NUR 2755 MULTIDIMENSIONAL CARE IV (MDC 4) FINAL EXAM Complete Practice Test Bank –
300 Questions with Verified Answers & Detailed Rationales | All Core Domains Covered | A+
Graded
Exam Overview
NUR 2755 Multidimensional Care IV (MDC 4) is the fourth course in Rasmussen University's
Multidimensional Care series, focusing on advanced clinical judgment, prioritization of care,
complex patient assessment, medication management, and nursing interventions across the
healthcare continuum. This final exam covers high-acuity, complex, and multisystem patient
conditions across eight core domains.
Core Domains Covered:
- Critical Care & Hemodynamic Monitoring – Shock states, hemodynamic parameters (CVP,
PAWP, CO, SVR), vasoactive medications, ABG interpretation
- Complex Respiratory & Cardiac Conditions – Respiratory failure, ARDS, mechanical ventilation,
acute coronary syndromes, heart failure
- Neurological Emergencies & Renal Crises – Stroke, seizures, increased ICP, spinal cord injuries,
acute kidney injury, dialysis
- Endocrine & Metabolic Crises – DKA, HHS, thyroid storm, adrenal crisis, SIADH, diabetes
insipidus
- Leadership, Delegation & Management – Prioritization, delegation, interdisciplinary care,
patient safety
- Emergency & Disaster Nursing – Triage, emergency response, environmental emergencies
- End-of-Life & Palliative Care – Hospice, symptom management, advance directives
- Ethics, Legal Issues & Quality Improvement – Informed consent, ethical principles, quality
improvement
---
,SECTION 1: CRITICAL CARE & HEMODYNAMIC MONITORING
Questions 1–45
---
Question 1
A patient in the intensive care unit has a pulmonary artery catheter (Swan-Ganz) in place. Which
hemodynamic value reflects left ventricular preload?
A. Central venous pressure (CVP)
B. Pulmonary artery wedge pressure (PAWP)
C. Cardiac output (CO)
D. Systemic vascular resistance (SVR)
---
Answer: B – Pulmonary artery wedge pressure (PAWP)
Rationale: PAWP (also called pulmonary artery occlusion pressure, PAOP) reflects left atrial
pressure and left ventricular end-diastolic volume (preload). CVP reflects right heart preload. CO
measures cardiac function, and SVR reflects afterload.
---
Question 2
,A patient with septic shock has a central venous pressure (CVP) of 4 mmHg. Which of the
following interventions is the priority?
A. Administer norepinephrine
B. Administer a fluid bolus
C. Start broad-spectrum antibiotics
D. Obtain a stat lactate level
---
Answer: B – Administer a fluid bolus
Rationale: In septic shock, the Surviving Sepsis Campaign recommends early fluid resuscitation
for patients with hypotension or elevated lactate. A low CVP (< 8 mmHg) suggests hypovolemia
and indicates the need for fluid resuscitation before starting vasopressors.
---
Question 3
A nurse is caring for a patient in the compensatory stage of shock. Which of the following
findings would the nurse expect?
A. Hypotension and bradycardia
B. Cool, clammy skin and decreased urine output
C. Tachycardia and narrowing pulse pressure
D. Unresponsiveness and absent peripheral pulses
, ---
Answer: C – Tachycardia and narrowing pulse pressure
Rationale: In the compensatory stage, the body attempts to maintain perfusion through
sympathetic nervous system activation. Findings include tachycardia, peripheral
vasoconstriction (cool skin), narrowing pulse pressure, and mild anxiety. Hypotension is a late
(progressive stage) finding.
---
Question 4
A patient is receiving norepinephrine for septic shock. Which assessment finding indicates the
medication is effective?
A. Heart rate increases from 100 to 120 beats/min
B. Blood pressure increases from 82/50 to 110/68 mmHg
C. Urine output decreases from 40 to 20 mL/hr
D. Skin becomes cool and clammy
---
Answer: B – Blood pressure increases from 82/50 to 110/68 mmHg
Rationale: Norepinephrine is a potent vasopressor used in septic shock to increase systemic
vascular resistance and blood pressure. An improvement in mean arterial pressure (MAP) to ≥65
mmHg indicates effective therapy.
300 Questions with Verified Answers & Detailed Rationales | All Core Domains Covered | A+
Graded
Exam Overview
NUR 2755 Multidimensional Care IV (MDC 4) is the fourth course in Rasmussen University's
Multidimensional Care series, focusing on advanced clinical judgment, prioritization of care,
complex patient assessment, medication management, and nursing interventions across the
healthcare continuum. This final exam covers high-acuity, complex, and multisystem patient
conditions across eight core domains.
Core Domains Covered:
- Critical Care & Hemodynamic Monitoring – Shock states, hemodynamic parameters (CVP,
PAWP, CO, SVR), vasoactive medications, ABG interpretation
- Complex Respiratory & Cardiac Conditions – Respiratory failure, ARDS, mechanical ventilation,
acute coronary syndromes, heart failure
- Neurological Emergencies & Renal Crises – Stroke, seizures, increased ICP, spinal cord injuries,
acute kidney injury, dialysis
- Endocrine & Metabolic Crises – DKA, HHS, thyroid storm, adrenal crisis, SIADH, diabetes
insipidus
- Leadership, Delegation & Management – Prioritization, delegation, interdisciplinary care,
patient safety
- Emergency & Disaster Nursing – Triage, emergency response, environmental emergencies
- End-of-Life & Palliative Care – Hospice, symptom management, advance directives
- Ethics, Legal Issues & Quality Improvement – Informed consent, ethical principles, quality
improvement
---
,SECTION 1: CRITICAL CARE & HEMODYNAMIC MONITORING
Questions 1–45
---
Question 1
A patient in the intensive care unit has a pulmonary artery catheter (Swan-Ganz) in place. Which
hemodynamic value reflects left ventricular preload?
A. Central venous pressure (CVP)
B. Pulmonary artery wedge pressure (PAWP)
C. Cardiac output (CO)
D. Systemic vascular resistance (SVR)
---
Answer: B – Pulmonary artery wedge pressure (PAWP)
Rationale: PAWP (also called pulmonary artery occlusion pressure, PAOP) reflects left atrial
pressure and left ventricular end-diastolic volume (preload). CVP reflects right heart preload. CO
measures cardiac function, and SVR reflects afterload.
---
Question 2
,A patient with septic shock has a central venous pressure (CVP) of 4 mmHg. Which of the
following interventions is the priority?
A. Administer norepinephrine
B. Administer a fluid bolus
C. Start broad-spectrum antibiotics
D. Obtain a stat lactate level
---
Answer: B – Administer a fluid bolus
Rationale: In septic shock, the Surviving Sepsis Campaign recommends early fluid resuscitation
for patients with hypotension or elevated lactate. A low CVP (< 8 mmHg) suggests hypovolemia
and indicates the need for fluid resuscitation before starting vasopressors.
---
Question 3
A nurse is caring for a patient in the compensatory stage of shock. Which of the following
findings would the nurse expect?
A. Hypotension and bradycardia
B. Cool, clammy skin and decreased urine output
C. Tachycardia and narrowing pulse pressure
D. Unresponsiveness and absent peripheral pulses
, ---
Answer: C – Tachycardia and narrowing pulse pressure
Rationale: In the compensatory stage, the body attempts to maintain perfusion through
sympathetic nervous system activation. Findings include tachycardia, peripheral
vasoconstriction (cool skin), narrowing pulse pressure, and mild anxiety. Hypotension is a late
(progressive stage) finding.
---
Question 4
A patient is receiving norepinephrine for septic shock. Which assessment finding indicates the
medication is effective?
A. Heart rate increases from 100 to 120 beats/min
B. Blood pressure increases from 82/50 to 110/68 mmHg
C. Urine output decreases from 40 to 20 mL/hr
D. Skin becomes cool and clammy
---
Answer: B – Blood pressure increases from 82/50 to 110/68 mmHg
Rationale: Norepinephrine is a potent vasopressor used in septic shock to increase systemic
vascular resistance and blood pressure. An improvement in mean arterial pressure (MAP) to ≥65
mmHg indicates effective therapy.
