1
NUR 2356 / NUR2356 Multidimensional Care I
Actual Exam 2026/2027 / MDC 1 Final Exam
Review | Highly Rated Quiz Bank| Questions and
Answers | Latest 2026/2027 Actual Exam |
Rasmussen College
Item ID: [MDC1-001] Item Type: [Complex MCQ] Scenario: A 64-year-old male with a history
of Chronic Obstructive Pulmonary Disease (COPD) is admitted for an acute exacerbation. He
lives alone in a rural area and expresses fear that he will lose his independ ence. His current SpO2
is 89% on 2L NC, and he appears anxious, using accessory muscles to breathe.
Question: Which multidimensional nursing intervention is the priority to address both his
physiological stability and his psychosocial distress?
Options: A. Increase oxygen flow to 6L via simple mask to alleviate anxiety. B. Assist the
patient with pursed-lip breathing while remaining at the bedside. C. Administer a PRN dose of
alprazolam to treat the patient's fear of losing independence. D. Request a social work consult to
discuss long-term care facilities immediately.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: Pursed-lip breathing physically improves gas exchange by
keeping airways open longer (physiological) and provides the patient with a sense of
control over his dyspnea, which directly mitigates the anxiety and fear of losing
independence (psychosocial). Remaining at the bedside provides a therapeutic presence, a
core 2026 nursing standard for acute respiratory distress.
• Distractor Breakdown: A is dangerous; high-flow oxygen can suppress the hypoxic
drive in chronic COPD. C addresses the psyche but may cause respiratory depression. D
is premature and ignores the patient's stated goal of maintaining independence, failing the
psychosocial/cultural assessment.
Item ID: [MDC1-002] Item Type: [NGN: Case Study - Analysis] Scenario: A 42-year-old female
is admitted with a new diagnosis of Type 2 Diabetes Mellitus. She is a primary caregiver for her
elderly mother and works two jobs. She tells the nurse, "I don't have time for a special diet or
testing my blood." Her HbA1c is 9.2%.
, 2
Question: The nurse is developing a multidimensional teaching plan. Which approach best
addresses the patient's barriers to care?
Options: A. Provide a standardized 1,500-calorie meal plan and a logbook for glucose tracking.
B. Explain the long-term risks of blindness and amputation to increase her motivation. C.
Collaborate with the patient to identify "quick-fix" healthy food options that fit her schedule. D.
Suggest she quit one of her jobs to prioritize her health and caregiver duties.
Rationale (Verified):
• Correct Answer: C
• Multidimensional Analysis: This choice integrates her physiological need for glucose
control with her psychosocial reality (time poverty and caregiver burden). Tailoring
education to the patient’s lifestyle (2026 individualized care standards) increases
adherence more effectively than rigid protocols.
• Distractor Breakdown: A is a "one-size-fits-all" approach that ignores the patient's
specific barriers. B uses fear-based tactics which are often counterproductive in
psychosocially stressed patients. D is an unrealistic and dismissive solution to her
financial and family needs.
Item ID: [MDC1-003] Item Type: [Complex MCQ] Scenario: An 82-year-old Hispanic female is
postoperative Day 1 following a total hip arthroplasty. She is quiet, avoids eye contact, and
refuses to participate in physical therapy, stating, "I will just wait for God to heal me." Her
daughter whispers that in their culture, complaining of pain is seen as a weakness.
Question: Which action by the nurse demonstrates culturally competent, multidimensional care?
Options: A. Respect her wish to refuse therapy and document "non-compliant." B. Use a
validated pain scale and offer scheduled analgesics while explaining their role in recovery. C.
Ask the hospital chaplain to convince her to participate in physical therapy. D. Tell the patient
that she will develop a blood clot if she does not move.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: This recognizes the cultural barrier (stoicism and religious
fatalism) and addresses the physiological need (pain management for mobility). Offering
scheduled meds avoids the "weakness" of asking for them, while education links
physiological recovery to her functional goals.
• Distractor Breakdown: A ignores the physiological risk of immobility. C misuses
spiritual care to coerce the patient. D is a threat-based approach that ignores the
psychosocial and cultural context of her behavior.
, 3
Item ID: [MDC1-004] Item Type: [NGN: Prioritization] Scenario: The nurse is caring for a 55-
year-old male with Heart Failure (HF) and a history of depression. He was discharged 2 days ago
but has returned with a 5lb weight gain, 2+ pitting edema, and reports feeling "hopeless" about
managing his medications.
Question: Which assessment finding requires the most immediate physiological intervention?
Options: A. Pitting edema in the lower extremities. B. Statement of "feeling hopeless." C.
Crackles heard in the lung bases upon auscultation. D. S3 heart sound noted during assessment.
Rationale (Verified):
• Correct Answer: C
• Multidimensional Analysis: While the psychosocial state (hopelessness) is critical,
crackles indicate pulmonary edema (physiological crisis), which is life-threatening.
According to 2026 ABC (Airway, Breathing, Circulation) standards, respiratory status is
the priority in acute HF exacerbation.
• Distractor Breakdown: A and D are expected findings in HF but not as immediately
life-threatening as potential pulmonary edema. B is high priority for the care plan but
follows physiological stabilization.
Item ID: [MDC1-005] Item Type: [Complex MCQ] Scenario: A 30-year-old male is admitted
with an acute exacerbation of Crohn’s Disease. He is concerned about how his frequent
bathroom trips will affect his new marriage. He is currently NPO for bowel rest and receiving
TPN.
Question: How should the nurse integrate the patient's developmental needs into his care plan?
Options: A. Limit visitors to ensure the patient has maximum privacy for bowel movements. B.
Encourage the patient to express his concerns with his spouse and facilitate private time. C.
Explain that his condition is chronic and his spouse will "just have to get used to it." D. Focus
strictly on his TPN administration and electrolyte balance.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: According to Erikson (Intimacy vs. Isolation), this young
adult’s developmental focus is on his marriage. Addressing his psychosocial fear
regarding his spouse is essential for his long-term adaptation to a chronic physiological
illness.
• Distractor Breakdown: A increases isolation. C is dismissive and non-therapeutic. D
ignores the psychosocial and developmental dimensions of care.
, 4
Item ID: [MDC1-006] Item Type: [NGN: Case Study - Interpretation] Scenario: An older adult
patient with Chronic Kidney Disease (CKD) Stage 3 is prescribed a new low-protein, low-
potassium diet. The patient identifies as a devout Buddhist and follows a strict vegetarian diet.
Question: What is the nurse's priority when coordinating this patient's nutritional care?
Options: A. Tell the patient he must eat eggs to get high-quality protein for kidney health. B.
Collaborate with a dietitian to find plant-based proteins low in potassium. C. Inform the patient
that his religious diet is causing his kidney function to decline. D. Provide a standard CKD
pamphlet and tell him to choose what he can.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: This integrates the physiological requirements of CKD
(potassium/protein restriction) with the patient's cultural and religious identity. 2026
standards emphasize that dietary changes must be culturally congruent to be sustainable.
• Distractor Breakdown: A violates religious beliefs. C is culturally insensitive and
factually incorrect. D is lazy care coordination that risks physiological harm
(hyperkalemia).
Item ID: [MDC1-007] Item Type: [Complex MCQ] Scenario: A 70-year-old female with
osteoporosis and mild cognitive impairment lives in an assisted living facility. She has a history
of falls but refuses to use a walker because it makes her feel "old."
Question: Which multidimensional strategy most effectively promotes safety?
Options: A. Remove the walker from her room to prevent her from tripping over it. B. Enlist a
"peer ambassador" in the facility who uses a walker to talk with her. C. Ask the provider to
prescribe a sedative so she stays in bed more often. D. Tell her she will be moved to a skilled
nursing facility if she falls again.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: This addresses the psychosocial barrier (stigma of aging)
through social support while aiming for the physiological goal of fall prevention. Peer
influence is a powerful developmental tool for older adults.
• Distractor Breakdown: A increases the risk of falls. C is a chemical restraint and causes
physiological decline. D is a threat that ignores her autonomy and psychosocial needs.
NUR 2356 / NUR2356 Multidimensional Care I
Actual Exam 2026/2027 / MDC 1 Final Exam
Review | Highly Rated Quiz Bank| Questions and
Answers | Latest 2026/2027 Actual Exam |
Rasmussen College
Item ID: [MDC1-001] Item Type: [Complex MCQ] Scenario: A 64-year-old male with a history
of Chronic Obstructive Pulmonary Disease (COPD) is admitted for an acute exacerbation. He
lives alone in a rural area and expresses fear that he will lose his independ ence. His current SpO2
is 89% on 2L NC, and he appears anxious, using accessory muscles to breathe.
Question: Which multidimensional nursing intervention is the priority to address both his
physiological stability and his psychosocial distress?
Options: A. Increase oxygen flow to 6L via simple mask to alleviate anxiety. B. Assist the
patient with pursed-lip breathing while remaining at the bedside. C. Administer a PRN dose of
alprazolam to treat the patient's fear of losing independence. D. Request a social work consult to
discuss long-term care facilities immediately.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: Pursed-lip breathing physically improves gas exchange by
keeping airways open longer (physiological) and provides the patient with a sense of
control over his dyspnea, which directly mitigates the anxiety and fear of losing
independence (psychosocial). Remaining at the bedside provides a therapeutic presence, a
core 2026 nursing standard for acute respiratory distress.
• Distractor Breakdown: A is dangerous; high-flow oxygen can suppress the hypoxic
drive in chronic COPD. C addresses the psyche but may cause respiratory depression. D
is premature and ignores the patient's stated goal of maintaining independence, failing the
psychosocial/cultural assessment.
Item ID: [MDC1-002] Item Type: [NGN: Case Study - Analysis] Scenario: A 42-year-old female
is admitted with a new diagnosis of Type 2 Diabetes Mellitus. She is a primary caregiver for her
elderly mother and works two jobs. She tells the nurse, "I don't have time for a special diet or
testing my blood." Her HbA1c is 9.2%.
, 2
Question: The nurse is developing a multidimensional teaching plan. Which approach best
addresses the patient's barriers to care?
Options: A. Provide a standardized 1,500-calorie meal plan and a logbook for glucose tracking.
B. Explain the long-term risks of blindness and amputation to increase her motivation. C.
Collaborate with the patient to identify "quick-fix" healthy food options that fit her schedule. D.
Suggest she quit one of her jobs to prioritize her health and caregiver duties.
Rationale (Verified):
• Correct Answer: C
• Multidimensional Analysis: This choice integrates her physiological need for glucose
control with her psychosocial reality (time poverty and caregiver burden). Tailoring
education to the patient’s lifestyle (2026 individualized care standards) increases
adherence more effectively than rigid protocols.
• Distractor Breakdown: A is a "one-size-fits-all" approach that ignores the patient's
specific barriers. B uses fear-based tactics which are often counterproductive in
psychosocially stressed patients. D is an unrealistic and dismissive solution to her
financial and family needs.
Item ID: [MDC1-003] Item Type: [Complex MCQ] Scenario: An 82-year-old Hispanic female is
postoperative Day 1 following a total hip arthroplasty. She is quiet, avoids eye contact, and
refuses to participate in physical therapy, stating, "I will just wait for God to heal me." Her
daughter whispers that in their culture, complaining of pain is seen as a weakness.
Question: Which action by the nurse demonstrates culturally competent, multidimensional care?
Options: A. Respect her wish to refuse therapy and document "non-compliant." B. Use a
validated pain scale and offer scheduled analgesics while explaining their role in recovery. C.
Ask the hospital chaplain to convince her to participate in physical therapy. D. Tell the patient
that she will develop a blood clot if she does not move.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: This recognizes the cultural barrier (stoicism and religious
fatalism) and addresses the physiological need (pain management for mobility). Offering
scheduled meds avoids the "weakness" of asking for them, while education links
physiological recovery to her functional goals.
• Distractor Breakdown: A ignores the physiological risk of immobility. C misuses
spiritual care to coerce the patient. D is a threat-based approach that ignores the
psychosocial and cultural context of her behavior.
, 3
Item ID: [MDC1-004] Item Type: [NGN: Prioritization] Scenario: The nurse is caring for a 55-
year-old male with Heart Failure (HF) and a history of depression. He was discharged 2 days ago
but has returned with a 5lb weight gain, 2+ pitting edema, and reports feeling "hopeless" about
managing his medications.
Question: Which assessment finding requires the most immediate physiological intervention?
Options: A. Pitting edema in the lower extremities. B. Statement of "feeling hopeless." C.
Crackles heard in the lung bases upon auscultation. D. S3 heart sound noted during assessment.
Rationale (Verified):
• Correct Answer: C
• Multidimensional Analysis: While the psychosocial state (hopelessness) is critical,
crackles indicate pulmonary edema (physiological crisis), which is life-threatening.
According to 2026 ABC (Airway, Breathing, Circulation) standards, respiratory status is
the priority in acute HF exacerbation.
• Distractor Breakdown: A and D are expected findings in HF but not as immediately
life-threatening as potential pulmonary edema. B is high priority for the care plan but
follows physiological stabilization.
Item ID: [MDC1-005] Item Type: [Complex MCQ] Scenario: A 30-year-old male is admitted
with an acute exacerbation of Crohn’s Disease. He is concerned about how his frequent
bathroom trips will affect his new marriage. He is currently NPO for bowel rest and receiving
TPN.
Question: How should the nurse integrate the patient's developmental needs into his care plan?
Options: A. Limit visitors to ensure the patient has maximum privacy for bowel movements. B.
Encourage the patient to express his concerns with his spouse and facilitate private time. C.
Explain that his condition is chronic and his spouse will "just have to get used to it." D. Focus
strictly on his TPN administration and electrolyte balance.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: According to Erikson (Intimacy vs. Isolation), this young
adult’s developmental focus is on his marriage. Addressing his psychosocial fear
regarding his spouse is essential for his long-term adaptation to a chronic physiological
illness.
• Distractor Breakdown: A increases isolation. C is dismissive and non-therapeutic. D
ignores the psychosocial and developmental dimensions of care.
, 4
Item ID: [MDC1-006] Item Type: [NGN: Case Study - Interpretation] Scenario: An older adult
patient with Chronic Kidney Disease (CKD) Stage 3 is prescribed a new low-protein, low-
potassium diet. The patient identifies as a devout Buddhist and follows a strict vegetarian diet.
Question: What is the nurse's priority when coordinating this patient's nutritional care?
Options: A. Tell the patient he must eat eggs to get high-quality protein for kidney health. B.
Collaborate with a dietitian to find plant-based proteins low in potassium. C. Inform the patient
that his religious diet is causing his kidney function to decline. D. Provide a standard CKD
pamphlet and tell him to choose what he can.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: This integrates the physiological requirements of CKD
(potassium/protein restriction) with the patient's cultural and religious identity. 2026
standards emphasize that dietary changes must be culturally congruent to be sustainable.
• Distractor Breakdown: A violates religious beliefs. C is culturally insensitive and
factually incorrect. D is lazy care coordination that risks physiological harm
(hyperkalemia).
Item ID: [MDC1-007] Item Type: [Complex MCQ] Scenario: A 70-year-old female with
osteoporosis and mild cognitive impairment lives in an assisted living facility. She has a history
of falls but refuses to use a walker because it makes her feel "old."
Question: Which multidimensional strategy most effectively promotes safety?
Options: A. Remove the walker from her room to prevent her from tripping over it. B. Enlist a
"peer ambassador" in the facility who uses a walker to talk with her. C. Ask the provider to
prescribe a sedative so she stays in bed more often. D. Tell her she will be moved to a skilled
nursing facility if she falls again.
Rationale (Verified):
• Correct Answer: B
• Multidimensional Analysis: This addresses the psychosocial barrier (stigma of aging)
through social support while aiming for the physiological goal of fall prevention. Peer
influence is a powerful developmental tool for older adults.
• Distractor Breakdown: A increases the risk of falls. C is a chemical restraint and causes
physiological decline. D is a threat that ignores her autonomy and psychosocial needs.
