,NUR 2502 / NUR 2502 Exam 2
Multidimensional Care III (MDC III) |
Rasmussen University | 2026/2027 Exam Prep
+ Clinical Judgment Q&A
Q1. A client with chronic obstructive pulmonary disease has a barrel chest, pursed-lip
breathing, and a chronic productive cough. Which assessment finding should the nurse
monitor as the priority?
A. Barrel chest shape
B. Oxygen saturation level
C. Sputum characteristics
D. Clubbing of the fingers
Correct Answer: B. Oxygen saturation level
Rationale: In COPD, the priority is monitoring oxygenation because hypoxemia can lead to
respiratory failure. Barrel chest, clubbing, and sputum characteristics are important but do
not guide immediate intervention. The nurse should monitor SpO₂ continuously or frequently
and administer oxygen titrated to maintain SpO₂ between 88% and 92% in clients with chronic
CO₂ retention.
Key Takeaway: Monitor oxygen saturation as the priority in COPD to detect hypoxemia and
guide oxygen therapy.
Q2. A nurse is providing discharge teaching to a client newly diagnosed with tuberculosis.
Which statement by the client indicates correct understanding?
A. "I can stop taking my medications when I feel better."
B. "I will need to take my medications for at least 6 to 12 months."
C. "My family does not need to be tested."
D. "I only need to take medications until my cough stops."
Correct Answer: B. "I will need to take my medications for at least 6 to 12 months."
,Rationale: Active TB requires a prolonged course of multiple antibiotics for 6 to 12 months to
eradicate the bacteria and prevent drug resistance. Clients must complete the full course even
if symptoms improve. Family members require testing. The nurse should also teach the client
about the importance of adherence and follow-up.
Key Takeaway: TB treatment requires 6 to 12 months of multiple antibiotics; clients must
complete the full course.
Q3. A client with status asthmaticus is admitted with severe respiratory distress. Which action
should the nurse take first?
A. Administer prescribed bronchodilators
B. Assess respiratory status and oxygen saturation
C. Apply continuous pulse oximetry
D. Prepare for emergency intubation
Correct Answer: B. Assess respiratory status and oxygen saturation
Rationale: Status asthmaticus is a life-threatening asthma exacerbation. The priority is to
assess respiratory status and oxygenation to determine the severity and guide interventions.
Administering bronchodilators, applying pulse oximetry, and preparing for intubation are
important but follow assessment. The nurse should also administer oxygen and prepare for
possible mechanical ventilation.
Key Takeaway: Assess respiratory status first in status asthmaticus to determine severity and
guide interventions.
Q4. A client with COPD is prescribed albuterol. Which therapeutic effect should the nurse
expect?
A. Reduced airway inflammation
B. Relaxation of bronchial smooth muscle
C. Thinning of pulmonary secretions
D. Suppression of the cough reflex
Correct Answer: B. Relaxation of bronchial smooth muscle
, Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that stimulates beta₂ receptors
in bronchial smooth muscle, causing bronchodilation. It is used as a rescue inhaler for acute
bronchospasm. It does not reduce inflammation (that is the role of corticosteroids), thin
secretions (mucolytics), or suppress cough. The nurse should teach the client to use albuterol
for acute symptoms.
Key Takeaway: Albuterol is a beta₂ agonist that relaxes bronchial smooth muscle to cause
bronchodilation.
Q5. A client with a chest tube inserted for a pneumothorax has continuous bubbling in the
water seal chamber. Which action should the nurse take first?
A. Clamp the chest tube at the insertion site
B. Notify the provider immediately
C. Lower the suction level
D. Increase the suction level
Correct Answer: B. Notify the provider immediately
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the chest
tube system. The nurse should notify the provider immediately. Clamping the chest tube can
cause tension pneumothorax. Lowering or increasing suction does not address the air leak.
The nurse should also assess the insertion site and tubing for leaks or disconnection.
Key Takeaway: Continuous bubbling in the water seal chamber indicates an air leak; notify the
provider immediately.
Q6. A client with a chest tube accidentally dislodges the tube. Which action should the nurse
take first?
A. Clamp the tubing
B. Cover the insertion site with a sterile occlusive dressing taped on three sides
C. Notify the provider
D. Reinsert the tube
Correct Answer: B. Cover the insertion site with a sterile occlusive dressing taped on three
sides
Multidimensional Care III (MDC III) |
Rasmussen University | 2026/2027 Exam Prep
+ Clinical Judgment Q&A
Q1. A client with chronic obstructive pulmonary disease has a barrel chest, pursed-lip
breathing, and a chronic productive cough. Which assessment finding should the nurse
monitor as the priority?
A. Barrel chest shape
B. Oxygen saturation level
C. Sputum characteristics
D. Clubbing of the fingers
Correct Answer: B. Oxygen saturation level
Rationale: In COPD, the priority is monitoring oxygenation because hypoxemia can lead to
respiratory failure. Barrel chest, clubbing, and sputum characteristics are important but do
not guide immediate intervention. The nurse should monitor SpO₂ continuously or frequently
and administer oxygen titrated to maintain SpO₂ between 88% and 92% in clients with chronic
CO₂ retention.
Key Takeaway: Monitor oxygen saturation as the priority in COPD to detect hypoxemia and
guide oxygen therapy.
Q2. A nurse is providing discharge teaching to a client newly diagnosed with tuberculosis.
Which statement by the client indicates correct understanding?
A. "I can stop taking my medications when I feel better."
B. "I will need to take my medications for at least 6 to 12 months."
C. "My family does not need to be tested."
D. "I only need to take medications until my cough stops."
Correct Answer: B. "I will need to take my medications for at least 6 to 12 months."
,Rationale: Active TB requires a prolonged course of multiple antibiotics for 6 to 12 months to
eradicate the bacteria and prevent drug resistance. Clients must complete the full course even
if symptoms improve. Family members require testing. The nurse should also teach the client
about the importance of adherence and follow-up.
Key Takeaway: TB treatment requires 6 to 12 months of multiple antibiotics; clients must
complete the full course.
Q3. A client with status asthmaticus is admitted with severe respiratory distress. Which action
should the nurse take first?
A. Administer prescribed bronchodilators
B. Assess respiratory status and oxygen saturation
C. Apply continuous pulse oximetry
D. Prepare for emergency intubation
Correct Answer: B. Assess respiratory status and oxygen saturation
Rationale: Status asthmaticus is a life-threatening asthma exacerbation. The priority is to
assess respiratory status and oxygenation to determine the severity and guide interventions.
Administering bronchodilators, applying pulse oximetry, and preparing for intubation are
important but follow assessment. The nurse should also administer oxygen and prepare for
possible mechanical ventilation.
Key Takeaway: Assess respiratory status first in status asthmaticus to determine severity and
guide interventions.
Q4. A client with COPD is prescribed albuterol. Which therapeutic effect should the nurse
expect?
A. Reduced airway inflammation
B. Relaxation of bronchial smooth muscle
C. Thinning of pulmonary secretions
D. Suppression of the cough reflex
Correct Answer: B. Relaxation of bronchial smooth muscle
, Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that stimulates beta₂ receptors
in bronchial smooth muscle, causing bronchodilation. It is used as a rescue inhaler for acute
bronchospasm. It does not reduce inflammation (that is the role of corticosteroids), thin
secretions (mucolytics), or suppress cough. The nurse should teach the client to use albuterol
for acute symptoms.
Key Takeaway: Albuterol is a beta₂ agonist that relaxes bronchial smooth muscle to cause
bronchodilation.
Q5. A client with a chest tube inserted for a pneumothorax has continuous bubbling in the
water seal chamber. Which action should the nurse take first?
A. Clamp the chest tube at the insertion site
B. Notify the provider immediately
C. Lower the suction level
D. Increase the suction level
Correct Answer: B. Notify the provider immediately
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the chest
tube system. The nurse should notify the provider immediately. Clamping the chest tube can
cause tension pneumothorax. Lowering or increasing suction does not address the air leak.
The nurse should also assess the insertion site and tubing for leaks or disconnection.
Key Takeaway: Continuous bubbling in the water seal chamber indicates an air leak; notify the
provider immediately.
Q6. A client with a chest tube accidentally dislodges the tube. Which action should the nurse
take first?
A. Clamp the tubing
B. Cover the insertion site with a sterile occlusive dressing taped on three sides
C. Notify the provider
D. Reinsert the tube
Correct Answer: B. Cover the insertion site with a sterile occlusive dressing taped on three
sides
