NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
NUR 2356 FINAL EXAM 2
LATEST VERSIONS 2026/2027
MULTIDIMENSIONAL CARE 1 FINAL / MDC 1 FINAL EXAM
200 Questions and Correct Answers
Rasmussen College
Aligned with NCLEX-RN Foundational Competencies
Total Questions: 200 (Multiple Choice, A-D)
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Content: 10 Sections covering MDC 1 Final Exam 2 Blueprint
Version A
1
, NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
Section 1: Safety, Infection Control, and Immunity (Q1-Q30)
Q1: A nurse is preparing to enter the room of a client diagnosed with Clostridioides difficile (C. diff). Which type of
transmission-based precautions should the nurse implement?
A. Airborne precautions with N95 respirator
B. Droplet precautions with surgical mask and eye protection
C. Contact precautions with gown and gloves [CORRECT]
D. Standard precautions with hand sanitizer only
Correct Answer: C
Rationale: C. diff is spread through direct and indirect contact with spores in the environment. Contact precautions require a private room or
cohorting, gown and gloves, and dedicated equipment. Airborne precautions are for TB, measles, and varicella. Droplet precautions are for
influenza and pertussis. Hand sanitizer is insufficient because C. diff spores are not killed by alcohol-based products; soap and water are required.
Q2: A nurse is caring for a client with active pulmonary tuberculosis (TB). Which intervention is the priority when entering
the client's room?
A. Apply a surgical mask before entering the room
B. Don an N95 respirator before entering the negative-pressure room [CORRECT]
C. Place the client in a room with the door open for ventilation
D. Wear a gown and gloves to prevent contact transmission
Correct Answer: B
Rationale: TB is transmitted via airborne particles that remain suspended in the air. Airborne precautions require an N95 respirator or PAPR, a
negative-pressure room, and the door must remain closed. A surgical mask does not provide adequate protection against airborne particles. The door
must stay closed to maintain negative pressure. Gown and gloves are for contact precautions.
Q3: A nurse is caring for a client who is immunocompromised following chemotherapy. Which intervention is most
appropriate for neutropenic precautions?
A. Place the client in a negative-pressure room
B. Allow fresh flowers and live plants in the room for morale
C. Maintain a positive-pressure room and restrict visitors with infections [CORRECT]
D. Encourage the client to attend group therapy sessions for psychosocial support
Correct Answer: C
Rationale: Neutropenic precautions (reverse/protective isolation) protect the immunocompromised client from opportunistic infections. The client
should be in a positive-pressure room to prevent contaminated air from entering. Fresh flowers, live plants, and crowds should be avoided. A
negative-pressure room is for airborne pathogens.
Q4: In which order should a nurse don personal protective equipment (PPE) when preparing to care for a client on contact
precautions?
A. Gloves, gown, mask, eye protection
B. Gown, mask/respirator, eye protection, gloves [CORRECT]
C. Mask, eye protection, gown, gloves
D. Eye protection, mask, gloves, gown
Correct Answer: B
Rationale: The correct donning order is: gown first to protect the body, then mask/respirator to protect the respiratory tract, followed by eye
protection, and finally gloves pulled over the gown cuffs. This sequence ensures each piece of PPE covers its intended area without contaminating
previously applied items.
Q5: A nurse is removing PPE after caring for a client on contact precautions. Which is the correct doffing sequence?
A. Gloves, eye protection, gown, mask/respirator [CORRECT]
B. Mask/respirator, gloves, gown, eye protection
C. Gown, gloves, mask/respirator, eye protection
D. Eye protection, gown, gloves, mask/respirator
Correct Answer: A
2
, NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
Rationale: The correct doffing sequence removes the most contaminated items first: gloves (highest contamination from direct contact), then eye
protection, then gown (touching only inside surfaces), and finally mask/respirator. This order minimizes self-contamination during removal.
Q6: A nurse is educating a client about standard precautions. Which statement by the nurse is most accurate?
A. Standard precautions apply only to clients with diagnosed infections
B. Hand hygiene is the single most important measure to prevent the spread of infection [CORRECT]
C. Standard precautions require the use of an N95 respirator for all client encounters
D. Gloves are required regardless of the anticipated contact with body fluids
Correct Answer: B
Rationale: Standard precautions apply to ALL clients regardless of diagnosis. Hand hygiene is the most critical infection control measure. An N95
is only for airborne precautions. Gloves are required when anticipating contact with blood, body fluids, secretions, and non-intact skin, not for every
interaction.
Q7: A nurse sustains a needlestick injury while administering an injection to a client with HIV. Which action should the
nurse take first?
A. Complete an incident report and notify the charge nurse
B. Wash or flush the exposed skin area with water immediately [CORRECT]
C. Request antiretroviral prophylaxis from the provider
D. Have the source client tested for HIV antibodies
Correct Answer: B
Rationale: The first action after a needlestick injury is to wash or flush the exposed area with soap and water immediately to reduce the viral load
at the exposure site. After immediate first aid, the nurse should report the incident, undergo baseline antibody testing, and consult occupational
health regarding post-exposure prophylaxis.
Q8: A client with HIV has a CD4+ T-cell count of 180 cells/mm3. The nurse understands that this finding indicates:
A. The client is in the early stages of HIV infection
B. The client meets the diagnostic criteria for AIDS [CORRECT]
C. The client has adequate immune function to fight opportunistic infections
D. The client should discontinue antiretroviral therapy
Correct Answer: B
Rationale: A CD4+ T-cell count below 200 cells/mm3 meets the CDC diagnostic criteria for AIDS. Normal CD4+ count is greater than 500
cells/mm3. At this level, the client is at significant risk for opportunistic infections. ART should be continued, not discontinued.
Q9: A nurse is caring for a client with HIV who is suspected of developing Pneumocystis jiroveci pneumonia (PCP). Which
assessment finding is the priority?
A. Skin lesions on the lower extremities
B. Lung sounds for crackles and ineffective airway clearance [CORRECT]
C. Mental status changes and cognitive decline
D. Oral candidiasis and white patches in the mouth
Correct Answer: B
Rationale: PCP causes bilateral crackles, dyspnea, hypoxemia, and ineffective airway clearance. The priority is monitoring lung sounds. Skin
lesions suggest Kaposi sarcoma. Mental status changes suggest HIV encephalopathy. Oral candidiasis is a fungal infection but not the priority for
PCP.
Q10: A client with advanced HIV presents with purple, raised lesions on the skin and oral mucosa. The nurse identifies
these findings as which condition?
A. Kaposi sarcoma [CORRECT]
B. Toxoplasmosis encephalitis
C. HIV encephalopathy
D. Pneumocystis jiroveci pneumonia
Correct Answer: A
Rationale: Kaposi sarcoma is an AIDS-defining malignancy caused by HHV-8, presenting as purple, raised, vascular lesions on the skin and oral
mucosa. Toxoplasmosis presents with neurologic changes. HIV encephalopathy causes cognitive and motor decline. PCP affects the lungs.
3
, NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
Q11: A nurse is providing discharge teaching to a client with HIV who is starting antiretroviral therapy (ART). Which
statement indicates understanding?
A. I will stop taking my medications when I feel better
B. I should take my medications at the same time every day and never skip doses [CORRECT]
C. I only need to take my medications when my viral load increases
D. I can share my medications with my partner if they have similar symptoms
Correct Answer: B
Rationale: Strict ART adherence is essential to prevent viral resistance and maintain suppression. Medications must be taken at the same time daily.
Stopping when feeling better leads to resistance. ART is lifelong therapy. Medications should never be shared.
Q12: A nurse is assessing a client with HIV for early signs of HIV encephalopathy. Which finding should the nurse
prioritize?
A. Persistent dry cough and shortness of breath
B. Progressive cognitive, behavioral, and motor decline [CORRECT]
C. Purple nodular lesions on the upper extremities
D. Severe headache, fever, and photophobia
Correct Answer: B
Rationale: HIV encephalopathy causes progressive cognitive impairment, behavioral changes, and motor deficits. Cough and dyspnea suggest PCP.
Purple lesions indicate Kaposi sarcoma. Headache with fever suggests meningitis or toxoplasmosis.
Q13: A client with HIV asks the nurse about dietary precautions related to toxoplasmosis. Which instruction is most
important?
A. Avoid raw or undercooked meat and cat feces [CORRECT]
B. Limit intake of dairy products and eggs
C. Avoid all fresh fruits and vegetables
D. Eliminate all seafood from the diet
Correct Answer: A
Rationale: Toxoplasmosis is transmitted through undercooked meat containing cysts or exposure to cat feces. The client should cook meat
thoroughly, avoid cleaning cat litter boxes, and wash fruits and vegetables. Dairy, eggs, and seafood are not primary sources.
Q14: A client is admitted with influenza. Which type of transmission-based precautions should the nurse implement?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions [CORRECT]
D. Neutropenic precautions
Correct Answer: C
Rationale: Influenza is transmitted via large respiratory droplets. Droplet precautions require a private room, surgical mask and eye protection
within 3 feet, and a mask on the client during transport. Airborne precautions are for TB, measles, and varicella.
Q15: A nurse is caring for a client with methicillin-resistant Staphylococcus aureus (MRSA) in a surgical wound. Which
intervention is essential?
A. Place the client in a negative-pressure room
B. Require all visitors to wear an N95 respirator
C. Implement contact precautions with dedicated equipment [CORRECT]
D. Place the client on droplet precautions with a surgical mask
Correct Answer: C
Rationale: MRSA is transmitted through direct and indirect contact. Contact precautions include a private room, gown and gloves, and dedicated
equipment. Negative-pressure rooms and N95 respirators are for airborne precautions. Droplet precautions are not appropriate for MRSA.
Q16: A nurse is caring for a client with vancomycin-resistant Enterococcus (VRE). Which precautions are required?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions [CORRECT]
4
NUR 2356 FINAL EXAM 2
LATEST VERSIONS 2026/2027
MULTIDIMENSIONAL CARE 1 FINAL / MDC 1 FINAL EXAM
200 Questions and Correct Answers
Rasmussen College
Aligned with NCLEX-RN Foundational Competencies
Total Questions: 200 (Multiple Choice, A-D)
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Content: 10 Sections covering MDC 1 Final Exam 2 Blueprint
Version A
1
, NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
Section 1: Safety, Infection Control, and Immunity (Q1-Q30)
Q1: A nurse is preparing to enter the room of a client diagnosed with Clostridioides difficile (C. diff). Which type of
transmission-based precautions should the nurse implement?
A. Airborne precautions with N95 respirator
B. Droplet precautions with surgical mask and eye protection
C. Contact precautions with gown and gloves [CORRECT]
D. Standard precautions with hand sanitizer only
Correct Answer: C
Rationale: C. diff is spread through direct and indirect contact with spores in the environment. Contact precautions require a private room or
cohorting, gown and gloves, and dedicated equipment. Airborne precautions are for TB, measles, and varicella. Droplet precautions are for
influenza and pertussis. Hand sanitizer is insufficient because C. diff spores are not killed by alcohol-based products; soap and water are required.
Q2: A nurse is caring for a client with active pulmonary tuberculosis (TB). Which intervention is the priority when entering
the client's room?
A. Apply a surgical mask before entering the room
B. Don an N95 respirator before entering the negative-pressure room [CORRECT]
C. Place the client in a room with the door open for ventilation
D. Wear a gown and gloves to prevent contact transmission
Correct Answer: B
Rationale: TB is transmitted via airborne particles that remain suspended in the air. Airborne precautions require an N95 respirator or PAPR, a
negative-pressure room, and the door must remain closed. A surgical mask does not provide adequate protection against airborne particles. The door
must stay closed to maintain negative pressure. Gown and gloves are for contact precautions.
Q3: A nurse is caring for a client who is immunocompromised following chemotherapy. Which intervention is most
appropriate for neutropenic precautions?
A. Place the client in a negative-pressure room
B. Allow fresh flowers and live plants in the room for morale
C. Maintain a positive-pressure room and restrict visitors with infections [CORRECT]
D. Encourage the client to attend group therapy sessions for psychosocial support
Correct Answer: C
Rationale: Neutropenic precautions (reverse/protective isolation) protect the immunocompromised client from opportunistic infections. The client
should be in a positive-pressure room to prevent contaminated air from entering. Fresh flowers, live plants, and crowds should be avoided. A
negative-pressure room is for airborne pathogens.
Q4: In which order should a nurse don personal protective equipment (PPE) when preparing to care for a client on contact
precautions?
A. Gloves, gown, mask, eye protection
B. Gown, mask/respirator, eye protection, gloves [CORRECT]
C. Mask, eye protection, gown, gloves
D. Eye protection, mask, gloves, gown
Correct Answer: B
Rationale: The correct donning order is: gown first to protect the body, then mask/respirator to protect the respiratory tract, followed by eye
protection, and finally gloves pulled over the gown cuffs. This sequence ensures each piece of PPE covers its intended area without contaminating
previously applied items.
Q5: A nurse is removing PPE after caring for a client on contact precautions. Which is the correct doffing sequence?
A. Gloves, eye protection, gown, mask/respirator [CORRECT]
B. Mask/respirator, gloves, gown, eye protection
C. Gown, gloves, mask/respirator, eye protection
D. Eye protection, gown, gloves, mask/respirator
Correct Answer: A
2
, NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
Rationale: The correct doffing sequence removes the most contaminated items first: gloves (highest contamination from direct contact), then eye
protection, then gown (touching only inside surfaces), and finally mask/respirator. This order minimizes self-contamination during removal.
Q6: A nurse is educating a client about standard precautions. Which statement by the nurse is most accurate?
A. Standard precautions apply only to clients with diagnosed infections
B. Hand hygiene is the single most important measure to prevent the spread of infection [CORRECT]
C. Standard precautions require the use of an N95 respirator for all client encounters
D. Gloves are required regardless of the anticipated contact with body fluids
Correct Answer: B
Rationale: Standard precautions apply to ALL clients regardless of diagnosis. Hand hygiene is the most critical infection control measure. An N95
is only for airborne precautions. Gloves are required when anticipating contact with blood, body fluids, secretions, and non-intact skin, not for every
interaction.
Q7: A nurse sustains a needlestick injury while administering an injection to a client with HIV. Which action should the
nurse take first?
A. Complete an incident report and notify the charge nurse
B. Wash or flush the exposed skin area with water immediately [CORRECT]
C. Request antiretroviral prophylaxis from the provider
D. Have the source client tested for HIV antibodies
Correct Answer: B
Rationale: The first action after a needlestick injury is to wash or flush the exposed area with soap and water immediately to reduce the viral load
at the exposure site. After immediate first aid, the nurse should report the incident, undergo baseline antibody testing, and consult occupational
health regarding post-exposure prophylaxis.
Q8: A client with HIV has a CD4+ T-cell count of 180 cells/mm3. The nurse understands that this finding indicates:
A. The client is in the early stages of HIV infection
B. The client meets the diagnostic criteria for AIDS [CORRECT]
C. The client has adequate immune function to fight opportunistic infections
D. The client should discontinue antiretroviral therapy
Correct Answer: B
Rationale: A CD4+ T-cell count below 200 cells/mm3 meets the CDC diagnostic criteria for AIDS. Normal CD4+ count is greater than 500
cells/mm3. At this level, the client is at significant risk for opportunistic infections. ART should be continued, not discontinued.
Q9: A nurse is caring for a client with HIV who is suspected of developing Pneumocystis jiroveci pneumonia (PCP). Which
assessment finding is the priority?
A. Skin lesions on the lower extremities
B. Lung sounds for crackles and ineffective airway clearance [CORRECT]
C. Mental status changes and cognitive decline
D. Oral candidiasis and white patches in the mouth
Correct Answer: B
Rationale: PCP causes bilateral crackles, dyspnea, hypoxemia, and ineffective airway clearance. The priority is monitoring lung sounds. Skin
lesions suggest Kaposi sarcoma. Mental status changes suggest HIV encephalopathy. Oral candidiasis is a fungal infection but not the priority for
PCP.
Q10: A client with advanced HIV presents with purple, raised lesions on the skin and oral mucosa. The nurse identifies
these findings as which condition?
A. Kaposi sarcoma [CORRECT]
B. Toxoplasmosis encephalitis
C. HIV encephalopathy
D. Pneumocystis jiroveci pneumonia
Correct Answer: A
Rationale: Kaposi sarcoma is an AIDS-defining malignancy caused by HHV-8, presenting as purple, raised, vascular lesions on the skin and oral
mucosa. Toxoplasmosis presents with neurologic changes. HIV encephalopathy causes cognitive and motor decline. PCP affects the lungs.
3
, NUR 2356 MDC 1 Final Exam 2 | Rasmussen College | 2026/2027
Q11: A nurse is providing discharge teaching to a client with HIV who is starting antiretroviral therapy (ART). Which
statement indicates understanding?
A. I will stop taking my medications when I feel better
B. I should take my medications at the same time every day and never skip doses [CORRECT]
C. I only need to take my medications when my viral load increases
D. I can share my medications with my partner if they have similar symptoms
Correct Answer: B
Rationale: Strict ART adherence is essential to prevent viral resistance and maintain suppression. Medications must be taken at the same time daily.
Stopping when feeling better leads to resistance. ART is lifelong therapy. Medications should never be shared.
Q12: A nurse is assessing a client with HIV for early signs of HIV encephalopathy. Which finding should the nurse
prioritize?
A. Persistent dry cough and shortness of breath
B. Progressive cognitive, behavioral, and motor decline [CORRECT]
C. Purple nodular lesions on the upper extremities
D. Severe headache, fever, and photophobia
Correct Answer: B
Rationale: HIV encephalopathy causes progressive cognitive impairment, behavioral changes, and motor deficits. Cough and dyspnea suggest PCP.
Purple lesions indicate Kaposi sarcoma. Headache with fever suggests meningitis or toxoplasmosis.
Q13: A client with HIV asks the nurse about dietary precautions related to toxoplasmosis. Which instruction is most
important?
A. Avoid raw or undercooked meat and cat feces [CORRECT]
B. Limit intake of dairy products and eggs
C. Avoid all fresh fruits and vegetables
D. Eliminate all seafood from the diet
Correct Answer: A
Rationale: Toxoplasmosis is transmitted through undercooked meat containing cysts or exposure to cat feces. The client should cook meat
thoroughly, avoid cleaning cat litter boxes, and wash fruits and vegetables. Dairy, eggs, and seafood are not primary sources.
Q14: A client is admitted with influenza. Which type of transmission-based precautions should the nurse implement?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions [CORRECT]
D. Neutropenic precautions
Correct Answer: C
Rationale: Influenza is transmitted via large respiratory droplets. Droplet precautions require a private room, surgical mask and eye protection
within 3 feet, and a mask on the client during transport. Airborne precautions are for TB, measles, and varicella.
Q15: A nurse is caring for a client with methicillin-resistant Staphylococcus aureus (MRSA) in a surgical wound. Which
intervention is essential?
A. Place the client in a negative-pressure room
B. Require all visitors to wear an N95 respirator
C. Implement contact precautions with dedicated equipment [CORRECT]
D. Place the client on droplet precautions with a surgical mask
Correct Answer: C
Rationale: MRSA is transmitted through direct and indirect contact. Contact precautions include a private room, gown and gloves, and dedicated
equipment. Negative-pressure rooms and N95 respirators are for airborne precautions. Droplet precautions are not appropriate for MRSA.
Q16: A nurse is caring for a client with vancomycin-resistant Enterococcus (VRE). Which precautions are required?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions [CORRECT]
4
