NUR 2356 / NUR2356 Multidimensional Care I (MDC 1) Exam 1 Review (Latest 2026/2027 Update) | Rasmussen University | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A

NUR 2356 / NUR2356 Multidimensional Care I (MDC 1) Exam 1 Review (Latest 2026/2027 Update) | Rasmussen University | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A Q: Burn patient with signs and symptoms of 3rd Spacing. Based on this statement, what imbalance do the s/s show? Answer Hypovolemia Q: Breast cancer patient going through chemo, and has had a mastectomy, now complains of SOB, Persistant cough, CT shows a small nodule, not infiltrating the lungs. What are the next steps? Answer Pulmonology referral is needed Q: Patient enrolled in hospice care, family has questions and needs to be educated. What should the nurse educate in regards to MAIN GOAL of hospice? Answer Quality of life preparation of death Q: Breast cancer patient having peripheral neuropathy from chemotherapy. What intervention would the nurse do to promote client safety? Answer Inspect feet daily for injuries that go unoticed Q: Patient expressing a desire for cultural sensative care at the end of life. What would the nurse as the patient? Answer Can you tell me about any cultural/spiritual practices important to you. See their priest Q: Patient with vomiting/diarrhea, s/s of Fluid volume defecit. The nurse checks Bun/Cr. and its 25:1. What action would the nurse do to correct the problem? Answer Initiate IV infusion of Isotonic electrolyte solution. examples: 0.9% NS Q: Patient with chronic kidney disease, what is the body doing? Answer retaining fluid Q: Patient with CKD has edema, JVD(Jugular vein distention). Nurse hears crackles in the lungs. Patient is on a sodium restricted diet. still c/o Fluid volume excess. What should the nurse expect the MD to order? Answer Loop Diuretic monitor electrolyte ( nurse to do) Q: Patient with severe dehydration, there is an order for IV to correct defecit. what solution should be ordered? Answer 0.9% NS ( Isotonic) Q: Patient with heart failure, admitted to ED with s/s of dehydration. Provider orders isotonic IV solution. What should the nurse do to keep patient safe, what to monitor for? Answer signs of fluid overload Q: What is the primary cancer prevention? Answer promoting/providing vaccines EX: HPV Q: Cancer patient getting chemo agent. The nurse is aware of the side effects of chemo is thrombocytopenia. What symptom should the nurse assess for? Answer increased bruising Q: elderly patient (84), recovering from hip sx, patient is confused, has dry mucus membranes. Patient says he stopped drinking water, because it is too hard to go to the bathroom at night. What should the nurse tell the pateint? Answer Limiting fluid can create imbalances that result in confusion. Lets try adjusting the time of your fluids Q: What are the causes of hypovolemia? Answer Vomiting Hemorrhage Fever Perfused Diaphoresis (Sweating) Q: Patient with leukemia, c/o mouth sores after completing cytotoxicity chemo. Which of the following should the nurse tell the patient? Answer - avoid alcohol based mouthwash - maintain fluid intake (at least 2L daily) - oral cryotherapy( w/ice chips/cold water) Q: Patient ask nurse how chemo works to destroy cancer cells. What should the nurse tell the patient? Answer damage DNA interfering with cell division, and cellular regulation in cancer cells Q: Patient with CHF and renal failure. What would the patient say to indicate to the nurse he may need further teaching in avoiding hypovolemic episode? Answer increase oral intake to stay hydrated Patient with suspected lung cancer is scheduled for sx to remove tumor and have it biopsied, What would this be classified as a treatment type? Answer diagnostic tx elderly patient (84) present with mental status change, elevated HR, Dry mucus membrane, poor skin turgor. What is the nurse priority intervention? Answer Encourage oral fluid intake measure fluid intake The nurse needs to provide a patient and their family education on common problems associated with chemotherapy. What would indicate to the nurse the teaching was successful? Answer I am at an increased risk of developing an infection The nurse is teaching a patient and their family on primary prevention. What would indicate to the nurse teaching was successful? Answer removal of at risk tissue young female(18) with N/V/D for 3 days, HR 130, RR 16, BO96/50, Sodium level is 155Meq/L. What fluid would the nurse plan to administer? Answer 0.9% NS (isotonic) A patients tumor is staged Answer T4, N2, MO What does this mean? Large primary tumor w/ extension into 2 lymph nodes, no distant metastasis. T= TUMOR N= NODES M= METASTISIS Patient with cancer has exhausted ALL treatment options, and has a life expectancy of less than 6 months. What would be the next step? Answer Hospice What is an example of a HYPOtonic solution? 0.45% sodium chloride (1/2 NS) What kind of patient would you recommend to hospice? terminal cancer patients with assistance with pain management THINK: PAIN - MORPHINE Patient with cheyne-stokes breathing? What should the nurse expect to see? Deep shallow breathing with Apnea Patient having chemo at risk for Tumor Lysis Syndrome. What does the nurse need to monitor? Potassium Patient with cancer has facial swelling, distended neck veins, and SOB. What should the nurse suspect? Superior Vena Cava Syndrome Provider ordered Furosemide for a patient with hypovolemia. Before the nurse can administer, what is the most important thing that needs to be done? Assess potassium serum level 1ST Patient getting magnesium sulfate IV, Nurse sees the patient BP low, Bradycardia, and has low DTR. What should the nurse do? STOP! the magnesium sulfate immediately Patient with severe vomiting and diarrhea, labs show Sodium: 126. Patient C/O of muscle cramps, weak, muscle twitching. what should the nurse dot o prioritize condition? Administer 0.9%NS (isotonic) Patient post thyroidectomy x1 day c/o tingling in lips and fingers, positive trousseaus ( muscle twitch). What lab value should the nurse look and what would be suspected? calcium hypocalcemia Patient with hypokalemia getting potassium. what does the nurse need to do before administering potassium IV? Apply continued cardiac monitoring follow facility policy for potassium infusion assess Bun/Cr prior to potassium IV Patient with kidney stones, What electrolyte imbalance should be considered? hypercalcemia Patient is immobilized, calcium level is 13. C/O nausea and confusion. What intervention is a priority for physiological effect? Administer calcitonin (IM) as prescribed start hydration to lower calcium level Patient with chronic renal failure, c/o TALL TENTED T WAVES on EKG. What imbalance should the nurse suspect? hyperkalemia elderly pt (70) with head trauma, C/O N/V, confusion, muscle cramps, sodim level is 118, potassium level 2.5. What should the nurse prioritize quickly? -Administer 0.3% sodium chloride -fluid restriction to manage sever hyponatremia -monitor vital signs -give potassium Patient with Hx of HTN, DM, admitted for confusion, and now hypotension. Labs show sodium 122. What is the nurse most appropriate action to take? administer 0.3% sodium chloride IV pump Patient with Hypervolemia (excess), what should the nurse do for this dx? asses lungs for crackles/SOB Patient with prostate cancer c/o back pain, leg numbness, difficulty controlling his bladder, weakness. What type of emergency is this? Spinal cord compression Patient with cancer at risk for tumor lysis syndrome. What intervention should the nurse prioritize for the patient? encourage aggressive hydration Patient with metastatic brain tumor at risk for developing SIADH. What lab value would show thats indicative of SIADH? Sodium level (110) What lab finding is consistent with fluid volume excess? sodium (110) Which of the following conditions may cause Fluid volume excess? SIADH female (35) c/o syncope when standing, drowsy and hx of breast cancer. Low urine output, no LMP, weak, poor skin turgor, alocepcia. Vital signs: weight 119, temp99.2, BP 88/58, o2 95% on RA. Echo - WNL, ekg - sinus tach what is the potential condition? What should the nurse monitor? What action should the nurse take? 1. dehydration 2. poor skin turgor/urine output/BP 3. fluid replacement Sodium levels 135-145 mEq/L potassium level 3.5-5 mEq/L calcium level 8.5-10.5 isotonic solution examples ISO- PERFECT! ( everything stays the same) NS LR D5W hypotonic solution examples HIPPO -tonic ( bigger, full of water) 0.45% NaCl