NUR 2356 FINAL EXAM 2 LATEST VERSIONS 2025 MULTIDIMENSIONAL CARE 1
FINAL/ MDC 1 FINAL EXAM 200+ QUESTIONS AND CORRECT ANSWERS |
RASMUSSEN COLLEGE
Question 1
A nurse is preparing to administer an oral medication to a patient. Which of the following is the
most important initial nursing action to ensure patient safety?
A) Check the medication's expiration date.
B) Verify the patient's identity using two identifiers.
C) Assess the patient's ability to swallow.
D) Explain the medication's purpose to the patient.
Correct Answer: B) Verify the patient's identity using two identifiers.
Rationale: The "right patient" is the first and most critical of the "rights of medication
administration." Failing to correctly identify the patient can lead to serious medication
errors. All other actions are important but follow patient identification.
Question 2
A patient is admitted with severe dehydration. The nurse expects to find which of the following
vital sign changes?
A) Decreased heart rate
B) Increased blood pressure
C) Decreased respiratory rate
D) Increased heart rate
Correct Answer: D) Increased heart rate
Rationale: In dehydration, the body attempts to compensate for decreased circulating
blood volume by increasing heart rate (tachycardia) to maintain cardiac output and tissue
perfusion. Blood pressure may decrease (hypotension), and respiratory rate may increase
(tachypnea) as part of compensatory mechanisms.
Question 3
Which of the following is a key characteristic of a third-degree burn?
A) Superficial redness and pain, no blisters.
B) Blisters, severe pain, and mottled red-pink skin.
C) White, waxy, leathery appearance, with no pain sensation.
D) Redness and sensitivity to touch, intact skin.
Correct Answer: C) White, waxy, leathery appearance, with no pain sensation.
Rationale: Third-degree (full-thickness) burns destroy the epidermis, dermis, and often
underlying tissues. The skin appears white, waxy, leathery, or charred. Nerve endings are
destroyed, so the burn area itself is painless, though surrounding partial-thickness areas
may be extremely painful.
Question 4
A nurse is caring for a patient with a newly inserted nasogastric (NG) tube. What is the most
reliable method for confirming initial NG tube placement?
,A) Auscultating for air insufflation over the epigastrium.
B) Measuring the pH of aspirate from the tube.
C) Observing for bubbling in water when the tube is immersed.
D) Obtaining an X-ray of the chest and abdomen.
Correct Answer: D) Obtaining an X-ray of the chest and abdomen.
Rationale: An X-ray is considered the gold standard for confirming the initial placement of
an NG tube, especially before administering anything through it, as it directly visualizes the
tube's position in the stomach or small intestine and rules out tracheal placement.
Question 5
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2
L/min via nasal cannula. The nurse understands that providing high-flow oxygen to a patient
with COPD can lead to:
A) Improved gas exchange.
B) Respiratory depression.
C) Increased oxygen saturation without side effects.
D) Reduced risk of infection.
Correct Answer: B) Respiratory depression.
Rationale: In some patients with severe COPD, the hypoxic drive (low oxygen levels) is the
primary stimulus for breathing. Providing high concentrations of oxygen can suppress this
drive, leading to hypoventilation, CO2 retention, and potentially respiratory depression or
arrest. Oxygen should be titrated to the lowest effective dose.
Question 6
Which medication is commonly prescribed to manage an acute asthma exacerbation due to its
rapid bronchodilating effects?
A) Fluticasone
B) Salmeterol
C) Albuterol
D) Montelukast
Correct Answer: C) Albuterol
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that causes rapid
bronchodilation. It is the rescue medication of choice for acute asthma symptoms and
exacerbations. Fluticasone and salmeterol are for maintenance, and montelukast is a
leukotriene modifier for prevention.
Question 7
A nurse is preparing to administer insulin glargine to a patient with Type 2 Diabetes. The nurse
understands that this insulin should never be mixed with other insulins because it is:
A) A rapid-acting insulin.
B) A concentrated insulin.
C) A basal insulin.
,D) Incompatible with other insulin formulations due to its acidic pH.
Correct Answer: D) Incompatible with other insulin formulations due to its acidic pH.
Rationale: Insulin glargine (Lantus, Toujeo) has an acidic pH (around 4), which makes it
incompatible with other insulins that are typically neutral or slightly alkaline. Mixing it
would alter its pharmacokinetic profile (e.g., its long, peakless action) and could cause
precipitation. It is a basal insulin, but its incompatibility is due to pH.
Question 8
A patient with a history of heart failure reports a 5-pound weight gain over the past 2 days, along
with increased shortness of breath and ankle swelling. The nurse should anticipate an order for
which medication?
A) Metoprolol
B) Lisinopril
C) Digoxin
D) Furosemide
Correct Answer: D) Furosemide
Rationale: The patient's symptoms (rapid weight gain, dyspnea, edema) are indicative of
fluid overload due to worsening heart failure. Furosemide, a loop diuretic, is the most
appropriate medication to rapidly remove excess fluid and alleviate these symptoms.
Question 9
What is the most critical nursing intervention for a patient experiencing an acute episode of
angina pectoris?
A) Administer aspirin 325 mg orally.
B) Administer nitroglycerin sublingually.
C) Obtain a 12-lead ECG.
D) Provide oxygen via nasal cannula.
Correct Answer: B) Administer nitroglycerin sublingually.
Rationale: For acute angina, the immediate priority is to relieve myocardial ischemia.
Nitroglycerin, administered sublingually, is the fastest-acting medication to cause
vasodilation and reduce cardiac workload. While aspirin, oxygen, and ECG are all crucial,
nitroglycerin directly targets the pain first.
Question 10
A nurse is educating a patient about warfarin therapy. Which food should the patient be advised
to consume consistently rather than varying intake, to avoid altering warfarin's effect?
A) Dairy products
B) High-fiber foods
C) Foods rich in Vitamin K
D) Citrus fruits
Correct Answer: C) Foods rich in Vitamin K
Rationale: Warfarin works by antagonizing Vitamin K. Large fluctuations in Vitamin K
, intake (found in leafy green vegetables, certain oils) can significantly alter the effectiveness
of warfarin, leading to either increased bleeding risk or decreased anticoagulation.
Consistent intake allows for stable dosing.
Question 11
Which laboratory value is primarily used to monitor the therapeutic effects of heparin?
A) Prothrombin Time (PT)
B) International Normalized Ratio (INR)
C) Activated Partial Thromboplastin Time (aPTT)
D) Platelet count
Correct Answer: C) Activated Partial Thromboplastin Time (aPTT)
Rationale: The aPTT (activated Partial Thromboplastin Time) is the standard laboratory
test used to monitor the therapeutic range of unfractionated heparin. The INR is used for
warfarin.
Question 12
A nurse is caring for a patient with a peripherally inserted central catheter (PICC). Which action
is essential to prevent air embolism during dressing changes?
A) Have the patient perform the Valsalva maneuver.
B) Place the patient in a sitting position.
C) Use sterile gloves only.
D) Apply firm pressure to the insertion site.
Correct Answer: A) Have the patient perform the Valsalva maneuver.
Rationale: Having the patient perform the Valsalva maneuver (holding breath and bearing
down) or exhaling slowly increases intrathoracic pressure, which helps to prevent air from
being drawn into the vein during a PICC dressing change, especially when the catheter is
open to air.
Question 13
A patient is diagnosed with Clostridium difficile infection. Which type of precaution should the
nurse implement?
A) Droplet precautions
B) Contact precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: B) Contact precautions
Rationale: Clostridium difficile (C. diff) is transmitted via direct and indirect contact,
particularly through spores. Contact precautions, including strict handwashing with soap
and water (alcohol-based hand rubs are less effective against spores) and wearing gowns
and gloves, are essential.
FINAL/ MDC 1 FINAL EXAM 200+ QUESTIONS AND CORRECT ANSWERS |
RASMUSSEN COLLEGE
Question 1
A nurse is preparing to administer an oral medication to a patient. Which of the following is the
most important initial nursing action to ensure patient safety?
A) Check the medication's expiration date.
B) Verify the patient's identity using two identifiers.
C) Assess the patient's ability to swallow.
D) Explain the medication's purpose to the patient.
Correct Answer: B) Verify the patient's identity using two identifiers.
Rationale: The "right patient" is the first and most critical of the "rights of medication
administration." Failing to correctly identify the patient can lead to serious medication
errors. All other actions are important but follow patient identification.
Question 2
A patient is admitted with severe dehydration. The nurse expects to find which of the following
vital sign changes?
A) Decreased heart rate
B) Increased blood pressure
C) Decreased respiratory rate
D) Increased heart rate
Correct Answer: D) Increased heart rate
Rationale: In dehydration, the body attempts to compensate for decreased circulating
blood volume by increasing heart rate (tachycardia) to maintain cardiac output and tissue
perfusion. Blood pressure may decrease (hypotension), and respiratory rate may increase
(tachypnea) as part of compensatory mechanisms.
Question 3
Which of the following is a key characteristic of a third-degree burn?
A) Superficial redness and pain, no blisters.
B) Blisters, severe pain, and mottled red-pink skin.
C) White, waxy, leathery appearance, with no pain sensation.
D) Redness and sensitivity to touch, intact skin.
Correct Answer: C) White, waxy, leathery appearance, with no pain sensation.
Rationale: Third-degree (full-thickness) burns destroy the epidermis, dermis, and often
underlying tissues. The skin appears white, waxy, leathery, or charred. Nerve endings are
destroyed, so the burn area itself is painless, though surrounding partial-thickness areas
may be extremely painful.
Question 4
A nurse is caring for a patient with a newly inserted nasogastric (NG) tube. What is the most
reliable method for confirming initial NG tube placement?
,A) Auscultating for air insufflation over the epigastrium.
B) Measuring the pH of aspirate from the tube.
C) Observing for bubbling in water when the tube is immersed.
D) Obtaining an X-ray of the chest and abdomen.
Correct Answer: D) Obtaining an X-ray of the chest and abdomen.
Rationale: An X-ray is considered the gold standard for confirming the initial placement of
an NG tube, especially before administering anything through it, as it directly visualizes the
tube's position in the stomach or small intestine and rules out tracheal placement.
Question 5
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2
L/min via nasal cannula. The nurse understands that providing high-flow oxygen to a patient
with COPD can lead to:
A) Improved gas exchange.
B) Respiratory depression.
C) Increased oxygen saturation without side effects.
D) Reduced risk of infection.
Correct Answer: B) Respiratory depression.
Rationale: In some patients with severe COPD, the hypoxic drive (low oxygen levels) is the
primary stimulus for breathing. Providing high concentrations of oxygen can suppress this
drive, leading to hypoventilation, CO2 retention, and potentially respiratory depression or
arrest. Oxygen should be titrated to the lowest effective dose.
Question 6
Which medication is commonly prescribed to manage an acute asthma exacerbation due to its
rapid bronchodilating effects?
A) Fluticasone
B) Salmeterol
C) Albuterol
D) Montelukast
Correct Answer: C) Albuterol
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that causes rapid
bronchodilation. It is the rescue medication of choice for acute asthma symptoms and
exacerbations. Fluticasone and salmeterol are for maintenance, and montelukast is a
leukotriene modifier for prevention.
Question 7
A nurse is preparing to administer insulin glargine to a patient with Type 2 Diabetes. The nurse
understands that this insulin should never be mixed with other insulins because it is:
A) A rapid-acting insulin.
B) A concentrated insulin.
C) A basal insulin.
,D) Incompatible with other insulin formulations due to its acidic pH.
Correct Answer: D) Incompatible with other insulin formulations due to its acidic pH.
Rationale: Insulin glargine (Lantus, Toujeo) has an acidic pH (around 4), which makes it
incompatible with other insulins that are typically neutral or slightly alkaline. Mixing it
would alter its pharmacokinetic profile (e.g., its long, peakless action) and could cause
precipitation. It is a basal insulin, but its incompatibility is due to pH.
Question 8
A patient with a history of heart failure reports a 5-pound weight gain over the past 2 days, along
with increased shortness of breath and ankle swelling. The nurse should anticipate an order for
which medication?
A) Metoprolol
B) Lisinopril
C) Digoxin
D) Furosemide
Correct Answer: D) Furosemide
Rationale: The patient's symptoms (rapid weight gain, dyspnea, edema) are indicative of
fluid overload due to worsening heart failure. Furosemide, a loop diuretic, is the most
appropriate medication to rapidly remove excess fluid and alleviate these symptoms.
Question 9
What is the most critical nursing intervention for a patient experiencing an acute episode of
angina pectoris?
A) Administer aspirin 325 mg orally.
B) Administer nitroglycerin sublingually.
C) Obtain a 12-lead ECG.
D) Provide oxygen via nasal cannula.
Correct Answer: B) Administer nitroglycerin sublingually.
Rationale: For acute angina, the immediate priority is to relieve myocardial ischemia.
Nitroglycerin, administered sublingually, is the fastest-acting medication to cause
vasodilation and reduce cardiac workload. While aspirin, oxygen, and ECG are all crucial,
nitroglycerin directly targets the pain first.
Question 10
A nurse is educating a patient about warfarin therapy. Which food should the patient be advised
to consume consistently rather than varying intake, to avoid altering warfarin's effect?
A) Dairy products
B) High-fiber foods
C) Foods rich in Vitamin K
D) Citrus fruits
Correct Answer: C) Foods rich in Vitamin K
Rationale: Warfarin works by antagonizing Vitamin K. Large fluctuations in Vitamin K
, intake (found in leafy green vegetables, certain oils) can significantly alter the effectiveness
of warfarin, leading to either increased bleeding risk or decreased anticoagulation.
Consistent intake allows for stable dosing.
Question 11
Which laboratory value is primarily used to monitor the therapeutic effects of heparin?
A) Prothrombin Time (PT)
B) International Normalized Ratio (INR)
C) Activated Partial Thromboplastin Time (aPTT)
D) Platelet count
Correct Answer: C) Activated Partial Thromboplastin Time (aPTT)
Rationale: The aPTT (activated Partial Thromboplastin Time) is the standard laboratory
test used to monitor the therapeutic range of unfractionated heparin. The INR is used for
warfarin.
Question 12
A nurse is caring for a patient with a peripherally inserted central catheter (PICC). Which action
is essential to prevent air embolism during dressing changes?
A) Have the patient perform the Valsalva maneuver.
B) Place the patient in a sitting position.
C) Use sterile gloves only.
D) Apply firm pressure to the insertion site.
Correct Answer: A) Have the patient perform the Valsalva maneuver.
Rationale: Having the patient perform the Valsalva maneuver (holding breath and bearing
down) or exhaling slowly increases intrathoracic pressure, which helps to prevent air from
being drawn into the vein during a PICC dressing change, especially when the catheter is
open to air.
Question 13
A patient is diagnosed with Clostridium difficile infection. Which type of precaution should the
nurse implement?
A) Droplet precautions
B) Contact precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: B) Contact precautions
Rationale: Clostridium difficile (C. diff) is transmitted via direct and indirect contact,
particularly through spores. Contact precautions, including strict handwashing with soap
and water (alcohol-based hand rubs are less effective against spores) and wearing gowns
and gloves, are essential.
