Multidimensional Care III (MDC III) –
Exam 1 Comprehensive Question &
Answer Bank 200 Evidence-Based
Practice Questions Covering
Multisystem Disorders, Acid-Base
Balance, Reproductive Health, Renal
Pathophysiology, Cardiac
Emergencies, and Endocrine Crises
A nurse is caring for a client with severe hyperkalemia (potassium level 6.8
mEq/L). Which intervention should the nurse implement FIRST?
Administer IV calcium gluconate. In severe hyperkalemia (>6.5 mEq/L), the
priority is cardiac membrane stabilization. IV calcium gluconate directly
antagonizes the effects of potassium on the cardiac cell membrane,
reducing the risk of life-threatening arrhythmias. Cardiac protection is
always the priority.
A client with heart failure has a serum sodium level of 128 mEq/L. Which IV
fluid should the nurse anticipate administering?
0.9% normal saline. For clients with heart failure who have hyponatremia,
isotonic fluids are the safest choice. Hypotonic fluids would worsen fluid
overload, and hypertonic saline carries significant fluid overload risks.
,A nurse is reviewing ABG results: pH 7.30, PaCO2 37 mmHg, HCO3 15
mEq/L. Which acid-base imbalance is present?
Metabolic acidosis. The pH is low (acidosis), PaCO2 is normal, and HCO3 is
low, indicating a metabolic cause.
A client with a urinary tract infection has just been diagnosed with acute
kidney injury. The nurse expects which abnormal lab value?
Creatinine elevation (e.g., 1.6 mg/dL). In acute kidney injury, serum
creatinine and BUN are elevated, while calcium may be low and potassium
high.
The nurse educates a teenage client on the benefits of receiving the HPV
vaccine as protection against which type of cancer?
Cervical cancer. The HPV vaccine protects against human papillomavirus,
which is a major risk factor for cervical cancer.
A 40-year-old woman has heavy vaginal bleeding. Which question is the
priority when evaluating the client's chief complaint?
"Are you feeling weak, dizzy, or lightheaded?" This assesses for signs of
hypovolemia or anemia, which are immediate safety concerns.
A client experiencing secondary syphilis may experience which signs and
symptoms? (Select all that apply)
Generalized rash, headache, low-grade fever, and malaise. Secondary
syphilis is characterized by a generalized maculopapular rash, flu-like
symptoms, and lymphadenopathy.
A nurse is teaching an older adult client with diabetes about preventing
long-term complications of nephropathy. Which instruction should the
nurse include?
"Maintain stable blood glucose levels." Strict glycemic control is the most
important intervention to prevent or delay diabetic nephropathy.
, The nurse includes which of the following in self-management teaching for
a client diagnosed with vulvovaginitis?
Cleanse the inner labial mucosa with water, not soap. Soap can irritate the
inflamed tissues. Feminine sprays and tight clothing should be avoided, and
wiping should be front to back.
A client with urinary incontinence is receiving education. Which should be
included?
Maintain an ideal body weight. Excess weight increases intra-abdominal
pressure and can worsen stress incontinence. Fluid restriction and caffeine
are not recommended.
What is the most common cause of chronic pyelonephritis?
Recurrent urinary tract infections, often related to vesicoureteral reflux or
obstructive uropathy.
Define interprofessional collaborative care for clients with reproductive
system disorders.
Multiple healthcare workers from different backgrounds working together
with patients, their families, caregivers, and communities to provide the
highest level and quality of care.
Describe multidimensional nursing care strategies for clients with female
reproductive system disorders, including screening and prevention.
Breast cancer screening: mammograms annually beginning at age 45 (ages
40-45 have a choice), clinical breast exams every 3 years for women in their
20s-30s and yearly starting at 40, and breast self-awareness monthly.
Uterine leiomyoma management includes contraceptives, uterine artery
embolization, myomectomy, or hysterectomy.
What are the signs and symptoms of uterine leiomyoma?
Heavy bleeding, altered elimination, dyspareunia (painful intercourse),
infertility, and iron deficiency from heavy bleeding.
Exam 1 Comprehensive Question &
Answer Bank 200 Evidence-Based
Practice Questions Covering
Multisystem Disorders, Acid-Base
Balance, Reproductive Health, Renal
Pathophysiology, Cardiac
Emergencies, and Endocrine Crises
A nurse is caring for a client with severe hyperkalemia (potassium level 6.8
mEq/L). Which intervention should the nurse implement FIRST?
Administer IV calcium gluconate. In severe hyperkalemia (>6.5 mEq/L), the
priority is cardiac membrane stabilization. IV calcium gluconate directly
antagonizes the effects of potassium on the cardiac cell membrane,
reducing the risk of life-threatening arrhythmias. Cardiac protection is
always the priority.
A client with heart failure has a serum sodium level of 128 mEq/L. Which IV
fluid should the nurse anticipate administering?
0.9% normal saline. For clients with heart failure who have hyponatremia,
isotonic fluids are the safest choice. Hypotonic fluids would worsen fluid
overload, and hypertonic saline carries significant fluid overload risks.
,A nurse is reviewing ABG results: pH 7.30, PaCO2 37 mmHg, HCO3 15
mEq/L. Which acid-base imbalance is present?
Metabolic acidosis. The pH is low (acidosis), PaCO2 is normal, and HCO3 is
low, indicating a metabolic cause.
A client with a urinary tract infection has just been diagnosed with acute
kidney injury. The nurse expects which abnormal lab value?
Creatinine elevation (e.g., 1.6 mg/dL). In acute kidney injury, serum
creatinine and BUN are elevated, while calcium may be low and potassium
high.
The nurse educates a teenage client on the benefits of receiving the HPV
vaccine as protection against which type of cancer?
Cervical cancer. The HPV vaccine protects against human papillomavirus,
which is a major risk factor for cervical cancer.
A 40-year-old woman has heavy vaginal bleeding. Which question is the
priority when evaluating the client's chief complaint?
"Are you feeling weak, dizzy, or lightheaded?" This assesses for signs of
hypovolemia or anemia, which are immediate safety concerns.
A client experiencing secondary syphilis may experience which signs and
symptoms? (Select all that apply)
Generalized rash, headache, low-grade fever, and malaise. Secondary
syphilis is characterized by a generalized maculopapular rash, flu-like
symptoms, and lymphadenopathy.
A nurse is teaching an older adult client with diabetes about preventing
long-term complications of nephropathy. Which instruction should the
nurse include?
"Maintain stable blood glucose levels." Strict glycemic control is the most
important intervention to prevent or delay diabetic nephropathy.
, The nurse includes which of the following in self-management teaching for
a client diagnosed with vulvovaginitis?
Cleanse the inner labial mucosa with water, not soap. Soap can irritate the
inflamed tissues. Feminine sprays and tight clothing should be avoided, and
wiping should be front to back.
A client with urinary incontinence is receiving education. Which should be
included?
Maintain an ideal body weight. Excess weight increases intra-abdominal
pressure and can worsen stress incontinence. Fluid restriction and caffeine
are not recommended.
What is the most common cause of chronic pyelonephritis?
Recurrent urinary tract infections, often related to vesicoureteral reflux or
obstructive uropathy.
Define interprofessional collaborative care for clients with reproductive
system disorders.
Multiple healthcare workers from different backgrounds working together
with patients, their families, caregivers, and communities to provide the
highest level and quality of care.
Describe multidimensional nursing care strategies for clients with female
reproductive system disorders, including screening and prevention.
Breast cancer screening: mammograms annually beginning at age 45 (ages
40-45 have a choice), clinical breast exams every 3 years for women in their
20s-30s and yearly starting at 40, and breast self-awareness monthly.
Uterine leiomyoma management includes contraceptives, uterine artery
embolization, myomectomy, or hysterectomy.
What are the signs and symptoms of uterine leiomyoma?
Heavy bleeding, altered elimination, dyspareunia (painful intercourse),
infertility, and iron deficiency from heavy bleeding.
