NUR2755: Multidimensional Care IV MDC 4 Final Exam Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
SECTION 1: Critical Care & Shock States (Q1-Q20)
Q1: A 45-year-old male is brought to the ED after a motor vehicle collision. He has a
heart rate of 128 bpm, blood pressure of 82/48 mmHg, respiratory rate of 32, and cool,
clammy skin. His estimated blood loss is 1,500 mL. Which stage of hypovolemic shock
is this patient experiencing?
A. Stage I (compensated) with blood loss <750 mL
B. Stage II with blood loss 750-1,500 mL and normal blood pressure
C. Stage III with blood loss 1,500-2,000 mL, tachycardia, and hypotension [CORRECT]
D. Stage IV with blood loss >2,000 mL and profound hypotension
Correct Answer: C
Rationale: Stage III hypovolemic shock is characterized by blood loss of 1,500-2,000 mL
(30-40% of blood volume), marked tachycardia (>120 bpm), hypotension (systolic BP
<90 mmHg), tachypnea, and cool, clammy skin due to peripheral vasoconstriction. A is
,incorrect because Stage I presents with minimal symptoms and normal vital signs. B is
incorrect because Stage II maintains normal blood pressure despite blood loss of
750-1,500 mL. D is incorrect because Stage IV involves blood loss >2,000 mL with
profound hypotension, altered mental status, and imminent death. [100% VERIFIED –
Rasmussen NUR2755 MDC4]
Q2: A patient in septic shock has a mean arterial pressure (MAP) of 52 mmHg despite
30 mL/kg crystalloid resuscitation. Which vasopressor should be initiated first per
Surviving Sepsis Campaign guidelines?
A. Phenylephrine 0.5-2 mcg/kg/min
B. Norepinephrine 0.01-3 mcg/kg/min [CORRECT]
C. Epinephrine 1-10 mcg/min
D. Vasopressin 0.03 units/min as monotherapy
Correct Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock due to its potent
alpha-1 agonist effects (vasoconstriction) with less pronounced beta-1 effects than
epinephrine, improving MAP with less tachycardia and arrhythmia risk. A is incorrect
because phenylephrine is a pure alpha-agonist that may reduce stroke volume and is
not first-line. C is incorrect because epinephrine is reserved for second-line therapy or
anaphylaxis due to increased arrhythmia risk. D is incorrect because vasopressin is
used as an adjunct (not monotherapy) when norepinephrine requirements escalate or to
spare catecholamine doses. [100% VERIFIED – Rasmussen NUR2755 MDC4]
,Q3: A patient with acute myocardial infarction develops cardiogenic shock. Which
hemodynamic profile is most consistent with this diagnosis?
A. Decreased cardiac output (CO), decreased preload (PCWP), decreased systemic
vascular resistance (SVR)
B. Decreased CO, increased preload (PCWP), increased SVR [CORRECT]
C. Increased CO, decreased preload, decreased SVR
D. Decreased CO, normal preload, decreased SVR
Correct Answer: B
Rationale: Cardiogenic shock is characterized by decreased cardiac output due to pump
failure, leading to increased pulmonary capillary wedge pressure (PCWP) from
backward failure (pulmonary congestion), and increased systemic vascular resistance
as a compensatory mechanism to maintain perfusion pressure. A describes
hypovolemic shock (decreased preload). C describes distributive/septic shock
(vasodilation with high or normal CO initially). D describes obstructive shock where
preload may be normal but afterload is compromised. [100% VERIFIED – Rasmussen
NUR2755 MDC4]
Q4: A 28-year-old female develops sudden hypotension, bronchospasm, and urticaria
after receiving IV penicillin. Her blood pressure is 68/40 mmHg. What is the immediate
priority intervention?
, A. Administer diphenhydramine 50 mg IV and observe
B. Administer epinephrine 0.3-0.5 mg IM (1:1000) in the anterolateral thigh [CORRECT]
C. Start normal saline at 125 mL/hr and call the provider
D. Administer albuterol nebulizer treatment first
Correct Answer: B
Rationale: Anaphylactic shock requires immediate intramuscular epinephrine in the
anterolateral thigh (vastus lateralis) for optimal absorption; this is the life-saving
intervention that reverses vasodilation, bronchoconstriction, and mucosal edema. A is
incorrect because antihistamines are adjunctive only and do not address the immediate
life-threatening vasodilation and bronchospasm. C is incorrect because fluid
resuscitation alone is insufficient without epinephrine, and the rate is too slow for
shock. D is incorrect because bronchodilators are secondary to epinephrine, which has
both alpha and beta effects needed for this emergency. [100% VERIFIED – Rasmussen
NUR2755 MDC4]
Q5: A patient with a T6 spinal cord injury presents with hypotension (BP 78/52),
bradycardia (HR 48), and warm, dry skin. Which intervention is most appropriate?
A. Administer high-dose norepinephrine for vasoconstriction
B. Administer atropine 0.5 mg IV for bradycardia and fluid resuscitation [CORRECT]
C. Place the patient in Trendelenburg position immediately
D. Administer epinephrine for anaphylaxis protocol
Complete Exam-Style Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
SECTION 1: Critical Care & Shock States (Q1-Q20)
Q1: A 45-year-old male is brought to the ED after a motor vehicle collision. He has a
heart rate of 128 bpm, blood pressure of 82/48 mmHg, respiratory rate of 32, and cool,
clammy skin. His estimated blood loss is 1,500 mL. Which stage of hypovolemic shock
is this patient experiencing?
A. Stage I (compensated) with blood loss <750 mL
B. Stage II with blood loss 750-1,500 mL and normal blood pressure
C. Stage III with blood loss 1,500-2,000 mL, tachycardia, and hypotension [CORRECT]
D. Stage IV with blood loss >2,000 mL and profound hypotension
Correct Answer: C
Rationale: Stage III hypovolemic shock is characterized by blood loss of 1,500-2,000 mL
(30-40% of blood volume), marked tachycardia (>120 bpm), hypotension (systolic BP
<90 mmHg), tachypnea, and cool, clammy skin due to peripheral vasoconstriction. A is
,incorrect because Stage I presents with minimal symptoms and normal vital signs. B is
incorrect because Stage II maintains normal blood pressure despite blood loss of
750-1,500 mL. D is incorrect because Stage IV involves blood loss >2,000 mL with
profound hypotension, altered mental status, and imminent death. [100% VERIFIED –
Rasmussen NUR2755 MDC4]
Q2: A patient in septic shock has a mean arterial pressure (MAP) of 52 mmHg despite
30 mL/kg crystalloid resuscitation. Which vasopressor should be initiated first per
Surviving Sepsis Campaign guidelines?
A. Phenylephrine 0.5-2 mcg/kg/min
B. Norepinephrine 0.01-3 mcg/kg/min [CORRECT]
C. Epinephrine 1-10 mcg/min
D. Vasopressin 0.03 units/min as monotherapy
Correct Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock due to its potent
alpha-1 agonist effects (vasoconstriction) with less pronounced beta-1 effects than
epinephrine, improving MAP with less tachycardia and arrhythmia risk. A is incorrect
because phenylephrine is a pure alpha-agonist that may reduce stroke volume and is
not first-line. C is incorrect because epinephrine is reserved for second-line therapy or
anaphylaxis due to increased arrhythmia risk. D is incorrect because vasopressin is
used as an adjunct (not monotherapy) when norepinephrine requirements escalate or to
spare catecholamine doses. [100% VERIFIED – Rasmussen NUR2755 MDC4]
,Q3: A patient with acute myocardial infarction develops cardiogenic shock. Which
hemodynamic profile is most consistent with this diagnosis?
A. Decreased cardiac output (CO), decreased preload (PCWP), decreased systemic
vascular resistance (SVR)
B. Decreased CO, increased preload (PCWP), increased SVR [CORRECT]
C. Increased CO, decreased preload, decreased SVR
D. Decreased CO, normal preload, decreased SVR
Correct Answer: B
Rationale: Cardiogenic shock is characterized by decreased cardiac output due to pump
failure, leading to increased pulmonary capillary wedge pressure (PCWP) from
backward failure (pulmonary congestion), and increased systemic vascular resistance
as a compensatory mechanism to maintain perfusion pressure. A describes
hypovolemic shock (decreased preload). C describes distributive/septic shock
(vasodilation with high or normal CO initially). D describes obstructive shock where
preload may be normal but afterload is compromised. [100% VERIFIED – Rasmussen
NUR2755 MDC4]
Q4: A 28-year-old female develops sudden hypotension, bronchospasm, and urticaria
after receiving IV penicillin. Her blood pressure is 68/40 mmHg. What is the immediate
priority intervention?
, A. Administer diphenhydramine 50 mg IV and observe
B. Administer epinephrine 0.3-0.5 mg IM (1:1000) in the anterolateral thigh [CORRECT]
C. Start normal saline at 125 mL/hr and call the provider
D. Administer albuterol nebulizer treatment first
Correct Answer: B
Rationale: Anaphylactic shock requires immediate intramuscular epinephrine in the
anterolateral thigh (vastus lateralis) for optimal absorption; this is the life-saving
intervention that reverses vasodilation, bronchoconstriction, and mucosal edema. A is
incorrect because antihistamines are adjunctive only and do not address the immediate
life-threatening vasodilation and bronchospasm. C is incorrect because fluid
resuscitation alone is insufficient without epinephrine, and the rate is too slow for
shock. D is incorrect because bronchodilators are secondary to epinephrine, which has
both alpha and beta effects needed for this emergency. [100% VERIFIED – Rasmussen
NUR2755 MDC4]
Q5: A patient with a T6 spinal cord injury presents with hypotension (BP 78/52),
bradycardia (HR 48), and warm, dry skin. Which intervention is most appropriate?
A. Administer high-dose norepinephrine for vasoconstriction
B. Administer atropine 0.5 mg IV for bradycardia and fluid resuscitation [CORRECT]
C. Place the patient in Trendelenburg position immediately
D. Administer epinephrine for anaphylaxis protocol
