NUR2392/NUR 2392 Exam 2 V1 |
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which
of the following actions should the nurse take to prevent hip dislocation?
A. Maintain the client’s legs in an adducted position.
B. Encourage the client to cross their legs when sitting.
C. Place an abduction pillow between the client’s legs.
D. Keep the hip at an angle greater than 90 degrees of flexion.
Correct Answer: C
Rationale: To prevent dislocation after a total hip arthroplasty, the nurse must ensure the
client maintains the hip in an abducted position. Using an abduction pillow or wedge
prevents the legs from crossing the midline, which is a common cause of prosthesis
displacement. The nurse should also instruct the client to avoid bending the hip more than
90 degrees.
2. A nurse is monitoring a client during the immediate post-operative period for malignant
hyperthermia. Which of the following is the earliest sign of this condition?
A. Hyperpyrexia (high fever)
B. Sinus bradycardia
,C. Muscle rigidity and jaw clamping
D. Increased end-tidal carbon dioxide level
Correct Answer: D
Rationale: Malignant hyperthermia is a life-threatening anesthetic complication
characterized by a hypermetabolic state. An increase in end-tidal carbon dioxide (ETCO2)
is typically the earliest clinical sign of this reaction. Although high fever is a hallmark of the
condition, it is often a late finding compared to tachycardia and CO2 elevation.
3. A nurse is preparing to administer a medication to a client who is scheduled for surgery.
Which of the following medications should the nurse expect the provider to withhold
preoperatively?
A. Atorvastatin
B. Lisinopril
C. Warfarin
D. Metoprolol
Correct Answer: C
Rationale: Anticoagulants like warfarin increase the risk of intraoperative and
postoperative bleeding and are typically discontinued several days before surgery. The
nurse must verify the client’s coagulation studies, such as PT and INR, before they go to the
operating room. Beta-blockers like metoprolol are often continued to maintain
cardiovascular stability during anesthesia.
,4. A client with a newly applied plaster cast for a fractured tibia reports increased pain and a
tingling sensation in the toes. What is the nurse’s priority action?
A. Assess the neurovascular status of the extremity.
B. Elevate the affected extremity above the level of the heart.
C. Administer the prescribed PRN opioid analgesic.
D. Apply an ice pack to the cast over the fracture site.
Correct Answer: A
Rationale: The client’s reports of tingling and increased pain are early indicators of
compartment syndrome, which is a medical emergency. The nurse must first perform a
neurovascular assessment, checking for the 6 Ps: pain, pallor, pulselessness, paresthesia,
paralysis, and poikilothermia. Once the assessment is complete, the nurse must notify the
provider immediately to prevent permanent tissue damage.
5. Which of the following clinical manifestations should a nurse expect to see in a client
diagnosed with Osteoarthritis (OA)?
A. Symmetrical joint swelling in the hands
B. Pain that is worse in the morning and improves with activity
C. Systemic symptoms such as fatigue and low-grade fever
D. Pain that increases with activity and is relieved by rest
Correct Answer: D
, Rationale: Osteoarthritis is a degenerative joint disease where the cartilage wears down,
leading to pain that typically worsens with weight-bearing or activity and improves with
rest. Unlike rheumatoid arthritis, OA is usually asymmetrical and does not involve systemic
inflammatory symptoms like fever. Morning stiffness in OA usually lasts less than 30
minutes, whereas in RA, it lasts significantly longer.
6. A nurse is teaching a client about the use of an incentive spirometer. Which statement by
the client indicates an understanding of the teaching?
A. I will blow into the device as hard as I can.
B. I should use this device once every 4 hours while I am awake.
C. I will take a deep breath in through the mouthpiece and hold it.
D. I will use this only if I feel short of breath.
Correct Answer: C
Rationale: Incentive spirometry is used to prevent atelectasis by encouraging deep
inhalation and lung expansion. The client should be taught to inhale slowly and deeply
through the mouthpiece and hold their breath for 3 to 5 seconds. This exercise should be
performed approximately 10 times every hour while awake to be effective.
7. A client is diagnosed with a pulmonary embolism (PE). Which of the following is the most
common symptom the nurse should expect the client to exhibit?
A. Sudden onset of shortness of breath
B. Productive cough with yellow sputum
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which
of the following actions should the nurse take to prevent hip dislocation?
A. Maintain the client’s legs in an adducted position.
B. Encourage the client to cross their legs when sitting.
C. Place an abduction pillow between the client’s legs.
D. Keep the hip at an angle greater than 90 degrees of flexion.
Correct Answer: C
Rationale: To prevent dislocation after a total hip arthroplasty, the nurse must ensure the
client maintains the hip in an abducted position. Using an abduction pillow or wedge
prevents the legs from crossing the midline, which is a common cause of prosthesis
displacement. The nurse should also instruct the client to avoid bending the hip more than
90 degrees.
2. A nurse is monitoring a client during the immediate post-operative period for malignant
hyperthermia. Which of the following is the earliest sign of this condition?
A. Hyperpyrexia (high fever)
B. Sinus bradycardia
,C. Muscle rigidity and jaw clamping
D. Increased end-tidal carbon dioxide level
Correct Answer: D
Rationale: Malignant hyperthermia is a life-threatening anesthetic complication
characterized by a hypermetabolic state. An increase in end-tidal carbon dioxide (ETCO2)
is typically the earliest clinical sign of this reaction. Although high fever is a hallmark of the
condition, it is often a late finding compared to tachycardia and CO2 elevation.
3. A nurse is preparing to administer a medication to a client who is scheduled for surgery.
Which of the following medications should the nurse expect the provider to withhold
preoperatively?
A. Atorvastatin
B. Lisinopril
C. Warfarin
D. Metoprolol
Correct Answer: C
Rationale: Anticoagulants like warfarin increase the risk of intraoperative and
postoperative bleeding and are typically discontinued several days before surgery. The
nurse must verify the client’s coagulation studies, such as PT and INR, before they go to the
operating room. Beta-blockers like metoprolol are often continued to maintain
cardiovascular stability during anesthesia.
,4. A client with a newly applied plaster cast for a fractured tibia reports increased pain and a
tingling sensation in the toes. What is the nurse’s priority action?
A. Assess the neurovascular status of the extremity.
B. Elevate the affected extremity above the level of the heart.
C. Administer the prescribed PRN opioid analgesic.
D. Apply an ice pack to the cast over the fracture site.
Correct Answer: A
Rationale: The client’s reports of tingling and increased pain are early indicators of
compartment syndrome, which is a medical emergency. The nurse must first perform a
neurovascular assessment, checking for the 6 Ps: pain, pallor, pulselessness, paresthesia,
paralysis, and poikilothermia. Once the assessment is complete, the nurse must notify the
provider immediately to prevent permanent tissue damage.
5. Which of the following clinical manifestations should a nurse expect to see in a client
diagnosed with Osteoarthritis (OA)?
A. Symmetrical joint swelling in the hands
B. Pain that is worse in the morning and improves with activity
C. Systemic symptoms such as fatigue and low-grade fever
D. Pain that increases with activity and is relieved by rest
Correct Answer: D
, Rationale: Osteoarthritis is a degenerative joint disease where the cartilage wears down,
leading to pain that typically worsens with weight-bearing or activity and improves with
rest. Unlike rheumatoid arthritis, OA is usually asymmetrical and does not involve systemic
inflammatory symptoms like fever. Morning stiffness in OA usually lasts less than 30
minutes, whereas in RA, it lasts significantly longer.
6. A nurse is teaching a client about the use of an incentive spirometer. Which statement by
the client indicates an understanding of the teaching?
A. I will blow into the device as hard as I can.
B. I should use this device once every 4 hours while I am awake.
C. I will take a deep breath in through the mouthpiece and hold it.
D. I will use this only if I feel short of breath.
Correct Answer: C
Rationale: Incentive spirometry is used to prevent atelectasis by encouraging deep
inhalation and lung expansion. The client should be taught to inhale slowly and deeply
through the mouthpiece and hold their breath for 3 to 5 seconds. This exercise should be
performed approximately 10 times every hour while awake to be effective.
7. A client is diagnosed with a pulmonary embolism (PE). Which of the following is the most
common symptom the nurse should expect the client to exhibit?
A. Sudden onset of shortness of breath
B. Productive cough with yellow sputum
