MDC III Exam 2 (Rasmussen) 2026 | Medical-
Surgical Nursing III Practice Questions &
Verified Answers with Rationales |
Comprehensive Exam 2 Review
MDC III EXAM 2 (RASMUSSEN) 2026 – MEDICAL-SURGICAL NURSING III
Practice Questions & Verified Answers with Rationales
OVERVIEW
• Comprehensive multiple-choice questions designed to mirror the actual
Rasmussen MDC III Exam 2 format, covering all major systems and nursing
interventions in medical-surgical care settings
• Study approach: Use this material to identify knowledge gaps by topic, practice
clinical reasoning under timed conditions, and review detailed rationales to
strengthen understanding of pathophysiology and evidence-based interventions
SECTION 1: CARDIOVASCULAR NURSING
1) A 65-year-old male client presents to the emergency department with chest
pain radiating to his left arm and diaphoresis. His ECG shows ST-segment
elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A) Left main coronary artery
B) Left anterior descending artery
C) Right coronary artery
D) Left circumflex artery
E) Diagonal branch
CORRECT ANSWER: C) Right coronary artery
Rationale: ST-segment elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction. The right coronary artery supplies the inferior wall of the left
,ventricle in approximately 80% of the population. The left anterior descending
artery supplies the anterior wall, and the left circumflex artery supplies the lateral
wall. Recognition of the specific coronary distribution is critical for determining
treatment urgency and anticipated complications such as right ventricular
involvement.
2) A client with acute myocardial infarction is receiving aspirin 325 mg PO and
dual antiplatelet therapy with clopidogrel. Which nursing assessment finding
would require immediate intervention?
A) Petechiae on lower extremities
B) Heart rate of 88 beats per minute
C) Blood pressure of 130/85 mmHg
D) Oxygen saturation of 98% on room air
E) Mild dyspnea on exertion
CORRECT ANSWER: A) Petechiae on lower extremities
Rationale: Petechiae represent small hemorrhages into the skin and suggest
thrombocytopenia or excessive bleeding tendency. In a client on dual antiplatelet
therapy, this finding indicates a potentially serious adverse effect requiring
immediate physician notification, laboratory assessment of platelet count, and
possible discontinuation of medications. The other findings represent expected or
within-normal parameters for a post-MI client.
3) A 72-year-old female presents with signs of heart failure and elevated B-
type natriuretic peptide (BNP). She is started on an ACE inhibitor. What is the
primary mechanism by which ACE inhibitors reduce afterload?
A) Direct vasodilation of arteries and veins
B) Inhibition of angiotensin II production, leading to vasodilation
C) Increased sympathetic nervous system activity
,D) Increased sodium reabsorption in the kidneys
E) Direct myocardial contractility enhancement
CORRECT ANSWER: B) Inhibition of angiotensin II production, leading to
vasodilation
Rationale: ACE inhibitors work by blocking the conversion of angiotensin I to
angiotensin II. Since angiotensin II is a potent vasoconstrictor and promotes sodium
and water retention, its inhibition results in decreased peripheral vascular
resistance (afterload), vasodilation, and reduced cardiac workload. This mechanism
makes ACE inhibitors particularly beneficial in heart failure management. ACE
inhibitors do not directly dilate vessels or increase contractility.
4) A client is admitted with atrial fibrillation and a rapid ventricular response.
The physician orders intravenous amiodarone. Which monitoring parameter
is most critical during amiodarone administration?
A) Urine output
B) QT interval on ECG
C) Blood glucose levels
D) Respiratory rate
E) Hemoglobin levels
CORRECT ANSWER: B) QT interval on ECG
Rationale: Amiodarone is a Class III antiarrhythmic agent that prolongs the QT
interval. Significant QT prolongation increases the risk of torsades de pointes, a
potentially fatal arrhythmia. Continuous cardiac monitoring with particular
attention to QT interval duration is essential. While amiodarone can affect other
parameters like thyroid function and pulmonary status, QT interval monitoring is
the immediate priority during administration to prevent serious dysrhythmias.
, 5) A 58-year-old male with chronic hypertension and left ventricular
hypertrophy presents with dyspnea and fatigue. Which compensatory
mechanism has become maladaptive in this client?
A) Increased sympathetic nervous system activity
B) Frank-Starling mechanism leading to ventricular remodeling
C) Aldosterone release causing sodium and water retention
D) Increased myocardial contractility from catecholamine release
E) All of the above
CORRECT ANSWER: E) All of the above
Rationale: In chronic hypertension with resultant heart failure, all initially
compensatory mechanisms become maladaptive. The Frank-Starling mechanism
stretches the ventricle beyond optimal length, reducing efficiency. Chronic
sympathetic activation causes tachycardia and increases myocardial oxygen
demand. Prolonged aldosterone activation causes fluid retention, increasing
preload and worsening congestion. This shift from compensation to
decompensation is central to heart failure pathophysiology and guides therapeutic
interventions aimed at neurohormonal antagonism.
6) A client receives nitroglycerin sublingual for acute chest pain. Within 5
minutes, the client reports severe headache and dizziness. What is the most
appropriate nursing action?
A) Administer acetaminophen for headache management
B) Place client in supine position and notify physician
C) Administer a second dose of nitroglycerin
D) Increase the oxygen flow rate
E) Reassure the client that these are expected side effects
CORRECT ANSWER: B) Place client in supine position and notify physician
Surgical Nursing III Practice Questions &
Verified Answers with Rationales |
Comprehensive Exam 2 Review
MDC III EXAM 2 (RASMUSSEN) 2026 – MEDICAL-SURGICAL NURSING III
Practice Questions & Verified Answers with Rationales
OVERVIEW
• Comprehensive multiple-choice questions designed to mirror the actual
Rasmussen MDC III Exam 2 format, covering all major systems and nursing
interventions in medical-surgical care settings
• Study approach: Use this material to identify knowledge gaps by topic, practice
clinical reasoning under timed conditions, and review detailed rationales to
strengthen understanding of pathophysiology and evidence-based interventions
SECTION 1: CARDIOVASCULAR NURSING
1) A 65-year-old male client presents to the emergency department with chest
pain radiating to his left arm and diaphoresis. His ECG shows ST-segment
elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A) Left main coronary artery
B) Left anterior descending artery
C) Right coronary artery
D) Left circumflex artery
E) Diagonal branch
CORRECT ANSWER: C) Right coronary artery
Rationale: ST-segment elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction. The right coronary artery supplies the inferior wall of the left
,ventricle in approximately 80% of the population. The left anterior descending
artery supplies the anterior wall, and the left circumflex artery supplies the lateral
wall. Recognition of the specific coronary distribution is critical for determining
treatment urgency and anticipated complications such as right ventricular
involvement.
2) A client with acute myocardial infarction is receiving aspirin 325 mg PO and
dual antiplatelet therapy with clopidogrel. Which nursing assessment finding
would require immediate intervention?
A) Petechiae on lower extremities
B) Heart rate of 88 beats per minute
C) Blood pressure of 130/85 mmHg
D) Oxygen saturation of 98% on room air
E) Mild dyspnea on exertion
CORRECT ANSWER: A) Petechiae on lower extremities
Rationale: Petechiae represent small hemorrhages into the skin and suggest
thrombocytopenia or excessive bleeding tendency. In a client on dual antiplatelet
therapy, this finding indicates a potentially serious adverse effect requiring
immediate physician notification, laboratory assessment of platelet count, and
possible discontinuation of medications. The other findings represent expected or
within-normal parameters for a post-MI client.
3) A 72-year-old female presents with signs of heart failure and elevated B-
type natriuretic peptide (BNP). She is started on an ACE inhibitor. What is the
primary mechanism by which ACE inhibitors reduce afterload?
A) Direct vasodilation of arteries and veins
B) Inhibition of angiotensin II production, leading to vasodilation
C) Increased sympathetic nervous system activity
,D) Increased sodium reabsorption in the kidneys
E) Direct myocardial contractility enhancement
CORRECT ANSWER: B) Inhibition of angiotensin II production, leading to
vasodilation
Rationale: ACE inhibitors work by blocking the conversion of angiotensin I to
angiotensin II. Since angiotensin II is a potent vasoconstrictor and promotes sodium
and water retention, its inhibition results in decreased peripheral vascular
resistance (afterload), vasodilation, and reduced cardiac workload. This mechanism
makes ACE inhibitors particularly beneficial in heart failure management. ACE
inhibitors do not directly dilate vessels or increase contractility.
4) A client is admitted with atrial fibrillation and a rapid ventricular response.
The physician orders intravenous amiodarone. Which monitoring parameter
is most critical during amiodarone administration?
A) Urine output
B) QT interval on ECG
C) Blood glucose levels
D) Respiratory rate
E) Hemoglobin levels
CORRECT ANSWER: B) QT interval on ECG
Rationale: Amiodarone is a Class III antiarrhythmic agent that prolongs the QT
interval. Significant QT prolongation increases the risk of torsades de pointes, a
potentially fatal arrhythmia. Continuous cardiac monitoring with particular
attention to QT interval duration is essential. While amiodarone can affect other
parameters like thyroid function and pulmonary status, QT interval monitoring is
the immediate priority during administration to prevent serious dysrhythmias.
, 5) A 58-year-old male with chronic hypertension and left ventricular
hypertrophy presents with dyspnea and fatigue. Which compensatory
mechanism has become maladaptive in this client?
A) Increased sympathetic nervous system activity
B) Frank-Starling mechanism leading to ventricular remodeling
C) Aldosterone release causing sodium and water retention
D) Increased myocardial contractility from catecholamine release
E) All of the above
CORRECT ANSWER: E) All of the above
Rationale: In chronic hypertension with resultant heart failure, all initially
compensatory mechanisms become maladaptive. The Frank-Starling mechanism
stretches the ventricle beyond optimal length, reducing efficiency. Chronic
sympathetic activation causes tachycardia and increases myocardial oxygen
demand. Prolonged aldosterone activation causes fluid retention, increasing
preload and worsening congestion. This shift from compensation to
decompensation is central to heart failure pathophysiology and guides therapeutic
interventions aimed at neurohormonal antagonism.
6) A client receives nitroglycerin sublingual for acute chest pain. Within 5
minutes, the client reports severe headache and dizziness. What is the most
appropriate nursing action?
A) Administer acetaminophen for headache management
B) Place client in supine position and notify physician
C) Administer a second dose of nitroglycerin
D) Increase the oxygen flow rate
E) Reassure the client that these are expected side effects
CORRECT ANSWER: B) Place client in supine position and notify physician
