Multidimensional Care III MDC 3 Exam Study Guide, NUR2502 Exam
Prep, Complex Adult Health, Cardiovascular, Hematologic,
Respiratory, Renal, Reproductive & Multisystem Disorders, Clinical
Judgment, Practice Questions, Answers & Rationales
Question 1: A nurse is assessing a client who has been taking levothyroxine for
hypothyroidism. Which finding indicates the client may be experiencing
excessive thyroid replacement?
A. Weight gain and bradycardia
B. Tachycardia and weight loss
C. Constipation and dry skin
D. Hypotension and lethargy
CORRECT ANSWER: B. Tachycardia and weight loss
Rationale: Excessive levothyroxine replacement produces a hyperthyroid-like
state characterized by tachycardia, weight loss, heat intolerance, and anxiety.
Weight gain, bradycardia, constipation, and dry skin suggest inadequate
replacement.
Question 2: A client with type 1 diabetes mellitus is prescribed insulin glargine.
At which time should the nurse instruct the client to administer this
medication?
A. At the same time each day, typically at bedtime
B. Only when blood glucose exceeds 250 mg/dL
C. Immediately before each meal
D. Fifteen minutes after each meal
CORRECT ANSWER: A. At the same time each day, typically at bedtime
Rationale: Insulin glargine is a long-acting basal insulin administered once daily at
a consistent time, often at bedtime, to provide 24-hour coverage without a
pronounced peak.
Question 3: A nurse is caring for a client receiving furosemide. Which laboratory
value requires immediate follow-up?
,A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.4 mg/dL
D. Magnesium 2.0 mg/dL
CORRECT ANSWER: A. Potassium 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium loss. A potassium
level of 3.1 mEq/L is below the normal range of 3.5 to 5.0 mEq/L and places the
client at risk for dysrhythmias.
Question 4: A client is started on metformin for type 2 diabetes. Which
instruction should the nurse include in teaching?
A. Take the medication on an empty stomach only
B. Report any muscle pain or difficulty breathing
C. Expect weight gain as a common side effect
D. Discontinue the drug before any imaging with contrast
CORRECT ANSWER: D. Discontinue the drug before any imaging with contrast
Rationale: Metformin must be withheld before procedures using iodinated
contrast because of the risk of contrast-induced nephropathy and subsequent
lactic acidosis.
Question 5: A nurse is reviewing the plan of care for a client with heart failure
receiving digoxin. Which assessment finding suggests digoxin toxicity?
A. Heart rate of 58 beats per minute with nausea
B. Blood pressure of 118/72 mm Hg
C. Serum potassium of 4.2 mEq/L
D. Weight loss of 1 kg over one week
CORRECT ANSWER: A. Heart rate of 58 beats per minute with nausea
Rationale: Bradycardia, nausea, vomiting, and visual disturbances such as yellow
halos are classic signs of digoxin toxicity. The therapeutic digoxin level is 0.5 to 2.0
ng/mL.
Question 6: A client with asthma is prescribed albuterol. The nurse should teach
the client that this medication works by which mechanism?
,A. Blocking histamine receptors
B. Stimulating beta-2 adrenergic receptors
C. Inhibiting leukotriene synthesis
D. Suppressing the immune response
CORRECT ANSWER: B. Stimulating beta-2 adrenergic receptors
Rationale: Albuterol is a short-acting beta-2 agonist that stimulates beta-2
receptors in the bronchial smooth muscle, producing rapid bronchodilation.
Question 7: A nurse is preparing to administer warfarin to a client. Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A. Activated partial thromboplastin time
B. International normalized ratio
C. Bleeding time
D. Platelet count
CORRECT ANSWER: B. International normalized ratio
Rationale: The international normalized ratio (INR) is the standard laboratory test
used to monitor warfarin therapy, with a typical target range of 2.0 to 3.0 for
most indications.
Question 8: A client receiving heparin develops a sudden drop in platelet count.
Which complication should the nurse suspect?
A. Hemophilia A
B. Heparin-induced thrombocytopenia
C. Disseminated intravascular coagulation
D. Vitamin K deficiency
CORRECT ANSWER: B. Heparin-induced thrombocytopenia
Rationale: Heparin-induced thrombocytopenia is an immune-mediated reaction
causing a significant drop in platelets and a paradoxical risk of thrombosis.
Question 9: A nurse is teaching a client about prednisone. Which adverse effect
should the nurse include in the teaching?
, A. Hypoglycemia
B. Weight loss
C. Increased risk of infection
D. Bradycardia
CORRECT ANSWER: C. Increased risk of infection
Rationale: Prednisone is a corticosteroid that suppresses the immune response,
increasing susceptibility to infection. It also causes hyperglycemia, weight gain,
and tachycardia.
Question 10: A client with hypertension is prescribed lisinopril. Which side
effect should the nurse monitor for?
A. Dry, persistent cough
B. Constipation
C. Hyperkalemia
D. Both A and C
CORRECT ANSWER: D. Both A and C
Rationale: Angiotensin-converting enzyme inhibitors such as lisinopril commonly
cause a dry cough and can elevate potassium levels, especially in clients with
renal impairment.
Question 11: A nurse is administering intravenous potassium chloride to a client
with hypokalemia. Which action is essential?
A. Administer as a rapid IV push
B. Dilute and infuse via pump at a controlled rate
C. Give undiluted via central line
D. Administer intramuscularly
CORRECT ANSWER: B. Dilute and infuse via pump at a controlled rate
Rationale: IV potassium must always be diluted and infused at a controlled rate,
typically no faster than 10 to 20 mEq per hour, because rapid infusion can cause
fatal cardiac dysrhythmias.
Question 12: A client is prescribed atorvastatin. Which instruction should the
nurse include?