NUR 2356 / NUR2356: MULTIDIMENSIONAL CARE I / MDC 1
EXAM 2 - COMPREHENSIVE EXAMINATION
(LATEST ) - RASMUSSEN
120 Questions | Sections 1-10 | Aligned with the Rasmussen University NUR 2356 Course Syllabus, NCLEX-RN Test Plan, QSEN
Competencies, and Multidimensional Care I Nursing Standards (2026/2027 Edition)
Section 1: Health Assessment & Physical Examination
Q1: A nursing student is preparing to perform a physical assessment on an adult client. Which statement made
by the student indicates a correct understanding of the sequence of assessment techniques?
A. Palpation should always be performed before inspection to locate tender areas early.
B. Inspection, palpation, percussion, and auscultation are performed in that exact order for every body system.
C. For the abdominal assessment, auscultation is performed before percussion and palpation. *[CORRECT]*
D. Percussion precedes inspection so that underlying masses can be identified first.
Correct Answer: C
Rationale: The standard assessment sequence is inspection, palpation, percussion, and auscultation, except for the abdomen,
where auscultation comes first because percussion and palpation can stimulate peristalsis and alter bowel sound findings. This
sequencing is a foundational skill in the NUR 2356 health assessment module and is tested under the NCLEX-RN Health
Promotion and Maintenance category. Palpation before inspection, and percussion before inspection, contradict the
evidence-based order taught in the course.
Q2: The nurse enters a client's room to begin a complete head-to-toe assessment. Which action should the nurse
perform first?
A. Auscultate heart sounds at the apex with the diaphragm of the stethoscope.
B. Conduct a general survey of the client's appearance, behavior, and body structure. *[CORRECT]*
C. Palpate the bilateral radial pulses and rate their amplitude.
D. Ask the client to rate any current pain on a 0 to 10 scale.
Correct Answer: B
Rationale: The general survey is the first component of the physical assessment and provides an overall impression of the client's
appearance, behavior, and condition before system-specific techniques begin. This framework is emphasized throughout NUR
2356 as the starting point of every comprehensive assessment. The other actions are valid assessment components, but each
belongs to a later phase of the examination.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 1
,NUR 2356: Multidimensional Care I (MDC 1) - Exam 2 Comprehensive Examination Sections 1-10
Q3: Which charting entry made by the nurse contains objective data obtained during the assessment?
A. The client states the pain is 8 out of 10.
B. The client reports feeling nauseated since midnight.
C. The client denies feeling anxious about surgery.
D. The client's abdomen is distended with bowel sounds audible in all four quadrants. *[CORRECT]*
Correct Answer: D
Rationale: Objective data are findings that the nurse observes, inspects, palpates, percusses, or auscultates, such as a distended
abdomen with audible bowel sounds. The client's stated pain level, reported nausea, and denied anxiety are subjective symptoms
that only the client can verify. NUR 2356 requires students to separate subjective from objective data because documentation and
clinical reasoning depend on that distinction (NCLEX-RN: Management of Care and Basic Care and Comfort).
Q4: Before administering a scheduled dose of digoxin, the nurse must assess the client's apical pulse. Where
should the nurse place the stethoscope to count the apical impulse?
A. Second intercostal space at the right sternal border.
B. Twelfth rib margin at the left posterior axillary line.
C. Suprasternal notch at the midline of the neck.
D. Fifth intercostal space at the left midclavicular line. *[CORRECT]*
Correct Answer: D
Rationale: The apical pulse is heard at the point of maximal impulse, located at the fifth intercostal space at the left midclavicular
line in most adults, and it must be counted for one full minute before digoxin administration. The second intercostal space at the
right sternal border is the aortic auscultation area, and the suprasternal notch is not a cardiac landmark. This standard is taught in
the NUR 2356 cardiovascular assessment content and supports safe medication administration (NCLEX-RN: Pharmacological and
Parenteral Therapies).
Q5: The nurse is assigned to four clients at the start of the shift. Which client should the nurse assess first?
A. A 68-year-old postoperative client with a small amount of pink serous drainage on the surgical dressing.
B. A 54-year-old client with fine crackles in the bilateral lower lobes and an oxygen saturation of 88%.
*[CORRECT]*
C. A 30-year-old client reporting incisional pain rated 6 out of 10 before the next scheduled analgesic dose.
D. A 45-year-old stable client waiting for discharge teaching before going home.
Correct Answer: B
Rationale: Using the ABC priority framework taught in NUR 2356 and reflected in the NCLEX-RN test plan, airway and
breathing problems always take precedence. Crackles with a saturation of 88% indicate impaired gas exchange that requires
immediate assessment and intervention. The other clients have stable or expected findings that can be managed after the
respiratory concern is addressed.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 2
,NUR 2356: Multidimensional Care I (MDC 1) - Exam 2 Comprehensive Examination Sections 1-10
Q6: While auscultating the breath sounds of an adult client, the nurse notes several findings. Which finding
should the nurse document as abnormal?
A. Clear breath sounds equal bilaterally throughout all lung fields.
B. Vesicular breath sounds heard over the peripheral lung fields.
C. High-pitched, continuous musical sounds heard on expiration throughout the lower fields. *[CORRECT]*
D. Bronchial breath sounds heard over the trachea near the suprasternal notch.
Correct Answer: C
Rationale: High-pitched, continuous musical sounds on expiration describe wheezes, an adventitious breath sound associated with
narrowed airways seen in asthma or reactive airway disease. Clear bilateral sounds, vesicular sounds over peripheral fields, and
bronchial sounds over the trachea are all expected findings. Differentiating normal from adventitious sounds is a core competency
of the NUR 2356 respiratory assessment unit and maps to NCLEX-RN Physiological Adaptation.
Q7: After assessing the client's pupils, the nurse documents the finding as PERRLA. Which observation is
consistent with this documentation?
A. Pupils are equal, round, and reactive to light and accommodation. *[CORRECT]*
B. Pupils are constricted and unequal with a sluggish response to light.
C. Pupils are fixed and dilated bilaterally.
D. Pupils are unequal with nystagmus noted on lateral gaze.
Correct Answer: A
Rationale: PERRLA is the standard neurologic assessment acronym meaning pupils equal, round, and reactive to light and
accommodation. Unequal, fixed, dilated, or sluggish pupils are abnormal findings that suggest neurologic deterioration and require
immediate provider notification. This terminology is introduced in the NUR 2356 neurologic assessment content and is routinely
tested on the NCLEX-RN under Physiological Adaptation.
Q8: The nurse auscultates the abdomen of a postoperative client and does not hear bowel sounds in any quadrant
during the initial brief assessment. What is the appropriate nursing action?
A. Document absent bowel sounds after listening in each quadrant for a full five minutes. *[CORRECT]*
B. Document normal bowel sounds because silence indicates a quiet, resting abdomen.
C. Insert a nasogastric tube immediately to decompress the stomach.
D. Notify the provider that the client has developed a bowel obstruction.
Correct Answer: A
Rationale: Normal bowel sounds occur irregularly at 5 to 30 per minute, so the nurse must listen for a full five minutes in each
area before documenting that bowel sounds are absent. Hypoactive bowel sounds are common for 24 to 48 hours after anesthesia,
and invasive interventions such as nasogastric insertion require confirmation and a provider order. This standard comes from the
NUR 2356 gastrointestinal assessment content and reflects safe, evidence-based practice.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 3
, NUR 2356: Multidimensional Care I (MDC 1) - Exam 2 Comprehensive Examination Sections 1-10
Q9: When assessing skin turgor in an 82-year-old client, where should the nurse pinch the skin to obtain the
most accurate finding?
A. Over the dorsum of the hand.
B. Over the anterior surface of the forearm.
C. Over the skin of the sternum or forehead. *[CORRECT]*
D. Over the lateral aspect of the upper arm.
Correct Answer: C
Rationale: Age-related loss of skin elasticity makes the hands, forearms, and arms unreliable sites for turgor assessment in older
adults, often producing falsely poor results. The skin over the sternum or forehead retains elasticity longer and provides a more
accurate indicator of hydration status. This age-related consideration is explicitly taught in the NUR 2356 older adult assessment
guidelines and corresponds to NCLEX-RN Health Promotion and Maintenance content on developmental stages.
Q10: A nurse is preparing to assess a newly admitted client whose culture emphasizes modesty in health care
settings. Which action by the nurse demonstrates culturally competent assessment?
A. Completing the full assessment as quickly as possible to minimize the client's embarrassment.
B. Asking the client about preferences regarding modesty and same-gender care before beginning the
assessment. *[CORRECT]*
C. Skipping the assessment and documenting that the client declined the examination.
D. Asking a family member to translate all sensitive health information.
Correct Answer: B
Rationale: Culturally competent care begins by asking clients directly about their preferences and honoring practices related to
modesty, touch, and gender whenever possible. Skipping the assessment compromises safety, and family members should not
serve as interpreters because accuracy and confidentiality cannot be guaranteed; a professional interpreter should be used. This
approach reflects the QSEN patient-centered care competency and the cultural considerations content of the NUR 2356 syllabus.
Q11: A client reports a sore throat and swollen glands. During the focused HEENT assessment, which technique
should the nurse use to palpate the cervical lymph nodes?
A. Sharp percussion over each nodal chain with the ulnar surface of the hand.
B. Auscultation for bruits directly over each enlarged node.
C. Deep palpation using the heel of the hand to compress the nodal tissue.
D. Gentle circular motion of the fingertips along the anterior and posterior cervical chains. *[CORRECT]*
Correct Answer: D
Rationale: Lymph nodes are palpated with the pads of the fingers using a gentle circular motion along the nodal chains to detect
enlargement, tenderness, or fixation. Auscultation is reserved for vascular structures such as the carotid arteries and thyroid, not
lymph nodes, and deep pressure can cause unnecessary pain. This technique is demonstrated in the NUR 2356 head, ears, eyes,
nose, and throat assessment unit.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 4
EXAM 2 - COMPREHENSIVE EXAMINATION
(LATEST ) - RASMUSSEN
120 Questions | Sections 1-10 | Aligned with the Rasmussen University NUR 2356 Course Syllabus, NCLEX-RN Test Plan, QSEN
Competencies, and Multidimensional Care I Nursing Standards (2026/2027 Edition)
Section 1: Health Assessment & Physical Examination
Q1: A nursing student is preparing to perform a physical assessment on an adult client. Which statement made
by the student indicates a correct understanding of the sequence of assessment techniques?
A. Palpation should always be performed before inspection to locate tender areas early.
B. Inspection, palpation, percussion, and auscultation are performed in that exact order for every body system.
C. For the abdominal assessment, auscultation is performed before percussion and palpation. *[CORRECT]*
D. Percussion precedes inspection so that underlying masses can be identified first.
Correct Answer: C
Rationale: The standard assessment sequence is inspection, palpation, percussion, and auscultation, except for the abdomen,
where auscultation comes first because percussion and palpation can stimulate peristalsis and alter bowel sound findings. This
sequencing is a foundational skill in the NUR 2356 health assessment module and is tested under the NCLEX-RN Health
Promotion and Maintenance category. Palpation before inspection, and percussion before inspection, contradict the
evidence-based order taught in the course.
Q2: The nurse enters a client's room to begin a complete head-to-toe assessment. Which action should the nurse
perform first?
A. Auscultate heart sounds at the apex with the diaphragm of the stethoscope.
B. Conduct a general survey of the client's appearance, behavior, and body structure. *[CORRECT]*
C. Palpate the bilateral radial pulses and rate their amplitude.
D. Ask the client to rate any current pain on a 0 to 10 scale.
Correct Answer: B
Rationale: The general survey is the first component of the physical assessment and provides an overall impression of the client's
appearance, behavior, and condition before system-specific techniques begin. This framework is emphasized throughout NUR
2356 as the starting point of every comprehensive assessment. The other actions are valid assessment components, but each
belongs to a later phase of the examination.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 1
,NUR 2356: Multidimensional Care I (MDC 1) - Exam 2 Comprehensive Examination Sections 1-10
Q3: Which charting entry made by the nurse contains objective data obtained during the assessment?
A. The client states the pain is 8 out of 10.
B. The client reports feeling nauseated since midnight.
C. The client denies feeling anxious about surgery.
D. The client's abdomen is distended with bowel sounds audible in all four quadrants. *[CORRECT]*
Correct Answer: D
Rationale: Objective data are findings that the nurse observes, inspects, palpates, percusses, or auscultates, such as a distended
abdomen with audible bowel sounds. The client's stated pain level, reported nausea, and denied anxiety are subjective symptoms
that only the client can verify. NUR 2356 requires students to separate subjective from objective data because documentation and
clinical reasoning depend on that distinction (NCLEX-RN: Management of Care and Basic Care and Comfort).
Q4: Before administering a scheduled dose of digoxin, the nurse must assess the client's apical pulse. Where
should the nurse place the stethoscope to count the apical impulse?
A. Second intercostal space at the right sternal border.
B. Twelfth rib margin at the left posterior axillary line.
C. Suprasternal notch at the midline of the neck.
D. Fifth intercostal space at the left midclavicular line. *[CORRECT]*
Correct Answer: D
Rationale: The apical pulse is heard at the point of maximal impulse, located at the fifth intercostal space at the left midclavicular
line in most adults, and it must be counted for one full minute before digoxin administration. The second intercostal space at the
right sternal border is the aortic auscultation area, and the suprasternal notch is not a cardiac landmark. This standard is taught in
the NUR 2356 cardiovascular assessment content and supports safe medication administration (NCLEX-RN: Pharmacological and
Parenteral Therapies).
Q5: The nurse is assigned to four clients at the start of the shift. Which client should the nurse assess first?
A. A 68-year-old postoperative client with a small amount of pink serous drainage on the surgical dressing.
B. A 54-year-old client with fine crackles in the bilateral lower lobes and an oxygen saturation of 88%.
*[CORRECT]*
C. A 30-year-old client reporting incisional pain rated 6 out of 10 before the next scheduled analgesic dose.
D. A 45-year-old stable client waiting for discharge teaching before going home.
Correct Answer: B
Rationale: Using the ABC priority framework taught in NUR 2356 and reflected in the NCLEX-RN test plan, airway and
breathing problems always take precedence. Crackles with a saturation of 88% indicate impaired gas exchange that requires
immediate assessment and intervention. The other clients have stable or expected findings that can be managed after the
respiratory concern is addressed.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 2
,NUR 2356: Multidimensional Care I (MDC 1) - Exam 2 Comprehensive Examination Sections 1-10
Q6: While auscultating the breath sounds of an adult client, the nurse notes several findings. Which finding
should the nurse document as abnormal?
A. Clear breath sounds equal bilaterally throughout all lung fields.
B. Vesicular breath sounds heard over the peripheral lung fields.
C. High-pitched, continuous musical sounds heard on expiration throughout the lower fields. *[CORRECT]*
D. Bronchial breath sounds heard over the trachea near the suprasternal notch.
Correct Answer: C
Rationale: High-pitched, continuous musical sounds on expiration describe wheezes, an adventitious breath sound associated with
narrowed airways seen in asthma or reactive airway disease. Clear bilateral sounds, vesicular sounds over peripheral fields, and
bronchial sounds over the trachea are all expected findings. Differentiating normal from adventitious sounds is a core competency
of the NUR 2356 respiratory assessment unit and maps to NCLEX-RN Physiological Adaptation.
Q7: After assessing the client's pupils, the nurse documents the finding as PERRLA. Which observation is
consistent with this documentation?
A. Pupils are equal, round, and reactive to light and accommodation. *[CORRECT]*
B. Pupils are constricted and unequal with a sluggish response to light.
C. Pupils are fixed and dilated bilaterally.
D. Pupils are unequal with nystagmus noted on lateral gaze.
Correct Answer: A
Rationale: PERRLA is the standard neurologic assessment acronym meaning pupils equal, round, and reactive to light and
accommodation. Unequal, fixed, dilated, or sluggish pupils are abnormal findings that suggest neurologic deterioration and require
immediate provider notification. This terminology is introduced in the NUR 2356 neurologic assessment content and is routinely
tested on the NCLEX-RN under Physiological Adaptation.
Q8: The nurse auscultates the abdomen of a postoperative client and does not hear bowel sounds in any quadrant
during the initial brief assessment. What is the appropriate nursing action?
A. Document absent bowel sounds after listening in each quadrant for a full five minutes. *[CORRECT]*
B. Document normal bowel sounds because silence indicates a quiet, resting abdomen.
C. Insert a nasogastric tube immediately to decompress the stomach.
D. Notify the provider that the client has developed a bowel obstruction.
Correct Answer: A
Rationale: Normal bowel sounds occur irregularly at 5 to 30 per minute, so the nurse must listen for a full five minutes in each
area before documenting that bowel sounds are absent. Hypoactive bowel sounds are common for 24 to 48 hours after anesthesia,
and invasive interventions such as nasogastric insertion require confirmation and a provider order. This standard comes from the
NUR 2356 gastrointestinal assessment content and reflects safe, evidence-based practice.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 3
, NUR 2356: Multidimensional Care I (MDC 1) - Exam 2 Comprehensive Examination Sections 1-10
Q9: When assessing skin turgor in an 82-year-old client, where should the nurse pinch the skin to obtain the
most accurate finding?
A. Over the dorsum of the hand.
B. Over the anterior surface of the forearm.
C. Over the skin of the sternum or forehead. *[CORRECT]*
D. Over the lateral aspect of the upper arm.
Correct Answer: C
Rationale: Age-related loss of skin elasticity makes the hands, forearms, and arms unreliable sites for turgor assessment in older
adults, often producing falsely poor results. The skin over the sternum or forehead retains elasticity longer and provides a more
accurate indicator of hydration status. This age-related consideration is explicitly taught in the NUR 2356 older adult assessment
guidelines and corresponds to NCLEX-RN Health Promotion and Maintenance content on developmental stages.
Q10: A nurse is preparing to assess a newly admitted client whose culture emphasizes modesty in health care
settings. Which action by the nurse demonstrates culturally competent assessment?
A. Completing the full assessment as quickly as possible to minimize the client's embarrassment.
B. Asking the client about preferences regarding modesty and same-gender care before beginning the
assessment. *[CORRECT]*
C. Skipping the assessment and documenting that the client declined the examination.
D. Asking a family member to translate all sensitive health information.
Correct Answer: B
Rationale: Culturally competent care begins by asking clients directly about their preferences and honoring practices related to
modesty, touch, and gender whenever possible. Skipping the assessment compromises safety, and family members should not
serve as interpreters because accuracy and confidentiality cannot be guaranteed; a professional interpreter should be used. This
approach reflects the QSEN patient-centered care competency and the cultural considerations content of the NUR 2356 syllabus.
Q11: A client reports a sore throat and swollen glands. During the focused HEENT assessment, which technique
should the nurse use to palpate the cervical lymph nodes?
A. Sharp percussion over each nodal chain with the ulnar surface of the hand.
B. Auscultation for bruits directly over each enlarged node.
C. Deep palpation using the heel of the hand to compress the nodal tissue.
D. Gentle circular motion of the fingertips along the anterior and posterior cervical chains. *[CORRECT]*
Correct Answer: D
Rationale: Lymph nodes are palpated with the pads of the fingers using a gentle circular motion along the nodal chains to detect
enlargement, tenderness, or fixation. Auscultation is reserved for vascular structures such as the carotid arteries and thyroid, not
lymph nodes, and deep pressure can cause unnecessary pain. This technique is demonstrated in the NUR 2356 head, ears, eyes,
nose, and throat assessment unit.
NUR 2356 / NUR2356: MDC 1 Exam 2 (Latest 2026/2027) - Rasmussen 4
