1 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1) EXAM 2
PRACTICE EXAM, ACTUAL STUDY GUIDE, TESTBANK, LATEST
UPDATE, 2026/2027 LATEST UPDATE, ADVANCED PRACTICE
QUESTIONS, 100% CORRECT ANSWERS, INSTANT PDF
DOWNLOAD
higher education level student
100+ Q&As with rationales
10 domains
academic year 2026/2027
Table of Contents
i. Cardiovascular assessment and multidimensional management
ii. Respiratory disorders and oxygenation
iii. Fluid, electrolyte, and acid-base management
iv. Renal and urinary disorders
v. Gastrointestinal and hepatic disorders
vi. Neurologic assessment and acute deterioration
vii. Infection prevention and clinical safety
viii. Pharmacologic management and nursing priorities
ix. Clinical judgment, prioritization, and delegation
x. Documentation, patient education, and interdisciplinary care
INTRODUCTION
This comprehensive practice examination is designed for students preparing for NUR 2356
Multidimensional Care I (MDC 1) Exam 2 at Rasmussen College. It emphasizes advanced
clinical judgment, prioritization, pathophysiology, pharmacologic management, patient
safety, assessment interpretation, and evidence-based nursing interventions. The questions are
intentionally challenging and require application rather than simple memorization. It is
appropriate for nursing students seeking to strengthen preparation for high-stakes
examinations and clinical practice. Students should expect realistic patient scenarios,
competing priorities, clinical deterioration, and nuanced decision-making. The complete
resource contains 100+ questions and answers with rationales. Purchase and instantly get a
downloadable and editable PDF for convenient study and review.
,2 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Question 1
A patient with acute decompensated heart failure is receiving IV loop diuretic therapy. Four
hours later, the nurse notes a blood pressure of 88/54 mm Hg, heart rate of 118/min, urine
output of 15 mL/hr, potassium of 3.0 mEq/L, and increasing confusion. Which action should
the nurse take first?
A. Administer the next prescribed dose of the loop diuretic
B. Notify the provider of probable intravascular volume depletion and electrolyte disturbance
C. Encourage oral fluids to restore circulating volume
D. Place the patient in a high-Fowler position and reassess in 30 minutes
Correct Answer: B
The combination of hypotension, oliguria, tachycardia, hypokalemia, and altered mental
status suggests excessive diuresis with impaired tissue perfusion. The nurse should promptly
escalate the deterioration rather than administer additional diuretic therapy or independently
increase fluids.
Question 2
A patient with chronic obstructive pulmonary disease is receiving supplemental oxygen. The
patient's respiratory rate is 8/min, oxygen saturation is 95%, and the patient is increasingly
somnolent. Which interpretation is most appropriate?
A. The oxygen saturation demonstrates adequate ventilation
B. The findings suggest possible carbon dioxide retention with hypoventilation
C. The patient is experiencing isolated hypoxemia requiring higher oxygen flow
D. The patient is demonstrating an expected response to oxygen therapy
Correct Answer: B
Oxygen saturation measures oxygenation but does not directly assess ventilation. Decreased
respiratory rate, somnolence, and relatively preserved oxygen saturation in a patient with
COPD can indicate hypoventilation and worsening carbon dioxide retention.
Question 3
A patient receiving unfractionated heparin for an acute thromboembolic condition develops a
platelet count decrease from 220,000/mm³ to 96,000/mm³ on day 7. The patient has a new
painful, swollen calf. Which action is the priority?
A. Continue heparin and administer the prescribed analgesic
B. Hold all anticoagulation permanently
C. Suspect heparin-induced thrombocytopenia and notify the provider immediately
D. Administer platelet replacement before further assessment
Correct Answer: C
The substantial platelet decline occurring approximately 5–10 days after heparin exposure,
combined with new thrombosis, is highly concerning for heparin-induced thrombocytopenia
(HIT). Immediate clinical escalation and discontinuation of heparin under the appropriate
treatment protocol are required.
,3 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Question 4
A patient with pneumonia becomes acutely confused. Vital signs are temperature 39.4°C,
heart rate 126/min, respiratory rate 30/min, and blood pressure 82/48 mm Hg. Which finding
most strongly indicates progression toward septic shock?
A. Fever
B. Tachycardia
C. Hypotension despite systemic infection
D. Respiratory rate greater than 20/min
Correct Answer: C
Severe hypotension in the setting of suspected infection indicates inadequate systemic
perfusion and is a critical feature of septic shock physiology. Fever, tachycardia, and
tachypnea are important manifestations but are less specific for shock.
Question 5
A patient with chronic kidney disease has potassium 6.7 mEq/L and reports generalized
weakness. The ECG demonstrates peaked T waves. Which prescribed intervention should the
nurse anticipate as the most immediately protective against lethal dysrhythmia?
A. IV calcium administration
B. Oral potassium-binding resin alone
C. Dietary potassium restriction
D. Administration of a loop diuretic alone
Correct Answer: A
IV calcium stabilizes the cardiac membrane and reduces the immediate risk of ventricular
dysrhythmia from severe hyperkalemia. It does not remove potassium but is prioritized when
significant ECG changes are present.
Question 6
A patient with severe vomiting has the following laboratory results: pH 7.51, PaCO₂ 47 mm
Hg, HCO₃⁻ 35 mEq/L. Which interpretation is most accurate?
A. Uncompensated respiratory alkalosis
B. Partially compensated metabolic alkalosis
C. Fully compensated metabolic acidosis
D. Mixed respiratory and metabolic acidosis
Correct Answer: B
The elevated pH and bicarbonate indicate metabolic alkalosis, consistent with prolonged
vomiting. The elevated PaCO₂ represents respiratory compensation, but because the pH
remains alkalotic, compensation is incomplete.
Question 7
, 4 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
A patient with cirrhosis becomes increasingly confused and develops asterixis. Which
intervention most directly addresses the underlying cause of these neurologic findings?
A. Restrict all dietary protein indefinitely
B. Administer prescribed lactulose and monitor bowel elimination
C. Administer a benzodiazepine to reduce agitation
D. Encourage a high-sodium diet to improve neurologic function
Correct Answer: B
Hepatic encephalopathy is associated with accumulation of neurotoxins, particularly
ammonia. Lactulose decreases ammonia absorption by promoting conversion to a less
absorbable form and increasing intestinal elimination.
Question 8
A patient with a suspected upper gastrointestinal hemorrhage has hematemesis, cool clammy
skin, heart rate 132/min, and blood pressure 86/50 mm Hg. Which nursing action has the
highest priority?
A. Obtain a detailed dietary history
B. Establish or maintain large-bore IV access and prepare for rapid fluid/blood replacement
C. Administer oral antacid therapy
D. Place the patient in a supine position without further intervention
Correct Answer: B
The patient demonstrates signs of hemorrhagic hypovolemia and impaired perfusion. Rapid
vascular access and preparation for volume and blood-product resuscitation are priorities
while definitive bleeding control is pursued.
Question 9
A patient with a history of atrial fibrillation suddenly develops right-sided weakness and
expressive aphasia. The symptoms began approximately 20 minutes ago. Which nursing
action is most appropriate?
A. Give oral aspirin immediately without further evaluation
B. Activate the acute stroke response and determine the exact time the patient was last known
well
C. Lower the blood pressure rapidly to a normal range
D. Encourage ambulation to assess the degree of weakness
Correct Answer: B
Acute focal neurologic deficits require immediate stroke evaluation. Establishing the last-
known-well time is critical because eligibility for reperfusion therapies depends on timing
and other clinical criteria.
Question 10
A patient with increased intracranial pressure develops a decreasing level of consciousness
and unequal pupils. Which action should the nurse prioritize?
NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1) EXAM 2
PRACTICE EXAM, ACTUAL STUDY GUIDE, TESTBANK, LATEST
UPDATE, 2026/2027 LATEST UPDATE, ADVANCED PRACTICE
QUESTIONS, 100% CORRECT ANSWERS, INSTANT PDF
DOWNLOAD
higher education level student
100+ Q&As with rationales
10 domains
academic year 2026/2027
Table of Contents
i. Cardiovascular assessment and multidimensional management
ii. Respiratory disorders and oxygenation
iii. Fluid, electrolyte, and acid-base management
iv. Renal and urinary disorders
v. Gastrointestinal and hepatic disorders
vi. Neurologic assessment and acute deterioration
vii. Infection prevention and clinical safety
viii. Pharmacologic management and nursing priorities
ix. Clinical judgment, prioritization, and delegation
x. Documentation, patient education, and interdisciplinary care
INTRODUCTION
This comprehensive practice examination is designed for students preparing for NUR 2356
Multidimensional Care I (MDC 1) Exam 2 at Rasmussen College. It emphasizes advanced
clinical judgment, prioritization, pathophysiology, pharmacologic management, patient
safety, assessment interpretation, and evidence-based nursing interventions. The questions are
intentionally challenging and require application rather than simple memorization. It is
appropriate for nursing students seeking to strengthen preparation for high-stakes
examinations and clinical practice. Students should expect realistic patient scenarios,
competing priorities, clinical deterioration, and nuanced decision-making. The complete
resource contains 100+ questions and answers with rationales. Purchase and instantly get a
downloadable and editable PDF for convenient study and review.
,2 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Question 1
A patient with acute decompensated heart failure is receiving IV loop diuretic therapy. Four
hours later, the nurse notes a blood pressure of 88/54 mm Hg, heart rate of 118/min, urine
output of 15 mL/hr, potassium of 3.0 mEq/L, and increasing confusion. Which action should
the nurse take first?
A. Administer the next prescribed dose of the loop diuretic
B. Notify the provider of probable intravascular volume depletion and electrolyte disturbance
C. Encourage oral fluids to restore circulating volume
D. Place the patient in a high-Fowler position and reassess in 30 minutes
Correct Answer: B
The combination of hypotension, oliguria, tachycardia, hypokalemia, and altered mental
status suggests excessive diuresis with impaired tissue perfusion. The nurse should promptly
escalate the deterioration rather than administer additional diuretic therapy or independently
increase fluids.
Question 2
A patient with chronic obstructive pulmonary disease is receiving supplemental oxygen. The
patient's respiratory rate is 8/min, oxygen saturation is 95%, and the patient is increasingly
somnolent. Which interpretation is most appropriate?
A. The oxygen saturation demonstrates adequate ventilation
B. The findings suggest possible carbon dioxide retention with hypoventilation
C. The patient is experiencing isolated hypoxemia requiring higher oxygen flow
D. The patient is demonstrating an expected response to oxygen therapy
Correct Answer: B
Oxygen saturation measures oxygenation but does not directly assess ventilation. Decreased
respiratory rate, somnolence, and relatively preserved oxygen saturation in a patient with
COPD can indicate hypoventilation and worsening carbon dioxide retention.
Question 3
A patient receiving unfractionated heparin for an acute thromboembolic condition develops a
platelet count decrease from 220,000/mm³ to 96,000/mm³ on day 7. The patient has a new
painful, swollen calf. Which action is the priority?
A. Continue heparin and administer the prescribed analgesic
B. Hold all anticoagulation permanently
C. Suspect heparin-induced thrombocytopenia and notify the provider immediately
D. Administer platelet replacement before further assessment
Correct Answer: C
The substantial platelet decline occurring approximately 5–10 days after heparin exposure,
combined with new thrombosis, is highly concerning for heparin-induced thrombocytopenia
(HIT). Immediate clinical escalation and discontinuation of heparin under the appropriate
treatment protocol are required.
,3 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
Question 4
A patient with pneumonia becomes acutely confused. Vital signs are temperature 39.4°C,
heart rate 126/min, respiratory rate 30/min, and blood pressure 82/48 mm Hg. Which finding
most strongly indicates progression toward septic shock?
A. Fever
B. Tachycardia
C. Hypotension despite systemic infection
D. Respiratory rate greater than 20/min
Correct Answer: C
Severe hypotension in the setting of suspected infection indicates inadequate systemic
perfusion and is a critical feature of septic shock physiology. Fever, tachycardia, and
tachypnea are important manifestations but are less specific for shock.
Question 5
A patient with chronic kidney disease has potassium 6.7 mEq/L and reports generalized
weakness. The ECG demonstrates peaked T waves. Which prescribed intervention should the
nurse anticipate as the most immediately protective against lethal dysrhythmia?
A. IV calcium administration
B. Oral potassium-binding resin alone
C. Dietary potassium restriction
D. Administration of a loop diuretic alone
Correct Answer: A
IV calcium stabilizes the cardiac membrane and reduces the immediate risk of ventricular
dysrhythmia from severe hyperkalemia. It does not remove potassium but is prioritized when
significant ECG changes are present.
Question 6
A patient with severe vomiting has the following laboratory results: pH 7.51, PaCO₂ 47 mm
Hg, HCO₃⁻ 35 mEq/L. Which interpretation is most accurate?
A. Uncompensated respiratory alkalosis
B. Partially compensated metabolic alkalosis
C. Fully compensated metabolic acidosis
D. Mixed respiratory and metabolic acidosis
Correct Answer: B
The elevated pH and bicarbonate indicate metabolic alkalosis, consistent with prolonged
vomiting. The elevated PaCO₂ represents respiratory compensation, but because the pH
remains alkalotic, compensation is incomplete.
Question 7
, 4 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
A patient with cirrhosis becomes increasingly confused and develops asterixis. Which
intervention most directly addresses the underlying cause of these neurologic findings?
A. Restrict all dietary protein indefinitely
B. Administer prescribed lactulose and monitor bowel elimination
C. Administer a benzodiazepine to reduce agitation
D. Encourage a high-sodium diet to improve neurologic function
Correct Answer: B
Hepatic encephalopathy is associated with accumulation of neurotoxins, particularly
ammonia. Lactulose decreases ammonia absorption by promoting conversion to a less
absorbable form and increasing intestinal elimination.
Question 8
A patient with a suspected upper gastrointestinal hemorrhage has hematemesis, cool clammy
skin, heart rate 132/min, and blood pressure 86/50 mm Hg. Which nursing action has the
highest priority?
A. Obtain a detailed dietary history
B. Establish or maintain large-bore IV access and prepare for rapid fluid/blood replacement
C. Administer oral antacid therapy
D. Place the patient in a supine position without further intervention
Correct Answer: B
The patient demonstrates signs of hemorrhagic hypovolemia and impaired perfusion. Rapid
vascular access and preparation for volume and blood-product resuscitation are priorities
while definitive bleeding control is pursued.
Question 9
A patient with a history of atrial fibrillation suddenly develops right-sided weakness and
expressive aphasia. The symptoms began approximately 20 minutes ago. Which nursing
action is most appropriate?
A. Give oral aspirin immediately without further evaluation
B. Activate the acute stroke response and determine the exact time the patient was last known
well
C. Lower the blood pressure rapidly to a normal range
D. Encourage ambulation to assess the degree of weakness
Correct Answer: B
Acute focal neurologic deficits require immediate stroke evaluation. Establishing the last-
known-well time is critical because eligibility for reperfusion therapies depends on timing
and other clinical criteria.
Question 10
A patient with increased intracranial pressure develops a decreasing level of consciousness
and unequal pupils. Which action should the nurse prioritize?
