MDC III EXAM 1 (RASMUSSEN) NEWEST 2026/2027
ACTUAL EXAM | MDC 3 EXAM 1 REVIEW WITH REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
Section 1: Renal and Urinary Disorders (Questions 1-40)
1. A 70-year-old woman with chronic kidney disease and a history
of type 2 diabetes had surgery two weeks ago to place a vascular
graft access for hemodialysis. Which precaution will the nurse
follow to ensure the function of the AV graft?
A. Insert the IV and run saline at 10 mL/hr
B. Keep the patient's arm elevated on two pillows
C. Monitor blood pressure and radial pulses in both arms
D. Check for a bruit and thrill by auscultation and palpation over the site
Answer: D
Rationale: To ensure patency and function of an AV graft, the nurse must auscultate for
a bruit and palpate for a thrill over the access site daily. A bruit (whooshing sound) and
thrill (vibration) indicate blood flow through the graft. The absence of these findings
suggests occlusion or thrombosis requiring immediate intervention. Options A, B, and C
are incorrect interventions that do not directly assess graft function .
2. A nurse is caring for a client recently diagnosed with acute
kidney injury. Which of the following is a possible cause of acute
kidney injury due to perfusion issues?
,A. Glomerulonephritis
B. Dehydration
C. Nephrotoxic medications
D. Urinary obstruction
Answer: B
Rationale: Dehydration leads to prerenal azotemia, a form of acute kidney injury caused
by decreased renal perfusion. Other prerenal causes include hypovolemia, hypotension,
and heart failure. Glomerulonephritis causes intrinsic kidney injury, nephrotoxic
medications cause intrinsic damage, and urinary obstruction causes postrenal AKI .
3. A patient has a GFR of 25 mL/min and a potassium level of 6.2
mEq/L. What is occurring physiologically?
A. The kidneys are retaining potassium due to increased filtration
B. The kidneys are failing to excrete potassium due to decreased filtration
C. The kidneys are reabsorbing potassium excessively
D. The kidneys are producing excess aldosterone
Answer: B
Rationale: A GFR of 25 mL/min indicates significant renal impairment. With decreased
glomerular filtration, the kidneys cannot adequately excrete potassium, leading to
hyperkalemia. A potassium level of 6.2 mEq/L is dangerously elevated and can cause
life-threatening cardiac dysrhythmias .
4. A patient with an indwelling urinary catheter develops fever
and chills. What is the nurse's priority action?
A. Irrigate the catheter with sterile saline
B. Notify the provider immediately
C. Increase the patient's fluid intake
D. Obtain a urine culture and sensitivity
Answer: B
Rationale: Fever and chills in a patient with an indwelling catheter suggest a catheter-
associated urinary tract infection (CAUTI) that may have progressed to urosepsis. The
,nurse must notify the provider immediately for prompt antibiotic therapy. While a urine
culture is important, the provider must be notified first .
5. Which dietary restriction is most important for a patient with
acute kidney injury?
A. Avoid calcium to prevent hypercalcemia
B. Avoid potassium to prevent dysrhythmias
C. Increase sodium to maintain blood pressure
D. Increase protein to promote healing
Answer: B
Rationale: In acute kidney injury, potassium excretion is impaired, leading to
hyperkalemia which can cause fatal cardiac dysrhythmias. Patients must restrict dietary
potassium, including bananas, oranges, potatoes, and tomatoes. Sodium and protein
may also be restricted, but potassium is the most immediate life-threatening concern .
6. What nursing intervention is required for a patient with chronic
kidney disease receiving IV contrast for a CT scan?
A. Administer IV fluids before and after the procedure
B. Hold all medications 24 hours before the procedure
C. Restrict fluids before and after the procedure
D. Administer diuretics before the procedure
Answer: A
Rationale: Contrast-induced nephropathy is a serious risk in CKD patients. Hydration
with IV fluids before and after contrast administration helps dilute and excrete the
contrast media, reducing the risk of acute kidney injury. Fluid restriction would worsen
the risk, and diuretics are not recommended .
7. What teaching is appropriate for a patient with neurogenic
bladder?
A. Limit fluid intake to prevent incontinence
B. Use double voiding and infection prevention
, C. Catheterize only when the bladder is full
D. Avoid all physical activity
Answer: B
Rationale: Neurogenic bladder results from neurological conditions such as multiple
sclerosis or spinal cord injury. Double voiding (urinating, waiting a few minutes, then
trying again) helps empty the bladder more completely. Infection prevention includes
good hygiene and regular catheter care if applicable .
8. Which finding differentiates pyelonephritis from a lower
urinary tract infection?
A. Fever
B. Dysuria
C. Flank pain
D. Urinary frequency
Answer: C
Rationale: Flank pain is the hallmark sign that distinguishes pyelonephritis (upper UTI
involving the kidneys) from a lower UTI (cystitis). Lower UTIs present with dysuria,
frequency, and urgency without flank pain. Fever may occur in both conditions, though
it is more common in pyelonephritis .
9. Which nursing action reduces infection risk during peritoneal
dialysis?
A. Place the patient in a supine position
B. Use a mask, perform hand hygiene, and maintain a dust-free environment
C. Limit fluid intake during dialysis
D. Administer prophylactic antibiotics before each exchange
Answer: B
Rationale: Peritoneal dialysis carries a significant risk of peritonitis. Strict aseptic
technique, including hand hygiene, wearing a mask during exchanges, and maintaining
a clean, dust-free environment, is essential for infection prevention. Antibiotics are not
given prophylactically with each exchange .
ACTUAL EXAM | MDC 3 EXAM 1 REVIEW WITH REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
Section 1: Renal and Urinary Disorders (Questions 1-40)
1. A 70-year-old woman with chronic kidney disease and a history
of type 2 diabetes had surgery two weeks ago to place a vascular
graft access for hemodialysis. Which precaution will the nurse
follow to ensure the function of the AV graft?
A. Insert the IV and run saline at 10 mL/hr
B. Keep the patient's arm elevated on two pillows
C. Monitor blood pressure and radial pulses in both arms
D. Check for a bruit and thrill by auscultation and palpation over the site
Answer: D
Rationale: To ensure patency and function of an AV graft, the nurse must auscultate for
a bruit and palpate for a thrill over the access site daily. A bruit (whooshing sound) and
thrill (vibration) indicate blood flow through the graft. The absence of these findings
suggests occlusion or thrombosis requiring immediate intervention. Options A, B, and C
are incorrect interventions that do not directly assess graft function .
2. A nurse is caring for a client recently diagnosed with acute
kidney injury. Which of the following is a possible cause of acute
kidney injury due to perfusion issues?
,A. Glomerulonephritis
B. Dehydration
C. Nephrotoxic medications
D. Urinary obstruction
Answer: B
Rationale: Dehydration leads to prerenal azotemia, a form of acute kidney injury caused
by decreased renal perfusion. Other prerenal causes include hypovolemia, hypotension,
and heart failure. Glomerulonephritis causes intrinsic kidney injury, nephrotoxic
medications cause intrinsic damage, and urinary obstruction causes postrenal AKI .
3. A patient has a GFR of 25 mL/min and a potassium level of 6.2
mEq/L. What is occurring physiologically?
A. The kidneys are retaining potassium due to increased filtration
B. The kidneys are failing to excrete potassium due to decreased filtration
C. The kidneys are reabsorbing potassium excessively
D. The kidneys are producing excess aldosterone
Answer: B
Rationale: A GFR of 25 mL/min indicates significant renal impairment. With decreased
glomerular filtration, the kidneys cannot adequately excrete potassium, leading to
hyperkalemia. A potassium level of 6.2 mEq/L is dangerously elevated and can cause
life-threatening cardiac dysrhythmias .
4. A patient with an indwelling urinary catheter develops fever
and chills. What is the nurse's priority action?
A. Irrigate the catheter with sterile saline
B. Notify the provider immediately
C. Increase the patient's fluid intake
D. Obtain a urine culture and sensitivity
Answer: B
Rationale: Fever and chills in a patient with an indwelling catheter suggest a catheter-
associated urinary tract infection (CAUTI) that may have progressed to urosepsis. The
,nurse must notify the provider immediately for prompt antibiotic therapy. While a urine
culture is important, the provider must be notified first .
5. Which dietary restriction is most important for a patient with
acute kidney injury?
A. Avoid calcium to prevent hypercalcemia
B. Avoid potassium to prevent dysrhythmias
C. Increase sodium to maintain blood pressure
D. Increase protein to promote healing
Answer: B
Rationale: In acute kidney injury, potassium excretion is impaired, leading to
hyperkalemia which can cause fatal cardiac dysrhythmias. Patients must restrict dietary
potassium, including bananas, oranges, potatoes, and tomatoes. Sodium and protein
may also be restricted, but potassium is the most immediate life-threatening concern .
6. What nursing intervention is required for a patient with chronic
kidney disease receiving IV contrast for a CT scan?
A. Administer IV fluids before and after the procedure
B. Hold all medications 24 hours before the procedure
C. Restrict fluids before and after the procedure
D. Administer diuretics before the procedure
Answer: A
Rationale: Contrast-induced nephropathy is a serious risk in CKD patients. Hydration
with IV fluids before and after contrast administration helps dilute and excrete the
contrast media, reducing the risk of acute kidney injury. Fluid restriction would worsen
the risk, and diuretics are not recommended .
7. What teaching is appropriate for a patient with neurogenic
bladder?
A. Limit fluid intake to prevent incontinence
B. Use double voiding and infection prevention
, C. Catheterize only when the bladder is full
D. Avoid all physical activity
Answer: B
Rationale: Neurogenic bladder results from neurological conditions such as multiple
sclerosis or spinal cord injury. Double voiding (urinating, waiting a few minutes, then
trying again) helps empty the bladder more completely. Infection prevention includes
good hygiene and regular catheter care if applicable .
8. Which finding differentiates pyelonephritis from a lower
urinary tract infection?
A. Fever
B. Dysuria
C. Flank pain
D. Urinary frequency
Answer: C
Rationale: Flank pain is the hallmark sign that distinguishes pyelonephritis (upper UTI
involving the kidneys) from a lower UTI (cystitis). Lower UTIs present with dysuria,
frequency, and urgency without flank pain. Fever may occur in both conditions, though
it is more common in pyelonephritis .
9. Which nursing action reduces infection risk during peritoneal
dialysis?
A. Place the patient in a supine position
B. Use a mask, perform hand hygiene, and maintain a dust-free environment
C. Limit fluid intake during dialysis
D. Administer prophylactic antibiotics before each exchange
Answer: B
Rationale: Peritoneal dialysis carries a significant risk of peritonitis. Strict aseptic
technique, including hand hygiene, wearing a mask during exchanges, and maintaining
a clean, dust-free environment, is essential for infection prevention. Antibiotics are not
given prophylactically with each exchange .
