NUR 2356 / NUR2356 Multidimensional Care I Final
Exam / MDC 1 FINAL EXAM REVIEW | ACTUAL EXAM |
Highly Rated Quiz Bank | Questions and Answers |
Latest 2025/2026 | Rasmussen College
1
A 68-year-old client recovering from a right total-hip replacement is receiving enoxaparin
40 mg subcut daily. Which laboratory value requires immediate nursing intervention?
A. INR 1.3
B. Platelets 90,000/mm³
C. aPTT 35 seconds
D. Hemoglobin 11 g/dL
Correct Answer: B
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). A platelet
count below 100,000/mm³ or a 50 % drop from baseline necessitates immediate
discontinuation and provider notification. INR is not monitored for low-molecular-weight
heparin; aPTT is unaffected at therapeutic doses; mild anemia is common
post-operatively and not urgent.
2
The nurse is caring for a client with a serum potassium of 3.2 mEq/L. Which nursing
action is most appropriate?
,A. Administer furosemide as scheduled
B. Encourage bananas and orange juice
C. Obtain a 12-lead ECG
D. Begin potassium 40 mEq IV push
Correct Answer: C
Rationale: Hypokalemia < 3.5 mEq/L predisposes to life-threatening ventricular
dysrhythmias; obtaining an ECG first evaluates QT prolongation, U waves, or T-wave
flattening. Dietary replacement is insufficient for this level; IV potassium must never be
given as a push and requires cardiac monitoring.
3
Which client should the nurse see first during morning rounds?
A. Client with type 2 DM whose fasting glucose is 140 mg/dL
B. Client with pneumonia reporting pleuritic chest pain 6/10
C. Client with heart rate 46 beats/min and cool clammy skin
D. Client with stage 2 pressure injury requesting pain medication
Correct Answer: C
Rationale: Bradycardia with hypoperfusion (cool, clammy skin) suggests shock or
complete heart block—an emergent situation. The other clients have concerning but
non-immediately life-threatening issues.
4
,A client with COPD is receiving oxygen at 5 L/min via nasal cannula. Which finding
indicates oxygen toxicity?
A. SaO₂ 96 %
B. Respiratory rate 18/min
C. Decreased level of consciousness
D. Use of pursed-lip breathing
Correct Answer: C
Rationale: High-flow oxygen in COPD clients can blunt hypoxic respiratory drive, leading
to CO₂ narcosis and decreased level of consciousness. SaO₂ 96 % is above target for
many COPD patients but is not itself toxicity. Pursed-lip breathing is appropriate.
5
The nurse is delegating care to an assistive personnel (AP). Which task is most
appropriate to assign?
A. Obtain vital signs on a stable post-op client
B. Insert a nasogastric tube
C. Evaluate gait training progress
D. Perform sterile wound irrigation
Correct Answer: A
Rationale: APs may obtain routine vital signs on stable clients. All other tasks require
licensed nurse knowledge or sterile technique.
, 6
A client with acute pancreatitis is prescribed nothing-by-mouth status and a nasogastric
tube to low intermittent suction. The nurse notes the suction is set to high continuous.
Which complication is the greatest risk?
A. Paralytic ileus
B. Electrolyte imbalance
C. Esophageal varices
D. Aspiration pneumonia
Correct Answer: B
Rationale: High continuous suction removes large volumes of gastric secretions rich in
hydrogen, potassium, and chloride, leading to metabolic alkalosis and hypokalemia.
Ileus is already common in pancreatitis; varices are unrelated; aspiration risk is
unchanged.
7
The nurse is teaching a client with heart failure about daily weights. Which statement
indicates understanding?
A. “I will weigh myself weekly, naked, after breakfast.”
B. “A 2-pound gain overnight or 5 pounds in a week means I should call my doctor.”
C. “I will weigh at different times each day as long as it is before lunch.”
D. “I only need to weigh if my ankles are swollen.”
Exam / MDC 1 FINAL EXAM REVIEW | ACTUAL EXAM |
Highly Rated Quiz Bank | Questions and Answers |
Latest 2025/2026 | Rasmussen College
1
A 68-year-old client recovering from a right total-hip replacement is receiving enoxaparin
40 mg subcut daily. Which laboratory value requires immediate nursing intervention?
A. INR 1.3
B. Platelets 90,000/mm³
C. aPTT 35 seconds
D. Hemoglobin 11 g/dL
Correct Answer: B
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). A platelet
count below 100,000/mm³ or a 50 % drop from baseline necessitates immediate
discontinuation and provider notification. INR is not monitored for low-molecular-weight
heparin; aPTT is unaffected at therapeutic doses; mild anemia is common
post-operatively and not urgent.
2
The nurse is caring for a client with a serum potassium of 3.2 mEq/L. Which nursing
action is most appropriate?
,A. Administer furosemide as scheduled
B. Encourage bananas and orange juice
C. Obtain a 12-lead ECG
D. Begin potassium 40 mEq IV push
Correct Answer: C
Rationale: Hypokalemia < 3.5 mEq/L predisposes to life-threatening ventricular
dysrhythmias; obtaining an ECG first evaluates QT prolongation, U waves, or T-wave
flattening. Dietary replacement is insufficient for this level; IV potassium must never be
given as a push and requires cardiac monitoring.
3
Which client should the nurse see first during morning rounds?
A. Client with type 2 DM whose fasting glucose is 140 mg/dL
B. Client with pneumonia reporting pleuritic chest pain 6/10
C. Client with heart rate 46 beats/min and cool clammy skin
D. Client with stage 2 pressure injury requesting pain medication
Correct Answer: C
Rationale: Bradycardia with hypoperfusion (cool, clammy skin) suggests shock or
complete heart block—an emergent situation. The other clients have concerning but
non-immediately life-threatening issues.
4
,A client with COPD is receiving oxygen at 5 L/min via nasal cannula. Which finding
indicates oxygen toxicity?
A. SaO₂ 96 %
B. Respiratory rate 18/min
C. Decreased level of consciousness
D. Use of pursed-lip breathing
Correct Answer: C
Rationale: High-flow oxygen in COPD clients can blunt hypoxic respiratory drive, leading
to CO₂ narcosis and decreased level of consciousness. SaO₂ 96 % is above target for
many COPD patients but is not itself toxicity. Pursed-lip breathing is appropriate.
5
The nurse is delegating care to an assistive personnel (AP). Which task is most
appropriate to assign?
A. Obtain vital signs on a stable post-op client
B. Insert a nasogastric tube
C. Evaluate gait training progress
D. Perform sterile wound irrigation
Correct Answer: A
Rationale: APs may obtain routine vital signs on stable clients. All other tasks require
licensed nurse knowledge or sterile technique.
, 6
A client with acute pancreatitis is prescribed nothing-by-mouth status and a nasogastric
tube to low intermittent suction. The nurse notes the suction is set to high continuous.
Which complication is the greatest risk?
A. Paralytic ileus
B. Electrolyte imbalance
C. Esophageal varices
D. Aspiration pneumonia
Correct Answer: B
Rationale: High continuous suction removes large volumes of gastric secretions rich in
hydrogen, potassium, and chloride, leading to metabolic alkalosis and hypokalemia.
Ileus is already common in pancreatitis; varices are unrelated; aspiration risk is
unchanged.
7
The nurse is teaching a client with heart failure about daily weights. Which statement
indicates understanding?
A. “I will weigh myself weekly, naked, after breakfast.”
B. “A 2-pound gain overnight or 5 pounds in a week means I should call my doctor.”
C. “I will weigh at different times each day as long as it is before lunch.”
D. “I only need to weigh if my ankles are swollen.”
