1
MDC 2 EXAM 3 2026/2027 | MULTIDIMENSIONAL CARE II –
RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: GASTROINTESTINAL DISORDERS (Questions 1-15)
Q1: A patient with cirrhosis is admitted with ascites and peripheral edema. Which pathophysiologic
mechanism primarily contributes to fluid accumulation?
A. Increased albumin production
B. Decreased oncotic pressure due to low albumin
C. Increased renal perfusion
D. Elevated hematocrit levels
Correct Answer: B
Rationale: Cirrhosis causes decreased albumin production, leading to decreased oncotic (colloid osmotic)
pressure. This allows fluid to shift from the intravascular space to the interstitial space, causing ascites and
peripheral edema. Albumin production is decreased, not increased (A). Renal perfusion is decreased due to
portal hypertension and activation of the RAAS system (C). Hematocrit is not directly elevated (D). Key
teaching point: Cirrhosis causes ascites and edema due to decreased albumin (low oncotic pressure) and
portal hypertension.
Q2: A patient with hepatic encephalopathy is prescribed lactulose. The nurse understands that the purpose of
this medication is to:
A. Decrease serum ammonia levels
B. Increase serum ammonia levels
C. Treat constipation only
D. Reduce portal hypertension
Correct Answer: A
Rationale: Lactulose is a synthetic disaccharide that works by trapping ammonia in the colon and promoting
its excretion in the stool. It also acts as an osmotic laxative. It lowers serum ammonia levels, which improves
hepatic encephalopathy. It is not used to increase ammonia (B) or primarily for constipation (C), though it
does treat constipation. It does not reduce portal hypertension (D). Key teaching point: Lactulose lowers
serum ammonia levels in hepatic encephalopathy by trapping ammonia in the colon for excretion.
,2
Q3: A patient with acute pancreatitis has severe epigastric pain radiating to the back. Which laboratory
finding is most specific for acute pancreatitis?
A. Elevated serum amylase
B. Elevated serum lipase
C. Elevated serum bilirubin
D. Elevated serum glucose
Correct Answer: B
Rationale: Serum lipase is more specific for acute pancreatitis than amylase. Lipase remains elevated longer
than amylase and is produced exclusively by the pancreas. Amylase (A) can also be elevated in salivary gland
disorders and other conditions. Bilirubin (C) is elevated in biliary obstruction. Glucose (D) may be elevated
due to pancreatic damage but is not specific. Key teaching point: Lipase is the most specific laboratory
marker for acute pancreatitis; it rises within 4-8 hours and remains elevated for 7-14 days.
Q4: The nurse is caring for a patient with a nasogastric (NG) tube for gastric decompression. Which finding
indicates the NG tube is correctly placed?
A. The patient is able to speak clearly
B. Aspiration of gastric contents with a pH of 4
C. The tube is taped securely to the nose
D. The patient reports no discomfort
Correct Answer: B
Rationale: Correct NG tube placement is confirmed by aspiration of gastric contents with a pH < 5 (typically
1-4). A chest X-ray is the gold standard for confirmation. Ability to speak (A) does not confirm placement.
Secure taping (C) prevents dislodgement but does not confirm placement. No discomfort (D) is not a reliable
indicator. Key teaching point: NG tube placement is confirmed by aspirating gastric contents with pH <5;
chest X-ray is the gold standard.
Q5: A patient with Crohn's disease is experiencing frequent diarrhea and abdominal pain. Which dietary
modification should the nurse recommend?
A. High-fiber diet
B. Low-residue diet
C. High-fat diet
D. High-dairy diet
Correct Answer: B
, 3
Rationale: A low-residue diet reduces the amount of undigested fiber and residue in the intestines, which can
help decrease diarrhea and abdominal pain in Crohn's disease. High-fiber (A) and high-fat (C) diets can
exacerbate symptoms. High-dairy (D) may worsen symptoms if lactose intolerance is present. Key teaching
point: Low-residue diet is recommended during active Crohn's disease to reduce intestinal irritation and
diarrhea.
Q6: A patient with peptic ulcer disease (PUD) is prescribed omeprazole. Which statement indicates the
patient understands the medication?
A. "I should take this medication with food."
B. "I should take this medication 30-60 minutes before meals."
C. "I can take this medication as needed for pain."
D. "I should stop taking this medication when I feel better."
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor (PPI) that should be taken 30-60 minutes before meals for
optimal acid suppression. It is not taken with food (A). It is taken daily for maintenance, not PRN (C). It
should not be stopped abruptly (D); it should be taken as prescribed, and discontinuation should be done
under provider guidance. Key teaching point: PPIs (omeprazole) should be taken 30-60 minutes before
meals for optimal acid suppression; do not stop abruptly.
Q7: A patient with ulcerative colitis is at risk for which complication?
A. Fistula formation
B. Toxic megacolon
C. Stricture formation
D. Perianal abscess
Correct Answer: B
Rationale: Toxic megacolon is a life-threatening complication of ulcerative colitis (UC). It is characterized by
severe colonic dilation and systemic toxicity. Fistulas (A), strictures (C), and perianal abscesses (D) are more
common in Crohn's disease, not UC. Key teaching point: Toxic megacolon is a complication of ulcerative
colitis; fistulas and strictures are more common in Crohn's disease.
Q8: The nurse is caring for a patient with acute hepatitis B. Which finding indicates the patient is in the icteric
phase?
A. Dark urine and jaundice
B. Fatigue and malaise
MDC 2 EXAM 3 2026/2027 | MULTIDIMENSIONAL CARE II –
RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: GASTROINTESTINAL DISORDERS (Questions 1-15)
Q1: A patient with cirrhosis is admitted with ascites and peripheral edema. Which pathophysiologic
mechanism primarily contributes to fluid accumulation?
A. Increased albumin production
B. Decreased oncotic pressure due to low albumin
C. Increased renal perfusion
D. Elevated hematocrit levels
Correct Answer: B
Rationale: Cirrhosis causes decreased albumin production, leading to decreased oncotic (colloid osmotic)
pressure. This allows fluid to shift from the intravascular space to the interstitial space, causing ascites and
peripheral edema. Albumin production is decreased, not increased (A). Renal perfusion is decreased due to
portal hypertension and activation of the RAAS system (C). Hematocrit is not directly elevated (D). Key
teaching point: Cirrhosis causes ascites and edema due to decreased albumin (low oncotic pressure) and
portal hypertension.
Q2: A patient with hepatic encephalopathy is prescribed lactulose. The nurse understands that the purpose of
this medication is to:
A. Decrease serum ammonia levels
B. Increase serum ammonia levels
C. Treat constipation only
D. Reduce portal hypertension
Correct Answer: A
Rationale: Lactulose is a synthetic disaccharide that works by trapping ammonia in the colon and promoting
its excretion in the stool. It also acts as an osmotic laxative. It lowers serum ammonia levels, which improves
hepatic encephalopathy. It is not used to increase ammonia (B) or primarily for constipation (C), though it
does treat constipation. It does not reduce portal hypertension (D). Key teaching point: Lactulose lowers
serum ammonia levels in hepatic encephalopathy by trapping ammonia in the colon for excretion.
,2
Q3: A patient with acute pancreatitis has severe epigastric pain radiating to the back. Which laboratory
finding is most specific for acute pancreatitis?
A. Elevated serum amylase
B. Elevated serum lipase
C. Elevated serum bilirubin
D. Elevated serum glucose
Correct Answer: B
Rationale: Serum lipase is more specific for acute pancreatitis than amylase. Lipase remains elevated longer
than amylase and is produced exclusively by the pancreas. Amylase (A) can also be elevated in salivary gland
disorders and other conditions. Bilirubin (C) is elevated in biliary obstruction. Glucose (D) may be elevated
due to pancreatic damage but is not specific. Key teaching point: Lipase is the most specific laboratory
marker for acute pancreatitis; it rises within 4-8 hours and remains elevated for 7-14 days.
Q4: The nurse is caring for a patient with a nasogastric (NG) tube for gastric decompression. Which finding
indicates the NG tube is correctly placed?
A. The patient is able to speak clearly
B. Aspiration of gastric contents with a pH of 4
C. The tube is taped securely to the nose
D. The patient reports no discomfort
Correct Answer: B
Rationale: Correct NG tube placement is confirmed by aspiration of gastric contents with a pH < 5 (typically
1-4). A chest X-ray is the gold standard for confirmation. Ability to speak (A) does not confirm placement.
Secure taping (C) prevents dislodgement but does not confirm placement. No discomfort (D) is not a reliable
indicator. Key teaching point: NG tube placement is confirmed by aspirating gastric contents with pH <5;
chest X-ray is the gold standard.
Q5: A patient with Crohn's disease is experiencing frequent diarrhea and abdominal pain. Which dietary
modification should the nurse recommend?
A. High-fiber diet
B. Low-residue diet
C. High-fat diet
D. High-dairy diet
Correct Answer: B
, 3
Rationale: A low-residue diet reduces the amount of undigested fiber and residue in the intestines, which can
help decrease diarrhea and abdominal pain in Crohn's disease. High-fiber (A) and high-fat (C) diets can
exacerbate symptoms. High-dairy (D) may worsen symptoms if lactose intolerance is present. Key teaching
point: Low-residue diet is recommended during active Crohn's disease to reduce intestinal irritation and
diarrhea.
Q6: A patient with peptic ulcer disease (PUD) is prescribed omeprazole. Which statement indicates the
patient understands the medication?
A. "I should take this medication with food."
B. "I should take this medication 30-60 minutes before meals."
C. "I can take this medication as needed for pain."
D. "I should stop taking this medication when I feel better."
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor (PPI) that should be taken 30-60 minutes before meals for
optimal acid suppression. It is not taken with food (A). It is taken daily for maintenance, not PRN (C). It
should not be stopped abruptly (D); it should be taken as prescribed, and discontinuation should be done
under provider guidance. Key teaching point: PPIs (omeprazole) should be taken 30-60 minutes before
meals for optimal acid suppression; do not stop abruptly.
Q7: A patient with ulcerative colitis is at risk for which complication?
A. Fistula formation
B. Toxic megacolon
C. Stricture formation
D. Perianal abscess
Correct Answer: B
Rationale: Toxic megacolon is a life-threatening complication of ulcerative colitis (UC). It is characterized by
severe colonic dilation and systemic toxicity. Fistulas (A), strictures (C), and perianal abscesses (D) are more
common in Crohn's disease, not UC. Key teaching point: Toxic megacolon is a complication of ulcerative
colitis; fistulas and strictures are more common in Crohn's disease.
Q8: The nurse is caring for a patient with acute hepatitis B. Which finding indicates the patient is in the icteric
phase?
A. Dark urine and jaundice
B. Fatigue and malaise
