MDC II FINAL EXAM RASMUSSEN ACTUAL EXAM
NEWEST VERSION 2026-2027 ACTUAL QUESTION
AND
CORRECT DETAILED ANSWERS RATED A
GRADE.(Modules 8, 9, 10)
QUESTION
A nurse is caring for a patient who presents with acute adrenal insufficiency, a life-
threatening condition characterized by a deficiency of cortisol and aldosterone.
The patient is hemodynamically unstable and requires immediate intervention.
Which medication should the nurse prepare to administer as the initial emergency
treatment for an Addisonian crisis?
CORRECT ANS: Dexamethasone 4-12 mg IV bolus
Expert Rationale
An Addisonian crisis, or acute adrenal insufficiency, is a medical emergency
characterized by severe hypotension, shock, and electrolyte imbalances due to a
critical deficiency of cortisol and aldosterone. The immediate priority is to replace
glucocorticoids rapidly. Dexamethasone is the preferred initial agent for several
reasons. It is a potent synthetic glucocorticoid that does not interfere with the
diagnostic tests used to determine the underlying etiology of the adrenal
insufficiency, such as the cosyntropin stimulation test, because it does not cross-
react in the assay used to measure serum cortisol. An IV bolus of 4 to 12 mg of
dexamethasone provides a rapid and potent glucocorticoid effect, stabilizing the
patient's cardiovascular status and preventing further deterioration. While
hydrocortisone is also used, it can affect the diagnostic testing, making
dexamethasone the ideal first-line emergency treatment. Fluid resuscitation with
normal saline and dextrose is also a critical component of the initial management.
1 | Page
, DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Pharmacological and Parenteral Therapies
WITHOUT MULTICHOICES
QUESTION
A nurse is providing dietary education to a patient diagnosed with
hypoparathyroidism, a condition characterized by low serum calcium levels due to
insufficient parathyroid hormone (PTH). The nurse is instructing the patient on
foods that should be avoided to prevent exacerbating the condition. Which
specific food item should be eliminated or restricted in the diet of a patient with
hypoparathyroidism?
CORRECT ANS: milk (it's high in phosphate)
Expert Rationale
Hypoparathyroidism is characterized by decreased production of parathyroid
hormone (PTH), which leads to hypocalcemia and hyperphosphatemia. The
primary goal of dietary management is to maintain serum calcium levels within a
safe range while managing phosphorus levels. Patients with hypoparathyroidism
should avoid foods that are high in phosphate, as elevated phosphate levels
further suppress serum calcium by promoting the formation of calcium-
phosphate complexes and reducing the active form of vitamin D. Milk and other
dairy products are rich in both calcium and phosphate; however, the high
phosphate content makes them problematic for patients with
hypoparathyroidism. Therefore, milk should be avoided. Patients are encouraged
to consume a diet high in calcium and low in phosphate, with an emphasis on
2 | Page
, green leafy vegetables, which are good sources of calcium but are not as high in
phosphate as dairy products.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
WITHOUT MULTICHOICES
QUESTION
A nurse is developing a comprehensive care plan for a patient newly diagnosed
with Type 2 diabetes mellitus. The plan must include pharmacological and non-
pharmacological interventions to manage the condition effectively. Which of the
following is a first-line oral antihyperglycemic agent commonly used in the
treatment of Type 2 diabetes?
CORRECT ANS: Metformin (Glucophage)
Expert Rationale
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by insulin
resistance and relative insulin deficiency. The management of Type 2 diabetes
involves a multifaceted approach that includes lifestyle modifications (diet and
exercise), patient education, and pharmacological therapy. Metformin
(Glucophage) is widely recognized as the first-line oral pharmacological agent for
the treatment of Type 2 diabetes. Its mechanism of action includes decreasing
hepatic glucose production, increasing peripheral insulin sensitivity, and reducing
intestinal glucose absorption. Metformin is effective, has a low risk of
hypoglycemia when used as monotherapy, and is generally well-tolerated. While
other agents like glyburide (a sulfonylurea), pioglitazone (a thiazolidinedione), and
repaglinide (a meglitinide) are also used in the treatment of Type 2 diabetes, they
3 | Page
, are typically added to metformin or used as second-line therapies. Lifestyle
modifications, including diet and exercise, are also fundamental components of
the treatment plan.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Planning
MSC: NCLEX: Pharmacological and Parenteral Therapies
WITHOUT MULTICHOICES
QUESTION
A nurse is providing multidimensional care to a patient with Type 2 diabetes
mellitus. The nurse recognizes that effective management of this chronic
condition requires a collaborative, interdisciplinary approach. Which healthcare
professional would be most appropriate for the nurse to refer the patient to for
specialized instruction on carbohydrate counting, meal planning, and blood
glucose management?
CORRECT ANS: dietician
Expert Rationale
Type 2 diabetes mellitus requires a comprehensive, patient-centered, and
multidisciplinary approach to achieve optimal glycemic control and prevent
complications. While the primary care provider prescribes medications, and the
diabetes educator provides broad education on self-management, the dietician
(or registered dietitian nutritionist) is the specialist in medical nutrition therapy
(MNT). The dietician plays a crucial role in teaching patients about carbohydrate
counting, which is the foundation of meal planning for diabetes. They provide
individualized guidance on food choices, portion sizes, and timing of meals to
match the patient's insulin regimen and activity level. A culturally sensitive
4 | Page
NEWEST VERSION 2026-2027 ACTUAL QUESTION
AND
CORRECT DETAILED ANSWERS RATED A
GRADE.(Modules 8, 9, 10)
QUESTION
A nurse is caring for a patient who presents with acute adrenal insufficiency, a life-
threatening condition characterized by a deficiency of cortisol and aldosterone.
The patient is hemodynamically unstable and requires immediate intervention.
Which medication should the nurse prepare to administer as the initial emergency
treatment for an Addisonian crisis?
CORRECT ANS: Dexamethasone 4-12 mg IV bolus
Expert Rationale
An Addisonian crisis, or acute adrenal insufficiency, is a medical emergency
characterized by severe hypotension, shock, and electrolyte imbalances due to a
critical deficiency of cortisol and aldosterone. The immediate priority is to replace
glucocorticoids rapidly. Dexamethasone is the preferred initial agent for several
reasons. It is a potent synthetic glucocorticoid that does not interfere with the
diagnostic tests used to determine the underlying etiology of the adrenal
insufficiency, such as the cosyntropin stimulation test, because it does not cross-
react in the assay used to measure serum cortisol. An IV bolus of 4 to 12 mg of
dexamethasone provides a rapid and potent glucocorticoid effect, stabilizing the
patient's cardiovascular status and preventing further deterioration. While
hydrocortisone is also used, it can affect the diagnostic testing, making
dexamethasone the ideal first-line emergency treatment. Fluid resuscitation with
normal saline and dextrose is also a critical component of the initial management.
1 | Page
, DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Pharmacological and Parenteral Therapies
WITHOUT MULTICHOICES
QUESTION
A nurse is providing dietary education to a patient diagnosed with
hypoparathyroidism, a condition characterized by low serum calcium levels due to
insufficient parathyroid hormone (PTH). The nurse is instructing the patient on
foods that should be avoided to prevent exacerbating the condition. Which
specific food item should be eliminated or restricted in the diet of a patient with
hypoparathyroidism?
CORRECT ANS: milk (it's high in phosphate)
Expert Rationale
Hypoparathyroidism is characterized by decreased production of parathyroid
hormone (PTH), which leads to hypocalcemia and hyperphosphatemia. The
primary goal of dietary management is to maintain serum calcium levels within a
safe range while managing phosphorus levels. Patients with hypoparathyroidism
should avoid foods that are high in phosphate, as elevated phosphate levels
further suppress serum calcium by promoting the formation of calcium-
phosphate complexes and reducing the active form of vitamin D. Milk and other
dairy products are rich in both calcium and phosphate; however, the high
phosphate content makes them problematic for patients with
hypoparathyroidism. Therefore, milk should be avoided. Patients are encouraged
to consume a diet high in calcium and low in phosphate, with an emphasis on
2 | Page
, green leafy vegetables, which are good sources of calcium but are not as high in
phosphate as dairy products.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
WITHOUT MULTICHOICES
QUESTION
A nurse is developing a comprehensive care plan for a patient newly diagnosed
with Type 2 diabetes mellitus. The plan must include pharmacological and non-
pharmacological interventions to manage the condition effectively. Which of the
following is a first-line oral antihyperglycemic agent commonly used in the
treatment of Type 2 diabetes?
CORRECT ANS: Metformin (Glucophage)
Expert Rationale
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by insulin
resistance and relative insulin deficiency. The management of Type 2 diabetes
involves a multifaceted approach that includes lifestyle modifications (diet and
exercise), patient education, and pharmacological therapy. Metformin
(Glucophage) is widely recognized as the first-line oral pharmacological agent for
the treatment of Type 2 diabetes. Its mechanism of action includes decreasing
hepatic glucose production, increasing peripheral insulin sensitivity, and reducing
intestinal glucose absorption. Metformin is effective, has a low risk of
hypoglycemia when used as monotherapy, and is generally well-tolerated. While
other agents like glyburide (a sulfonylurea), pioglitazone (a thiazolidinedione), and
repaglinide (a meglitinide) are also used in the treatment of Type 2 diabetes, they
3 | Page
, are typically added to metformin or used as second-line therapies. Lifestyle
modifications, including diet and exercise, are also fundamental components of
the treatment plan.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Planning
MSC: NCLEX: Pharmacological and Parenteral Therapies
WITHOUT MULTICHOICES
QUESTION
A nurse is providing multidimensional care to a patient with Type 2 diabetes
mellitus. The nurse recognizes that effective management of this chronic
condition requires a collaborative, interdisciplinary approach. Which healthcare
professional would be most appropriate for the nurse to refer the patient to for
specialized instruction on carbohydrate counting, meal planning, and blood
glucose management?
CORRECT ANS: dietician
Expert Rationale
Type 2 diabetes mellitus requires a comprehensive, patient-centered, and
multidisciplinary approach to achieve optimal glycemic control and prevent
complications. While the primary care provider prescribes medications, and the
diabetes educator provides broad education on self-management, the dietician
(or registered dietitian nutritionist) is the specialist in medical nutrition therapy
(MNT). The dietician plays a crucial role in teaching patients about carbohydrate
counting, which is the foundation of meal planning for diabetes. They provide
individualized guidance on food choices, portion sizes, and timing of meals to
match the patient's insulin regimen and activity level. A culturally sensitive
4 | Page
