1
MDC 2 EXAM 1 2026/2027 | MULTIDIMENSIONAL CARE
II – RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: FLUID & ELECTROLYTE IMBALANCES (Questions 1-15)
Q1: The nurse is caring for a client in the oliguric phase of acute kidney injury (AKI). The nurse should
monitor the client for which of the following complications?
A. Hypokalemia and hyponatremia
B. Hyperkalemia and fluid volume overload
C. Hypovolemia and hypercalcemia
D. Anemia and hypophosphatemia
Correct Answer: B
Rationale: During the oliguric phase, urine output is severely decreased (<400 mL/day). This leads to fluid
retention (hypervolemia, hypertension, edema) and the accumulation of waste products, leading to
hyperkalemia, hyperphosphatemia, and metabolic acidosis. Options A, C, and D are incorrect because the
oliguric phase causes potassium retention (hyperkalemia), not loss (hypokalemia), and fluid volume overload,
not hypovolemia . Key teaching point: Oliguria in AKI causes fluid retention and hyperkalemia; monitor for
signs of fluid overload and cardiac arrhythmias.
Q2: A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: B
Rationale: SIADH causes excessive ADH release, leading to water retention and dilutional hyponatremia. The
client has hypervolemia with low serum sodium. Diabetes insipidus causes hypernatremia. This is a key
distinguishing feature between the two disorders . Key teaching point: SIADH causes water retention and
dilutional hyponatremia; fluid restriction is the primary intervention.
,2
Q3: The nurse reviews the laboratory results of a patient receiving furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that blocks sodium and potassium reabsorption in the loop of Henle,
causing potassium wasting. Hypokalemia is a common adverse effect. Options A, C, and D are incorrect
because loop diuretics cause potassium loss, not retention . Key teaching point: Loop diuretics cause
hypokalemia; monitor serum potassium and assess for signs of hypokalemia (muscle weakness, cardiac
arrhythmias).
Q4: Which assessment finding is most consistent with dehydration in an older adult patient?
A. Blood pressure of 160/90 mmHg
B. Decreased skin turgor on the forehead or sternum
C. Urine output of 50 mL/hr
D. Bradycardia
Correct Answer: B
Rationale: Decreased skin turgor on the forehead or sternum is a key sign of dehydration in older adults. Skin
elasticity decreases with age, making skin turgor assessment more reliable on the forehead or sternum rather
than the back of the hand. Urine output of 50 mL/hr is normal. Hypotension and tachycardia (not
hypertension and bradycardia) are more consistent with dehydration . Key teaching point: Assess skin turgor
on the forehead or sternum in older adults for accurate dehydration assessment.
Q5: A patient has an arterial blood gas (ABG) result of pH 7.30, PaCO₂ 52 mmHg, and HCO₃⁻ 26 mEq/L.
Which acid-base imbalance does this represent?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: A
Rationale: pH 7.30 is below normal (acidosis). PaCO₂ 52 mmHg is elevated (respiratory cause). HCO₃⁻ 26
mEq/L is normal, indicating no renal compensation. This is acute respiratory acidosis. Hypoventilation causes
, 3
CO₂ retention. Renal compensation would take 24-48 hours . Key teaching point: Respiratory acidosis = low
pH + high PaCO₂; causes include hypoventilation, COPD, and respiratory depression.
Q6: A patient is hyperventilating due to anxiety. Which ABG result does the nurse anticipate?
A. pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 52 mmHg, HCO₃⁻ 26 mEq/L
C. pH 7.25, PaCO₂ 38 mmHg, HCO₃⁻ 16 mEq/L
D. pH 7.52, PaCO₂ 44 mmHg, HCO₃⁻ 34 mEq/L
Correct Answer: A
Rationale: Hyperventilation causes excessive CO₂ elimination, leading to respiratory alkalosis. pH 7.48
indicates alkalosis; PaCO₂ 30 mmHg is low; HCO₃⁻ is normal (no renal compensation yet). Option B is
respiratory acidosis; C is metabolic acidosis; D is metabolic alkalosis . Key teaching point: Hyperventilation
→ respiratory alkalosis (high pH, low PaCO₂).
Q7: A patient with diabetic ketoacidosis has an ABG result of pH 7.22, PaCO₂ 32 mmHg, HCO₃⁻ 14 mEq/L.
What is the primary acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: C
Rationale: DKA causes accumulation of ketone bodies, leading to metabolic acidosis. pH 7.22 is low; HCO₃⁻
14 mEq/L is low (metabolic cause). The low PaCO₂ 32 mmHg indicates respiratory compensation (Kussmaul
respirations). Option A would have high PaCO₂; B would have low PaCO₂ with normal HCO₃⁻; D would
have high HCO₃⁻ . Key teaching point: DKA causes metabolic acidosis with respiratory compensation
(Kussmaul respirations).
Q8: A patient has prolonged vomiting and presents with pH 7.50, PaCO₂ 46 mmHg, HCO₃⁻ 34 mEq/L.
Which acid-base imbalance is present?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
MDC 2 EXAM 1 2026/2027 | MULTIDIMENSIONAL CARE
II – RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: FLUID & ELECTROLYTE IMBALANCES (Questions 1-15)
Q1: The nurse is caring for a client in the oliguric phase of acute kidney injury (AKI). The nurse should
monitor the client for which of the following complications?
A. Hypokalemia and hyponatremia
B. Hyperkalemia and fluid volume overload
C. Hypovolemia and hypercalcemia
D. Anemia and hypophosphatemia
Correct Answer: B
Rationale: During the oliguric phase, urine output is severely decreased (<400 mL/day). This leads to fluid
retention (hypervolemia, hypertension, edema) and the accumulation of waste products, leading to
hyperkalemia, hyperphosphatemia, and metabolic acidosis. Options A, C, and D are incorrect because the
oliguric phase causes potassium retention (hyperkalemia), not loss (hypokalemia), and fluid volume overload,
not hypovolemia . Key teaching point: Oliguria in AKI causes fluid retention and hyperkalemia; monitor for
signs of fluid overload and cardiac arrhythmias.
Q2: A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: B
Rationale: SIADH causes excessive ADH release, leading to water retention and dilutional hyponatremia. The
client has hypervolemia with low serum sodium. Diabetes insipidus causes hypernatremia. This is a key
distinguishing feature between the two disorders . Key teaching point: SIADH causes water retention and
dilutional hyponatremia; fluid restriction is the primary intervention.
,2
Q3: The nurse reviews the laboratory results of a patient receiving furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that blocks sodium and potassium reabsorption in the loop of Henle,
causing potassium wasting. Hypokalemia is a common adverse effect. Options A, C, and D are incorrect
because loop diuretics cause potassium loss, not retention . Key teaching point: Loop diuretics cause
hypokalemia; monitor serum potassium and assess for signs of hypokalemia (muscle weakness, cardiac
arrhythmias).
Q4: Which assessment finding is most consistent with dehydration in an older adult patient?
A. Blood pressure of 160/90 mmHg
B. Decreased skin turgor on the forehead or sternum
C. Urine output of 50 mL/hr
D. Bradycardia
Correct Answer: B
Rationale: Decreased skin turgor on the forehead or sternum is a key sign of dehydration in older adults. Skin
elasticity decreases with age, making skin turgor assessment more reliable on the forehead or sternum rather
than the back of the hand. Urine output of 50 mL/hr is normal. Hypotension and tachycardia (not
hypertension and bradycardia) are more consistent with dehydration . Key teaching point: Assess skin turgor
on the forehead or sternum in older adults for accurate dehydration assessment.
Q5: A patient has an arterial blood gas (ABG) result of pH 7.30, PaCO₂ 52 mmHg, and HCO₃⁻ 26 mEq/L.
Which acid-base imbalance does this represent?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: A
Rationale: pH 7.30 is below normal (acidosis). PaCO₂ 52 mmHg is elevated (respiratory cause). HCO₃⁻ 26
mEq/L is normal, indicating no renal compensation. This is acute respiratory acidosis. Hypoventilation causes
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CO₂ retention. Renal compensation would take 24-48 hours . Key teaching point: Respiratory acidosis = low
pH + high PaCO₂; causes include hypoventilation, COPD, and respiratory depression.
Q6: A patient is hyperventilating due to anxiety. Which ABG result does the nurse anticipate?
A. pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 52 mmHg, HCO₃⁻ 26 mEq/L
C. pH 7.25, PaCO₂ 38 mmHg, HCO₃⁻ 16 mEq/L
D. pH 7.52, PaCO₂ 44 mmHg, HCO₃⁻ 34 mEq/L
Correct Answer: A
Rationale: Hyperventilation causes excessive CO₂ elimination, leading to respiratory alkalosis. pH 7.48
indicates alkalosis; PaCO₂ 30 mmHg is low; HCO₃⁻ is normal (no renal compensation yet). Option B is
respiratory acidosis; C is metabolic acidosis; D is metabolic alkalosis . Key teaching point: Hyperventilation
→ respiratory alkalosis (high pH, low PaCO₂).
Q7: A patient with diabetic ketoacidosis has an ABG result of pH 7.22, PaCO₂ 32 mmHg, HCO₃⁻ 14 mEq/L.
What is the primary acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: C
Rationale: DKA causes accumulation of ketone bodies, leading to metabolic acidosis. pH 7.22 is low; HCO₃⁻
14 mEq/L is low (metabolic cause). The low PaCO₂ 32 mmHg indicates respiratory compensation (Kussmaul
respirations). Option A would have high PaCO₂; B would have low PaCO₂ with normal HCO₃⁻; D would
have high HCO₃⁻ . Key teaching point: DKA causes metabolic acidosis with respiratory compensation
(Kussmaul respirations).
Q8: A patient has prolonged vomiting and presents with pH 7.50, PaCO₂ 46 mmHg, HCO₃⁻ 34 mEq/L.
Which acid-base imbalance is present?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
