NUR2755 Multidimensional Care IV Final Exam
Guide (Rasmussen MDC 4) Questions And Well
Graded Solutions With Rationales
Updated 2026-2027
Ace your NUR2755 Multidimensional Care IV (MDC 4) Final Exam with this comprehensive study guide.
It features highly relevant multiple-choice practice questions, correct answers, and detailed rationales
tailored to critical nursing care. Master high-yield exam topics including advanced burn fluid
resuscitation (Parkland formula), septic shock, neurogenic emergencies, EKG changes in electrolyte
imbalances, and disaster triage. Perfect for nursing students looking to boost their exam scores.
🚨 Section 1: Emergency, Trauma, & Disaster Triage
1. A nurse triage officer at a mass casualty incident assesses a patient with an open
femur fracture, strong radial pulses, and a respiratory rate of 22. Which color tag
should the nurse assign?
A) Green
B) Yellow
C) Red
D) Black
Answer: B) Yellow
Rationale: Yellow tags are for urgent but stable patients. The patient has a major
injury (femur fracture) but does not have immediate airway, breathing, or circulatory
collapse (respiratory rate is under 30 and radial pulses are strong).
2. A patient arrives in the emergency department with deep frostbite of the bilateral
lower extremities. Which action should the nurse take first?
A) Rub the affected areas vigorously with a warm washcloth.
B) Immerse the affected extremities in a warm water bath between 104°F and 108°F.
C) Apply tight, occlusive dressings to the frostbitten areas.
D) Administer a cold water soak to slowly thaw the tissues.
Answer: B) Immerse the affected extremities in a warm water bath between
104°F and 108°F.
Rationale: Rapid rewarming in a warm water bath is the standard treatment for
frostbite to save viable tissue. Rubbing or massaging frostbitten tissue causes
severe mechanical friction damage and must be avoided. Occlusive dressings are
contraindicated.
3. During a mass casualty triage, a patient is found unresponsive, not breathing, and
has no palpable pulse even after manually opening the airway. Which color tag is
appropriate?
A) Yellow
B) Red
C) Green
D) Black
Answer: D) Black
Rationale: Black tags indicate patients who are deceased or have injuries so severe
that survival is highly unlikely with the resources available during a disaster.
4. A patient is brought to the emergency department experiencing heat stroke. Which
nursing intervention is the absolute priority?
, A) Obtain a comprehensive dietary history.
B) Administer oral antipyretic medications immediately.
C) Remove restrictive clothing and initiate rapid external cooling methods.
D) Place the patient in a warm environment to prevent shivering.
Answer: C) Remove restrictive clothing and initiate rapid external cooling
methods.
Rationale: Heat stroke is a medical emergency requiring rapid cooling (e.g., cool
mist, ice packs to axilla/groin) to protect vital organs. Antipyretics are ineffective
because heat stroke involves environmental overheating, not a hypothalamic set-
point change.
5. A 62-year-old patient is brought to triage with a simple, closed radius fracture and an
anxiety attack following a minor motor vehicle collision. How should this patient be
categorized?
A) Emergent
B) Urgent
C) Non-urgent
D) Expectant
Answer: C) Non-urgent
Rationale: A simple, closed fracture with intact distal pulses and neurovascular
function is stable and can wait for treatment behind life-threatening or systemic
emergencies.
6. A nurse is triaging victims of an industrial explosion. A patient presents with a
respiratory rate of 36, weak peripheral pulses, and altered mental status. Which tag
should the nurse apply?
A) Green
B) Yellow
C) Red
D) Black
Answer: C) Red
Rationale: A respiratory rate greater than 30 breaths per minute, combined with
altered mental status and poor perfusion (weak pulses), places the patient
immediately in the Red (Emergent) category.
7. Which patient requires immediate prioritization by the emergency department triage
nurse over all other stable patients?
A) A 19-year-old with an ankle sprain and a pain level of 8/10.
B) A 45-year-old complaining of a sudden, severe headache described as the "worst
headache of my life."
C) A 30-year-old with a productive cough and a low-grade fever of 100.2°F.
D) A 12-year-old with a minor superficial laceration on the forearm.
Answer: B) A 45-year-old complaining of a sudden, severe headache described
as the "worst headache of my life."
Rationale: A sudden, severe headache ("thunderclap headache") is a classic
presentation of a subarachnoid hemorrhage, which is a life-threatening neurological
emergency requiring immediate intervention.
8. When managing a patient with severe hypothermia, what complication must the
nurse monitor for most closely during the rewarming process?
A) Severe hyperthermia
B) Malignant hypertension
C) Ventricular fibrillation
D) Metabolic alkalosis
, Answer: C) Ventricular fibrillation
Rationale: As a hypothermic patient is rewarmed, cold and potassium-rich blood
from the periphery flows back to the core (afterdrop). This makes the myocardium
extremely irritable and highly prone to lethal dysrhythmias like ventricular fibrillation.
9. A patient presents to the emergency department after inhaling chemical fumes. The
patient is wheezing and stridorous. Which action should the nurse take first?
A) Document the patient's home medications.
B) Administer a sedative to reduce anxiety.
C) Prepare for immediate endotracheal intubation.
D) Apply a warm compress to the patient's chest.
Answer: C) Prepare for immediate endotracheal intubation.
Rationale: Stridor indicates an impending, acute upper airway obstruction due to
chemical edema. Securing the airway via endotracheal intubation is the ultimate life-
saving priority.
10. A nurse is working as a triage officer during a natural disaster. A patient is brought in
with a severe head injury, exposed brain tissue, and no spontaneous respirations.
Which action is most appropriate?
A) Intubate the patient immediately.
B) Assign a black tag and move to the next patient.
C) Administer high-dose IV fluids.
D) Call the operating room to prepare for immediate surgery.
Answer: B) Assign a black tag and move to the next patient.
Rationale: In a disaster scenario with limited resources, patients with non-survivable
injuries are tagged black so that resources can be directed toward saving those with
a high probability of survival.
11. A patient is admitted to the emergency department following a near-drowning
incident in cold water. Which assessment parameter is the most critical for the nurse
to monitor?
A) Bowel sounds
B) Core body temperature
C) Skin turgor
D) Peripheral reflexes
Answer: B) Core body temperature
Rationale: Hypothermia is common in near-drowning incidents and directly affects
cardiac stability, oxygenation, and survival. Tracking core temperature is essential to
guide rewarming therapies safely.
12. The nurse is caring for a patient who sustained a high-voltage electrical injury. What
is the priority nursing assessment?
A) Visual acuity
B) Continuous cardiac rhythm monitoring
C) Skin integrity of the palms
D) Range of motion of the upper extremities
Answer: B) Continuous cardiac rhythm monitoring
Rationale: Electrical currents traveling through the body can disrupt the heart's
electrical conduction system, leading to fatal arrhythmias such as ventricular
fibrillation or asystole. Continuous ECG monitoring is mandatory.
13. A patient presents with a deep laceration to the forearm that is spurting bright red
blood. What is the nurse's immediate action?
A) Elevate the extremity above the level of the heart only.
B) Apply firm, direct pressure to the wound using a clean dressing.
, C) Cleanse the wound thoroughly with normal saline.
D) Apply a loose, non-adherent dressing.
Answer: B) Apply firm, direct pressure to the wound using a clean dressing.
Rationale: Spurting bright red blood indicates arterial bleeding. Immediate direct
pressure is the fastest and most effective way to control hemorrhage and prevent
hypovolemic shock.
14. During an emergency department shift, four patients arrive simultaneously. Which
patient should the nurse assess first?
A) A 50-year-old with a history of heart failure who has a dry, hacking cough.
B) A 28-year-old presenting with an open mandibular fracture and active bleeding in
the oral cavity.
C) A 35-year-old with a painful, swollen ankle following a fall.
D) A 70-year-old with chronic obstructive pulmonary disease (COPD) whose
baseline oxygen saturation is 89%.
Answer: B) A 28-year-old presenting with an open mandibular fracture and
active bleeding in the oral cavity.
Rationale: A mandibular fracture combined with bleeding in the mouth poses a
severe risk for airway obstruction and aspiration, making it an immediate priority over
the other stable or chronic conditions.
15. What is the primary purpose of the "debriefing" phase after a mass casualty incident
or major disaster?
A) To assign blame for errors made during the emergency response.
B) To calculate the total financial cost of medical supplies used.
C) To provide emotional support and review operational effectiveness for future
improvements.
D) To report administrative discrepancies to local media outlets.
Answer: C) To provide emotional support and review operational effectiveness
for future improvements.
Rationale: Critical incident stress debriefing helps healthcare workers process
emotional trauma and evaluate what processes worked or failed to improve future
disaster response plans.
16. A nurse responds to a patient in heat exhaustion. The patient is sweating profusely,
pale, and dizzy. Which action should the nurse take first?
A) Submerge the patient completely in ice-cold water.
B) Move the patient to a cool, shaded environment and provide oral electrolyte fluids
if conscious.
C) Administer an intramuscular injection of epinephrine.
D) Apply a heating pad to the abdominal area.
Answer: B) Move the patient to a cool, shaded environment and provide oral
electrolyte fluids if conscious.
Rationale: Heat exhaustion is less severe than heat stroke. Moving the patient to a
cool environment and replacing lost fluids orally is effective. Ice water submersion is
reserved for severe heat stroke where the body's cooling mechanism has completely
failed.
17. A patient presents to the emergency department following a spider bite and is
suspected of having a black widow bite. What systemic symptom should the nurse
monitor for?
A) Profound flaccid paralysis of all limbs
B) Severe abdominal rigidity and muscle spasms
C) Widespread maculopapular rash
Guide (Rasmussen MDC 4) Questions And Well
Graded Solutions With Rationales
Updated 2026-2027
Ace your NUR2755 Multidimensional Care IV (MDC 4) Final Exam with this comprehensive study guide.
It features highly relevant multiple-choice practice questions, correct answers, and detailed rationales
tailored to critical nursing care. Master high-yield exam topics including advanced burn fluid
resuscitation (Parkland formula), septic shock, neurogenic emergencies, EKG changes in electrolyte
imbalances, and disaster triage. Perfect for nursing students looking to boost their exam scores.
🚨 Section 1: Emergency, Trauma, & Disaster Triage
1. A nurse triage officer at a mass casualty incident assesses a patient with an open
femur fracture, strong radial pulses, and a respiratory rate of 22. Which color tag
should the nurse assign?
A) Green
B) Yellow
C) Red
D) Black
Answer: B) Yellow
Rationale: Yellow tags are for urgent but stable patients. The patient has a major
injury (femur fracture) but does not have immediate airway, breathing, or circulatory
collapse (respiratory rate is under 30 and radial pulses are strong).
2. A patient arrives in the emergency department with deep frostbite of the bilateral
lower extremities. Which action should the nurse take first?
A) Rub the affected areas vigorously with a warm washcloth.
B) Immerse the affected extremities in a warm water bath between 104°F and 108°F.
C) Apply tight, occlusive dressings to the frostbitten areas.
D) Administer a cold water soak to slowly thaw the tissues.
Answer: B) Immerse the affected extremities in a warm water bath between
104°F and 108°F.
Rationale: Rapid rewarming in a warm water bath is the standard treatment for
frostbite to save viable tissue. Rubbing or massaging frostbitten tissue causes
severe mechanical friction damage and must be avoided. Occlusive dressings are
contraindicated.
3. During a mass casualty triage, a patient is found unresponsive, not breathing, and
has no palpable pulse even after manually opening the airway. Which color tag is
appropriate?
A) Yellow
B) Red
C) Green
D) Black
Answer: D) Black
Rationale: Black tags indicate patients who are deceased or have injuries so severe
that survival is highly unlikely with the resources available during a disaster.
4. A patient is brought to the emergency department experiencing heat stroke. Which
nursing intervention is the absolute priority?
, A) Obtain a comprehensive dietary history.
B) Administer oral antipyretic medications immediately.
C) Remove restrictive clothing and initiate rapid external cooling methods.
D) Place the patient in a warm environment to prevent shivering.
Answer: C) Remove restrictive clothing and initiate rapid external cooling
methods.
Rationale: Heat stroke is a medical emergency requiring rapid cooling (e.g., cool
mist, ice packs to axilla/groin) to protect vital organs. Antipyretics are ineffective
because heat stroke involves environmental overheating, not a hypothalamic set-
point change.
5. A 62-year-old patient is brought to triage with a simple, closed radius fracture and an
anxiety attack following a minor motor vehicle collision. How should this patient be
categorized?
A) Emergent
B) Urgent
C) Non-urgent
D) Expectant
Answer: C) Non-urgent
Rationale: A simple, closed fracture with intact distal pulses and neurovascular
function is stable and can wait for treatment behind life-threatening or systemic
emergencies.
6. A nurse is triaging victims of an industrial explosion. A patient presents with a
respiratory rate of 36, weak peripheral pulses, and altered mental status. Which tag
should the nurse apply?
A) Green
B) Yellow
C) Red
D) Black
Answer: C) Red
Rationale: A respiratory rate greater than 30 breaths per minute, combined with
altered mental status and poor perfusion (weak pulses), places the patient
immediately in the Red (Emergent) category.
7. Which patient requires immediate prioritization by the emergency department triage
nurse over all other stable patients?
A) A 19-year-old with an ankle sprain and a pain level of 8/10.
B) A 45-year-old complaining of a sudden, severe headache described as the "worst
headache of my life."
C) A 30-year-old with a productive cough and a low-grade fever of 100.2°F.
D) A 12-year-old with a minor superficial laceration on the forearm.
Answer: B) A 45-year-old complaining of a sudden, severe headache described
as the "worst headache of my life."
Rationale: A sudden, severe headache ("thunderclap headache") is a classic
presentation of a subarachnoid hemorrhage, which is a life-threatening neurological
emergency requiring immediate intervention.
8. When managing a patient with severe hypothermia, what complication must the
nurse monitor for most closely during the rewarming process?
A) Severe hyperthermia
B) Malignant hypertension
C) Ventricular fibrillation
D) Metabolic alkalosis
, Answer: C) Ventricular fibrillation
Rationale: As a hypothermic patient is rewarmed, cold and potassium-rich blood
from the periphery flows back to the core (afterdrop). This makes the myocardium
extremely irritable and highly prone to lethal dysrhythmias like ventricular fibrillation.
9. A patient presents to the emergency department after inhaling chemical fumes. The
patient is wheezing and stridorous. Which action should the nurse take first?
A) Document the patient's home medications.
B) Administer a sedative to reduce anxiety.
C) Prepare for immediate endotracheal intubation.
D) Apply a warm compress to the patient's chest.
Answer: C) Prepare for immediate endotracheal intubation.
Rationale: Stridor indicates an impending, acute upper airway obstruction due to
chemical edema. Securing the airway via endotracheal intubation is the ultimate life-
saving priority.
10. A nurse is working as a triage officer during a natural disaster. A patient is brought in
with a severe head injury, exposed brain tissue, and no spontaneous respirations.
Which action is most appropriate?
A) Intubate the patient immediately.
B) Assign a black tag and move to the next patient.
C) Administer high-dose IV fluids.
D) Call the operating room to prepare for immediate surgery.
Answer: B) Assign a black tag and move to the next patient.
Rationale: In a disaster scenario with limited resources, patients with non-survivable
injuries are tagged black so that resources can be directed toward saving those with
a high probability of survival.
11. A patient is admitted to the emergency department following a near-drowning
incident in cold water. Which assessment parameter is the most critical for the nurse
to monitor?
A) Bowel sounds
B) Core body temperature
C) Skin turgor
D) Peripheral reflexes
Answer: B) Core body temperature
Rationale: Hypothermia is common in near-drowning incidents and directly affects
cardiac stability, oxygenation, and survival. Tracking core temperature is essential to
guide rewarming therapies safely.
12. The nurse is caring for a patient who sustained a high-voltage electrical injury. What
is the priority nursing assessment?
A) Visual acuity
B) Continuous cardiac rhythm monitoring
C) Skin integrity of the palms
D) Range of motion of the upper extremities
Answer: B) Continuous cardiac rhythm monitoring
Rationale: Electrical currents traveling through the body can disrupt the heart's
electrical conduction system, leading to fatal arrhythmias such as ventricular
fibrillation or asystole. Continuous ECG monitoring is mandatory.
13. A patient presents with a deep laceration to the forearm that is spurting bright red
blood. What is the nurse's immediate action?
A) Elevate the extremity above the level of the heart only.
B) Apply firm, direct pressure to the wound using a clean dressing.
, C) Cleanse the wound thoroughly with normal saline.
D) Apply a loose, non-adherent dressing.
Answer: B) Apply firm, direct pressure to the wound using a clean dressing.
Rationale: Spurting bright red blood indicates arterial bleeding. Immediate direct
pressure is the fastest and most effective way to control hemorrhage and prevent
hypovolemic shock.
14. During an emergency department shift, four patients arrive simultaneously. Which
patient should the nurse assess first?
A) A 50-year-old with a history of heart failure who has a dry, hacking cough.
B) A 28-year-old presenting with an open mandibular fracture and active bleeding in
the oral cavity.
C) A 35-year-old with a painful, swollen ankle following a fall.
D) A 70-year-old with chronic obstructive pulmonary disease (COPD) whose
baseline oxygen saturation is 89%.
Answer: B) A 28-year-old presenting with an open mandibular fracture and
active bleeding in the oral cavity.
Rationale: A mandibular fracture combined with bleeding in the mouth poses a
severe risk for airway obstruction and aspiration, making it an immediate priority over
the other stable or chronic conditions.
15. What is the primary purpose of the "debriefing" phase after a mass casualty incident
or major disaster?
A) To assign blame for errors made during the emergency response.
B) To calculate the total financial cost of medical supplies used.
C) To provide emotional support and review operational effectiveness for future
improvements.
D) To report administrative discrepancies to local media outlets.
Answer: C) To provide emotional support and review operational effectiveness
for future improvements.
Rationale: Critical incident stress debriefing helps healthcare workers process
emotional trauma and evaluate what processes worked or failed to improve future
disaster response plans.
16. A nurse responds to a patient in heat exhaustion. The patient is sweating profusely,
pale, and dizzy. Which action should the nurse take first?
A) Submerge the patient completely in ice-cold water.
B) Move the patient to a cool, shaded environment and provide oral electrolyte fluids
if conscious.
C) Administer an intramuscular injection of epinephrine.
D) Apply a heating pad to the abdominal area.
Answer: B) Move the patient to a cool, shaded environment and provide oral
electrolyte fluids if conscious.
Rationale: Heat exhaustion is less severe than heat stroke. Moving the patient to a
cool environment and replacing lost fluids orally is effective. Ice water submersion is
reserved for severe heat stroke where the body's cooling mechanism has completely
failed.
17. A patient presents to the emergency department following a spider bite and is
suspected of having a black widow bite. What systemic symptom should the nurse
monitor for?
A) Profound flaccid paralysis of all limbs
B) Severe abdominal rigidity and muscle spasms
C) Widespread maculopapular rash
