NUR 2502 / NUR2502 FINAL EXAM:
MULTIDIMENSIONAL CARE III / MDC
3 Rasmussen University | Complete
Study Guide with 300 Practice
Questions & Detailed Rationales |
Latest 2026/2027 Updated Version |
Already Graded A+
1. A patient with a history of heart failure is admitted with acute decompensated
heart failure. The nurse assesses jugular venous distention, 3+ pitting edema in
the lower extremities, and crackles in the lung bases. Which of the following is the
priority nursing action?
• A. Administer a loop diuretic as ordered.
• B. Place the patient in a high-Fowler's position.
• C. Begin strict intake and output monitoring.
• D. Weigh the patient to establish a baseline.
Answer: B
Rationale: The priority is to manage the patient's symptoms. Placing the patient in a
high-Fowler's position uses gravity to reduce preload and improve lung expansion,
which alleviates dyspnea and crackles. While diuretics are the definitive treatment,
positioning is an immediate, independent nursing action to support ventilation .
2. How often should a patient with heart failure weigh themselves?
• A. Weekly
, • B. Monthly
• C. Daily
• D. Hourly
Answer: C
Rationale: Patients with heart failure should weigh themselves daily at the same time,
using the same scale, and wearing similar clothing. Daily weights are the most accurate
way to assess fluid gain (weight gain of 2-3 lbs in 24 hours or 5 lbs in 1 week should be
reported) .
3. What blood test is used to detect heart failure?
• A. Troponins
• B. CBC
• C. BNP (B-type Natriuretic Peptide)
• D. ABGs
Answer: C
Rationale: BNP is a hormone released by the ventricles in response to increased
pressure and volume overload. Elevated BNP levels indicate heart failure. Normal BNP is
<100 pg/mL .
4. What diagnostic test is the gold standard to determine if a patient has heart
failure?
• A. ECHO (Echocardiogram)
• B. MRI
• C. Chest X-ray
• D. Ultrasound
Answer: A
Rationale: An echocardiogram is the gold standard for diagnosing heart failure. It
,evaluates ejection fraction (EF), valve function, and structural abnormalities. A normal EF
is 55-65% .
5. What are some risk factors that can lead to heart failure? (Select all that apply)
• A. Lifestyle factors
• B. Hypertension
• C. Smoking
• D. Diabetes
Answer: A, B, C, D
Rationale: All are risk factors for heart failure. Other risk factors include coronary artery
disease, obesity, high cholesterol, and family history. Management of these risk factors is
essential for prevention .
6. Which of the following is an early sign of left ventricular heart failure?
• A. Swollen legs
• B. Abdominal distension
• C. Weight gain
• D. Nocturnal cough
Answer: D
Rationale: A nocturnal cough is an early sign of left-sided heart failure due to
pulmonary congestion when lying flat. Other early signs include dyspnea on exertion
and orthopnea. Peripheral edema and weight gain occur later with right-sided failure .
7. What can predispose a patient to mitral stenosis?
• A. Rheumatic Fever
• B. Age
, • C. Connective tissue disorder
• D. Infective endocarditis
Answer: A
Rationale: Rheumatic fever is the most common cause of mitral stenosis. The
inflammation from rheumatic fever causes scarring and narrowing of the mitral valve
orifice, impeding blood flow from the left atrium to the left ventricle during diastole .
8. A nurse is caring for a patient with mitral valve stenosis. On auscultation, what is
the classic heart sound the nurse expects to hear?
• A. A high-pitched, blowing systolic murmur at the apex.
• B. A low-pitched, rumbling diastolic murmur at the apex.
• C. A mid-systolic click followed by a late systolic murmur.
• D. A harsh, crescendo-decrescendo murmur at the right sternal border.
Answer: B
Rationale: Mitral valve stenosis creates a low-pitched, rumbling diastolic murmur best
heard at the apex of the heart. It occurs because the narrowed valve impedes blood flow
from the left atrium to the left ventricle during diastole .
9. What is NOT a symptom of mitral valve stenosis?
• A. Fatigue
• B. Hypertension
• C. Dyspnea on exertion
• D. Pink frothy sputum
Answer: B
Rationale: Hypertension is NOT a symptom of mitral stenosis. Symptoms include
fatigue, dyspnea on exertion, orthopnea, palpitations, and pink frothy sputum
(indicating pulmonary edema). Mitral stenosis may cause hypotension due to decreased
cardiac output .
MULTIDIMENSIONAL CARE III / MDC
3 Rasmussen University | Complete
Study Guide with 300 Practice
Questions & Detailed Rationales |
Latest 2026/2027 Updated Version |
Already Graded A+
1. A patient with a history of heart failure is admitted with acute decompensated
heart failure. The nurse assesses jugular venous distention, 3+ pitting edema in
the lower extremities, and crackles in the lung bases. Which of the following is the
priority nursing action?
• A. Administer a loop diuretic as ordered.
• B. Place the patient in a high-Fowler's position.
• C. Begin strict intake and output monitoring.
• D. Weigh the patient to establish a baseline.
Answer: B
Rationale: The priority is to manage the patient's symptoms. Placing the patient in a
high-Fowler's position uses gravity to reduce preload and improve lung expansion,
which alleviates dyspnea and crackles. While diuretics are the definitive treatment,
positioning is an immediate, independent nursing action to support ventilation .
2. How often should a patient with heart failure weigh themselves?
• A. Weekly
, • B. Monthly
• C. Daily
• D. Hourly
Answer: C
Rationale: Patients with heart failure should weigh themselves daily at the same time,
using the same scale, and wearing similar clothing. Daily weights are the most accurate
way to assess fluid gain (weight gain of 2-3 lbs in 24 hours or 5 lbs in 1 week should be
reported) .
3. What blood test is used to detect heart failure?
• A. Troponins
• B. CBC
• C. BNP (B-type Natriuretic Peptide)
• D. ABGs
Answer: C
Rationale: BNP is a hormone released by the ventricles in response to increased
pressure and volume overload. Elevated BNP levels indicate heart failure. Normal BNP is
<100 pg/mL .
4. What diagnostic test is the gold standard to determine if a patient has heart
failure?
• A. ECHO (Echocardiogram)
• B. MRI
• C. Chest X-ray
• D. Ultrasound
Answer: A
Rationale: An echocardiogram is the gold standard for diagnosing heart failure. It
,evaluates ejection fraction (EF), valve function, and structural abnormalities. A normal EF
is 55-65% .
5. What are some risk factors that can lead to heart failure? (Select all that apply)
• A. Lifestyle factors
• B. Hypertension
• C. Smoking
• D. Diabetes
Answer: A, B, C, D
Rationale: All are risk factors for heart failure. Other risk factors include coronary artery
disease, obesity, high cholesterol, and family history. Management of these risk factors is
essential for prevention .
6. Which of the following is an early sign of left ventricular heart failure?
• A. Swollen legs
• B. Abdominal distension
• C. Weight gain
• D. Nocturnal cough
Answer: D
Rationale: A nocturnal cough is an early sign of left-sided heart failure due to
pulmonary congestion when lying flat. Other early signs include dyspnea on exertion
and orthopnea. Peripheral edema and weight gain occur later with right-sided failure .
7. What can predispose a patient to mitral stenosis?
• A. Rheumatic Fever
• B. Age
, • C. Connective tissue disorder
• D. Infective endocarditis
Answer: A
Rationale: Rheumatic fever is the most common cause of mitral stenosis. The
inflammation from rheumatic fever causes scarring and narrowing of the mitral valve
orifice, impeding blood flow from the left atrium to the left ventricle during diastole .
8. A nurse is caring for a patient with mitral valve stenosis. On auscultation, what is
the classic heart sound the nurse expects to hear?
• A. A high-pitched, blowing systolic murmur at the apex.
• B. A low-pitched, rumbling diastolic murmur at the apex.
• C. A mid-systolic click followed by a late systolic murmur.
• D. A harsh, crescendo-decrescendo murmur at the right sternal border.
Answer: B
Rationale: Mitral valve stenosis creates a low-pitched, rumbling diastolic murmur best
heard at the apex of the heart. It occurs because the narrowed valve impedes blood flow
from the left atrium to the left ventricle during diastole .
9. What is NOT a symptom of mitral valve stenosis?
• A. Fatigue
• B. Hypertension
• C. Dyspnea on exertion
• D. Pink frothy sputum
Answer: B
Rationale: Hypertension is NOT a symptom of mitral stenosis. Symptoms include
fatigue, dyspnea on exertion, orthopnea, palpitations, and pink frothy sputum
(indicating pulmonary edema). Mitral stenosis may cause hypotension due to decreased
cardiac output .
