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 subcutaneous daily. Which laboratory value
requires immediate nursing intervention?
A. Platelet count 110,000/mm³
B. PT/INR 1.2
C. aPTT 35 seconds
D. Hemoglobin 14 g/dL
Correct Answer: A
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). A
platelet drop below 150,000/mm³ or a 50 % reduction from baseline warrants
immediate physician notification and possible drug discontinuation. PT/INR and
aPTT are not routinely used to monitor low-molecular-weight heparin, and the
listed values are within normal limits. Hemoglobin 14 g/dL is normal and does
not require action.
, 2. The nurse is delegating morning hygiene care for a stable client 2 days
post–laparoscopic cholecystectomy. Which action is appropriate to assign
to the unlicensed assistive personnel (UAP)?
A. Assess the client’s abdominal incision for redness
B. Record the client’s intake and output
C. Assist the client with a bed bath and oral care
D. Auscultate bowel sounds in all four quadrants
Correct Answer: C
Rationale: UAPs may provide basic hygienic care. Assessment (A, D) and
measurement requiring clinical judgment (B) remain within RN scope. Bathing
and oral care are routine, non-invasive tasks suitable for delegation when the
client is stable.
3. A client with chronic obstructive pulmonary disease (COPD) is prescribed
prednisone 40 mg daily. Which nursing diagnosis is the priority?
A. Risk for infection
B. Impaired skin integrity
C. Constipation
D. Deficient knowledge
Correct Answer: A
,Rationale: Corticosteroids suppress immunity, increasing infection
risk—especially dangerous in COPD clients prone to pneumonia. While other
diagnoses may be relevant, infection can rapidly decompensate respiratory
status and is therefore the priority.
4. The nurse notes a pulsating mass in the client’s abdomen while bathing a
70-year-old hypertensive male. What is the nurse’s first action?
A. Palpate deeply to estimate size
B. Notify the provider immediately
C. Auscultate for bruit
D. Document as a normal finding
Correct Answer: B
Rationale: A pulsating abdominal mass suggests possible abdominal aortic
aneurysm (AAA). Deep palpation (A) could rupture the aneurysm. Immediate
provider notification allows stat imaging. Auscultation (C) is not contraindicated
but is secondary to securing medical evaluation.
5. A client with heart failure is started on furosemide 40 mg IV push. Which
assessment finding best indicates the desired effect?
A. Weight loss of 1 kg in 24 h
B. Urine output 30 mL/h
C. Blood pressure 90/60 mm Hg
, D. Serum potassium 3.0 mEq/L
Correct Answer: A
Rationale: Furosemide is a loop diuretic; acute weight reduction reflects fluid
loss. Thirty mL/h urine output (B) is below normal. Hypotension (C) and
hypokalemia (D) are potential adverse effects, not therapeutic goals.
6. When caring for a client with a chest tube after a thoracotomy, which
occurrence mandates immediate intervention?
A. Oscillation (tidaling) in water-seal chamber
B. Continuous bubbling in water-seal chamber
C. 200 mL serosanguinous output in 4 h
D. Client reports pain 6/10 at insertion site
Correct Answer: B
Rationale: Continuous bubbling indicates an air leak, possibly from loose
connections or bronchopleural fistula, and requires prompt assessment. Tidaling
(A) is normal with respiration. Output 200 mL/4 h (C) and pain (D) are expected
post-op findings.
7. A client with diabetes mellitus type 2 is scheduled for a coronary
angiography. Which medication held prior to the procedure is the nurse’s
priority to communicate?
A. Metformin
/ 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 subcutaneous daily. Which laboratory value
requires immediate nursing intervention?
A. Platelet count 110,000/mm³
B. PT/INR 1.2
C. aPTT 35 seconds
D. Hemoglobin 14 g/dL
Correct Answer: A
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). A
platelet drop below 150,000/mm³ or a 50 % reduction from baseline warrants
immediate physician notification and possible drug discontinuation. PT/INR and
aPTT are not routinely used to monitor low-molecular-weight heparin, and the
listed values are within normal limits. Hemoglobin 14 g/dL is normal and does
not require action.
, 2. The nurse is delegating morning hygiene care for a stable client 2 days
post–laparoscopic cholecystectomy. Which action is appropriate to assign
to the unlicensed assistive personnel (UAP)?
A. Assess the client’s abdominal incision for redness
B. Record the client’s intake and output
C. Assist the client with a bed bath and oral care
D. Auscultate bowel sounds in all four quadrants
Correct Answer: C
Rationale: UAPs may provide basic hygienic care. Assessment (A, D) and
measurement requiring clinical judgment (B) remain within RN scope. Bathing
and oral care are routine, non-invasive tasks suitable for delegation when the
client is stable.
3. A client with chronic obstructive pulmonary disease (COPD) is prescribed
prednisone 40 mg daily. Which nursing diagnosis is the priority?
A. Risk for infection
B. Impaired skin integrity
C. Constipation
D. Deficient knowledge
Correct Answer: A
,Rationale: Corticosteroids suppress immunity, increasing infection
risk—especially dangerous in COPD clients prone to pneumonia. While other
diagnoses may be relevant, infection can rapidly decompensate respiratory
status and is therefore the priority.
4. The nurse notes a pulsating mass in the client’s abdomen while bathing a
70-year-old hypertensive male. What is the nurse’s first action?
A. Palpate deeply to estimate size
B. Notify the provider immediately
C. Auscultate for bruit
D. Document as a normal finding
Correct Answer: B
Rationale: A pulsating abdominal mass suggests possible abdominal aortic
aneurysm (AAA). Deep palpation (A) could rupture the aneurysm. Immediate
provider notification allows stat imaging. Auscultation (C) is not contraindicated
but is secondary to securing medical evaluation.
5. A client with heart failure is started on furosemide 40 mg IV push. Which
assessment finding best indicates the desired effect?
A. Weight loss of 1 kg in 24 h
B. Urine output 30 mL/h
C. Blood pressure 90/60 mm Hg
, D. Serum potassium 3.0 mEq/L
Correct Answer: A
Rationale: Furosemide is a loop diuretic; acute weight reduction reflects fluid
loss. Thirty mL/h urine output (B) is below normal. Hypotension (C) and
hypokalemia (D) are potential adverse effects, not therapeutic goals.
6. When caring for a client with a chest tube after a thoracotomy, which
occurrence mandates immediate intervention?
A. Oscillation (tidaling) in water-seal chamber
B. Continuous bubbling in water-seal chamber
C. 200 mL serosanguinous output in 4 h
D. Client reports pain 6/10 at insertion site
Correct Answer: B
Rationale: Continuous bubbling indicates an air leak, possibly from loose
connections or bronchopleural fistula, and requires prompt assessment. Tidaling
(A) is normal with respiration. Output 200 mL/4 h (C) and pain (D) are expected
post-op findings.
7. A client with diabetes mellitus type 2 is scheduled for a coronary
angiography. Which medication held prior to the procedure is the nurse’s
priority to communicate?
A. Metformin
