NUR 2755 MDC IV Exam 1 –
Comprehensive Practice Question Bank
RASMUSSEN UNIVERSITY | MEDICAL-SURGICAL
NURSING IV
COMPLETE PRACTICE EXAM | 200 QUESTIONS |
STUVIA-READY FORMAT
Overall Exam Overview: This comprehensive document contains 200 high-quality, exam-style multiple-
choice questions specifically designed to align with the NUR 2755 MDC IV (Medical-Surgical Nursing IV)
Exam 1 content at Rasmussen University. The questions cover all major domains including critical care
concepts, complex multisystem disorders, advanced cardiac and respiratory conditions, neurological
emergencies, endocrine crises, shock states, and nursing management of critically ill patients. Each
question includes a detailed rationale and a situational overview to reinforce learning and ensure you
understand the foundational concepts required to pass the exam. This question bank mirrors the depth,
breadth, and application-level thinking of the actual NUR 2755 Exam 1.
QUESTION 1
Overview: A nurse is caring for a client with septic shock.
The client's blood pressure is 82/54 mmHg, heart rate 118
bpm, and temperature 39.2°C (102.6°F). The provider
orders fluid resuscitation and antibiotics.
,Question: Which intervention should the nurse implement
FIRST?
A) Administer broad-spectrum antibiotics as ordered
B) Initiate vasopressor therapy
C) Administer IV fluids rapidly as prescribed
D) Apply external cooling measures
Answer: *C) Administer IV fluids rapidly as prescribed *
Rationale: In septic shock, the Surviving Sepsis Campaign
guidelines recommend rapid fluid resuscitation (30 mL/kg)
as the first priority to restore intravascular volume and
improve tissue perfusion. While antibiotics (A) should be
given early, fluids are the immediate priority. Vasopressors
(B) are initiated if fluids fail to restore adequate perfusion.
Cooling measures (D) are not the first priority in the initial
management.
QUESTION 2
Overview: A client with acute respiratory distress
syndrome (ARDS) is on mechanical ventilation with a
PaO2/FiO2 ratio of 180. The nurse notes increasing peak
airway pressures and decreased breath sounds on the
right side.
,Question: What is the nurse's priority action?
A) Suction the endotracheal tube
B) Prepare for emergency chest tube insertion
C) Increase the FiO2
D) Assess for bilateral breath sounds and notify the
provider
Answer: *B) Prepare for emergency chest tube
insertion *
Rationale: The client is showing signs of a tension
pneumothorax: decreased breath sounds on one side and
increasing peak airway pressures. This is a life-threatening
emergency requiring immediate needle decompression and
chest tube insertion. Suctioning (A) will not resolve a
pneumothorax. Increasing FiO2 (C) addresses oxygenation
but not the underlying tension pneumothorax. Notifying the
provider (D) is important but immediate action is required.
QUESTION 3
Overview: A nurse is assessing a client with acute
pancreatitis. Which finding indicates the client may be
developing acute respiratory distress syndrome (ARDS)?
, A) Abdominal pain radiating to the back
B) Crackles in the lung bases
C) Sudden onset of dyspnea and hypoxia
D) Elevated serum amylase and lipase
Answer: *C) Sudden onset of dyspnea and hypoxia *
Rationale: ARDS is a potential complication of acute
pancreatitis due to systemic inflammatory response. Sudden
onset of dyspnea and hypoxia are key indicators. Abdominal
pain radiating to the back (A) is typical of pancreatitis itself
but not ARDS. Crackles (B) may indicate pulmonary edema
but are not specific to ARDS. Elevated amylase/lipase (D)
indicate pancreatitis but not ARDS development.
QUESTION 4
Overview: A client with heart failure is receiving a
continuous infusion of milrinone. Which assessment
finding indicates a therapeutic response to this
medication?
A) Decreased blood pressure
B) Increased cardiac output and decreased pulmonary
wedge pressure
C) Increased urine output and decreased heart rate
Comprehensive Practice Question Bank
RASMUSSEN UNIVERSITY | MEDICAL-SURGICAL
NURSING IV
COMPLETE PRACTICE EXAM | 200 QUESTIONS |
STUVIA-READY FORMAT
Overall Exam Overview: This comprehensive document contains 200 high-quality, exam-style multiple-
choice questions specifically designed to align with the NUR 2755 MDC IV (Medical-Surgical Nursing IV)
Exam 1 content at Rasmussen University. The questions cover all major domains including critical care
concepts, complex multisystem disorders, advanced cardiac and respiratory conditions, neurological
emergencies, endocrine crises, shock states, and nursing management of critically ill patients. Each
question includes a detailed rationale and a situational overview to reinforce learning and ensure you
understand the foundational concepts required to pass the exam. This question bank mirrors the depth,
breadth, and application-level thinking of the actual NUR 2755 Exam 1.
QUESTION 1
Overview: A nurse is caring for a client with septic shock.
The client's blood pressure is 82/54 mmHg, heart rate 118
bpm, and temperature 39.2°C (102.6°F). The provider
orders fluid resuscitation and antibiotics.
,Question: Which intervention should the nurse implement
FIRST?
A) Administer broad-spectrum antibiotics as ordered
B) Initiate vasopressor therapy
C) Administer IV fluids rapidly as prescribed
D) Apply external cooling measures
Answer: *C) Administer IV fluids rapidly as prescribed *
Rationale: In septic shock, the Surviving Sepsis Campaign
guidelines recommend rapid fluid resuscitation (30 mL/kg)
as the first priority to restore intravascular volume and
improve tissue perfusion. While antibiotics (A) should be
given early, fluids are the immediate priority. Vasopressors
(B) are initiated if fluids fail to restore adequate perfusion.
Cooling measures (D) are not the first priority in the initial
management.
QUESTION 2
Overview: A client with acute respiratory distress
syndrome (ARDS) is on mechanical ventilation with a
PaO2/FiO2 ratio of 180. The nurse notes increasing peak
airway pressures and decreased breath sounds on the
right side.
,Question: What is the nurse's priority action?
A) Suction the endotracheal tube
B) Prepare for emergency chest tube insertion
C) Increase the FiO2
D) Assess for bilateral breath sounds and notify the
provider
Answer: *B) Prepare for emergency chest tube
insertion *
Rationale: The client is showing signs of a tension
pneumothorax: decreased breath sounds on one side and
increasing peak airway pressures. This is a life-threatening
emergency requiring immediate needle decompression and
chest tube insertion. Suctioning (A) will not resolve a
pneumothorax. Increasing FiO2 (C) addresses oxygenation
but not the underlying tension pneumothorax. Notifying the
provider (D) is important but immediate action is required.
QUESTION 3
Overview: A nurse is assessing a client with acute
pancreatitis. Which finding indicates the client may be
developing acute respiratory distress syndrome (ARDS)?
, A) Abdominal pain radiating to the back
B) Crackles in the lung bases
C) Sudden onset of dyspnea and hypoxia
D) Elevated serum amylase and lipase
Answer: *C) Sudden onset of dyspnea and hypoxia *
Rationale: ARDS is a potential complication of acute
pancreatitis due to systemic inflammatory response. Sudden
onset of dyspnea and hypoxia are key indicators. Abdominal
pain radiating to the back (A) is typical of pancreatitis itself
but not ARDS. Crackles (B) may indicate pulmonary edema
but are not specific to ARDS. Elevated amylase/lipase (D)
indicate pancreatitis but not ARDS development.
QUESTION 4
Overview: A client with heart failure is receiving a
continuous infusion of milrinone. Which assessment
finding indicates a therapeutic response to this
medication?
A) Decreased blood pressure
B) Increased cardiac output and decreased pulmonary
wedge pressure
C) Increased urine output and decreased heart rate
