NUR 2755 MDC4 Final Exam 2026/2027 | Multidimensional Care IV | Questions, Answers & Detailed Rationales | Rasmussen University

NUR 2755 MDC4 Final Exam 2026/2027 |
Questions with Verified Answers & Detailed
Rationales | Multidimensional Care IV | A+
Graded



Section 1: Shock, Sepsis & Emergency Management (Questions 1-40)

1. A patient in septic shock has a mean arterial pressure (MAP) of 52 mmHg despite
fluid resuscitation. Which medication does the nurse anticipate?

 A) Furosemide
 B) Norepinephrine
 C) Dobutamine
 D) Nitroprusside

Correct Answer: B

Rationale: Norepinephrine is the first-line vasopressor for septic shock to raise MAP to ≥65
mmHg. Furosemide is for fluid overload; dobutamine is for cardiogenic shock with low
cardiac output; nitroprusside lowers BP .

, 2. The nurse is calculating the mean arterial pressure (MAP) for a patient with a blood
pressure of 90/50 mmHg. What is the MAP?

 A) 60 mmHg
 B) 63 mmHg
 C) 70 mmHg
 D) 73 mmHg

Correct Answer: B

Rationale: MAP = (SBP + 2×DBP) / 3 = (90 + 100) / 3 = = 63.3 mmHg, rounded to
63 mmHg .




3. A patient with suspected shock has a central venous pressure (CVP) of 2 mmHg.
How should the nurse interpret this finding?

 A) Normal CVP indicating adequate volume status
 B) Low CVP indicating hypovolemia
 C) Elevated CVP indicating fluid overload
 D) Indicating right-sided heart failure

Correct Answer: B

Rationale: Normal CVP is 2-6 mmHg. A CVP of 2 mmHg is low, indicating decreased
venous return and hypovolemia. This is commonly seen in hypovolemic shock. Fluid
resuscitation is indicated .

, 4. A patient in septic shock is receiving vasopressin as an adjunctive vasopressor.
The nurse understands that vasopressin works by:

 A) Increasing cardiac contractility
 B) Causing vasoconstriction via V1 receptors
 C) Decreasing systemic vascular resistance
 D) Increasing heart rate

Correct Answer: B

Rationale: Vasopressin is a potent vasoconstrictor that works on V1 receptors on vascular
smooth muscle. It is used as a second-line vasopressor in septic shock when
norepinephrine doses are high. It does not increase heart rate or contractility .




5. The nurse is caring for a patient with anaphylactic shock. Which medication should
the nurse prepare to administer first?

 A) Diphenhydramine (Benadryl)
 B) Methylprednisolone (Solu-Medrol)
 C) Epinephrine
 D) Albuterol

Correct Answer: C

Rationale: Epinephrine is the first-line treatment for anaphylactic shock. It rapidly reverses
vasodilation and bronchoconstriction, increases cardiac output, and reduces airway edema.
It should be administered immediately, preferably intramuscularly in the anterolateral thigh .

, 6. The refractory (irreversible) stage of shock is characterized by:

 A) Improved urine output
 B) Multiple organ failure that is unresponsive to treatment
 C) Increased blood pressure
 D) Decreased heart rate

Correct Answer: B

Rationale: The refractory (irreversible) stage of shock is characterized by severe organ
dysfunction that does not respond to treatment. Cellular death occurs, and the patient may
not survive even with aggressive interventions. This stage is associated with MODS .




7. A patient with a suspected shock has a central venous pressure (CVP) of 2 mmHg.
Which intervention is indicated?

 A) Administer diuretics
 B) Fluid resuscitation
 C) Start vasopressors
 D) Restrict fluids

Correct Answer: B

Rationale: A low CVP indicates hypovolemia and decreased venous return. Fluid
resuscitation is indicated to restore intravascular volume and improve cardiac output .