1|Page
NUR 2755 MDC4 FINAL EXAM -MULTIDIMENSIONAL
CARE (IV) | ALL PRACTICE Q&A 2026/2027 | A+ GRADED
| COMPREHENSIVE EXAM GUIDE 2026&2027
1. A client with acute heart failure suddenly develops severe dyspnea, bilateral crackles,
and an oxygen saturation of 84%. Which action should the nurse take first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position and apply prescribed oxygen
C. Encourage oral fluids
D. Prepare the client for ambulation
Placing the client upright improves lung expansion and decreases venous return, while
supplemental oxygen addresses the immediate hypoxemia. Airway and breathing take
priority over routine heart-failure assessments.
2. A client receiving IV furosemide for pulmonary edema reports muscle weakness and
palpitations. Which laboratory result is most concerning?
A. Sodium 138 mEq/L
B. Calcium 9.1 mg/dL
C. Potassium 2.8 mEq/L
D. Chloride 101 mEq/L
Furosemide promotes potassium loss. A potassium level of 2.8 mEq/L places the client at risk
for dysrhythmias and requires prompt intervention.
3. A nurse is caring for a client with chronic obstructive pulmonary disease who is
receiving oxygen. Which finding requires the most immediate follow-up?
A. Respiratory rate of 20/min
B. Oxygen saturation of 90%
C. New lethargy and increasing difficulty arousing
D. Productive cough with clear sputum
New lethargy and decreased responsiveness may indicate worsening carbon dioxide retention
or respiratory failure. This represents a significant change in neurologic and respiratory
status.
4. A client with suspected pulmonary embolism suddenly reports pleuritic chest pain and
shortness of breath. What is the nurse's priority action?
A. Encourage the client to walk
B. Apply oxygen and assess respiratory status
C. Offer oral fluids
D. Place the client flat
1|Page
,2|Page
A suspected pulmonary embolism can rapidly compromise oxygenation. Supporting
oxygenation and immediately assessing respiratory status are priorities.
5. A client with pneumonia has a temperature of 39.2°C (102.6°F), respiratory rate of
30/min, and confusion. Which finding most strongly suggests systemic deterioration?
A. Productive cough
B. Chest discomfort with coughing
C. New confusion
D. Decreased appetite
Acute confusion can indicate impaired cerebral perfusion or severe systemic infection and
may be an early sign of sepsis-related deterioration.
6. A client with asthma develops wheezing that suddenly becomes very faint after several
minutes of severe respiratory distress. How should the nurse interpret this finding?
A. The asthma attack is resolving
B. Bronchodilator therapy is no longer necessary
C. Airflow may be critically reduced
D. The client has developed pulmonary edema
A sudden decrease in wheezing during severe distress can indicate minimal airflow rather
than improvement. A "silent chest" is an ominous sign requiring immediate intervention.
7. A client with a tracheostomy becomes restless and develops noisy respirations. What
should the nurse do first?
A. Remove the tracheostomy tube
B. Assess the tube for obstruction and suction as indicated
C. Give the client oral fluids
D. Place the client in a supine position
Restlessness and noisy breathing may indicate airway obstruction from secretions. The nurse
should rapidly assess airway patency and suction when clinically indicated.
8. A postoperative client suddenly develops tachycardia, hypotension, and decreased
oxygen saturation. Which complication should the nurse suspect?
A. Pulmonary embolism
B. Constipation
C. Urinary retention
D. Mild postoperative pain
The combination of sudden hypoxemia, tachycardia, and hypotension is concerning for
pulmonary embolism, particularly in a postoperative client with increased thromboembolic
risk.
2|Page
,3|Page
9. A client with heart failure has gained 2.5 kg (5.5 lb) over three days. Which explanation
is most appropriate?
A. Increased muscle mass
B. Fluid retention
C. Improved nutritional status
D. Reduced metabolic activity
Rapid weight gain over several days is most consistent with fluid accumulation rather than
tissue gain and may indicate worsening heart failure.
10. Which assessment finding is most characteristic of left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Dependent peripheral edema only
D. Enlarged liver without respiratory symptoms
Left-sided heart failure causes pulmonary vascular congestion, which commonly produces
dyspnea and crackles. Right-sided failure more commonly causes systemic venous congestion.
11. A client taking digoxin reports nausea and seeing yellow-green halos around lights.
Which action should the nurse take?
A. Administer the next dose with food
B. Document the findings as expected
C. Hold the medication and notify the provider
D. Encourage increased potassium restriction
Nausea and visual disturbances such as yellow-green halos are classic warning signs of
digoxin toxicity. The medication should be withheld and the client evaluated.
12. A client with atrial fibrillation is prescribed an anticoagulant. What is the primary
therapeutic purpose?
A. Reduce ventricular contractility
B. Prevent thromboembolic stroke
C. Increase cardiac output directly
D. Correct the underlying rhythm
Atrial fibrillation promotes blood stasis in the atria, increasing thrombus formation and
embolic stroke risk. Anticoagulation reduces that risk.
13. A client with chest pain has ST-segment elevation on an ECG. Which intervention
should the nurse prioritize?
A. Delay treatment until the pain resolves
B. Activate the appropriate acute coronary syndrome response
C. Encourage ambulation
D. Administer a high-fat meal
3|Page
, 4|Page
ST-segment elevation with acute chest pain may indicate myocardial infarction requiring
rapid reperfusion-focused management. Delays can increase myocardial injury.
14. A client receiving nitroglycerin for angina reports dizziness. Which assessment is most
important?
A. Blood pressure
B. Bowel sounds
C. Skin turgor
D. Visual acuity
Nitroglycerin causes vasodilation and may produce significant hypotension. Blood pressure
should therefore be assessed promptly.
15. A client with peripheral arterial disease reports severe leg pain when walking that
resolves with rest. Which term describes this finding?
A. Orthopnea
B. Intermittent claudication
C. Paresthesia
D. Venous stasis
Intermittent claudication is ischemic muscle pain caused by inadequate arterial blood flow
during activity and relieved by rest.
16. A client with deep vein thrombosis suddenly develops shortness of breath. What
complication should the nurse suspect?
A. Pulmonary embolism
B. Pneumonia caused by aspiration
C. Acute renal failure
D. Hypoglycemia
A thrombus from a deep vein can dislodge and travel to the pulmonary circulation, causing a
potentially life-threatening pulmonary embolism.
17. Which assessment finding is most concerning in a client receiving heparin therapy?
A. Mild fatigue
B. New hematuria
C. Increased appetite
D. Warm hands
Hematuria can indicate clinically significant bleeding during anticoagulant therapy and
requires prompt assessment.
18. A client with chronic venous insufficiency has bilateral ankle edema. Which
intervention is generally appropriate when arterial circulation is adequate?
A. Elevate the legs
4|Page
NUR 2755 MDC4 FINAL EXAM -MULTIDIMENSIONAL
CARE (IV) | ALL PRACTICE Q&A 2026/2027 | A+ GRADED
| COMPREHENSIVE EXAM GUIDE 2026&2027
1. A client with acute heart failure suddenly develops severe dyspnea, bilateral crackles,
and an oxygen saturation of 84%. Which action should the nurse take first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position and apply prescribed oxygen
C. Encourage oral fluids
D. Prepare the client for ambulation
Placing the client upright improves lung expansion and decreases venous return, while
supplemental oxygen addresses the immediate hypoxemia. Airway and breathing take
priority over routine heart-failure assessments.
2. A client receiving IV furosemide for pulmonary edema reports muscle weakness and
palpitations. Which laboratory result is most concerning?
A. Sodium 138 mEq/L
B. Calcium 9.1 mg/dL
C. Potassium 2.8 mEq/L
D. Chloride 101 mEq/L
Furosemide promotes potassium loss. A potassium level of 2.8 mEq/L places the client at risk
for dysrhythmias and requires prompt intervention.
3. A nurse is caring for a client with chronic obstructive pulmonary disease who is
receiving oxygen. Which finding requires the most immediate follow-up?
A. Respiratory rate of 20/min
B. Oxygen saturation of 90%
C. New lethargy and increasing difficulty arousing
D. Productive cough with clear sputum
New lethargy and decreased responsiveness may indicate worsening carbon dioxide retention
or respiratory failure. This represents a significant change in neurologic and respiratory
status.
4. A client with suspected pulmonary embolism suddenly reports pleuritic chest pain and
shortness of breath. What is the nurse's priority action?
A. Encourage the client to walk
B. Apply oxygen and assess respiratory status
C. Offer oral fluids
D. Place the client flat
1|Page
,2|Page
A suspected pulmonary embolism can rapidly compromise oxygenation. Supporting
oxygenation and immediately assessing respiratory status are priorities.
5. A client with pneumonia has a temperature of 39.2°C (102.6°F), respiratory rate of
30/min, and confusion. Which finding most strongly suggests systemic deterioration?
A. Productive cough
B. Chest discomfort with coughing
C. New confusion
D. Decreased appetite
Acute confusion can indicate impaired cerebral perfusion or severe systemic infection and
may be an early sign of sepsis-related deterioration.
6. A client with asthma develops wheezing that suddenly becomes very faint after several
minutes of severe respiratory distress. How should the nurse interpret this finding?
A. The asthma attack is resolving
B. Bronchodilator therapy is no longer necessary
C. Airflow may be critically reduced
D. The client has developed pulmonary edema
A sudden decrease in wheezing during severe distress can indicate minimal airflow rather
than improvement. A "silent chest" is an ominous sign requiring immediate intervention.
7. A client with a tracheostomy becomes restless and develops noisy respirations. What
should the nurse do first?
A. Remove the tracheostomy tube
B. Assess the tube for obstruction and suction as indicated
C. Give the client oral fluids
D. Place the client in a supine position
Restlessness and noisy breathing may indicate airway obstruction from secretions. The nurse
should rapidly assess airway patency and suction when clinically indicated.
8. A postoperative client suddenly develops tachycardia, hypotension, and decreased
oxygen saturation. Which complication should the nurse suspect?
A. Pulmonary embolism
B. Constipation
C. Urinary retention
D. Mild postoperative pain
The combination of sudden hypoxemia, tachycardia, and hypotension is concerning for
pulmonary embolism, particularly in a postoperative client with increased thromboembolic
risk.
2|Page
,3|Page
9. A client with heart failure has gained 2.5 kg (5.5 lb) over three days. Which explanation
is most appropriate?
A. Increased muscle mass
B. Fluid retention
C. Improved nutritional status
D. Reduced metabolic activity
Rapid weight gain over several days is most consistent with fluid accumulation rather than
tissue gain and may indicate worsening heart failure.
10. Which assessment finding is most characteristic of left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Dependent peripheral edema only
D. Enlarged liver without respiratory symptoms
Left-sided heart failure causes pulmonary vascular congestion, which commonly produces
dyspnea and crackles. Right-sided failure more commonly causes systemic venous congestion.
11. A client taking digoxin reports nausea and seeing yellow-green halos around lights.
Which action should the nurse take?
A. Administer the next dose with food
B. Document the findings as expected
C. Hold the medication and notify the provider
D. Encourage increased potassium restriction
Nausea and visual disturbances such as yellow-green halos are classic warning signs of
digoxin toxicity. The medication should be withheld and the client evaluated.
12. A client with atrial fibrillation is prescribed an anticoagulant. What is the primary
therapeutic purpose?
A. Reduce ventricular contractility
B. Prevent thromboembolic stroke
C. Increase cardiac output directly
D. Correct the underlying rhythm
Atrial fibrillation promotes blood stasis in the atria, increasing thrombus formation and
embolic stroke risk. Anticoagulation reduces that risk.
13. A client with chest pain has ST-segment elevation on an ECG. Which intervention
should the nurse prioritize?
A. Delay treatment until the pain resolves
B. Activate the appropriate acute coronary syndrome response
C. Encourage ambulation
D. Administer a high-fat meal
3|Page
, 4|Page
ST-segment elevation with acute chest pain may indicate myocardial infarction requiring
rapid reperfusion-focused management. Delays can increase myocardial injury.
14. A client receiving nitroglycerin for angina reports dizziness. Which assessment is most
important?
A. Blood pressure
B. Bowel sounds
C. Skin turgor
D. Visual acuity
Nitroglycerin causes vasodilation and may produce significant hypotension. Blood pressure
should therefore be assessed promptly.
15. A client with peripheral arterial disease reports severe leg pain when walking that
resolves with rest. Which term describes this finding?
A. Orthopnea
B. Intermittent claudication
C. Paresthesia
D. Venous stasis
Intermittent claudication is ischemic muscle pain caused by inadequate arterial blood flow
during activity and relieved by rest.
16. A client with deep vein thrombosis suddenly develops shortness of breath. What
complication should the nurse suspect?
A. Pulmonary embolism
B. Pneumonia caused by aspiration
C. Acute renal failure
D. Hypoglycemia
A thrombus from a deep vein can dislodge and travel to the pulmonary circulation, causing a
potentially life-threatening pulmonary embolism.
17. Which assessment finding is most concerning in a client receiving heparin therapy?
A. Mild fatigue
B. New hematuria
C. Increased appetite
D. Warm hands
Hematuria can indicate clinically significant bleeding during anticoagulant therapy and
requires prompt assessment.
18. A client with chronic venous insufficiency has bilateral ankle edema. Which
intervention is generally appropriate when arterial circulation is adequate?
A. Elevate the legs
4|Page
