NUR 2502 | Multidimensional Care 3 — Exam 2 Rasmussen College | 2026/2027
NUR 2502 | Multidimensional Care 3 (MDC3) — Exam 2
Comprehensive 50-Question Examination with Detailed Rationales
Rasmussen College | 2026/2027 Edition | A+ Graded
Total Questions: 50 Cognitive Distribution: 25% Recall | 55% Application | 20% Analysi
Format: Multiple Choice + Select All That Apply
Question Style: 75% Scenario-Based | 20% Direct Recall | 5
Sections: 4 (Respiratory | Renal/Hepatic | Multi-System
Alignment: | Integrated Cases)
Rasmussen NUR2502 Curriculum + NCLEX
Instructions: This comprehensive examination assesses mastery of complex adult health
alterations covered in the second half of NUR 2502 Multidimensional Care 3. Each question
contains four options (A-D) with one most-correct answer. For Select All That Apply (SATA)
questions, multiple options may be correct. Comprehensive rationales explaining the
nursing clinical reasoning, pathophysiology, pharmacology, and evidence-based practice
principles accompany each question. Prioritize using the ABC (Airway, Breathing,
Circulation) framework, Maslow's hierarchy of needs, and the nursing process when
analyzing clinical scenarios.
SECTION 1: Respiratory Disorders and Airway Management (Q1–Q25)
Topics: Asthma, COPD, Emphysema, Cystic Fibrosis, Tuberculosis, Laryngeal Cancer, Pneumonia, Influenza, Epistaxis, Rhinoplasty,
Chronic Airflow Limitation.
Q1. A 7-year-old child with persistent asthma is prescribed montelukast. The nurse is teaching the parents about
the medication's mechanism of action. Which statement by the nurse is most accurate?
A. Montelukast relaxes bronchial smooth muscle by stimulating beta-2 receptors
within minutes of administration.
B. Montelukast blocks leukotriene receptors to decrease airway inflammation
and bronchoconstriction. [CORRECT]
C. Montelukast inhibits the enzyme phosphodiesterase, increasing intracellular cyclic
AMP in bronchial cells.
D. Montelukast blocks muscarinic receptors in the airway to reduce mucus secretion
and bronchospasm.
Correct Answer: B
Rationale: Montelukast is a leukotriene receptor antagonist. Leukotrienes are inflammatory
mediators released by mast cells and eosinophils that produce bronchoconstriction, mucus
secretion, and airway edema. By blocking leukotriene receptors, montelukast reduces airway
inflammation and is used for prophylaxis of persistent asthma and exercise-induced
bronchospasm. It is not a rescue medication. Choice A describes a short-acting beta-agonist
(e.g., albuterol). Choice C describes the mechanism of methylxanthines (theophylline).
Choice D describes the mechanism of anticholinergics such as ipratropium.
Page 1 | MDC3 Exam 2 — A+ Graded | 50 Questions
,NUR 2502 | Multidimensional Care 3 — Exam 2 Rasmussen College | 2026/2027
Q2. A patient with asthma is prescribed both albuterol (a bronchodilator) and fluticasone (an inhaled
corticosteroid). The nurse identifies that additional teaching is needed when the patient states:
A. I will rinse my mouth with water after using the fluticasone inhaler.
B. I will take the albuterol at least 5 minutes before the fluticasone.
C. I will use the fluticasone inhaler first, then the albuterol afterward.
[CORRECT]
D. I will use the albuterol inhaler only when I have acute shortness of breath.
Correct Answer: C
Rationale: The bronchodilator (albuterol) must be administered at least 5 minutes before
the inhaled corticosteroid (fluticasone) so that the airways are opened, allowing the
corticosteroid to reach deeper lung tissue and improve anti-inflammatory effectiveness.
Statement C indicates the reverse order and requires correction. Statement A is correct
because rinsing prevents oral candidiasis (thrush) from inhaled corticosteroids. Statement B
reflects correct sequencing. Statement D is correct because albuterol is a rescue medication
used for acute symptoms, not on a schedule.
Q3. A nurse is caring for a client admitted with status asthmaticus. The client was audibly wheezing on
admission, but suddenly the wheezing stops and the client's respiratory effort becomes markedly diminished
withSpO2 dropping to 86%. Which action should the nurse take first?
A. Increase the oxygen flow rate and reassess lung sounds in 15 minutes.
B. Administer a nebulized beta-agonist treatment and reassess breath sounds.
C. Activate the rapid response team to secure an airway immediately.
[CORRECT]
D. Document the finding and reposition the client into high-Fowler's position.
Correct Answer: C
Rationale: Sudden absence of audible wheezing in a client with status asthmaticus indicates
impending complete airway obstruction from severe bronchoconstriction — a 'silent chest'
emergency. Air movement is so restricted that wheezing can no longer be heard. This is a
life-threatening situation requiring immediate airway intervention. The nurse must activate
the rapid response team to secure an airway without delay. Increasing oxygen (A) or giving
more medication (B) will not help if no air is moving. Documentation (D) is inappropriate for
an emergency.
Page 2 | MDC3 Exam 2 — A+ Graded | 50 Questions
, NUR 2502 | Multidimensional Care 3 — Exam 2 Rasmussen College | 2026/2027
Q4. A nurse is providing discharge teaching to a client with asthma who is prescribed salmeterol (a long-acting
beta-agonist). Which statement by the client indicates understanding of the medication?
A. I should use this inhaler only when I have an acute asthma attack.
B. I should take this medication every morning to help prevent acute asthma
attacks. [CORRECT]
C. I should use this medication if my peak flow drops below my personal best.
D. I should stop taking this medication once my symptoms improve.
Correct Answer: B
Rationale: Salmeterol is a long-acting beta-agonist (LABA) used for maintenance therapy to
prevent asthma attacks. It must be taken on a scheduled basis (typically every morning and
evening) and is never used as a rescue medication because of its slow onset of action (15-30
minutes). Statements A and C reflect misuse as a rescue inhaler, which is dangerous.
Statement D is incorrect because LABAs must be continued even when symptoms improve;
stopping abruptly can precipitate rebound bronchospasm. LABAs should always be paired
with an inhaled corticosteroid due to black box warning.
Q5. A 14-year-old with exercise-induced bronchospasm is being discharged with an albuterol inhaler. The nurse
teaches the client to use the inhaler before exercise and to monitor for symptoms during activity. Which finding
should the client report immediately to the coach or school nurse during exercise?
A. Mild muscle fatigue and increased perspiration after 20 minutes of activity.
B. Wheezing, chest tightness, or persistent coughing during or after exercise.
[CORRECT]
C. Heart rate increase to 140 beats per minute during vigorous activity.
D. Mild shortness of breath that resolves within 2 minutes of stopping activity.
Correct Answer: B
Rationale: Exercise-induced bronchospasm manifests as wheezing, chest tightness,
coughing, or dyspnea during or after physical exertion, caused by airway heat and water loss
from rapid breathing. These symptoms require immediate cessation of activity and
administration of a rescue inhaler. Choice A and C are expected physiologic responses to
exercise. Choice D may be acceptable if minor and quickly resolves, but B represents the
cardinal signs of bronchospasm that must be reported and treated promptly to prevent
progression to severe respiratory distress.
Page 3 | MDC3 Exam 2 — A+ Graded | 50 Questions
NUR 2502 | Multidimensional Care 3 (MDC3) — Exam 2
Comprehensive 50-Question Examination with Detailed Rationales
Rasmussen College | 2026/2027 Edition | A+ Graded
Total Questions: 50 Cognitive Distribution: 25% Recall | 55% Application | 20% Analysi
Format: Multiple Choice + Select All That Apply
Question Style: 75% Scenario-Based | 20% Direct Recall | 5
Sections: 4 (Respiratory | Renal/Hepatic | Multi-System
Alignment: | Integrated Cases)
Rasmussen NUR2502 Curriculum + NCLEX
Instructions: This comprehensive examination assesses mastery of complex adult health
alterations covered in the second half of NUR 2502 Multidimensional Care 3. Each question
contains four options (A-D) with one most-correct answer. For Select All That Apply (SATA)
questions, multiple options may be correct. Comprehensive rationales explaining the
nursing clinical reasoning, pathophysiology, pharmacology, and evidence-based practice
principles accompany each question. Prioritize using the ABC (Airway, Breathing,
Circulation) framework, Maslow's hierarchy of needs, and the nursing process when
analyzing clinical scenarios.
SECTION 1: Respiratory Disorders and Airway Management (Q1–Q25)
Topics: Asthma, COPD, Emphysema, Cystic Fibrosis, Tuberculosis, Laryngeal Cancer, Pneumonia, Influenza, Epistaxis, Rhinoplasty,
Chronic Airflow Limitation.
Q1. A 7-year-old child with persistent asthma is prescribed montelukast. The nurse is teaching the parents about
the medication's mechanism of action. Which statement by the nurse is most accurate?
A. Montelukast relaxes bronchial smooth muscle by stimulating beta-2 receptors
within minutes of administration.
B. Montelukast blocks leukotriene receptors to decrease airway inflammation
and bronchoconstriction. [CORRECT]
C. Montelukast inhibits the enzyme phosphodiesterase, increasing intracellular cyclic
AMP in bronchial cells.
D. Montelukast blocks muscarinic receptors in the airway to reduce mucus secretion
and bronchospasm.
Correct Answer: B
Rationale: Montelukast is a leukotriene receptor antagonist. Leukotrienes are inflammatory
mediators released by mast cells and eosinophils that produce bronchoconstriction, mucus
secretion, and airway edema. By blocking leukotriene receptors, montelukast reduces airway
inflammation and is used for prophylaxis of persistent asthma and exercise-induced
bronchospasm. It is not a rescue medication. Choice A describes a short-acting beta-agonist
(e.g., albuterol). Choice C describes the mechanism of methylxanthines (theophylline).
Choice D describes the mechanism of anticholinergics such as ipratropium.
Page 1 | MDC3 Exam 2 — A+ Graded | 50 Questions
,NUR 2502 | Multidimensional Care 3 — Exam 2 Rasmussen College | 2026/2027
Q2. A patient with asthma is prescribed both albuterol (a bronchodilator) and fluticasone (an inhaled
corticosteroid). The nurse identifies that additional teaching is needed when the patient states:
A. I will rinse my mouth with water after using the fluticasone inhaler.
B. I will take the albuterol at least 5 minutes before the fluticasone.
C. I will use the fluticasone inhaler first, then the albuterol afterward.
[CORRECT]
D. I will use the albuterol inhaler only when I have acute shortness of breath.
Correct Answer: C
Rationale: The bronchodilator (albuterol) must be administered at least 5 minutes before
the inhaled corticosteroid (fluticasone) so that the airways are opened, allowing the
corticosteroid to reach deeper lung tissue and improve anti-inflammatory effectiveness.
Statement C indicates the reverse order and requires correction. Statement A is correct
because rinsing prevents oral candidiasis (thrush) from inhaled corticosteroids. Statement B
reflects correct sequencing. Statement D is correct because albuterol is a rescue medication
used for acute symptoms, not on a schedule.
Q3. A nurse is caring for a client admitted with status asthmaticus. The client was audibly wheezing on
admission, but suddenly the wheezing stops and the client's respiratory effort becomes markedly diminished
withSpO2 dropping to 86%. Which action should the nurse take first?
A. Increase the oxygen flow rate and reassess lung sounds in 15 minutes.
B. Administer a nebulized beta-agonist treatment and reassess breath sounds.
C. Activate the rapid response team to secure an airway immediately.
[CORRECT]
D. Document the finding and reposition the client into high-Fowler's position.
Correct Answer: C
Rationale: Sudden absence of audible wheezing in a client with status asthmaticus indicates
impending complete airway obstruction from severe bronchoconstriction — a 'silent chest'
emergency. Air movement is so restricted that wheezing can no longer be heard. This is a
life-threatening situation requiring immediate airway intervention. The nurse must activate
the rapid response team to secure an airway without delay. Increasing oxygen (A) or giving
more medication (B) will not help if no air is moving. Documentation (D) is inappropriate for
an emergency.
Page 2 | MDC3 Exam 2 — A+ Graded | 50 Questions
, NUR 2502 | Multidimensional Care 3 — Exam 2 Rasmussen College | 2026/2027
Q4. A nurse is providing discharge teaching to a client with asthma who is prescribed salmeterol (a long-acting
beta-agonist). Which statement by the client indicates understanding of the medication?
A. I should use this inhaler only when I have an acute asthma attack.
B. I should take this medication every morning to help prevent acute asthma
attacks. [CORRECT]
C. I should use this medication if my peak flow drops below my personal best.
D. I should stop taking this medication once my symptoms improve.
Correct Answer: B
Rationale: Salmeterol is a long-acting beta-agonist (LABA) used for maintenance therapy to
prevent asthma attacks. It must be taken on a scheduled basis (typically every morning and
evening) and is never used as a rescue medication because of its slow onset of action (15-30
minutes). Statements A and C reflect misuse as a rescue inhaler, which is dangerous.
Statement D is incorrect because LABAs must be continued even when symptoms improve;
stopping abruptly can precipitate rebound bronchospasm. LABAs should always be paired
with an inhaled corticosteroid due to black box warning.
Q5. A 14-year-old with exercise-induced bronchospasm is being discharged with an albuterol inhaler. The nurse
teaches the client to use the inhaler before exercise and to monitor for symptoms during activity. Which finding
should the client report immediately to the coach or school nurse during exercise?
A. Mild muscle fatigue and increased perspiration after 20 minutes of activity.
B. Wheezing, chest tightness, or persistent coughing during or after exercise.
[CORRECT]
C. Heart rate increase to 140 beats per minute during vigorous activity.
D. Mild shortness of breath that resolves within 2 minutes of stopping activity.
Correct Answer: B
Rationale: Exercise-induced bronchospasm manifests as wheezing, chest tightness,
coughing, or dyspnea during or after physical exertion, caused by airway heat and water loss
from rapid breathing. These symptoms require immediate cessation of activity and
administration of a rescue inhaler. Choice A and C are expected physiologic responses to
exercise. Choice D may be acceptable if minor and quickly resolves, but B represents the
cardinal signs of bronchospasm that must be reported and treated promptly to prevent
progression to severe respiratory distress.
Page 3 | MDC3 Exam 2 — A+ Graded | 50 Questions
