1 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1) MIDTERM
PRACTICE EXAM — ADVANCED STUDY GUIDE & TESTBANK |
LATEST UPDATE 2026/2027 | 100+ PRACTICE QUESTIONS &
100% CORRECT ANSWERS | INSTANT PDF DOWNLOAD
Advanced education level
100+ Q&As with rationales
10 domains
academic year 2026/2027
TABLE OF CONTENTS
i. Comprehensive Nursing Assessment & Clinical Judgment
ii. Safety, Risk Reduction & Patient Prioritization
iii. Infection Prevention & Standard Precautions
iv. Mobility, Positioning & Skin Integrity
v. Nutrition, Hydration & Enteral Care
vi. Elimination & Gastrointestinal Management
vii. Oxygenation, Respiratory Assessment & Airway Care
viii. Pain, Comfort & Symptom Management
ix. Psychosocial, Cultural & Developmental Care
x. Medication Safety, Documentation & Interprofessional Practice
INTRODUCTION
This comprehensive NUR 2356 Multidimensional Care I (MDC 1) Midterm
Practice Exam is designed to strengthen advanced clinical reasoning across
foundational nursing care, patient safety, assessment, prioritization,
communication, nutrition, elimination, mobility, oxygenation, pain, infection
prevention, and psychosocial needs. It is intended for nursing students preparing
for rigorous midterm examinations and students seeking to integrate theoretical
knowledge with realistic bedside decision-making. Expect complex, scenario-
based questions requiring analysis, prioritization, interpretation, and
professional judgment. The resource contains 100+ questions and answers with
rationales designed to reinforce understanding and identify knowledge gaps.
Purchase and instantly get a downloadable and editable PDF.
,2 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
QUESTION 1
A nurse is completing the initial assessment of four hospitalized patients. Which patient
should the nurse assess first?
A. A patient with chronic heart failure who has gained 1 kg over the past 48 hours
B. A postoperative patient reporting incisional pain rated 7/10
C. A patient with pneumonia who has new confusion and an oxygen saturation of 88% on
prescribed oxygen
D. A patient with diabetes whose premeal blood glucose is 214 mg/dL
Correct Answer: C.
Rationale: New confusion accompanied by inadequate oxygenation represents a
potentially life-threatening deterioration. Airway and breathing take priority
over pain, chronic fluid changes, and moderate hyperglycemia.
QUESTION 2
A nurse is caring for an older adult who becomes suddenly disoriented several hours after
admission. The patient's family reports that the patient was fully oriented at home. Which
nursing action is the priority?
A. Document the behavior as an expected manifestation of aging
B. Assess for reversible physiologic causes of acute confusion
C. Administer a prescribed sedative to decrease agitation
D. Limit family visitation to reduce environmental stimulation
Correct Answer: B.
Rationale: Acute confusion is not a normal consequence of aging and may
reflect hypoxia, infection, medication effects, metabolic abnormalities,
dehydration, or other acute conditions. Identifying the underlying cause is
essential.
QUESTION 3
A patient who has been on bed rest for several days reports dizziness when standing. The
blood pressure changes from 128/74 mmHg while supine to 98/60 mmHg while standing.
Which intervention is most appropriate?
A. Encourage the patient to ambulate independently to improve tolerance
B. Have the patient return to bed and implement gradual position changes
C. Restrict oral fluids to prevent further blood-pressure fluctuations
D. Place the patient in a high-Fowler position and encourage rapid standing
Correct Answer: B.
Rationale: The substantial blood-pressure decrease with positional change is
consistent with orthostatic hypotension. Returning the patient to a safe position
and progressing gradually reduces syncope and fall risk.
,3 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
QUESTION 4
A nurse is repositioning an immobile patient who is at high risk for pressure injury. Which
intervention provides the greatest preventive benefit?
A. Massage reddened areas over bony prominences
B. Maintain continuous pressure on the sacrum using a supportive cushion
C. Reposition regularly while minimizing friction and shear
D. Apply a heating pad to areas exposed to prolonged pressure
Correct Answer: C.
Rationale: Regular repositioning, pressure redistribution, moisture
management, and reduction of friction and shear are central to pressure-injury
prevention. Massage of erythematous tissue can cause additional damage.
QUESTION 5
A patient receiving continuous enteral nutrition through a nasogastric tube begins coughing
forcefully and develops respiratory distress. What should the nurse do first?
A. Increase the feeding rate to compensate for interrupted nutrition
B. Stop the feeding and assess airway and respiratory status
C. Flush the tube with sterile water
D. Place the patient flat and obtain a residual volume
Correct Answer: B.
Rationale: Coughing and acute respiratory distress during enteral feeding raise
concern for aspiration or tube displacement. The feeding should be stopped
while airway and respiratory status are immediately assessed.
QUESTION 6
A patient with dysphagia following a stroke is prescribed oral medications. Which finding
requires the nurse to intervene before administering the medication?
A. The patient requests medication with applesauce
B. The patient has a weak cough and wet-sounding voice after swallowing water
C. The patient prefers sitting upright during medication administration
D. The patient reports that pills are difficult to swallow
Correct Answer: B.
Rationale: A wet voice and weak cough after swallowing suggest impaired
airway protection and possible aspiration. Oral medication administration
should be reconsidered until swallowing safety is established.
QUESTION 7
, 4 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
A nurse evaluates a patient's fluid balance. The patient has consumed 1,500 mL of oral fluids
and received 1,000 mL of IV fluid during a 24-hour period. Urine output is 900 mL, emesis is
250 mL, and drain output is 350 mL. What is the patient's net fluid balance?
A. +500 mL
B. +750 mL
C. +1,000 mL
D. +1,250 mL
Correct Answer: C.
Rationale: Total intake is 2,500 mL. Total measurable output is 1,500 mL.
Therefore, 2,500 − 1,500 = +1,000 mL.
QUESTION 8
A patient with chronic obstructive pulmonary disease becomes increasingly dyspneic. The
patient is anxious, using accessory muscles, and has an oxygen saturation of 84%. Which
action should the nurse take first?
A. Place the patient in an upright position and assess respiratory status
B. Encourage the patient to lie flat to conserve energy
C. Immediately administer a large fluid bolus
D. Instruct the patient to breathe rapidly through the mouth
Correct Answer: A.
Rationale: Upright positioning improves lung expansion and reduces the work
of breathing. The nurse should rapidly assess and support oxygenation while
implementing prescribed respiratory interventions.
QUESTION 9
A postoperative patient suddenly reports severe shortness of breath and sharp chest pain that
worsens with inspiration. The heart rate is 124/min and oxygen saturation is 86%. What is the
nurse's priority response?
A. Encourage oral fluids
B. Assist the patient to ambulate
C. Recognize possible pulmonary embolism and initiate urgent assessment/intervention
D. Administer the next scheduled analgesic and reassess in one hour
Correct Answer: C.
Rationale: Acute dyspnea, pleuritic chest pain, tachycardia, and hypoxemia
after surgery are concerning for pulmonary embolism. This potentially life-
threatening condition requires immediate action.
QUESTION 10
NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1) MIDTERM
PRACTICE EXAM — ADVANCED STUDY GUIDE & TESTBANK |
LATEST UPDATE 2026/2027 | 100+ PRACTICE QUESTIONS &
100% CORRECT ANSWERS | INSTANT PDF DOWNLOAD
Advanced education level
100+ Q&As with rationales
10 domains
academic year 2026/2027
TABLE OF CONTENTS
i. Comprehensive Nursing Assessment & Clinical Judgment
ii. Safety, Risk Reduction & Patient Prioritization
iii. Infection Prevention & Standard Precautions
iv. Mobility, Positioning & Skin Integrity
v. Nutrition, Hydration & Enteral Care
vi. Elimination & Gastrointestinal Management
vii. Oxygenation, Respiratory Assessment & Airway Care
viii. Pain, Comfort & Symptom Management
ix. Psychosocial, Cultural & Developmental Care
x. Medication Safety, Documentation & Interprofessional Practice
INTRODUCTION
This comprehensive NUR 2356 Multidimensional Care I (MDC 1) Midterm
Practice Exam is designed to strengthen advanced clinical reasoning across
foundational nursing care, patient safety, assessment, prioritization,
communication, nutrition, elimination, mobility, oxygenation, pain, infection
prevention, and psychosocial needs. It is intended for nursing students preparing
for rigorous midterm examinations and students seeking to integrate theoretical
knowledge with realistic bedside decision-making. Expect complex, scenario-
based questions requiring analysis, prioritization, interpretation, and
professional judgment. The resource contains 100+ questions and answers with
rationales designed to reinforce understanding and identify knowledge gaps.
Purchase and instantly get a downloadable and editable PDF.
,2 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
QUESTION 1
A nurse is completing the initial assessment of four hospitalized patients. Which patient
should the nurse assess first?
A. A patient with chronic heart failure who has gained 1 kg over the past 48 hours
B. A postoperative patient reporting incisional pain rated 7/10
C. A patient with pneumonia who has new confusion and an oxygen saturation of 88% on
prescribed oxygen
D. A patient with diabetes whose premeal blood glucose is 214 mg/dL
Correct Answer: C.
Rationale: New confusion accompanied by inadequate oxygenation represents a
potentially life-threatening deterioration. Airway and breathing take priority
over pain, chronic fluid changes, and moderate hyperglycemia.
QUESTION 2
A nurse is caring for an older adult who becomes suddenly disoriented several hours after
admission. The patient's family reports that the patient was fully oriented at home. Which
nursing action is the priority?
A. Document the behavior as an expected manifestation of aging
B. Assess for reversible physiologic causes of acute confusion
C. Administer a prescribed sedative to decrease agitation
D. Limit family visitation to reduce environmental stimulation
Correct Answer: B.
Rationale: Acute confusion is not a normal consequence of aging and may
reflect hypoxia, infection, medication effects, metabolic abnormalities,
dehydration, or other acute conditions. Identifying the underlying cause is
essential.
QUESTION 3
A patient who has been on bed rest for several days reports dizziness when standing. The
blood pressure changes from 128/74 mmHg while supine to 98/60 mmHg while standing.
Which intervention is most appropriate?
A. Encourage the patient to ambulate independently to improve tolerance
B. Have the patient return to bed and implement gradual position changes
C. Restrict oral fluids to prevent further blood-pressure fluctuations
D. Place the patient in a high-Fowler position and encourage rapid standing
Correct Answer: B.
Rationale: The substantial blood-pressure decrease with positional change is
consistent with orthostatic hypotension. Returning the patient to a safe position
and progressing gradually reduces syncope and fall risk.
,3 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
QUESTION 4
A nurse is repositioning an immobile patient who is at high risk for pressure injury. Which
intervention provides the greatest preventive benefit?
A. Massage reddened areas over bony prominences
B. Maintain continuous pressure on the sacrum using a supportive cushion
C. Reposition regularly while minimizing friction and shear
D. Apply a heating pad to areas exposed to prolonged pressure
Correct Answer: C.
Rationale: Regular repositioning, pressure redistribution, moisture
management, and reduction of friction and shear are central to pressure-injury
prevention. Massage of erythematous tissue can cause additional damage.
QUESTION 5
A patient receiving continuous enteral nutrition through a nasogastric tube begins coughing
forcefully and develops respiratory distress. What should the nurse do first?
A. Increase the feeding rate to compensate for interrupted nutrition
B. Stop the feeding and assess airway and respiratory status
C. Flush the tube with sterile water
D. Place the patient flat and obtain a residual volume
Correct Answer: B.
Rationale: Coughing and acute respiratory distress during enteral feeding raise
concern for aspiration or tube displacement. The feeding should be stopped
while airway and respiratory status are immediately assessed.
QUESTION 6
A patient with dysphagia following a stroke is prescribed oral medications. Which finding
requires the nurse to intervene before administering the medication?
A. The patient requests medication with applesauce
B. The patient has a weak cough and wet-sounding voice after swallowing water
C. The patient prefers sitting upright during medication administration
D. The patient reports that pills are difficult to swallow
Correct Answer: B.
Rationale: A wet voice and weak cough after swallowing suggest impaired
airway protection and possible aspiration. Oral medication administration
should be reconsidered until swallowing safety is established.
QUESTION 7
, 4 NUR 2356 MULTIDIMENSIONAL CARE I (MDC 1)
A nurse evaluates a patient's fluid balance. The patient has consumed 1,500 mL of oral fluids
and received 1,000 mL of IV fluid during a 24-hour period. Urine output is 900 mL, emesis is
250 mL, and drain output is 350 mL. What is the patient's net fluid balance?
A. +500 mL
B. +750 mL
C. +1,000 mL
D. +1,250 mL
Correct Answer: C.
Rationale: Total intake is 2,500 mL. Total measurable output is 1,500 mL.
Therefore, 2,500 − 1,500 = +1,000 mL.
QUESTION 8
A patient with chronic obstructive pulmonary disease becomes increasingly dyspneic. The
patient is anxious, using accessory muscles, and has an oxygen saturation of 84%. Which
action should the nurse take first?
A. Place the patient in an upright position and assess respiratory status
B. Encourage the patient to lie flat to conserve energy
C. Immediately administer a large fluid bolus
D. Instruct the patient to breathe rapidly through the mouth
Correct Answer: A.
Rationale: Upright positioning improves lung expansion and reduces the work
of breathing. The nurse should rapidly assess and support oxygenation while
implementing prescribed respiratory interventions.
QUESTION 9
A postoperative patient suddenly reports severe shortness of breath and sharp chest pain that
worsens with inspiration. The heart rate is 124/min and oxygen saturation is 86%. What is the
nurse's priority response?
A. Encourage oral fluids
B. Assist the patient to ambulate
C. Recognize possible pulmonary embolism and initiate urgent assessment/intervention
D. Administer the next scheduled analgesic and reassess in one hour
Correct Answer: C.
Rationale: Acute dyspnea, pleuritic chest pain, tachycardia, and hypoxemia
after surgery are concerning for pulmonary embolism. This potentially life-
threatening condition requires immediate action.
QUESTION 10
