MDC 3 Final Exam 2026–2028 | Rasmussen University | Complete
Study Guide & Practice Test | Verified Questions & Answers
Prepare for the Rasmussen University MDC 3 Final Exam with this comprehensive practice test
featuring verified questions, answers, and detailed explanations. This study guide covers
essential concepts commonly taught in Medical/Surgical Nursing and advanced patient care
courses, including clinical judgment, pharmacology, disease management, patient assessment,
safety, and evidence-based nursing interventions. Designed to reinforce critical nursing
knowledge and improve exam readiness, the material helps students build confidence through
realistic exam-style questions. Ideal for Rasmussen University nursing students seeking a reliable
resource to prepare for and successfully pass the MDC 3 Final Examination.
Q1. A nurse in the intensive care unit is caring for a patient on mechanical
ventilation. The ventilator’s high-pressure alarm suddenly sounds. Which action
should the nurse take first?
A) Disconnect the patient from the ventilator and manually bag them.
B) Check the system loops for any loose tubing connections.
C) Suction the patient's endotracheal tube to clear accumulated secretions.
D) Call the respiratory therapist to adjust the tidal volume settings.
Rationale: High-pressure alarms signify increased resistance within the circuit or the
patient's airway. Common causes include thick secretions, biting on the tube, kinks, or
coughing. The nurse must first clear the airway via suctioning or assess for biting.
Disconnecting the patient (Option A) is only indicated if the ventilator malfunctions
completely. Loose connections (Option B) trigger low-pressure alarms.
Q2. A patient in septic shock has failed to respond to an initial 30 mL/kg
crystalloid fluid bolus. The patient’s current mean arterial pressure (MAP) is 54
mmHg. Which medication should the nurse prepare to initiate immediately?
A) Intravenous Furosemide infusion
B) Continuous Norepinephrine infusion
,C) Intravenous Nitroprusside bolus
D) Subcutaneous Epinephrine injection
Rationale: Norepinephrine is the first-line vasopressor of choice for refractory
hypotension in septic shock after adequate fluid resuscitation. It acts primarily on alpha-
1 adrenergic receptors to cause profound vasoconstriction, thereby increasing systemic
vascular resistance and raising the MAP to the target goal of ≥65 mmHg. Furosemide
(Option A) and nitroprusside (Option C) would further decrease blood pressure.
Q3. A nurse is interpreting the arterial blood gas (ABG) results for a patient with
severe acute pancreatitis: pH 7.31, PaCO2 32 mmHg, HCO3 16 mEq/L. How
should the nurse accurately document this acid-base imbalance?
A) Uncompensated respiratory acidosis
B) Fully compensated metabolic alkalosis
C) Partially compensated metabolic acidosis
D) Uncompensated metabolic acidosis
Rationale: The pH is low (<7.35), indicating acidosis. The HCO3 is low (<22 mEq/L),
which matches the acidosis, identifying it as metabolic. The PaCO2 is also low (<35
mmHg), indicating that the respiratory system is actively trying to blow off CO2 to
correct the pH. Because the pH has not yet returned to the normal range, the
compensation is partial.
Q4. A patient is admitted to the emergency department with deep partial-
thickness burns across the entire anterior chest, abdomen, and the entire front of
both legs. Using the Rule of Nines, what is the estimated total body surface area
(TBSA) burned?
A) 18%
B) 27%
C) 36%
D) 45%
Rationale: According to the Rule of Nines: the entire anterior torso (chest and abdomen)
equals 18%. The anterior portion of a single leg equals 9%. Because both anterior legs
are involved, that adds another 18% (9% + 9%). Combining the regions: 18% (torso) +
18% (legs) = 36% TBSA.
,Q5. A 75 kg patient presents with 40% TBSA burns. Using the Parkland Formula
(4 mL/kg/%TBSA), the nurse calculates the total 24-hour fluid resuscitation
volume. What hourly rate should the nurse program the infusion pump for during
the first 8 hours?
A) 375 mL/hr
B) 750 mL/hr
C) 1,500 mL/hr
D) 500 mL/hr
Rationale: Total 24-hour volume = 4 mL × 75 kg × 40 = 12,000 mL. The Parkland
formula dictates that half of this total volume must be administered within the first 8
hours from the time of the burn injury: 12,000 mL / 2 = 6,000 mL. Hourly rate for the first
8 hours = 6,000 mL / 8 hours = 750 mL/hr.
Q6. A nurse is caring for a patient in the ICU following an acute ischemic stroke.
The provider prescribes a continuous Nicardipine infusion. Which physiological
parameter must the nurse monitor most closely to titrate this medication?
A) Intracranial pressure (ICP)
B) Serum potassium level
C) Hourly blood pressure
D) Respiratory rate and depth
Rationale: Nicardipine is a short-acting calcium channel blocker used as an intravenous
antihypertensive to precisely manage blood pressure in acute stroke settings. The nurse
must monitor blood pressure closely (often every 5 to 15 minutes) to keep it within the
strict parameters prescribed to maintain cerebral perfusion without causing hemorrhagic
conversion.
Q7. A patient with an advanced traumatic brain injury is monitored via an
intraventricular catheter. The nurse notes the following vital signs: BP 180/54
mmHg, HR 46 beats/min, and irregular respirations. The nurse recognizes this
presentation as which clinical phenomenon?
A) Beck's Triad
, B) Virchow's Triad
C) Cushing's Triad
D) Autonomic Dysreflexia
Rationale: Cushing's Triad consists of widening pulse pressure (severe systolic
hypertension with a stable or low diastolic), bradycardia, and irregular or altered
respirations. It is a late, critical indicator of significantly increased intracranial pressure
(ICP) and impending brain herniation.
Q8. A nurse is assessing a patient with a suspected basilar skull fracture. Which
clinical finding explicitly supports this diagnosis?
A) Symmetrical facial grimacing
B) Periorbital ecchymosis and clear fluid draining from the nose
C) Unilateral pinpoint pupil reactivity
D) Hyperactive deep tendon reflexes in all extremities
Rationale: Signs of a basilar skull fracture include periorbital ecchymosis (Raccoon
eyes), mastoid ecchymosis (Battle's sign), rhinorrhea (CSF leaking from nose), or
otorrhea (CSF leaking from ears). Clear nasal drainage must be tested for glucose or
the "halo sign" to confirm it is cerebrospinal fluid.
Q9. A patient in the ICU with severe sepsis develops petechiae, prolonged
prothrombin time (PT/INR), a platelet count of 42,000/mm³, and oozing of blood
from all old puncture sites. Which condition should the nurse suspect?
A) Idiopathic thrombocytopenic purpura (ITP)
B) Acute deep vein thrombosis (DVT)
C) Disseminated intravascular coagulation (DIC)
D) Heparin-induced thrombocytopenia (HIT)
Rationale: DIC is a catastrophic multi-system complication of sepsis characterized by
widespread microvascular clotting that depletes clotting factors and platelets, rapidly
resulting in severe, systemic bleeding. Bleeding from invasive lines or puncture sites
combined with thrombocytopenia and prolonged coagulation times are classic
indicators.
Study Guide & Practice Test | Verified Questions & Answers
Prepare for the Rasmussen University MDC 3 Final Exam with this comprehensive practice test
featuring verified questions, answers, and detailed explanations. This study guide covers
essential concepts commonly taught in Medical/Surgical Nursing and advanced patient care
courses, including clinical judgment, pharmacology, disease management, patient assessment,
safety, and evidence-based nursing interventions. Designed to reinforce critical nursing
knowledge and improve exam readiness, the material helps students build confidence through
realistic exam-style questions. Ideal for Rasmussen University nursing students seeking a reliable
resource to prepare for and successfully pass the MDC 3 Final Examination.
Q1. A nurse in the intensive care unit is caring for a patient on mechanical
ventilation. The ventilator’s high-pressure alarm suddenly sounds. Which action
should the nurse take first?
A) Disconnect the patient from the ventilator and manually bag them.
B) Check the system loops for any loose tubing connections.
C) Suction the patient's endotracheal tube to clear accumulated secretions.
D) Call the respiratory therapist to adjust the tidal volume settings.
Rationale: High-pressure alarms signify increased resistance within the circuit or the
patient's airway. Common causes include thick secretions, biting on the tube, kinks, or
coughing. The nurse must first clear the airway via suctioning or assess for biting.
Disconnecting the patient (Option A) is only indicated if the ventilator malfunctions
completely. Loose connections (Option B) trigger low-pressure alarms.
Q2. A patient in septic shock has failed to respond to an initial 30 mL/kg
crystalloid fluid bolus. The patient’s current mean arterial pressure (MAP) is 54
mmHg. Which medication should the nurse prepare to initiate immediately?
A) Intravenous Furosemide infusion
B) Continuous Norepinephrine infusion
,C) Intravenous Nitroprusside bolus
D) Subcutaneous Epinephrine injection
Rationale: Norepinephrine is the first-line vasopressor of choice for refractory
hypotension in septic shock after adequate fluid resuscitation. It acts primarily on alpha-
1 adrenergic receptors to cause profound vasoconstriction, thereby increasing systemic
vascular resistance and raising the MAP to the target goal of ≥65 mmHg. Furosemide
(Option A) and nitroprusside (Option C) would further decrease blood pressure.
Q3. A nurse is interpreting the arterial blood gas (ABG) results for a patient with
severe acute pancreatitis: pH 7.31, PaCO2 32 mmHg, HCO3 16 mEq/L. How
should the nurse accurately document this acid-base imbalance?
A) Uncompensated respiratory acidosis
B) Fully compensated metabolic alkalosis
C) Partially compensated metabolic acidosis
D) Uncompensated metabolic acidosis
Rationale: The pH is low (<7.35), indicating acidosis. The HCO3 is low (<22 mEq/L),
which matches the acidosis, identifying it as metabolic. The PaCO2 is also low (<35
mmHg), indicating that the respiratory system is actively trying to blow off CO2 to
correct the pH. Because the pH has not yet returned to the normal range, the
compensation is partial.
Q4. A patient is admitted to the emergency department with deep partial-
thickness burns across the entire anterior chest, abdomen, and the entire front of
both legs. Using the Rule of Nines, what is the estimated total body surface area
(TBSA) burned?
A) 18%
B) 27%
C) 36%
D) 45%
Rationale: According to the Rule of Nines: the entire anterior torso (chest and abdomen)
equals 18%. The anterior portion of a single leg equals 9%. Because both anterior legs
are involved, that adds another 18% (9% + 9%). Combining the regions: 18% (torso) +
18% (legs) = 36% TBSA.
,Q5. A 75 kg patient presents with 40% TBSA burns. Using the Parkland Formula
(4 mL/kg/%TBSA), the nurse calculates the total 24-hour fluid resuscitation
volume. What hourly rate should the nurse program the infusion pump for during
the first 8 hours?
A) 375 mL/hr
B) 750 mL/hr
C) 1,500 mL/hr
D) 500 mL/hr
Rationale: Total 24-hour volume = 4 mL × 75 kg × 40 = 12,000 mL. The Parkland
formula dictates that half of this total volume must be administered within the first 8
hours from the time of the burn injury: 12,000 mL / 2 = 6,000 mL. Hourly rate for the first
8 hours = 6,000 mL / 8 hours = 750 mL/hr.
Q6. A nurse is caring for a patient in the ICU following an acute ischemic stroke.
The provider prescribes a continuous Nicardipine infusion. Which physiological
parameter must the nurse monitor most closely to titrate this medication?
A) Intracranial pressure (ICP)
B) Serum potassium level
C) Hourly blood pressure
D) Respiratory rate and depth
Rationale: Nicardipine is a short-acting calcium channel blocker used as an intravenous
antihypertensive to precisely manage blood pressure in acute stroke settings. The nurse
must monitor blood pressure closely (often every 5 to 15 minutes) to keep it within the
strict parameters prescribed to maintain cerebral perfusion without causing hemorrhagic
conversion.
Q7. A patient with an advanced traumatic brain injury is monitored via an
intraventricular catheter. The nurse notes the following vital signs: BP 180/54
mmHg, HR 46 beats/min, and irregular respirations. The nurse recognizes this
presentation as which clinical phenomenon?
A) Beck's Triad
, B) Virchow's Triad
C) Cushing's Triad
D) Autonomic Dysreflexia
Rationale: Cushing's Triad consists of widening pulse pressure (severe systolic
hypertension with a stable or low diastolic), bradycardia, and irregular or altered
respirations. It is a late, critical indicator of significantly increased intracranial pressure
(ICP) and impending brain herniation.
Q8. A nurse is assessing a patient with a suspected basilar skull fracture. Which
clinical finding explicitly supports this diagnosis?
A) Symmetrical facial grimacing
B) Periorbital ecchymosis and clear fluid draining from the nose
C) Unilateral pinpoint pupil reactivity
D) Hyperactive deep tendon reflexes in all extremities
Rationale: Signs of a basilar skull fracture include periorbital ecchymosis (Raccoon
eyes), mastoid ecchymosis (Battle's sign), rhinorrhea (CSF leaking from nose), or
otorrhea (CSF leaking from ears). Clear nasal drainage must be tested for glucose or
the "halo sign" to confirm it is cerebrospinal fluid.
Q9. A patient in the ICU with severe sepsis develops petechiae, prolonged
prothrombin time (PT/INR), a platelet count of 42,000/mm³, and oozing of blood
from all old puncture sites. Which condition should the nurse suspect?
A) Idiopathic thrombocytopenic purpura (ITP)
B) Acute deep vein thrombosis (DVT)
C) Disseminated intravascular coagulation (DIC)
D) Heparin-induced thrombocytopenia (HIT)
Rationale: DIC is a catastrophic multi-system complication of sepsis characterized by
widespread microvascular clotting that depletes clotting factors and platelets, rapidly
resulting in severe, systemic bleeding. Bleeding from invasive lines or puncture sites
combined with thrombocytopenia and prolonged coagulation times are classic
indicators.
