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.
The nurse is caring for a client with a stage III pressure injury. Which intervention is
most appropriate to promote wound healing?
A. Apply dry gauze dressing to absorb drainage
B. Reposition every 4 hours to minimize shear
C. Use a moisture-retaining dressing with antimicrobial properties
D. Massage around the wound to increase circulation
Correct Answer: C
Rationale: Stage III injuries require moist wound healing and infection control.
Moisture-retaining antimicrobial dressings support granulation and prevent bacterial
colonization. Dry gauge causes desiccation of viable tissue. Repositioning must occur
every 2 hours, not 4. Massage increases shear and further tissue damage.
2.
A client receiving morphine via PCA complains of nausea and is difficult to arouse.
Respirations are 8/min. What is the nurse’s first action?
A. Administer naloxone 0.4 mg IV and call the provider
,B. Decrease the PCA dose by 25%
C. Apply high-flow O2 via non-rebreather
D. Increase IV fluids to dilute the morphine
Correct Answer: A
Rationale: Opioid-induced respiratory depression is a medical emergency; naloxone
reverses the effect within minutes. The provider must be notified for further orders.
Simply lowering the PCA dose or giving oxygen does not immediately reverse sedation
or hypoventilation. IV fluids do not expedite morphine clearance.
3.
Which laboratory finding best indicates acute kidney injury (AKI) in a client who received
IV contrast two hours ago?
A. Serum creatinine rise ≥0.3 mg/dL within 48 h
B. Urine output 800 mL in 8 h
C. BUN 18 mg/dL
D. Urine specific gravity 1.010
Correct Answer: A
Rationale: KDIGO defines AKI as creatinine increase ≥0.3 mg/dL within 48 h or 1.5×
baseline. Contrast-induced nephropathy peaks 24–48 h post-exposure. Normal urine
output and BUN do not confirm injury. Fixed specific gravity suggests chronic changes.
4.
,The nurse is delegating care of a stable client with diabetes to an experienced LPN.
Which task must remain with the RN?
A. Administering pre-breakfast lispro insulin
B. Performing foot assessment for neuropathy
C. Teaching carbohydrate counting
D. Obtaining Accu-Chek in the afternoon
Correct Answer: C
Rationale: Teaching is an RN responsibility under state nurse practice acts. Insulin
administration, routine glucose checks, and focused assessments may be performed by
LPNs when the client is stable and the facility policy allows.
5.
A postoperative client has a new-onset heart rate of 125 bpm and BP 88/52 mmHg.
What should the nurse suspect?
A. Hypovolemic shock
B. Autonomic dysreflexia
C. Pulmonary embolism
D. Paralytic ileus
Correct Answer: A
Rationale: Tachycardia with narrowing pulse pressure and hypotension are early signs
of hypovolemic shock due to blood or fluid loss. Autonomic dysreflexia presents with
, hypertension. PE usually shows hypoxemia and clear lungs. Ileus does not affect vital
signs this way.
6.
A client with COPD is prescribed prednisone 40 mg daily for exacerbation. Which
nursing diagnosis takes priority?
A. Risk for infection
B. Impaired gas exchange
C. Disturbed body image
D. Risk for falls
Correct Answer: A
Rationale: High-dose corticosteroids suppress immunity, increasing infection
risk—especially in clients with chronic lung disease already prone to bacterial
colonization. Gas exchange is important but infection can be life-threatening. Body
image and falls are secondary.
7.
The nurse is preparing a client for thoracentesis. Which action is essential prior to the
procedure?
A. Position supine with head elevated 45°
B. Obtain informed consent and verify allergies
C. Administer 100% oxygen via mask
D. Insert a Foley catheter for output monitoring
/ MDC 1 FINAL EXAM REVIEW | ACTUAL EXAM | Highly
Rated Quiz Bank | Questions and Answers | Latest
2025/2026 | Rasmussen College
1.
The nurse is caring for a client with a stage III pressure injury. Which intervention is
most appropriate to promote wound healing?
A. Apply dry gauze dressing to absorb drainage
B. Reposition every 4 hours to minimize shear
C. Use a moisture-retaining dressing with antimicrobial properties
D. Massage around the wound to increase circulation
Correct Answer: C
Rationale: Stage III injuries require moist wound healing and infection control.
Moisture-retaining antimicrobial dressings support granulation and prevent bacterial
colonization. Dry gauge causes desiccation of viable tissue. Repositioning must occur
every 2 hours, not 4. Massage increases shear and further tissue damage.
2.
A client receiving morphine via PCA complains of nausea and is difficult to arouse.
Respirations are 8/min. What is the nurse’s first action?
A. Administer naloxone 0.4 mg IV and call the provider
,B. Decrease the PCA dose by 25%
C. Apply high-flow O2 via non-rebreather
D. Increase IV fluids to dilute the morphine
Correct Answer: A
Rationale: Opioid-induced respiratory depression is a medical emergency; naloxone
reverses the effect within minutes. The provider must be notified for further orders.
Simply lowering the PCA dose or giving oxygen does not immediately reverse sedation
or hypoventilation. IV fluids do not expedite morphine clearance.
3.
Which laboratory finding best indicates acute kidney injury (AKI) in a client who received
IV contrast two hours ago?
A. Serum creatinine rise ≥0.3 mg/dL within 48 h
B. Urine output 800 mL in 8 h
C. BUN 18 mg/dL
D. Urine specific gravity 1.010
Correct Answer: A
Rationale: KDIGO defines AKI as creatinine increase ≥0.3 mg/dL within 48 h or 1.5×
baseline. Contrast-induced nephropathy peaks 24–48 h post-exposure. Normal urine
output and BUN do not confirm injury. Fixed specific gravity suggests chronic changes.
4.
,The nurse is delegating care of a stable client with diabetes to an experienced LPN.
Which task must remain with the RN?
A. Administering pre-breakfast lispro insulin
B. Performing foot assessment for neuropathy
C. Teaching carbohydrate counting
D. Obtaining Accu-Chek in the afternoon
Correct Answer: C
Rationale: Teaching is an RN responsibility under state nurse practice acts. Insulin
administration, routine glucose checks, and focused assessments may be performed by
LPNs when the client is stable and the facility policy allows.
5.
A postoperative client has a new-onset heart rate of 125 bpm and BP 88/52 mmHg.
What should the nurse suspect?
A. Hypovolemic shock
B. Autonomic dysreflexia
C. Pulmonary embolism
D. Paralytic ileus
Correct Answer: A
Rationale: Tachycardia with narrowing pulse pressure and hypotension are early signs
of hypovolemic shock due to blood or fluid loss. Autonomic dysreflexia presents with
, hypertension. PE usually shows hypoxemia and clear lungs. Ileus does not affect vital
signs this way.
6.
A client with COPD is prescribed prednisone 40 mg daily for exacerbation. Which
nursing diagnosis takes priority?
A. Risk for infection
B. Impaired gas exchange
C. Disturbed body image
D. Risk for falls
Correct Answer: A
Rationale: High-dose corticosteroids suppress immunity, increasing infection
risk—especially in clients with chronic lung disease already prone to bacterial
colonization. Gas exchange is important but infection can be life-threatening. Body
image and falls are secondary.
7.
The nurse is preparing a client for thoracentesis. Which action is essential prior to the
procedure?
A. Position supine with head elevated 45°
B. Obtain informed consent and verify allergies
C. Administer 100% oxygen via mask
D. Insert a Foley catheter for output monitoring
