NUR 2502 Multidimensional Care III (MDC 3)
Exam 2 | Questions and Correct Answers plus
Rationale | 2026-2027 Update
1. A nurse is assessing a patient who was recently struck in the face during a
motor vehicle accident. Which finding requires the nurse to notify the provider
immediately?
A. Sensation of "crackling" when touching the skin around the nose
B. A yellow "halo" ring appearing on filter paper from nasal drainage
C. Swelling and bruising around both eyes (periorbital ecchymosis)
D. Pain at the bridge of the nose rated 7 out of 10
Correct Answer: B. A yellow "halo" ring appearing on filter paper from nasal
drainage
Rationale: A yellow "halo" ring (or halo sign) is a classic indicator of cerebrospinal
fluid (CSF) rhinorrhea, which suggests a basilar skull fracture. This is a critical
finding because it indicates a direct connection between the subarachnoid space
and the outside environment, posing a high risk for meningitis. This requires
immediate medical notification. Option A describes subcutaneous emphysema,
which is also concerning but less immediately life-threatening than a CSF leak.
Option C is a sign of a basilar skull fracture (raccoon eyes) but the halo sign is a
more definitive indication of a CSF leak. Option D is subjective and less urgent
than a potential CSF leak.
2. Which clinical manifestation should a nurse expect to see in a patient
diagnosed with neck cancer?
A. Increased saliva production and drooling
B. Weight gain due to decreased activity
C. Persistent hoarseness for more than two weeks
D. Acute onset of high fever and chills
,Correct Answer: C. Persistent hoarseness for more than two weeks
Rationale: Laryngeal cancer often presents with persistent hoarseness or a
change in voice quality that lasts longer than two weeks. This is a classic early
warning sign. Other symptoms can include a lump in the neck, difficulty
swallowing, and a persistent sore throat. Options A, B, and D are not typical
presenting signs of neck cancer.
3. What is the first priority for the nurse when caring for a patient following a
total laryngectomy?
A. Airway maintenance and gas exchange
B. Facilitating alternative means of communication
C. Assessing the surgical site for wound breakdown
D. Managing intense post-operative pain
Correct Answer: A. Airway maintenance and gas exchange
Rationale: Following a total laryngectomy, the patient's airway is permanently
altered. They now breathe through a stoma in their neck. According to Maslow's
hierarchy of needs and the ABCs (Airway, Breathing, Circulation) of nursing care,
maintaining a patent airway and ensuring adequate oxygenation are the highest
priorities. All other interventions, while important, are secondary to ensuring the
patient can breathe.
4. A patient with obstructive sleep apnea (OSA) is being discharged with a CPAP
machine. Which statement by the patient indicates a need for further teaching?
A. "I will clean my machine regularly using distilled water."
B. "I should try to lose weight to help reduce my symptoms."
C. "I will sleep on my back to help keep my airway open."
D. "I should avoid drinking alcohol before I go to bed."
Correct Answer: C. "I will sleep on my back to help keep my airway open."
Rationale: This statement is incorrect and indicates a need for further teaching.
Sleeping in a supine position (on the back) allows gravity to pull the tongue and
soft tissues backward, which can worsen airway obstruction in a patient with OSA.
,Patients should be advised to sleep on their side. Options A, B, and D are all
correct statements regarding OSA management.
5. What is the priority nursing action for a patient who has sustained severe
facial trauma?
A. Performing a comprehensive airway assessment
B. Assessing the patient for a change in level of consciousness
C. Administering IV fluids for potential blood loss
D. Cleaning and debriding facial lacerations
Correct Answer: A. Performing a comprehensive airway assessment
Rationale: The priority in any trauma situation, especially one involving the face
and neck, is to assess and secure the airway. Severe facial trauma can lead to
airway obstruction from swelling, bleeding, or displaced structures. Following the
ABC protocol, airway assessment is the first and most critical step. Neurological
status (B) and circulation (C) are assessed next. Wound care (D) is a lower priority.
6. A patient is experiencing an emergency posterior nasal bleed. Which
intervention is most appropriate?
A. Instruct the patient to blow their nose to clear clots.
B. Have the patient tilt their head back to stop the flow.
C. Position the patient upright and leaning forward.
D. Apply a warm compress to the bridge of the nose.
Correct Answer: C. Position the patient upright and leaning forward.
Rationale: For a posterior nasal bleed (epistaxis), the patient should be
positioned upright and leaning forward. This position helps to reduce blood
pressure in the nasal vessels and prevents the patient from swallowing blood,
which can cause nausea and vomiting. Tilting the head back (B) is incorrect as it
promotes blood swallowing. Blowing the nose (A) can dislodge clots and worsen
the bleeding. A cold compress, not a warm one (D), would be used to promote
vasoconstriction.
, 7. Which medication is classified as a "rescue" inhaler to be used during an
acute asthma attack?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Correct Answer: B. Albuterol
Rationale: Albuterol is a short-acting beta2-agonist (SABA) that provides rapid
bronchodilation. It is the medication of choice for relieving acute symptoms of
asthma, such as wheezing and shortness of breath, making it a "rescue" inhaler.
Salmeterol (A) is a long-acting beta2-agonist (LABA) used for maintenance, not for
acute attacks. Fluticasone (C) is an inhaled corticosteroid (ICS) for long-term
control of inflammation. Montelukast (D) is an oral leukotriene modifier used for
prophylaxis.
8. A nurse recognizes that a patient with emphysema has a "barrel chest"
appearance. This is primarily caused by:
A. Chronic inflammation of the bronchi and bronchioles
B. Excessive mucus production in the larger airways
C. Hyperinflation of the lungs and air trapping in the alveoli
D. Thickening of the bronchial walls from scarring
Correct Answer: C. Hyperinflation of the lungs and air trapping in the alveoli
Rationale: In emphysema, the destruction of alveolar walls leads to a loss of
elastic recoil. This causes air to become trapped in the lungs (air trapping), leading
to hyperinflation. Over time, this chronic hyperinflation causes the chest to
assume a barrel shape, with an increased anterior-posterior diameter. Options A
and B are more characteristic of chronic bronchitis. Option D can occur in various
chronic lung diseases but is not the primary cause of a barrel chest.
9. When educating a patient on the correct sequence for administering inhaled
medications, the nurse should instruct them to:
Exam 2 | Questions and Correct Answers plus
Rationale | 2026-2027 Update
1. A nurse is assessing a patient who was recently struck in the face during a
motor vehicle accident. Which finding requires the nurse to notify the provider
immediately?
A. Sensation of "crackling" when touching the skin around the nose
B. A yellow "halo" ring appearing on filter paper from nasal drainage
C. Swelling and bruising around both eyes (periorbital ecchymosis)
D. Pain at the bridge of the nose rated 7 out of 10
Correct Answer: B. A yellow "halo" ring appearing on filter paper from nasal
drainage
Rationale: A yellow "halo" ring (or halo sign) is a classic indicator of cerebrospinal
fluid (CSF) rhinorrhea, which suggests a basilar skull fracture. This is a critical
finding because it indicates a direct connection between the subarachnoid space
and the outside environment, posing a high risk for meningitis. This requires
immediate medical notification. Option A describes subcutaneous emphysema,
which is also concerning but less immediately life-threatening than a CSF leak.
Option C is a sign of a basilar skull fracture (raccoon eyes) but the halo sign is a
more definitive indication of a CSF leak. Option D is subjective and less urgent
than a potential CSF leak.
2. Which clinical manifestation should a nurse expect to see in a patient
diagnosed with neck cancer?
A. Increased saliva production and drooling
B. Weight gain due to decreased activity
C. Persistent hoarseness for more than two weeks
D. Acute onset of high fever and chills
,Correct Answer: C. Persistent hoarseness for more than two weeks
Rationale: Laryngeal cancer often presents with persistent hoarseness or a
change in voice quality that lasts longer than two weeks. This is a classic early
warning sign. Other symptoms can include a lump in the neck, difficulty
swallowing, and a persistent sore throat. Options A, B, and D are not typical
presenting signs of neck cancer.
3. What is the first priority for the nurse when caring for a patient following a
total laryngectomy?
A. Airway maintenance and gas exchange
B. Facilitating alternative means of communication
C. Assessing the surgical site for wound breakdown
D. Managing intense post-operative pain
Correct Answer: A. Airway maintenance and gas exchange
Rationale: Following a total laryngectomy, the patient's airway is permanently
altered. They now breathe through a stoma in their neck. According to Maslow's
hierarchy of needs and the ABCs (Airway, Breathing, Circulation) of nursing care,
maintaining a patent airway and ensuring adequate oxygenation are the highest
priorities. All other interventions, while important, are secondary to ensuring the
patient can breathe.
4. A patient with obstructive sleep apnea (OSA) is being discharged with a CPAP
machine. Which statement by the patient indicates a need for further teaching?
A. "I will clean my machine regularly using distilled water."
B. "I should try to lose weight to help reduce my symptoms."
C. "I will sleep on my back to help keep my airway open."
D. "I should avoid drinking alcohol before I go to bed."
Correct Answer: C. "I will sleep on my back to help keep my airway open."
Rationale: This statement is incorrect and indicates a need for further teaching.
Sleeping in a supine position (on the back) allows gravity to pull the tongue and
soft tissues backward, which can worsen airway obstruction in a patient with OSA.
,Patients should be advised to sleep on their side. Options A, B, and D are all
correct statements regarding OSA management.
5. What is the priority nursing action for a patient who has sustained severe
facial trauma?
A. Performing a comprehensive airway assessment
B. Assessing the patient for a change in level of consciousness
C. Administering IV fluids for potential blood loss
D. Cleaning and debriding facial lacerations
Correct Answer: A. Performing a comprehensive airway assessment
Rationale: The priority in any trauma situation, especially one involving the face
and neck, is to assess and secure the airway. Severe facial trauma can lead to
airway obstruction from swelling, bleeding, or displaced structures. Following the
ABC protocol, airway assessment is the first and most critical step. Neurological
status (B) and circulation (C) are assessed next. Wound care (D) is a lower priority.
6. A patient is experiencing an emergency posterior nasal bleed. Which
intervention is most appropriate?
A. Instruct the patient to blow their nose to clear clots.
B. Have the patient tilt their head back to stop the flow.
C. Position the patient upright and leaning forward.
D. Apply a warm compress to the bridge of the nose.
Correct Answer: C. Position the patient upright and leaning forward.
Rationale: For a posterior nasal bleed (epistaxis), the patient should be
positioned upright and leaning forward. This position helps to reduce blood
pressure in the nasal vessels and prevents the patient from swallowing blood,
which can cause nausea and vomiting. Tilting the head back (B) is incorrect as it
promotes blood swallowing. Blowing the nose (A) can dislodge clots and worsen
the bleeding. A cold compress, not a warm one (D), would be used to promote
vasoconstriction.
, 7. Which medication is classified as a "rescue" inhaler to be used during an
acute asthma attack?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Correct Answer: B. Albuterol
Rationale: Albuterol is a short-acting beta2-agonist (SABA) that provides rapid
bronchodilation. It is the medication of choice for relieving acute symptoms of
asthma, such as wheezing and shortness of breath, making it a "rescue" inhaler.
Salmeterol (A) is a long-acting beta2-agonist (LABA) used for maintenance, not for
acute attacks. Fluticasone (C) is an inhaled corticosteroid (ICS) for long-term
control of inflammation. Montelukast (D) is an oral leukotriene modifier used for
prophylaxis.
8. A nurse recognizes that a patient with emphysema has a "barrel chest"
appearance. This is primarily caused by:
A. Chronic inflammation of the bronchi and bronchioles
B. Excessive mucus production in the larger airways
C. Hyperinflation of the lungs and air trapping in the alveoli
D. Thickening of the bronchial walls from scarring
Correct Answer: C. Hyperinflation of the lungs and air trapping in the alveoli
Rationale: In emphysema, the destruction of alveolar walls leads to a loss of
elastic recoil. This causes air to become trapped in the lungs (air trapping), leading
to hyperinflation. Over time, this chronic hyperinflation causes the chest to
assume a barrel shape, with an increased anterior-posterior diameter. Options A
and B are more characteristic of chronic bronchitis. Option D can occur in various
chronic lung diseases but is not the primary cause of a barrel chest.
9. When educating a patient on the correct sequence for administering inhaled
medications, the nurse should instruct them to:
