NUR 2502 MDC 3 FINAL EXAM REVIEW
QUESTIONS AND CORRECT ANSWERS
PLUS RATIONALE 2026-2027 UPDATE
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Prioritize and interpret complex clinical data to formulate safe, evidence-based nursing interventions for
adults with multisystem health alterations
2 Apply current national guidelines (AHA/ACC, Surviving Sepsis, KDIGO, ADA, AACN) to predict
complications and evaluate therapeutic responses in critical care scenarios
3 Analyze pharmacologic and technological interventions (vasoactive drips, mechanical ventilation, CRRT,
insulin pumps) for efficacy, contraindications, and adverse effects
4 Demonstrate clinical judgment in emergency, perioperative, and end-of-life situations using ethical and
interprofessional frameworks
5 NUR 2502 MDC 3 Final Exam Review Questions and Correct Answers plus Rationale 2026
6 2027 Update
7 Foundations of Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and
Multisystem Management
8 Applied Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and Multisystem
Management
9 Advanced Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and Multisystem
Management
10 Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and Multisystem
Management Review
ABSTRACT
Page 1
,This study document brings together 97 carefully worded exam questions drawn from NUR 2502
MDC 3 Final Exam Review Questions and Correct Answers plus Rationale 2026-2027 Update,
with the strongest emphasis placed on Prioritize and interpret complex clinical data to formulate
safe, evidence-based nursing interventions for adults with multisystem health alterations, Apply
current national guidelines (AHA/ACC, Surviving Sepsis, KDIGO, ADA, AACN) to predict
complications and evaluate therapeutic responses in critical care scenarios, Analyze
pharmacologic and technological interventions (vasoactive drips, mechanical ventilation, CRRT,
insulin pumps) for efficacy, contraindications and and adverse effects. Every item follows the
wording style and level of reasoning you meet in the real paper, and each one is paired with a clear
rationale so the correct choice is never a guess. Work through the set at your own pace, mark the
questions that slow you down, then come back to them until the reasoning feels automatic.
Learners who revise this way walk into the exam room recognising the pattern behind the
questions instead of meeting them for the first time. Keep going - steady, honest practice is what
turns a difficult paper into a comfortable pass.
Q1 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with acute decompensated heart failure is receiving IV furosemide.
Which assessment finding most urgently indicates a need to hold the dose and
notify the provider?
A. Serum potassium 3.1 mEq/L with new U waves on ECG CORRECT
B. Urine output 40 mL/hr with specific gravity 1.020
C. Blood pressure 106/68 mm Hg with mild dizziness on standing
D. Weight loss of 1.2 kg over 24 hours
RATIONALE: Loop diuretics cause hypokalemia; a K+ of 3.1 with U waves signals dangerous
cardiac irritability and risk for dysrhythmias, requiring holding the dose and replacement. The
other findings are expected therapeutic effects or mild, non-urgent side effects.
Page 2
,Q2 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with type 1 diabetes on an insulin pump develops nausea, abdominal
pain, and Kussmaul respirations. Blood glucose is 412 mg/dL, pH 7.12, HCO3 8
mEq/L, and beta-hydroxybutyrate is elevated. Which action should the nurse
anticipate first?
A. Administer a 1-L bolus of 0.9% sodium chloride CORRECT
B. Give subcutaneous insulin glargine 20 units
C. Initiate sodium bicarbonate infusion
D. Place the patient on a bicarbonate-based CRRT circuit
RATIONALE: DKA management begins with aggressive isotonic fluid resuscitation to restore
intravascular volume and renal perfusion. Subcutaneous long-acting insulin is too slow;
bicarbonate is reserved for pH <6.9; CRRT is not indicated for uncomplicated DKA.
Q3 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with an acute ischemic stroke is being evaluated for IV thrombolytic
therapy. Which finding would be an absolute contraindication to alteplase?
A. Blood pressure 178/102 mm Hg
B. Platelet count 185,000/mm³
C. INR 1.1
D. History of intracranial hemorrhage 2 years ago CORRECT
RATIONALE: Any prior intracranial hemorrhage is an absolute contraindication to alteplase due
to prohibitive risk of recurrent bleeding. Blood pressure >185/110 is a relative contraindication
requiring correction; normal platelets and INR are not contraindications.
Page 3
, Q4 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with chronic kidney disease stage 5 develops a serum potassium of 6.8
mEq/L with peaked T waves. Which intervention should the nurse anticipate as the
priority?
A. Administer sodium polystyrene sulfonate orally
B. Give IV calcium gluconate CORRECT
C. Initiate regular insulin with dextrose infusion
D. Prepare for emergent hemodialysis
RATIONALE: IV calcium gluconate is the immediate priority to stabilize myocardial cell
membranes and prevent lethal dysrhythmias while other measures take effect. Insulin/dextrose
and dialysis shift or remove potassium but do not provide immediate cardiac protection.
Q5 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with a traumatic brain injury has an ICP monitor reading 22 mm Hg.
Which nursing action is most appropriate to reduce ICP?
A. Cluster nursing care to allow uninterrupted rest CORRECT
B. Maintain the head of bed flat to promote cerebral perfusion
C. Hyperventilate the patient to a PaCO2 of 25 mm Hg
D. Administer IV mannitol 0.25 g/kg bolus
RATIONALE: Clustering care minimizes stimulation and prevents spikes in ICP. Flat positioning
increases ICP; hyperventilation to PaCO2 <30 is only a temporizing measure for herniation;
mannitol is used but not as a first-line independent nursing action without orders.
Page 4
QUESTIONS AND CORRECT ANSWERS
PLUS RATIONALE 2026-2027 UPDATE
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Prioritize and interpret complex clinical data to formulate safe, evidence-based nursing interventions for
adults with multisystem health alterations
2 Apply current national guidelines (AHA/ACC, Surviving Sepsis, KDIGO, ADA, AACN) to predict
complications and evaluate therapeutic responses in critical care scenarios
3 Analyze pharmacologic and technological interventions (vasoactive drips, mechanical ventilation, CRRT,
insulin pumps) for efficacy, contraindications, and adverse effects
4 Demonstrate clinical judgment in emergency, perioperative, and end-of-life situations using ethical and
interprofessional frameworks
5 NUR 2502 MDC 3 Final Exam Review Questions and Correct Answers plus Rationale 2026
6 2027 Update
7 Foundations of Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and
Multisystem Management
8 Applied Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and Multisystem
Management
9 Advanced Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and Multisystem
Management
10 Medical-Surgical Nursing III (MDC 3) - Complex Adult Health, Critical Care, and Multisystem
Management Review
ABSTRACT
Page 1
,This study document brings together 97 carefully worded exam questions drawn from NUR 2502
MDC 3 Final Exam Review Questions and Correct Answers plus Rationale 2026-2027 Update,
with the strongest emphasis placed on Prioritize and interpret complex clinical data to formulate
safe, evidence-based nursing interventions for adults with multisystem health alterations, Apply
current national guidelines (AHA/ACC, Surviving Sepsis, KDIGO, ADA, AACN) to predict
complications and evaluate therapeutic responses in critical care scenarios, Analyze
pharmacologic and technological interventions (vasoactive drips, mechanical ventilation, CRRT,
insulin pumps) for efficacy, contraindications and and adverse effects. Every item follows the
wording style and level of reasoning you meet in the real paper, and each one is paired with a clear
rationale so the correct choice is never a guess. Work through the set at your own pace, mark the
questions that slow you down, then come back to them until the reasoning feels automatic.
Learners who revise this way walk into the exam room recognising the pattern behind the
questions instead of meeting them for the first time. Keep going - steady, honest practice is what
turns a difficult paper into a comfortable pass.
Q1 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with acute decompensated heart failure is receiving IV furosemide.
Which assessment finding most urgently indicates a need to hold the dose and
notify the provider?
A. Serum potassium 3.1 mEq/L with new U waves on ECG CORRECT
B. Urine output 40 mL/hr with specific gravity 1.020
C. Blood pressure 106/68 mm Hg with mild dizziness on standing
D. Weight loss of 1.2 kg over 24 hours
RATIONALE: Loop diuretics cause hypokalemia; a K+ of 3.1 with U waves signals dangerous
cardiac irritability and risk for dysrhythmias, requiring holding the dose and replacement. The
other findings are expected therapeutic effects or mild, non-urgent side effects.
Page 2
,Q2 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with type 1 diabetes on an insulin pump develops nausea, abdominal
pain, and Kussmaul respirations. Blood glucose is 412 mg/dL, pH 7.12, HCO3 8
mEq/L, and beta-hydroxybutyrate is elevated. Which action should the nurse
anticipate first?
A. Administer a 1-L bolus of 0.9% sodium chloride CORRECT
B. Give subcutaneous insulin glargine 20 units
C. Initiate sodium bicarbonate infusion
D. Place the patient on a bicarbonate-based CRRT circuit
RATIONALE: DKA management begins with aggressive isotonic fluid resuscitation to restore
intravascular volume and renal perfusion. Subcutaneous long-acting insulin is too slow;
bicarbonate is reserved for pH <6.9; CRRT is not indicated for uncomplicated DKA.
Q3 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with an acute ischemic stroke is being evaluated for IV thrombolytic
therapy. Which finding would be an absolute contraindication to alteplase?
A. Blood pressure 178/102 mm Hg
B. Platelet count 185,000/mm³
C. INR 1.1
D. History of intracranial hemorrhage 2 years ago CORRECT
RATIONALE: Any prior intracranial hemorrhage is an absolute contraindication to alteplase due
to prohibitive risk of recurrent bleeding. Blood pressure >185/110 is a relative contraindication
requiring correction; normal platelets and INR are not contraindications.
Page 3
, Q4 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with chronic kidney disease stage 5 develops a serum potassium of 6.8
mEq/L with peaked T waves. Which intervention should the nurse anticipate as the
priority?
A. Administer sodium polystyrene sulfonate orally
B. Give IV calcium gluconate CORRECT
C. Initiate regular insulin with dextrose infusion
D. Prepare for emergent hemodialysis
RATIONALE: IV calcium gluconate is the immediate priority to stabilize myocardial cell
membranes and prevent lethal dysrhythmias while other measures take effect. Insulin/dextrose
and dialysis shift or remove potassium but do not provide immediate cardiac protection.
Q5 PRIORITIZE AND INTERPRET COMPLEX CLINICAL DATA TO FORMULATE SAFE,
EVIDENCE-BASED NURSING INTERVENTIONS FOR ADULTS WITH MULTISYSTEM HEALTH
ALTERATIONS
A patient with a traumatic brain injury has an ICP monitor reading 22 mm Hg.
Which nursing action is most appropriate to reduce ICP?
A. Cluster nursing care to allow uninterrupted rest CORRECT
B. Maintain the head of bed flat to promote cerebral perfusion
C. Hyperventilate the patient to a PaCO2 of 25 mm Hg
D. Administer IV mannitol 0.25 g/kg bolus
RATIONALE: Clustering care minimizes stimulation and prevents spikes in ICP. Flat positioning
increases ICP; hyperventilation to PaCO2 <30 is only a temporizing measure for herniation;
mannitol is used but not as a first-line independent nursing action without orders.
Page 4
