MDC 1 Final Exam Review Q&A 2026/2027 | Rasmussen
College Verified Nursing Answers
Medical-Surgical Nursing I | Key Domains: Fluid, Electrolyte, & Acid-Base Balance, Perioperative
Nursing, Inflammation & Infection, Pain Management, Oncology Nursing, Integumentary Disorders,
and Musculoskeletal Disorders | Expert-Aligned Structure | Comprehensive Review Format
Introduction
This structured MDC 1 Final Exam Review for Rasmussen College for 2026/2027 provides a
comprehensive set of practice questions with correct answers and rationales. It emphasizes the
nursing management of foundational medical-surgical conditions, focusing on homeostasis, surgical
care, infection control, symptom management, and patient education essential for success in the
first medical-surgical nursing course.
Review Structure:
• Final Exam Review Set: (80 PRACTICE QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the pathophysiological principle (e.g., cause of an imbalance, stages of infection), the
priority nursing intervention for a given disorder, the rationale for a specific pain management
approach, or key patient teaching, and why alternative options are incorrect, lower priority, or
potentially harmful.
Domain 1: Fluid, Electrolyte, & Acid-Base Balance
1. A client has a serum sodium level of 128 mEq/L. Which clinical manifestation should the
nurse expect?
A. Hypertension
B. Muscle twitching
C. Confusion and headache
D. Polyuria
,C. Confusion and headache
Hyponatremia (Na⁺ <135 mEq/L) causes cerebral edema due to water shifting into brain cells, leading
to headache, confusion, seizures, and coma. Hypertension (A) is not typical. Muscle twitching (B) and
polyuria (D) are seen in hypercalcemia or diabetes insipidus.
2. A client with severe vomiting has ABG results: pH 7.50, PaCO₂ 42 mm Hg, HCO₃⁻ 32 mEq/L.
What acid-base imbalance is present?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
D. Metabolic alkalosis
Vomiting causes loss of gastric acid (HCl), leading to metabolic alkalosis: elevated pH (>7.45) and
HCO₃⁻ (>26 mEq/L) with normal PaCO₂. Respiratory disorders show PaCO₂ changes.
3. A client’s potassium level is 6.0 mEq/L. What is the priority nursing action?
A. Administer oral potassium supplements
B. Place the client on a cardiac monitor
C. Encourage banana consumption
D. Increase IV fluid rate
B. Place the client on a cardiac monitor
Hyperkalemia (K⁺ >5.0 mEq/L) can cause life-threatening dysrhythmias. Cardiac monitoring is
essential to detect peaked T waves, widened QRS, or sine wave pattern. Potassium supplements (A, C)
would worsen it. Fluids (D) do not correct acute hyperkalemia.
,Domain 2: Perioperative Nursing
4. Which assessment finding in the post-anesthesia care unit (PACU) requires immediate
intervention?
A. Oxygen saturation of 94% on 2 L/min oxygen
B. Respiratory rate of 8 breaths/minute
C. Blood pressure of 130/80 mm Hg
D. Urine output of 30 mL/hr
B. Respiratory rate of 8 breaths/minute
A respiratory rate <10 breaths/minute in the PACU suggests opioid-induced respiratory depression or
airway obstruction—requiring immediate stimulation, reversal, or airway support. SpO₂ 94% (A) may
be acceptable. BP (C) and urine output (D) are within normal limits.
5. A client is scheduled for abdominal surgery. Which preoperative instruction is most
important?
A. “Take your blood pressure medication with a sip of water.”
B. “Eat a light breakfast before coming to the hospital.”
C. “Leave your wedding ring on for good luck.”
D. “Stop all medications 1 week before surgery.”
A. “Take your blood pressure medication with a sip of water.”
Antihypertensives are usually continued to prevent intraoperative hypertension. Patients are NPO after
midnight, so “a sip of water” is permitted for essential meds. Eating (B) increases aspiration risk.
Jewelry (C) must be removed. Stopping all meds (D) is unsafe—some (e.g., anticoagulants) are held,
but others (e.g., beta-blockers) are continued.
6. A client 12 hours post-op has absent bowel sounds, abdominal distension, and no flatus.
What condition is suspected?
, A. Paralytic ileus
B. Bowel obstruction
C. Gastroenteritis
D. Peritonitis
A. Paralytic ileus
Paralytic ileus—common after abdominal surgery—causes absent bowel sounds, distension, and lack
of flatus due to temporary loss of peristalsis. Obstruction (B) typically has high-pitched or tinkling
bowel sounds early on. Gastroenteritis (C) causes diarrhea. Peritonitis (D) presents with rigid abdomen
and fever.
Domain 3: Inflammation & Infection
7. A client has an infected wound with redness, swelling, warmth, and purulent drainage.
Which phase of inflammation is this?
A. Vascular phase
B. Cellular phase
C. Proliferative phase
D. Maturation phase
B. Cellular phase
The cellular phase (days 2–7) involves white blood cell migration to the site, causing pus (WBCs,
bacteria, debris). The vascular phase (A) is immediate (vasodilation, increased permeability).
Proliferative (C) and maturation (D) are healing phases, not infection.
8. A nurse is caring for a client on contact precautions for MRSA. What PPE is required?
A. N95 respirator
College Verified Nursing Answers
Medical-Surgical Nursing I | Key Domains: Fluid, Electrolyte, & Acid-Base Balance, Perioperative
Nursing, Inflammation & Infection, Pain Management, Oncology Nursing, Integumentary Disorders,
and Musculoskeletal Disorders | Expert-Aligned Structure | Comprehensive Review Format
Introduction
This structured MDC 1 Final Exam Review for Rasmussen College for 2026/2027 provides a
comprehensive set of practice questions with correct answers and rationales. It emphasizes the
nursing management of foundational medical-surgical conditions, focusing on homeostasis, surgical
care, infection control, symptom management, and patient education essential for success in the
first medical-surgical nursing course.
Review Structure:
• Final Exam Review Set: (80 PRACTICE QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the pathophysiological principle (e.g., cause of an imbalance, stages of infection), the
priority nursing intervention for a given disorder, the rationale for a specific pain management
approach, or key patient teaching, and why alternative options are incorrect, lower priority, or
potentially harmful.
Domain 1: Fluid, Electrolyte, & Acid-Base Balance
1. A client has a serum sodium level of 128 mEq/L. Which clinical manifestation should the
nurse expect?
A. Hypertension
B. Muscle twitching
C. Confusion and headache
D. Polyuria
,C. Confusion and headache
Hyponatremia (Na⁺ <135 mEq/L) causes cerebral edema due to water shifting into brain cells, leading
to headache, confusion, seizures, and coma. Hypertension (A) is not typical. Muscle twitching (B) and
polyuria (D) are seen in hypercalcemia or diabetes insipidus.
2. A client with severe vomiting has ABG results: pH 7.50, PaCO₂ 42 mm Hg, HCO₃⁻ 32 mEq/L.
What acid-base imbalance is present?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
D. Metabolic alkalosis
Vomiting causes loss of gastric acid (HCl), leading to metabolic alkalosis: elevated pH (>7.45) and
HCO₃⁻ (>26 mEq/L) with normal PaCO₂. Respiratory disorders show PaCO₂ changes.
3. A client’s potassium level is 6.0 mEq/L. What is the priority nursing action?
A. Administer oral potassium supplements
B. Place the client on a cardiac monitor
C. Encourage banana consumption
D. Increase IV fluid rate
B. Place the client on a cardiac monitor
Hyperkalemia (K⁺ >5.0 mEq/L) can cause life-threatening dysrhythmias. Cardiac monitoring is
essential to detect peaked T waves, widened QRS, or sine wave pattern. Potassium supplements (A, C)
would worsen it. Fluids (D) do not correct acute hyperkalemia.
,Domain 2: Perioperative Nursing
4. Which assessment finding in the post-anesthesia care unit (PACU) requires immediate
intervention?
A. Oxygen saturation of 94% on 2 L/min oxygen
B. Respiratory rate of 8 breaths/minute
C. Blood pressure of 130/80 mm Hg
D. Urine output of 30 mL/hr
B. Respiratory rate of 8 breaths/minute
A respiratory rate <10 breaths/minute in the PACU suggests opioid-induced respiratory depression or
airway obstruction—requiring immediate stimulation, reversal, or airway support. SpO₂ 94% (A) may
be acceptable. BP (C) and urine output (D) are within normal limits.
5. A client is scheduled for abdominal surgery. Which preoperative instruction is most
important?
A. “Take your blood pressure medication with a sip of water.”
B. “Eat a light breakfast before coming to the hospital.”
C. “Leave your wedding ring on for good luck.”
D. “Stop all medications 1 week before surgery.”
A. “Take your blood pressure medication with a sip of water.”
Antihypertensives are usually continued to prevent intraoperative hypertension. Patients are NPO after
midnight, so “a sip of water” is permitted for essential meds. Eating (B) increases aspiration risk.
Jewelry (C) must be removed. Stopping all meds (D) is unsafe—some (e.g., anticoagulants) are held,
but others (e.g., beta-blockers) are continued.
6. A client 12 hours post-op has absent bowel sounds, abdominal distension, and no flatus.
What condition is suspected?
, A. Paralytic ileus
B. Bowel obstruction
C. Gastroenteritis
D. Peritonitis
A. Paralytic ileus
Paralytic ileus—common after abdominal surgery—causes absent bowel sounds, distension, and lack
of flatus due to temporary loss of peristalsis. Obstruction (B) typically has high-pitched or tinkling
bowel sounds early on. Gastroenteritis (C) causes diarrhea. Peritonitis (D) presents with rigid abdomen
and fever.
Domain 3: Inflammation & Infection
7. A client has an infected wound with redness, swelling, warmth, and purulent drainage.
Which phase of inflammation is this?
A. Vascular phase
B. Cellular phase
C. Proliferative phase
D. Maturation phase
B. Cellular phase
The cellular phase (days 2–7) involves white blood cell migration to the site, causing pus (WBCs,
bacteria, debris). The vascular phase (A) is immediate (vasodilation, increased permeability).
Proliferative (C) and maturation (D) are healing phases, not infection.
8. A nurse is caring for a client on contact precautions for MRSA. What PPE is required?
A. N95 respirator
