1
MDC 2 EXAM 2 2026/2027 | MULTIDIMENSIONAL CARE II –
RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-15)
Q1: A patient with heart failure is prescribed furosemide (Lasix) and digoxin. Which laboratory value should
the nurse monitor closely to prevent digoxin toxicity?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia increases the risk of
digoxin toxicity because digoxin competes with potassium for binding sites on the Na⁺-K⁺ ATPase pump. The
nurse should monitor serum potassium levels closely and report levels below 3.5 mEq/L. Sodium (A) is not
directly related to digoxin toxicity. Calcium (C) and magnesium (D) are less directly related, though
hypomagnesemia can also increase digoxin toxicity risk. Key teaching point: Monitor potassium levels in
patients taking digoxin and diuretics; hypokalemia increases digoxin toxicity risk.
Q2: A patient with chronic heart failure has an ejection fraction of 25%. The nurse understands that this
indicates:
A. Normal cardiac function
B. Mildly reduced cardiac function
C. Moderately reduced cardiac function
D. Severely reduced cardiac function
Correct Answer: D
Rationale: Ejection fraction (EF) is the percentage of blood pumped out of the left ventricle with each
contraction. Normal EF is 55-70%. An EF of 25% indicates severely reduced cardiac function (heart failure
with reduced ejection fraction, HFrEF). This patient is at high risk for complications and requires aggressive
management. Options A, B, and C are incorrect because an EF of 25% is severely reduced. Key teaching point:
,2
Ejection fraction <40% indicates heart failure with reduced ejection fraction (HFrEF); EF <30% is severe
impairment.
Q3: A patient with coronary artery disease is prescribed sublingual nitroglycerin for angina. The nurse
instructs the patient to:
A. Swallow the tablet with water
B. Place the tablet under the tongue and allow it to dissolve
C. Chew the tablet for faster relief
D. Place the tablet between the cheek and gum
Correct Answer: B
Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to dissolve for rapid
absorption through the sublingual mucosa. Swallowing (A) reduces absorption because the drug undergoes
first-pass metabolism in the liver. Chewing (C) and buccal placement (D) are not the recommended routes for
sublingual nitroglycerin. Key teaching point: Sublingual nitroglycerin is placed under the tongue and
allowed to dissolve; it should not be swallowed or chewed.
Q4: A patient is 4 hours post-myocardial infarction. The nurse should assess for which complication during
this time?
A. Cardiac tamponade
B. Dysrhythmias
C. Ventricular aneurysm
D. Pericarditis
Correct Answer: B
Rationale: Dysrhythmias are the most common complication in the first 24 hours after an MI, especially
ventricular tachycardia and ventricular fibrillation. The risk is highest within the first 4 hours. Cardiac
tamponade (A) occurs later. Ventricular aneurysm (C) develops weeks to months later. Pericarditis (D)
occurs 2-3 days post-MI. Key teaching point: Dysrhythmias are the most common complication in the first
24 hours post-MI; continuous ECG monitoring is essential.
Q5: A patient presents with chest pain radiating to the left arm, diaphoresis, and nausea. Which cardiac
enzyme is most specific for myocardial infarction?
A. Creatine kinase-MB (CK-MB)
B. Myoglobin
, 3
C. Troponin I
D. Aspartate aminotransferase (AST)
Correct Answer: C
Rationale: Troponin I and T are the most specific and sensitive markers for myocardial infarction. They rise
within 3-4 hours and remain elevated for 7-10 days. CK-MB (A) is also elevated but less specific. Myoglobin
(B) rises early but is not cardiac-specific. AST (D) is less specific and is also elevated in liver disease. Key
teaching point: Troponin is the most specific cardiac biomarker for MI; it remains elevated for 7-10 days.
Q6: A patient with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A. aPTT
B. Platelet count
C. PT/INR
D. Hemoglobin
Correct Answer: C
Rationale: Warfarin is monitored using the PT (Prothrombin Time) and INR (International Normalized
Ratio). The therapeutic INR for atrial fibrillation is typically 2.0-3.0. aPTT (A) is used to monitor heparin
therapy. Platelet count (B) is monitored for heparin-induced thrombocytopenia. Hemoglobin (D) is
monitored for bleeding. Key teaching point: Warfarin is monitored with PT/INR (target 2.0-3.0 for atrial
fibrillation); aPTT is for heparin monitoring.
Q7: The nurse is assessing a patient with left-sided heart failure. Which finding is most consistent with this
condition?
A. Peripheral edema
B. Jugular venous distention
C. Dyspnea and crackles in the lungs
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, leading to dyspnea, orthopnea, and crackles
(rales) in the lungs. Peripheral edema (A), jugular venous distention (B), and hepatomegaly (D) are signs of
right-sided heart failure. Left-sided failure leads to backward flow into the lungs, not the systemic
circulation. Key teaching point: Left-sided heart failure → pulmonary congestion (dyspnea, crackles,
orthopnea); right-sided failure → systemic congestion (edema, JVD, hepatomegaly).
MDC 2 EXAM 2 2026/2027 | MULTIDIMENSIONAL CARE II –
RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-15)
Q1: A patient with heart failure is prescribed furosemide (Lasix) and digoxin. Which laboratory value should
the nurse monitor closely to prevent digoxin toxicity?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia increases the risk of
digoxin toxicity because digoxin competes with potassium for binding sites on the Na⁺-K⁺ ATPase pump. The
nurse should monitor serum potassium levels closely and report levels below 3.5 mEq/L. Sodium (A) is not
directly related to digoxin toxicity. Calcium (C) and magnesium (D) are less directly related, though
hypomagnesemia can also increase digoxin toxicity risk. Key teaching point: Monitor potassium levels in
patients taking digoxin and diuretics; hypokalemia increases digoxin toxicity risk.
Q2: A patient with chronic heart failure has an ejection fraction of 25%. The nurse understands that this
indicates:
A. Normal cardiac function
B. Mildly reduced cardiac function
C. Moderately reduced cardiac function
D. Severely reduced cardiac function
Correct Answer: D
Rationale: Ejection fraction (EF) is the percentage of blood pumped out of the left ventricle with each
contraction. Normal EF is 55-70%. An EF of 25% indicates severely reduced cardiac function (heart failure
with reduced ejection fraction, HFrEF). This patient is at high risk for complications and requires aggressive
management. Options A, B, and C are incorrect because an EF of 25% is severely reduced. Key teaching point:
,2
Ejection fraction <40% indicates heart failure with reduced ejection fraction (HFrEF); EF <30% is severe
impairment.
Q3: A patient with coronary artery disease is prescribed sublingual nitroglycerin for angina. The nurse
instructs the patient to:
A. Swallow the tablet with water
B. Place the tablet under the tongue and allow it to dissolve
C. Chew the tablet for faster relief
D. Place the tablet between the cheek and gum
Correct Answer: B
Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to dissolve for rapid
absorption through the sublingual mucosa. Swallowing (A) reduces absorption because the drug undergoes
first-pass metabolism in the liver. Chewing (C) and buccal placement (D) are not the recommended routes for
sublingual nitroglycerin. Key teaching point: Sublingual nitroglycerin is placed under the tongue and
allowed to dissolve; it should not be swallowed or chewed.
Q4: A patient is 4 hours post-myocardial infarction. The nurse should assess for which complication during
this time?
A. Cardiac tamponade
B. Dysrhythmias
C. Ventricular aneurysm
D. Pericarditis
Correct Answer: B
Rationale: Dysrhythmias are the most common complication in the first 24 hours after an MI, especially
ventricular tachycardia and ventricular fibrillation. The risk is highest within the first 4 hours. Cardiac
tamponade (A) occurs later. Ventricular aneurysm (C) develops weeks to months later. Pericarditis (D)
occurs 2-3 days post-MI. Key teaching point: Dysrhythmias are the most common complication in the first
24 hours post-MI; continuous ECG monitoring is essential.
Q5: A patient presents with chest pain radiating to the left arm, diaphoresis, and nausea. Which cardiac
enzyme is most specific for myocardial infarction?
A. Creatine kinase-MB (CK-MB)
B. Myoglobin
, 3
C. Troponin I
D. Aspartate aminotransferase (AST)
Correct Answer: C
Rationale: Troponin I and T are the most specific and sensitive markers for myocardial infarction. They rise
within 3-4 hours and remain elevated for 7-10 days. CK-MB (A) is also elevated but less specific. Myoglobin
(B) rises early but is not cardiac-specific. AST (D) is less specific and is also elevated in liver disease. Key
teaching point: Troponin is the most specific cardiac biomarker for MI; it remains elevated for 7-10 days.
Q6: A patient with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A. aPTT
B. Platelet count
C. PT/INR
D. Hemoglobin
Correct Answer: C
Rationale: Warfarin is monitored using the PT (Prothrombin Time) and INR (International Normalized
Ratio). The therapeutic INR for atrial fibrillation is typically 2.0-3.0. aPTT (A) is used to monitor heparin
therapy. Platelet count (B) is monitored for heparin-induced thrombocytopenia. Hemoglobin (D) is
monitored for bleeding. Key teaching point: Warfarin is monitored with PT/INR (target 2.0-3.0 for atrial
fibrillation); aPTT is for heparin monitoring.
Q7: The nurse is assessing a patient with left-sided heart failure. Which finding is most consistent with this
condition?
A. Peripheral edema
B. Jugular venous distention
C. Dyspnea and crackles in the lungs
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, leading to dyspnea, orthopnea, and crackles
(rales) in the lungs. Peripheral edema (A), jugular venous distention (B), and hepatomegaly (D) are signs of
right-sided heart failure. Left-sided failure leads to backward flow into the lungs, not the systemic
circulation. Key teaching point: Left-sided heart failure → pulmonary congestion (dyspnea, crackles,
orthopnea); right-sided failure → systemic congestion (edema, JVD, hepatomegaly).
