MDC 2 EXAM 1 — RASMUSSEN COLLEGE
Actual Exam 2026/2027 Complete
Questions and Answers | 100% Verified
Detailed Rationales - Pass Guaranteed - A+
Graded
TABLE OF CONTENTS
Section 1 | Fluid, Electrolyte, and Acid-Base Balance | Q1 – Q10
Section 2 | Cardiovascular Disorders | Q11 – Q20
Section 3 | Respiratory Disorders | Q21 – Q30
Section 4 | Renal and Urinary Disorders | Q31 – Q40
Section 5 | Hematologic and Immunologic Disorders | Q41 – Q50
══════════════════════════════════════
SECTION 1: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old patient is admitted with confusion, dry mucous membranes, and poor skin
turgor. Laboratory results reveal a serum sodium level of 158 mEq/L. The nurse
recognizes that this patient is most likely experiencing which fluid imbalance?
A. Hypotonic dehydration
B. Isotonic dehydration
C. Hypertonic dehydration ✓ CORRECT
D. Third-spacing of fluid
Correct Answer: C
,Rationale: Hypertonic dehydration is characterized by water loss exceeding sodium
loss, resulting in elevated serum sodium above 145 mEq/L, which causes cellular
shrinkage and neurologic symptoms like confusion. Isotonic dehydration would present
with a normal sodium level, and hypotonic dehydration would show a low sodium level
with fluid shifting into cells. Older adults are particularly vulnerable to hypertonic
dehydration due to decreased thirst sensation and impaired renal concentrating ability.
Question 2 of 50
A nurse is caring for a 45-year-old patient who has been vomiting profusely for 24 hours
after food poisoning. Arterial blood gas results show pH 7.50, PaCO2 48 mmHg, and
HCO3- 35 mEq/L. The nurse should identify which acid-base disturbance?
A. Respiratory acidosis with partial compensation
B. Respiratory alkalosis with full compensation
C. Metabolic alkalosis with respiratory compensation ✓ CORRECT
D. Metabolic acidosis with respiratory compensation
Correct Answer: C
Rationale: The elevated pH indicates alkalosis, the elevated HCO3- confirms a metabolic
origin from loss of gastric acid through vomiting, and the slightly elevated PaCO2
represents the lungs' compensatory attempt to retain CO2 and normalize pH.
Respiratory acidosis would show a low pH with elevated PaCO2, and metabolic acidosis
would present with a low pH and low HCO3-. Prolonged vomiting depletes hydrogen and
chloride ions, which drives the metabolic alkalosis.
Question 3 of 50
A 62-year-old patient with heart failure is receiving IV furosemide 40 mg twice daily. The
nurse monitors the patient for hypokalemia and recognizes that a serum potassium
level below which value requires immediate notification of the prescriber?
,A. 3.8 mEq/L
B. 3.5 mEq/L
C. 3.0 mEq/L ✓ CORRECT
D. 2.5 mEq/L
Correct Answer: C
Rationale: A serum potassium below 3.0 mEq/L represents severe hypokalemia that
significantly increases the risk of life-threatening cardiac arrhythmias, muscle paralysis,
and rhabdomyolysis, requiring immediate intervention. While 3.5 mEq/L defines mild
hypokalemia and warrants monitoring, and 2.5 mEq/L is critical, 3.0 mEq/L is the
threshold where most protocols require prescriber notification and aggressive
replacement. Loop diuretics like furosemide cause potassium wasting through
inhibition of the Na-K-2Cl cotransporter in the thick ascending limb.
Question 4 of 50
A nurse is reviewing morning laboratory results for a 55-year-old patient with chronic
kidney disease. The serum calcium is 7.8 mg/dL and the phosphate is 5.2 mg/dL. The
nurse should anticipate which intervention?
A. Administration of IV calcium gluconate immediately
B. Initiation of a phosphate binder with meals ✓ CORRECT
C. Restriction of calcium-rich foods in the diet
D. Increase in vitamin D supplementation
Correct Answer: B
Rationale: In chronic kidney disease, impaired phosphate excretion leads to
hyperphosphatemia, which binds with calcium and causes hypocalcemia; phosphate
binders taken with meals reduce intestinal phosphate absorption and help restore
calcium-phosphate balance. IV calcium gluconate is reserved for symptomatic
hypocalcemia with tetany or arrhythmias, and restricting calcium would worsen the
, existing deficit. Active vitamin D may be used later but does not address the primary
problem of phosphate retention.
Question 5 of 50
A 30-year-old patient is admitted after a motor vehicle accident with multiple fractures
and significant blood loss. The patient has received 4 liters of lactated Ringer's solution
in the emergency department. The nurse should monitor for which potential
complication of rapid fluid resuscitation?
A. Hypernatremia and cellular dehydration
B. Fluid volume excess and pulmonary edema ✓ CORRECT
C. Metabolic acidosis from lactate accumulation
D. Hypokalemia from dilutional effects
Correct Answer: B
Rationale: Rapid infusion of large crystalloid volumes can precipitate fluid volume
excess, particularly in patients with compromised cardiac function, leading to
pulmonary edema, elevated jugular venous pressure, and crackles on auscultation.
Lactated Ringer's is isotonic and does not cause hypernatremia, and the lactate is
converted to bicarbonate by the liver rather than causing acidosis. While electrolyte
shifts can occur, pulmonary edema is the most immediate life-threatening concern with
aggressive fluid resuscitation.
Question 6 of 50
A nurse is caring for a diabetic patient whose arterial blood gas shows pH 7.30, PaCO2
30 mmHg, and HCO3- 15 mEq/L. The patient has fruity breath and is breathing deeply
and rapidly. The nurse should recognize these findings as consistent with:
A. Respiratory acidosis from opioid overdose
B. Metabolic acidosis with respiratory compensation ✓ CORRECT
C. Respiratory alkalosis from anxiety
Actual Exam 2026/2027 Complete
Questions and Answers | 100% Verified
Detailed Rationales - Pass Guaranteed - A+
Graded
TABLE OF CONTENTS
Section 1 | Fluid, Electrolyte, and Acid-Base Balance | Q1 – Q10
Section 2 | Cardiovascular Disorders | Q11 – Q20
Section 3 | Respiratory Disorders | Q21 – Q30
Section 4 | Renal and Urinary Disorders | Q31 – Q40
Section 5 | Hematologic and Immunologic Disorders | Q41 – Q50
══════════════════════════════════════
SECTION 1: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old patient is admitted with confusion, dry mucous membranes, and poor skin
turgor. Laboratory results reveal a serum sodium level of 158 mEq/L. The nurse
recognizes that this patient is most likely experiencing which fluid imbalance?
A. Hypotonic dehydration
B. Isotonic dehydration
C. Hypertonic dehydration ✓ CORRECT
D. Third-spacing of fluid
Correct Answer: C
,Rationale: Hypertonic dehydration is characterized by water loss exceeding sodium
loss, resulting in elevated serum sodium above 145 mEq/L, which causes cellular
shrinkage and neurologic symptoms like confusion. Isotonic dehydration would present
with a normal sodium level, and hypotonic dehydration would show a low sodium level
with fluid shifting into cells. Older adults are particularly vulnerable to hypertonic
dehydration due to decreased thirst sensation and impaired renal concentrating ability.
Question 2 of 50
A nurse is caring for a 45-year-old patient who has been vomiting profusely for 24 hours
after food poisoning. Arterial blood gas results show pH 7.50, PaCO2 48 mmHg, and
HCO3- 35 mEq/L. The nurse should identify which acid-base disturbance?
A. Respiratory acidosis with partial compensation
B. Respiratory alkalosis with full compensation
C. Metabolic alkalosis with respiratory compensation ✓ CORRECT
D. Metabolic acidosis with respiratory compensation
Correct Answer: C
Rationale: The elevated pH indicates alkalosis, the elevated HCO3- confirms a metabolic
origin from loss of gastric acid through vomiting, and the slightly elevated PaCO2
represents the lungs' compensatory attempt to retain CO2 and normalize pH.
Respiratory acidosis would show a low pH with elevated PaCO2, and metabolic acidosis
would present with a low pH and low HCO3-. Prolonged vomiting depletes hydrogen and
chloride ions, which drives the metabolic alkalosis.
Question 3 of 50
A 62-year-old patient with heart failure is receiving IV furosemide 40 mg twice daily. The
nurse monitors the patient for hypokalemia and recognizes that a serum potassium
level below which value requires immediate notification of the prescriber?
,A. 3.8 mEq/L
B. 3.5 mEq/L
C. 3.0 mEq/L ✓ CORRECT
D. 2.5 mEq/L
Correct Answer: C
Rationale: A serum potassium below 3.0 mEq/L represents severe hypokalemia that
significantly increases the risk of life-threatening cardiac arrhythmias, muscle paralysis,
and rhabdomyolysis, requiring immediate intervention. While 3.5 mEq/L defines mild
hypokalemia and warrants monitoring, and 2.5 mEq/L is critical, 3.0 mEq/L is the
threshold where most protocols require prescriber notification and aggressive
replacement. Loop diuretics like furosemide cause potassium wasting through
inhibition of the Na-K-2Cl cotransporter in the thick ascending limb.
Question 4 of 50
A nurse is reviewing morning laboratory results for a 55-year-old patient with chronic
kidney disease. The serum calcium is 7.8 mg/dL and the phosphate is 5.2 mg/dL. The
nurse should anticipate which intervention?
A. Administration of IV calcium gluconate immediately
B. Initiation of a phosphate binder with meals ✓ CORRECT
C. Restriction of calcium-rich foods in the diet
D. Increase in vitamin D supplementation
Correct Answer: B
Rationale: In chronic kidney disease, impaired phosphate excretion leads to
hyperphosphatemia, which binds with calcium and causes hypocalcemia; phosphate
binders taken with meals reduce intestinal phosphate absorption and help restore
calcium-phosphate balance. IV calcium gluconate is reserved for symptomatic
hypocalcemia with tetany or arrhythmias, and restricting calcium would worsen the
, existing deficit. Active vitamin D may be used later but does not address the primary
problem of phosphate retention.
Question 5 of 50
A 30-year-old patient is admitted after a motor vehicle accident with multiple fractures
and significant blood loss. The patient has received 4 liters of lactated Ringer's solution
in the emergency department. The nurse should monitor for which potential
complication of rapid fluid resuscitation?
A. Hypernatremia and cellular dehydration
B. Fluid volume excess and pulmonary edema ✓ CORRECT
C. Metabolic acidosis from lactate accumulation
D. Hypokalemia from dilutional effects
Correct Answer: B
Rationale: Rapid infusion of large crystalloid volumes can precipitate fluid volume
excess, particularly in patients with compromised cardiac function, leading to
pulmonary edema, elevated jugular venous pressure, and crackles on auscultation.
Lactated Ringer's is isotonic and does not cause hypernatremia, and the lactate is
converted to bicarbonate by the liver rather than causing acidosis. While electrolyte
shifts can occur, pulmonary edema is the most immediate life-threatening concern with
aggressive fluid resuscitation.
Question 6 of 50
A nurse is caring for a diabetic patient whose arterial blood gas shows pH 7.30, PaCO2
30 mmHg, and HCO3- 15 mEq/L. The patient has fruity breath and is breathing deeply
and rapidly. The nurse should recognize these findings as consistent with:
A. Respiratory acidosis from opioid overdose
B. Metabolic acidosis with respiratory compensation ✓ CORRECT
C. Respiratory alkalosis from anxiety
