1
NUR 2502 / NUR2502 Final Exam (Latest
2025/2026): Multidimensional Care III /
MDC 3 Rasmussen Comprehensive 150-
Question Multiple-Choice Examination
Instructions:
This examination consists of 150 multiple-choice questions. Select the single best answer for
each question. Each question has one correct answer. Read each question carefully and choose
the response that most accurately addresses the clinical scenario or concept presented.
SECTION 1: CARDIOVASCULAR DISORDERS
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.
- detailed 100% correctanswer :- 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.
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2. 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.
- detailed 100% correctanswer :- B
Rationale: Mitral valve stenosis, a narrowing of the mitral valve orifice, impedes blood flow
from the left atrium to the left ventricle during diastole, creating a low-pitched, rumbling
diastolic murmur best heard at the apex of the heart.
3. A patient is receiving a continuous heparin infusion for a deep vein thrombosis. The nurse
notes the patient has new-onset epistaxis and a blood pressure of 100/60 mm Hg. Which of
the following is the nurse's priority action?
A. Notify the healthcare provider immediately.
B. Stop the heparin infusion.
C. Apply direct pressure to the patient's nares.
D. Decrease the heparin infusion rate by half.
- detailed 100% correctanswer :- A
Rationale: The patient is showing signs of bleeding (epistaxis, hypotension) as a complication of
heparin therapy. The nurse should notify the healthcare provider immediately while continuing
to monitor the patient. Stopping the infusion independently requires a provider order unless
standing protocol exists.
4. Which laboratory value is most indicative of a patient's risk for bleeding complications
while on warfarin therapy?
A. Platelet count
B. Prothrombin time (PT) and International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Hemoglobin and hematocrit
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- detailed 100% correctanswer :- B
Rationale: PT and INR are the primary monitoring parameters for warfarin therapy. The
therapeutic INR range for most indications is 2.0-3.0. aPTT is used to monitor heparin therapy,
not warfarin.
5. A patient with atrial fibrillation is prescribed digoxin. Which assessment finding would
indicate digoxin toxicity?
A. Heart rate of 72 bpm
B. Serum potassium of 4.0 mEq/L
C. Visual disturbances such as yellow-green halos
D. Blood pressure of 130/80 mm Hg
- detailed 100% correctanswer :- C
Rationale: Visual disturbances, including yellow-green halos around lights and blurred vision,
are classic signs of digoxin toxicity. Other signs include nausea, vomiting, bradycardia, and
cardiac dysrhythmias.
6. The nurse is caring for a patient 2 hours post-myocardial infarction. Which of the following
cardiac markers would be expected to rise first?
A. Troponin I
B. Creatine kinase-MB (CK-MB)
C. Myoglobin
D. Lactate dehydrogenase (LDH)
- detailed 100% correctanswer :- C
Rationale: Myoglobin is the earliest cardiac marker to rise, typically within 1-3 hours of
myocardial injury. However, it lacks cardiac specificity. Troponin is the preferred biomarker due
to its high sensitivity and specificity for myocardial injury.
7. A patient with peripheral artery disease (PAD) reports leg pain that occurs with walking and
is relieved by rest. The nurse documents this finding as:
A. Rest pain
B. Claudication
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C. Venous insufficiency
D. Neuropathic pain
- detailed 100% correctanswer :- B
Rationale: Intermittent claudication is the hallmark symptom of PAD, characterized by muscle
pain or cramping in the lower extremities that occurs with exercise and is relieved by rest. This
results from inadequate blood flow to meet metabolic demands during activity.
8. Which dietary modification should the nurse recommend for a patient with hypertension?
A. Increased sodium intake
B. DASH diet emphasizing fruits, vegetables, and low-fat dairy
C. High-protein, low-carbohydrate diet
D. Increased caffeine consumption
- detailed 100% correctanswer :- B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits,
vegetables, whole grains, and low-fat dairy products while limiting sodium, saturated fat, and
added sugars. This dietary pattern has been shown to effectively lower blood pressure.
9. A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the
nurse most concerned about with this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
- detailed 100% correctanswer :- B
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the
loop of Henle, leading to increased excretion of potassium. Hypokalemia can precipitate cardiac
dysrhythmias, especially in patients on digoxin.
10. The nurse is assessing a patient with suspected infective endocarditis. Which assessment
finding is most consistent with this diagnosis?
NUR 2502 / NUR2502 Final Exam (Latest
2025/2026): Multidimensional Care III /
MDC 3 Rasmussen Comprehensive 150-
Question Multiple-Choice Examination
Instructions:
This examination consists of 150 multiple-choice questions. Select the single best answer for
each question. Each question has one correct answer. Read each question carefully and choose
the response that most accurately addresses the clinical scenario or concept presented.
SECTION 1: CARDIOVASCULAR DISORDERS
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.
- detailed 100% correctanswer :- 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
2. 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.
- detailed 100% correctanswer :- B
Rationale: Mitral valve stenosis, a narrowing of the mitral valve orifice, impedes blood flow
from the left atrium to the left ventricle during diastole, creating a low-pitched, rumbling
diastolic murmur best heard at the apex of the heart.
3. A patient is receiving a continuous heparin infusion for a deep vein thrombosis. The nurse
notes the patient has new-onset epistaxis and a blood pressure of 100/60 mm Hg. Which of
the following is the nurse's priority action?
A. Notify the healthcare provider immediately.
B. Stop the heparin infusion.
C. Apply direct pressure to the patient's nares.
D. Decrease the heparin infusion rate by half.
- detailed 100% correctanswer :- A
Rationale: The patient is showing signs of bleeding (epistaxis, hypotension) as a complication of
heparin therapy. The nurse should notify the healthcare provider immediately while continuing
to monitor the patient. Stopping the infusion independently requires a provider order unless
standing protocol exists.
4. Which laboratory value is most indicative of a patient's risk for bleeding complications
while on warfarin therapy?
A. Platelet count
B. Prothrombin time (PT) and International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Hemoglobin and hematocrit
,3
- detailed 100% correctanswer :- B
Rationale: PT and INR are the primary monitoring parameters for warfarin therapy. The
therapeutic INR range for most indications is 2.0-3.0. aPTT is used to monitor heparin therapy,
not warfarin.
5. A patient with atrial fibrillation is prescribed digoxin. Which assessment finding would
indicate digoxin toxicity?
A. Heart rate of 72 bpm
B. Serum potassium of 4.0 mEq/L
C. Visual disturbances such as yellow-green halos
D. Blood pressure of 130/80 mm Hg
- detailed 100% correctanswer :- C
Rationale: Visual disturbances, including yellow-green halos around lights and blurred vision,
are classic signs of digoxin toxicity. Other signs include nausea, vomiting, bradycardia, and
cardiac dysrhythmias.
6. The nurse is caring for a patient 2 hours post-myocardial infarction. Which of the following
cardiac markers would be expected to rise first?
A. Troponin I
B. Creatine kinase-MB (CK-MB)
C. Myoglobin
D. Lactate dehydrogenase (LDH)
- detailed 100% correctanswer :- C
Rationale: Myoglobin is the earliest cardiac marker to rise, typically within 1-3 hours of
myocardial injury. However, it lacks cardiac specificity. Troponin is the preferred biomarker due
to its high sensitivity and specificity for myocardial injury.
7. A patient with peripheral artery disease (PAD) reports leg pain that occurs with walking and
is relieved by rest. The nurse documents this finding as:
A. Rest pain
B. Claudication
, 4
C. Venous insufficiency
D. Neuropathic pain
- detailed 100% correctanswer :- B
Rationale: Intermittent claudication is the hallmark symptom of PAD, characterized by muscle
pain or cramping in the lower extremities that occurs with exercise and is relieved by rest. This
results from inadequate blood flow to meet metabolic demands during activity.
8. Which dietary modification should the nurse recommend for a patient with hypertension?
A. Increased sodium intake
B. DASH diet emphasizing fruits, vegetables, and low-fat dairy
C. High-protein, low-carbohydrate diet
D. Increased caffeine consumption
- detailed 100% correctanswer :- B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits,
vegetables, whole grains, and low-fat dairy products while limiting sodium, saturated fat, and
added sugars. This dietary pattern has been shown to effectively lower blood pressure.
9. A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the
nurse most concerned about with this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
- detailed 100% correctanswer :- B
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the
loop of Henle, leading to increased excretion of potassium. Hypokalemia can precipitate cardiac
dysrhythmias, especially in patients on digoxin.
10. The nurse is assessing a patient with suspected infective endocarditis. Which assessment
finding is most consistent with this diagnosis?
