Standards and QSEN Competencies
Total Questions Sections Cognitive Levels Format
100 9 25% Recall, 50% Application, 25% Analysis Multiple Choice (A-D)
Section 1: Cardiovascular and Multisystem Disorders (Q1-Q20)
Q1: A nurse is caring for a client with left-sided heart failure. Which assessment finding would the nurse expect?
A. Jugular venous distension and dependent peripheral edema
B. Crackles on auscultation, dyspnea, and paroxysmal nocturnal dyspnea [CORRECT]
C. Hepatomegaly and ascites
D. Weight gain and anorexia with nausea
Correct Answer: B
Rationale: Left-sided heart failure results in pulmonary congestion due to the inability of the left ventricle to effectively pump blood
forward. This causes backup of blood into the pulmonary circulation, leading to crackles (fluid in alveoli), dyspnea, orthopnea, and
paroxysmal nocturnal dyspnea (PND). An S3 gallop may also be heard. Options A, C, and D are findings of right-sided heart failure,
which occurs when the right ventricle fails, causing systemic venous congestion with peripheral edema, JVD, hepatomegaly, ascites, and
GI symptoms. Distinguishing between left and right-sided heart failure is a core competency in NUR2502 Multidimensional Care III at
Rasmussen University.
Q2: A nurse is preparing to administer digoxin to a client with heart failure. The client's apical pulse is 56 bpm. Which
action should the nurse take?
A. Administer the dose as prescribed and monitor the heart rate.
B. Hold the dose and notify the healthcare provider. [CORRECT]
C. Administer half the prescribed dose and reassess in 1 hour.
D. Give the dose with orange juice to enhance absorption.
Correct Answer: B
Rationale: Digoxin has a narrow therapeutic range (0.8-2.0 ng/mL) and slows atrioventricular conduction, which can lead to
bradycardia. The nurse should hold the dose if the apical pulse is below 60 bpm (or below the specific rate parameters set by the
provider) and notify the healthcare provider. Administering the dose (option A) could cause further bradycardia and digoxin toxicity.
Option C is not an appropriate nursing action without a provider order. Option D is not evidence-based and does not address the clinical
concern. Monitoring for digoxin toxicity (nausea/vomiting, visual changes such as halos, bradycardia) is essential in MDC 3
cardiovascular nursing care.
Q3: A nurse is providing discharge teaching to a client with heart failure. Which statement by the client indicates an
understanding of fluid management?
A. I should weigh myself once a week and report a gain of 5 pounds.
B. I should restrict my sodium intake to 4 grams per day.
C. I should weigh myself daily and report a weight gain of 2-3 pounds in one day. [CORRECT]
D. I should drink at least 3 liters of fluid per day to stay hydrated.
Correct Answer: C
Rationale: Daily weights are the most reliable indicator of fluid retention in heart failure clients. The client should be instructed to weigh
themselves at the same time each day on the same scale with similar clothing, and to report a weight gain of 2-3 pounds in one day or
3-5 pounds in one week to the healthcare provider, as this indicates fluid retention requiring adjustment of diuretic therapy. Option A is
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,NUR2502 MDC 3 Final Exam | Multidimensional Care III Rasmussen University 2026/2027
incorrect because weekly weighing is insufficient and 5 pounds is too high a threshold. Option B is incorrect because sodium restriction
should be 2 grams per day, not 4 grams. Option D is incorrect because fluid is typically restricted to 1.5-2 liters per day. Heart failure
discharge education is a key component of NUR2502.
Q4: A client with a history of rheumatic fever presents with dyspnea, a loud S1, and a diastolic rumble murmur. The
nurse understands that which valve is most likely affected?
A. Aortic valve
B. Mitral valve [CORRECT]
C. Tricuspid valve
D. Pulmonic valve
Correct Answer: B
Rationale: The presentation of dyspnea, a loud S1, and a diastolic rumble murmur is classic for mitral stenosis. Rheumatic fever is the
most common predisposing factor for mitral stenosis, which causes narrowing of the mitral valve orifice and obstructs blood flow from
the left atrium to the left ventricle. Aortic stenosis (option A) presents with the classic triad of syncope, angina, and dyspnea with a
systolic ejection murmur. Tricuspid and pulmonic valve disorders (options C and D) are less common and do not present with this
constellation of findings. Understanding valvular heart disorders and their associated murmurs is a critical component of
cardiovascular nursing in MDC 3.
Q5: A nurse is caring for a client in hypertensive crisis with a blood pressure of 210/130 mmHg. Which intervention is
the priority?
A. Encourage the client to rest quietly and recheck BP in 30 minutes.
B. Administer IV antihypertensive medication as prescribed and continuously monitor neurological status.
[CORRECT]
C. Administer oral antihypertensives and encourage lifestyle modifications.
D. Apply a warm compress to the back of the neck and decrease lighting.
Correct Answer: B
Rationale: Hypertensive crisis (BP >180/120 mmHg) with signs of target organ damage requires immediate IV antihypertensive therapy
(such as labetalol, nicardipine, or sodium nitroprusside) in an intensive care setting. Continuous monitoring of neurological status is
critical because hypertensive encephalopathy can progress rapidly. Option A delays necessary treatment. Option C is inappropriate for a
crisis situation because oral medications act too slowly. Option D is a non-pharmacologic comfort measure for routine headaches, not a
hypertensive crisis. Rapid identification and treatment of hypertensive crisis is an emergency competency in NUR2502.
Q6: A client presents to the emergency department with chest pain. The 12-lead ECG shows ST-segment elevation in
leads II, III, and aVF. The nurse understands that this indicates which condition?
A. Non-ST-elevation myocardial infarction (NSTEMI)
B. ST-elevation myocardial infarction (STEMI) of the inferior wall [CORRECT]
C. Unstable angina
D. Pericarditis
Correct Answer: B
Rationale: ST-segment elevation on ECG is the hallmark finding of an ST-elevation myocardial infarction (STEMI). Leads II, III, and
aVF correspond to the inferior wall of the left ventricle, indicating an inferior wall MI. NSTEMI (option A) presents with ST-segment
depression or T-wave inversion, not elevation. Unstable angina (option C) typically presents with normal or nonspecific ECG changes.
Pericarditis (option D) may show ST elevation but it is diffuse (widespread across multiple leads) rather than localized to a specific
territory. Recognizing STEMI on ECG is critical because it indicates the need for immediate reperfusion therapy (PCI or thrombolytics),
which is a core MDC 3 competency.
Q7: A nurse is providing care for a client experiencing an acute myocardial infarction. Which medication in the
MONA protocol is administered first?
A. Morphine sulfate
B. Oxygen therapy
C. Nitroglycerin
D. Chewable aspirin 325 mg [CORRECT]
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,NUR2502 MDC 3 Final Exam | Multidimensional Care III Rasmussen University 2026/2027
Correct Answer: D
Rationale: In the MONA protocol for acute coronary syndrome, aspirin (325 mg chewable) is administered first to inhibit platelet
aggregation and reduce thrombus formation. Oxygen, nitroglycerin, and morphine follow. Aspirin has the strongest evidence base for
reducing mortality in acute MI and should be given as soon as possible. While the traditional mnemonic is MONA, the actual order of
administration prioritizes aspirin. Oxygen is given if SpO2 is below 94%, nitroglycerin relieves chest pain through vasodilation, and
morphine is given for pain unresponsive to nitroglycerin. Understanding the MONA protocol and the rationale for each medication is
essential in NUR2502 cardiovascular emergency care.
Q8: A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is most consistent with this
condition?
A. Pain in the lower extremities that occurs with walking and is relieved by rest (intermittent claudication)
[CORRECT]
B. Pain in the lower extremities that worsens with leg elevation and is relieved by dependency
C. Bilateral ankle edema that worsens throughout the day
D. Warm, pink, and well-perfused lower extremities with bounding pulses
Correct Answer: A
Rationale: Intermittent claudication is the classic symptom of peripheral arterial disease, characterized by pain, cramping, or fatigue in
the calf, thigh, or buttock muscles that occurs with walking and is relieved by rest. Other findings include decreased or absent peripheral
pulses, hair loss on the lower extremities, cool and pale skin, and thickened toenails. Option B describes the pain pattern of venous
insufficiency (worse with elevation, relieved by dependency), which is the opposite of PAD. Option C describes venous stasis. Option D is
the opposite of what is seen in PAD, where extremities are typically cool with diminished pulses. For PAD, the best position for legs is
dependent (hanging down) to improve arterial flow. Understanding PAD assessment is a key NUR2502 competency.
Q9: A nurse is monitoring a client with atrial fibrillation. Which finding on the cardiac monitor is most consistent with
this dysrhythmia?
A. Regular rhythm with absent P waves and a wide QRS complex
B. Irregularly irregular rhythm with absent P waves and a narrow QRS complex [CORRECT]
C. Regular rhythm with P waves preceding each QRS and a PR interval of 0.24 seconds
D. Irregular rhythm with tall, peaked T waves and a prolonged QT interval
Correct Answer: B
Rationale: Atrial fibrillation is characterized by an irregularly irregular rhythm (no predictable pattern), absent P waves (replaced by
chaotic fibrillatory waves), and a narrow QRS complex (unless there is concurrent conduction disease). The irregularly irregular pattern
and absent P waves are the hallmark ECG findings. Option A describes an accelerated idioventricular rhythm or ventricular
tachycardia. Option C describes first-degree AV block. Option D describes hyperkalemia or a prolonged QT syndrome. Atrial fibrillation
carries a significant risk of thromboembolism, requiring anticoagulation (warfarin with target INR 2.0-3.0 or DOACs), rate control, and
potentially rhythm control. Recognizing and managing atrial fibrillation is a core MDC 3 competency at Rasmussen.
Q10: A client with pericarditis reports sharp chest pain. Which position would the nurse expect to provide the most
comfort?
A. Lying flat in the supine position
B. Sitting upright and leaning forward [CORRECT]
C. Lying on the left side with legs elevated
D. In the Trendelenburg position with head elevated 15 degrees
Correct Answer: B
Rationale: Pericarditis causes sharp, stabbing chest pain that worsens when lying flat (supine position) and improves when sitting upright
and leaning forward because this position reduces contact between the inflamed pericardium and the heart. A pericardial friction rub is
the hallmark auscultatory finding. Treatment includes NSAIDs and colchicine to reduce inflammation. Option A would worsen the pain.
Options C and D do not specifically address the pathophysiology of pericardial pain. Understanding the clinical presentation and
positioning interventions for pericarditis is part of the cardiovascular disorders content in NUR2502 Multidimensional Care III.
Q11: A nurse is caring for a client with aortic stenosis. Which classic triad of symptoms should the nurse assess for?
A. Hemoptysis, barrel chest, and clubbing
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, NUR2502 MDC 3 Final Exam | Multidimensional Care III Rasmussen University 2026/2027
B. Syncope, angina, and dyspnea [CORRECT]
C. Dyspnea, orthopnea, and paroxysmal nocturnal dyspnea
D. Palpitations, fatigue, and holosystolic murmur
Correct Answer: B
Rationale: The classic triad of aortic stenosis is syncope, angina, and dyspnea, which typically occur in advanced disease. Aortic stenosis
is characterized by a systolic ejection murmur heard best at the right upper sternal border. Management may require valve replacement,
and antibiotic prophylaxis is indicated for certain procedures to prevent endocarditis. Option A describes COPD findings. Option C
describes left-sided heart failure symptoms. Option D describes mitral regurgitation. Understanding the classic presentations of valvular
heart disease is essential for cardiovascular assessment in NUR2502 at Rasmussen University.
Q12: A nurse on a telemetry unit observes ventricular fibrillation on a client's cardiac monitor. Which intervention is
the priority?
A. Administer amiodarone 300 mg IV push.
B. Initiate CPR and immediately defibrillate. [CORRECT]
C. Administer epinephrine 1 mg IV push.
D. Perform carotid sinus massage.
Correct Answer: B
Rationale: Ventricular fibrillation (VF) is a lethal dysrhythmia characterized by chaotic, disorganized ventricular electrical activity with
no effective cardiac output, resulting in cardiac arrest. The priority intervention is immediate CPR and defibrillation. Defibrillation is
the definitive treatment for VF, and early defibrillation significantly improves survival rates. Epinephrine and amiodarone (options A
and C) are administered after the first defibrillation attempt per ACLS algorithms. Carotid sinus massage (option D) is contraindicated
in VF and is used for supraventricular tachycardia. VF management is a critical emergency response competency in NUR2502
Multidimensional Care III.
Q13: A nurse is caring for a client with aortic regurgitation. Which assessment finding is most characteristic of this
valvular disorder?
A. Water-hammer pulse (bounding pulse with rapid collapse) [CORRECT]
B. Loud S1 and diastolic rumble murmur
C. Holosystolic murmur at the apex radiating to the axilla
D. Systolic ejection murmur at the right upper sternal border
Correct Answer: B
Rationale: Aortic regurgitation is characterized by a diastolic decrescendo murmur and a water-hammer pulse (also called Corrigan's
pulse or bounding pulse), which is a large, forceful pulse with a rapid collapse due to the backflow of blood from the aorta into the left
ventricle during diastole. Option B describes mitral stenosis. Option C describes mitral regurgitation. Option D describes aortic stenosis.
Understanding the unique assessment findings for each valvular disorder is critical for accurate cardiovascular assessment in the
NUR2502 curriculum at Rasmussen University.
Q14: A nurse is educating a client with hypertension about lifestyle modifications. Which statement by the client
indicates effective teaching has occurred?
A. I will follow the DASH diet, restrict sodium, exercise regularly, and maintain a healthy weight. [CORRECT]
B. I only need to take my blood pressure medication and do not need to change my diet.
C. I can continue smoking as long as I take my medication consistently.
D. I should restrict all physical activity to prevent cardiac stress.
Correct Answer: A
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet, combined with sodium restriction, regular exercise, and weight
loss, are the cornerstone lifestyle modifications for hypertension management. These non-pharmacologic interventions are recommended
as first-line therapy for elevated blood pressure and stage 1 hypertension, and as adjuncts to medication for higher stages. Options B
and C reflect non-adherence to evidence-based guidelines. Option D is incorrect because regular aerobic exercise (at least 150 minutes
per week) is recommended. Lifestyle modification education is a fundamental component of cardiovascular nursing care in NUR2502.
Q15: A client with mitral regurgitation is being assessed. Which finding would the nurse most likely observe?
A. Fatigue, dyspnea, and a holosystolic murmur at the apex radiating to the axilla [CORRECT]
Page 4
Comprehensive Final Exam (Latest 2026/2027)
Test Guide Questions and Verified Answers | 100% Correct | Rasmussen University
100 Questions | Aligned with 2026-2027 Curriculum Standards and QSEN Competencies
Total Questions Sections Cognitive Levels Format
100 9 25% Recall, 50% Application, 25% Analysis Multiple Choice (A-D)
Section 1: Cardiovascular and Multisystem Disorders (Q1-Q20)
Q1: A nurse is caring for a client with left-sided heart failure. Which assessment finding would the nurse expect?
A. Jugular venous distension and dependent peripheral edema
B. Crackles on auscultation, dyspnea, and paroxysmal nocturnal dyspnea [CORRECT]
C. Hepatomegaly and ascites
D. Weight gain and anorexia with nausea
Correct Answer: B
Rationale: Left-sided heart failure results in pulmonary congestion due to the inability of the left ventricle to effectively pump blood
forward. This causes backup of blood into the pulmonary circulation, leading to crackles (fluid in alveoli), dyspnea, orthopnea, and
paroxysmal nocturnal dyspnea (PND). An S3 gallop may also be heard. Options A, C, and D are findings of right-sided heart failure,
which occurs when the right ventricle fails, causing systemic venous congestion with peripheral edema, JVD, hepatomegaly, ascites, and
GI symptoms. Distinguishing between left and right-sided heart failure is a core competency in NUR2502 Multidimensional Care III at
Rasmussen University.
Q2: A nurse is preparing to administer digoxin to a client with heart failure. The client's apical pulse is 56 bpm. Which
action should the nurse take?
A. Administer the dose as prescribed and monitor the heart rate.
B. Hold the dose and notify the healthcare provider. [CORRECT]
C. Administer half the prescribed dose and reassess in 1 hour.
D. Give the dose with orange juice to enhance absorption.
Correct Answer: B
Rationale: Digoxin has a narrow therapeutic range (0.8-2.0 ng/mL) and slows atrioventricular conduction, which can lead to
bradycardia. The nurse should hold the dose if the apical pulse is below 60 bpm (or below the specific rate parameters set by the
provider) and notify the healthcare provider. Administering the dose (option A) could cause further bradycardia and digoxin toxicity.
Option C is not an appropriate nursing action without a provider order. Option D is not evidence-based and does not address the clinical
concern. Monitoring for digoxin toxicity (nausea/vomiting, visual changes such as halos, bradycardia) is essential in MDC 3
cardiovascular nursing care.
Q3: A nurse is providing discharge teaching to a client with heart failure. Which statement by the client indicates an
understanding of fluid management?
A. I should weigh myself once a week and report a gain of 5 pounds.
B. I should restrict my sodium intake to 4 grams per day.
C. I should weigh myself daily and report a weight gain of 2-3 pounds in one day. [CORRECT]
D. I should drink at least 3 liters of fluid per day to stay hydrated.
Correct Answer: C
Rationale: Daily weights are the most reliable indicator of fluid retention in heart failure clients. The client should be instructed to weigh
themselves at the same time each day on the same scale with similar clothing, and to report a weight gain of 2-3 pounds in one day or
3-5 pounds in one week to the healthcare provider, as this indicates fluid retention requiring adjustment of diuretic therapy. Option A is
Page 1
,NUR2502 MDC 3 Final Exam | Multidimensional Care III Rasmussen University 2026/2027
incorrect because weekly weighing is insufficient and 5 pounds is too high a threshold. Option B is incorrect because sodium restriction
should be 2 grams per day, not 4 grams. Option D is incorrect because fluid is typically restricted to 1.5-2 liters per day. Heart failure
discharge education is a key component of NUR2502.
Q4: A client with a history of rheumatic fever presents with dyspnea, a loud S1, and a diastolic rumble murmur. The
nurse understands that which valve is most likely affected?
A. Aortic valve
B. Mitral valve [CORRECT]
C. Tricuspid valve
D. Pulmonic valve
Correct Answer: B
Rationale: The presentation of dyspnea, a loud S1, and a diastolic rumble murmur is classic for mitral stenosis. Rheumatic fever is the
most common predisposing factor for mitral stenosis, which causes narrowing of the mitral valve orifice and obstructs blood flow from
the left atrium to the left ventricle. Aortic stenosis (option A) presents with the classic triad of syncope, angina, and dyspnea with a
systolic ejection murmur. Tricuspid and pulmonic valve disorders (options C and D) are less common and do not present with this
constellation of findings. Understanding valvular heart disorders and their associated murmurs is a critical component of
cardiovascular nursing in MDC 3.
Q5: A nurse is caring for a client in hypertensive crisis with a blood pressure of 210/130 mmHg. Which intervention is
the priority?
A. Encourage the client to rest quietly and recheck BP in 30 minutes.
B. Administer IV antihypertensive medication as prescribed and continuously monitor neurological status.
[CORRECT]
C. Administer oral antihypertensives and encourage lifestyle modifications.
D. Apply a warm compress to the back of the neck and decrease lighting.
Correct Answer: B
Rationale: Hypertensive crisis (BP >180/120 mmHg) with signs of target organ damage requires immediate IV antihypertensive therapy
(such as labetalol, nicardipine, or sodium nitroprusside) in an intensive care setting. Continuous monitoring of neurological status is
critical because hypertensive encephalopathy can progress rapidly. Option A delays necessary treatment. Option C is inappropriate for a
crisis situation because oral medications act too slowly. Option D is a non-pharmacologic comfort measure for routine headaches, not a
hypertensive crisis. Rapid identification and treatment of hypertensive crisis is an emergency competency in NUR2502.
Q6: A client presents to the emergency department with chest pain. The 12-lead ECG shows ST-segment elevation in
leads II, III, and aVF. The nurse understands that this indicates which condition?
A. Non-ST-elevation myocardial infarction (NSTEMI)
B. ST-elevation myocardial infarction (STEMI) of the inferior wall [CORRECT]
C. Unstable angina
D. Pericarditis
Correct Answer: B
Rationale: ST-segment elevation on ECG is the hallmark finding of an ST-elevation myocardial infarction (STEMI). Leads II, III, and
aVF correspond to the inferior wall of the left ventricle, indicating an inferior wall MI. NSTEMI (option A) presents with ST-segment
depression or T-wave inversion, not elevation. Unstable angina (option C) typically presents with normal or nonspecific ECG changes.
Pericarditis (option D) may show ST elevation but it is diffuse (widespread across multiple leads) rather than localized to a specific
territory. Recognizing STEMI on ECG is critical because it indicates the need for immediate reperfusion therapy (PCI or thrombolytics),
which is a core MDC 3 competency.
Q7: A nurse is providing care for a client experiencing an acute myocardial infarction. Which medication in the
MONA protocol is administered first?
A. Morphine sulfate
B. Oxygen therapy
C. Nitroglycerin
D. Chewable aspirin 325 mg [CORRECT]
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,NUR2502 MDC 3 Final Exam | Multidimensional Care III Rasmussen University 2026/2027
Correct Answer: D
Rationale: In the MONA protocol for acute coronary syndrome, aspirin (325 mg chewable) is administered first to inhibit platelet
aggregation and reduce thrombus formation. Oxygen, nitroglycerin, and morphine follow. Aspirin has the strongest evidence base for
reducing mortality in acute MI and should be given as soon as possible. While the traditional mnemonic is MONA, the actual order of
administration prioritizes aspirin. Oxygen is given if SpO2 is below 94%, nitroglycerin relieves chest pain through vasodilation, and
morphine is given for pain unresponsive to nitroglycerin. Understanding the MONA protocol and the rationale for each medication is
essential in NUR2502 cardiovascular emergency care.
Q8: A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is most consistent with this
condition?
A. Pain in the lower extremities that occurs with walking and is relieved by rest (intermittent claudication)
[CORRECT]
B. Pain in the lower extremities that worsens with leg elevation and is relieved by dependency
C. Bilateral ankle edema that worsens throughout the day
D. Warm, pink, and well-perfused lower extremities with bounding pulses
Correct Answer: A
Rationale: Intermittent claudication is the classic symptom of peripheral arterial disease, characterized by pain, cramping, or fatigue in
the calf, thigh, or buttock muscles that occurs with walking and is relieved by rest. Other findings include decreased or absent peripheral
pulses, hair loss on the lower extremities, cool and pale skin, and thickened toenails. Option B describes the pain pattern of venous
insufficiency (worse with elevation, relieved by dependency), which is the opposite of PAD. Option C describes venous stasis. Option D is
the opposite of what is seen in PAD, where extremities are typically cool with diminished pulses. For PAD, the best position for legs is
dependent (hanging down) to improve arterial flow. Understanding PAD assessment is a key NUR2502 competency.
Q9: A nurse is monitoring a client with atrial fibrillation. Which finding on the cardiac monitor is most consistent with
this dysrhythmia?
A. Regular rhythm with absent P waves and a wide QRS complex
B. Irregularly irregular rhythm with absent P waves and a narrow QRS complex [CORRECT]
C. Regular rhythm with P waves preceding each QRS and a PR interval of 0.24 seconds
D. Irregular rhythm with tall, peaked T waves and a prolonged QT interval
Correct Answer: B
Rationale: Atrial fibrillation is characterized by an irregularly irregular rhythm (no predictable pattern), absent P waves (replaced by
chaotic fibrillatory waves), and a narrow QRS complex (unless there is concurrent conduction disease). The irregularly irregular pattern
and absent P waves are the hallmark ECG findings. Option A describes an accelerated idioventricular rhythm or ventricular
tachycardia. Option C describes first-degree AV block. Option D describes hyperkalemia or a prolonged QT syndrome. Atrial fibrillation
carries a significant risk of thromboembolism, requiring anticoagulation (warfarin with target INR 2.0-3.0 or DOACs), rate control, and
potentially rhythm control. Recognizing and managing atrial fibrillation is a core MDC 3 competency at Rasmussen.
Q10: A client with pericarditis reports sharp chest pain. Which position would the nurse expect to provide the most
comfort?
A. Lying flat in the supine position
B. Sitting upright and leaning forward [CORRECT]
C. Lying on the left side with legs elevated
D. In the Trendelenburg position with head elevated 15 degrees
Correct Answer: B
Rationale: Pericarditis causes sharp, stabbing chest pain that worsens when lying flat (supine position) and improves when sitting upright
and leaning forward because this position reduces contact between the inflamed pericardium and the heart. A pericardial friction rub is
the hallmark auscultatory finding. Treatment includes NSAIDs and colchicine to reduce inflammation. Option A would worsen the pain.
Options C and D do not specifically address the pathophysiology of pericardial pain. Understanding the clinical presentation and
positioning interventions for pericarditis is part of the cardiovascular disorders content in NUR2502 Multidimensional Care III.
Q11: A nurse is caring for a client with aortic stenosis. Which classic triad of symptoms should the nurse assess for?
A. Hemoptysis, barrel chest, and clubbing
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, NUR2502 MDC 3 Final Exam | Multidimensional Care III Rasmussen University 2026/2027
B. Syncope, angina, and dyspnea [CORRECT]
C. Dyspnea, orthopnea, and paroxysmal nocturnal dyspnea
D. Palpitations, fatigue, and holosystolic murmur
Correct Answer: B
Rationale: The classic triad of aortic stenosis is syncope, angina, and dyspnea, which typically occur in advanced disease. Aortic stenosis
is characterized by a systolic ejection murmur heard best at the right upper sternal border. Management may require valve replacement,
and antibiotic prophylaxis is indicated for certain procedures to prevent endocarditis. Option A describes COPD findings. Option C
describes left-sided heart failure symptoms. Option D describes mitral regurgitation. Understanding the classic presentations of valvular
heart disease is essential for cardiovascular assessment in NUR2502 at Rasmussen University.
Q12: A nurse on a telemetry unit observes ventricular fibrillation on a client's cardiac monitor. Which intervention is
the priority?
A. Administer amiodarone 300 mg IV push.
B. Initiate CPR and immediately defibrillate. [CORRECT]
C. Administer epinephrine 1 mg IV push.
D. Perform carotid sinus massage.
Correct Answer: B
Rationale: Ventricular fibrillation (VF) is a lethal dysrhythmia characterized by chaotic, disorganized ventricular electrical activity with
no effective cardiac output, resulting in cardiac arrest. The priority intervention is immediate CPR and defibrillation. Defibrillation is
the definitive treatment for VF, and early defibrillation significantly improves survival rates. Epinephrine and amiodarone (options A
and C) are administered after the first defibrillation attempt per ACLS algorithms. Carotid sinus massage (option D) is contraindicated
in VF and is used for supraventricular tachycardia. VF management is a critical emergency response competency in NUR2502
Multidimensional Care III.
Q13: A nurse is caring for a client with aortic regurgitation. Which assessment finding is most characteristic of this
valvular disorder?
A. Water-hammer pulse (bounding pulse with rapid collapse) [CORRECT]
B. Loud S1 and diastolic rumble murmur
C. Holosystolic murmur at the apex radiating to the axilla
D. Systolic ejection murmur at the right upper sternal border
Correct Answer: B
Rationale: Aortic regurgitation is characterized by a diastolic decrescendo murmur and a water-hammer pulse (also called Corrigan's
pulse or bounding pulse), which is a large, forceful pulse with a rapid collapse due to the backflow of blood from the aorta into the left
ventricle during diastole. Option B describes mitral stenosis. Option C describes mitral regurgitation. Option D describes aortic stenosis.
Understanding the unique assessment findings for each valvular disorder is critical for accurate cardiovascular assessment in the
NUR2502 curriculum at Rasmussen University.
Q14: A nurse is educating a client with hypertension about lifestyle modifications. Which statement by the client
indicates effective teaching has occurred?
A. I will follow the DASH diet, restrict sodium, exercise regularly, and maintain a healthy weight. [CORRECT]
B. I only need to take my blood pressure medication and do not need to change my diet.
C. I can continue smoking as long as I take my medication consistently.
D. I should restrict all physical activity to prevent cardiac stress.
Correct Answer: A
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet, combined with sodium restriction, regular exercise, and weight
loss, are the cornerstone lifestyle modifications for hypertension management. These non-pharmacologic interventions are recommended
as first-line therapy for elevated blood pressure and stage 1 hypertension, and as adjuncts to medication for higher stages. Options B
and C reflect non-adherence to evidence-based guidelines. Option D is incorrect because regular aerobic exercise (at least 150 minutes
per week) is recommended. Lifestyle modification education is a fundamental component of cardiovascular nursing care in NUR2502.
Q15: A client with mitral regurgitation is being assessed. Which finding would the nurse most likely observe?
A. Fatigue, dyspnea, and a holosystolic murmur at the apex radiating to the axilla [CORRECT]
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