MDC II (NUR2392) Exam 3 Multidimensional Care II:
Questions with Answers| Rasmussen University|
Updated| Pass Guaranteed
1. A patient is 1 day post transsphenoidal hypophysectomy for a
pituitary adenoma. Which instruction is most important?
A. Lie flat for 24 hours
B. Blow the nose gently every hour
C. Use a straw to drink
D. Avoid coughing, sneezing, straining, and bending forward
Answer: D. Avoid coughing, sneezing, straining, and bending forward
Rationale: These actions raise intracranial pressure and risk a
cerebrospinal fluid leak. Monitor for clear nasal drainage (halo sign,
glucose-positive), signs of diabetes insipidus (high urine output, low
specific gravity), and hormone deficiency.
2. Lab results show low TSH, high free T4, and high free T3. Which
condition is most consistent?
A. Primary hypothyroidism
B. Primary hyperthyroidism
C. Euthyroid state
D. Secondary hypothyroidism
Answer: B. Primary hyperthyroidism
Rationale: In primary hyperthyroidism, thyroid hormones are high and TSH
is suppressed by negative feedback. In primary hypothyroidism, TSH is
high and T4 low.
MDC II Exam 3 | Page 1
,3. A patient receiving radioactive iodine (I-131) for hyperthyroidism
should be taught to:
A. Flush the toilet twice, use separate utensils, and limit close contact with
children and pregnant women for the period advised
B. Avoid drinking fluids
C. Stay in the hospital for a month
D. Share dishes normally
Answer: A. Flush the toilet twice, use separate utensils, and limit
close contact with children and pregnant women for the period
advised
Rationale: I-131 is excreted in saliva and urine for days. Follow radiation
safety instructions; hypothyroidism often develops later and requires
lifelong levothyroxine.
4. A patient with myxedema coma is admitted. Which manifestation is
expected?
A. Hypertension and agitation
B. Hyperthermia and tachycardia
C. Hypothermia, bradycardia, hypoventilation, and altered mental status
D. Diarrhea and tremor
Answer: C. Hypothermia, bradycardia, hypoventilation, and altered
mental status
Rationale: Myxedema coma is a life-threatening extreme of
hypothyroidism, usually triggered by infection, cold, or sedatives. Treatment
includes IV levothyroxine, hydrocortisone, ventilatory support, and gentle
rewarming.
MDC II Exam 3 | Page 2
, 5. A patient with hypertension, muscle weakness, and a potassium of
2.8 mEq/L has a low renin level. What condition is suspected?
A. Pheochromocytoma
B. Addison disease
C. Primary aldosteronism (Conn syndrome)
D. Hypothyroidism
Answer: C. Primary aldosteronism (Conn syndrome)
Rationale: Excess aldosterone causes sodium and water retention with
potassium loss. Treatment includes spironolactone or surgical removal of
an adenoma.
6. The patient in DKA has a glucose of 210 mg/dL after 4 hours of IV
insulin infusion, and the anion gap remains elevated. What is the best
action?
A. Add dextrose to IV fluids and continue insulin until ketosis resolves
B. Discontinue potassium
C. Give only oral fluids
D. Stop insulin
Answer: A. Add dextrose to IV fluids and continue insulin until ketosis
resolves
Rationale: DKA resolution is judged by closure of the anion gap and
correction of acidosis, not by glucose alone. Dextrose prevents
hypoglycemia while insulin clears ketones.
7. A hemoglobin A1c of 8.4% reflects an average blood glucose over
about how long?
A. 2–3 months
B. 1 year
C. 24 hours
D. 1 week
Answer: A. 2–3 months
Rationale: A1c reflects glycation of hemoglobin over the red cell lifespan
(about 120 days). The usual target for many adults with diabetes is below
7%, individualized.
MDC II Exam 3 | Page 3
Questions with Answers| Rasmussen University|
Updated| Pass Guaranteed
1. A patient is 1 day post transsphenoidal hypophysectomy for a
pituitary adenoma. Which instruction is most important?
A. Lie flat for 24 hours
B. Blow the nose gently every hour
C. Use a straw to drink
D. Avoid coughing, sneezing, straining, and bending forward
Answer: D. Avoid coughing, sneezing, straining, and bending forward
Rationale: These actions raise intracranial pressure and risk a
cerebrospinal fluid leak. Monitor for clear nasal drainage (halo sign,
glucose-positive), signs of diabetes insipidus (high urine output, low
specific gravity), and hormone deficiency.
2. Lab results show low TSH, high free T4, and high free T3. Which
condition is most consistent?
A. Primary hypothyroidism
B. Primary hyperthyroidism
C. Euthyroid state
D. Secondary hypothyroidism
Answer: B. Primary hyperthyroidism
Rationale: In primary hyperthyroidism, thyroid hormones are high and TSH
is suppressed by negative feedback. In primary hypothyroidism, TSH is
high and T4 low.
MDC II Exam 3 | Page 1
,3. A patient receiving radioactive iodine (I-131) for hyperthyroidism
should be taught to:
A. Flush the toilet twice, use separate utensils, and limit close contact with
children and pregnant women for the period advised
B. Avoid drinking fluids
C. Stay in the hospital for a month
D. Share dishes normally
Answer: A. Flush the toilet twice, use separate utensils, and limit
close contact with children and pregnant women for the period
advised
Rationale: I-131 is excreted in saliva and urine for days. Follow radiation
safety instructions; hypothyroidism often develops later and requires
lifelong levothyroxine.
4. A patient with myxedema coma is admitted. Which manifestation is
expected?
A. Hypertension and agitation
B. Hyperthermia and tachycardia
C. Hypothermia, bradycardia, hypoventilation, and altered mental status
D. Diarrhea and tremor
Answer: C. Hypothermia, bradycardia, hypoventilation, and altered
mental status
Rationale: Myxedema coma is a life-threatening extreme of
hypothyroidism, usually triggered by infection, cold, or sedatives. Treatment
includes IV levothyroxine, hydrocortisone, ventilatory support, and gentle
rewarming.
MDC II Exam 3 | Page 2
, 5. A patient with hypertension, muscle weakness, and a potassium of
2.8 mEq/L has a low renin level. What condition is suspected?
A. Pheochromocytoma
B. Addison disease
C. Primary aldosteronism (Conn syndrome)
D. Hypothyroidism
Answer: C. Primary aldosteronism (Conn syndrome)
Rationale: Excess aldosterone causes sodium and water retention with
potassium loss. Treatment includes spironolactone or surgical removal of
an adenoma.
6. The patient in DKA has a glucose of 210 mg/dL after 4 hours of IV
insulin infusion, and the anion gap remains elevated. What is the best
action?
A. Add dextrose to IV fluids and continue insulin until ketosis resolves
B. Discontinue potassium
C. Give only oral fluids
D. Stop insulin
Answer: A. Add dextrose to IV fluids and continue insulin until ketosis
resolves
Rationale: DKA resolution is judged by closure of the anion gap and
correction of acidosis, not by glucose alone. Dextrose prevents
hypoglycemia while insulin clears ketones.
7. A hemoglobin A1c of 8.4% reflects an average blood glucose over
about how long?
A. 2–3 months
B. 1 year
C. 24 hours
D. 1 week
Answer: A. 2–3 months
Rationale: A1c reflects glycation of hemoglobin over the red cell lifespan
(about 120 days). The usual target for many adults with diabetes is below
7%, individualized.
MDC II Exam 3 | Page 3
