NUR 2356 / NUR2356: Multidimensional Care I
MDC 1 Exam 1 (Latest ) - Rasmussen
Comprehensive 120-Question Examination
Aligned with Rasmussen University NUR 2356 Course Syllabus, NCLEX-RN Test Plan, QSEN Competencies, and Multidimensional Care I
Nursing Standards (2026/2027 Edition).
Total Questions 120
Cognitive Mix 20% Recall | 50% Application | 30% Analysis
Special Inclusions 20 Priority-Setting | 15 Pharmacology | 10+ Infection/Safety
Question Style 75% Scenario-Based | 25% Direct Knowledge
Format Multiple Choice (4 options, one correct) with Rationale
Section 1: Health Assessment & Physical Examination
Q1: The nurse is preparing to perform a comprehensive abdominal assessment on an adult client. In which order
should the four fundamental assessment techniques be performed for the abdomen specifically?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, inspection, percussion, palpation
C. Inspection, auscultation, percussion, palpation [CORRECT]
D. Inspection, palpation, percussion, auscultation
Correct Answer: C
Rationale: For most body systems, the correct order is inspection, palpation, percussion, auscultation. However, the abdomen is
the EXCEPTION — auscultation is performed before palpation and percussion to avoid altering bowel sounds through manual
manipulation. This is a foundational NUR 2356 assessment principle aligned with the NCLEX-RN Health Assessment content.
Q2: A 65-year-old Muslim female client is admitted for a comprehensive physical examination. Which action by the
nurse best demonstrates culturally competent care during the assessment?
A. Ask the client to remove her head covering for the entire examination
B. Schedule a female provider and allow the client to keep her head covering when possible [CORRECT]
C. Perform the examination in the presence of a male family member for chaperone purposes
D. Skip the head and neck assessment entirely to avoid cultural discomfort
Correct Answer: B
Rationale: Cultural competence requires respecting the client's religious practices. Muslim women may prefer female providers
and wear a head covering (hijab) for modesty. The nurse should accommodate these preferences whenever clinically feasible
while completing the necessary assessment. The other options violate cultural norms, compromise assessment completeness, or
impose Western practices on the client, contradicting QSEN patient-centered care.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 1
,NUR 2356 / MDC 1 Exam 1 (2026/2027) - Rasmussen Comprehensive 120-Question Examination
Q3: During a focused respiratory assessment, the nurse auscultates high-pitched, musical, continuous sounds on
expiration over the bilateral lower lobes. How should the nurse document these findings?
A. Crackles (rales) bilaterally in the lower lobes
B. Wheezes bilaterally in the lower lobes [CORRECT]
C. Pleural friction rub bilaterally in the lower lobes
D. Stridor bilaterally in the lower lobes
Correct Answer: B
Rationale: Wheezes are high-pitched, musical, continuous sounds heard predominantly on expiration and are caused by
narrowed airway passages (e.g., asthma, bronchospasm). Crackles are discontinuous popping sounds; pleural friction rub is
grating and synchronous with respiration; stridor is a harsh inspiratory crowing sound indicating upper airway obstruction.
Accurate documentation of adventitious breath sounds is a core NUR 2356 respiratory assessment competency.
Q4: The nurse is performing a cardiovascular assessment on a 72-year-old client. Which finding requires immediate
follow-up and provider notification?
A. Apical pulse rate of 64 beats/minute and regular
B. Systolic blood pressure of 138/86 mmHg after ambulation
C. Jugular venous distention (JVD) at 45 degrees of head elevation [CORRECT]
D. Bounding peripheral pulses rated +3 bilaterally in upper extremities
Correct Answer: C
Rationale: Jugular venous distention greater than 3 cm above the sternal angle at 45 degrees indicates elevated right atrial
pressure, suggesting right-sided heart failure, fluid overload, or cardiac tamponade. This finding requires prompt provider
notification. A heart rate of 64 is within normal limits for an older adult, the blood pressure is mildly elevated but not emergent,
and +3 pulses are normal-to-bounding but not immediately dangerous. NCLEX-RN prioritization principles emphasize
hemodynamic instability as a priority.
Q5: Which technique should the nurse use when assessing for the presence of a fluid wave in a client suspected of
having ascites?
A. Percuss the abdomen for shifting dullness with the client supine
B. Place one hand flat against the client's flank and tap the opposite flank with the other hand [CORRECT]
C. Auscultate the abdomen for bruits in all four quadrants
D. Measure abdominal girth at the umbilicus with the client in semi-Fowler's
Correct Answer: B
Rationale: To assess for a fluid wave, the nurse places one hand flat against the client's flank and taps the opposite flank with the
fingertips of the other hand. A fluid wave (palpable impulse) indicates free fluid within the peritoneal cavity (ascites). Shifting
dullness is an alternative technique but involves percussion, not the fluid wave test itself. Bruits are vascular sounds; abdominal
girth is a measurement, not a fluid wave assessment. This is a foundational NUR 2356 abdominal assessment skill.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 2
,NUR 2356 / MDC 1 Exam 1 (2026/2027) - Rasmussen Comprehensive 120-Question Examination
Q6: An 82-year-old client is admitted for a comprehensive assessment. Which age-related change in the neurological
system should the nurse anticipate as an expected finding versus a pathological change requiring further evaluation?
A. Slowed reaction time and mild decreased vibratory sense in the lower extremities [CORRECT]
B. Bilateral Babinski reflex positive and absence of deep tendon reflexes
C. Sudden onset of confusion and disorientation to person
D. Asymmetric grip strength with right side significantly weaker than left
Correct Answer: A
Rationale: Slowed reaction time and decreased vibratory sense in the lower extremities are normal age-related changes in the
older adult neurological system. A positive Babinski sign in an adult is pathological and indicates upper motor neuron disease.
Sudden onset confusion suggests delirium and requires immediate evaluation. Asymmetric grip strength suggests a focal
neurological deficit such as stroke. Distinguishing normal aging from pathological findings is a critical NUR 2356 assessment
competency.
Q7: The nurse is completing a comprehensive health history on a 45-year-old client. Which question best
exemplifies the use of the CAGE screening tool?
A. "Have you ever felt the need to Cut down on your drinking?" [CORRECT]
B. "Do you currently smoke cigarettes or use tobacco products?"
C. "Have you experienced any Chest pain with Activity or exertion?"
D. "Do you have a family history of Gestational diabetes?"
Correct Answer: A
Rationale: The CAGE questionnaire is a validated alcohol use screening tool with four questions: (C) Have you ever felt the
need to Cut down? (A) Have you ever felt Annoyed by criticism of your drinking? (G) Have you ever felt Guilty about your
drinking? (E) Have you ever had a drink first thing in the morning (Eye-opener)? Two or more positive responses suggest a
potential alcohol use disorder. This screening tool is emphasized in NUR 2356 health history content.
Q8: The nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess FIRST based
on the principles of priority setting?
A. A 60-year-old client requesting pain medication for chronic osteoarthritis rated 6/10
B. A 45-year-old client with new-onset shortness of breath and an oxygen saturation of 88% on room air
[CORRECT]
C. A 78-year-old client awaiting discharge instructions and transportation home
D. A 52-year-old client with a blood pressure of 148/92 mmHg scheduled for antihypertensive administration
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework and Maslow's hierarchy, the client with
new-onset shortness of breath and hypoxemia (SpO2 88%) is the most physiologically unstable and requires immediate
assessment. Airway and breathing always take priority over circulation, pain, and discharge needs. This question reflects
NCLEX-RN priority-setting standards and NUR 2356 clinical reasoning emphasis.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 3
, NUR 2356 / MDC 1 Exam 1 (2026/2027) - Rasmussen Comprehensive 120-Question Examination
Q9: While performing a head-to-toe assessment, the nurse notes that the client's pupils are 5 mm and unresponsive to
light. The client is somnolent but arousable. Which action should the nurse take FIRST?
A. Document the finding as an expected variation and continue the assessment
B. Reassess the pupils in 30 minutes after completing the remainder of the examination
C. Immediately assess level of consciousness using the Glasgow Coma Scale and notify the provider
[CORRECT]
D. Administer naloxone 0.4 mg IV push per standing orders for suspected opioid overdose
Correct Answer: C
Rationale: Dilated, unreactive pupils in a somnolent client suggest a neurological emergency such as increased intracranial
pressure, brain herniation, or toxic/metabolic encephalopathy. The nurse must immediately assess level of consciousness using
the Glasgow Coma Scale (GCS) and notify the provider for emergent evaluation. Documenting or delaying is unsafe;
administering naloxone without confirming opioid use is inappropriate. This scenario requires NCLEX-RN-level clinical
judgment and NUR 2356 neurological assessment competence.
Q10: During inspection of a client's skin, the nurse observes a darkly pigmented, asymmetric lesion with irregular
borders and a diameter of 8 mm on the client's back. Which documentation is most accurate using the ABCDE rule?
A. Benign-appearing nevus, monitor at next routine visit
B. Suspicious lesion demonstrating asymmetry, border irregularity, color variation, and diameter >6 mm
requiring provider evaluation [CORRECT]
C. Stage 1 pressure injury on the posterior thorax requiring wound care intervention
D. Ecchymosis consistent with minor trauma, monitor for resolution
Correct Answer: B
Rationale: The ABCDE rule for melanoma screening includes Asymmetry, Border irregularity, Color variation, Diameter
greater than 6 mm, and Evolution (changing). The described lesion meets multiple suspicious criteria and requires prompt
provider evaluation for potential biopsy. Misclassifying as benign or as a pressure injury delays critical diagnosis. The ABCDE
rule is a NUR 2356 integumentary assessment standard and aligns with the American Cancer Society skin cancer screening
guidelines.
Q11: The nurse is preparing to perform a focused musculoskeletal assessment on a client with suspected decreased
mobility. Which finding during inspection and palpation should the nurse identify as a significant abnormality?
A. Symmetric muscle bulk in bilateral upper and lower extremities
B. Full range of motion in all joints without pain or crepitus
C. Asymmetric muscle atrophy in the right lower extremity compared with the left [CORRECT]
D. Equal muscle strength rated 5/5 in bilateral upper and lower extremities
Correct Answer: C
Rationale: Asymmetric muscle atrophy suggests disuse, denervation, or chronic pathology affecting one extremity more than the
other, and requires further evaluation. Symmetric muscle bulk, full painless range of motion, and equal 5/5 strength are all
normal findings. Recognizing asymmetric findings is a critical NUR 2356 musculoskeletal assessment competency and aligns
with NCLEX-RN reduction of risk potential.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 4
MDC 1 Exam 1 (Latest ) - Rasmussen
Comprehensive 120-Question Examination
Aligned with Rasmussen University NUR 2356 Course Syllabus, NCLEX-RN Test Plan, QSEN Competencies, and Multidimensional Care I
Nursing Standards (2026/2027 Edition).
Total Questions 120
Cognitive Mix 20% Recall | 50% Application | 30% Analysis
Special Inclusions 20 Priority-Setting | 15 Pharmacology | 10+ Infection/Safety
Question Style 75% Scenario-Based | 25% Direct Knowledge
Format Multiple Choice (4 options, one correct) with Rationale
Section 1: Health Assessment & Physical Examination
Q1: The nurse is preparing to perform a comprehensive abdominal assessment on an adult client. In which order
should the four fundamental assessment techniques be performed for the abdomen specifically?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, inspection, percussion, palpation
C. Inspection, auscultation, percussion, palpation [CORRECT]
D. Inspection, palpation, percussion, auscultation
Correct Answer: C
Rationale: For most body systems, the correct order is inspection, palpation, percussion, auscultation. However, the abdomen is
the EXCEPTION — auscultation is performed before palpation and percussion to avoid altering bowel sounds through manual
manipulation. This is a foundational NUR 2356 assessment principle aligned with the NCLEX-RN Health Assessment content.
Q2: A 65-year-old Muslim female client is admitted for a comprehensive physical examination. Which action by the
nurse best demonstrates culturally competent care during the assessment?
A. Ask the client to remove her head covering for the entire examination
B. Schedule a female provider and allow the client to keep her head covering when possible [CORRECT]
C. Perform the examination in the presence of a male family member for chaperone purposes
D. Skip the head and neck assessment entirely to avoid cultural discomfort
Correct Answer: B
Rationale: Cultural competence requires respecting the client's religious practices. Muslim women may prefer female providers
and wear a head covering (hijab) for modesty. The nurse should accommodate these preferences whenever clinically feasible
while completing the necessary assessment. The other options violate cultural norms, compromise assessment completeness, or
impose Western practices on the client, contradicting QSEN patient-centered care.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 1
,NUR 2356 / MDC 1 Exam 1 (2026/2027) - Rasmussen Comprehensive 120-Question Examination
Q3: During a focused respiratory assessment, the nurse auscultates high-pitched, musical, continuous sounds on
expiration over the bilateral lower lobes. How should the nurse document these findings?
A. Crackles (rales) bilaterally in the lower lobes
B. Wheezes bilaterally in the lower lobes [CORRECT]
C. Pleural friction rub bilaterally in the lower lobes
D. Stridor bilaterally in the lower lobes
Correct Answer: B
Rationale: Wheezes are high-pitched, musical, continuous sounds heard predominantly on expiration and are caused by
narrowed airway passages (e.g., asthma, bronchospasm). Crackles are discontinuous popping sounds; pleural friction rub is
grating and synchronous with respiration; stridor is a harsh inspiratory crowing sound indicating upper airway obstruction.
Accurate documentation of adventitious breath sounds is a core NUR 2356 respiratory assessment competency.
Q4: The nurse is performing a cardiovascular assessment on a 72-year-old client. Which finding requires immediate
follow-up and provider notification?
A. Apical pulse rate of 64 beats/minute and regular
B. Systolic blood pressure of 138/86 mmHg after ambulation
C. Jugular venous distention (JVD) at 45 degrees of head elevation [CORRECT]
D. Bounding peripheral pulses rated +3 bilaterally in upper extremities
Correct Answer: C
Rationale: Jugular venous distention greater than 3 cm above the sternal angle at 45 degrees indicates elevated right atrial
pressure, suggesting right-sided heart failure, fluid overload, or cardiac tamponade. This finding requires prompt provider
notification. A heart rate of 64 is within normal limits for an older adult, the blood pressure is mildly elevated but not emergent,
and +3 pulses are normal-to-bounding but not immediately dangerous. NCLEX-RN prioritization principles emphasize
hemodynamic instability as a priority.
Q5: Which technique should the nurse use when assessing for the presence of a fluid wave in a client suspected of
having ascites?
A. Percuss the abdomen for shifting dullness with the client supine
B. Place one hand flat against the client's flank and tap the opposite flank with the other hand [CORRECT]
C. Auscultate the abdomen for bruits in all four quadrants
D. Measure abdominal girth at the umbilicus with the client in semi-Fowler's
Correct Answer: B
Rationale: To assess for a fluid wave, the nurse places one hand flat against the client's flank and taps the opposite flank with the
fingertips of the other hand. A fluid wave (palpable impulse) indicates free fluid within the peritoneal cavity (ascites). Shifting
dullness is an alternative technique but involves percussion, not the fluid wave test itself. Bruits are vascular sounds; abdominal
girth is a measurement, not a fluid wave assessment. This is a foundational NUR 2356 abdominal assessment skill.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 2
,NUR 2356 / MDC 1 Exam 1 (2026/2027) - Rasmussen Comprehensive 120-Question Examination
Q6: An 82-year-old client is admitted for a comprehensive assessment. Which age-related change in the neurological
system should the nurse anticipate as an expected finding versus a pathological change requiring further evaluation?
A. Slowed reaction time and mild decreased vibratory sense in the lower extremities [CORRECT]
B. Bilateral Babinski reflex positive and absence of deep tendon reflexes
C. Sudden onset of confusion and disorientation to person
D. Asymmetric grip strength with right side significantly weaker than left
Correct Answer: A
Rationale: Slowed reaction time and decreased vibratory sense in the lower extremities are normal age-related changes in the
older adult neurological system. A positive Babinski sign in an adult is pathological and indicates upper motor neuron disease.
Sudden onset confusion suggests delirium and requires immediate evaluation. Asymmetric grip strength suggests a focal
neurological deficit such as stroke. Distinguishing normal aging from pathological findings is a critical NUR 2356 assessment
competency.
Q7: The nurse is completing a comprehensive health history on a 45-year-old client. Which question best
exemplifies the use of the CAGE screening tool?
A. "Have you ever felt the need to Cut down on your drinking?" [CORRECT]
B. "Do you currently smoke cigarettes or use tobacco products?"
C. "Have you experienced any Chest pain with Activity or exertion?"
D. "Do you have a family history of Gestational diabetes?"
Correct Answer: A
Rationale: The CAGE questionnaire is a validated alcohol use screening tool with four questions: (C) Have you ever felt the
need to Cut down? (A) Have you ever felt Annoyed by criticism of your drinking? (G) Have you ever felt Guilty about your
drinking? (E) Have you ever had a drink first thing in the morning (Eye-opener)? Two or more positive responses suggest a
potential alcohol use disorder. This screening tool is emphasized in NUR 2356 health history content.
Q8: The nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess FIRST based
on the principles of priority setting?
A. A 60-year-old client requesting pain medication for chronic osteoarthritis rated 6/10
B. A 45-year-old client with new-onset shortness of breath and an oxygen saturation of 88% on room air
[CORRECT]
C. A 78-year-old client awaiting discharge instructions and transportation home
D. A 52-year-old client with a blood pressure of 148/92 mmHg scheduled for antihypertensive administration
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework and Maslow's hierarchy, the client with
new-onset shortness of breath and hypoxemia (SpO2 88%) is the most physiologically unstable and requires immediate
assessment. Airway and breathing always take priority over circulation, pain, and discharge needs. This question reflects
NCLEX-RN priority-setting standards and NUR 2356 clinical reasoning emphasis.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 3
, NUR 2356 / MDC 1 Exam 1 (2026/2027) - Rasmussen Comprehensive 120-Question Examination
Q9: While performing a head-to-toe assessment, the nurse notes that the client's pupils are 5 mm and unresponsive to
light. The client is somnolent but arousable. Which action should the nurse take FIRST?
A. Document the finding as an expected variation and continue the assessment
B. Reassess the pupils in 30 minutes after completing the remainder of the examination
C. Immediately assess level of consciousness using the Glasgow Coma Scale and notify the provider
[CORRECT]
D. Administer naloxone 0.4 mg IV push per standing orders for suspected opioid overdose
Correct Answer: C
Rationale: Dilated, unreactive pupils in a somnolent client suggest a neurological emergency such as increased intracranial
pressure, brain herniation, or toxic/metabolic encephalopathy. The nurse must immediately assess level of consciousness using
the Glasgow Coma Scale (GCS) and notify the provider for emergent evaluation. Documenting or delaying is unsafe;
administering naloxone without confirming opioid use is inappropriate. This scenario requires NCLEX-RN-level clinical
judgment and NUR 2356 neurological assessment competence.
Q10: During inspection of a client's skin, the nurse observes a darkly pigmented, asymmetric lesion with irregular
borders and a diameter of 8 mm on the client's back. Which documentation is most accurate using the ABCDE rule?
A. Benign-appearing nevus, monitor at next routine visit
B. Suspicious lesion demonstrating asymmetry, border irregularity, color variation, and diameter >6 mm
requiring provider evaluation [CORRECT]
C. Stage 1 pressure injury on the posterior thorax requiring wound care intervention
D. Ecchymosis consistent with minor trauma, monitor for resolution
Correct Answer: B
Rationale: The ABCDE rule for melanoma screening includes Asymmetry, Border irregularity, Color variation, Diameter
greater than 6 mm, and Evolution (changing). The described lesion meets multiple suspicious criteria and requires prompt
provider evaluation for potential biopsy. Misclassifying as benign or as a pressure injury delays critical diagnosis. The ABCDE
rule is a NUR 2356 integumentary assessment standard and aligns with the American Cancer Society skin cancer screening
guidelines.
Q11: The nurse is preparing to perform a focused musculoskeletal assessment on a client with suspected decreased
mobility. Which finding during inspection and palpation should the nurse identify as a significant abnormality?
A. Symmetric muscle bulk in bilateral upper and lower extremities
B. Full range of motion in all joints without pain or crepitus
C. Asymmetric muscle atrophy in the right lower extremity compared with the left [CORRECT]
D. Equal muscle strength rated 5/5 in bilateral upper and lower extremities
Correct Answer: C
Rationale: Asymmetric muscle atrophy suggests disuse, denervation, or chronic pathology affecting one extremity more than the
other, and requires further evaluation. Symmetric muscle bulk, full painless range of motion, and equal 5/5 strength are all
normal findings. Recognizing asymmetric findings is a critical NUR 2356 musculoskeletal assessment competency and aligns
with NCLEX-RN reduction of risk potential.
NUR 2356 Multidimensional Care I | 2026/2027 Edition | Aligned with NCLEX-RN Test Plan & QSEN Page 4
