NUR2392 Final Exam (2025): MDC II –
Rasmussen | Practice Questions with
Rationale
Student Name:
Date:
Time Limit: 90 minutes Total Questions: 55
Instructions
• Read each question and associated case carefully.
• Select the best answer(s) for multiple-choice, drop-down, and multiple-response items.
• For highlight text responses, identify the most critical information.
• Mark answers on the provided answer sheet.
• Manage time to complete all 55 questions within the 90-minute limit.
1. Respiratory Compromise
1.1 Case 1: Client with Acute Respiratory Distress
A 62-year-old male presents to the ED with dyspnea, cyanosis, and accessory muscle use. Vital
signs: BP 140/90 mmHg, HR 110 bpm, RR 30 breaths/min, SpO2 88%, Temp 99.1°F. The
nurse reviews the chart.
Chart Tab Information
Medical COPD, smoking (25 pack-years)
History
Medications Albuterol inhaler PRN, Tiotropium daily
Labs ABG: pH 7.30, PaCO2 58 mmHg, PaO2 55 mmHg
Orders Oxygen 2 L/min via nasal cannula, Albuterol nebulizer 2.5
mg q4h, Prednisone 40 mg PO daily
1.1.1 Question 1 (Delegation)
Which task can the nurse delegate to the unlicensed assistive personnel (UAP)?
a) Administer albuterol nebulizer
b) Monitor respiratory rate
c) Apply oxygen via nasal cannula
d) Interpret ABG results
b) Monitor respiratory rate
a) Medication administration is outside UAP scope. c) Oxygen application requires assessment.
d) ABG interpretation is a nursing responsibility.
1
,1.1.2 Question 2 (Lab Analysis)
The client’s ABG results indicate:
a) Respiratory acidosis
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Metabolic acidosis
a) Respiratory acidosis
b) No metabolic compensation. c) Alkalosis has low PaCO2. d) No metabolic acid-base distur-
bance.
1.1.3 Question 3 (Safety Protocols)
Which safety protocol should the nurse prioritize?
a) Encourage ambulation to improve breathing
b) Apply oxygen as ordered
c) Administer tiotropium immediately
d) Obtain a chest X-ray
b) Apply oxygen as ordered
a) Ambulation may worsen hypoxia. c) Tiotropium is maintenance. d) X-ray is not immediate.
1.1.4 Question 4 (Multiple Response)
Select all interventions the nurse should implement to ensure safety.
a) Monitor SpO2 levels
b) Elevate head of bed
c) Increase oxygen to 4 L/min
d) Administer prednisone
e) Encourage deep coughing
a) Monitor SpO2 levels, b) Elevate head of bed, d) Administer prednisone, e) Encourage
deep coughing
c) Increasing oxygen requires an order due to COPD risks.
Rationale for Case 1: The client’s symptoms and ABG results indicate a COPD exacerbation
with respiratory acidosis. Oxygen corrects hypoxia, and prednisone with albuterol treats in-
flammation. Monitoring and positioning enhance safety. ABG results confirm the acid-base
imbalance.
1.2 Case 2: Client with Pneumonia
A 70-year-old female presents with fever, productive cough, and dyspnea. Vital signs: BP
130/80 mmHg, HR 100 bpm, RR 28 breaths/min, SpO2 90%, Temp 101.4°F. The nurse re-
views the chart.
Chart Tab Information
Medical Hypertension, diabetes
History
Medications Lisinopril 20 mg daily, Metformin 500 mg BID
Labs WBC 15,000/mm³, Chest X-ray: Left lower lobe infiltrate
2
, Orders Oxygen 2 L/min, Levofloxacin 750 mg IV daily, Sputum
culture
1.2.1 Question 5 (Delegation)
Which task can the nurse delegate to the UAP?
a) Obtain sputum culture
b) Assist with positioning
c) Administer levofloxacin
d) Assess lung sounds
b) Assist with positioning
a) Sputum collection requires training. c) Medication administration is outside UAP scope. d)
Lung sound assessment is a nursing task.
1.2.2 Question 6 (Lab Analysis)
The chest X-ray result confirms:
a) Pulmonary edema
b) Pneumonia
c) Pulmonary embolism
d) Pleural effusion
b) Pneumonia
a) Edema involves bilateral infiltrates. c) PE shows no infiltrates. d) Effusion shows fluid levels.
1.2.3 Question 7 (Safety Protocols)
Which safety protocol should the nurse prioritize?
a) Encourage oral hydration
b) Apply oxygen as ordered
c) Administer metformin
d) Obtain a repeat WBC
b) Apply oxygen as ordered
a) Oral hydration is secondary. c) Metformin is held in acute illness. d) Repeat WBC is not
immediate.
1.2.4 Question 8 (Multiple Response)
Select all interventions to promote safety.
a) Monitor respiratory status
b) Administer levofloxacin
c) Encourage incentive spirometry
d) Increase oxygen to 4 L/min
e) Monitor blood glucose
a) Monitor respiratory status, b) Administer levofloxacin, c) Encourage incentive spirom-
etry, e) Monitor blood glucose
d) Increasing oxygen requires an order.
Rationale for Case 2: Fever, infiltrate, and elevated WBC confirm pneumonia. Oxygen ad-
dresses hypoxia, and levofloxacin treats infection. Spirometry prevents atelectasis, and glucose
monitoring is essential due to diabetes. The infiltrate is diagnostic.
3
Rasmussen | Practice Questions with
Rationale
Student Name:
Date:
Time Limit: 90 minutes Total Questions: 55
Instructions
• Read each question and associated case carefully.
• Select the best answer(s) for multiple-choice, drop-down, and multiple-response items.
• For highlight text responses, identify the most critical information.
• Mark answers on the provided answer sheet.
• Manage time to complete all 55 questions within the 90-minute limit.
1. Respiratory Compromise
1.1 Case 1: Client with Acute Respiratory Distress
A 62-year-old male presents to the ED with dyspnea, cyanosis, and accessory muscle use. Vital
signs: BP 140/90 mmHg, HR 110 bpm, RR 30 breaths/min, SpO2 88%, Temp 99.1°F. The
nurse reviews the chart.
Chart Tab Information
Medical COPD, smoking (25 pack-years)
History
Medications Albuterol inhaler PRN, Tiotropium daily
Labs ABG: pH 7.30, PaCO2 58 mmHg, PaO2 55 mmHg
Orders Oxygen 2 L/min via nasal cannula, Albuterol nebulizer 2.5
mg q4h, Prednisone 40 mg PO daily
1.1.1 Question 1 (Delegation)
Which task can the nurse delegate to the unlicensed assistive personnel (UAP)?
a) Administer albuterol nebulizer
b) Monitor respiratory rate
c) Apply oxygen via nasal cannula
d) Interpret ABG results
b) Monitor respiratory rate
a) Medication administration is outside UAP scope. c) Oxygen application requires assessment.
d) ABG interpretation is a nursing responsibility.
1
,1.1.2 Question 2 (Lab Analysis)
The client’s ABG results indicate:
a) Respiratory acidosis
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Metabolic acidosis
a) Respiratory acidosis
b) No metabolic compensation. c) Alkalosis has low PaCO2. d) No metabolic acid-base distur-
bance.
1.1.3 Question 3 (Safety Protocols)
Which safety protocol should the nurse prioritize?
a) Encourage ambulation to improve breathing
b) Apply oxygen as ordered
c) Administer tiotropium immediately
d) Obtain a chest X-ray
b) Apply oxygen as ordered
a) Ambulation may worsen hypoxia. c) Tiotropium is maintenance. d) X-ray is not immediate.
1.1.4 Question 4 (Multiple Response)
Select all interventions the nurse should implement to ensure safety.
a) Monitor SpO2 levels
b) Elevate head of bed
c) Increase oxygen to 4 L/min
d) Administer prednisone
e) Encourage deep coughing
a) Monitor SpO2 levels, b) Elevate head of bed, d) Administer prednisone, e) Encourage
deep coughing
c) Increasing oxygen requires an order due to COPD risks.
Rationale for Case 1: The client’s symptoms and ABG results indicate a COPD exacerbation
with respiratory acidosis. Oxygen corrects hypoxia, and prednisone with albuterol treats in-
flammation. Monitoring and positioning enhance safety. ABG results confirm the acid-base
imbalance.
1.2 Case 2: Client with Pneumonia
A 70-year-old female presents with fever, productive cough, and dyspnea. Vital signs: BP
130/80 mmHg, HR 100 bpm, RR 28 breaths/min, SpO2 90%, Temp 101.4°F. The nurse re-
views the chart.
Chart Tab Information
Medical Hypertension, diabetes
History
Medications Lisinopril 20 mg daily, Metformin 500 mg BID
Labs WBC 15,000/mm³, Chest X-ray: Left lower lobe infiltrate
2
, Orders Oxygen 2 L/min, Levofloxacin 750 mg IV daily, Sputum
culture
1.2.1 Question 5 (Delegation)
Which task can the nurse delegate to the UAP?
a) Obtain sputum culture
b) Assist with positioning
c) Administer levofloxacin
d) Assess lung sounds
b) Assist with positioning
a) Sputum collection requires training. c) Medication administration is outside UAP scope. d)
Lung sound assessment is a nursing task.
1.2.2 Question 6 (Lab Analysis)
The chest X-ray result confirms:
a) Pulmonary edema
b) Pneumonia
c) Pulmonary embolism
d) Pleural effusion
b) Pneumonia
a) Edema involves bilateral infiltrates. c) PE shows no infiltrates. d) Effusion shows fluid levels.
1.2.3 Question 7 (Safety Protocols)
Which safety protocol should the nurse prioritize?
a) Encourage oral hydration
b) Apply oxygen as ordered
c) Administer metformin
d) Obtain a repeat WBC
b) Apply oxygen as ordered
a) Oral hydration is secondary. c) Metformin is held in acute illness. d) Repeat WBC is not
immediate.
1.2.4 Question 8 (Multiple Response)
Select all interventions to promote safety.
a) Monitor respiratory status
b) Administer levofloxacin
c) Encourage incentive spirometry
d) Increase oxygen to 4 L/min
e) Monitor blood glucose
a) Monitor respiratory status, b) Administer levofloxacin, c) Encourage incentive spirom-
etry, e) Monitor blood glucose
d) Increasing oxygen requires an order.
Rationale for Case 2: Fever, infiltrate, and elevated WBC confirm pneumonia. Oxygen ad-
dresses hypoxia, and levofloxacin treats infection. Spirometry prevents atelectasis, and glucose
monitoring is essential due to diabetes. The infiltrate is diagnostic.
3
