Rasmussen College MDC 4 Exam 2
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Rationales 100% Verified Answers Latest
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1. A patient is admitted to the same day surgery unit for liver biopsy. Which of the following
laboratory tests assesses coagulation? Select all that apply.
1. Partial thromboplastin time.
2. Prothrombin time.
3. Platelet count.
4. Hemoglobin
5. Complete Blood Count
6. White Blood Cell Count –
Answer ✓✓Answers and Rationale
1. Answer: 1, 2, and 3
Prothrombin time, partial thromboplastin time, and platelet count are all included in
coagulation studies. The hemoglobin level, though important information prior to an invasive
procedure like liver biopsy, does not assess coagulation.
A+ 1
,2. A patient is admitted to the hospital with suspected polycythemia vera. Which of the
following symptoms is consistent with the diagnosis? Select all that apply.
1. Weight loss.
2. Increased clotting time.
3. Hypertension.
4. Headaches. - Answer ✓✓2. Answer: 2, 3, and 4
Polycythemia vera is a condition in which the bone marrow produces too many red blood
cells. This causes an increase in hematocrit and viscosity of the blood. Patients can experience
headaches, dizziness, and visual disturbances. Cardiovascular effects include increased blood
pressure and delayed clotting time. Weight loss is not a manifestation of polycythemia vera.
3. The nurse is teaching the client how to use a metered dose inhaler (MDI) to administer a
Corticosteroid drug. Which of the following client actions indicates that he is using the MDI
correctly? Select all that apply.
1. The inhaler is held upright.
2. Head is tilted down while inhaling the medication
3. Client waits 5 minutes between puffs.
4. Mouth is rinsed with water following administration
5. Client lies supine for 15 minutes following administration. - Answer ✓✓3. Answer: 1 and 4.
4. The nurse is teaching a client with polycythemia vera about potential complications from
this disease. Which manifestations would the nurse include in the client's teaching plan?
Select all that apply.
1. Hearing loss
2. Visual disturbance
3. Headache
4. Orthopnea5. Gout6. Weight loss - Answer ✓✓4. Answers: 2, 3, 4 and 5.
A+ 2
,Polycythemia vera, a condition in which too many RBCs are produced in the blood serum, can
lead to an increase in the hematocrit and hypervolemia, hyperviscosity, and hypertension.
Subsequently, the client can experience dizziness, tinnitus, visual disturbances, headaches, or
a feeling of fullness in the head. The client may also experience cardiovascular symptoms such
as heart failure (shortness of breath and orthopnea) and increased clotting time or symptoms
of an increased uric acid level such as painful swollen joints (usually the big toe). Hearing loss
and weight loss are not manifestations associated with polycythemia vera.
5. Which of the following would be priority assessment data to gather from a client who has
been diagnosed with pneumonia? Select all that apply.
1. Auscultation of breath sounds2. Auscultation of bowel sounds3. Presence of chest pain.4.
Presence of peripheral edema5. Color of nail beds - Answer ✓✓5. Answer: 1, 3, 5.
A respiratory assessment, which includes auscultation of breath sounds and assessing the
color of the nail beds, is a priority for clients with pneumonia. Assessing for the presence of
chest pain is also an important respiratory assessment as chest pain can interfere with the
client's ability to breathe deeply.
6. The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the
disease to family members. Which statement(s) by the client indicate(s) that he has
understood the nurses instructions? Select all that apply.
1. "I will need to dispose of my old clothing when I return home."2. "I should always cover my
mouth and nose when sneezing."3. "It is important that I isolate myself from family when
possible."4. "I should use paper tissues to cough in and dispose of them properly."5. "I can
use regular plate and utensils whenever I eat." - Answer ✓✓6. Answer: 2, 4, 5.
7. The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the
nurse should expect. Select all that apply.
1. Thirst
2. Palpitations
3. Diaphoresis
A+ 3
, 4. Slurred speech
5. Hyperventilation - Answer ✓✓7. Answer: 2, 3, 4.
Palpitations, an adrenergic symptom, occur as the glucose levels fall; the sympathetic nervous
system is activated and epinephrine and norepinephrine are secreted causing this response.
Diaphoresis is a sympathetic nervous system response that occurs as epinephrine and
norepinephrine are released. Slurred speech is a neuroglycopenic symptom; as the brain
receives insufficient glucose, the activity of the CNS becomes depressed.
8. Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the
client to exhibit? Select all that apply:
1. Sweating
2. Low PCO2
3. Retinopathy
4. Acetone breath
5. Elevated serum bicarbonate - Answer ✓✓8. Answer: 2, 4.
Metabolic acidosis initiates respiratory compensation in the form of Kussmaul respirations to
counteract the effects of ketone buildup, resulting in a lowered PCO2. A fruity odor to the
breath (acetone breath) occurs when the ketone level is elevated in ketoacidosis.
9. When planning care for a client with ulcerative colitis who is experiencing symptoms, which
client care activities can the nurse appropriately delegate to a unlicensed assistant? Select all
that apply.
1. Assessing the client's bowel sounds
2. Providing skin care following bowel movements
3. Evaluating the client's response to antidiarrheal medications
4. Maintaining intake and output records
5. Obtaining the client's weight. - Answer ✓✓9. Answer: 2, 4, and 5.
A+ 4
Verified Questions and Answers with Detailed
Rationales 100% Verified Answers Latest
Versions 2025
1. A patient is admitted to the same day surgery unit for liver biopsy. Which of the following
laboratory tests assesses coagulation? Select all that apply.
1. Partial thromboplastin time.
2. Prothrombin time.
3. Platelet count.
4. Hemoglobin
5. Complete Blood Count
6. White Blood Cell Count –
Answer ✓✓Answers and Rationale
1. Answer: 1, 2, and 3
Prothrombin time, partial thromboplastin time, and platelet count are all included in
coagulation studies. The hemoglobin level, though important information prior to an invasive
procedure like liver biopsy, does not assess coagulation.
A+ 1
,2. A patient is admitted to the hospital with suspected polycythemia vera. Which of the
following symptoms is consistent with the diagnosis? Select all that apply.
1. Weight loss.
2. Increased clotting time.
3. Hypertension.
4. Headaches. - Answer ✓✓2. Answer: 2, 3, and 4
Polycythemia vera is a condition in which the bone marrow produces too many red blood
cells. This causes an increase in hematocrit and viscosity of the blood. Patients can experience
headaches, dizziness, and visual disturbances. Cardiovascular effects include increased blood
pressure and delayed clotting time. Weight loss is not a manifestation of polycythemia vera.
3. The nurse is teaching the client how to use a metered dose inhaler (MDI) to administer a
Corticosteroid drug. Which of the following client actions indicates that he is using the MDI
correctly? Select all that apply.
1. The inhaler is held upright.
2. Head is tilted down while inhaling the medication
3. Client waits 5 minutes between puffs.
4. Mouth is rinsed with water following administration
5. Client lies supine for 15 minutes following administration. - Answer ✓✓3. Answer: 1 and 4.
4. The nurse is teaching a client with polycythemia vera about potential complications from
this disease. Which manifestations would the nurse include in the client's teaching plan?
Select all that apply.
1. Hearing loss
2. Visual disturbance
3. Headache
4. Orthopnea5. Gout6. Weight loss - Answer ✓✓4. Answers: 2, 3, 4 and 5.
A+ 2
,Polycythemia vera, a condition in which too many RBCs are produced in the blood serum, can
lead to an increase in the hematocrit and hypervolemia, hyperviscosity, and hypertension.
Subsequently, the client can experience dizziness, tinnitus, visual disturbances, headaches, or
a feeling of fullness in the head. The client may also experience cardiovascular symptoms such
as heart failure (shortness of breath and orthopnea) and increased clotting time or symptoms
of an increased uric acid level such as painful swollen joints (usually the big toe). Hearing loss
and weight loss are not manifestations associated with polycythemia vera.
5. Which of the following would be priority assessment data to gather from a client who has
been diagnosed with pneumonia? Select all that apply.
1. Auscultation of breath sounds2. Auscultation of bowel sounds3. Presence of chest pain.4.
Presence of peripheral edema5. Color of nail beds - Answer ✓✓5. Answer: 1, 3, 5.
A respiratory assessment, which includes auscultation of breath sounds and assessing the
color of the nail beds, is a priority for clients with pneumonia. Assessing for the presence of
chest pain is also an important respiratory assessment as chest pain can interfere with the
client's ability to breathe deeply.
6. The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the
disease to family members. Which statement(s) by the client indicate(s) that he has
understood the nurses instructions? Select all that apply.
1. "I will need to dispose of my old clothing when I return home."2. "I should always cover my
mouth and nose when sneezing."3. "It is important that I isolate myself from family when
possible."4. "I should use paper tissues to cough in and dispose of them properly."5. "I can
use regular plate and utensils whenever I eat." - Answer ✓✓6. Answer: 2, 4, 5.
7. The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the
nurse should expect. Select all that apply.
1. Thirst
2. Palpitations
3. Diaphoresis
A+ 3
, 4. Slurred speech
5. Hyperventilation - Answer ✓✓7. Answer: 2, 3, 4.
Palpitations, an adrenergic symptom, occur as the glucose levels fall; the sympathetic nervous
system is activated and epinephrine and norepinephrine are secreted causing this response.
Diaphoresis is a sympathetic nervous system response that occurs as epinephrine and
norepinephrine are released. Slurred speech is a neuroglycopenic symptom; as the brain
receives insufficient glucose, the activity of the CNS becomes depressed.
8. Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the
client to exhibit? Select all that apply:
1. Sweating
2. Low PCO2
3. Retinopathy
4. Acetone breath
5. Elevated serum bicarbonate - Answer ✓✓8. Answer: 2, 4.
Metabolic acidosis initiates respiratory compensation in the form of Kussmaul respirations to
counteract the effects of ketone buildup, resulting in a lowered PCO2. A fruity odor to the
breath (acetone breath) occurs when the ketone level is elevated in ketoacidosis.
9. When planning care for a client with ulcerative colitis who is experiencing symptoms, which
client care activities can the nurse appropriately delegate to a unlicensed assistant? Select all
that apply.
1. Assessing the client's bowel sounds
2. Providing skin care following bowel movements
3. Evaluating the client's response to antidiarrheal medications
4. Maintaining intake and output records
5. Obtaining the client's weight. - Answer ✓✓9. Answer: 2, 4, and 5.
A+ 4
