NUR 2502 / NUR2502:
Multidimensional Care III / MDC 3 Exam 2 Review
Latest Update 2026/2027 | Rasmussen College | 100% Correct
Verified Questions & Answers with detailed Rationales
Section 1: Respiratory Disorders
Q1: A patient with chronic obstructive pulmonary disease (COPD) presents with a barrel chest, pursed-lip
breathing, and a chronic cough productive of clear sputum. The nurse understands that these findings are
most characteristic of which pathophysiological change?
A. Destruction of alveolar walls leading to increased compliance
B. Hypertrophy of mucous glands and chronic inflammation of the bronchi
C. Brochiectasis causing pooling of secretions
D. Fibrosis of the lung tissue causing decreased lung compliance
Correct Answer: A
Rationale: [CORRECT] A barrel chest and pursed-lip breathing are classic signs of emphysema, which
involves the destruction of alveolar walls, leading to air trapping, hyperinflation, and increased lung
compliance. Option B is incorrect because chronic bronchitis is characterized by a productive cough and
hypoxemia/hypercapnia ("blue bloater"), not primarily the barrel chest seen with air trapping. Option C is
incorrect because bronchiectasis involves permanent dilation of bronchi and copious foul-smelling
sputum. Option D is incorrect because fibrosis causes restrictive disease (decreased compliance), not
obstructive hyperinflation.
Q2: The nurse is educating a patient with asthma about the correct use of a metered -dose inhaler (MDI)
with a spacer. Which of the following statements by the patient indicates a need for further teaching?
A. "I will shake the inhaler well before I use it."
B. "I will breathe out fully before placing the spacer in my mouth."
C. "I will spray the medication into the spacer and immediately inhale slowly."
D. "I will hold my breath for about 10 seconds after inhaling the medication."
Correct Answer: C
,Rationale: [CORRECT] When using an MDI with a spacer, the patient should spray the medication into
the spacer and then take a slow, deep breath after the medication is suspended in the spacer, not
immediately. Option A is incorrect because shaking the inhaler is correct to mix the medication. Option B
is incorrect because exhaling fully maximizes lung capacity for inhalation. Option D is incorrect because
holding the breath for 10 seconds allows the medication to deposit in the airways.
Q3: A patient admitted with an acute exacerbation of COPD has an arterial blood gas (ABG) result of pH
7.32, PaCO2 58 mmHg, and HCO3- 32 mEq/L. The nurse interprets these findings as which of the
following?
A. Respiratory acidosis with partial compensation
B. Respiratory alkalosis with uncompensated
C. Metabolic acidosis with respiratory compensation
D. Respiratory acidosis with full compensation
Correct Answer: A
Rationale: [CORRECT] The low pH indicates acidosis, and the elevated PaCO2 indicates that it is
respiratory in origin. The elevated HCO3- indicates the kidneys are retaining bicarbonate to compensate,
but the pH is not yet within the normal range, meaning it is partially compensated. Option B is incorrect
because the PaCO2 is high, not low. Option C is incorrect because the primary issue is respiratory, not
metabolic. Option D is incorrect because full compensation would mean the pH has returned to the
normal range (7.35-7.45).
Q4: Which of the following medications is considered a "rescue" inhaler for a patient with asthma?
(Select all that apply)
A. Albuterol
B. Fluticasone
C. Ipratropium
D. Montelukast
E. Levalbuterol
Correct Answer: A, C, E
Rationale: [CORRECT] Short-acting beta-agonists (SABAs) like albuterol and levalbuterol, and short-
acting anticholinergics like ipratropium, are bronchodilators used for quick relief of acute asthma
symptoms. Option B is incorrect because fluticasone is an inhaled corticosteroid (ICS) used for long-term
control. Option D is incorrect because montelukast is a leukotriene modifier used for maintenance
therapy.
, Q5: A patient with pneumonia has a temperature of 102.5°F (39.2°C), productive cough with rust-colored
sputum, and decreased breath sounds in the left lower lobe. Which intervention should the nurse
implement first?
A. Administer the prescribed oral antibiotic.
B. Obtain a sputum culture before initiating antibiotics.
C. Encourage increased fluid intake to thin secretions.
D. Place the patient in a high-Fowler's position.
Correct Answer: B
Rationale: [CORRECT] Obtaining a sputum culture before initiating antibiotic therapy is the priority to
ensure the causative organism is identified and the most effective antibiotic is chosen, preventing
antibiotic resistance. Option A is incorrect because administering the antibiotic first can alter the culture
results. Options C and D are incorrect because while they are appropriate supportive interventions, they
do not take priority over obtaining accurate diagnostic data.
Q6: A patient with a pulmonary embolism (PE) is suddenly experiencing severe dyspnea, chest pain, and
is coughing up blood-tinged sputum. Which vital sign finding should the nurse anticipate?
A. Hypertension
B. Bradycardia
C. Tachycardia
D. Bradypnea
Correct Answer: C
Rationale: [CORRECT] A pulmonary embolism causes hypoxemia and stimulation of the sympathetic
nervous system, which leads to tachycardia as the heart attempts to compensate for decreased
oxygenation. Options A and B are incorrect because hypotension and tachycardia, not hypertension and
bradycardia, are expected due to decreased cardiac output. Option D is incorrect because tachypnea (fast
breathing), not bradypnea, is expected with dyspnea and hypoxia.
Q7: The nurse is assessing a patient who is 12 hours post-operative from a total knee replacement. The
patient suddenly complains of sharp chest pain and palpitations. Which diagnostic test is the most specific
for confirming a pulmonary embolism?
A. D-dimer
B. Arterial blood gas (ABG)
C. Chest X-ray
D. Computed tomography pulmonary angiography (CTPA)
Correct Answer: D
Multidimensional Care III / MDC 3 Exam 2 Review
Latest Update 2026/2027 | Rasmussen College | 100% Correct
Verified Questions & Answers with detailed Rationales
Section 1: Respiratory Disorders
Q1: A patient with chronic obstructive pulmonary disease (COPD) presents with a barrel chest, pursed-lip
breathing, and a chronic cough productive of clear sputum. The nurse understands that these findings are
most characteristic of which pathophysiological change?
A. Destruction of alveolar walls leading to increased compliance
B. Hypertrophy of mucous glands and chronic inflammation of the bronchi
C. Brochiectasis causing pooling of secretions
D. Fibrosis of the lung tissue causing decreased lung compliance
Correct Answer: A
Rationale: [CORRECT] A barrel chest and pursed-lip breathing are classic signs of emphysema, which
involves the destruction of alveolar walls, leading to air trapping, hyperinflation, and increased lung
compliance. Option B is incorrect because chronic bronchitis is characterized by a productive cough and
hypoxemia/hypercapnia ("blue bloater"), not primarily the barrel chest seen with air trapping. Option C is
incorrect because bronchiectasis involves permanent dilation of bronchi and copious foul-smelling
sputum. Option D is incorrect because fibrosis causes restrictive disease (decreased compliance), not
obstructive hyperinflation.
Q2: The nurse is educating a patient with asthma about the correct use of a metered -dose inhaler (MDI)
with a spacer. Which of the following statements by the patient indicates a need for further teaching?
A. "I will shake the inhaler well before I use it."
B. "I will breathe out fully before placing the spacer in my mouth."
C. "I will spray the medication into the spacer and immediately inhale slowly."
D. "I will hold my breath for about 10 seconds after inhaling the medication."
Correct Answer: C
,Rationale: [CORRECT] When using an MDI with a spacer, the patient should spray the medication into
the spacer and then take a slow, deep breath after the medication is suspended in the spacer, not
immediately. Option A is incorrect because shaking the inhaler is correct to mix the medication. Option B
is incorrect because exhaling fully maximizes lung capacity for inhalation. Option D is incorrect because
holding the breath for 10 seconds allows the medication to deposit in the airways.
Q3: A patient admitted with an acute exacerbation of COPD has an arterial blood gas (ABG) result of pH
7.32, PaCO2 58 mmHg, and HCO3- 32 mEq/L. The nurse interprets these findings as which of the
following?
A. Respiratory acidosis with partial compensation
B. Respiratory alkalosis with uncompensated
C. Metabolic acidosis with respiratory compensation
D. Respiratory acidosis with full compensation
Correct Answer: A
Rationale: [CORRECT] The low pH indicates acidosis, and the elevated PaCO2 indicates that it is
respiratory in origin. The elevated HCO3- indicates the kidneys are retaining bicarbonate to compensate,
but the pH is not yet within the normal range, meaning it is partially compensated. Option B is incorrect
because the PaCO2 is high, not low. Option C is incorrect because the primary issue is respiratory, not
metabolic. Option D is incorrect because full compensation would mean the pH has returned to the
normal range (7.35-7.45).
Q4: Which of the following medications is considered a "rescue" inhaler for a patient with asthma?
(Select all that apply)
A. Albuterol
B. Fluticasone
C. Ipratropium
D. Montelukast
E. Levalbuterol
Correct Answer: A, C, E
Rationale: [CORRECT] Short-acting beta-agonists (SABAs) like albuterol and levalbuterol, and short-
acting anticholinergics like ipratropium, are bronchodilators used for quick relief of acute asthma
symptoms. Option B is incorrect because fluticasone is an inhaled corticosteroid (ICS) used for long-term
control. Option D is incorrect because montelukast is a leukotriene modifier used for maintenance
therapy.
, Q5: A patient with pneumonia has a temperature of 102.5°F (39.2°C), productive cough with rust-colored
sputum, and decreased breath sounds in the left lower lobe. Which intervention should the nurse
implement first?
A. Administer the prescribed oral antibiotic.
B. Obtain a sputum culture before initiating antibiotics.
C. Encourage increased fluid intake to thin secretions.
D. Place the patient in a high-Fowler's position.
Correct Answer: B
Rationale: [CORRECT] Obtaining a sputum culture before initiating antibiotic therapy is the priority to
ensure the causative organism is identified and the most effective antibiotic is chosen, preventing
antibiotic resistance. Option A is incorrect because administering the antibiotic first can alter the culture
results. Options C and D are incorrect because while they are appropriate supportive interventions, they
do not take priority over obtaining accurate diagnostic data.
Q6: A patient with a pulmonary embolism (PE) is suddenly experiencing severe dyspnea, chest pain, and
is coughing up blood-tinged sputum. Which vital sign finding should the nurse anticipate?
A. Hypertension
B. Bradycardia
C. Tachycardia
D. Bradypnea
Correct Answer: C
Rationale: [CORRECT] A pulmonary embolism causes hypoxemia and stimulation of the sympathetic
nervous system, which leads to tachycardia as the heart attempts to compensate for decreased
oxygenation. Options A and B are incorrect because hypotension and tachycardia, not hypertension and
bradycardia, are expected due to decreased cardiac output. Option D is incorrect because tachypnea (fast
breathing), not bradypnea, is expected with dyspnea and hypoxia.
Q7: The nurse is assessing a patient who is 12 hours post-operative from a total knee replacement. The
patient suddenly complains of sharp chest pain and palpitations. Which diagnostic test is the most specific
for confirming a pulmonary embolism?
A. D-dimer
B. Arterial blood gas (ABG)
C. Chest X-ray
D. Computed tomography pulmonary angiography (CTPA)
Correct Answer: D
