MDC 3 FINAL EXAMINATION
Rasmussen College
Multidimensional Care 3
Final Examination 2026/2027
75 Questions | Verified Answers | Graded A+
Core Domains:
Complex Medical-Surgical Nursing | Advanced Pharmacology
Critical Care Concepts | Endocrine Disorders | Cardiovascular Disorders
Respiratory Disorders | Renal & Urinary Disorders | Gastrointestinal Disorders
Neurological Disorders | Hematological Disorders | Oncology
Fluid & Electrolyte Imbalances | Acid-Base Disorders | Prioritization & Delegation
, MDC 3 Final Examination | Rasmussen College
Abstract
This MDC 3 Final Examination document for the 2026/2027 academic cycle reflects the official
Rasmussen College Multidimensional Care 3 curriculum requirements. MDC 3 is an advanced nursing
course that integrates pathophysiology, pharmacology, and nursing management for clients with
complex, multisystem health alterations across the lifespan. The examination evaluates
comprehensive understanding of complex medical-surgical nursing concepts, critical care principles,
and clinical judgment essential for nursing program progression and NCLEX-RN readiness. This
document contains 75 multiple-choice questions with verified answers and detailed rationales
covering endocrine disorders, cardiovascular disorders, respiratory disorders, renal and urinary
disorders, gastrointestinal disorders, neurological disorders, hematological disorders, oncology, fluid
and electrolyte imbalances, acid-base disorders, and prioritization and delegation.
Keywords: MDC 3, Multidimensional Care, Medical-Surgical Nursing, NCLEX-RN, Rasmussen
College, Clinical Judgment, Pharmacology, Pathophysiology
Introduction
The Multidimensional Care 3 (MDC 3) course at Rasmussen College represents a critical milestone in
the nursing curriculum, bridging foundational nursing knowledge with advanced clinical practice.
This comprehensive examination assesses students' ability to integrate complex physiological
concepts with evidence-based nursing interventions across multiple body systems. The questions
contained within this document have been carefully developed to align with current NCLEX-RN test
plans and reflect real-world clinical scenarios that nurses encounter in acute care settings.
Each question has been designed to evaluate clinical reasoning, prioritization skills, pharmacological
knowledge, and the application of pathophysiological principles to patient care. The rationales
provided offer detailed explanations that reinforce evidence-based nursing practice, clinical judgment,
and test-taking strategies essential for NCLEX-RN success. Students are encouraged to review each
rationale thoroughly, even for correctly answered questions, to deepen their understanding of the
underlying concepts.
This examination covers the following core domains: endocrine disorders (diabetes mellitus, thyroid
disorders, adrenal disorders), cardiovascular disorders (heart failure, coronary artery disease, valvular
disease, hypertension), respiratory disorders (COPD, asthma, pneumonia, ARDS), renal and urinary
disorders (acute kidney injury, chronic kidney disease), gastrointestinal disorders (bowel obstruction,
pancreatitis, liver disease), neurological disorders (stroke, seizures, head injuries, increased
intracranial pressure), hematological disorders, oncology, fluid and electrolyte imbalances, acid-base
disorders, and prioritization and delegation principles.
Examination Questions
1. A nurse is caring for a client with diabetic ketoacidosis (DKA). Which of the following
arterial blood gas results would the nurse expect to find?
A. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 28 mm Hg, HCO₃⁻ 18 mEq/L
C. pH 7.35, PaCO₂ 45 mm Hg, HCO₃⁻ 26 mEq/L
D. pH 7.48, PaCO₂ 42 mm Hg, HCO₃⁻ 30 mEq/L
Rationale: DKA causes metabolic acidosis with respiratory compensation. The pH is low
(acidosis), PaCO₂ is decreased due to Kussmaul respirations (compensatory
hyperventilation), and HCO₃⁻ is decreased due to accumulation of ketone bodies. This
pattern indicates partially compensated metabolic acidosis.
Page 2
, MDC 3 Final Examination | Rasmussen College
2. A client with type 1 diabetes mellitus is experiencing signs of hypoglycemia. Which
symptom would the nurse anticipate?
A. Polyuria and polydipsia
B. Diaphoresis and tremors
C. Fruity breath odor
D. Slow, deep respirations
Rationale: Hypoglycemia triggers the sympathetic nervous system, causing adrenergic
symptoms including diaphoresis, tremors, tachycardia, anxiety, and hunger. Polyuria,
polydipsia, and fruity breath are associated with hyperglycemia and DKA. Slow, deep
respirations may indicate metabolic acidosis compensation.
3. The nurse is teaching a client with Addison's disease about corticosteroid therapy.
Which statement by the client indicates understanding of the teaching?
A. I should stop taking my medication when I feel better.
B. I will need to increase my dose during periods of stress.
C. I should take my medication only in the evening.
D. I can expect to lose weight while on this medication.
Rationale: Clients with Addison's disease require lifelong corticosteroid replacement.
During periods of stress (illness, surgery, trauma), the body normally increases cortisol
production. Since these clients cannot produce additional cortisol, they must increase their
medication dose to prevent Addisonian crisis.
4. A nurse is assessing a client with hyperthyroidism. Which finding would the nurse
expect to observe?
A. Weight gain and cold intolerance
B. Bradycardia and constipation
C. Heat intolerance and weight loss
D. Dry skin and lethargy
Rationale: Hyperthyroidism causes increased metabolic rate, resulting in heat intolerance,
weight loss despite increased appetite, tachycardia, diarrhea, anxiety, tremors, and
exophthalmos (in Graves' disease). Weight gain, cold intolerance, bradycardia, and dry skin
are manifestations of hypothyroidism.
5. A client with syndrome of inappropriate antidiuretic hormone (SIADH) is receiving
hypertonic saline. Which laboratory value indicates the treatment is effective?
A. Serum sodium 125 mEq/L
B. Serum sodium 138 mEq/L
C. Serum osmolality 260 mOsm/kg
D. Urine specific gravity 1.035
Rationale: SIADH causes dilutional hyponatremia due to excessive water retention. Normal
serum sodium is 135-145 mEq/L. A serum sodium of 138 mEq/L indicates the treatment is
effectively correcting hyponatremia. Values of 125 mEq/L and osmolality of 260 mOsm/kg
indicate continued hyponatremia and hypo-osmolality.
6. The nurse is caring for a client with Cushing's syndrome. Which intervention is a
priority for this client?
A. Encouraging increased fluid intake
B. Monitoring for signs of infection
C. Promoting a high-sodium diet
D. Administering potassium supplements
Page 3
Rasmussen College
Multidimensional Care 3
Final Examination 2026/2027
75 Questions | Verified Answers | Graded A+
Core Domains:
Complex Medical-Surgical Nursing | Advanced Pharmacology
Critical Care Concepts | Endocrine Disorders | Cardiovascular Disorders
Respiratory Disorders | Renal & Urinary Disorders | Gastrointestinal Disorders
Neurological Disorders | Hematological Disorders | Oncology
Fluid & Electrolyte Imbalances | Acid-Base Disorders | Prioritization & Delegation
, MDC 3 Final Examination | Rasmussen College
Abstract
This MDC 3 Final Examination document for the 2026/2027 academic cycle reflects the official
Rasmussen College Multidimensional Care 3 curriculum requirements. MDC 3 is an advanced nursing
course that integrates pathophysiology, pharmacology, and nursing management for clients with
complex, multisystem health alterations across the lifespan. The examination evaluates
comprehensive understanding of complex medical-surgical nursing concepts, critical care principles,
and clinical judgment essential for nursing program progression and NCLEX-RN readiness. This
document contains 75 multiple-choice questions with verified answers and detailed rationales
covering endocrine disorders, cardiovascular disorders, respiratory disorders, renal and urinary
disorders, gastrointestinal disorders, neurological disorders, hematological disorders, oncology, fluid
and electrolyte imbalances, acid-base disorders, and prioritization and delegation.
Keywords: MDC 3, Multidimensional Care, Medical-Surgical Nursing, NCLEX-RN, Rasmussen
College, Clinical Judgment, Pharmacology, Pathophysiology
Introduction
The Multidimensional Care 3 (MDC 3) course at Rasmussen College represents a critical milestone in
the nursing curriculum, bridging foundational nursing knowledge with advanced clinical practice.
This comprehensive examination assesses students' ability to integrate complex physiological
concepts with evidence-based nursing interventions across multiple body systems. The questions
contained within this document have been carefully developed to align with current NCLEX-RN test
plans and reflect real-world clinical scenarios that nurses encounter in acute care settings.
Each question has been designed to evaluate clinical reasoning, prioritization skills, pharmacological
knowledge, and the application of pathophysiological principles to patient care. The rationales
provided offer detailed explanations that reinforce evidence-based nursing practice, clinical judgment,
and test-taking strategies essential for NCLEX-RN success. Students are encouraged to review each
rationale thoroughly, even for correctly answered questions, to deepen their understanding of the
underlying concepts.
This examination covers the following core domains: endocrine disorders (diabetes mellitus, thyroid
disorders, adrenal disorders), cardiovascular disorders (heart failure, coronary artery disease, valvular
disease, hypertension), respiratory disorders (COPD, asthma, pneumonia, ARDS), renal and urinary
disorders (acute kidney injury, chronic kidney disease), gastrointestinal disorders (bowel obstruction,
pancreatitis, liver disease), neurological disorders (stroke, seizures, head injuries, increased
intracranial pressure), hematological disorders, oncology, fluid and electrolyte imbalances, acid-base
disorders, and prioritization and delegation principles.
Examination Questions
1. A nurse is caring for a client with diabetic ketoacidosis (DKA). Which of the following
arterial blood gas results would the nurse expect to find?
A. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 28 mm Hg, HCO₃⁻ 18 mEq/L
C. pH 7.35, PaCO₂ 45 mm Hg, HCO₃⁻ 26 mEq/L
D. pH 7.48, PaCO₂ 42 mm Hg, HCO₃⁻ 30 mEq/L
Rationale: DKA causes metabolic acidosis with respiratory compensation. The pH is low
(acidosis), PaCO₂ is decreased due to Kussmaul respirations (compensatory
hyperventilation), and HCO₃⁻ is decreased due to accumulation of ketone bodies. This
pattern indicates partially compensated metabolic acidosis.
Page 2
, MDC 3 Final Examination | Rasmussen College
2. A client with type 1 diabetes mellitus is experiencing signs of hypoglycemia. Which
symptom would the nurse anticipate?
A. Polyuria and polydipsia
B. Diaphoresis and tremors
C. Fruity breath odor
D. Slow, deep respirations
Rationale: Hypoglycemia triggers the sympathetic nervous system, causing adrenergic
symptoms including diaphoresis, tremors, tachycardia, anxiety, and hunger. Polyuria,
polydipsia, and fruity breath are associated with hyperglycemia and DKA. Slow, deep
respirations may indicate metabolic acidosis compensation.
3. The nurse is teaching a client with Addison's disease about corticosteroid therapy.
Which statement by the client indicates understanding of the teaching?
A. I should stop taking my medication when I feel better.
B. I will need to increase my dose during periods of stress.
C. I should take my medication only in the evening.
D. I can expect to lose weight while on this medication.
Rationale: Clients with Addison's disease require lifelong corticosteroid replacement.
During periods of stress (illness, surgery, trauma), the body normally increases cortisol
production. Since these clients cannot produce additional cortisol, they must increase their
medication dose to prevent Addisonian crisis.
4. A nurse is assessing a client with hyperthyroidism. Which finding would the nurse
expect to observe?
A. Weight gain and cold intolerance
B. Bradycardia and constipation
C. Heat intolerance and weight loss
D. Dry skin and lethargy
Rationale: Hyperthyroidism causes increased metabolic rate, resulting in heat intolerance,
weight loss despite increased appetite, tachycardia, diarrhea, anxiety, tremors, and
exophthalmos (in Graves' disease). Weight gain, cold intolerance, bradycardia, and dry skin
are manifestations of hypothyroidism.
5. A client with syndrome of inappropriate antidiuretic hormone (SIADH) is receiving
hypertonic saline. Which laboratory value indicates the treatment is effective?
A. Serum sodium 125 mEq/L
B. Serum sodium 138 mEq/L
C. Serum osmolality 260 mOsm/kg
D. Urine specific gravity 1.035
Rationale: SIADH causes dilutional hyponatremia due to excessive water retention. Normal
serum sodium is 135-145 mEq/L. A serum sodium of 138 mEq/L indicates the treatment is
effectively correcting hyponatremia. Values of 125 mEq/L and osmolality of 260 mOsm/kg
indicate continued hyponatremia and hypo-osmolality.
6. The nurse is caring for a client with Cushing's syndrome. Which intervention is a
priority for this client?
A. Encouraging increased fluid intake
B. Monitoring for signs of infection
C. Promoting a high-sodium diet
D. Administering potassium supplements
Page 3
