1 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1) FINAL EXAM
PRACTICE EXAM — RASMUSSEN COLLEGE | ACTUAL STUDY
GUIDE & TESTBANK | LATEST UPDATE 2026/2027 | ADVANCED
PRACTICE QUESTIONS & 100% CORRECT ANSWERS | INSTANT
PDF DOWNLOAD
higher education level student
100+ Q&As with rationales
10 domains
academic year 2026/2027
i. Multidimensional nursing assessment and clinical judgment
ii. Acute and chronic alterations in health
iii. Pharmacologic and therapeutic nursing management
iv. Safety, prioritization, delegation, and infection prevention
v. Fluid, electrolyte, acid-base, and nutritional management
vi. Cardiovascular, respiratory, neurologic, and renal care
vii. Endocrine, gastrointestinal, and multisystem disorders
viii. Psychosocial, cultural, ethical, and patient-centered care
ix. Complications, deterioration, and emergency interventions
x. Evidence-based practice, documentation, and interdisciplinary collaboration
INTRODUCTION
This comprehensive practice examination is designed for students preparing for
NUR 2356 Multidimensional Care I (MDC 1) and emphasizes advanced clinical
judgment rather than simple memorization. It evaluates assessment,
prioritization, pathophysiology, pharmacologic management, safety, patient
education, delegation, documentation, and evidence-based nursing interventions
across complex clinical situations. The questions are intended for nursing
students who need to integrate multiple findings and determine the safest, most
appropriate action under realistic conditions. Expect challenging scenario-based
questions with carefully constructed distractors, 100+ questions and answers
with a rationale when the complete set is obtained, and opportunities to
strengthen clinical reasoning. Purchase and instantly get a downloadable and
editable pdf.
,2 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
QUESTION 1
A nurse receives report on four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client with chronic kidney disease whose potassium is 5.7 mEq/L and who reports
generalized weakness
B. A client with pneumonia whose temperature is 38.2°C (100.8°F) and respiratory rate is
22/min
C. A client with heart failure who gained 1.5 kg over the past week and has bilateral ankle
edema
D. A client with type 2 diabetes whose premeal glucose is 238 mg/dL and who is requesting
dietary teaching
Correct Answer: A. A client with chronic kidney disease whose potassium is 5.7 mEq/L
and who reports generalized weakness
Rationale: Hyperkalemia combined with muscle weakness may indicate
clinically significant potassium-related neuromuscular and cardiac conduction
abnormalities. This client has the greatest immediate risk for dysrhythmia and
requires prompt assessment and cardiac monitoring.
QUESTION 2
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by nasal
cannula. The client becomes increasingly somnolent, and the respiratory rate decreases from
20/min to 10/min. Which action should the nurse take first?
A. Increase oxygen to 6 L/min
B. Assess respiratory effort and obtain an oxygen saturation
C. Administer the prescribed opioid analgesic
D. Place the client in a supine position
Correct Answer: B. Assess respiratory effort and obtain an oxygen saturation
Rationale: New somnolence and bradypnea require immediate respiratory
assessment. Increasing oxygen without assessing ventilation can worsen the
clinical situation in a patient susceptible to carbon dioxide retention; the
priority is determining airway and ventilatory status.
QUESTION 3
A client receiving IV furosemide for acute decompensated heart failure has a potassium level
of 2.9 mEq/L. The client reports new palpitations. Which prescription should the nurse
question?
A. Continuous cardiac monitoring
B. Repeat serum potassium measurement
C. IV potassium replacement according to protocol
D. Additional IV furosemide immediately
,3 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Correct Answer: D. Additional IV furosemide immediately
Rationale: Furosemide promotes potassium loss. Severe hypokalemia with
palpitations increases the risk of potentially life-threatening dysrhythmias, so
additional diuresis should be evaluated carefully while the electrolyte
abnormality is addressed.
QUESTION 4
A postoperative client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and an
oxygen saturation of 86%. Which intervention has the highest priority?
A. Encourage incentive spirometry
B. Assist the client to ambulate
C. Apply supplemental oxygen and rapidly notify the appropriate provider or rapid-response
team
D. Administer the next scheduled dose of opioid analgesic
Correct Answer: C. Apply supplemental oxygen and rapidly notify the appropriate
provider or rapid-response team
Rationale: The sudden onset of hypoxemia, tachycardia, and pleuritic pain is
concerning for pulmonary embolism. Immediate stabilization of oxygenation
and urgent escalation of care are priorities.
QUESTION 5
A client with heart failure takes digoxin and reports nausea, anorexia, and seeing yellow-
green halos around lights. The apical pulse is 52/min. What is the nurse's priority action?
A. Administer the scheduled digoxin
B. Hold digoxin and notify the provider
C. Encourage foods high in sodium
D. Administer an additional diuretic
Correct Answer: B. Hold digoxin and notify the provider
Rationale: Bradycardia, gastrointestinal symptoms, and visual disturbances are
classic manifestations of possible digoxin toxicity. The medication should be
withheld and the client promptly evaluated.
QUESTION 6
A client with diabetic ketoacidosis has received several liters of IV fluid and continuous IV
insulin. The blood glucose has decreased from 580 mg/dL to 220 mg/dL, but the serum
potassium has fallen from 5.4 to 3.1 mEq/L. Which intervention is most important?
A. Continue insulin at the same rate without modification
B. Initiate prescribed potassium replacement and closely monitor cardiac rhythm
C. Restrict IV fluids
D. Administer a rapid IV dose of sodium bicarbonate routinely
, 4 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Correct Answer: B. Initiate prescribed potassium replacement and closely monitor
cardiac rhythm
Rationale: Insulin shifts potassium intracellularly, potentially causing
dangerous hypokalemia during DKA treatment. A potassium level of 3.1 mEq/L
creates substantial dysrhythmia risk and requires prompt replacement
according to the treatment protocol.
QUESTION 7
A client with suspected ischemic stroke develops facial drooping and expressive aphasia 45
minutes before arrival at the emergency department. Which information is most important for
the nurse to obtain?
A. The client's usual dietary pattern
B. The client's last known well time
C. The client's family history of hypertension
D. The client's preferred learning style
Correct Answer: B. The client's last known well time
Rationale: Determining the last known well time is critical when evaluating
eligibility for time-sensitive stroke interventions. Accurate timing directly
influences treatment decisions.
QUESTION 8
A client with cirrhosis becomes increasingly confused and has asterixis. Which prescribed
medication should the nurse anticipate administering?
A. Lactulose
B. Furosemide only
C. Warfarin
D. Diphenhydramine
Correct Answer: A. Lactulose
Rationale: Confusion and asterixis in advanced liver disease are consistent with
hepatic encephalopathy. Lactulose decreases intestinal ammonia absorption
and promotes ammonia elimination through the stool.
QUESTION 9
A client with SIADH has a sodium level of 118 mEq/L and develops a generalized seizure.
Which intervention should the nurse prioritize?
A. Encourage unrestricted oral water intake
B. Institute seizure precautions and administer prescribed hypertonic saline as indicated
C. Administer hypotonic IV fluid
D. Encourage a low-sodium diet
NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1) FINAL EXAM
PRACTICE EXAM — RASMUSSEN COLLEGE | ACTUAL STUDY
GUIDE & TESTBANK | LATEST UPDATE 2026/2027 | ADVANCED
PRACTICE QUESTIONS & 100% CORRECT ANSWERS | INSTANT
PDF DOWNLOAD
higher education level student
100+ Q&As with rationales
10 domains
academic year 2026/2027
i. Multidimensional nursing assessment and clinical judgment
ii. Acute and chronic alterations in health
iii. Pharmacologic and therapeutic nursing management
iv. Safety, prioritization, delegation, and infection prevention
v. Fluid, electrolyte, acid-base, and nutritional management
vi. Cardiovascular, respiratory, neurologic, and renal care
vii. Endocrine, gastrointestinal, and multisystem disorders
viii. Psychosocial, cultural, ethical, and patient-centered care
ix. Complications, deterioration, and emergency interventions
x. Evidence-based practice, documentation, and interdisciplinary collaboration
INTRODUCTION
This comprehensive practice examination is designed for students preparing for
NUR 2356 Multidimensional Care I (MDC 1) and emphasizes advanced clinical
judgment rather than simple memorization. It evaluates assessment,
prioritization, pathophysiology, pharmacologic management, safety, patient
education, delegation, documentation, and evidence-based nursing interventions
across complex clinical situations. The questions are intended for nursing
students who need to integrate multiple findings and determine the safest, most
appropriate action under realistic conditions. Expect challenging scenario-based
questions with carefully constructed distractors, 100+ questions and answers
with a rationale when the complete set is obtained, and opportunities to
strengthen clinical reasoning. Purchase and instantly get a downloadable and
editable pdf.
,2 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
QUESTION 1
A nurse receives report on four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client with chronic kidney disease whose potassium is 5.7 mEq/L and who reports
generalized weakness
B. A client with pneumonia whose temperature is 38.2°C (100.8°F) and respiratory rate is
22/min
C. A client with heart failure who gained 1.5 kg over the past week and has bilateral ankle
edema
D. A client with type 2 diabetes whose premeal glucose is 238 mg/dL and who is requesting
dietary teaching
Correct Answer: A. A client with chronic kidney disease whose potassium is 5.7 mEq/L
and who reports generalized weakness
Rationale: Hyperkalemia combined with muscle weakness may indicate
clinically significant potassium-related neuromuscular and cardiac conduction
abnormalities. This client has the greatest immediate risk for dysrhythmia and
requires prompt assessment and cardiac monitoring.
QUESTION 2
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by nasal
cannula. The client becomes increasingly somnolent, and the respiratory rate decreases from
20/min to 10/min. Which action should the nurse take first?
A. Increase oxygen to 6 L/min
B. Assess respiratory effort and obtain an oxygen saturation
C. Administer the prescribed opioid analgesic
D. Place the client in a supine position
Correct Answer: B. Assess respiratory effort and obtain an oxygen saturation
Rationale: New somnolence and bradypnea require immediate respiratory
assessment. Increasing oxygen without assessing ventilation can worsen the
clinical situation in a patient susceptible to carbon dioxide retention; the
priority is determining airway and ventilatory status.
QUESTION 3
A client receiving IV furosemide for acute decompensated heart failure has a potassium level
of 2.9 mEq/L. The client reports new palpitations. Which prescription should the nurse
question?
A. Continuous cardiac monitoring
B. Repeat serum potassium measurement
C. IV potassium replacement according to protocol
D. Additional IV furosemide immediately
,3 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Correct Answer: D. Additional IV furosemide immediately
Rationale: Furosemide promotes potassium loss. Severe hypokalemia with
palpitations increases the risk of potentially life-threatening dysrhythmias, so
additional diuresis should be evaluated carefully while the electrolyte
abnormality is addressed.
QUESTION 4
A postoperative client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and an
oxygen saturation of 86%. Which intervention has the highest priority?
A. Encourage incentive spirometry
B. Assist the client to ambulate
C. Apply supplemental oxygen and rapidly notify the appropriate provider or rapid-response
team
D. Administer the next scheduled dose of opioid analgesic
Correct Answer: C. Apply supplemental oxygen and rapidly notify the appropriate
provider or rapid-response team
Rationale: The sudden onset of hypoxemia, tachycardia, and pleuritic pain is
concerning for pulmonary embolism. Immediate stabilization of oxygenation
and urgent escalation of care are priorities.
QUESTION 5
A client with heart failure takes digoxin and reports nausea, anorexia, and seeing yellow-
green halos around lights. The apical pulse is 52/min. What is the nurse's priority action?
A. Administer the scheduled digoxin
B. Hold digoxin and notify the provider
C. Encourage foods high in sodium
D. Administer an additional diuretic
Correct Answer: B. Hold digoxin and notify the provider
Rationale: Bradycardia, gastrointestinal symptoms, and visual disturbances are
classic manifestations of possible digoxin toxicity. The medication should be
withheld and the client promptly evaluated.
QUESTION 6
A client with diabetic ketoacidosis has received several liters of IV fluid and continuous IV
insulin. The blood glucose has decreased from 580 mg/dL to 220 mg/dL, but the serum
potassium has fallen from 5.4 to 3.1 mEq/L. Which intervention is most important?
A. Continue insulin at the same rate without modification
B. Initiate prescribed potassium replacement and closely monitor cardiac rhythm
C. Restrict IV fluids
D. Administer a rapid IV dose of sodium bicarbonate routinely
, 4 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Correct Answer: B. Initiate prescribed potassium replacement and closely monitor
cardiac rhythm
Rationale: Insulin shifts potassium intracellularly, potentially causing
dangerous hypokalemia during DKA treatment. A potassium level of 3.1 mEq/L
creates substantial dysrhythmia risk and requires prompt replacement
according to the treatment protocol.
QUESTION 7
A client with suspected ischemic stroke develops facial drooping and expressive aphasia 45
minutes before arrival at the emergency department. Which information is most important for
the nurse to obtain?
A. The client's usual dietary pattern
B. The client's last known well time
C. The client's family history of hypertension
D. The client's preferred learning style
Correct Answer: B. The client's last known well time
Rationale: Determining the last known well time is critical when evaluating
eligibility for time-sensitive stroke interventions. Accurate timing directly
influences treatment decisions.
QUESTION 8
A client with cirrhosis becomes increasingly confused and has asterixis. Which prescribed
medication should the nurse anticipate administering?
A. Lactulose
B. Furosemide only
C. Warfarin
D. Diphenhydramine
Correct Answer: A. Lactulose
Rationale: Confusion and asterixis in advanced liver disease are consistent with
hepatic encephalopathy. Lactulose decreases intestinal ammonia absorption
and promotes ammonia elimination through the stool.
QUESTION 9
A client with SIADH has a sodium level of 118 mEq/L and develops a generalized seizure.
Which intervention should the nurse prioritize?
A. Encourage unrestricted oral water intake
B. Institute seizure precautions and administer prescribed hypertonic saline as indicated
C. Administer hypotonic IV fluid
D. Encourage a low-sodium diet
