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MDC 2 EXAM 4 2026/2027 | MULTIDIMENSIONAL CARE
II – RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: NEUROLOGICAL DISORDERS (Questions 1-20)
Q1: A patient presents with sudden onset of right-sided weakness, facial droop, and difficulty speaking.
Which type of stroke is most likely?
A. Ischemic stroke
B. Hemorrhagic stroke
C. Transient ischemic attack (TIA)
D. Subarachnoid hemorrhage
Correct Answer: A
Rationale: Ischemic stroke is the most common type of stroke (approximately 87% of cases), caused by
occlusion of a cerebral artery. Sudden onset of unilateral weakness, facial droop, and aphasia is characteristic
of an ischemic stroke in the left middle cerebral artery territory. Hemorrhagic stroke (B) can present similarly
but is less common. TIA (C) symptoms resolve within 24 hours. Subarachnoid hemorrhage (D) typically
presents with a sudden severe headache. Key teaching point: Sudden unilateral weakness + facial droop +
aphasia = ischemic stroke until proven otherwise; time is brain.
Q2: The nurse is assessing a patient with increased intracranial pressure (ICP). Which finding is an early sign
of increased ICP?
A. Cushing's triad (hypertension, bradycardia, irregular respirations)
B. Decerebrate posturing
C. Decreased level of consciousness
D. Pupillary dilation
Correct Answer: C
Rationale: A decreased level of consciousness (LOC) is the most sensitive and earliest indicator of increased
ICP. Cushing's triad (A) is a late sign of herniation. Decerebrate posturing (B) is also a late sign. Pupillary
dilation (D) occurs with uncal herniation. Key teaching point: Decreased LOC is the earliest sign of increased
ICP; Cushing's triad (HTN, bradycardia, irregular respirations) is a late sign.
,2
Q3: A patient with a traumatic brain injury (TBI) has an intracranial pressure (ICP) monitor in place. Which
ICP reading requires immediate intervention?
A. 10 mmHg
B. 15 mmHg
C. 22 mmHg
D. 8 mmHg
Correct Answer: C
Rationale: Normal ICP is 5-15 mmHg. An ICP of 22 mmHg is elevated and requires immediate intervention
to prevent cerebral ischemia and herniation. Treatment may include elevating the head of the bed,
hyperventilation, osmotic diuretics (mannitol), or sedation. Options A (10 mmHg), B (15 mmHg), and D (8
mmHg) are within normal limits. Key teaching point: Normal ICP is 5-15 mmHg; ICP >20 mmHg requires
immediate intervention; monitor for signs of herniation.
Q4: A patient with Parkinson's disease exhibits a resting tremor, rigidity, and bradykinesia. These symptoms
are caused by:
A. Excess dopamine in the basal ganglia
B. Degeneration of dopaminergic neurons in the substantia nigra
C. Acetylcholine deficiency in the cerebral cortex
D. Demyelination of motor neurons
Correct Answer: B
Rationale: Parkinson's disease is caused by progressive degeneration of dopaminergic neurons in the
substantia nigra pars compacta, leading to decreased dopamine in the basal ganglia. This results in the classic
motor symptoms: resting tremor, rigidity, bradykinesia, and postural instability. Excess dopamine (A) would
cause hyperkinetic movements. Acetylcholine deficiency (C) is seen in Alzheimer's. Demyelination (D) is seen
in multiple sclerosis. Key teaching point: Parkinson's = dopamine deficiency in the substantia nigra;
treatment includes levodopa-carbidopa and dopamine agonists.
Q5: Which medication is used to increase dopamine levels in the brain for Parkinson's disease?
A. Donepezil
B. Levodopa-carbidopa
C. Rivastigmine
D. Memantine
Correct Answer: B
, 3
Rationale: Levodopa-carbidopa (Sinemet) is the most effective medication for Parkinson's disease. Levodopa
is a precursor to dopamine that crosses the blood-brain barrier, and carbidopa prevents its peripheral
breakdown. Donepezil (A) and rivastigmine (C) are used for Alzheimer's disease. Memantine (D) is also used
for Alzheimer's. Key teaching point: Levodopa-carbidopa is the mainstay of Parkinson's treatment; monitor
for dyskinesias and "on-off" phenomena.
Q6: A patient with relapsing-remitting multiple sclerosis (MS) experiences episodes of neurologic dysfunction
followed by periods of recovery. The pathophysiology of MS involves:
A. Autoimmune destruction of oligodendrocytes and demyelination
B. Degeneration of motor neurons in the spinal cord
C. Accumulation of beta-amyloid plaques
D. Ischemia of the cerebral cortex
Correct Answer: A
Rationale: Multiple sclerosis is an autoimmune disease characterized by inflammation, demyelination, and
axonal loss in the central nervous system. The immune system attacks myelin sheaths (produced by
oligodendrocytes), leading to slowed or blocked nerve conduction. Motor neuron degeneration (B) occurs in
ALS. Beta-amyloid (C) is seen in Alzheimer's. Ischemia (D) is seen in stroke. Key teaching point: MS =
autoimmune demyelination of CNS; relapsing-remitting is the most common type.
Q7: A patient with a seizure disorder is prescribed phenytoin. The nurse should monitor for which adverse
effect?
A. Gingival hyperplasia
B. Weight gain
C. Photosensitivity
D. Dry mouth
Correct Answer: A
Rationale: Phenytoin commonly causes gingival hyperplasia (overgrowth of gum tissue). Clients should be
instructed on good oral hygiene and regular dental visits. Weight gain (B) is associated with valproic acid.
Photosensitivity (C) is associated with tetracyclines. Dry mouth (D) is associated with anticholinergics. Key
teaching point: Phenytoin causes gingival hyperplasia; encourage meticulous oral hygiene and regular
dental visits.
Q8: Which type of seizure is characterized by a sudden loss of muscle tone, causing the patient to fall?
MDC 2 EXAM 4 2026/2027 | MULTIDIMENSIONAL CARE
II – RASMUSSEN COLLEGE | EXPERT VERIFIED | 60
QUESTIONS & COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
SECTION 1: NEUROLOGICAL DISORDERS (Questions 1-20)
Q1: A patient presents with sudden onset of right-sided weakness, facial droop, and difficulty speaking.
Which type of stroke is most likely?
A. Ischemic stroke
B. Hemorrhagic stroke
C. Transient ischemic attack (TIA)
D. Subarachnoid hemorrhage
Correct Answer: A
Rationale: Ischemic stroke is the most common type of stroke (approximately 87% of cases), caused by
occlusion of a cerebral artery. Sudden onset of unilateral weakness, facial droop, and aphasia is characteristic
of an ischemic stroke in the left middle cerebral artery territory. Hemorrhagic stroke (B) can present similarly
but is less common. TIA (C) symptoms resolve within 24 hours. Subarachnoid hemorrhage (D) typically
presents with a sudden severe headache. Key teaching point: Sudden unilateral weakness + facial droop +
aphasia = ischemic stroke until proven otherwise; time is brain.
Q2: The nurse is assessing a patient with increased intracranial pressure (ICP). Which finding is an early sign
of increased ICP?
A. Cushing's triad (hypertension, bradycardia, irregular respirations)
B. Decerebrate posturing
C. Decreased level of consciousness
D. Pupillary dilation
Correct Answer: C
Rationale: A decreased level of consciousness (LOC) is the most sensitive and earliest indicator of increased
ICP. Cushing's triad (A) is a late sign of herniation. Decerebrate posturing (B) is also a late sign. Pupillary
dilation (D) occurs with uncal herniation. Key teaching point: Decreased LOC is the earliest sign of increased
ICP; Cushing's triad (HTN, bradycardia, irregular respirations) is a late sign.
,2
Q3: A patient with a traumatic brain injury (TBI) has an intracranial pressure (ICP) monitor in place. Which
ICP reading requires immediate intervention?
A. 10 mmHg
B. 15 mmHg
C. 22 mmHg
D. 8 mmHg
Correct Answer: C
Rationale: Normal ICP is 5-15 mmHg. An ICP of 22 mmHg is elevated and requires immediate intervention
to prevent cerebral ischemia and herniation. Treatment may include elevating the head of the bed,
hyperventilation, osmotic diuretics (mannitol), or sedation. Options A (10 mmHg), B (15 mmHg), and D (8
mmHg) are within normal limits. Key teaching point: Normal ICP is 5-15 mmHg; ICP >20 mmHg requires
immediate intervention; monitor for signs of herniation.
Q4: A patient with Parkinson's disease exhibits a resting tremor, rigidity, and bradykinesia. These symptoms
are caused by:
A. Excess dopamine in the basal ganglia
B. Degeneration of dopaminergic neurons in the substantia nigra
C. Acetylcholine deficiency in the cerebral cortex
D. Demyelination of motor neurons
Correct Answer: B
Rationale: Parkinson's disease is caused by progressive degeneration of dopaminergic neurons in the
substantia nigra pars compacta, leading to decreased dopamine in the basal ganglia. This results in the classic
motor symptoms: resting tremor, rigidity, bradykinesia, and postural instability. Excess dopamine (A) would
cause hyperkinetic movements. Acetylcholine deficiency (C) is seen in Alzheimer's. Demyelination (D) is seen
in multiple sclerosis. Key teaching point: Parkinson's = dopamine deficiency in the substantia nigra;
treatment includes levodopa-carbidopa and dopamine agonists.
Q5: Which medication is used to increase dopamine levels in the brain for Parkinson's disease?
A. Donepezil
B. Levodopa-carbidopa
C. Rivastigmine
D. Memantine
Correct Answer: B
, 3
Rationale: Levodopa-carbidopa (Sinemet) is the most effective medication for Parkinson's disease. Levodopa
is a precursor to dopamine that crosses the blood-brain barrier, and carbidopa prevents its peripheral
breakdown. Donepezil (A) and rivastigmine (C) are used for Alzheimer's disease. Memantine (D) is also used
for Alzheimer's. Key teaching point: Levodopa-carbidopa is the mainstay of Parkinson's treatment; monitor
for dyskinesias and "on-off" phenomena.
Q6: A patient with relapsing-remitting multiple sclerosis (MS) experiences episodes of neurologic dysfunction
followed by periods of recovery. The pathophysiology of MS involves:
A. Autoimmune destruction of oligodendrocytes and demyelination
B. Degeneration of motor neurons in the spinal cord
C. Accumulation of beta-amyloid plaques
D. Ischemia of the cerebral cortex
Correct Answer: A
Rationale: Multiple sclerosis is an autoimmune disease characterized by inflammation, demyelination, and
axonal loss in the central nervous system. The immune system attacks myelin sheaths (produced by
oligodendrocytes), leading to slowed or blocked nerve conduction. Motor neuron degeneration (B) occurs in
ALS. Beta-amyloid (C) is seen in Alzheimer's. Ischemia (D) is seen in stroke. Key teaching point: MS =
autoimmune demyelination of CNS; relapsing-remitting is the most common type.
Q7: A patient with a seizure disorder is prescribed phenytoin. The nurse should monitor for which adverse
effect?
A. Gingival hyperplasia
B. Weight gain
C. Photosensitivity
D. Dry mouth
Correct Answer: A
Rationale: Phenytoin commonly causes gingival hyperplasia (overgrowth of gum tissue). Clients should be
instructed on good oral hygiene and regular dental visits. Weight gain (B) is associated with valproic acid.
Photosensitivity (C) is associated with tetracyclines. Dry mouth (D) is associated with anticholinergics. Key
teaching point: Phenytoin causes gingival hyperplasia; encourage meticulous oral hygiene and regular
dental visits.
Q8: Which type of seizure is characterized by a sudden loss of muscle tone, causing the patient to fall?
