NUR 2502 / MDC III FINAL EXAM (2026) RASMUSSEN – 120
QUESTIONS WITH 100 % CORRECT ANSWERS & RATIONALES |
MULTIDIMENSIONAL CARE III, ALREADY GRADED A+
1. A 68-year-old client with heart failure is admitted with shortness of
breath, orthopnea, and bilateral crackles. Which nursing intervention
has the highest priority?
A. Administer prescribed furosemide
B. Educate the client on fluid restriction
C. Check daily weight
D. Place client in high Fowler’s position
Correct Answer: D
Rationale: High Fowler’s improves oxygenation immediately;
medication and teaching follow once the client is stabilized.
2. A patient receiving digoxin reports nausea and visual halos. The
nurse finds the heart rate at 52 bpm. What is the priority action?
A. Administer antiemetic
B. Hold the digoxin and notify provider
C. Give the next dose as scheduled
D. Monitor blood pressure closely
Correct Answer: B
Rationale: Bradycardia, nausea, and halos are signs of digoxin toxicity.
The nurse should hold the medication.
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3. A client with COPD is receiving oxygen via nasal cannula at 4 L/min.
The nurse notes decreased respiratory rate and drowsiness. What is the
best action?
A. Increase oxygen flow rate
B. Notify provider and reduce O2 to 2 L/min
C. Encourage coughing and deep breathing
D. Prepare for mechanical ventilation
Correct Answer: B
Rationale: High O₂ in COPD may depress drive. Oxygen should be
titrated carefully and provider notified.
4. A client with type 2 diabetes is prescribed metformin. Which teaching
is most important?
A. “Take this medication with meals.”
B. “Avoid grapefruit juice while taking this drug.”
C. “Report muscle pain or weakness immediately.”
D. “Do not take if your blood sugar is low.”
Correct Answer: A
Rationale: Metformin should be taken with meals to decrease GI upset.
Grapefruit is not relevant; hypoglycemia risk is minimal.
5. A nurse reviews labs for a patient with renal failure. Potassium is 6.5
mEq/L. Which order should the nurse anticipate?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Furosemide
C. Insulin with dextrose
D. All of the above
Correct Answer: D
Rationale: Severe hyperkalemia may require multiple interventions to
rapidly lower potassium and prevent arrhythmias.
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6. A client receiving chemotherapy develops mouth sores (stomatitis).
Which nursing intervention is most appropriate?
A. Rinse with alcohol-based mouthwash
B. Use soft-bristle toothbrush and saline rinses
C. Encourage hot, spicy foods for comfort
D. Apply oral lidocaine and allow swallowing
Correct Answer: B
Rationale: Gentle oral care with saline prevents irritation and infection.
Alcohol and spicy foods worsen symptoms.
7. A 75-year-old on warfarin presents with INR of 5.6 and mild gum
bleeding. What should the nurse anticipate?
A. Give vitamin K
B. Administer fresh frozen plasma
C. Hold warfarin and notify provider
D. Increase dose of warfarin
Correct Answer: C
Rationale: INR >5 with mild bleeding = hold warfarin, notify provider.
Vitamin K reserved for serious bleeding.
8. A client with pneumonia has RR 32, O₂ sat 88% on room air, and
accessory muscle use. What is the priority action?
A. Notify respiratory therapy
B. Start oxygen therapy
C. Obtain sputum culture
D. Administer antibiotics
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Correct Answer: B
Rationale: Oxygenation is priority in acute respiratory distress.
Cultures/antibiotics follow stabilization.
9. A nurse cares for a patient on IV morphine. Which finding requires
immediate intervention?
A. Constipation
B. Nausea
C. Respiratory rate of 8/min
D. Itching
Correct Answer: C
Rationale: Opioid-induced respiratory depression is life-threatening
and must be addressed first.
10. A client with chronic kidney disease is prescribed erythropoietin.
Which lab should be monitored?
A. Hemoglobin and hematocrit
B. Potassium
C. Liver enzymes
D. INR
Correct Answer: A
Rationale: Erythropoietin stimulates RBC production; risk is
polycythemia, requiring Hgb/Hct monitoring.
11. A patient with DVT is prescribed heparin infusion. Which lab
indicates therapeutic effect?
A. INR 1.0
B. aPTT 65 seconds
C. Platelet count 90,000
D. Hemoglobin 12 g/dL